HomeMy WebLinkAboutPermit Building 2005-6-28
:: Status
Issued
225 Fifth Street, Springfieid, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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--.
'-Ltl i' OF SPRINGFI~LD
Building/Combination Permit
PERMIT NO: cOM2005-00614
ISSUED: 06128/2005
APPLIED: OS/2512005
EXPIRES: 12/28/2005
VALUE: $ 142,288.00
SITE ADDRESS: 529 Ethan Ct Springfield TYMnF>JWO/:lN:J~fl fclWi~ R~sidence
ASSESSOR'S PARCEL NO.: BREANNE COMMONS S follow rules adop.led b Ih r qu res you ~
WI1I!J\QKil!/{i~enlell~h y e OregORd..-\a~tial
PROJECT DESCRIPTION: Single family residence - SAME AS COM20DS{l)P~ql!J9l-'b!HI.!(JIi1'rl ~se rules are set forth
0090. Ynr J m~.. ~h'~:_ t. ro~gh OAR 952-001.
calling the CEPllDl)eti~;ft~tX- 9.-4'7!1l~ ,
number for the Oregon Utili; N . ~hone
Cenler is 1_a00-332'2~,lifIcatJon
Owner:
Address:
DENNIS R MINIUM
8745 THURSTON RD
SPRINGFIELD OR 97478
Contractor Type
General
Eleetricai
Mechanical
Plumbing
I, CONTRACTOR INFORMATION I
Contractor
DENNIS R MINIUM
STEVE HAUCK
MICHAEL GRIFFIN
CHAPIN ENTERPRISES INC
Phone
541-747-8495
541-221-2665
541-942-8339
541-485-1146
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
.; # of Bedrooms:
(
,.
,
.
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Subdivision Not Accepted
Street Improvements:
Storm Sewer Available:
Special I nstruction:
License
62682
147618
150189
81994
Expiration Date
12/1112005
04/30/2007
01/2312007
05/06/2008
1
R-3
U
VN
BUILDING INFORMATION I
nVI'VL.
# of Stories: THIS PERMIT SH'ILL i!i~,t~l~~lE THE WO
Height ofStructl!.i'eHORllEDI2:t~ER ~R,t:.t !~J;'!'I~r1S RK
Type of Heat: CO' F,orced.Air,GaslS ASq Ft2nii'Floor: NOT
I~, WIL..I"-VLU 'n ~t{"II" 1f\Il-n cnR
Water Type: ANY 180 DAY g~s IODSq Ft.Basement:
Range Type: Ga~ Sq Ft Garage/Carport
Energy Path: Path 1 Sq Ft Other:
Sprinkled Building: nla Occupant Load:
400
5,268
1,378
3
I uJC~JCLOPMENTINFORMATION I
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
18.00
5.00
10.00
10.00
0.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
2
Yes
33.40
I PUBLIC IMPROVEMENTS I
Fully Improved
Yes
Sidewaik Type:
DownspoutslDrains:
Curbside 5'
To Storm Sewer
. Notes: No hook-up to City Infrastructure until Public Improvements'aeeepted by the City; storm drainage piped to system
rea r of lot 6/1/2005 CAS
)
Paee 1 of4
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,
Status
Issued
225 Fifth Strcct, Springfieid, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Dwcilines
Garaee
Tvpe of Construction
V Wood Frame
Garaee
Fee Description
Plan Rcview Same As
-J\h'l'hanieal issuance Fee-
+ 10'Yo Administrative Fee
+ 70/0 State Surcharge
2 Baths Onc or Two Family
Addressing Assignmcnt
Building Pcrmit
Curbcut Permit
Dryer Vent
Exhanst Hoods
Furnacc - nl' to 100,000 btu
Gas Fireplal'e
Gas anllets 1-4
Hcat Pump
Plan Review J\lajor - Planning
PW Ilisc - 2nd Pcrmit (Street)
Rcsidcnee Wiring 1000 Sq Ft
Residcnee Wiring Ea Addtl 500
Sanitary Scwer - Improvement
Sanilary Sewer - Reimbursement
SDC MWJ\IC Administration
SDC J\IWJ\IC Improvement
SDC J\IWMC Reimburscment
SDC Sanitary/Storm Admin
SDC Tr:lIlsl'o Admin
SDC Tl":lnsl'o Improvcment
SDC Tr:Jllspo Rl'imburscment
Sidewalk Permit
Storm Draill~lgc Impervious Area
Vcnt Fan
WiIlulII:llanc Single Family
Total Amount Paid
.
