8334 SW CHAR COURT ADDRESS:
i
i\record s\microflm\ta rgets\bu ild ing.doc
IffSPlCTION NOTIgn J/ /
City of! Tigard HuL2dlaq Dspwx�Yasnt ��,�//�"---//////
13125 M Ball ■Ltd. Tigard, Or.gcwm 97
Inspection Lin. (Roc-O-Phone)a 639-4175 Business Phones 639-4171
Inspections, _
Footing Ylbq. Underelab h Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line — FINAL*
Poet/E)eam Atruct. San. Sewcre ;t�ranii -Bldg.
Post/Beam Nech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. Rd. -Nosh.
Date R.questede / _ l Times
- L )1M PN
Addr...* = _ C _ P.rmit i�61
TEM POLI.ONING OORRECTIONS ARZ REQUIRED*
Tnepectors Dates�`L �/
PPRCIV D _ DISAPPP)VAD APPROVED SUBJECT To Apo"
_—__Call For Rsinep.
.,, CI1N' 0F Y I GARD CERTIF: KEINE OF
OCCUPANCY
COMMUNITY DEVELt OPMENT DEPAR T PERMIT #. . . . . . . ii M"0T94-9029
DWL ISGUED1 06/10/94
13125 SW Hall Blvd.Tigard,Oregon 97223*81W jhU'yt1V1-71
1;-'PS- 14600
SITE ADDRFSS. . . : P)S"334 SW CHAR CT
SUBDIVISION— . S CDLONY CREEDil, NO. 6 LON I NU c R,-i
IAL OCK. . . . . . . . . . s LOT. . . . . . . . . . . . . 3124
CLASS OF WORK. iNEW
TYPE OF U8F-. . . iGF
OCCUPANCY ORFS. :R3
OCCUPANCY LOW)c20-2. 4
TENRNT NAME— l:
Remarks.- PATH T
Owners
JAY MTLLER
P o nny Pip,41
TIGAW) OR 9�7c'l"0
Phone #! 684-7541�
Contractors ------
JAY MILLER
Pa Sax 2329t
TTGARD OR 97e8l
Phnne 0% 684- 7543
Peg #. . 1 30101?
Orcupancy of the above t-efet-ettir-wd building is 1-1ptleby givzrrl, and cet-tifiec,
the complience with the State Of Oi-egon Specialty Codes for the group,
cicf-,,.Apaocy, akrid i.ise undev- which the v,pfer-,enced pot-mit waw issued.
L I
ni`r I c i At
POST IN CONSPICUOUS PLACE
N� I OLN�
City of Tigard Building repartment
13125 SW Ball Blvd_ Tigard Or"m 97223
Inspection Line (Roc-o-Phone;t 639-417.) Business Phona• V63 -4'lt7l'
Inspections�4 X f "7SQ('C
Footing Plbg. Underslab 4*ch. Rough-in Appr/Sdwlk j
Found. Plbg. Top Out Gas Line �Fs
Po.t!Beam Struct. San. Sewer Framing �
Post/Beam Hoch. Rain Drain Insulation -Pltt.sb
Plbq. Underfloor Nater LLn'e f / Gyp. Ed. Meth.
Date Requestedti�Q �(/ `j �/ Timet AN PM
Addre.e s �3.j( C,hou /Parre tto t
Builder: Q / //'e �7 p 1
THE FOLLOWING CORRECTIONS ARE REQUIRErt
Inspector:
PROVED i� DISAPPROVED _- APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
LIjSPECTION NOTIM
City of Tigard Building Department
13125 RW Nall Blvd. Tigard, Oregon 97223
Inspection ,Line (Rec-O-Phone)t 639-4175 Business )Phone: I
Inspections ( l►
Footing Plbg. Cnderalab Nisch. Rough-in Appr./Sdwlk
Found. Plbg. Top shut- Gas Line
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Misch. Rain Drain Insulation 1
Plbg. Underfloor Nater Line ayp. M. -Misch.
