HomeMy WebLinkAboutRECEIPTS - 06-00034 - Birch Plaza - SignCLAIM FORM
VENDOR # II
;Y OF
R.EXBURG
AMEKICA'S FAMILY COMMUNITY
NAME�1PCi �i'�Zii� LLB
ADDRESS
CITY, STATE, ZIP
l
DATETT,j�
FED ID or SS#
TELEPHONE ]0` -"�'l
DESCRIPTION
CODE
AMOUNT
APPROVED
Q�t mik Olsl 000�52—
CLAIMANT O1 .AS AGENT SIGN HERE
- e RE BURG City of Rexburg *MO NONFIr
Receipt Number OG0032
Department of Community Dove lopm ent
19 E Main St. / Rexburg, D. 83440
Phone (208) 359-3020 / Fax (208) 359-3022
ceiptDate: 01/18/2006 Cashier:JANELLH Payer/Payee Name: STONEGATEREXBURG LLC ETAL
Original Fee
Amount
Fee
Permit#
Fee Description
Amount
Paid
Balance
0600034
Sign Deposit
$75.00
$75.00
$0.00
0600034
Sign Permit
$25.00
$25.00
$0.00
Total:
$100.00
Previous Payment History
Receipt# Receipt Date Fee Description Amount Paid Permit
Payment
Check Paymen
Method
Number Amou t
CHECK
9999 $ 100.00
Total $100.00
genpmirreceipts Page 1 of 1
! IlF,XI''t R(' City of Rexburg
Department of Community Development
Receipt Number: 06-0258
19 E Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 / Fax (208) 359-3022
Prewous Payment History
Receipt# Receipt Date. Fee Description Amount Paid
06-0032 01118/2006 Sign Deposit $75.00
06-0032 01/18/2006 Sign Perm it $25.00
i
Payment
Check
Payment
Method
`Number
Amount
CHECK
6043
-$ 75.00
Total-$75.00
Permit #
0600034
0600034
genprrtrreceipts Page 1 of 1