HomeMy WebLinkAboutRECEIPT - 05-00148 - Comfort Inn - SignTn' Of
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CIfY of Rexburg
Department of Comm unUy N veloprn ent
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 1 Fax (208) 3,59-3022
l[ReceiptDate: 0511912005 Gashier: BETHANy
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I! Permit # Fee Description
U5 U0148
1C A64 -4 ()
Receipt #
IPayment
Method
CHECK
No. 20742
IDAHO BLJ,�NESS FopMS - 1_84)0_632-14--58
Sign Permit
oil Uepo'S11
ire ce!Pt Date
Gheck
Number
Receipt Number-
Payer/Payee Name: CROSS C'WALKER REVOCALBETR
Tran Original Fee Amount
Code Moun
Paid
01-322-20
01-322.20
$75.00
Total: $100.00
Previaus Paymenf History
Description:
Paym e nt
Am ountl
1488 $100.00
Total 000,00
56227
Amount Paid Permit it
Fee
Ba I an ce
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Pa ge I of I
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FAX TRANSMITTAL FORM
DATE: 5'2o/G5
City of Rexburg TO: NAME:
P.O. Box 280
12 North Center Street COMPANY: Tco 5 �qp�
Rexburg, Idaho 83440
Phone: (208) 359-3020 AX N[IMBER: 5 2-3 —�`i Li ZS
FAX: (208) 359-3022
PHONE NUMBER.- 5
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FROM:
Nom: Bethany Caufleld
PHONENi.JMBER: 208-359-3020 XZ
Please forward this fay transmi��l �o the above named individuaL