HomeMy WebLinkAboutRECEIPTS - 05-00404 - Hard Hat Cafe - SignsCIFY 01
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19 E. Main St. I Rexburg, ID. 83440
Phone (208) 359-3020 / Fax (208.) 359-3022
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10/2412005 ce i pt Date Cas hie r:CATHYW Payer/Payee Name: BILLMAN JAMES
.......................................
. _. _
Permit #
0500404
0500404
Payor e nt
M ethod
CHECK
Fee Description
Sign Deposit
Sign Permit
Receipt Date
Chick
Number
3942
Previous Payment ti
Total
Original Fee Amount
Amount Paid
$75.00
$25.00 $25.00
Total: $100.00.
Fee Description Amount Paid
Paym e n�
Am oujit
$100.00
Permit, #
Fe
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gerip alrreceipts Page 1 of 1
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CLAIM FORM
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CL-AdMANT OR HIS AGENT SIGN HERE
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CITY Ot-
A%AER,tC-rVS
F.NMILY COMMUNffY
City of Rexburg
P.O. Bax Aga
12 Forth Center Street
Rexburg, Idaho 83440
Phone: (208) 359-3020
FAX: (208) 359-324
Message:
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DATE:
TO0
: NAME:
FROM:
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COMPANY:
FAX NUMBER:
PHONE NUMBER:
FAX TRANSMITTAL FORM
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NAME-. BETHANY CA'UFIELD
'HONE NUMBER:
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Please forward this fax transmittal to the above named individual.
It
Date/Time: Nov.
J' LO05
Transmi33ion Result Report(MemorYTX)
9 : I C I I A I M
(Nov, 7. 2006
9:16ANI )
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12 Nooll Ceillm Sire
G`AF1 & MAD 93-140
Phone (2,09) 359-3021D X I
F Yy ( -359-302-4
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