HomeMy WebLinkAboutRECEIPTS - 05-00411 - Rexburg Motor Sports - Signsfky 01
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EXR
C'tY ofRexburg
[ar rpt of Cpm unity Dewe fpm rpt ptNurrber
a 0 5N"I ^.
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 1 Fax (208) 359-3022
1 05 0041
0500411
Sign Deposit,
Sign Permit
Previous Paym end History
Total
$75.00
$25.00
Total,
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City f Rexburg ^1"N.
Department of Cornmull, Development
Receipt Number*
0-6-0132
t # '
Recei
Previous Payment History
P Receipt late Fee Description Amount Paid Perm i.. . ..........t
-0183
1012512005
10125/2005
Sign Deposit
Sign Permit
9
$75.0U 0500411
$25.00 0500411
Fe 6
Balance
genp"rrec.elpts Paae 1 of I
CLAIM FORM
VENDOR #
NAME
ADDRESS
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COY OF
AMERICAS FAMILY COMMUNITY
,�"\ �� �� I� - DATE 0?
1�J`��
FED ID or SS#
CITY, STATE, ZIP �`, M.0 ki i -. j 0 TELEPHONE ��
ANT OR HIS A -GENT SIGN HERE