Subaru- CS160204 T H E C 1 T Y O F
COPPELL
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P.O.Box 9478•Coppell,Texas 75019•972-304-3679
Engineering/Enviromental Health
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Service Address - , .I .i •
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Phone Number
Date "'I ° 14' Cash Check No.
Service f
Food Permit
Pool Permit
Waste Hauler Permit
Temp. Event Permit
Construction Inspection Fee
Roadway Impact Fee ` 0S n]0. OD
ROW Use Permit T'
Street Cut Permit
1318 TOTAL 2.0-&, oD
Receive. By
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Check Date Feb/02/2016 Check No. 142173
Invoice Number Invoice Date I Business Unit Voucher ID Gross Amount Paid Amount
102715 Impact Fee Oct/27/2015 51000 00098922 203,040.00 203,040.00
Vendor Number Vendor Name Total Discounts
0000001917 CITY OF COPPELL $0.00
Check Number Date Payment Handling Total Amount Discounts Taken Total Paid Amount
142173 Feb/02/2016 HD $203,040.00 $0.00 $203,040.00
P-003(11/02)