Application FeesQw f T"f "9~~ CITY O~ - ~.. ~ ~ ~. -~ - ~ _ ,
YELM
P,o. sox 47s . RECEIPT No. 4 ~' ~ ~ S
Yelm, WA 98597
$I' 360-458-3244
RECEIVED .
****THREE HUNDRED FIFTY DOLLARS & 00 CENTS '
RECEIVED FROM DATE REC. NO. AMOUNT REF. NO.
KENNETH JEWELL 06/14/07 4892.6 350.00 CHECK 236'172
17041. SR 507
YELii, UlA 98597 BUDGETARY
ANNEXCATION JEt~ELL
ANX-07-0233-YL
~~pf THFp~~ City of Yelm
.~ ':, 7~ Community Development Department
~ . ,. _ ` ~
Building Division
Phone: (360) 458-8407
YELM Fax: (360) 458-3144
Applicant:
Name: Kenneth Jewell
Address: City:
Permit Fees Schedule
Permit No: ANX-07-0233-YL
Phone:
State: Zip
Project Information:
Project: Jewell Annexation
Description of VVork: Annex 9.33 acres on SR 507, east edge of city limits
Site Address: 17041 SR 507 Assessor Parcel No. 64303200300
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- ------------- ----------- ----------- ----------- ----------- --------- ------------
Ann Simple 001-345-81-01 350.00 350.00 0.00 0.0000 0.0000
TOTAL FEES: $350.00
PERSONAL MONEY ORDER
Date 6/07/07
Pay to thf ~,, ~-~~
order o
EXACTLY **350
venture
B A N K
Telephone Number 1-888.373.2265
~~~' ~ ~l. ~`l
/D 00/100 DOLLARS
236172
Ul
350.00
8
NOT VALID OVER S 1,000.00
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