HomeMy WebLinkAboutPermit Building 2007-7-23
Status
Iss u ed
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2007-00854
ISSUED: 07/23/2007
APPLIED: 06/12/2007
EXPIRES: 01123/2008
VALUE: $ 395,358.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6099 Graystone Lp
ASSESSOR'S PARCEL NO.: 1702343303200
Springfield
TYPE OF WORK: Single Family Residence
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Single family residence - Mt Gate PH 4 lot 29
Owner: HOUSEGUARD
Address: 2295 COBURG RD
EUGENE OR 97401
Phone Number: 541-2559
I CONTRACTOR INJFORMA TION I
Contractor Type Contractor License Expiration Date Phone
General HOUSEGUARD LLC 176411 OS/25/2011 541-514-2559
Electrical STEVE HAUCK 147618 04/09/2009 541-221-2665
Mechanical SUNSET HEATING & AIR INC 541-988-3181
Plumbing ROUNDS PLUMBING 141736 01109/2008 541- 726-5448
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
3
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
2
30.00
Heat Pump
Gas
Gas
Path 1
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
14,470
2,312
1,642
1
R-3
VB
500
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback: 12.00 Overlay Dist: Hillside Total: 2
Side 1 Setback: 15.00 # Street Trees Rqd: 7 Handicapped:
Side 2 Setback: 35.00 . Paved Drive Rqd: Yes Compact:
RearyM~~~ACk: 67.00 % of Lot Coverag~TTENT'ON. cfr7.80
Solar>Se. b':t~1eIZ: 45.00 f II . regon faw requires you to
I f1 S Ot"'~r . .. 0 ow I/'ules adooted bv th~ nrl)~,," II.m~.
sUbJ(JIsTlltOi.uetfJgfiJ.LL EXPIRE I PUBLIC IMPROVEIVi~h'J{f~i:.}~~ ~~1n~~1 cih~se rules are set forth
C;O/(IN!f~" NDtR TH IF THE ~ ~ . - t rough OAR 952-001-
Str~~~ ynj~o e.iff~~R IS AB IS P~'Nt~r,.~R<< calilngO~h~:~~S of the rules bYCurbside 5'
Storm Sewer Q-<1:\'iurm'10D ANDONED E IVriTs number for ffiWOl:B~W~f~.tel~PhOflQ) Storm Sewer
Special Instruction: Stormwater to lJJ~irected to on-site stormwater sf(gbrR~'if,q800~3~~23~~;~catlon
Notes: For this parcel in Mt. Gate West, it is the recommendation to the Building Division, by the City Engineer: "that no
connections shall be made to sanitary or storm H20 systems, until the subdivision is accepted by City Council".
Pa2e 1 of 5
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
AC - Residential
V Wood Frame
Gara2e
A.C. - Residen
Dwellin2s
Gara2e
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
3 Baths One & Two Family
Addressing Assignment
Appliance Vent
Building Permit
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Fireplace (Listed)
Furnace - up to 100,000 btu
Gas Outlets 1-4
Heat Pump
Plan Review Major - Planning
Plan ReviewIResidential Hourly
PW Disc - 2nd Permit
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Sidewalk Permit
Storm Drainage Impervious Area
Storm Sewer Each Addtll00'
Temp Power 200 amps or less
Vent FaD
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
$4.00
$103.00
$27.00
Square Footage
or Bid Amount
3,594.00
3,594.00
400.00
Total Value of Project
~
Amount Paid
$992.97
$10.00
$219.94
$116.38
$159.97
$306.00
$31.00
$6.00
$1,527.65
$80.00
$6.00
$9.00
$199.70
$15.00
$12.00
$4.00
$12.00
$198.00
$292.50
$-30.00
$752.04
$989.01
$10.00
$961.52
$91.61
$194.67
$64.53
$836.32
$189.58
$80.00
$1,353.88
$28.00
$50.00
$24.00
Date Paid
6/12/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
7/23/07
Pa2e 2 of5
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00854
ISSUED: 07/23/2007
APPLIED: 06/12/2007
EXPIRES: 01/23/2008
VALUE: $ 395,358.00
Value
Date Calculated
$14,376.00
$370,182.00
$10,800.00
$395,358.00
06/12/2007
06/12/2007
06/12/2007
Receipt Number
3200700000000000390
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
1200700000000000952
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT.NO: COM2007-00854
ISSUED: 07/23/2007
APPLIED: 06/12/2007
EXPIRES: 01/23/2008
VALUE: $ 395,358.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Willamalane Single Family
$2,303.00
7/23/07
Total Amount Paid
$12,096.27
I Plan Reviews I
Initial Review
Plannin2 Review
OK
APP
06/14/2007
06/14/2007
06/14/2007
06/22/2007
NJM
TAJ
Public Works Review
06/14/2007
06/19/2007
APP
BRC
Structural Review
06/14/2007
07/23/2007
APP
DLM
1200700000000000952
7 street trees are required: 3 along
the front property line and 4 on the
street side line. Must choose from
the list of Native Trees in hillside
Development attached to the street
tree handout.
