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Receipt PLANNER 1/5/2021
SPRINGFIELD OREGON Transaction Receipt Record ID: 811-21-000002-TYP1 IVR Number: 811015835317 Receipt Number: 477561 Receipt Date: 1/5/21 hftp:lN .sprn9Wd .geWOwlCerW9e WmWDW m.hhn Worksite address: 200 INTERNATIONAL WAY, Springfield, OR 97477 Parcel: 1703154003600 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Fax: 541-726-3689 permiteenterIfspri ngfield-or.gov Fees Paid Transaction urits Description Account code Fee amount Paid amount date 1/5/21 1.99 Fs Type l - Pmpety Line Adjustment, City 109-00900.425092-1039 $760.99 $760.00 1/5/21 1.60 Automatic Technology Fee .. .. _ _ 209-00000.4256050060 _ _ _ $38.60 _ _ . _ . _ . _ _$38.00 Payment Method: Check number: 24895 Payer: SSW Fsginees Payment Amount: $798.00 Transaction Cornment: 2350 Oalanont Way, Suite 105 Eugene, OR 97401 Cashier: Liz Miller Receipt Total: $798.00 Noted: 1/5121 3:47 pm Pagel dl FIN TrmsaclisnRecaptyr