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City of Eugene Planning <br />Method of Payment <br />Cash <br />Check <br />0 Visa/MC <br />Amount Received <br />5,155.70 <br />PLANNING RECEIPT <br />DATE 6/13/2019 <br />Customer Information <br />Name Craig & Holly Kohler <br />Address PO Box 377 <br />Harrisburg OR 97446 <br />Project 17-04-25-21-03200 112 & 114 Hansen <br />City/Government Agency <br />Appllcaflonaype Modificationconcurrent Qty Base Fee Discount Total <br />1 Annexation 1 $ 4,730.00 4,730.00 <br />2 <br />b <br />7 <br />8 <br />Other. <br />Other <br />Appeal 1 <br />Appeal <br />Subtotal App Fees 4,730.00 <br />Subtotal Other Fees <br />I Admin Fee (not included on appeals or other fees)9%425.70 ; <br />I <br />Total 5,155.70 <br />Staff Receiving Application j <br />MHD <br />i <br />99 West 10th Avenue ® Eugene, Oregon ® 97401 ® 541-682-5377 m eugeneplanning.org <br />September 9, 2019, Meeting – Item 2C