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Correspondence
1 • CITY OF TIGARD ■ Building Division TIGARD 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171 INVOICE TO: Stone Bridge Homes NW LLC Customer ID: 173318 16869 SW 65th Ave., #505 Invoice No.: INV2009-00002 Lake Oswego, OR 97035 Invoice Date: 11/04/09 Date Due: Upon Receipt Case No. Site Address Subdivision-Lot#or Project Name Amount Due MST2008-00129 13199 SW Nicole Ln. Wilson Ridge II,Lot 23 $426.79 QPi. ID - /76 33 Invoice Total: $426.79 ® Please see attached fee schedule for description of fees due. (Detach and return this portion with payment.) Case No.: MSt2008-00129 Customer ID: 173318 Site Address: 13199 SW Nicole Ln. Invoice No.: INV2009-00002 Project: Wilson Ridge II,Lot 23 Invoice Date: 11/04/09 Date Due: Upon Receipt Invoice Total: $426.79 Amount Paid: $ Office Note: Check parcel condition "met" and route copy of receipt to Dianna Howse. Please mail payment to: City of Tigard,Building Division 13125 SW Hall Blvd. Tigard, OR 97223 Attn: Dianna Howse I:\Building\Accounting\Invoice.doc 04/06 IIICITY OF TIGARD FEE AND PAYMENT HISTORY II S . 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD MST2008-00129 - 13199 SW NICOLE LN Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due [BUPPLN] Pln Rv Deposit 245-0000-433000 $750.00 $750.00 $750.00 8/21/08 Check 2720080000 $0.00 0000002962 [CDCPLN]CDC Pln Rev 100-0000-433060 $46.00 $46.00 $46.P^ [LRPF] LR Planning Surcharge 100-0000-438050 $6.00 $6.00 $6.. [BUPPLN] Pln Rv Balance 245-0000-433000 $283.69 $283.69 $283.69 [BUPPLN] Pln Rv Extra Set 245-0000-433000 $62.50 $62.50 $62.50 [EROSN] Erosn Pln Rv COT 245-0000-433010 $28.60 $28.60 $28.60 Totals for Fees $1,176.79 $1,176.79 $750.00 $426.79 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount 27200800000000002962 Check 10233 STONE BRIDGE 08/21/2008 $750.00 HOMES NW LLC Total Payments: $750.00 Balance Due: $426.79 / �--5 LIZ Cis 12C /SS tL/92vCe /`Is7Zoo ?-- e0 c2 / 0 ///5-A y -ok-/----- • • CITY OF TIGARD RECEIPT 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 176333 - 12/17/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2008-00129 [CDCPLN]CDC Pln Rev 100-0000-433060 $46.00 MST2008-00129 [LRPF] LR Planning Surcharge 100-0000-438050 $6.00 MST2008-00129 [BUPPLN]Pln Rv Balance 245-0000-433000 $283.69 MST2008-00129 [BUPPLN]Pln Rv Extra Set 245-0000-433000 $62.50 MST2008-00129 [EROSN] Erosn Pln Rv COT 245-0000-433010 $28.60 Total: $426.79 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 30781 DADAMSKI 12/17/2009 $426.79 Payor: Stone Bridge Homes NW LLC Total Payments: $426.79 Balance Due: $0.00 Page 1 of 1