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Receipt PLANNER 2/24/2010
.~ 225 Fifth"S tnet Springfiel<l, Oregon 97477 541-726-3759Phone ... -".' . 'S"lA..62-00'l -oOC2.-1 City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000166 Date: 02/24/2010 11:11:23AM Payments: Type of Payril{~nt Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due ],250.00 $1,250.00 Job/Journal N..mler Description Miscellaneous Deposit - 1,250.0000@$1.0000 Amount Paid Check GEOFFREY COSSEN emm 1102 In Person Payment Total: $1,250.00 $1,250.00 ,), r: "j .: ,.I (1 ..,,~ J (..", LJi ,,~ u~ C./ ' I I [- I ! c/ U1 .,'.~~) L-7 ~, ! ! ,'j \.J." ./ c ,.' - ). ". ,./ / /7 I . I ',. I' / r, -(./ I --..-:J . , . 1/1 ri\U j / (i , I _";//e1 t/" ...'1...... ~ c 1 ret ~- I , ,- rr } 0'10" CJ (011/\(/' I ~- . /'/1 (; I (j ./." ( I B D 5 2.10 H, $f., ~'" ?" ~ t...'f J.k.J ~ 80'5 2f., +J- S;/-. a.-.J 21,,),2 G51-, 'i ~< .,.-,., GEOF.Y;r~CB'ssEN~?G;':f ',' ELIZABETH, ACOSSEt..m~,;\; i" -1.4~ E: 50~H AV~ '~\ " ,~"':~,-r~'~':,:,~ " EUGENE,' OR 97405 w ' NICE, REMA~KA8LVNI[E7' '2(:,c:;Z :.;. , ?f.6LI &f,t H.~.nd CIa,,~. .!O ~ ::,;". :~~{~' ( .~ '",1- s