HomeMy WebLinkAboutBuilding Miscellaneous 2010-8-2
CUSTOMER INFORMATION REQUEST
Development Services/Public Works
225 Fifth Street; Springfield, OR 97477 (541) 726-3753
(3/0. 05
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You will receive a reply by tbe end of the next business day: ~ ~ ~
. date
Name:~~ t't"J . ~)'I7)I//() Company:
Daytime Phone: 9t I - 12 r - [) '79 Ii Cell:
Email:
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Fax:
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BUILDING: New Application: Cd Existing: EJ Other: D
Information requested (please include City CaserPermit #, Address and/or Map & Tax Lot # if applicable):
CoP 1 EC: ~ &P 'Fz..c>D{L ,
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C-L( - 1'-1 'S'I
C.r;- /30 '2-
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Staff responding: , (;?-;; '7l-t T Date: :f/-:J//O Time:
PLANNING: New Application: D Existing: D Other: D
Information requested (Please include Address, Map & Tax Lot #, Journal No, and/or Planner assigned if applicable):
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Staff responding: Date: Time:
PUBLIC WORKSIENGINEERING: New Application: D Existing: D Other: D
Information requested (Please include Address, Map & Tax Lot # and/or any otber pertinent information):
Staff Responding: Date: Time:
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I q,t~f~?~~&~!~*~~~~t~~~~t4Y;,i::~:::'\'i:',\;;~..~~ii~:;;.1 Received by:
Date:
Fees Associated With 8/2/2010
Case #: COM2010-00005 2:02:57PM
225 5TH ST
CITY OF SPRINGFIELD
Trans Revenue Date Calculated Original Amount
Description Code Account Number Calculated By AnlOunt Due
Research Rqst - Technical ]023 224-00000-425602 51712010 D18 51.00 0.00
Copies - Ea Addtl @ 50 Cnts Ea 1041 224-00000-425602 517120]0 D18 15.50 0.00
Copy 6th @ 75 cents 1040 224-00000-425602 51712010 D18 0.75 0.00
Miscellaneous Copy Chgs 1040 224-00000-425602 5/27/20] 0 BAR 36.00 0.00
Research Rqst - Technical ]023 224-00000-425602 5/27/2010 BAR 25.00 0.00
Research Rqst - Non Technical 1023 224-00000-425602 5/27/2010 BAR 17.00 0.00
Miscellaneous Copy Chgs 1040 224-00000-425602 6/30/20 I 0 KLK 12.00 0.00
Copy 6th @ 75 cents ]040 224-00000-425602 8/2/2010 CJC 0.75 0.75
.Research Rqst - Non Technical 1023 224-00000-425602 8/2/20 I 0 CJC 31.00 31.00
'Miscellaneous Copy Chgs ]040 224-00000-425602 8/2/2010 CJC 6.00 6.00
Total Due: $37.75
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Page 1 of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000911
Date: 08/03/2010
1I:53:06AM
Description ;~h_~~'~ 'i[&\'A~\:~; ":-:, ': ~'..
Copy 6th @ 75 cents .ii~~i~, ,":1"
Research Rqst - Non Technicar'..'~,,"'" ", ',',
Miscellaneous Copy Chgs
Job/Journal Number
COM20 I 0-00005
COM2010-00005
COM20 I 0-00005
Payments:
Type of Payment
CreditCard
Paid By
JACK TERRILL
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
0,75
31.00
6,00
$37,75
Amount Paid
cjc
07651 b In Person
Payment Total:
$37,75
$37.75
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8/3/2010