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Receipt PLANNER 8/12/2011
. . SP::N~.G=EL~ .~* !f;,1J't OREGON www.ci.springfield.or.us TRANSACTION RECEIPT TYP111-00019 1005 MAIN 5T CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 permitcenler@cLspringfield.or.us L~~XMENi'r,yp~~" Check 186276 . PAYOR'" cAiHiE_~:.TJONES _~ RECORD NO: TYP111-00019 ., .~..'.;j.l:.'.' 'S"::.:/- - n'ACCClUNij;()DEI;';, ' ~ " 100-00000-425605 100.00000.425002 -----_.- TOTAL DUE: " " COtv;MEN:rJ''',::c'_''':, " _ Check #186276 Springfield Utility Board PO BOX 300 Springfield OR 97477 (Check total was $1,491.10 . $188.05 was applied to TYP111-00018) DATE: 08/12/2011 ., 'AMoUN!f1DUE,:-c"':::"::J 62.05 1,241.00 1,303.05 .AMOUNTpAlp+jf,< ,,,, .:.:.:...J RECEIPT NO: 378277 !DE5CRIP.JTION,,'-;;T -. -, 4 j'~~: . 5% Technology Fee Site Plan Revi~,,^: Modifications ~ Minor - City 1,303.05 TOTAL PAID: 1,303.05 , ,. , I,' I Date Received: AUG 1 2 2011 Original Submittal