HomeMy WebLinkAboutPermit Building 2005-1-4
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o
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY OF ~rKll~GFIELD
Building/Combination Permit
PERMIT NO: cOM2004-01492
ISSUED: 01104/2005
APPLIED: 12/07/2004
EXPIRES: 07/04/2005
VALUE: $ 60,014.00
SITE ADDRESS: 2513 MAlA LP
ASSESSOR'S PARCEL NO.: 1703251408100
SPRINGFIE TYPE OF WORK: Manufactured Home on
Private Lot
TYPE OF USE: New Residential
PROJECT DESCRIPTION: New M.H. wi Garage
Owner: DAVID NELSON
Address: 1216 Q ST #2 SPRINGFIELD OR 97477
Phone Number: 736-3164
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Manuf Home Inst
Plumbing
Contractor
RALPH W BROWN
HARRISONJACOBSONINC
HARRISONJACOBSONINC
Phone
541-729-1500
541-689-7762
541-689-7762
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
License
63137
66447
66447
Expiration Date
02/1 5/2006
05/07/2005
05/07/2005
I
R-3
U-l
VN
BUlLDI1~G INFORMA nON I
# of Stories: '", ""r law requirE'f yOll tOlfize:
, . Iml\
I Height of Stru. ~t,ur.ej by the Oregon Us~. Ist Floor:
, Type ofHea~: "1 Those rEleCtric'Ol ses '2nd Floor:
! Water Type.: '~;)1 0 thrOl'-'!:.leclri~q 95%; Basement:
\ Range Ty~e~ ' ~Jbtaio cop'I!'IectHc1e rU~FtyGarage/Carport
, Energy P~th:~ ~ ,t r (Note: f,lIJlialephSlj'lFt Other:
Sprinkled'B.tildin~: goo Uti\!!/aNotilicmeRpant Load:
nr the VI e ~ _ . .
. . ...... ""'V' .j.
I DEVELOPMENT'INFORMATION i
480
5,663
1,027
3
REQUIRED PARKING
Frontyard Setback: . 25.00 Overlay Dist: Total: 2
Side 1 Setback: 15.00 # Street Trees Rqd: 2 Handicapped:
Side 2 Setback: 5.00 Paved Drive Rqd: Yes Compact:
Rearyard Setback: 15.00 % of Lot Coverage: 27.60
Solar Setbacks: 0.00
_.....,
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I PUBLIC IMPROMEMEl'!TS I fl,Ll t.'i-I'IRt. \\' \\"It I~ N01
I'~\-INI\ \ S\-\ . _~. '\~ ptRMII
,.\-\\S \.. \),Sldewalk':rYI~e: D ~OR
Fullv Improved \ \-\OR\It.D \W~~. AP.I\N\.JONt. ' Curbside 5'
Yes fl,\)1 ~t.\'lCt.D ODownspoutslDrains: Curb and Gutter
COI'AN Dfl,'{ I't.RIOD.
fl,t-l'{"\t\O
Paee I of3
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Foundation Onlv
Garaee
ManufHome
Use Bid Amount
Garaee
Manufactured Home
Fee Description
Plan Review Residential
+ 10% Administrative Fee
+ 70/0 State Surcharge
Add, Alter, Extend Circ Ea Add
Addressing Assignment
Garage/Carport
Manuf Home State Issuance
Manufactured Home Conn - Plmb
Manufactured Home Feeder
Manufactured Home Placement
Manufactured Home Service
Plan Review Major - Planning
Sanitary Sewer' Ist 50 Feet
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC SanitarylStorm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Storm Drainage Impervious Area
Storm Sewer - 1st 50 Feet
Water Line - Ist 50 Feet
WilIamalane ManufHome Private
Total Amount Paid
Initial Review
Plan nine Review
12/08/2004
12/0812004
.
