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R.EXBUR-G
City of Rexburg
De Partm e nt of Com m u,nity Dewe lop m ent
19 E. Main 5t.1 Rexburg, ID. 83440
Plane (208) 359-3020 1 Fax (208) 359-3022
Receipt Number
05-'0061
Receipt Date-, 0812212005 Cas hier:B
Paye r/Paye e Nam e.: C USTOM DESIG N FILA C ES
0500278
Payor e n
Method
CHECK
Mechanical Residential Fixtures
$100.00 $100.00
Total: $100.00
Check
Number
003087
Payor e nt
Amount
$100.00
Total $100.00
genprWreceipts Page I of 1
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City of Rexburg
Department of Com m unity Development
19 E. Maim St.1 Rexburg, la. 83444
Phone (248) 359-3020 !Fax {208} 359-3022
PERMIT APPLICATION INVOICE
Invoice Date l 9/2005
N
Applicant: CUSTOM DESIGN FIREFLACESite Address:'I t IT I !' IB/V D
859 S YELLOWSTONE NO 901
Rexburg, D 83440
The follow ing fee am ountsfor this perm it application are unpaid at this time:
Page 1 of 1
CITY 0t-
R...EXB
UR�
AMERICAS FAMILY COMMUNITY
Ciiy of Rexburg
P.Q. Box 280
12 North Center Street
Rexburg, Idaho $3440
Phone: (208)
359-3020 X 2
FAX: (208) 359-3024
Message:
DATE: Icy —jai —05
TO: NAME:
FROM*
COMPANY:
FAX TRANSMITTAL FORM
d
FAX NUMBER: saw
'HONE NUMBER: L3S cl - %Ozli �-
NAME: BETHANY CAUFIELD
PHONE NUMBER: x 345
1
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PAGE I pp �
Please forward this fax transmittal to the above named individual.,