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Receipt PLANNER 10/12/2009
....' ('l-J : ..~1;. . \ ..::'.15;_!,::, -I ,{.;..... 225 Fifth StreetT; ii ;": . Springfield, .Or~gon.97477 " ~~ . "! If" _.1, r. ': 541-726-3759 Phone .,.~ ,. ,:,. ., , r . _.,." i:.~. RECEIPT#:'-' 1200900000000001131 Job/Journal Numb~~i:,~-:. ~.~.~.f~!P!i.~.~.:',.;}~~(s~1;;~;},: . S UB2009-00020 ::,:>'f,::,q-y' .~artitiOn' ~lat" . .. :..;. ':.li ':i4'~".'~,_, ~ ,~.'.... t SUB2009-00020 ':4Yi ';'+';5% Technology Fee f.' '; , ",~~;'!;'~1 f ~~: ~;'~:o~n~:~me~: >\~'~~~Y~~~~i~~?t. ~ '{;~ri;['f~~:.;,~~,'. Check i: ;:; q.~:.-;: : . ".,." ""~' . i'h', ;:;' It... .; '~. ,. 'I ji .. , cReceint I MARlLL YN OLSON . ';~;pr~k~'?,'t'., ... '. :4t .Ii~i~l~~~;~~~~:l~J~: \~{: I,. i, .~...; :~t~_r ~~~f:, t',. ,fJ ',::, I:: 'f.: '~i;~;' ii!;' ~ ~L,~,.'!;" l~';rrlt:~~ " , {r,;,: \, .~' .. ..:t~:' ;.t"!~1':;"!~f,:'.:(:' : .,:..\:.~,~II~:":~~J~ ":;1 .;: .~ -g .~ .. ,. ". )i'ili.i,:.i.,4. ,_.:~'; ,-t',i '",S,:,: .~,~ ". _;.;:..; ~ r:., ~"';,l""'.'.r-""". ~t""~. ~'-~':~ ~~,,:~:'''l 't; ,I ,I.!. ' ~!:: ~) :.~ ,:';J"'ji'i1-,t, ~t~ C' I ;"~ l' ", .- ~ '" ~,I , ~:;-t.l':;:"~'itt ~, .: ~l'.;o':-- :,. '~ 1 }. ' .' , ..:.....~~:;~: . 1', " ~ "M': '~r::~ It "... .r.}:l.i! r:..,',. ~' , I, ",M . ':~.. '. ~ .' '~i ~: ,,;. \.: ~;.I'.:;-~. ~{ . ~l"';;:-- ii il in . , , ,1. , . . .:li" '.;\ .t ~,r~,' k ..11"'~~., , ~'! j .;: l\.'~~ "." _1.:.1l": 'I ~j " .. " " . f,j ., , ;: lJ t ~~5- ~~'~W?~~ l ;' ,- i;, :~?i',:~ ~. ~, " '-' 'J " Received By , tj Check Number Batch Number " Page '1 of.1 ( of Springfield Official Receipt Development Services Department Public Works Department Date: 10/12/2009 Item Total: Authorization Number How Received 6233 In Person Payment Total: Date Received: OCT 1 2 2009 Original Submittal 1 :26:02PM Amount Due 2.677.00 133.85 $2,810,85 Amount Paid $2.810.85 $2,810,85 10112/2009