DCT Fellowship- CS151118 (2)T H E C I T Y - O F
COPPELL
F k A S 1 a 9
P.O. Box 9478 - Coppell, Texas 75019 - 972-304-3679
Engineering / Enviromental Health
Name E;? T
Service AddressesT`lf�S-
I
Phone Number 164,Ci &Z
Date f Cash Check No.
Service
Date
Food Permit
Reference
Amount
Pool Permit
Net
11132015B
Waste Hauler Permit
ROADWAY IMPACT FEE
Temp. Event Permit
0.00
51,430.08
Construction Inspection Fee
Roadway Impact Fee
/
O6
ROW Use Permit
Street Cut Permit
125 9 TOTAL
n
�a L,
�'�fAa&Vvj%1-1
a
Invoice
Date
P.O. Num
Reference
Amount
Discount
Net
11132015B
11/13/2015
ROADWAY IMPACT FEE
51,430.08
0.00
51,430.08
Payor: DCT Property Management LLC Date Check No. Check Amount
Payee: City of Co ell 11/13/2015 164962 51,430.08
Retain this statement for your records