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Home My WebLink AboutPermit Miscellaneous 2004-9-21 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2004-00387 COM2004-00387 COM2004-00387 COM2004-00387 COM2004-00387 COM2004-00387 COM2004.00387 Payments: Type of Payment Check RECEIPT #: .r~"""ClPl"!.l), ........- .1.... ~, ~..1 City of Springfield Official Receipt tJtJopment Services Department - Public Works Department 2200400000000001182 Date: 09/21/2004 2:31:19PM Description Fixture Minimum/Adjustment Plumbing + 7% State Surcharge + 10% Administrative Fee Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Stonn Admin Paid By EVERGREEN LAND TITLE CO. Q1'1 F~{W~ PL 9/21/2004 Amount Due 14.00 31.00 3.15 4.50 67.92 51.63 5.97 $178.17 Item Total: Check Number Authorization Received By Batch Number Number How Received jmp 0026732 In Person Amount Paid $178.17 Payment Total: $178.17 Page I of I