HomeMy WebLinkAboutRECEIPT - 06-00247 - Clear Talk - SignCity of Rexburg
Department of Comm
y Development
19 E Main St, / Rexburg, ID. 83440
lone (208) 359-3020 / Fax (208) 359-3022
IFOI�- Receipt Number: 06-0331 —
. .........
..............
r% n jz 14 n lei A In dn m i P III ir w
0600247
Sign
Deposit
0600247
Sign
he rm it
$75.00 $75.00 $0.00
$25.00 $25.00, $0.00
Total: $100-00
Total
F
gen prarreceipts
MAY 1 9 2006
P P4
i Ft
4TH! bF FigRI 1
*1& 0
t
Page 1 of I
I
CLAIM FORM
NAME
C ITY, STAT E, ZI P
r
CIT' OF
R�xBUR�
AMERICA'S FAMILY COMMUNITY
DATE
w
FED ID or SS#
..
TELEPHONE lj -:
I Y
CLAJMI�NT OR HIS AGENT SIGN HERE