For this parcel in Mt. Gate West, it
is the recommendation to the
Building Division, by the City
Engineer: "that no connections shall
be made to sanitary or storm H20
systems, until the subdivision is
accepted by City Council".
Stormwater to be directed to
stormwater stub provided on lot. Be
Met w/ contractor to discuss
discrepancies between engineering
and plans. Engineer will fax revised
engineering 7/5/07dlm. Finshed
plan review, not approved. Truss.
drawings are not for this building.
Called contractor requesting correct
truss dwgs. 7/6/07dlm. Received
revised documents 7/10/07dlm.
Started re-review, documents still do
not agree. Met w/ contractor to
review discrepencies 7/16/07dlm.
Received new drawings and
engineering, truss dwgs unchanged.
7/17/07dlm.
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
~e(]uiredJnsnections I
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Pa2e 3 of 5
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-00854
ISSUED: 07/23/2007
APPLIED: 06/12/2007
EXPIRES: 01123/2008
VALUE: $ 395,358.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Final Building: After all required inspections have been requested and approved and the building is complete.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Underfloor Mechanical. Prior to insulation or decking and including required testing.
Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
Pa2e 4 of 5
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-00854
ISSUED: 07/23/2007
APPLIED: 06/12/2007
EXPIRES: 01123/2008
VALUE: $ 395,358.00
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I
further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, t permit ca . located at the front of the property, and the approved set of plans will remain on the site at all
ti ding co str n.
.-
Owner or Contractors Signature
Pa2e 5 of 5
7r-)..~ --0'(
Date
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
BATHTUB 2 0 3 = 6
DRINKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
/LAUNDRY TUB 0 0 2 = 0
ICLOTHESW ASHER / MOP SINK 1 0 3 I = 3
I CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 I = 0
IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 I = 0
RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 I = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 I = 3
SHOWER, SINGLE STALL 3 0 2 I = 6
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 I = 0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 I = 3
SINK: COMMERCIAL BAR 0 0 2 I = 0
ISINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 I = 2
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 3 0 1 I = 3
IURINAL, STALL! WALL 0 0 5 I = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 I = 0
ITOILET, PRIVATE INSTALLATION 4 0 3 I = 12
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 38
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single fami\L~welling unit (20 DFU's) set at ]67 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE] 979
]979
]980
]98]
]982
]983
]984
]985
1986
1987
]988
1989
1990
199]
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$l,OOO
ASSESSED VALUE
$5.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4.63
$4.40
$4.07
$3,67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
IS LAND ELGIBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE /1000 CREDIT RATE
$0.00 x $5.29
= I
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
o
TOTAL MWMC CREDIT
=
$0.00
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: C0M2007-00854
NAME OR COMPANY: House Guard LLC
LOCATION: 6099 Graystone Lp
TAX LOT NUMBER: 17-02,34-33-03200
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
. NEW DWELLING UNITS I BUILDING SIZE (SF: 0 LOT SIZE (SF):
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
IMPERVIOUS. S.F. x COST PER S.F. CHARGE
4034.00 $0.336 = $1.353.88
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
IMPERVIOUS S.F. x COST PER S.F. I x I DISCOUNT RATE I I
0.00 $0.336 I 50% = I
ITEM 1 TOTAL - STORM DRAINAGE SDC '$1,353.88
14470
rJJ
~
Cl
o
u
~
~
t-<
rJJ
.....
Ci
.~
DISCOUNT
$0.00
$1,353.88
1070
-'
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's x
I 38
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 38 \
COST PER DFU
$26.03
$989.01
1091
$19.79
$752.04
1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $1,741.05
3. TRANSPORTATION.
A. REIMBURSEMENT COST:
I ADT TRIP RATE x NUMBER OF UNITS I x I COST PER TRIP I x NEW TRIP FACTOR
I 9.57 1 I I $19.81 I 1.00 , $189.58 1093
B. IMPROVEMENT COST:
I ADT TRIP RATE x I NUMBER OF UNITS I x I COST PER TRIP x I NEW TRIP FACTOR
I 9.57 I 1 I I $87.39 I 1.00 = $836.32 1094
ITEM 3 TOTAL - TRANSPORTATION SDC = I $1,025.90
_.'_'_.r ~.
