HomeMy WebLinkAboutPermit Building 2003-10-27Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541 -7 26-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2003-01005ISSUED: 1012712003APPLIED: 10/0312003
EXPIRES: 05/0612004VALUE: $ 13,923.00
SITE ADDRESS: 303 36TH ST
ASSESSOR'S PARCEL NO.: 1702314203700
PROJECTDESCRIPTION: Garage
Owner: DUANE CARTWRIGHT
Address: 303 36TH ST SPRINGFIELD OR 97478
Springfield TYPE OF WORK: Garage
TYPE OF USE: New Residential
Contractor Type
General
Electrical
Plumbing
Contractor
OWNER
JOHNSEN ELECTRIC INC
OWNER
PhoneNumber: 541-744-9589
License Expiration Date Phone
38497 0u1012004 541-461-0291
CONTRACTOR INFORMATION
BUILDING INFORMATION
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
#Rqd:
Paved Drive Rqd:
Yo ofLot Coverage:
tss
REQUIRED PARIflNG
Total:
Handicapped:
Compact:
585
Curbside 5'
Curb and Gutter
R-3
u-1
VN
ofHeight
ofType
Storiesof#
,oo
.OO,\
67.00
s.00
10.00
s.00
15.00
$l'
1
Fully Improved
Yes \\\$
Notes:
Applicant is planning to
Paee 1 of3
L
\c'
tr''l
Size:
lst Floor:
2nd Floor:
Basement:
Garage/Carport
\ne Surface Area:
e" -tc.
CITY OF SPRIN
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-01005ISSUED: 1012712003APPLIED: 10/0312003EXPIRES: 05/0612004YALUE: $ 13,923.00
Valuation I)escrintion
Description
Garage
Fee Description
Plan Review Residential
+ l0o/o Administrative Fee
+ 77o State Surcharge
Building Permit
Curbcut Permit
Plan Review - Planning
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Storm Sewer - lst 50 Feet
Storm Sewer Each Addtl 100'
+ l0o Administrative Fee
+ 7oh State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Total Amount Paid
Type of Construction
Garage
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$23.80 585.00
Total Value of Project
Amount Paid Date Paid
Value
$13,923.00
$13,923.00
Receipt Number
1200200000000002268
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
r200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002431
1200200000000002431
120020000000000243r
1200200000000002431
Date Calculated
10/03/2003
$90.09
$19.76
s13.83
$138.60
$7s.00
$s9.00
$r3.69
$273.76
$45.00
$14.00
$7.20
$5.04
$9.00
$63.00
t0t3t03
10t27t03
t0t27t03
10t27t03
10t27103
10t27t03
10t27t03
10t27t03
10t27t03
10t27103
t,/6t03
tu6t03
tu6t03
tu6t03
$826.97
Fees Paid
Plan Reviews
Initial Review
Planning Review
Public Works Review
10t06t2003
10t06t2003
10t06t2003
10/15/2003
10t06t2003 10/10/2003 APP VRJ
APP TCM
No scale for height of structure
First 18' of driveway needs to be
paved ifit abuts a curb and gutter
street.
Site plan did not show storm
drainage and applicant had not
submitted second driveway
application. Contacted owner, and
Mr. Cartwright revised site plan and
applied for second driveway. Storm
drainage to drain to curb and
gutter. Transportation approved
2nd driveway 1011012003.
APP
APP
LLH
TAJ
Structural Review 10t06/2003 10t23t2003
Paee 2 of3
ff!
SpnlH(lFtaLD
Building/C ombination Permit
Status Issued
225Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2003-01005ISSUED: 1012712003APPLIED: 10/0312003
EXPIRES: 05/0612004VALUE: $ 13,923.00
To Request an inspection call the24 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 Curbcut - Second: After forms are erected but prior to placement of concrete.
2 Footing: After trenches are excavated.
3 Foundation: After forms are erected but prior to concrete placement.
4 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
5 Final Building: After all required inspections have been requested and approved and the building is complete.
6 Storm Sewer Line: Prior to filling trench.
7 Rough Electric: Prior to Cover
8 Electric Service: Approval required prior to utility company energizing service.
9 Final Electric: When all electrical work is complete.
Reouired Insnections
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 of any 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.
