HomeMy WebLinkAboutApplication receiptRECEIPT
Garfield County
108 8th Street Suite 401
Glenwood Springs, CO 81601 -
Phone: (970)945 -8212 Fax: (970)3844470
Invoice Number:
Invoice Date:
Plan Case:
INV -7 -13 -22531
26/2013 12:00:OOAM
General Administrative, GAPA
Fee Name
General Administrative Fee
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Fee Type
Fixed
Fee Amount
$250.00
Total Fees Due: $250.00
Date Pay Type
Check Number
07/26/2013 Credit Card -1
Amount Paid
$250.00
Change
$0.00
Total Paid: $250.00
Community Development
108 8th Street Suite 401
Glenwood Springs, CO 81601
MERCHANT # 941000097881
Swiped Sale
REF NUM. 276 AVS: 0
VISA
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INV NUM: 6ftPn -1444
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DATE: 07/26/2013 10:24:55 AM
AUTH NO: 001683
EXP.: " * ""
TOTAL:
CUSTOMER ID:
IVtA I ki
.� r
250.00
I Agree To Pay Above Total Amount
According To The Card Issuer Agreement
(Merchant Agreement If Credit Voucher)
Merchant Copy
Total Due: $O.00 I
Friday, July 26, 2013