Stormwater- Payment History

Facility Name: TRINITY REGIONAL MEDICAL CENTER

Permit Type: GP #2 Legal Status: Private     File No: 13015   Authorization No: 13015-12803

Expiration Date: 2/5/2009 (discontinued) Address: 802 KENYON RD. - FORT DODGE , IA 50501

County: WEBSTER Field Office: 2 SIC: Geospatial Information: 402039(X)/4705711(Y)

Payment History   Payment Date Activity Payment Account 01/17/2008 Received Fee (1-Year) 150.00 2782 02/05/2007 Received Fee (1-Year) 150.00 2479 Activity Date: MM/DD/YYYY Payment Option: --ACTIVITY TYPE-- INSUFFICIENT FEE PAYMENT RECEIVED PERMIT APPLICATION SENT RENEWAL REMINDER SENT DELINQUENT NOTICE (FIRST) RECEIVED FEE (1-YEAR) RECEIVED FEE (3-YEAR) RECEIVED FEE (4-YEAR) RECEIVED FEE (5-YEAR) RECEIVED FEE (TERM UNKNOWN) SENT PERMIT APPLICATION UPDATE RECEIVED PERMIT APPLICATION UPDATE IMPROPER NOTICE OF DISCONTINUATION RECEIVED SENT PAYMENT OPTION LETTER UPDATE INCOMPLETE – RETURNED APPLICATION DISCONTINUED PERMIT Payment: Invalid value Account: Comment: