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HomeMy WebLinkAboutPermit Electrical 2003-9-23 ,','-',.. i':~225FIF'fH,STREET .,.". ~> i,~~j;~m) ~;,~:,.,g ;'': ;;~;,;f EL~CALPERMIT APPLICATION,...., :t'1~~ ~~: SPRl)'lGFg;;LD, OREGON 97'\77 ~?~~ Ne ~ ',';f~[f;';~:; ,c';~;:~~.mr~f;'-"'~~1 Ii;; 'ii;;;';", ~INSP~c:r~Ol':(REQ~f\,;'.72(j,;37,69' r;' ";,"W i.",PtxJoh l1~~ber';~' W~\i:1'a'iJ~tl!'~;;i;?l!;; ,,~;,;:~t~9lFI~f~~~2~n:9;1 \;-:1.> ~ } i" ~KS9~k~.~ ~~'~'~~~Pf~i~f~~J~~;~[1:)i~\;'~l~l~~1{: )f;';~\,~,ft,~~ ~~,~ 1 ~CATI, Chi ,0, F -INSTM-tr" ~i1:lTI~HON ~,., ~1~~(; t41,:b~,": 3'C:,t' f~:'T'~\:,'j:,j,';~,j"ith1'~,:B:t,.~:rfJ.~,ts:,;":::,/j,,,''.{ff,":",(:,~,~;!;,::;.;;,.-;:"".:i(-:~;i:i,\ ',,(f,':;,<~,'~,~:' '~,:.~f~v, ;~:l. . ~/\ 'Ct" tJ"'i ,(JP :, .-.;(.lita.l ~{ ~~~'Fiei,:rR~~idcnti:~l~s~i~~i~;J';~:::jli:\~fE?":'~:',:;:~_b~~~":~<'!'~1'(~,;'d;:il:/:~;~~:1i~ Mult.i-Family per dwelling unit. '~~\, Service Included: ""~:J";;' Items Cost SutiJ':'!- ..y:,~~:, L $106,00 \t!o.()O ",;"ciJ .J.a $ 19,00 \l~t L~~R~C.neTION , ....l.l.l.OL::)'\'.~ \\~ , Permits are rion-tm crclble an expire if work is not'started within 180 days of issuance 'Irif work is suspended for 180 days,""1: t~;;i~i:~ :le:t:::~~a~:f~;;2;ON ~:fR"~ ,'n:jil; t:l~;;~:;, 1'(9 Address ,~r('~t, UO~ 'k:;, '6~ ,'-,~:l\1i" ,-'\(<01," ",,,()~ .!i.JJA!,\i':;>~;f'-'1 "~'"J.,XtI''' I- f\ C' .~,'l:t\',,,,,_ \ ~," 'cHp' h 0. ", It 'I' 'U\").:~,;r;)"II'V'~"'f"~T one -t'o;;.,;;, .' .~'~~'~:i!;""~> ~~;=,:r~ -~~~. . , ,~'l\.!\1!.,,,,, ,'"^c,.' , "".I")'\'li)' Supervis6rl~ic~ii.se';N\iih~er :,)'~<;1 . Ke){;o,'~:,~ k~':.'iJ:iy.'}.~: ,~~;,~})-~.~ , , fl~~~';"!i'I}'i,~Ji';:,,;<I#<\'~;t~'G~ ; Exp~ratl{))~ Qaw,:","I:lY';,;>>":'iK,?~:;\'r.,'::~,l~V;",,:. ,f; ~r;:~"1.t,~~,:,'~~~I,'; ;~~ji~~;,~j~~~~~WIN"~;,:i.;. . ~~" ;"'~1": i~~"".''''~-''~''''' ';~'~',1r."l.$ .. 'ConstrContr.iNumber"", . .._,.""..,...,~._.,-.,...., .-. .....'-".1.,,' ....'i"."-. -;;Lli:.-"~J '...-....".'t,,"..>".-.ioi::Si ~"'. "-',{~::,q;'l'i~~b""';:~;;:'~':';fl:ih'"j ,J'c. ..,~;,;z; : '"Expiration Date b ~{n'"" ,o:(~, ~ '-'~~~~;,~~ '".; .. .',' Owncrs Signature: .~ " " 1000 sq,[t. or less Each additional 500 sq, ft or portion thereof Eaclt Manui'd Home or 4" B s'm:~:::::~ j'h~;,' '""":~ Installation, Alterations' ''''is':;'',,,':');,, '}T22,;:;' Relocation: ::~t,i;~:~f~:1~~,,~,c ;~~t~ ,-,.,fA:).( '3:'$ 6'" 00--' ~-~'", _::.\ ;;";~.:'tt:f1~,%~ ~:~;;~; ;s~k,:'t}i~1;f~"';i~{ - ..,~;;: OO~aiiipsor ~is -,: ',;->,~"-i!?_,,;q{'-;'t'.,,' ''', qJ;a,!I1pi;t~,409,~I]}p Ov,<;r3:0},;t2,[~00,illh.p Over 600 amps oiIO vo ts liB II aboye 4~~~t~~r~- ""c. ~! #;.fy i';- ,"';(,,,,~ ~: '~._- D. Branch Circuits o,,:{:;~\<r , ,'..'c'._.." ""'.iA;.",_ Ne\\;'Alteiation or Extension Per Pan~] " O~~Elr~~~[;f' ~3it~'~~ii~~;r~9?~;.~tt!; Each Additional Circuit or with Service' , . ",'" ,.,,: or Feeder Permit "":; "'$ 3 ,OO;~:, , ~-.",. " ' ' ". -. '" 00 ., ~ ;( .,:, E. l\liscell'1I1eous (Service/feeder not inc\uu-ed) -Each installation ,:" ' ' , Pump or irrigation'" Sign/Outline Lighting' Limited Euergy/Res , Limited Energy/Comm ,f' ;;. ,., $50,00 $50.00 $25,00 $45,00 I\linimum Elcctric Permit Inspection Fcc is S~5.00 + SurchargcoS t~:; .