I Valuatinn Descriotion I
$ Per Sq Ft
or multiplier
.$96.00.
$25.00
Square Footage
or Bid Amount
1,378.00
400.00
Totai Value of Project
Fpp< P~irt I
Amount Paid
$100.00
$10,00
$117.94
$82.56
$254.00
$31.00
$705.40
$80.00
$6.00
$9.00
$12.00
$15.00
$4.00
$12.00
$103.00
$-30.00
$106.00
$38.00
$365.60
$480.80
$10.00
$865.31
$82.03
$114.03
$64.71
$772.49
$175.13
$80.00
$823,36
$18,00
$1,000,00
$6,507.36
Date Paid
5/25/05
. 6/28/05
6/28/05
6/28/05
6/28/05
6/28/05
6128105
6128/05
6/28/05
6128105
6/28/05
6/28/05
6128105
6128/05
6128/05
6/28/05
6/28/05
6/28/05
6/28/05
6/28/05
6/28/05
6/28/05
6/28/05
6/28/05
6128105
6128/05
6128/05
6128/05
6/28/05
6128105
6128/05
Paee 2 of 4
. L11 r VI' ~rK11~t:.l'l~LD
Building/Combination Permit"
PERMIT NO: cOM2005-00614
ISSUED: 06/28/2005
APPLIED: 05/25/2005
EXPIRES: 1212812005
VALUE: $ 142,288.00
Value
Date Caieulated
$132,288.00
$10,000.00
$142,288,00
0512512005
05/25/2005
Receipt Number
1200500000000000661
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
2200500000000000841
.
. CITY 01' 1)rK1N\.:o-N~LD .
Building/Combination Permit.
PERMIT NO: cOM2005-00614
ISSUED: 06/28/2005
APPLIED: 05/25/2005
EXPIRES: 12/28/2005
VALUE: $ 142,288.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-.175.1 Phone
541-726-.1676 Fax
541-7!6..1769 Inspection Line
Initiall{c\'icw
Plallninl.!. Rt'\'icw
Public Works ne\'iew
05/31/2005
05/31/2005
05/31/2005
I Plan Reviews ,
05/31/2005 APP
06/07/2005 APP
06/0112005 APP
SKG
TAJ
CAS
StrUt'tllnl1 nc\'il'W
05/31/2005
05/3112005 APP
SKG
No hook-up to City Infrastructure
until Public Improvements accepted
by the City; Storm drainage piped t(
system in rear of lot 6/112005 CAS
Same as 517 Ethan CT
: To Hel)uesl an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will he made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
IRPn~
I{uugh EIC'"ctric: Prior to Cover
lJ nder!loor Drain: Prior to cover or placement of concrete.
EIct.tric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is compiete.
\Vater Line: Prior to filling trench and including required testing.
Undcr!loor Mechanical. Prior to insulation or decking and Including required testing.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Si,kwal" - Curbside: After forms are erected but prior to placement of concrete.
Cnrhent - Standard: After forms are erected but prior to placement of concrete.
Final e"" When all gas work is complete.
Ufnr Electrical Ground: Install ground rod at footing and call for inspection In conjuction with footing and/or
fuundation inspection. .
Flluting: t\ftrr trenches are excavated.
FlInndation: After forms are erected but prior to concrete placement.
I'lIsl and Ileam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Sh,."r W"II Nailing: Before covering sheathing with finish materials.
Framing Inspeetion: Prior to cover and after all rough in inspections have been approved.
\\'alllllstilalion: Prior to cover.
Cl'iling Insulation: Prior to cover.
Finalllnilding: Arter all required Inspections have been requested and approved and the building Is complete.
Untll'rlloor Plumbing: Prior to insulation or decking.
