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<br />Zephyrhills Fire Rescue <br /> <br />6907 Dairy Road <br />Zephyrhills, FL 33542 <br />(813) 780-0041 <br />(813) 780-0044 Fax <br /> <br />,~'iRlj/~,. <br />~~"... "w <br />r~::,,~~ '. <br />..... ' "" l!':."!!I <br />!!I':'!I~ <br />" . ~~ <br /> <br />INVOICE <br /> <br />"- <br />..- ~ <br />) - - ........... <br />('f 1'1 ~ \ <br /> <br />IDATE <br />~2012005 <br /> <br />INVOICE # <br /> <br />05-0014 <br /> <br />BILLING ADDRESS <br /> <br />PHYSICAL ADDRESS <br /> <br />Patriotic Fireworks <br />Don Surenkamp <br />1314 S, High School Road <br />Indianapolis, IN 46241 <br /> <br />Patriotic FIreworks <br />38050 15th Avenue <br />Zephyrhills, FL 33542 <br /> <br />BILLED BY INSPECTOR <br /> <br />LLH KLB <br /> <br />ITEM DESCRIPTION QUANTITY RATE AMOUNT <br />Tent Tent Inspection 15.00 15,00 <br />Fire Works Fire Works Pennit 25,00 25.00 <br />Please remit to above address. TERMS <br /> Due on receipt T atal $40.00 <br /> <br />MAKE CHECKS PAYABLE TO: <br />CITY OF ZEPHYRlllLLS <br />6907 DAlRY ROAD <br />ZEPHYRlllLLS, FL 33542 <br />