90-71242 ~ 11575 SW Greenburg Road
r
• 3 j
a5 90-71242
8
Washington County
WARRANT'? rTr*1- ° r FORM
Irving PuzLw and Ke11y Puziss, Grantors, convey and warrant to The City of Tigard, Oregon,
a Municipal Corporation, Grantee, the following described real property free of
encumbrances except as specifically set forth herein, situated in Washington County, Oregon,
to•wit:
:gee Exhibit "X attached to and by reference made a part of this warranty deed.
Ong, however, unto the Grantor, its successors and assigns, the following:
THIS INSTRUMENT DOES NOT GUARANTEE THAT ANY PARTICULAR USE
MAY BE MADE OF THE PROPERTY DESCRIBED IN THIS INSTRUMENT. A
BUYER SHOULD CHECK W7 L H THE APPROPRIATE CITY OR COUNTY
PLANNING DEPARTMENTS T., VERIFY APPROVED USES.
The said property is free from encumbrances except Conditions, Restrictions, Re,&
Covenants and Easements of Record, if any, and the provisions of any ordinance of rr,t
"ity of Tigard, Oregon, enacted prior to the date hereof,
true consideration for this conveyance is Two Tbouasnd Nmo Hundred Ninety-Fm and
4100 DollallU4 991W as speci d per the requirements of ORS 93.030.)
Dated this day of,~ 1990.
by
t -E:N
Warranty Deed - Puziss
STATE OF Page 2
} 86
County of }
Personally appeared the above named Irving Puziss and ► Paz* who executed this
instrument and acknowledged to me that this instrument was executedvoluntarily and freely.
IN TESTIMONY WHEREOF, I have hereunto set my hand and seal this ~,dJ
day of 1990,
Notary Public for Oregon
My Commission Expires
TIN
Approved as to legal
description this ~ day af,1990.
By:
Title; TYi~o> A~GOv~
Accepted for road purposes this day of _/YpVeinhef , 1990.
DEPARTMENT OF c TTY DEVELOPMENT
By:
Title;
After recording return to:
CITY RECORDER
P.O. BOX 23397
TIGARD, OREGON 97223
STATE-OF ARIZONA
_ _ ;.R:ZOKA `
3:0PI, DEPARTIiIiEi4T OF iiEALT.: SERVICES - OFFICE OF VITAL RECOR 'S ucr.'r. IJJ.
r CERTIFICATE OF DEATH D ►ii2-
NAME OF A. FIRST S. MIDDLE C. LAST SEX DATE OF MONTH DAY YEAR
1DECEASED DEATH
. NG PUZISS 2. MALE AUGUST 5, 1990 J~
RACE (84).-hkm bb3cK Amerf®t trtdmn.ISpec ly trloel etc.) WAS DECEDENT OF HISPANIC ORIGIN: IF YES, INDICATE MEXICAN, SPANISH, PUERTO RICAN. WAS DECEASED EVER IN U.S. ARMED FORCES? 0'.
SPECIFY: - (SPECIFY YES OR NO) CUBAN. ETC. (SPECIFY YES OR NO)
4A White B. No C. 5. Yes
PLACE OF A. COUNTY B. TOWN OR CITY C. NOS HOSPITAL INSTITUTION (IF RESIDENCE. GIVE STREET ADDRESS) D. DOA
DEATH OP EMER
6. MARICOP-A PHOENIX VAMC 650 E. INDIAN SCHOOL RD. PM It IN PATIENT
DATE OF MONTH DAY YEAR AGE (YEARS IF UNDER 1 YEAR IF UNDER , DAY MARRIED, NEVER MARRIED, SURVIVING (IF WIFE, GIVE MAIDEN NAME)
BIRTH LASTEIRTHDAY) MOS. DAYS MRS. MIN. WIDOWED, DIVORCED (SPECIFY) SPOUSE
' 7. r 24, 2 111 65 C. Married 10. Kell Cohn
t STATE AND (d not in USA, name country) CITIZEN OF WHAT SPECIFY SOCIAL SECURITY NO. USUAL OCCUPATION (Give kind of work KIND OF BUSINESS OR INDUSTRY
CITY OF BIRTH COUNTRY? 544-18-1151 done most of working life, even it retired)