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$1.00
$24.30
$1.00
Square Footage
or Bid Amount
3,350.00
480.00
45,000,00
Total Value of Project
Fpp<. PiilIJ
Amount Paid
$100.23
$60.02
$42.01
$6.00
$31.00
$154.20
$30.00
$45.00
$50.00
$160.00
$50.00
$103.00
$45.00
$365.60
$480.80
$10.00
$865.31
$82.03
$96.12
$67.05
$772.49
$175.13
$512.12
$45.00
$45.00
$1,000.00
$5,393.11
Date Paid
12/7/04
1/4/05
1/4/05
114105
1/4105
1/4/05
1/4/05
1/4/05
114105
114105
114105
1/4/05
1/4/05
1/4/05
114105
114/05
1/4105
1/4/05
114105
1/4/05
1/4/05
1/4/05
1/4/05
1/4/05
1/4/05
1/4/05
I Plan Reviews I
12/08/2004
12/17/2004
APP SKG
APP TAJ
Paee 2 013
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2004-01492
ISSUED: 01/04/2005
APPLIED: 12/07/2004
EXPIRES: 07/04/2005
VALUE: $ 60,014.00
Value
Date Calculated
$3,350.00
$11,664.00
$45,000.00
$60,014.00
12/07/2004
1210712004
12/20/2004
Receipt Number
1200400000000001701
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
1200500000000000016
Front for setbacks is based on
easement road.
.
. CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: cOM2004-01492
ISSUED: 01104/2005
APPLIED: 12/07/2004
EXPIRES: 07/04/2005
VALUE: $ 60,014.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Public Works Review
Structural Review
12/08/2004
12/08/2004
12/09/2004
12/20/2004
APP
APP
CAS
DLM
Storm drainage piped to curb face
Called engineer for clarification of
garage engineering - left voicemaii"
re: shearwalls at front & rear of
garage. Received revised
engineering for front & rear garage
walls - OK 12/21/04
Used standard plan review
comments for M.H & Garage. dim
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I Reouired In~neetinn'!J
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Foundation: After forms are erected but prior to concrete placement.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Drywall: Prior to taping.
Hold Downs Instailed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Final Building: After all required inspections have been requested and approved and the building is complete.
Undernoor Drain: Prior to cover or placement of concrete.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Manuf Home Plumbing: After home has been connected to water and sewer.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
MH Electric: When blocking, setup and plumbing inspections have been approved and the home Is connected to
the panel.
MH Service: Approval required prior to utility company energizing service.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made ofany structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
U~,
1- 4 -05
Owner or Contractors Signature
Date
Paee 3 013
",\,,9.
,o~o r,0 .
,,~_~QVlELD ,,,.;,,.,...
" ..>"-
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~\ eG -
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:<541l726-37.53 . F. AX: <541lZ~61t-! '.' ~
\~ o..'V
ELECTRICAL PERMIT APPLICATION /. / ,0\00,,0\ '.
eity Job Number rDV"'''"l.604- /4 '7 z.. Date /2/ 2- -Z-i,9JSI.'O~00" .
.. ~ I .
I~.\v. ..,.
3.ff~~.~~.
~ ,~LL:" .
A. ~Si!lIfl\lI!!~~,9J..j~@Sll!ii_~l'~ll~
",
Service Included"o .
CITY OF SPRINGFIELD, OREGON
~.~.
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1. ~~~L6~QN~1
'Z- 'S ( "3 jIJ/! ,4-( A- L. P
LEGAL DESeRIPTION
/703 2 ~I 1-(
O'2'/Oc>
JOB DESeRIPTlON
flAr+ Se..j~iJ(L /iZClt'ZU.":+-S
Permits are non-transferable and expire if work Is
not started within 180 days oflssuance or If work is
Suspended for 180 days.
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Maoufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
z
$50.00
IuD
1t~-.r:"'~"__w_'l''''~
a ~ ST.' '1J~"
2. . ',. . In"- ,
Electrical eontractor m ~ E/e( fr/(!j'TrY.
Address p() fJrff 2f5Z!
B. fA~1{i)fa,~T<<eJlt""
eity ~.QjlQ_
200 Amps or less $ 63.00
201 Amps to 400 Amps $ 75.00
40 I Amps to 600 Amps $125.00
. 601 Amps to 1000 Amps $163.00
Phone b?,b.::J./4t./ Over 1000 AmpsIVolts $375.00
,::,,:;'nN: or\l;~f8R'1~,c,l}ro~uires you. to $ 50.00
, .... .l......Il;.~<''''n.IIt,lit''
Supervisor License Number 4il.\ '-l <s .)W i:~lecC' a~~~~~<;e~f~~
I l~ .."VCUIVn e .
I \ ' OAR 952 001-001o1hrough OAR 952-001-
Expiration Date 1 0 D \ () J In . . - In'fa latIOns Altn~UOlLf&Fi5rcatlon
. UU::lV. IUJ may o~ ~m cop I SO
I ~ II" 9 the cen ,'r. ~Bfe:rffi'ittelephone
eonstr. eontr. Number \ S I,.. In I a In f th Ik~'U\\=R!catiOn
) II IIIUgl or e 11 ~t0-6
~I \L1 Dr- Center ia 1 ~ s .
Expiration Date ---, = Over 600 Amps or 1000 Volts see "B" above.
Signature of Supervising Electrician D. ~~~i'~~
New A1teratlon or Extension Per Panel
One eircuit
Each Additional eircuit or with
Service or Feeder Permit
$ 50.00
$ 69.00
$100.00
9'?/ ~
$ 43.00
Owners Name Dfvl \~
-z.. $ 3.00
f-,
.,J E I<s.o-
A A ~ E. i\'i':f:?c"mm,~~Se'I;;Wf"I.1f::.r.'ft\""'alfli1l""-lSfEa~ ~"'tlilit~~
Vl/!rrf ~0111,t.: ~;~~~R~lFm-;\N\",;,.II!.- r.fI!..-'
Phone _ ,'~ f'\:RM\1 P"ump'or"mg~bontRM\1IS ~01 $ 50.00
I r\l-THOR\I\:DSigDT6{tli;\rt:~Kbn~E\) fOR $ 50.00
OWNER INSTALLATION 1\\.1 MMH-lC\:\!-iijJlte\l:E~.;}~~~Widential $ 25.00
The mstallabon is bemg made on property I own ~~cq 180 DI\\,-iin'iie'd'ERergy/eommercial $ 45.00
is not intended for sale, lease or rent. ,. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
Address
2'5/ '""J,
5?P1:::.
eity
Owners Signature:
&I~.~1IM'
4. '" I ?,(1iI "I.E. " 'lc2t! ,"
. " . ~
7% State Surcharge
10% Administrative Fee
/cIo
742-
lObO
IZI.( c:s..
Inspection Request: 726-3769
TOTAL
Shared Orive{T:)lBuilding FonnsIElectrical Permit Application 1-03.doc
CITY OF SaG FIELD SYSTEMS DEVELOPMEN&RKSHEET
JOURNAL OR JOB NUMBER: COM2004-01492
NAME OR COMPANY: David Nelson
LOCATION: 2513 Maia Loop
TAX LOT NUMBER: 1703251408100
DEVELOPMENT TYPE:
NEW DWELLING UNITS BUILDING SIZE (SF' 1494 LOT SIZE (SF):
1 STORM DRAINAGE
,.
