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Receipt
CITY OF CARMEL ZONING/ DEVELOPMENTS RECEIPT \lP ******************************************************************************** PARCEL ID PROJECT RECEIPT # RECEIPT DATE RECEIVED BY REC'D. FROM TEST106.1 UDF 106.2 NOTES : RIVERVIEW HEALTH PARK ADLS AMEND APP 1710220022001000 07040020 25058 05/14/2007 ADDRESS PRINT DATE PRINT TIME OPERATOR COPY # : CASH DRAWER: 14535 HAZEL DELL PKWY 05/14/2007 11:09:01 rboone 1 PZ rboone RIVERVIEW HOSPITAL FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- P-ADLSAMS SIGN 1. 00 333.00 0.00 333.00 0.00 P-ADLSAMS+ SIGN 4.00 222.00 0.00 222.00 0.00 ---------- ---------- ---------- ---------- TOTAL PROJECT : 555.00 0.00 555.00 0.00 METHOD OF PAYMENT AMOUNT NUMBER CHECK TOTAL RECEIPT : 555.00 0040837 ------------ ------------ 555.00