Report STREET TREE
TIGARD CERTIFICATION
I� a eMi , owner/agent for Ms rz fieto -�� u.ST4/eS
(PLEASE PRINT) (PERMIT HOLDER)
do hereby centib that the following location meets
City of Tigard land use and development standards
for street tree installation and is consistent
with the approved site plan.
PERMIT NO.:
SI'1 E ADDRESS: 88ii S.4/ 5,66/c 5y- 77&,¢,eo
SUBDIVISION: ,S/ ' Sr 44,¢. LOT#:
SIGNATURE: 1Ialr DAZE: //tea-/s
(OWNER/AGENT)
RECEIVED &
VERIFIED BY DA 1 E: j//60
(CITY• TIGARD) i
❑ Tree location verified per approved site plan.
I:\Building\Forms\StreetTreeCertificate 05/30/2012