HomeMy WebLinkAboutRECIEPTS - 07-000392 - Green Field Family Medicine - SignREX R(; City of Rexburg
Department of Community Development
+Receipt Number: 08-0047
19 E Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 / Fax (208) 359-3024
Recelpt Date: 01/2312008 Cashier: ELAINEM Payer/Payee Name: HARDYSCOTT
Perm it #
0700392
Parcel Fee Description
RPRXBCA02C Refund for a Sign Deposit
Previous Payment History
[Receipt# Receipt Date Fee Description
07-0491 08/23/2007 Sign Deposit
07-0491 08/23/2007 Sign Permit
Payment Check Payment
Method Number Amount
CHECK 13719 -$ 75.00
Total-$75.00
Original Fee Amount
Amount Paid
-$75.00-$75.00
Total:-$75.00
Amount Paid _
Permit #
$75.00
0700392
$25.00
0700392
Fee
Balance
$0.00
genpmtrreceipls Page 1 of 1
CLAIM FORM
VENDOR # II
NAME -L� , d',, ADDRESS ,0535 E L I'A/
CITY, STATE, ZIP jLx6(.(-!4' LI UU
0� 00
CI1*Af OF
REXB U
AMERICA'S FAMILY COMMUNITY
DATE 161--' I q JG 1
FED ID or SS#
TELEPHONE
AMOUNT t
r/r Ov
CLAIMANT OR HIS AGENT SIGN HERE
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�. REXBURGG City of Rexburg w4w � Receipt Number. 07-0491
Department of Community Development
MEN
19 E Main St. / Rexburg, D. 83440
Phone (208) 359-3020 / Fax (208) 359-3024
Receipt Date: 08/23/2007 Cashier: EMILYA -
Permit#
Parcel
Fee Description
0700392
0700392
RPRXBCA02C
RPRXBCA02C
Sign Deposit
Sign Permit
Payer/Payee Name: HARDYSCOTT
Previous Payment History
Receipt # Receipt Date Fee Description
Payment Check Paymen
Method Number Amoun
CHECK 1056 $ 100.00
Original Fee
Amount
$75.00
$25.00
Total:
Amount
Paid
$75.00
$25.00
$100.00
Fee
Balance
$0.00
$0.00
genpr*receipts Page 1 of 1