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PL-13-2477 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-202338 Permit Number: PL-11-13-2477 Scheduled Inspection Date: March 16,2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: CAMILLE HARRIS,ABDUL S MUKHTAR Work Classification: Addition/Alteration Job Address:15 NE 104 Street Miami Shores, FL 33138-2026 Phone Number Parcel Number 1121360120090 Project <NONE> Contractor: HOME OWNER Building Department Comments INSTALLATION OF BATHROOM FIXTURE TO INCLUDE Infractio Passed Comments NEW BATHROOM INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction or Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid March 15,2016 For Inspections please call: (305)762-4949 Page 1 of 31 Miami Shores Village -; a,__ � Building Department I NOV 24 2014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit , lJ PERMIT APPLICATION Sub Permit No. I --�- — ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [PLUMBING ❑ MECHANICAL ❑PUBLIC WORD r- CHANGE OF �' CANCELLATION ❑ SHOP CONTRACTOR, ;' DRAWINGS JOB ADDRESS: ISNE City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: e�L ad: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ffl04"bVPhone#: Address: ® q— City: State: Zip: Tenant/Le sse Name: Phone#: Email: spi'�7r�1 >� C�YY► CONTRACTOR:Company Name: [ 1 V A Yj Phone#: �W_wf—o�( Address: City: -State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$� y C'4- 1� Square/Linear Footage of work: Type of Work: ❑ Addition ❑ Alt ration ❑ New 191 Repair/,,Replace ❑ Demolition Description of Work: e- 0412� i t-D O w✓ Specify color of color thru tile: Submittal Fee$ Permit Fee$ 17-3 CCF$ CO/CC$ Scanning Fee$03° �Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 01 Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 / L• by day of ,20 ,by b4)4#t /- who is,—person ally known to ,who is personally known to me or who has produced ag36 '�� as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign. Si n• COVV Pubfics no Print: Joannfimissan pF os Se ExresoinzrzoAs Seal: �o�N �*«****sw*sx*+r�*aux**��*xmx��**s**s��ax��xa**s�*wxss*as��**xs��**►waax*x**+rwraass**x*��*+�s�*a:***�*gym**aa*�x* APPROVED BY ��;�"/y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 WJ O NER BUILDER DISCLO�iSUREt%ATE: ST/ATEMENTNAME: 0 d�� L_t I f ADDRESS: / 5 M C t o �z 3f Mial/Im' FL., 3 :3139 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.S 489.103(7).And I have read and understood the following disclosure statement,which entitles me to work as my own contractor;I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances.Any person working on your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and with-holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all applicable laws,ordinances,buildings codes and zoning regulations. Please read and initial each paragraph. 1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an exemption from the law.The exemption specifies that I,as the owner of the property listed,may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit flied in his or her name instead of my own name.I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial,��(�� 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may also build or improve a commercial building if the costs do not exceed$75,000.The building or residence must be for my use or occupancy.It may not be built or substantially Improved for sale or lease.If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete,the law will presume that I built or substantially improved it for sale or lease,which violates the exemption. Initial 5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction. Initial 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence.It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or ordinance. Initial,_ r e t R 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously implies that the property owner is providing his or her own labor and materials.I,as an owner-builder,may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property.My homeowner's insurance may not provide coverage for those injuries.I am willfully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial &1W 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done.Any person working on my building who is not licensed must work under my direct supervision and must be employed by me,which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act(FICA)and must provide workers compensation for the employee.I understand that my failure to follow these may subject to serious financial risk. /H Initial /,V 9. I agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable laws and requirement that govern owner-builders as well as employers.I also understand that the Construction must comply with all applicable laws,ordinances,building codes, and zoning regulation Initial14 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States Small Business Administration,and