Owner or Contractors Signature Date
Pase 3 of 3
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Offi'cial Receipt
Development Services Department
Public Works Department
I Date::10:29AM
coM2003-0100s
coM2003-0r00s
coM2003-01005
coM2003-0100s
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7Yo Slate Surcharge
+ lj%o Administrative Fee
63.00
9.00
5.04
7.20
Item Total:$84.24
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check BEACON ELECTRIC djb In Person
Payment Total:
$84.24
$84.24
(
Construction Contracto.^- Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-378-4621
Web Address: www.ccb.state.or.us
Permit +, CBrxAOo. _,"OLff,5
Address: 3O 3 elt
rY1 Date
statement: lnformation Notice to property owners
About construction Responsibilities
Note" oregon Law, oRS 701.055(4) requires residential construction permit applicants who are notregistered with the Construction Contractors Board to sign the following statement before a buildingpermit can be issued. This statement is requiredfor resiientiqi buildin{, ebctrical, mechanical andplumbing permits- Licensed architect and engineer applicants, exempt Ji"om registration under
ORS 701.010(7), need not submit this statement. This statement will be filed with the permit.
Irw
ef'h
Fill in the appropriate blanks and initial boxes I and 2, and either box 34 or 38
l. I own, reside in, or will reside in the completed structure
2. I understand that I must register as a construction contractor if the structure
sale before or on completion.#
is sold or offered for
(*,<..r
" t c7ff Co*lsz<,
7aK*{
(Name)(ccB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
38. I will be my owrt general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately noti$ the office issuing this building permit of the
name of the contractor.
I hereby certi$ that the above information is correct and that I have read and do understand the Information
Notice to Owners about Construction on the reverse side of this form.
3,{. My general contractor is l)un^re tc+(T
tloh,
(Signature of appl ''/ - {fua
prop-own/f/ 3-99
(White copy to issuing ogency permit file, pink copy to applicant.)
Issued by:rolar/os
A.G.o)
In rma tion Notice to ProPertY Clwners
About Construction Responsibilities
Irtlt,^ '!'ltis ln{i;rnxrrio4 \'rstit,e ttL !}ropcrh' Ott'nr'rs uh<;ut {'onstrttt'lion Respt'tt'vil)iltties vu't
tlevclttpec! h),rhe {-lonsrruction Contructors l}oarL! itt atcttr(Jant"t: tt'ith {}[lS i() I (]5i()i
If vou are actirig a3 l:ol*-orvn colltractor to corlstruct a ne\\ honte or make a strLrstant'ial impr.rveutent to an exisling
strucrure. ),su can prevent many problems by' being aware of the tbllowing responsibilities and concerns'
E m PloYe r Responsibitities
lf y,r.ru hire perstNrs,ot registerer] rvirh the construction contractors l3oard to di'r latror iti construetirtg 'rr assistin'r
in the construction or impror,ernent of a resitrerrtiar structure. vou i'iil. in nrost inslances, be ruled to be atl
employ,er arrcl the people .vou hire rnif l Ue..nrp!uy.", As the "*pit'-'' "'' )'ou nlust cornply' rvitlr thc iollor'ving:
oregon's nrithliotrting tax'lri*r: As tmEmployer. you mustavithholdrnab-m-fi&x€s tforn e-mF]oi'ee-wagx'm rhr
time enrpl,.rvees arc pairi. you rvill tre liabte forthe tar payments even if -vott don't actuallr r'vithhold the tax fror:t
vour enrplo,rees. []or ni,.:re irrformati.'rn. call the C)regott l)epartmcnt ol'I{elettue at 501-94-<-8091 '
fJnemployment insurance tax: As att cntplnl'er, )'ou are reqttirecl t() paY a tar fbr itnelnplOvntent insuranCe
purposes on t1e 1r,:rgcs.l"all enrplo;-'ees. Itor,nlr*'into.nation. call the OreSon Enrplol''ment Departnient at 50-l- '
.:i
j?8-.1-i21.
workers, comprnsation insurance: As an employ'er, you are subject to the oregon wrrrkers' compensation
l-arv. ancl nrust,btain *orkers' compensatir'rn insurance {br -vour emplo.vees. lf y'ou iail to obtain rvorkers'
cornpensati,n insurancc, .vrlu mav be suhject to penalties and uill be liable for all claittt tosts if otre of -Your
employees is.injurer! on the joh. l-or more iriformation. call thc wi"rrkers' C*ntperrsaticn Divisiorr at tltc
Depar.iment of Ct,noun,*r and Busine* Sr*ie*, at 503-947-7tti0.