~\ c;)pl) 4. SUBTOTAL OF ABOVE 70/0 State Surcharge 8% Administrative Fce TOTAL ". .', . .~"..~ WiIlamalane t, j Park & Recreation District "W SYSTEM DEVELOPMENT CHARGE . WORKSHEET NAME: ~-\u.Re ~'\\we<) ADDRESS: ~~t) " Job. No, ~J]fiQaJ~.DQCr1\ PHONE: -M. . r1JJJJ STATE: D{l.zIP: ~Ol LOCATION OF PROPOSED B ILOING SITE: Street Address: ~?J," , U \ ' Plat Name:~\\'~(L~,",Tax Lot Number: \\rrf) 1 ~ 'DEVELOPMENT TYPE (Check appropriate dwelling(s). SOC calculations and dwemrigt , )'l)e definitions are on t~e bacl<.) A. SiwIA-F~milv OpfR~hAd. \ Single Family home NO. OF UNITS . \ Manufactured home not in a park' ' X $1,000 perunit=$ \CfD~O B. Sin'alfl-FRmilv_Attachfld' NO.,OF UNITS . X $924 per unit ,-' $ C. Multi-Familv Aoartment NO. OF UNITS X .$692 per unit = $ l? Maol.!1ilcfurArl HomA PRrk NO. OF UNITS WILLAMALANE SDC X $699 per unlt = $ $ \fl1'\. aD $ r;( , $ .JDIj).00 2. SDC CREDIT (ll appficable) SOG-payer must lumlsh prool 01 WillamaJane Credit approval. See sac Credit Worksheet. 3; TOTAL WILLAMALANE NET SDC ASSESSED 01 SDC reduced lor Credit) ~(1\ Developmenl Se~c s Department City of Springfield . \ L- I 'l..1\- I 0"'7 Date . . I rroJ.2CX1~/rti o )r\J IS, ,\ 1\~_ J~\l'o...\ m IC]1fJ ..90 ?o/rTJ1i c7 9~J}h.71 (:J.f\!J~ ~a9 \.Jll(tJ j}ryfj-4~i9 &j& /, 0rrJI/ CW-..-S'eQr j !If;~ n.9}/)~vLq 00 1\'\'11 .UvVI J I , ! ua /Y'''t''']) oj_A}.}, '\,.01 ! , '-- , 6() (Y'C\ ). .......j0 J, -~ , I . <\i (r\~j;(, , Jov~r.lP \-~I5JLjI..f\'" \J ......ljJ/ J I "'~ Application For a Second Driveway or Overwidth Driveway Applicant (Property Owner!: ~ 13 ~.a..-- Date: ~Jt>_.~ Address of Property Owner: 111.. ~~~ 1 Lj- ~5 .. ' Address of Property for Driveway Permit: 8 r A R~~)\J IV-\. , f-"~ t t," (,,[)'~:.:r I ~ Building Permit N~~~"i. '0 ,c) .. () I 0 Second driveway ~verwidth ApplicatIon Fee: $35.00 I,' I Received By: fl :;, , / (Max, 30') 1D ~. ))C.e.t!- w / Receipt No: dt.f Please sketch the proposed driveway, Include the foilowing applicable items: house or building, proposed driveway, and street names. Include dimensions and measurements to property lines, road intersections and bordering driveways. (See attachment for an example), Ii 1111!H.i I'TTo.n.l-i-!- \-i,I.[I",li\,'r-jq,Tl-:t,..,i, i ' ii', .f.i..j-j",,'J:.1" ItTi-'" -- -1- - T -:t::: ::'_ L .."... j:::r..L, _, 1.._ _, '", .::h,- -r, - - '1- '-j]::rf-+:t T~ --'IITr:' ,T"+- , I I ,_**_,...L II _ITJ, T J+i, I '-_ , ....l.-U : i u. '--t--....L, II i I I _+- \-.-+-., +,' .. , 'I' I.... ....+ .. -.t . ..- +-1-"+ -- -FI-L~.L+ ,., T -++-H+ .- - 1 + -.1 I, :: -i-i-::Li," . - ~.._l.,1 - -.-- I I I -- II L '_1..1-_ _,_L___L,___ I I' Ii' ! i ,'!:-1- I I I! I.. I ..l. .!-.j=D r: i I! 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' '-1- -I' -too 1 I', jl ,i I' , I - T -, t,- -'--T I L. -- I -.. -4---" I ' I -..illl I....L+ " - i,j -, II, + -i+1 T -.... ..j..- '-'!-+t"- .