2003-114477 \\ Washington County, Oregon
0" 7 .003 10:16:39 AM 2003- 114477
Return Recorded Document to: -- D Cnt =1 Stn =8 RECORDSI
City Hall Records Department $5.00 $11.00 • Total = $16.00
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 00381478200301144770010017
I, Jerry Hanson, Director of Assessment and Taxation
and Ex- Officio County Clerk for Washington County, e'�"�S
TRAFFIC IMPACT FEE Oregon, do hereby cert(ty thetthe within Instrument of ? ,•
writing was received and recorded
bf A n i } the book of J
Installment Payment Application and Disclosure Statement records of said county. s.or
Jerry R. Henson, Director asesament and Taxation, F`+
Ex -Officio County Clerk
In the Matter of the Traffic Impact Fee for Integumend LLC
Tax Map 1S135AA
Lot Number(s) 01400
and as further described in Deed #
Building Permit # BUP 2003 -00219
Site Address 10215 SW Hall Blvd.
Subdivision
Case File # SDR 2003 -00002
TIF Land Use District C -N
• To Be Billed To: Integumend LLC
• Address: 9495 SW Locust St., Portland, OR 97223
To the City of Tigard:
In accordance with the provision of Oregon Revised Statute 223.208 and Washington County Code 3.17 which relates to the imposition of a traffic
impact fee for the financing of major collector roads and arterials of Washington County, I /we HEREBY MAKE APPLICATION AND AGREE,
JOINTLY AND SEVERALLY, to pay my /our traffic impact fee, as has been determined by Washington County Code 3.17 in 20 semi - annual
installments of the amount financed together with one -half of one year's interest thereon at a rate of 5.19 annual percentage rate on the unpaid
amount owed. The lien date is the first day of the month following the date the application is signed. The first payment is due six months thereafter
and at six (6) month intervals thereafter for a period of 10 years. Each installment payment will include principal and interest.
If I \we neglect or refuse to pay any part of the installments provided herein, including interest, within one (1) year after the same shall have become
due and payable, then the whole amount of the unpaid assessment shall become due and payable at once and shall be collected in the manner
provided by law including foreclosure on the above - described real property.
The traffic impact fee, annual percentage rate of interest ( 5.19 %) and finance charges which I /we agree to pay are as follows:
HIGHWAY TRANSIT
1) Amount of Traffic Impact Fee $ 33.330.00 $2,970.00
2) Amount Financed $ 33,330.00 $2,970.00
3) Equal Semi - Annual Principal Payments $ 1.666.50 $148.50
4) Interest on Balance at Rate of 5.19 %
I \We understand that the amount owed, as stated above, shall be a lien on the above - described subject property pursuant to Washington County
Code 3.17 and ORS 223.230.
DATED this day of vVQ , i .
fir
Sig : ure of Property Owner(s) • Signatur r of Property Owner(s) �-
2 ' ' A, �' S S
STATE OF OREGON ) Name (Please Print): �
6f \ _ 4 `� ` ry (i(�5 �' ( `
f1u?.t cc-e( c, �� IG 75 7 /ylc -P Circle
County of Washington ) Address: O ,. ( 2. 7 ? T • �,�
SUBSCRIBED AND SWORN TO BEFORE me this day of c J (tip , 1 O 0 .- f C(7 ID 3
Notary ' ublic for O ( ti � - ������ - �� - � - �� - - �� -�'��
(�� O (2.4 OFFICIAL SEAL
My Commission Expires: I i J BENGTSON
1 NOTARY PUBLIC - OREGON
COMMISSION NO. 368086
DOCUMENT1 MY EXPIRES APR. 27, 2007