{.1.S. Internal Revenne Senice: As an emplover. -vou urust rvithholcl fc<ieral incorne tax frot:l cntpio,r'ees'wages'
yexr rviil be liablc lbr the tax pa,vrneflt even il' you ,li,ln't actually rvithhold tlre tax. Ior niore in{brilration, call ihe
Internal Revenue Servite at t-800-829-10:10'
Other Responsihilities and Areas of Concerns
Cotle com lltia nce: \, rhc pcrrn ii ht,libr tir th is p|t1ject. .\'ou arc ryyqry]ble ftx resol-'.'in!'- lt nY fi ilttre to r;r ecl code
requirements that niar bt' brotrghi to !'otlr attention throrrglt inspections'
Liability arxl propert--v damage insurance: Contact -vour insurance agent to see if y'ou have acleclttate insuratrce
.,r*arog. {br accidents and omissions such as falling tools, paint overspra}-. water danlage frotn pipe punctttres.
fire. or u'r:rk tltat musl be re-dr>ne.
Time to supen-ise emplgyees: Make sure you have su{ficient tittie to supervise ;-our etnploy'ees'
Expertise: hlake surc vrlu lta\e the expertise to act as vour o\\'n geltcral contlac{Or. to colll'iJil}ate rhe rvllrk ol
rough-i1 ancl linish tracies. and tti notili truililing ol'ficials as the appropfiate tinies so thev can ;:erforttr the requircd
i nrpections.
If youhavcaddiriorralquestiiins.*rite orcalltheConstrutctit'rnContractorslloard(P0 Ilox l4i''l0"Salem.OIl
97309.5052.503-178--1621). ThelJoardislocatedatT00SLrrnnrerStNE.Suite300.inSalem.
prop-own,,fi 3-99
225 FIFTH STREET . SPRIN(;FIELD, OId.97477 . PH:(541)726-3753 o FAX: (541)726-3689
E LECT RI CAL P ERIIT IT AP P LI CAZO N
City Job Nurnber(1)4f ZCO3 - A /OO f Date u-le)pz
I. LOCAT'ION OF- INS'rETL4,T'ION 3. COMPLE'TE T.-EE SCHEDULE
3OZ N Stnh bJ,
,-ff
LEGAL DESCRIPTION
i7OZ3 r LlZ o37ocs
JOB DESCRIPTION
lrurrs 6 laElvtoD:€L
Permits are non-transferable and expire if lvork is
not started n'ithin 180 days of issuancc or if rvork is
Suspended for 180 days.
Electrical Contractor Beacon Electric
\dclress 2585 Roosevelt Blvd
City Eugene I,lrone ( 541) 461-0291
Superlisor LiccrrseNurnber 3485-S
E.xpiration Datc-10/01 /0
Corrstr. Coutr Nunrber 38491
Expiration I)ate 01 /10/04
Signature ot' Supelr.'ising E tnc larl
Ga rY Jo sen
Owners N ,Atrs*1(d
Address
'30's 36*L >tr
City s(fl Phone
OWNER INSTALLATION
The installation is being made on propeffy I own rvhich
is not intended for sale, lease or rent.