the Florida Department of Revenues.l also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or htto://www.mvforidalicense.com/dbr)r/pro/cilb/index.htmi Initial 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: c J <� - 'e! 61, Initial 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the information that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public.If you contract with a person who does not have a license,the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or employee of an individual or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized signature of the property owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this day of20 i3y� HQZC- /'1'1 who was personally known to me or who has �C Z K C is IS 03 �'3n1 -o IR Produced there License or /�/�� as identification. o m U, CSD TA a N� N W m OWNER r .r ABDULSAMAD MUKHTAR 15 NE 104 Street. Miami Shores, Florida 33138 Ph. 786-718-0444 November 19, 2014 Simpson Home Inc. 7137 Pine Creek Lane Coconut Creek, Florida 33073 Attn: Paul A. Simpson RE. Change of contractor.- Plumbing Permit # 13-2477 15 NE 104 Street. Miami Shores Florida 33138. Dear Mr Simpson, a Please accept this letter as an official notification that your company, Simpson Home Inc. has been removed as the plumbing contractor on record from the building department at Miami Shores Village Hall. A change of contractor process with the appropriate municipality or jurisdiction has been initiated and its expected to complete in a matter of days. If you have any question or clarification, please do not hesitate to call me at 786-718-0444. Thanks for your cooperation and understanding. Sincerely. Abdulsamad Mukhtar (Owner) Cc. Miami Shores Village '♦ ' T _ L h Postal Service" Kri CERTIFIEDMAILORECEIPT ,ne-Dof7i&-gtic Mail Only Its ,o For delivery information, �isit our website at www.usps.cornO. - L E Postage $ 1(1.49 i i $h�� G E` M Certified Fee $3.30 ,MZ Return Receipt Feel,35 O ` sti le �n 0 (Endorsement Required) GRestritxed Delivery Fee $j I,ru 1 J[1 � • - (Endor�ment Aequhed) NTotal Postage&Fees $5.14 11/24 .. �_ .. � b1 t ? r ----------------------------------- or . o weer a:fnc X30.',`- ( j� p B�,( 1 •----- N or PoeoxIYo. j L 'e_Q<C._4 l—aK)e-- «ns ��CYeEK30--3 USPS.com(g)-USPS Trackingm Page 1 of 2 English customer Service USPS mobiis Register t Sign in Affusps.coff Search or Enter a Tracking Number Quick Tools Mail&Ship Track&Manage Postai Store Business International Help Customer Service USPS T ra tikl t re[n g ED Have questions?We're here to help. Tracking Number:70142120000304468369 On Time Expected Delivery Day:Wednesday,November 26,2014 Product & Tracking Information Available Actions Postal Product* Features: First-Class MIPs Certified Mail" Return Receipt Electronic Text Updates November 25,2014,5:02 Delivered POMPANO pm BEACH,FL 33073 Email Updates Your item was delivered at 5:02 pm on November 25,2014 in POMPANO BEACH.FL 33073. November 25.2014.10:35 Arrived at Unit POMPANO am BEACH.FL 33073 November 25.2014,2:14 Departed USPS Origin MIAMI.FL 33152 am Facility November 24,2014,11:59 Arrived at USPS Origin MIAMI,FL 33152 pm Facility November 24,2014,3:57 Acceptance MIAMI,FL 33153 pm Track Another Package Tracking(or receipt)number Track It HELPFUL LIWS ON ABOUT.USPS.COM OTHER USPS SITES LEGAL INFORMATION Contact Us About USPS Home Business Customer Gateway Privacy Policy Sita Index Newsroom Postal Inspectors Terms of Use FAQs USPS Service Updates Inspector General FOIA Forms&Publications Postal Explorer No FEAR Act EEO Data Government Services National Postal Museum Careers Resources for Developers Copyright 02014 USPS.AN Rights Reserved. https://tools.usps.com/ao/TrackConfimiAction.action?tRef--fiallpage&tLc=1&text287 77=... 11/26/2014 Miami Shares 'pillage Building Department �,j UOT 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BY-—u------- INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. x-13 PERMIT APPLICATION Master Permit No. 24 f Permit Type:PLUMBING JOB ADDRESS: ,5 /V City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): I)U,( 5AW" �/''— -W6 Address: /S tv O City: State: -CJZip: TenandUssee Name: Phone#: Email: D( 14 S CONTRACTOR:Co any Name: Zr-,— city: r -" Phone#:`�S `t'"�fo'f Address: N G�// __ZC r� tT City: G� �'-� c.