Date Requested: ��l�l////n���� T�t / AN PM
Addresss� ,Iq
pisroit Lfj�� �
Buildisr1 L 1 �^
THE P'OL 110 RRECTION3 ARE REQtl7':(SD:
y
7e-,P firms - 7` icc.�c
1400,
_ APPROVED _ APPROVED APPROVED SUBJECT Tr ABOVE
Le611 For Reinep.
INSPSCT.ION NOTICE
City of Tigard Building Depa-tuaot
13125 Bw Hall Blvd, Tigard, Oregon 37223
Inspection Lina (Roc-O-Phcae)t 639-4175 Business Ph L--tl7l
Inspections -_
Footinq Plbg. Underal+ab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Tarp Out Oa• Line FINALS
Poet/se" Struct. San. Sewer framing -Bldg.
Post/Baum Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Linaayp. Bd. -Mech.
Date Res=uestede_ 752q- q I(f _- floras AM PN
Addresse D �1 i ' -- P.c'Lt tt
BuildersA ---
THE FOLUWINO OORRECTIONS ARE REQUIRED:
Inspectoc� �— - natal_. 21 �> -
-_APPROVED DISAPPROVED APPROVED SURJ+LCT To ABOVE
Cell For Ralnsp.
jNPSCTIOR MICE
City of Tigard Building Department
13125 aw Ball Blvd. Tigard. OroWm, 97223
Inspection Line (Roc-O-Phone): 6:39-4175 Uuainusa Phone: 63 4 71
Inspection:
looting Plb9. Underslab Mach. Rough-in Appr/Sdwlk
Pound. Plb9. Top Out Gas Line FINAL:
Post/Boss struct. Ban. Sower Framing -Bldg.
Post/imam Meeh. Rain Drain ( Inaulatlon ) -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Rogw/ted:1' /-LN
"J' ' Time: CLAM PM
Addresst 7 3 1 � M.y C Permit : I /1 _902
Builders., ( �(
TBE TOLLONINO CORRECTIONS ARE RNWIRED:
Inspector: Dat
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call. For Reinap.
INSPECTION NG (�
City of. Tigard Building �t u
13125 St Hall Blvd_ Tigard, 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone. 639-4171
Inspection:_
Footing '
Plbq. OndBrslab `��
l wpah. Rough-in ' wppr/Sdwlk
Found. 1 4430,r-- - Out`{ pas Line FINAL,
Post/Beam Stract. San. Sewer Framing) -Bldy.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line t Gyp. Bd. -Nech.
Date Requested: � — I''1 - L)
Z I / Tits: �_AN PM +
Address `b3?��� ( NCI. C� Cly
(�� Pettit 0t�i /
Suilderr C� \ iyuLt14ctc 7l>>
TM POLLONING CORRECTIONS ARE REQUIRED:
�—�A Ta
��
z
lAj e_ �.�.-� —�.t 4 .Zt,
Cj
—,tZ7-!a�—
X-4--AA
lie.
Date:_
—�APPRUI'ED __An�"DISAPPROVRb APPROVED BUBJE(^T TO ABOVE
For Reinap.
tea_
INSPECTION NOTICE
City o.0 Tigard Building DeFertment
13125 SR Ball sled. Tigard, 011.-ligan 97223
Inspection Lina (Ree-O-phone): 639-4175 Business Phones 639-4171
Inspections
Footing Plbg. Underslab Mach. Rough n Appr/sdwlk
Found. Plbg. Top Out Oaa Line ANAL: f
Pact/Beam Struct. San. Sewer Framing -Bldg. II
Post/Beam Hoch. Rain Drain Insulation _Ply.
Plbg. Underfloor Nater Line QGyp. Rd. -Koch. 111
Date Requeateds ` C1 1 _Times A _
Address. �� C_k,,,<�.f L0 4 0 o -2
— Permit 1:_
Builders,
TBE /OUAWINO CORRECTIONS ARE RRMIRED: - �-
(70
QA A
c —• 4
etc. 0
--�'�'LI-� �'--� �- c�►�n,-..� �i ���.p �..1.
1 1
Inspectors
LL bates
APPROVED —__DIAAPPROVED _ APPROVED SUBJECT TO ABOVE
I Call Por Rainap.