-:t'-r ...1..., -t.. -fool. -I" ~'fTt+.!-lTt l' 1-,..I+J+r, l1- --j- ...1-1-..\, 1 I I I - -" - - +t-- --1" ....... - no n__ I I I ; 1'--- I, I. I I I' -, ,I I' --L ,I - -. -- -1-.. --1..., - -L.L - --- ..L I Iii I l..j.~_J_....u I I i I I I I 1- -tooL;-+' 'H ',I I : i I-!--' L '," I I ii,' I I I : ' i , I i IT, I : i....LL II' J.~~i'i 1"1' H.I L~ "111tL.j+.:~j'jJii~ll ILjJ I, I++I! H l'lilll! c jJ i I T, _, ' i i I II, ,_ _I T I, I + +1 , I I : _..J. ill J I i II ' i I I. 1 I i I I '.....1 I j II i H...'+--l I I i I-+-.j-.-I-+-Li_+--_~--,.-+I--,..L-:t' l-. I I' -+-...i ! II~..~- 'r++rJ.-'.....I+.++. "'-..-...+.I.-r-t..++--.i-!-....j-.--..i..+r-l+t--I..".. ,-t..,,-\-. 11-+,+i-t-H-TI1-+t-, L ++..I-..L.., _1- ",I, I I I 'i', I I I -t-'IU-" _','1... -Li,""'" i I, ! 1..[_1--1-1- --11.-J....1 i I I I' 1 I I ",-l- If i I I j '--1: I t H rt-1 ! I " II 1 ," 'I I I I I I , '~' i I I '1 r III, i:~",~"~"q i~r-CI!-' "',"~' 1-:;. -I ,.,:I:.::~::,TI..I.I.."I'.I' I:: -~.I ..+! 1-1111 j... f. +~ I I1I1 h"'''TrtT++r-, " -ri+-i--- :, I ,h--.-"'T I Iii I --1-- '-, 'I I L.'i-'..J I Lj-,--r-rt~! : u I i'-,-h, II I, I I.'~ -i:.._LL_i....L1 :; I' 'I I _, ,I 1-i-..LJ I I I I ,I 1 I '. ill I I I I ' .; I j I I ill 1 i-.rl=r::'I'...I.i-'.'I--t.~_+Li-' 1-...1-1.. i I l-l-f.-Fl---"--'----!'-1+.,.L_-"ITT :1 ,__1.++_\..,..., .,.+- I I ' : I I, I ,..+-....-1-.., rl I, , I "=F-.."...I-...,---~+TI....-, I W" -""1-- +--1- ' I I I I I "11- -. -,-'-!--' ' ,,---'--H- -- -+-.... - -1....,_....,.... ,i" 11'-..1..++- -- , I I I I i'l ' I! I '....L" ,! I I , I , , I I I _ _I- _ I + ' , I ! I I ,'i ILlllJJ'1 I !ji...Ji 11-1 I II=-ll-UjJ~UJ I I iL~UJ. ,1 i I i I i i:U ~I ! II! )_ All applications outside the city limits of Springfield that are within the Urban Growth Boundary require a Lane County Permit. Note: The City of Springfield will not grant a second driveway permit on an Arterial or Colledor Street. Over width driveways up to 30ft. may be approved by the transportation planning engineer provided that safety and traffic guidelines are met. Driveways over 30' In width require a Land Use Decision and are not handled on this appllcation,(Contact the Planning Depl) The application fee Is not refundable, . . ,. .' " 1, Property type: Single Family Dwelling ~Plex _ Other 2. _The proposed driveway will take access from which street? 1{~ ~ W ~ 3, The distance from the edge of the driveway to the nearest comer (measured to the curb return) Is 2.2.l:; feet. 4. The second driveway will give access to: Garage_ Carport _ Side yard_ Other 'R, V, Y ~ Sf> ~ .. ~ - 5. The distance from the property line to the garage, carport, fence, wall or other (where the vehicle is to be pari<ed) is '2/) feet. 6._WiII the proposed parking I storage area create a vision obstruction to adjacent property driveways or to any vehicular movement on a public street? (See vision clearance attachment) 1--1,R'j A permit will require that the epplicant meet city andlor county standards, speclficetions, end codes, Generelly this means that the area behind the sidewalk shall be surfaced to the property line and also a minimum of 18 feet behind the property line. When this application is approved by the City, the applicant must obtain a curbcutldriveway permit from the Public Works Depart- ment, Engineering Division within 60 days or reapply, Property owner' sslgneture: h ~..