�tate: Zip: Quarter Name: `� rt m Phone#: State Certification or Registration#- catr.of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer. Phone#: Value of Work for this Permit:$ 6'00 (W SquarelLinear Footage of Work: Type of Work: OAddress DAlteration ONew ORepair/Replace ODemolition Description of Work: 44 ,-� vtf- r--7 -ru Submittal Fee$ bb- Permit Fee$ 2-5-12t CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ TraininglEducation Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$,�t t . t t Bonding,Vompany's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City Sta r Zip Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. F understand that a separate permit must be secured for ELEMtICAL WORK,PLUNMNOi,SMNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:' Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a cerci,fled copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent V Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of J:2k 20o by }t lc3u I c �% day of _,200—,by_ w o is personally known to me or who has produced wh is ersona kno to me or who has produced )� As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: h&eyvt Sign: Print• (� ,� Notary Pine state m t bdda Print: My Commissi Expires: + ✓<R ;op ,��sa oaam Ea 1s1 My Commissi * •�•,�•s*MygMISgiON 0 EE OUCH EXPIRES:August 23,20% 7w 7w APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012XRevised 07/10 07XRevised 06✓10MWXRevised 3/15109) SWE pF FLORtDAR DEPARTMENT OF 8US1NSS3 AND PROVASSiONAL REGULATION HOME: Z>.T3$LCTO t3 ICENShNC . PROGRAM $E L12061400263 •... .. _ 'M"mKENS$` N$R [06/14/ ,k ! The HOME I ?SpLCTOR f k Named 'below C>L$RT FI Under 'the. :�rovisio�ts of` Chapter r { Expiration date: JUL 31, 2014 ; i '140lFE. 6 7 SIMPSON, PAUL AND? I C l COC ONOT CREEK "..FL 3 3 0 73 s$ ,• RICK SCOTT*., REN LAWSON GOVERNOR DISPLAY AS REQUIRED BYLAW SECRETARY y STATE-OF FLORID BITS NESS � P1�0 ZONAL GIILATION s fONSTRUCZN INDTJSTRY T,TBfINC BOARD, r y. SEWL12080500147' h >' 0 $027 $0 ,btu R + SON TOS b a>"d�:� ► 't C SF' IIder theovsioas o �Chapt irati�a date: AUG 31, ...,2 01.4 .� i µ b � SIMP. Nr ray« . 7137NBCRET3R LANG G?CON1 CREEK FL....,3 3 073 _ xY Ik3frOT' REN LAWSON OR SECRETARY DISPLAY AS REQUIRED BY LAW 9• CI`I Oder the ° rovisf ons of Chapt 1 I�xpirat�,t date• AUG 31, 2014 �14IMP � p 3 ! SIMP3 ?N r� { 4539 NAT 60Z`FT COURT ` ¢ 6. CQwN T ,CREEK,, FLr: 53 07 3 r s x Ulm OTT ' KEN. LAWSON OR DISPLAY AS REQUIRED BY LAW SECRETARY: i Report Viewer Page 1 of 1 r1Ali JEFF AMATEit CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION ««CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW«w CONSTRUCTION INDUSTRY EXEMPTION This c artlfies that the i x Waal lid below has elected to be exempt from Flea Vftiw s`Cornpensatlon lair. EFFECTIVE DATE: 8/2212013 EXPIRATION DATE: 8122!2015 PERSON: SIMPSON PAUL A FEIN: 8610406W BUSINESS NAME AND ADDRESS: SIMPSON'S HOME INC 7137 P1t�l Ei;RI;EK L AN E COCONUT CREEK FL 33073 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL PLUMBING NOC AND ROOFING-ALL KINDS CONTRACTOR DRIVERS AND DRIVER PWs dtcCfmpW44aft(M),M.an aftw oleeoppa5m vftahemaamaft aoeNftaSeotelaoNote -aeoom�may Ort�e«aarmtormmPandmp�a�p� bCtm,4«f 12L R.8. rR to beef... wdM 9rewopa eT mw mobs sop lwd mocae nk000 t lmw m owm a I" alft 4emooe0e.f M0011 �w a �oewmmptdmybee�jaot�rewoa>Ie�tKeleirytome�tororo 4loieneoaeor ae ealo�srmea�Ure oloftaaeoankrtsaenae�eewe.The8e�bna�RsheBre�mi�a aataayWnebrfeCnedtlie pemm�eremedon oed�eto meetIm m*&Wmft aloft eeew. OFSF24Nr-252 CERTIFK:ATE OF ELECTION TO BE EXEMPT REVISED 07-12 QIEBTIO 49?(880)4131809 https://apps8.fldfs.com/crreportviewer/reportViewer.aspx?data=kdvpginc9D7Q3gH6TER6... 8/25/2013 �L VL41 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S.Andrews Ave., Rm.A-1 00, Ft. Lauderdale, FL 33301-1895—954831-4000 VALID OCTOBER 1,2013 THROUGH SEPTEMBER 30,2014 DBA:SIMPSONS HOME INC Receipt#:182-2289LWN SPRNKL/CO R Business Name: Business Type:(C`ERT PLUMB Owner Name:PAUL A SIMPSON Business Opened:ll/04/2009 Business Location:16 NE 4 ST STE 110 Stat91C0Unty/Cerf/Reg:CFC1428071 COCONUT CREEK Exemption Code: Business Phone: Rooms Seats Employass Machines Professionals j 1 i For Vending Bte(ness 0* Number of Machines: Vending Type: Tax Amount Transfer Fee NsF Fee Penaityr PriorYears Collection Cost Total Paid 27.00 0.001 0.00 0.00 0.00 0.00 27.00 i � I THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax Is levied for the privilege of doing business within Broward County and Is non-regulatory in nature.You must meet an County andfor Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business Dation.This receipt does not indicate that the business Is legal or that it is in compliance with State or local laws and regulations. j Mailing Address: PAUL A SIMPSON Receipt #04B-12-00002032 16 NE 4 ST STE� 110 Paid 09/30/2013 27.00 FORT LAUDERDALE, FL 33301 i 2013 . 2014 Ism — — — -- — BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT — — 115 S.Andrews Ave., Rm.A-1 00, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 DBA.SIMPSONS HOME INC ReCelpt#:182-228930 Business Name: Business Type:PLUMBING/LWN SPRNKL/CONTRACTOR (CERT PLUMBING CONTR) Owner Name:PAUL A SIMPSON Business Opened:11/04/2009 Business Location: 16 NE 4 ST STE 110 State/Coun /Cert/R ty eg:cFc142ao71 COCONUT CREEK Exemption Code: Business Phone: Room seats Employees Machines Professionals 1 signature For Vending BuWnm only Number of ohhnes: Verdin T • Tax Amount Transfer F NSF Fee Penalty Prior Years CoNealan Cost Total Paid 27.00 0.001 0.001 0.001 0.001 0.00 27.00 Receipt #04B-12-00002032 Paid 09/30/2013 27.00 1