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Receipt PLANNER 5/13/2022
SPRINGFIELD City of Springfield Development and Public Works Transaction Receipt 225 Fifth Street Record to: 811.22-000125-TYP4 Springfield, OR 97477 541-726-3753 OREGON rVR Number: 811092841327 Fax: 541-726-3689 permitmnker@spdngFieldor.gov Receipt Number: 484070 Receipt Date: 5113122 hnpL�.apdngfreldor.gm4dpW/CumntoavabpmentNvaion.hhn Worksite address: 4714 JASPER RD, Springfield, OR 97478 Parcel: 1802051303002 Fees Paid Transaction Units Description Account code Fee amount Paid amount data 5/13/22 1.00 Ea Type IV - Annexation < 1 Acres 100-00000425002-1039 $2,654.00 $2,654.00 511=2 1.00 Ea Type IV- Postage fee for all 100-00000-025505-1039 $658.00 $658.00 5/13!22 1.00 Acres UGB Only Comprehensive Planning 100-00000-025002-1039 $1,164.00 $1,145.50 fee, per acre 5/13122 265.40 Amount UGB Only Concurrent special district 10040000425002-1039 $285.40 $265.40 boundary adjustmentsWthdrawals - emer amount 5/1322 1.00 Automatic Technology Fee 204-00000425605-0000 $204.17 $203.25 Payment Method: Check number: 1114 Payer. Misty Avalos Payment Amount: $4,926.15 Transaction Comment: Misty Avalos Karen Gmsseth 4714 Jasper Rd. Springfield, Or 97478-7757 Cashier: Melissa Camino Receipt Total: $4,926.15 Primed 51132210:55 am Page 1 of 1 FIN_ TranaacfianRacaiptyr SVttYfltw`�I�(,L7- -� City of Springfield Transaction Receipt Development and Public Works 225 Fifth Street Record ID: 811-22-000125-TYP4 Springfield, OR 97477 541-726-3753 JkrdYYW IVR Number: 811092841327 Fac: 541-726-3689 permitcenter@springFleldror.gov Receipt Number: 484069 Receipt Date: 5113122 MIpll . ..springfieldor.g IdpwrCu..Membpmenmivaion.mm Worksite address: 4714 JASPER RD, Springfield, OR 97478 Parcel: 1802051303002 Fees Paid Transaction Units Description Account code Fee amount Paid amount data 511Y 1.00 Acres JOB Only- Comprehensive Planning 100-00000425002-1039 $1.164.00 $18,50 fee, Per acre 613/22 1.0 Automatic Technology Fee 204-00000425605-0000 $204.17 $0,92 Payment Method: Fee Waiver Payer: fee waiver Fee Waived Amount $19.42 Transacibn Comment: Fee waiver -due to miscalculation Cashier: Melissa Canno Receipt Total: $19.42 Printed 511 312 2 10:53 am Pagel 01 FIN_ TmraatlbnRacaim_,r