HomeMy WebLinkAboutRECEIPTS - 06-00035 - Birch Plaza East Side - SignCLAIM FORM
VENDOR #
NAME
ADDRESS
CITY, STATE, ZIP
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-r-Y OF
REXBURG
AMEKICA'S FAMILY COMMUNITY
DATE (� 115 VW
FED ID or SS#
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DESCRIPTION
CODE
AMOUNT
APPROVED
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City of Rexburg » 'ti
Department of Community Development
Receipt Number: 06-0033 -� 1
19 E Main St. / Rexburg, D. 83440
Phone (208) 359.3020 / Fax (208) 359-3022
Receipt Date:
01/18/2006 Cashier:JANELLH Payer/Payee Name: STONEGATEREKSURG LLC UAL
Original Fee
Amount Fe
Permit#
Fee Description
Amount
Paid Ealan
0600035
Sign Deposit
$75.00
$75.00 $0.00
0600035
Sign Permit
$25.00
$25.00 $0.00
Total:
$100.00
Previous Payment History
Receipt#
Receipt Date
Fee Description
Amount Paid
Perm it#
Payment
Check
Paymen
Method
Number
Amou t
CHECK
9999
$ 100.00
Total $100.00
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