Report (39) -11 STREET TREE
TIGARD I A TION
CER TIF C
I, DPY iD � ,D& Nom, P -r' , owner!agent for Foo,)z- D Cwstxu c r l o ti ,
(PLEASE PRINT) (PERMIT HOLDER)
do hereby cert 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.
PERMITNO.: MST .2() i5 —oOO73
Sri i ADDRESS: 1 2 7 0 5 , YY. 11 B .-1-14 C T.
SUBDIVISION: M el)p LL.1 OM NZetaA off/ S LOT #:
SIGNATURE: DATE: /2- 7 - / S
( R/AGENT)
RECEIVED &
VERIFIED BY: DA 1h: b2/e//S r
( OF TI )
Tree location verified per approved site plan.
[:\Building\Forms\StreetTreeCertificate 05/30/2012