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Receipt PLANNER 8/14/2020
GFIE City of Springfield Development and Public Warks Transaction Receipt i7OiiREGON 225 Fifth street Record lD: 811-20-000149-TYP2 Springfield, OR 97477 541-726-3753 IVR Number: 877083030387 Fan: 591-726-3699 piemitceme,,espringFleld-or.gov Receipt Number: 475690 Receipt Date: 8114120 nnv:nwww.aprineOela-or.9omdpwlcmrenloevaiopmentomaion.nen Worksite address: 1611 18TH ST, Springfield, OR 97477 Parcel: 1703253107701 Fees Paid Transaction Unita Description Accountcode Feeamount Paid amount date RIM= 1.00 Ea Type 11- Partitions - Partition Tentative 100-00000425002-1039 $5,938.00 $5,938.00 Plan, City W14/20 1.00 Ea Type 11 - Partitions- PaNBon Tentative 100-00000-425505-1039 $190.00 $190.00 Plan, Postage W14M 1.00 Automatic Technology Fee 204-00000-425605-0000 $29690 $296.90 Payment Method: Check number: 20484 Payer: Ambrosia OSR Payment Amount $6,424.90 Washington, LLC Transaction Comment: 522 SW 5th Ave. Portland OR 97204 Cashier: Drew Larson Receipt Total: $6,424.90 Prated, W14120 1'.25 pm Page 1 of 1 FIN_ T2nsactionRomipl_pr