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erlee4. oilMeag5 3 , June 24, 2009 Cit of Tigard Cedar Hills Development Att: Roger Stalick 915 NW Terryview Lane Portland, OR 97229 RE: Pacific Crossroads TRAFFIC IMPACT FEE CREDIT APPROVAL SW Pfaffle Street Improvements Mr. Stalick: This is to inform you that your request for Traffic Impact Fee (TIF) Credits has been reviewed for SW Pfaffle Street improvements that were constructed as part of the Pacific Crossroads project. You paid $66,444 prior to July 1, 2008 in an effort to avoid paying the fee increase of $3,987. You did not request your credit refund within 30 days of paying the TIF and therefore are not eligible for the refund under these circumstances. I discussed your dilemma with the Washington County TIF Administrator at length. If you believe there was an error in the transfer of information regarding how the refund process works then it is likely that you would have deferred paying the TIF until occupancy. Proceeding on that basis, I can process a refund based on the following: Original fee paid prior to July 1, 2008 $66,444.00 Fee increase July 1, 2008 3,987.00 Credit for street improvements $42,716.86 Less Fee increase - 3,987.00 Refund $38,729.86 Please contact me if you have any questions. Kim ' + cMillan, P.E. Private Development Manager cc: Al Dickman, Sr. Engineering Tech Albert Shields, Permit Coordinator e - 13125 SW Hall Blvd. o Tigard, Oregon 97223 O 503.639.4171 TTY Relay: 503.684.2772 ® www.tigard or.gov . . ;oar C '/ (,_ ‘ _.e 00/000 1 15 "/ 4 4 L4,- C/fa- 7// 7 Gry . _air_A__4__-_n.ty • ,5d3 - 97-3 / _A iee _La-ILL, fiL ce emiile„___alaaLt__24_, u __ pr-A. / , iruz ar :A:,; 6) cf As ; drlY . SI_:-1)..S1-kOk ii 1 dikRato _A ___ ,,,s__61 A i a_x„ Q..,,4k_ ei- H City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Accela System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Cedar Hills Development DATE: 7/13/09 915 NW Terryview Ln. Portland, OR 97229 REQUESTED BY: Kim McMillan Attn: Roger Stalick DLH TRANSACTION INFORMATION: Receipt #: 2008 -2319, 2318, 2317 Case #: BUP2008- 00057, 56, 55 Date: 6/30/08 Address /Parcel: Various Pay Method: Check Project Name: Pacific Crossroads EXPLANATION: Refund for TIF fees paid, for credit given for SW Pfaffle Street improvements. .ORMA N. •:R FIrN :�'INF . T. .. . ..R e d'' - - 'vertu ccou "Fee•.bes�r• e >:° �.. - ;:�: ..fµ .. - =�Sx •le. -. sI1D. `.Perrii�'F'ee •: ' :� � �;...... ,. _ ..`- 'Examp . .... ....9:.,.. .... , . _ .... . _ . . , .....gip -... '[B�.� ]. . .... ...... ..... .. ..... -, ., _ .. [TIF - TIF Office 4100000 -43323 $35,244.16 [TIF -MT] TIF -Mass Transit 4100000 -43325 3,485.70 • TOTAL REFUND: $38,729.86 APPROVALS: If under $500 Professional Staff If under $7,500 Division Manager its.. .. A A A . .� If under $22,500 Department Manager �y�,= t'ff3 ` .