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Receipt PLANNER 7/17/2020
SPRINGFIELD OREGON Transaction Receipt Record ID: 811 -20 -000132 -PRE IVR Number: 811000396274 Receipt Number: 475396 Receipt Date: 7117120 htlpl/m .springfield-or aov/dpw/cunentoevelopmeraDlvnion Not Worksite address: 1611 18TH ST, Springfield, OR 97477 Pancal:1703253107701 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Fax: 541-726-3689 permitaenter@springfield-or.gov Fees Paid Transaction Units Description Account code Fee amount Paid amount data 7117120 1.00 Ea Partitions - Pre -Submittal Meeting, 100-00000-425002-1039 $421.00 $421.00 Tentative or Plat - City Payment Method: Check number: 30998 Payer: Ambrosia DER Payment Amount: $421,00 Oregon LLC Transaction Comment: 522 SW 5th Ave. STE 925 Poniard, OR 87204 Cashier: Drew Larson Receipt Total: $421.00 Printed: 7117120 1:58 Pm Page 1 of 1 FIN TianaactiorReceii