>V~ Dete: q/~+(() ~ - 7- Approved by: ~ W/~__ _. (Traffic DMslon) Date: , / Zq /0 '5 , Staff Comments: l' rnNt':. WAl, K " .. -..."J '- ..l rt , I I I I 1.:)'10' -\- I , I I I I I I I I I I t I I I I I I I I I ,+. ~ I I I I 9 I ~ _-'.-_ L____ '- -- - - -"~ -?-~~ - -- . , Q I!' elL! _ w . ':::s lJ) r- 0.: ~~ PATIO ~ K21 -'11- ,., II , I I I I Ib'-O. I I t I . -l- : I I I I I I I I ~ I I I I I RV PAAK'N61 . . I I I It~ \"\18 E. ~. .;.~:~: :-Y:".r: I,.~~~~. 'VJ.~)'i.~, ;!;:~~'"". :::~,.. .f f' :.1\ ~".. ,:i.. - = =-.J.' _ ~~~ ~~~N = = = . . = - 'F '- -;6'-0:1 ......., 'r f ~ I I ~ ~ ~--- ----- t- ---- () K -" - - - C'I GONG, >'lAL_ - - - 5" _ _ _ _ _ - <!! {Il- - - - RETE- - -' -~ ~~'( ~ - 6ARA6E "i I ---l......l.. 5 &1'26'33' E _ ._ QS.oo' 53 / 13 I "JD :<: . , ~, . . CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: COM2003-00971 NAME OR COMPANY: Future B INC LOCATION: 818 River Knoll Way TAX LOT NUMBER: 17032343 Tax Lot 11000 DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE NEW DWELLING UNITS 1 BUILDING SIZE (SF: 0 LOT SIZE (SF): I. STORM DRAINM1F 10487 J- en W 18 0: w f- en o ~ DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F. x I COST PER S.F, CHARGE I I 4476,00 I $0.290 I = I $1.298,04 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S,F, I x I COST PER S.F, I x r DISCOUNT RATE 'I I DISCOUNT I 0,00 I $0,290 I I 50% = I $0,00 ITEM I TOTAL - STORM DRAINAGE SDC SI,298,04 , 2, SANITARY SEWER _ CITY SI,298.04 11070 I A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I COST PER DFU I 32 I I $22.64 B, IMPROVEMENT COST: I NUMBER OF DFU's I x COST PER DFU I 32 I $17,21 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , 3, TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIPRATE I x I NUMBER OF UNITS I I 9,57 I I I B, IMPROVEMENT COST: I ADTTRIPRATE I x I NUMBER OF UNITS I I 9,57 I' I ITEM 3 TOTAL - TRANSPORT A nON SDC S724.48 11091 5550.72 1092 SI,275.20 x I COST PER TRIP x INEW TRIP F ACTORI I $17,23 I 1.00 I x I COST PER TRIP x INEWTRIPFACTORI I $76.oJ I 1.00 I = , $892.31 SI64,89 11093 I S727.42 11094 4, SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I I $332.86 B. IMPROVEMENT COST: INUMBER 01 F FEU's I x ICOST PER FEU I $34,83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD< = $332.86 1054 DATE = $34,83 11055 SO.OO 11054 SIO.OO 1056 = , $377.69 = , $3,843,24 J CHARGE $192,16 , 142.68 1079 I $49.48 [1078 TOTAL SDC CHARGES =1 $4,035.40 I _L SUBTOTAL (ADD ITEMS 1,2, 3, & 4) 5 ADMINISTRATIVE FEE: I SUBTOTAL I x I ADM, FEE RATE 1= i $3,843.24 I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Matt Stouder I, PREPARED BY 9/29/2003 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT - DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS. CALCUlATE