Paee 3 of 4
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. Lit i' Ul' ~rlOl~GFIELD
Building/Combination Permit
Status
IsslIed
PERMIT NO: cOM2005-00614
ISSUED: 06/28/2005
APPLIED: 05/25/2005
EXPIRES: 1212812005
VALUE: $ 142,288.00
225 Fiflh Slreet, Springfield, OR
541-726-3753 Phooe
541-726-3676 Fax
541-726-3769 lo'p,'elion Line
Roogh Plolllhing: I'rior to cover and including required testing,
Hohl 0011'0' Instulled: Special Inspection performed prior to piacement of concrete. Provide report to City
lluihling Inspector.
Suoitary Sell'er Line: Prior to filling trench and including required tesling.
Storlll Sell'l'I' Line: Prior to filling trench.
FioulPlolllhing: When all plumbing work is complete.
Rough i\ h-d13nirlll: Prior to Cover
Filluj Ml'rhullical: When all mechanical work is complete.
T"lIIporary Electric: Approval required prior to Utility Company energizing pole.
Underlloor Gas: Arter line is installed and required testing and capped if not attached to an appliance.
ROllgh eus: AfI,'r line is installed and required testing and capped if not attached to an appliance.
Ga, Sen-ice: After line is installed and line has been connected to a minimum of one appliance Including required
h.~til1g. Prc~lIre tl'st done at this point.
DrYW:11I: Prior to tllping.
By signatore, I Slate and agree, that I have carefully examined the completed application and do hereby certify that all
informatioll hen'oll is true and correct, and I further certify that any and all work performed shall be done In accordance with
the Ol"llin:lfIees of Ihe Cily of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY 1I'i11 be made of any structure without permission of the Community Services Division, Building Safety.
I further rerlify thu' only rOllti-actors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree 10l'II,ure that all required inspections are requested at the proper time, that each address Is readable from the
street, Ih"lthe 1)(,1"I1I;t rani is located at the front of the property, and the approved set of plans will remain on the site at all
times dllrillu rllction.
~~
C .-2[}- ~ c:? r
OWDl'r or Confnlclul"s Signature
Date
Paee40f4
CITY OF SttNGFIELD SYSTEMS DEVELOPMENeoRKSHEET
JOURNAL OR JOB NUMBER: COM2005-00614
NAME OR COMPANY: Dennis Minium
LOCATION: 529 Ethan Ct
TAX LOT NUMBER: Breanne Commons Lnt 8
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 1 BUILDING SIZE (SF' 2005 LOT SIZE (SF):
I. STORM DRAINAGE
5314
r-
ICIl
~
10
10
I~
I~
CIl
o
~
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. I CHARGE
2656.00 $0.310 = I $823.36 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I
0.00 I $0.310 I I 50% ~ I
DISCOUNT
$0.00
ITEM I TOTAL - STORM DRAINAGE SDC
2. SANITARY SEWER - CITY
$823.36
$823.36
1070
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x COST PER DFU
I 20 I $24.04 5480.80 1091
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 20 I $18.28 $365.60 1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $846.40
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRJPRATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI
I 9.57 I I 1 I I $18.30 I 1.00 I $175.13 1093
B. IMPROVEMENT COST:
I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRJP x INEW TRJP FACTORI
I 9.57 I I I I I $80.72 I 1.00 I $772.49 11094
ITEM 3 TOTAL - TRANSPORTATION SDC = , $947.62
4. SANITARY SEWER - MWMf:
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 1 I I $82.03 = $82.03 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
1 1 I $865.31 = $865.31 11055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) 50.00 11054
MWMC ADMINISTRATIVE FEE $10.00 11056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =1 5957.34 I I
- .I
SUBTOTAL (ADD ITEMS I, 2, 3. & 4) = 1 $3.574.72 ,
5. ADMINISTRATIVE FEE:
I SUBTOTAL x I ADM. FEE RATE 1= CHARGE
i $3.574.72 5% I $178.74
TOTAL SANITARY ADMINISTRATION FEE: 114.03 11079
TOTAL TRANSPORTATION ADMINISTRATION FEE: $64.71 11078
Cheryl Slaymaker 6/1 /2005 TOTAL SDC CHARGES =l $3,753.46
PREPARED BY DATE
.-
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT - DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS. CALCULATE ONL V TIlE NET ADDIllONAL FIXTURES)
NO. OF FIXTURES
FIXTURE TYPE
I BATHTUB
IDRlNKING FOUNTAIN
I FLOOR DRAIN
I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETe.