INSPECTION NOT,�CB City
am-
City of Tigard Building Department.
13125 aw Ball. Blvd. Tiga--d, Oregon 97223
Inepection Line (Rea:-O-Phone)s 639-4175 Business Phone: 639-4111
Inspection:_
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. .' Plb-, ftV Out Gas Line FINAL:
r
Post/Beam Struct. San. Semr Framing _Bldg.
Post/Ream Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Line Gyp. Bd. _Mach
Date Requested:
Address: ( .
r.roit •A M5T j`�
Builder: `7
THE FOLLCWING CORRRCTIONS ARE REQUIRED:
I
Inspector:-
APPROVED DI3APPROVED APPROVED SUBJECT TO AROVE
�_ Cell For Rainep.
INSPECTION NC1fICR w City of of Tigard Buildiag DepartssewL
M25 SR Ball Blvd. Tigard, Oragon 97223
Inspection Line (Rec-O-Phones 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underrlab �, Nongh-Ln) Appr/Sdwlk
Pound. Plbq. Top Out Gas Line FINALS
-Com•--____,.
Poet/Beam Stvuct. San. Sewez Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater 1Line/ Gyp. ad. -Koch,
Date Rsqussteds �> 'I (1 t, Time:
Address: T��J"l`f �YY1�1' Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector s_/79-7 — — Dater
APPROVED DI4APPROVED -_ APPROVED SUBJECT TO ADOVE
tell For Reinep.
INBPECTION IfOTICT
City of Tigan! Building Department
1312S M Bali D!rd. Tigard, Oregon 97223
Inspection Lino fRec-o-Phonn): 639-4175 Business Phones S39-.4171
Inapec% ons
Footing Plbg. Underslab Meeh. Rough-in Appr/Sdwlk
round. 11 Plbq. Top Out Gas Lina /INALs
st/
�oeoam BtruGt- San. Bower rraminq -Bldg.
st/Boase Hoch Rain Drain Insulation -Plumb.
Underfl Nater Lino Gyp. Ed. -Hoch.
L--— } L1 1
Date Rs-Nesteds � / Times �AH PM
77� �va
1
Address `6;7 J�q y � I �Poneit 1 r �q� `1/02 /
Builders
THR FOLLOWING )CORRECTIONS ARE REQUI99fls
Inspectors �. „ --- Dstor 2 — / -
1►PPROVRD DISAPPROVED r APPROVED SU
RJMCT TO ABOyE
_Call Mor Roinap.
11452MICM NOTICE
City of Tigard Building Departssant
13125 Rid Ball Blvd. Tigard, Oregon 9722
In.p.ction Lin. (R.c-O-Phon.)s 639-4175 Business Phou a 9-4171
Imnp.ctlons_._ �^
Tooting Plbg. Dnderslab Hoch. trough-in Appr/Sdwlk
Found. Plbg. Top Out (Sas Lin. FINALr
Post/Beam Strum. ( San. S.w.r! Framing -Bldg.
Post/Beam Hoch. Rain Drain l in.ulation -Plumb.
Plbg. Ondarrioor
- Nater Lin._ Gyp. Bd. -Koch.
-__—
Dat. R.qu..t.dr! ,�, Times _AM
c�
Mdr..ss l /tj �� -� IlW 1� _ Permit tsl q-
Build.ri �_ 1 r �.� —7 9 L' - 92— i
THE FOUAMINO CORRECTIONS ARE REQ'7IRED2
Insp.c. ors�T Dates
t/ J►PPROVED DISAPPROVED APPROVED SUBJECT TO AWWR
Call For Rsinsp.
INSPZCTION NOTICE
City of Tigard Building Department
13128 SR Mall blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)e 539-4178 Businoae Phone6 -4171
n , 1
Inspection;,_ U l_0
Plbg. Onderalab Mach. Rough-in Appr/8dwlk
Plbg. Top Out Gas Line FINALt
Post/Baas Struct. San. Sewer Framing -bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb,
f
Plbg. Underfloor Mater Lies gyp. ad. -Koch. �
Data Requeatada__ �J�/ Tice: Llz_m
nn-- pN
Addreust_ �'Z,�l I�.�"rte . Permit #t�_L pZ `
Buildart'I'.Ll �� ( - 7 ��-7 .