and Cre)-on 12. U. S. o Am. ,3. 14A Sur eon e. Medical
USUAL A STATE . COUNTY C. TOWN OR CITY D. ZIP CODE HOW LONG IN AR DNA? EDUCATION
RESIDENCE HIGHEST GRADE COMPLETED
15. Arizona Mar' IParadise Valle 85253 is. 6 yrs. 17.
STIR pR I IDE CITY LIMITS? ON RESERVATION PREVIOUS STATE ELEMENTARY-SECONDARY COLLEGE
Dearwater (SPECIFY Yes or No) (SPECIFY Yes or No) OF RESIDENCE (0.12) (1.4 or S+)
15F- Parkwa SF. Yes 15G. No is. Oregon A. 12 B. 5+
I FATHER'S A. FIRST B. MIDDLE C. LAST MOTHER'S MAIDEN A. FIRST B. MIDDLE C. LAST -
NAME NAME
,g. Louis Puziss 20. Rose Blackman
RELATIONSHIP TO ADDRESS STREET NO. CITY AND STATE ZIP CODE
_ INFORMANTS SIGf 5Y! IDECEASED
PIP 211.1111- VA MEDICAL CENM RECORDS NONE 23650 E. INDIAN SCHOOL RD. PHOENIX,AZ. 85012
BURIAL, CREMATION, DATE ° Y C MATORY ME/ TION EMBALMER'S SIGNATURE CERT. NO.
' N1OV1" OTHER ( ' 8-6-90 fet i' sraeT emetery
24. Removal 25. 12s. Port and Org an ~A► B.7,5t FU HONE NAME S ADDRESS C AND STATE FUNERAL C or person acting Z:~TURE) CERT. NO.
`e`ssinger Mortuary & Chapel C PW b
28. Scottsdale. Arizona 29A.► l.i
TO THE BEST OF MY K ED H OCCU RED AT THE TIME,QATE ~~NNDD PLACE AND DN T11E. BASIS OF [AM INATON AND/ ?R STIGATION, IN MY OPINION DEATH OCCURRED
' DUE TO THE CAUSE(S) ST , W F ATTHE TIME DATE AND PLACE DUET CAUSE(S) AND MANNER STATED.
5 - °-m t7 = 30. SIGNATURE ? 3 w SIGNATURE
n i = AND TITLE ► ; m S W ¢ J 34. AND TITLE ►
F rS DATE SIGNED (Moo.., D , Y ) HOUR OF DEATH`( Q O zO DATE SIGNED (Mo., Day, Year) HOUR OF DEATH
o V > 31. I~ 32. • L"~ V '1Jti~. ,8 V r =o 35. 36.
l F y NAME O ATTENDING PHYSICIAN IF OTHER THAN CERTIFIER (Type or print) w W P OUNCED DEAD (Mo., Day, Year) PRONOUNCED DEAD (Hour)
ell 39. `r..i r E S . 37. ON 36. AT
NAME AND ADDRESS OF CERTIFIER, PHYSICIAN, MEDICAL EXAMINER O LAW ENFORCEM THORnY A RIZED FOR CREMATION MEDICAL EXAMINER'S SIGNATURE
(Type or Print) L+nL+nLeDT/~ F. L' tutAR tLnClnirV V1 ,L tutM
X i ❑ Yes No 41.
39. r L<c+L/•'•^ ' CK r DATE REGISTERED REG. FILE NO. R GIS S AT • A G. DISTFy~~/ DATE RECD. IN STATE OFFlCE
46.
SE LINE)
1 47. A IMMEDIATE CAUSE (FINAL N ESULTING IN DEATH) (ENTER ONLY"
-~u to
a t= > > W CAMIOPUU4WU.R AILURE APPR MATE
S. DUE TO OR AS A CONSEQUEN INTERVAL
s~j ~ g 01E ¢ BETWEEN
tullCe-ii cS INTRACRANIAL EVENT (BLEED VS STROKE) ONSET
Cg = p uuW1l F C. DUE TO OR AS A CONSEQUENCE OF: OFAND
-ATM
081 Sa¢
PART U. Other significant conditions contributing to death but not resulting in the underlying cause given in Pan I AUTOPSY WAS CASE REFERRED TO MEDICAL EXAMINER
- (Specify Yes or No) (Specify Yes or No) NO
48. 149. 50.