I INTERCEPTORS FOR SAND 1 AUTO WASH 1 ETe.
LAUNDRY TUB
ICLOTHESW ASHER / MOP SINK
CLOTHESWASHER - 3 OR MORE (EAl
MOBILE HOME PARK TRAP P PER TRAILER)
RECEPTOR FOR REFRIG / WATER STATION 1 ETe.
RECEPTOR FOR COM. SINK / DISHWASHER I ETe. I
SHOWER. SINGLE STALL
ISHOWER. GANG (NUMBER OF HEADSl
I SINK: COMMERCw.JRESIDENTIAL KITCHEN
ISINK: COMMERCIAL BAR
I SINK: WASH BASINIDOUBLE LAVATORY
ISINK: SINGLE LAVATORYIRESIDENTIAL BAR
I URINAL. STALL / WALL
ITOILET. PUBLIC INSTALLATION
ITOILET. PRIVATE INSTALLATION
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
TOTAL DRAINAGE FIXTURE UNITS
NEW
2
o
o
o
o
o
1
o
o
o
o
o
o
1
o
o
2
o
o
2
UNIT
OLD EQUIVALENT
o 3
o 1
o 3
o 3
o 6
o 2
o 3
o 6
o 12
o 1
o 3
o 2
o 2
o 3
o 2
o 2
o 1
o 5
o 6
o 3
20
~EDU (EQuivalent Dwellim!: Unit) is a discharge eauivalent to a single familv dwellinu: ~it (20 DFU's) set at 167 gallons per day
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
. .
DRAINAGE
FIXTURE
UNITS
6
o
o
o
o
o
3
o
o
o
o
o
o
3
o
o
2
o
o
6
o
20
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
I YEAR CREDIT RATE/$I,OOO '1
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2
I BEFORE 1979 $5.29 (Enter I for Yes. 2 for No) II
I 1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 2
I 1980 $5.19 (Enter I for Yes, 2 for No)
I 1981 $5.12 BASE YEAR 1979
I 1982 $4.98
I 1983 $4.80 CREDIT FOR LAND (IF APPLICABLE)
I 1984 $4.63 VALUE 11000 CREDIT RATE
I 1985 $4.40 $0.00 x $5.29 = , $0.00
I 1986 $4.07 I
1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) I
1988 $3.22 VALUE 11000 CREDIT RATE
1989 $2.73 $0.00 x $5.29 0 I
1990 $2.25 I
1991 $1.80
1992 $1.59 TOTAL MWMC CREDIT = $0.00
1993 $1.45
1994 $1.25
1995 $1.09 .
1996 $0.92
1997 $0.72
1998 $0.48
1999 $0.28
2000 $0.09
2001 $0.05
, . ."19 .~~~d~d~'9V~tt~~~~~d h.B,S the following
""-I~.(Jvar ~&~eClfIC land use
on;n94' J;).(!OC:;
spr:..u{G",^.!1::. -..
I\;' . .
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54i)726:-3689' S'9"afJ1JJM'j-.f1tZ-(fl~
ELECTRICAL PERMIT APPLICATION / /'1<:;//, . ~
City Job Number e-S"=cObl'l DateV;J/dO/ n< (f7J:::J
I '
3. COMPLETE FEE SCHEDULE BELOW
1.
LOCATION OFINSTALl.A710N
YZJt ~.
LEGAL DESCRIPTION
c:r
&/'r:.MM-- {PM~
5.A M-~8
JOB DESCRIPTION
{}N1"- ~}/., !la)d,ALL_
Permits a~e non.transfbable and expire if work is
not started within 180 da)'s of issuance or if work is
Suspended for 180 da)'s.
