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Receipt PLANNER 5/10/2022
SPRINGFIELD City of Springfield Development and Public Works Transaction Receipt 225 Fifth Street N/N Record ID: 811-22-000119-TYP2 Springfield, OR 97477 541-726-3753 N541-726-3753 IVR Number: 811078614049 Fax: 541-726-3689 permitcen ter@spd ngfield-or.gov Receipt Number: 483995 Receipt Date: 5/10/22 hftplN vsprin,fel r.goviOwnumesr oevrei opm ent0inumAlso Worksite address: 621 5TH ST, Springfield, OR 97477 Parcel: 1703352403400 Paid amount $218.00 ................... $193.00 ................... $10.90 Payment Method: Grath card Payer: Timothy Halverson Payment Amount: $421.90 suthaizatien: 697532 Paid through ePermitting website Receipt Total: $421.90 Pdrskal 11W22 937. Papel oft FIN Transaction Receiptyr Fees Paid Transaction units Description Account code Fee amount date 5/10/22 1.00 Fa Type II - Hisioric Commission Review 100-00000.425002-1039 $218.00 under Type II, City ................................. 5/10/22 1.00 Fa ................................................................... Type II - Hisiodc Commission Review 100-00000.425505-1039 $193.00 under Typell, Postage ................................... 5/10/22 1.00 Automatic ................................................................... Technology Fee 204-00000.425605-0000 $10.00 Paid amount $218.00 ................... $193.00 ................... $10.90 Payment Method: Grath card Payer: Timothy Halverson Payment Amount: $421.90 suthaizatien: 697532 Paid through ePermitting website Receipt Total: $421.90 Pdrskal 11W22 937. Papel oft FIN Transaction Receiptyr