Owners Signature
A. Ncw Residential - Singte or lVlulti-Itarrrily pcr drvelling unit
Service Included
1000 sq. ft. or less
Each additional 500 sq. [r. or
portion thereof
Each Manufact'd Horne or
Modular Dwelling Sen.ice or
Feeder $50.00
$ r 06.00
$ r9.00
2. 00NTRACTOR TNSTALLATION ONLt'.B. Sen,ices or Feetlers - Installation, Alterations or Relocation
200 Amps or less
20I Amps to 400 Anrps
40 I Anrps to 600 Arnps
601 Amps to I000 Arnps
Ovel I000 Anrps,'Volts
I(econnect Oulv
7o/u State Surcharge
I0% Adminislrative Fee
1'O'TAT,
$ 63.00
s 75.00
s125.00
s 16i.00
si 7-5.00
s -s0.00
b3,oo
cp
Lr
E. tr'Iiscellaneous
7L/"1 - 7Sg7 pumpor it0
Sign/Ou
Limited
Limited
N{inimrrm Electric Pernrit Inspection Fee is $45.00 -F Surchargcs
4. SUBTOTAL OF ABO\TE 7 ?,0-0_-_
5" 0t1
_ 7,_ZO _
_a]L),24
Eaclr Additional Circuit or u,ith -Service or Feeder Pemrit 5 $ 3'oo 1,ot)
lrrspection Ilcq rrest: 7 2(t-37 (t9
Sharc<l Drivc(T ) Burldirrg l:orltti E-[tlrirltl I'clll),1 ApPlicilirott i-1t.1 tii'c
C. Tcnrporarl Services or lie'etlt'rs
Installation, r\l
Pancl
$ 43.00
$ 4s.00
Building/Combination Permit
Status Issued
225 Fifth Street, Spring{ield, OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-01005ISSUED: 1012712003APPLIED: 10/0312003
EXPIRESz 0412712004VALUE: $ 13,923.00
PhoneNumber: 541-744-9589rouESru
ne
SITEADDRESS: 30336THST
ASSESSOR'S PARCEL NO.: 1702314203700
TYPE OF WORK: Garage
TYPE OF USE: Newn law re9u lres you to
the Ore gon UtilitY
rules are set tor
Oregon
is 1-800-
10.00
5.00
Springfield
EDU
0Rl
Residential
585
Curbside 5'
Curb and Gutter
PROJECT DESCRIPTION:
follow rules
Owner:
Address:
ca
nurnbe rtor the
Contractor Type
General
Electrical
Plumbing
C.antar
Contractor
OWNER
JOHNSEN ELECTRIC INC
OWNER
R-3
u-1
VN
67.00
5.00
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Vo ofLot Coverage:
License Expiration Date Phone
38497 0U10t2004 54r-46r-0291
IRE I
IS PERMIT IS NOT
I Lot Size:
RIOD.
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
15.00
Fullv Improved Sidewalk rYPe:
Yes Downspouts/Drains:
Applicant is planning to drain roof drainage to the street
DEVELOPMENT INFORMATI(
PUBLIC IMPROVEMENTS
Notes:
Page 1 of3
F
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2003-01005ISSUED: 1012712003APPLIED: 10/0312003
EXPIRESz 0412712004VALUE: $ 13,923.00
Description
Garage
Tvpe of Construction
Garage
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$23.80 s8s.00
Total Value of Project
Amount Paid Date Paid
Value
$13,923.00
$13,923.00
Date Calculated
10/03/2003
Fee Description
Plan Review Residential
+ l0o/o Administrative Fee
+ 7%o State Surcharge
Building Permit
Curbcut Permit
Plan Review - Planning
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Storm Sewer - lst 50 Feet
Storm Sewer Each Addtl 100'
Total Amount Paid
$90.09
$19.76
$13.83
$r38.60
$7s.00
$s9.00
$13.69
$273.76
$4s.00
$14.00
$742.73
10/3/03
10t27t03
10t27103
10t27t03
10t27t03
10t27t03
10127103
10t27t03
10t27t03
10127t03
Receipt Number
1200200000000002268
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
1200200000000002370
['cps Pnid
Plan Reviews
Initial Review
Planning Review
Public Works Review
Structural Review
1010612003
10t06t2003
t0t06t2003 l0/10/2003 APP VRJ
10t06t2003 10t23t2003 APP TCM
No scale for height of structure
First 18' of driveway needs to be
paved ifit abuts a curb and gutter
street.