-.. .-----
4. SANITARY SEWER-MWMC
A. REIMBURSEMENT COST: .
INUMBER OF FEU's x ICOST PER FEU
I 1 I $91.61 = $91.61 1054
B. IMPROVEMENT COST:
NUMBER OF FEU's x ICOST PER FEU
1 I $961.52 = $961.52 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 11054
MWMC ADMINISTRATIVE FEE $10.00 1056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , $1,063.13
-
SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I $5,183.96
. .
5. ADMINISTRATIVE FEE:
SUBTOTAL x I ADM. FEE RATE 1= CHARGE
$5,]83.96 I 5% I $259.20
TOTAL SANITARY ADMINISTRATION FEE: . ] 94.67 11079
, TOTAL TRANSPORTATION ADMINISTRATION FEE: $64.53 I 1078
TOtAL SDC CHARGES =, I
Billy Curtiss 6/15/2007 $5,443.16
PREPARED BY DATE
.....-..-..........-....,,-..........-... ...
,.__._..... ,n... ".""...__.
lJ'IJUAL:'>
DATE
SOURCE
225 FIFTH STREET II SPRINGFIELD, OR 97477 .. PH:(541)726-3753 .. FAX: (541)726-3689
ELECTRIC~~. 'ERMIT AP. 'PLICATION
City Job Number \' '-:7 - ()() gs l{
. - \
Owners Name tl)\W )"IUlCrl LLu
AddressL~ 'D Co bu lYoX - U
City~ JO..oj/J J_ J alJ./PhoneJj), L.J -dS5<1 Pump or irrigation $ 50.00
. v - b Sign/Outline Lighting $ 50.00
OWNER INSTALLATION Limited EnergylResidential $ 25.00
The installation is being made on property I own which Limited Energy/Commercial $ 45.00
is not intended for sale, lease or rent. . Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
ATTENTION: Oregon law requires you to . ~)
Owners Signattm'iow rules adopted by the Oregon Utirh .5 0 . u -
I\lntifit'~tinn r,pntp.L Those rules are set fortl1l% State Surcharge ;;). 50
in OAR 952-001-0010 through OAR 952-001-10% Administrative Fee y , aO
0090. You may obtain copies of the rules by5% Technology Fee oS. cs<=>
Inspection Req{f€~t~n7'2~~3769'nter, (Note:.the ,tele~ho~e TOTAL Jc\ Co ISo
number for the Oregon Utility I'-Jotlflcatlon " \.1:> \ .
. r " ) Shared Dnve(T:)/BUllding FormslElectrical Permit Application 8-06.doc
Center IS 1 800-332 2044 .
50~M.J
LEGAL DESCRIPTION:
\l-D~ :s <.(- 3~ O~2-o-D.
JOB DESCRlPTlON.' 0
SY12-- .j) BrtvP ffi-w12P--
Permits are non-transferable and expire if work is
uot started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor
Address \
~,
Phone
/
City
'"
Supervisor License N~
"tmr.on Da~ / .
NO ~JU.T"~~ ~I~' _ EXPIRE IF HE WORK
TH~rPsii"~I'1tr.'l"un .:rlt1t~ r[nl\.~IS NeT
AUTHQ.RfZED u ~) i v III
C~P.t~~H~6ffit~R IS ABANDONED FOR
t41Y 180 DAY PER,IOD. . .
SIgnature of SuperY1smg ElectrICIan
Date -).-'z. 3 - 0,
3.
A.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50.00
B.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c.
Installation, Alteration or Relocation
200 Amps or less J
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1 000 Volts see "B" above.
D.
$ 50.00
$ 69.00
$100.00
c>t)
(~() .
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E.
225 'Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007 -00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007 -00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
COM2007-00854
Payments:
Type of Payment
Check
cReceintl
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1200700000000000952
Date: 07/23/2007
Description
Fire SF Fee - Residential
Sidewalk Permit
Curb cut Permit
PW Disc - 2nd Permit
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sanitary/Storm Admin
SDC Transpo Admin
Plan Review Major - Planning
Building Permit
Addressing Assignment
Willamalane Single Family
3 Baths One & Two Family
Storm Sewer Each Addtl 100'
Furnace - up to 100,000 btu
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Fireplace (Listed)
~Mechanical Issuance Fee~
Temp Power 200 amps or less
Plan Review/Residential Hourly
Appliance Vent
Heat Pump
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
HOUSEGAURD, LLC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
nJm 1010 In Person
Payment Total:
Page 1 of 1
1 :51 :26PM
Amount Due
199.70
80.00
80.00
(30.00)
1,353.88
989.01
752.04
189.58
836.32
91.61
961.52
10.00
194.67
64.53
198.00
1,527.65
31.00
2,303.00
306.00
28.00
12.00
24.00
9.00
6.00
4.00
15.00
10.00
50.00
292.50
6.00
12.00
116.38
159.97
219.94
$11,103.30
Amount Paid
$11,103.30
$11,103.30
7/23/2007