Bill To:
City of Chicago Department of Buildings
120 N. Racine 1st FL Chicago, IL 60607-2010
Phone: 312-743-3600
TTY: 312-744-2975
* SEND Payment to Revenue Address below MUST include Paver ID/Invoice Ref # to ensure accurate payment posting.
149 T1 **"*********SINGLE-PIECE WASHINGTON JANE SMITH H 2340 W 113th PI Chicago, IL 60643-4107
INVOICE
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Payer ID |
Reference/Invoice Number |
Reference/Invoice Date |
Payment Due Date |
AC8060 |
271585 |
02/01/2011 |
03/03/2011 |
Location |
Bill Number |
Inspection Date |
Inspection Number |
Inspection Type |
Description |
Amount |
Current Billing 2340 W 113th PI |
368647 |
01/10/2011 |
10089769 |
BR_ANNUAL |
15units-Boiler Bureau |
$770.00 |
KEEP THIS PORTION FOR YOUR RECORDS. To avoid penalties, please remit payment by Payment Due Date. |
TOTAL |
$770.00 |
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DETACH HERE AND RETURN THIS PORTION WITH PAYMENT IN THE ENVELOPE PROVIDED.
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For information changes, check this box and make corrections below.
Organization:
Address: 2340 W 113th PI
Chicago, IL 60643-4107
Contact: WASHINGTON JANE SMITH H Phone:
CITY OF CHICAGO
Department of Revenue 8108 Innovation Way Chicago, IL 60682-0081
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Remit Payment by 03/03/2011.
Payer ID |
Reference Number |
AC8060 |
271585 |
Reference Date |
Amount Due |
02/01/2011 |
$770.00 |
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Check enclosed (payable to the City of Chicago)
Please include your Payer ID on your check.
Do Not Mail Cash.
For payment questions: Call Department of Revenue at 312-742-3317.
DTJOl'H
149-190 B8221
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