5663
[/)
~
Cl
[0
u
I~
I~
[/)
(3
~
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE
I 1652.00 I $0.310 = $512.12 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO elTY STANDARDS
I IMPERVIOUS S.F. I x I eOST PER S.F. I x I DISCOUNT RATE I I
0.00 I $0.310 50% I = I
ITEM I TOTAL- STORM DRAINAGE SDC $512.12
DlseOUNT
$0.00
$512.12
I i070
2 SANITARY SEWER - CITY
A. REIMBURSEMENT eOST:
I NUMBER OF DFU's I x eOST PER DFU
20 I $24.04 $480.80 11091
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
20 I $18.28 , $365.60 1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC =1 $846.40
J. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRJP RATE I x I NUMBER OF UNITS I x I COST PER TRJP x INEW TRIP FAeTORI
I 9.57 I I I I $18.30 I 100 $175.13 11093
B. IMPROVEMENT eOST: I
I ADTTRIP RATE I x I NUMBER OF UNITS I x I COST PER TRJP x INEW TRJP FACTORI
I 9.57 I I I I $80.72 I 1.00 $772.49 11094
ITEM 3 TOTAL - TRANSPORTATION SDe = 1 $947.62 I
4. SANITARY SEWER - MWMC I
A. REIMBURSEMENT eOST:
INUMBER OF FEU's J x leOST PER FEU
I I I $82.03 = $82.03 1054
B. IMPROVEMENT eOST:
INUMBER OF FEU's I x leOST PER FEU
I I I $865.31 = $865.31 1055
MWMC CREDIT IF APPLleABLE (SEE REVERSE) $0.00 1054
MWMe ADMINISTRATIVE FEE $10.00 1056
ITEM 4 TOTAL - MWMe SANIT ARV SEWER SDC ~ , $957.34
SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , $3,263.48
-
5 ADMINIST~TIVE FEE:
I SUBTOTAL x I ADM. FEE RATE I~ CHARGE
I $3.263.48 I 5% $163.17
TOTAL SANITARY ADMINISTRATION FEE: 96.12 f079
TOTAL TRANSPORTATION ADMINISTRATION FEE: $67.05 1078
-,
Cheryl Slaymaker 12/9/2004 TOTAL SDC CHARGES = I $3,426.65
PREPARED BY DATE
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS. CALCULATE ONt Y TIlE NET ADDmONAL FIXTURES)
NO. OF FIXruRES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
1M THTUB 2 0--3 = 6
I DRINKING FOUNTAIN 0 0 1 = 0
IFLOOR DRAIN 0 0 3 = 0
I INTEReEPTORS FOR GREASE lOlL I SOLIDS I ETe. 0 0 3 = 0
I INTERCEPTORS FOR SAND I AUTO WASH I ETe. 0 0 6 = 0
ILAUNDRY ruB 0 0 2 = 0
leLOTHESW ASHER I MOP SINK 1 0 3 = 3
leLOTHESWASHER - 3 OR MORE lEA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
IREeEPTOR FOR REFRlG I WATER STATION I ETC. 0 0 1 = 0
IREeEPTOR FOR eOM. SINK I DISHWASHER I ETC. 0 0 3 = 0
ISHOWER. SINGLE STALL 0 0 2 = 0
I SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: eOMMERCiAuRESIDENTIAL KITeHEN 1 0 3 = 3
I SINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 2 0 1 = 2
URINAL. STALL I WALL 0 0 5 = 0
TOILET. PUBLIe INSTALLATION 0 0 6 = 0
TOILET. PRIVATE INST ALLA TION 2 0 3 = 6 .:
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 20
.EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DRls) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR 1- eREDITRATFJ$I,OOO IJ
ANNEXED ASSESSED VALUE . IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2
BEFORE 1979 $5.29 (Enter I for Yes, 2 for No)
1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. eREDIT? 2
1980 $5.19 (Enter I for Yes, 2 for No)
1981 $5.12 BASE YEAR 1979
1982 $4.98
t983 $4.80 eREDIT FOR LAND (IF APPLICABLE)
1984 $4.63 VALUE I 1000 CREDIT RATE
1985 $4.40 $0.00 x $5.29 ~ , $0.00
1986 $4.07
1987 $3.67 eREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
1988 $3.22 VALUE I 1000 eREDIT RATE
1989 $2.73 $0.00 x $5.29 0
1990 $2.25
1991 $1.80
t992 $1.59 TOTAL MWMC CREDIT = $0.00
1993 $1.45
1994 $1.25
1995 $1.09
1996 $0.92
I, 1997 $0.72
1998 $0.48
'I 1999 $0.28
I 2000 $0.09
I 200t $0.05
.
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
MANUFAeTURED HOME LAND USE AGREEMENT
As required by the eity of Springfield Development eode, I agree that with the approval of the attached'
permits, one of the following manufactured homes will be placed at ~I ~ ~A LP.
