HomeMy WebLinkAboutRECEIPT & PIC - 07-00093 - American National Insurance - SignJ
city OF
RE)(BLTIkG
De partm e nt Of Com m u n ity De vein. en
19 E. Main St. l Rexburg, !D. 83440
Phone (208) 359-3020 1 Fax (2,08) 359-3022
Receipt Date: 03/08/2007
-Permit #
00093
00093
Receipt #
IPayment
Method
CHECK
genpmtrreceipts
P r f
@ AL - L
@lgoo
Cashier: EMILYA
Receipt Number: 07-0123
Payer/Payee Nam STOLWORTHy CHFUS
Fee Description Original Fee
Sig n De pos it $75.00
Sign P r it
5.00
Total
Previous PaYment History
Re rpt Date Fee Description
m-oun ai
Check
Paym
Num be r
NIA J
$100.00
Total $100.00
Amount
Paid
Permit #
Fey
8ala17C@
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