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58895*** RECEIPT*** Date: 09/10/13 Receipt: 58895 Quantity Transactions Reference Subtotal 1 Building Dept Fees -Building Permit 13-5195 $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK #2713 $250.00 Saz Llc Name: Saz Llc 1528 Route 376 Wappingers Falls, NY 12590 Clerk ID: JF Internal ID: 13-5195