2,
CONTRACTOR INSTALLATION ONLY
Electrical Contractor SfI!ilJE
IIINGIl..
Address f. (J, 50)( -=t/3b I
City
/iEos..
Phone ~~/- ~
v
Supervisor License Number
3~TtS
Expiration Date '0-1 - 01
Constr. Contr. Number 14Th(S
L.{- ~d -Ol-
Expiration Date
Signature of Supervising Electrician
F~ JI!-~
.. ,
Owners Name ~ ti\ ~
Address ~~~~ RA.
City ~~oM Phone ~1 ~
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners"Signature:
Inspection Request: 726-3769'
A. New Residential- Single or .Multi-Family per dwelling unit.
Ser\'ice Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
J
Z.
$106.00 Jd,OD
$ 19.00 ']6'-00
Each Ma~ufact'd Home or
~~~~;ar D)\'flfMfdtlf: 'Oregon law f89U~ to
.. . follow rules adopted by the Oregon Utility.-:
B. Ser\'i~ifiEamfl;G(lfi!fal1la11ali$&lll:lIli6dll'1S>llotd\l)l$hiOIl:
-In OAR 952-Q01-Q01 o through OAR 952-001/ .
200 AmpIlOO19~~ou may obtain conies O$t~j\j,OflJIE!lI bv
201 Amps tq;lI.a~!lSl center. /Note: the1la~on9 ..
401 Amps ~~ the Oreoon Utilitv tJ05l0Dat1on
601 Amps to 1000 ~er is 1-80D-332-2~~00
Over 1000 AmpsNohs $375.00
Reconnect Only $ 50.00
c. . ,,!,~mporary Services or Feedl.'rs
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
40 hAmps;to 600 Amps $100.00
I~U "",,-, n". , JivnlDr ,r TI-I~ WORK
Over:600~AmpSTorJIOOO.V hsrsee~B. above. .
D, ~'~~~~t~~~lEc]liiSNDER tH1S PERMlrlS NOT
NeQtAit~frio~Q,/'E'1tk7.si\i~lp~PP.~~P FOR'
O;'~l(;'ir1:Bfl1 DAY PERIOD. $ 43.00
Each Additional Circuit or with
Service or Feeder Permit $ 3.00
E. ~ ~lis~~aneo~s(Ser\'ice/feeder not included) -Each Installation
Pump or irrigation
Sign/Outline Lighting.
Limited EnergylResidential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. SUBTOTAL OF ABOVE
/WOD
lo,~
II{ 1(0
-.J ~~ye
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building FonnsfEleclrlcal Pcnnit Application I-03.duc
2?,5 Fifth Street
Spri~gfield; Oregon 97477
5~1-726-3759 Phone
.
.,~.....
~;
City of Springfield Official Receipt
.velopment Services Department
Public Works Department
:i
Job/Journal Number
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
qOM2005-00614
COM2005-00614
C'OM2005-00614
.,
qOM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
CbM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
COM2005-00614
,
COM2005-00614
Payments:
Type of Payment
Check
;~
,
"
j'
.
,
!
6/28/2005
RECEIPT #:
2200500000000000841
Date: 06/2812005
9:05:39AM
Description
Addressing Assignment
. Willamalane Single Family
Residence Wiring 1000 Sq Ft
Residence Wiring Ea AddU 500
Building Permit
2 Baths One or Two Family
Furnace - up to 100.000 btu
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Gas Fireplace
Heat Pump
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Sidewalk Permit
Curbcut Permit
PW Disc - 2nd Permit (Street)
Storm Drainage impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC SanitarylStorm Admin
SDC Transpo Admin
Plan Review Major - Planning
Amount Due
31.00
1,000.00
106.00
38.00
705.40
254.00
12.00
18,00
9.00
6.00
4.00
15.00
12.00
10.00
82.56
117.94
80.00
80,00
(30.00)
823.36
480.80
365.60
175.13
772.49
82.03
865.31
10.00
114.03
64.71
103.00
$6,407.36
Paid By
DENNIS MINiUM
CONSTRUCfiON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 3951 In Person
$6,407.36
Amount Paid
Payment Totai:
$6,407.36
Page I of 1