% r If under $50,000 City Manager s If over $50,000 Local Contract Review Board 6 „F,OR ACCELA=SYSTEM'ADM.IN.IST IJS ,ONL Y:•' Refund Request Reviewed: Date: T //:tee 7 By Case Refund Processed: Date: _ By: 1: \Building \ Refunds \RefundRequest.doc 04/13/09 Y5 'f /(o ij'`i " 64.L./ L. r4-A - • .3 91.3, 70 /11s� Tom/ . r7 . , Fee •Tape ' Revenue/GL Account ! Fee Amount Amount Due Updated 7 ,,3/ , 7.2 9 , pk, .• I '{ Qli ill pJ Clcl 2i'_'i'i :Q:j IEUr'F'L��:J r'Ir� F.�.: _ .,:•_Ufji li i.:i ]; :IJUi i _ (FLS) FLS Pin Rv 245-0000-433020 $547.88 $0.002/22/2008 [BULD] Permit Fee 245. 0000 - 432000 $1,871.60 $0,00 7 /182008 [TAX) 12% State Surcharge 100-0000 -207020 $224.59 $0.00 7/18/2008 (BUPPLN) Add Pin Rv ... _245. 0000 - 433000 $326.23 $0.00 7 1182008 (FLS] Add FLSPtnRv 245 - 0009433020 $200.76 $0.00 7/18/2008 (METCET) Metro Cant Excise Tx 245 - 0000 - 229202 $637.40 $0.00 7/1812008 • (CDCBLD) CDC Old Rev 245. 0000 - 433080 $143.50 $0.00 7/18/2038 (CDCPLNI CDC Pin Rev 100- 0000 - 433060 $143.50 $0.00 7,18/20138 (LRPF] LR Planning Surcharge 100-0000- 438050 $42.00 $0.00 7/1 8/2008 • • (ERPROAT] Erosion Control 100 -0000- 207307 5160.00 $0130 7 /182008 (ERPLN) Erosn Pin Rv CWS 100- 0000 - 207308 $52.00 $0.00 7 /18/2008 [EROSN) Erose Pin Rv COT 245 -0000 - 433010 $52.00 $0007 /18/2008 [BULD] Mac Fee 245- 0000 - 432000 $400.00. $.007/18/2008 [Tl- o)TIP- office 210-0000-448003 $19,440.00 $0006/3012008 1 1, 2.5 l •lo(o (TIF -MIT) TIF -Mess Trns ... - . _ ... 210 -0300- 4480 . . .. $1,728.00 . $0130 6302008 1, 1 (4 I . q a Refund - (BULD) Mite Fee 245-0000- 432000 ($40000) $0.0010/2912008 [BUPPLN) Addi Pin Rv 245-0000 - 433000 $400.00 $0.0010012008 Y • : ' • , Tolels:' $26,869:77 $0.00 • . • i:.. .. , I °ees AscocicittaI with 1311P2000-00055 - _ ::;''`; !1. ri 1 . 1. ' :. _ k, !::::''.:*60:,11411h, _ : ': .; • ' • Reitenu Account Fee Amount: Amoun Dtie_ . Updated . • • i (FLS) FLS Pin Rv 245- 0000 - 433020 $547.88 EOM 0 212 2/20 0 8 . [TAX] 12% State Surcharge 100- 0000 - 207020 $224.59 10.00 7/1872008 . (BULD) Perms Fee 245 -0000- 432000 $1,871.60 $0.00 7/18/2008 [OUPPLNI Add) Pin fly 245 -0000- 433000 $32823 $0.007 /18/2008 [FLS) Add FLS PtnRv 004330 $ _ _ 245.00- 20 200.76: . $0.00 [METCETJ Metro Const Excl se Tx245 -BUD 229202_ $637.78 $000 7/1 8/2008 7i/8/21938 [CDCBLD) CDC Bid Rev 24 5- 00 433 080 $143.50 $0.00 7 /18/2008 [CDCPLN] CDC Pin Rev 1 00- 0000. 433060 $143.50 $0.00 7 /182008 (LRPF) LR Planning Surcharge 100 - 0000 - 436050 $42.00 $0.00 7 /182008 • (ERPRMT) Erosion Control 100 -0000- 207307 $160.00 $0.00 7/18/2008 [ERPLN) Erosn Pin Rv CWS 100- 0000207308 $52.00 $0.00 7/18/2008 [EROSN)ErosnPlnRv COT ... 245 -0000- 433010 552.00 $0.007/1820138 [BUILD) Misc f _ 245-0000. 432000 8400.00. $0.00711 82008 1 [iF.o] TIP- Office '210-0000-446003 $19,440.00. 10.0081302008 1 1 L Z3l . (.040 (Tff -MT) TIF- Mess T 0.03 ins 21 00-448005 . $1,728.00 $0.0 0 600/008 l ' % ( . q a ' Refund • [BUILD) Misc Fee 245 0000 432000 ($400.00) $0.001 029/2008 • [BUPPLN) Add Pin Rv 245- 0000 - 433000 $400.00 $0.0010292008 _ - • . Totals; $26,860.15 • $0.00 . . • . fees A,soci,deJ with 0UP2000 -00057 i , ' ' t. -' • • o'a1 • . ` e; . •'F' ` e' ' : ' Revenue . ::Account • ' : Fee Amount • Amount: e U dated • [FLS] FLS Ptn Rv 245-0000-433020 $547.88 50.00 22220 CTR . • [BULD) Permf Fee 245-0000- 432000 $1,874.30 $0.00 7/1 8 /2008 CTR . [TAX] 12% State Surcharge 100. 