HomeMy WebLinkAboutRECEIPT - 06-00458 - Craigo's - SignCLAIM FORM
VENDOR # II
NAME
ADDRESS 2,n
CITY, STATE, ZIPr�la
V
CI1*,e OF
REXBURG
AMERICNS FAMILY COMMUNITY
DATE a 1 b1Q
FED ID or SS#
TELEPHONE
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CLAIMANT OR HIS AGENT SIGN HERE
City of Rexburg
Receipt Number: 06-0625
Department of Community Development
19 E Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 / Fax (208) 359-3022
Receipt Date:
09/19/2006 Cashier: EMILYA
Payer/Payee Name: Craigo's Pizza
Original Fee -
Amount Fee
Permit.#
'Parcel Fee Description
Amount
Paid Balance
06 00458
RPRRXB1031 Sign Deposit
$75.00
$75.00 $0.00
0600458
RPRRXB1031 Sign Permit
$25.00
_ $25.00 $0.00
Total:
$100.00 `
Previous rY
Pa Y_ ment;Histo ,
iecelpt # Re celpfiDate Fee'`DEs"cription . Amount Paid Permit#
Payment
Check
Paymen
Method
Number-,
Amoun
i CHECK
3633
$100.00
Total $100.00
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