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X2021-1648 - Misc
Costa Mesa Sanitary District FEE STATEMENT Applicant Name: Andrew Santa Maria Owner Name: APN: 930-590-44 Project Location: 3245 Clay St, Costa Mesa, CA, 92626 Fee Description Sewer Permit Fee Showers Small New Development Toilets (Water Closet) Laundry Tubs Bathroom Sink (Wash Basin) Totals: Fee Amount Please remit payment for the balance of your account to: For questions regarding your statement, please contact: Permits Department949-645-8400 ext229 Costa Mesa Sanitary District 290 Paularino Avenue Costa Mesa CA 92626 Permit No.: SD21-0171 Application No.: 550 Date: 7/30/2021 Payments Quantity Remaining Balance 140.00 140.00 1 0.00 34.50 34.50 1 0.00 420.00 420.00 1 0.00 103.50 103.50 1 0.00 51.75 51.75 1 0.00 1725 17.25 i 0.00 767.00 767.00 6 0.00 7/3012021 Transaction Receipt Merchant: COSTA MESA SANITARY 290 PAULARINO AVENUE COSTA MESA, CA 92626 9496458400 US Description: SD21-0171, 3245 Clay St, Newport Beach, CA; RCP construction, license #974386 Order Number: P.O. Number: Customer ID: Invoice Number: Billing Information Anand Matani 100 a redwood at, apt 2401 Baltimore, MD 21202 Phone:9098594594 Ahnundh@gmaii.com Item Description 3 Sewer Permit Fee Customer specified amount i DateTme: Transaction ID: Transaction Type: Transaction Status: Authorization Code: Payment Method: Shipping Information Qty Taxable Unit Price Item Total 1 N USD 767.00 USD 767.00 30-Jul-2021 10:29:17 PDT 63167660267 Authorization w/Auto Capture Captured/Pending Settlement 11904W MasterCard XXXX5309 Shipping: 0.00 Tax: 0.00 Total: USD 767.00 https://acmunt.authorize.nettuilthemes/bankofamericamemhant/TransactionlTmnsacbonReceipt.aspx?transid=63167660267 1!1