0000207020 $224.92 $0.00 7/18/2008 CTR •• [BUPPLN) Add Pin Rv 245-0000 - 433000 $327.99 $0.00 7/18/21308 CTR [FLS] Add FLS PlnRv '245-0000-433020 $201.84 50.001118/2008 CTR ; ' [METCET) Metro Cons! Excise Tx 245-01300-229202 $638.54 $0.007 /182008 CTR [CDCBLDI CDC Old Rev 245 - 0000 - 433080 $143.50 10.00 7/1 82008 CTR . [CDCPLNI CD 060 C Pln Rev 100 - 0000433 $143.50 00.00;7/team CTR ,: [LRPF)LR Planning Surcharge 100-0000. 438050 $42.00 $0.007 /182008 CTR - (ERPRMT) Erosion Control 1000000-207307 $160.00 $0.007 /182008 CTR '' [ERPLJd] Erosn Pin Rv Cw5 '100-0000-207308 $52.00 $0.00 7/18/20138 CTR C [EROSN) Erosn pin Rv. COT 245-0000 - 433010 . $52.00 $0.00 7/1 82008 CTR • pup] Odic Fee . 245- 0000 - 40 $4 320000.00 50.00 7/1 820 08 CTR { • [TIF -0] TIF- Offi 210-0000- 448003 $22,140.00 $0.006/302 CTR ' t Z, t "'!00.84 [TIF -MT] TIP -Mass T 410. 0000 - 44800 Tms 11 .968.03 $0.00.613012008 C*4, • X1 p 1 Refund - [BUILD) Misc Fee 245 -0000- 432000 ($400.00) 1 ' � [BUPPLN) Addi Pin Rv 245 -0000- 433000 $400.00 $0.0010292006 CTR • Totals: $0.0010292008 CTR 1 / $20,806.78 $0.00 : • , 1..% ov r O . l ig CITY OF TIGARD FEE AND PAYMENT HISTORY m .: 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TEGARD BUP2008 -00056 - 8020 SW PFAFFLE ST Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due [BUPPLN] Pln Rv 245 -0000- 433000 $890.31 $890.31 $890.31 2/22/08 CreditCard 2720080000 $0.00 0000000585 [FLS] FLS Pln Rv 245 -0000 -433020 $547.88 $547.88 $547.88 2/22/08 CreditCard 2720080000 $0.00 0000000585 [BUILD] Permit Fee 245 -0000- 432000 $1,871.60 $1,871.60 $1,871.60 7/18/08 Check 2720080000 $0.00 0000002534 [TAX] 12% State Surcharge 100 -0000- 207020 $224.59 $224.59 $224.59 7/18/08 Check 2720080000 $0.00 0000002534 [BUPPLN] Addl Pln Rv 245 -0000- 433000 $326.23 $326.23 $326.23 7/18/08 Check 2720080000 $0.00 0000002534 [FLS] Addl FLS PInRv 245 - 0000 -433020 $200.76 $200.76 $200.76 7/18/08 Check 2720080000 $0.00 0000002534 [METCET] Metro Const Excise Tx 245 -0000- 229202 $637.40 $637.40 $637.40 7/18/08 Check 2720080000 $0.00 0000002534 [CDCBLD] CDC Bld Rev 245 -0000- 433060 $143.50 $143.50 $143.50 7/18/08 Check 2720080000 $0.00 0000002534 [CDCPLN] CDC Pin Rev 100 -0000- 433060 $143.50 $143.50 $143.50 7/18/08 Check 2720080000 $0.00 0000002534 [LRPF] LR Planning Surcharge 100 -0000- 438050 $42.00 $42.00 $42.00 7/18/08 Check 2720080000 $0.00 0000002534 [ERPRMT] Erosion Control 100 -0000- 207307 $160.00 $160.00 $160.00 7/18/08 Check 2720080000 $0.00 0000002534 [ERPLN] Erosn Pin Rv CWS 100 -0000- 207308 $52.00 $52.00 $52.00 7/18/08 Check 2720080000 $0.00 0000002534 [EROSN] Erosn Pin Rv COT 245 -0000 -433010 $52.00 $52.00 $52.00 7/18/08 Check 2720080000 $0.00 0000002534 [BUILD] Misc Fee 245 -0000- 432000 $400.00 $400.00 $400.00 7/18/08 Check 2720080000 $0.00 0000002534 [TIF -O] TIF -Office Odom., y33,3 210 -0000-448003 $19,440.00 $19,440.00 $19,440.00 6/30/08 Check 2720080000 $0.00 0000002318 6 u,v2 O 0 - 0003'4, Revenue Payment • Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due [TIF -MT] TIF -Mass Tms *00000..