MANNER OF DEATH DATE OF MO DAY YR HOUR INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED
NAB ~ HOMICIDE INJURY - (Specify Yea at No)
El ACCIDENT ❑ INNVESTGATION P52, 153. 54. LACE OF INJURY (At home, farm, street, factory, office building, etc.) WHERE LOCATED?? STREET ADDRESS CITY OR TOWN STATE
v z SPECIFY
❑ SUICIDE ❑ UNDETERMINED
1 St. 56. 57.
SUPPLEMENTARY ENTRIES
1 so
'
CERTIFIED COPY OF VITAL RECORDS--
` STATE OF ARIZONA - - ' oS?vJU~h
v*~,, a1ry4i Aug 31, 1990 i fJjNt~ COUNTY OFMARICOPA DATE ISSUED
I - - ,
p jlf„ 11 thy Title is a true and exact reproduction of the document officially. registered end ptagetl i 1 • , f J;,
Tbr
on file in the VITAL RECORDS SECTION, DEPARTMENT OF HEALTH SERVICES, P
PHOENIX, ARIZONA Issued under the author of A.R.S. 36-341, and by direction of: Mani R. Saigh
Chief Deputy County Registrar
lr'~ Maricopa County Department of
3 Health Services 7
a
This copy not valid unless prepared on engraved border displaying county seall in color and raised seal of issuing agency.
l fr't t - - - - _ J
rd
EXHIBIT A
July 10, 1990
isi 35 DC 3000
RIGHT OF' WAY TAKE
A oarc el of land situated in ths soi- -Inwest quarter of the southeast
quarter of Section; 35, Tcwnshi~ 1 South; Ra: ge 1 West, W.M.,
Washington County, Oregon. Said parcel- of 'Land being more
part calarly described as fC11O:s
BEGINNING at a ocint cf intersection an tle easterly property lire
of that parcel of land conveyed by Irving ?uziss and Kelly Puziss
in Trust Seed recorded in fee No. 88-06103 on '.February 12, 1988,
Washington County Record-?s, and the southerly right of way line of
STS Gfreen. bra Read, as de:.ined in City o4- Tiga~- Ordinance No. 90-
07, dated January 22, 1990; Thence Southerly alonq sold easterly
property line tc a point, of intersection with anon tangent curve
said Point being 34.66 fee's left and cL -right anMle -o enul--neer's
Cen"~e'l.i.l"!E stay! on 118+51.65 feet, !.ore or less; as illustrated in
the City of Ti Qard' s S . v; . Greenberg Road R/ W Easement Exhibits
Sta. 10899 .8»' to Sta. 119+00.Z2 sheet 2 of 6 dated 2!21/90 and
st-,eet 3 of 6 dated 1/21/90; Thence W sterly 137."0 feet along the
arc of a 1095.CG foot radius curve to the :left. through a central
angle of 07111211811 to a poi n,_ of tanc'encV, said point teiI!g on the
right of way line of SW Greenberg Road and also being 30.070 feet
.Left of ez-j ne4r` S centerline Stilt on x.14-9~ .J- more _eSS;
T iprC2, Easterly alongg said rigi t cf war L_ e z- an amyl pot n,t~
c
sa' d &n^1. P. p41nL hei ng 30 . 0 .feet lef-L of ergq ;?'r ~n _cr! in
staL.ion. 118+73.78, more or less, Thence, C-,-_3 nu_n _said
.
r.Lg-1 of wtv ..1 ne y~ the P i n t 0. 3G~J' i^:..
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i
STATE OF OREGON
County of Washington
1, Jerry R. Hanson it t r of Assessment
and Taxation a ffiao rder of Con-
veyances for c99ni re rtify that
the within ' r e Qv eceived
and recor ~f i ounty.
y aHa : 'r or of
~,~,.r
ati Ex-
clwo,
Doc 90071242
Rect: 46577 33.00
12/31/1990 03:30:26PM