Site plan did not show storm
drainage and applicant had not
submitted second driveway
application. Contacted owner, and
Mr. Cartwright revised site plan and
applied for second driveway. Storm
drainage to drain to curb and
gutter. Transportation approved
2nd driveway 10/10/2003.
10t06t2003
t0n5t2003
APP
APP
LLH
TAJ
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.
Page 2 of3
,I
Valuation Description
Buildin g/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-01005ISSUED: 10127t2003APPLIED: 10/0312003EXPIRESz 0412712004VALUE: $ 13,923.00
I Curbcut - Second: After forms are erected but prior to placement of concrete.
2 Footing: After trenches are excavated.
3 Foundation: After forms are erected but prior to concrete placement.
4 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
5 Final Building: After all required inspections have been requested and approved and the building is complete.
6 Storm Sewer Line: Prior to filling trench.
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 of any 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
ZZ a
Owner or Contractors Signature Date
Paee 3 of 3
Keourreo tnsDectrons I
3{}ll9
.g4!-E-U-E!r
I lth Ju Iy
OF,US nd and wTTe
Ay a,
t.1.
E-z L7
1962,THIS IND
by and b
herelnafter referred to as t
corporation, ln Lane Countyl
That the Grantors,
hereby grant, barga
7.0
ENTURE I'{ADE and en ed lntoAaron L.a lor and ene ,
,Grantors, and TH OF SPRI I{GF I D, a munlclpal
Grantee.Oregon, herelnafter referred to as the
tgLl-N-E!!!I-E
for and ln conslderation of one dol lar to them ln hand pald, do
ln, sell and convey unto the Grantee, a perpetual easement
feet in wldth, together wlth the rlght to go upon sald easement
area herelnafter descrlbed for the purpose of constructlng, reconstructlng, maln-
talnlng and uslng any publlc utllltles wh!ch may trereafter be lnstelled on the
fol lowlng descrlbed property, to-wlt:
A 7.0 foot wide strip along and adjacent to the east line of the grantors property,
the said strip being described as beginning at a point south 0" 33rwest 1100.00'feet from a point on the south line of the Lucinda Comegys Donation Land Claim No.
81, Township l/ South, Range 2 West, Willamette Meridian; 1163,32 feet east of the
southwest corner thereof; thence south O" 33r west IOO.O feet; thence west 7.0 feet;
thence north 0" 33reast 100.0 feet; and thence east /.0 feet to the point of be-ginning, in Springfield, Lane Coonty, 0regon.
T0 HAVE AND T0 H0LD the above easement to the sald Grantee, lts heirs and asslgno
forever.
lN WITNESS IrHERE0F, the Grantors above named have hereunto set thelr hands and sealsthls-fla[_day of Julv ,19_Q_.
(senl)
(sral)
d (sEnu)
(sEnl)rJ'^*"p^J*-
/
STATE OF OREGON
ss
Coun
r/
)
)
)
hat on thl llth d ay of July , 1962 , be-
ed, a Notary Public ln and for sald County and State, person-
ln named A"ron L. T"ylo. lT l*ylor _
known to me to be tl',e Identlcal indivldual s descr-lbed
he wlthln lnstrument and acknowledged to me tirat;$ggexecuted
luntarl ly.
I have hereunto set my hand and afflxed my offlcial seal theIN TE
yea rl ast above wrltten.day and
Hy Commlsslon Explres Notary ubllc
E_Z 47
t a
8- I 0-63
I
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
coM2003-01005
coM2003-01005
coM2003-01005
coM2003-01005
coM2003-0100s
coM2003-0100s
coM2003-01005
coM2003-01005
coM2003-01005
Curbcut Permit
Storm Drainage Impervious Area
SDC Sanitary/Storm Admin
Plan Review - Planning
Building Permit
Storm Sewer Each Addtl 100'
Storm Sewer - lst 50 Feet
+ 7%o State Surcharge
+ l0yo Administrative Fee
Item Total:
75.00
273.76
13.69
59.00
138.60
14.00
45.00
13.83
19.76
of Payment Paid By Received By Batch Number Authorization Number How Received
njm 2379
Amount PaidCheckDUANE M. CARTWRIGHT
In Person
Payment Total:
$6s2.64
$652.64
$652.64