ONLY TIlE NET ADDITIONAL FIXTURES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 2 0 3 = 6 I I DRINKING FOUNTAIN 0 0 1 = 0 1 I FLOOR DRAIN 0 0 3 = 0 I IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 .I IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRY TUB 1 0 2 = 2 ICLOTHESW ASHER / MOP SINK 1 0 3 = 3 .CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER. SINGLE STALL 2 0 2 = 4 ISHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0 I I SINK: COMMERCiALiRESIDENTIAL KITCHEN 1 0 3 = 3 I SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASINIDOUBLELAVATORY 2 0 2 = 4 ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 1 0 1 = 1 IURlNAL. STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 32 .EDU (Equivalent Dwelling Unit) is a discharge eQuivalent to a sin!Ve family dwellinJ!: unit (20 DFU's) set at 167 nllons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 CREDITRATE/$I,OOO I ASSESSED VALUE I I I 1 I I I I I I I $4.92 $4,92 $4,83 $4,77 $4.64 $4.47 $4.30 $4.09 $3,78 $3.41 $2,98 $2,52 $2,06 $1.64 $1.45 $UI $1.13 $0,97 $0,82 $0,63 $0.41 $0.22 $0.04 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enler I for Yes, 2 for No) BASE YEAR o o 1998 CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATI~- $0,00 x $0,41 = , $0,00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/1000 CREDIT RATE $0,00 x $0,41 o TOTAL MWMC CREDIT = $0,00 ,..' 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0097I COM2003-0097I COM2003-0097I COM2003-00971 COM2003-00971 COM2003-00971 COM2003-0097I COM2003-0097I COM2003-00971 COM2003-0097I COM2003-00971 COM2003-0097I COM2003-0097I COM2003-0097I COM2003-0097I COM2003-00971 COM2003-00971 COM2003-00971 COM2003-00971 COM2003-0097I COM2003-0097I COM2003-0097I COM2003-0097I COM2003-0097I COM2003-0097I COM2003-0097I COM2003-0097I COM2003-00971 COM2003-00971 C0M2003-0097I COM2003-0097I COM2003-0097I Payments: Type of Payment CreditCard ~,~;~~.~~"" . ~ Receipt #: 1200200000000002663 Description Sidewalk Permit Curbcut Permit PW Mult 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 Curbcut - Overwidth Appl Plan Review - Planning Building Permit 3 Baths One & Two Family Furnace - up to 100,000 btu Boiler/Comp 3-15 HP Vent Fan Appliance Vent Dryer Vent Gas Outlets 1-4 Gas Fireplace -Mechanical Issuance Fee- Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Backflow Device + 7% State Surcharge + 10% Administrative Fee Plan Review/Residential Hourly Received By Check Number Batch Number Authorization Number Paid By JERRY BRAUNBERGER Jmp 000259 011560 City of Springfield' Official Receipt Development Services Department Public Works Department Date: 12/24/2003 1:37:48PM Amount Paid Item Total: 75.00 75.00 (30.00) 1,298,04 724.48 550,72 164,89 727.42 332,86 34,83 10,00 142,68 49.48 35.00 59,00 1,173.40 306,00 12,00 22,00 30,00 6,00 6,00 4,00 15,00 10,00 106.00 114.00 50.00 14.00 130.09 185.84 45.00 $6,478.73 ' . . How Received In Person Payment Total: Amount Paid $6,478,73 $6,478.73