Springfield, Oregon, eity Job Number (,~-l>I-'f!12. .
~ Type I Manufactured Home. A multi-sectional (double wide or wider) unit with an enclosed
noor area of not less than 1,000 square feet, that has a nominal roof pitch of3 feet in height for each 12
feet in width, that has no bare metal siding or roofing, and that has been certified by the manufacturer to
have an exterior thermal envelope meeting performance standards which reduce heat loss to levels
equivalent to the performance standards required of single family dwellings constructed under the State
Specialty eodes.
_ Type II Manufactured Home. A unit of not less than 12 feet in width with an enclosed floor area
of not less than 500 square feet, that has a nominal roof pitch of2 feet in height for each 12 feet in width
and. that has no bare metal siding or roof mg.
The manufactured home shall be placed on an excavated and back-filled foundation not to exceed 6
percent slope within 10 feet of the perimeter enclosure. The perimeter foundation wall surrounding the
home shall be constructed of stone, brick or other masonry materials, and with no more than 24 inches of
the enclosing material exposed above grade.
I further agree to meet all land use and eity eode requirements of the above mentioned parcel within 60
days of the date of issuance of the manufactured home set up permit. These requirements may include, but
are not limited to the items listed below. Specific land use requirements regarding your parcel are noted on
your approved set up plans and/or permit and your partition approval if applicable.
. Street Trees
. Paving Driveway
. Minimum 32 square foot storage structure
. eompletion of partition approval
. Removal of any existing structures as noted on your partition approval
. Signing and recording of any required partition, easement, improvement agreements, etc.
. Final lot grading
. City Sidewalk and curbcut installation
. Any outside agency approval as required i.e., Division of State Land approval.
By my signature below, I agree to complete the above mentioned land use requirements.
)<
qll.
Owner Signature
1iJ1/~~
eontractor Signature
Date
y
j - Y '6~
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
8"~'~I~.~.~.ELO. " . _ ;
Wi:. ,
.- ,
. ,
.' i
_____. . or .
Jib' of Springfield Official Receipt
"elopment Services Department
Public Works Department
Job/Journal Number
COM2004-0 1492
COM2004-0 1492
COM2004-0 1492
COM2004-0 1492
COM2004-0 1492
COM2004-0 1492
COM2004-0 1492
COM2004-0l492
COM2004-0 1492
COM2004-0 1492
COM2004-0 1492
eOM2004-0 1492
eOM2004-0l492
COM2004-0l492
COM2004-01492
COM2004-0 1492
eOM2004-0 1492
COM2004-0 1492
COM2004-0l492
COM2004-0 1492
eOM2004-0 1492
COM2004-0 1492
eOM2004-0 1492
eOM2004-0 1492
eOM2004-0 1492
Payments:
Type or Payment
erediteard
1/4/2005
RECEIPT #:
1200500000000000016
Date: 01104/2005
DescrIption
Manufactured Home Placement
Manuf Home State Issuance
Addressing Assignment
Sanitary Sewer - 1st 50 Feet
Water Line - 1st 50 Feet
Storm Sewer - 1st 50 Feet
Manufactured Home Conn - Plmb
Willamalane ManufHome Private
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDe Transpo Reimbursement
SDe Transpo Improvement
SDC MWMe Reimbursement
SDe MWMe Improvement
SDC MWMe Administration
SDe SanitarylStorm Admin
SDe Transpo Admin
Plan Review Major - Planning
Garage/Carport
Manufactured Home Feeder
Manufactured Home Service
Add, Alter, Extend eirc Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
WILLIAM HARRISON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 004551 In Person
Payment Total:
Page I of I
1:45:59PM
Amount Due
160.00
30.00
31.00
45.00
45.00
45.00
45.00
1,000.00
512.12
480.80
365.60
175.13
772.49
82.03
865.31
10.00
96.12
67.05
103.00
154.20
50.00
50.00
6.00
42.01
60.02
$5,292.88
Amount Paid
$5,292.88
$5,292.88