Permit n
r
CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2011 -00164
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/02/2011
Parcel: 2S103BA00201
Jurisdiction: Tigard
Site address: 11545 SW WALNUT ST
Project: NIHILL Subdivision: LERON HEIGHTS NO.2 Lot: 28
Project Description: Connecting existing house to sewer.
Contractor: Owner: NIHILL, GERALD T & DEANNA LYN
11545 SW WALNUT ST
TIGARD, OR 97223
PHONE PHONE:
FAX:
FEES
Description Date Amount
Specifics: Deferred Sewer Connection Fee 12/02/2011 $4,500.00
Deferred Sewer Inspection Fee 12/02/2011 $35.00
Type of Use: SF
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $4,535.00
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952 - 001 -0010 through BAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � •ermittee Signature:
411• -
Call 503.63•.41 0:00 a.m. for the next available inspection date.
This permit card shall be kept i a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
III CI
TY OF TIGARD RECEIPT
2 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TtGsARD
Receipt Number: 184776 - 12/02/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SWR2011 - 00164 Deferred Sewer Connection Fee 500- 0000 -23300 $4,500.00
SWR2011 -00164 Deferred Sewer Inspection Fee 230 - 0000 -23300 $35.00
Total: $4,535.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Journal Entry 000019 06 2012 BTAGGART 12/02/2011 $4,535.00
Payor: City of Tigard
Total Payments: $4,535.00
Balance Due: $0.00
Page 1 of 1
General Ledger
Journal Entry Proof List ,e
•
C
User: debbies
Printed: 12/02/201] - 2:36 PM T I GARD
Account Number Account Description Debit Amount Credit Amount Line Description System Reference Project Management
Journal Entry: 000019 06 2012 Journal Entry Date: 12/02/2011 System: General Ledger
230- 0000 -12103 Accts Receivable - Reimb. Dist 35.00 0.00 Sewer Connection Fee Loan - Nihill
230 - 0000 -23300 Deferred Revenue 0.00 35.00 Sewer Connection Fee Loan - Nihill
500- 0000 -12102 Accounts Receivable - CWS 4,500.00 0.00 Sewer Connection Fee Loan - Nihill
500 - 0000 -23300 Deferred Revenue 0.00 4,500.00 Sewer Connection Fee Loan - Nihill
Journal Entry Totals 4,535.00 4,535.00
Journal Entry Balance 0.00
Report Totals 4,535.00 4,535.00
•
Report Balance 0.00
•
GL - Journal Entry Proof List (Printed: 12/02/2011 - 2:36 PM) Page 1
PROMISSORY NOTE
$4,535 Tigard, Washington County, Oregon
December 2, 2011
FOR VALUE RECEIVED, the undersigned promises to pay in lawful money of
the United States to the order of City of Tigard the principal sum of
$ 4,535 , together with interest as provided below, in principal
installments as shown in Exhibit A.
The unpaid balance of the principal amount stated above shall bear interest at
the rate of 2.78 % per annum from the date of this Note until fully paid; interest
shall be paid semi - annually on or before the first day of the month in which payment is
due starting commencing July 1, 2012.
The entire principal balance with any accrued and unpaid interest shall be paid
on or before January 1, 2022.
This Note may be prepaid, in whole or in part, without penalty.
If any payment due pursuant to this Note is not made when due, then at the
option of the holder of this Note the entire indebtedness represented by this Note, upon
30 days' written notice to the undersigned, shall immediately become due and payable
and thereafter shall bear interest at the rate of 5% per annum above the prime rate
published in the Wall Street Journal or 12% per annum, whichever is higher, provided
such interest rate shall not exceed the maximum rate permitted by law. Failure or delay
of the holder to exercise this option shall not constitute a waiver of the right to exercise
the option in the event of subsequent default or in the event of continuance of any
existing default after demand for the performance under the terms of this Note.
The undersigned shall pay upon demand any and all expenses, including
reasonable attorney fees, incurred or paid by the holder of this Note without suit or
action in attempting to collect funds due under this Note. In the event an action is
instituted for the collection of this Note, the prevailing party shall be entitled to recover,
at trial or on appeal, such sums as the court may adjudge reasonable as attorney fees,
in addition to costs and necessary disbursements.
The undersigned and his /her /its successors and assigns hereby waive
presentment for payment, notice of dishonor, protest, notice of protest, and diligence in
collection, and consent that the time of payment on any part of this Note may be
extended by the holder without otherwise modifying, altering, releasing, affecting, or
limiting their liability.
• `Signature
Z ;')-- <& ( ; ). Z_I N ) , . , S AL (
Printed Name
Exhibit A
Nihill payment schedule
Pmt Payment Beginning Scheduled Ending
No. Date Balance Payment Principal Interest Balance
1 7/1/2012 $ 4,535.00 $ 261.33 $ 192.19 $ 69.14 $ 4,342.81
2 1/1/2013 4,342.81 261.33 203.79 57.54 4,139.03
3 7/1/2013 4,139.03 261.33 206.49 54.84 3,932.54
4 1/1/2014 .3,932.54 261.33 206.67 54.66 3,725.87
5 7/1/2014 3,725.87 261.33 209.54 51.79 3,516.33
6 1/1/2015 3,516.33 261.33 212.45 48.88 3,303.88
7 7/1/2015 3,303.88 261.33 215.41 45.92 3,088.47
8 1/1/2016 3,088.47 261.33 218.40 42.93 2,870.07
9 7/1/2016 2,870.07 261.33 221.44 39.89 2,648.63
10 1/1/2017 2,648.63 261.33 224.51 36.82 2,424.12
11 7/1/2017 2,424.12 261.33 227.63 33.70 2,196.49
12 1/1/2018 2,196.49 261.33 230.80 30.53 . 1,965.69
13 7/1/2018 1,965.69 261.33 234.01 27.32 1,731.68
14 1/1/2019 1,731.68 261.33 237.26 24.07 1,494.42
15 7/1/2019 1,494.42 261.33 240.56 20.77 1,253.86
16 1/1/2020 1,253.86 261.33 243.90 17.43 '1,009.96
17 7/1/2020 1,009.96 261.33 247.29 14.04 762.67
18 1/1/2021 762.67 261.33 250.73 10.60 511.94
19 7/1/2021 511.94 261.33 254.21 7.12 257.73
20 1/1/2022 257.73 261.31 257.73 3.58 (0.00)
$ 4,535.00 $ 691.58