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2004 Statement Department of Finance and Administration Office of City Clerk 300 West Ash Street, Suite 206 * P.O. Box 736 Salina, KS 67402-0736 Rodney Franz, Finance Director * Lieu Ann Elsey, City Clerk Telephone (785) 309-5735 * Fax (785) 309-5738 Salina Thursday, November 13, 2003 PLEASE RETURN YELLOW COPY WITH PAYMENT Irma Jean Hedges 320 E. Pleasant Hill Road Salina, KS 67401-0000 037-36-0-20-01-001 320 E. Pleasant Hill Road & 2516 N. Fifth Street "'-'1_"_"-"-" _'1_"_1'_"_' __"_1' _.._.._ "_1'_"_" _"_"_"_"_'1 _.._ 1'_"_"_1'_"_"_"_"_"_"_'1_"_' STATEMENT FOR 2004 RURAL FIRE CONTRACT January 1, 2004 through December 31, 2004 Cateaorv !YIm Percent Value Mill Levv Amount Land Residential 30.0% X $2,000.00 X 0.017598 = $10.56 Land Residential 11.5% X $24,040.00 X 0.017598 = $48.65 Buildings Residential 30.0% X $1,670.00 X 0.017598 = $8.82 Buildings Residential 11.5% X $200,460.00 X 0.017598 = $405.68 Amount Due: $473.71 Please make check payable to City of Salina and remit to prior to December 31. City of Salina Attn: City Clerk's Office P.O. Box 736 Salina, KS 67402-0736 -------------------------------------- FOR OFFICIAL USE ONLY Amount Paid: L\ 1~....:1 I Receipt No.: (04711 3 Received By: S uY~ Date Received:3.f}Q~ 2.f::r::5:3 ~ - - .-. ." ..- ".-. - . .- ;.:"; t' c.:'t)t...' ..:: City of Salina P.o. Box 736 Salina, Kansas 67402-0736 RECEIPT NO. '-',""'1 .~- c:).....;~.::; i."::; AMOUNT DESCRIPTION ~IRE ~:~'OTE ()37._..36-(:)-2(:,-.\)'L-()()1 :t ()~)--()()() {:~6Ei.. ()t)(, 320 E PLEASANT HILL RD ~.7'3.71 CHFTV RFl';':, RECEIVED" " ~- -- '.- . FROM: i:+7:3 I' 71 I F't1A JEtiN HEDGE::; Tcn?:d_. P;\I D ~1.'7:3" ,.;".'1. Oi~IGINAL RECEiPT