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Receipt PLANNER 11/18/2021
SPRINGFIELD-1 OREGON Transaction Receipt Record ID: 811.21-000302-TYPI IVR Number: 811018235596 Receipt Number: 482072 Receipt Date: 11118/21 hap:I�.sprmgreWbngov/dpwICuaentDevelopmentDlvsion.Mm Worksite address: 200 S Ash ST, Springfield, OR 97477 Parcel: 1803021301000 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Fax: 541-726-3689 pemitcenter@springfield-or.gov Fees Paid Transaction Units Description Account code Fee amount date 11/18/21 1.00 Ea Type I -Accessory Dwelling Unit, UGB 100-00000425002-1039 $990.00 11/18/21 1.00 Automatic Technology Fee 204-00000425605-0000 $49.50 Paid amount $990.00 $49.50 Payment Method: Credit card Payer: Dennis Jemberg PaymentAmount: $1,039.50 authorization: 06364D Transaction Comment: 3624 Hawthorne Eugene, OR 97402 Cashier: Liz Miller Receipt Total: $1,039.50 Printed: 11118/21 2:52 pm Page 1 of 1 FIN_Trensac4onReoeix,,r