- W25 -0000-448005 $1,728.00 $1,728.00 $1,728.00 6/30/08 Check 2720080000 $0.00 . 0000002318 [BUPPLN] Addl Pin Rv 245 -0000- 433000 $400.00 $400.00 $400.00 10/29/08 Check 2720080000 $0.00 0000003731 Refund - [BUILD] Misc Fee 245 -0000 -432000 $- 400.00 $ -400.00 $- 400.00 10/29/08 Check Refund 2720080000 $0.00 0000003730 Totals for Fees $26,859.77 $26,859.77 $26,859.77 $0.00 Receipt # Payment Method Check # Pavor: Receipt Date Receipt Amount 27200800000000000585 CreditCard PETER R STALICK 02/22/2008 $1,438.19 27200800000000002534 Check 1003 CEDAR HILLS 07/18/2008 $4,253.58 INVESTMENTS INC 27200800000000002318 Check 6041 ROGER STALOCK 06/30/2008 $21,168.00 27200800000000003730 Check Refund 10/29/2008 $- 400.00 27200800000000003731 Check 1003 CEDAR HILLS 10/29/2008 $400.00 INVESTMENTS INC Total Payments: $26,859.77 Balance Due: $0.00 CITY OF TIGARD FEE AND PAYMENT HISTORY • II a .. 13125 SW Hall Blvd., Tigard OR 97223 • 503.639.4171 I [CARD BUP2008 -00055 - 7910 SW PFAFFLE ST Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due [BUPPLN] Pln Rv 245 -0000- 433000 $890.31 $890.31 $890.31 2/22/08 CreditCard 2720080000 $0.00 0000000584 [FLS] FLS Pln Rv 245 -0000- 433020 $547.88 $547.88 $547.88 2/22/08 CreditCard 2720080000 $0.00 0000000584 [TAX] 12% State Surcharge 100 -0000- 207020 $224.59 $224.59 $224.59 7/18/08 Check 2720080000 $0.00 0000002533 [BUILD] Permit Fee 245 -0000- 432000 $1,871.60 $1,871.60 $1,871.60 7/18/08 Check 2720080000 $0.00 0000002533 [BUPPLN] Addl Pln Rv 245 -0000- 433000 $326.23 $326.23 $326.23 7/18/08 Check 0000002533 $0.00 [FLS] Addl FLS PInRv 245 -0000- 433020 $200.76 $200.76 $200.76 7/18/08 Check 0000002533 $0.00 [METCET] Metro Const Excise Tx 245 -0000- 229202 $637.78 $637.78 $637.78 7/18/08 Check 0000002533 $0.00 [CDCBLD] CDC Bld Rev 245 -0000- 433060 $143.50 $143.50 $143.50 7/18/08 Check 0000002533 $0.00 [CDCPLN] CDC Pln Rev 100 -0000 -433060 $143.50 $143.50 $143.50 7/18/08 Check 2720080000 $0.00 0000002533 [LRPF] LR Planning Surcharge 100 -0000 -438050 $42.00 $42.00 $42.00 7/18/08 Check 0000002533 $0.00 [ERPRMT] Erosion Control 100 -0000- 207307 $160.00 $160.00 $160.00 7/18/08 Check 0000002533 $0.00 [ERPLN] Erosn Pln Rv CWS 100 -0000- 207308 $52.00 $52.00 $52.00 7/18/08 Check 0000002533 $0.00 [EROSN] Erosn Pln Rv COT 245 -0000- 433010 $52.00 $52.00 $52.00 7/18/08 Check 0000002533 $0.00 [BUILD] Misc Fee 245 -0000- 432000 $400.00 $400.00 $400.00 7/18/08 Check 2720080000 $0.00 0000002533 [TIF -O] TIF -Office y /QiioO- (33023 210 -0000-448003 $19,440.00 $19,440.00 $19,440.00 6/30/08 Check 2720080000 $0.00 azipAool-Deas . Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due [TIF -MT] TIF -Mass Tms y /ODQA2• 93525 210-0000-448005 $1,728.00 $1,728.00 $1,728.00 6/30/08 Check 2720080000 $0.00 • 0000002317 [BUPPLN] Addl Pln Rv 245 -0000- 433000 $400.00 $400.00 $400.00 10/29/08 Check 2720080000 $0.00 0000003729 Refund - [BUILD] Misc Fee 245 -0000- 432000 $- 400.00 $- 400.00 $- 400.00 10/29/08 Check Refund 2720080000 $0.00 0000003728 Totals for Fees $26,860.15 $26,860.15 $26,860.15 $0.00 Receipt # Payment Method Check # Pavor: Receipt Date Receipt Amount 27200800000000000584 CreditCard PETER R STALICK 02/22/2008 $1,438.19 27200800000000002533 Check 1003 CEDAR HILLS 07/18/2008 $4,253.96 INVESTMENTS INC 27200800000000002317 Check 6041 ROGER STALICK 06/30/2008 $21,168.00 27200800000000003728 Check Refund - 10/29/2008 $- 400.00 27200800000000003729 Check 1003 CEDAR HILLS 10/29/2008 $400.00 INVESTMENTS INC Total Payments: $26,860.15 Balance Due: $0.00 CITY OF TIGARD FEE AND PAYMENT HISTORY i 1 2I : _ I 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TLGARL3 BUP2008 -00057 - 8050 SW PFAFFLE ST Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due [BUPPLN] Pln Rv 245 -0000 -433000 $890.31 $890.31 $890.31 2/22/08 CreditCard 2720080000 $0.00 0000000586 [FLS] FLS Pln Rv 245 -0000- 433020 $547.88 $547.88 $547.88 2/22/08 CreditCard 2720080000 $0.00 0000000586 [BUILD] Permit Fee 245 -0000- 432000 $1,874.30 $1,874.30 $1,874.30 7/18/08 Check 2720080000 $0.00 0000002535 [TAX] 12% State Surcharge 100 -0000- 207020 $224.92 $224.92 $224.92 7/18/08 Check 2720080000 $0.00 0000002535 [BUPPLN] Addl Pln Rv 245 -0000 -433000 $327.99 $327.99 $327.99 7/18/08 Check 2720080000 $0.00 0000002535 [FLS] Addl FLS PInRv 245 -0000- 433020 $201.84 $201.84 $201.84 7/18/08 Check 2720080000 $0.00 0000002535 [METCET] Metro Const Excise Tx 245 -0000- 229202 $638.54 $638.54 $638.54 7/18/08 Check 2720080000 $0.00 0000002535 [CDCBLD] CDC Bld Rev 245 -0000- 433060 $143.50 $143.50 $143.50 7/18/08 Check 2720080000 $0.00 0000002535 [CDCPLN] CDC Pln Rev 100 -0000 -433060 $143.50 $143.50 $143.50 7/18/08 Check 2720080000 $0.00 0000002535 [LRPF] LR Planning Surcharge 100 -0000- 438050 $42.00 $42.00 $42.00 7/18/08 Check 2720080000 $0.00 0000002535 [ERPRMT] Erosion Control 100 -0000- 207307 $160.00 $160.00 $160.00 7/18/08 Check 2720080000 $0.00 0000002535 [ERPLN] Erosn Pln Rv CWS 100 -0000- 207308 $52.00 $52.00 $52.00 7/18/08 Check 2720080000 $0.00 0000002535 [EROSN] Erosn Pln Rv COT 245 -0000- 433010 $52.00 $52.00 $52.00 7/18/08 Check 2720080000 $0.00 0000002535 [BUILD) Misc Fee 245 -0000- 432000 $400.00 $400.00 $400.00 7/18/08 Check 2720080000 $0.00 0000002535 [TIF -O] TIF -Office i X00- 0i4 210 -0000- 448003 $22,140.00 $22,140.00 $22,140.00 6/30/08 Check 2720080000 $0.00 0000002319 e -GdoS 7 . Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # . Due [TIF -MT] TIF -Mass Tms %pow- y3j $ 210 -0000 - 448005 $1,968.00 $1,968.00 $1,968.00 6/30/08 Check 2720080000 $0.00 0000002319 [BUPPLN] Addl Pin Rv 245-0000 - 433000 $400.00 $400.00 $400.00 10/29/08 Check 2720080000 $0.00 0000003733 Refund - [BUILD] Misc Fee 245 -0000- 432000 $- 400.00 $- 400.00 $- 400.00 10/29/08 Check Refund 2720080000 $0.00 0000003732 Totals for Fees $29,806.78 $29,806.78 $29,806.78 $0.00 Receipt # Payment Method Check # Pavor: Receipt Date Receipt Amount 27200800000000000586 CreditCard PETER R STALICK 02/22/2008 $1,438.19 27200800000000002535 Check 1003 CEDAR HILLS 07/18/2008 $4,260.59 INVESTMENTS INC 27200800000000002319 Check 6041 ROGER STALICK 06/30/2008 $24,108.00 27200800000000003732 Check Refund 10/29/2008 $- 400.00 27200800000000003733 Check 1003 CEDAR HILLS 10/29/2008 $400.00 INVESTMENTS INC Total Payments: $29,806.78 Balance Due: $0.00 Dianna Howse From: Kim McMillan Sent: Thursday, June 25, 2009 4:04 PM To: 'Roger Stalick' Cc: Dianna Howse Subject: RE: Pacific Crossroads SDR2007 -00005 Roger, At this point you just wait for the check to be issued. Dianna Howse will be following the process from here and mailing the check to you when available. Kim Kim McMillan Development Review Engineer Direct: 503- 718 -2642 Fax: 503 - 624 -0752 From: Roger Stalick [mailto:stalickco @comcast.net] Sent: Thursday, June 25, 2009 3:37 PM To: Kim McMillan Cc: Al Dickman; Mike White; Albert Shields; 'Peter Stalick' Subject: Kim: Thanks for the phone call today and going to bat for me in this matter. I appreciate all that was done by you, Al, Mike, and Albert. The $38,000+ really helps pay for other unanticipated costs of Pacific Crossroads. Please let me know the rest of the procedure and I will follow through. Thanks, Roger 1 11 1 1 11 e ° Building Division Request for Refunds TIGARD • TO: Phyllis Harris FROM: Dianna Howse L„ DATE: July 15, 2009 . SUBJECT: Refund Requests for the week of 7/6/09 Please process the attached expenditure requests and return checks and this memo to me for disbursement: • Refund Date Check Date Check Date of Case # or Refund Check Routed Mailed Payable To Receipt # Receipt Description Amount (Finance) (Building) Cedar Hills Development 2008 -2319, 6/30/08 BUP2008- 00057, $38,729.86 2008 -2318, BUP2008- 00056, • 2008 -2317 BUP2008 -00055 • If you have any questions please contact me at x2430. Thank you. I: \Building\ Refunds \Administration \RouteCheckRequests.doc 01/16/07 • Community Development TIGARD WILL CALL / PICKUP Fill out this form completely and attach it securely to the document(s). Bring it to the WILL CALL / PICK UP area at the Permit Center Counter and file alphabetically by last name of individual or company name. TO: 6 . SQL /C& • COMPANY NAME: C7i9/2.- /} /f/ S 25EV, DOCUMENT NAME: efis--- FROM: tic/ ,rs, /SE DEPARTMENT: e+ 6 DATE TO WILL CALL: FEES DUE: AIIIPP or ATTACH FEE INFORMATION (ACCOU _ ___ •jr�r C. Document will be returned to the A ,,,,,-, . ,.. 'f < �7. up within 5 business days of the j r TO WI '/ RECEIVED BY: {/ tti ✓ MUST BE SIGNED B THELCERSON LISTED ABOVE RECEIVED DATE: V 7-2s---O . RETURNED TO ORIGINATOR DATE: I:\ Buildin \FounARtcSlip - W ilICall.doc a A RE CEIVED JUL 2 8 2009 CITY OF TIGAR PCANAIIN3 /ENGINEERIN 1