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Receipt PLANNER 7/26/2021
SPRINGFIELD City of Springfield Development and Public Works Transaction Receipt 225 Fifth Street N/N Record ID: 811-21-000190-TYP2 Springfield, OR 97477 541-726-3753 N541-726-3753 IVR Number: 811004403325 Fax: 541-726-3689 permitcenter@xpringfield-or.gov Receipt Number: 480601 Receipt Date: 7/26/21 Nlp:lN .sprirVWd .goWOwlCwae0e Wma DO m.hhn Worksite address: 621 5TH ST, Springfield, OR 97477 Parcel: 1703352403400 Paid amount $218.00 ..................... $10.90 Payment Method: Credit card Payer: Timothy Halverson Payment Amonnt: $228.90 authorization: 92812Z Paid through ePermitting website Receipt Total: $228.90 Pnnf 4:7126121 5:14 pm Pagel a1 FIN TmeacbmRecaptyr Fees Paid Transaction units Description Account code Fee amount date 7/26/21 1.00 Fa Type 11 - Historic Commission Review 100-00000.425002-1039 $218.00 under Type II, City ................................... 7/26/21 1.00 Automatic ......................................................................... Technobgy Fee 204-00000.425605-0000 $10.911 Paid amount $218.00 ..................... $10.90 Payment Method: Credit card Payer: Timothy Halverson Payment Amonnt: $228.90 authorization: 92812Z Paid through ePermitting website Receipt Total: $228.90 Pnnf 4:7126121 5:14 pm Pagel a1 FIN TmeacbmRecaptyr