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DRB120521 Receipt
TOWN OF UAIL COM OEU 75 S FRONTASE RD. UAIL, CO 81657 918- 479 -2324 TERMINAL I.D.: 2002 MERCHANT #: UISA PURCH MAIL ORDER BATCH: 088584 I HU : 000003 AUTH:001056 OCT 1$: 12 11:03 TOTAL $20,00 CUSTOMER COPY TOWN OF VAIL, COLORADO Statement Statement Number: R120001696 Amount: $20.00 10/18/201212:11 PM Payment Method:Credit Crd Init: CG Notation: ----------------------------------------------------------------------------- VISA 2803 Permit No: DRB120521 Type: DRB -Chg to Appr Plans Parcel No: 2101 - 082 - 8400 -2 Site Address: 1 WILLOW BRIDGE RD VAIL Location: ONE WILLOW BRIDGE ROAD UNITS C2, C3, C4 Total Fees: $20.00 This Payment: $20.00 Total ALL Pmts: $20.00 Balance: $0.00 ACCOUNT ITEM LIST: Account Code Description Current Pmts -------------- - - - - -- ------------------------ - - - - -- ------ DR 00100003112200 DESIGN REVIEW FEES - - - - -- 20.00 TOWN OF UAIL COM OEU 75 S FRONTASE RD. UAIL, CO 81657 918- 479 -2324 TERMINAL I.D.: 2002 MERCHANT #: UISA PURCH MAIL ORDER BATCH: 088584 I HU : 000003 AUTH:001056 OCT 1$: 12 11:03 TOTAL $20,00 CUSTOMER COPY