TBE FOLLONIIKi OORAECTIONS ARE REQOIRZD s
InapectorfC'
�-- -�-- -
a& at
_APPROVED DISAPPROVED APPROVED SOB"CT TO A
Call For Reinsp.
INSPECTION NOTICE `.
City of Tigard building Deparhesnt
13135 ell Hall Sled. Tigard, Oregon 97223
In pec Lon Lina (Rec-O-Phono)s 639-4175 Business Phones 63 -
` -1- Plhg. Underalab Naoh. Rough-in Appr/Bdwlk
C J Plbg. Top Out Gas Line IINALi
Post/Seas Btruat. Ban. Bower Freeing -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Oyp. Ed. -Mach.
Date Requestedt Z Z q rc�/ Time:
_ AM '�- 1 PN
Address s �; _>>J� � p Permit #:
Suildarr�
THE FOLLOWING CORRECTIONS ARE REQUIRED
Inspector: DatesL
�.�AlROV�D DISAPPROVED APPROVED EDE.1EM To ABOVE
Call For Reinsp.
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MST94•-902 9
13125 SW Hill Blvd.Tigard,Oregon 97223•$196.11*Mt1974171 DATE ISSUED: 01/06/94
PARCEL: 2S110BB—CC124
SITE ADDRESS. . . : 08334 SW CHAR C'F
SUBDIVISION. . . . : COLONY CREEK NO. 6 ZONING: R--7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 124
BUIL.DING _____.____._______________•----------_--__
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:3 BATHS s 3 GARAGE. . . . . . . . . . t410 s f
TYPE OF USE. . . :SF FLOOR AREAS---,------------ REOU I RED SETBACKS-------- --
TYPE OF CONST. :SN FIRST. . . . :894 s f LEFT. . : 10 ft RIGHT. -5 ft
OCCUPANCY GRP. :R3 SECOND. . . :728 S f FRONT. -20 ft REAR. . -25 ft
ST0' ES. . . . . . . s2 THIRD. . . . :0 s f REQUIRED--__.___.—_—_.--•__—__—
I"
HE I GHT. . . . . . . . :22 ft TOTAL-------- - : 1622 5f SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $: 81992 PARKING SPACES. . : 1
Remarks : PATH I
---- --- PLUMBING
S I r`lKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . .4 WATER HEATERS. . . a1 TRAPS. . . . . . . . . . . . . . 10
TUB/SHOWERS. . . . :'- LAUNDRY TRAYS. . . :0 CATCH BASINF. . . . . . . :0
WATER CLOSET"S. . :3 SEWER LINE: (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL -__.__.__.__.__.._..___________________._.____ FEE:
FUEL TYPES--------------- UNIT HTRS. . :0 type amount by date recpt
/GAS/ / / VENTS . . . . . z0 TIF $ 1520. 00 PL.L 01/26/94 —
MAX INPUT:O BTU VENT FANS. . t4 BPRT $ 379. 00 PLL 01/26/94 —
FURN ( 100K . . s1 HOODS. . . . . . t1 BPLC $ 246. 35 JLH 01/20/94 94-247911
TURN ) -100K . . :0 WOODSTOVES. :0 BSPC $ 18. 95 PLL 01/226/94 --
F=LOOR FURN. . . . s0 CLO DRYERS. : 1 SSDC $ 280. 00 PLL 01/26/94 —
BOIL/CMP ( 3HP:0 OTHER UNITS: 1 PARK $ 500. 00 PLL 01/2G/94 —
GAS OUTLETS: 1 MPRT $ 43. 50 PLL 01/26/94 —
Owner: ---------------------------------------MPLC $ 10. 88 PLL 01/26/94 —
JAY MILLER MSPC $ R. 18 FILL 01/26/94 -
P O BOX 23291 PPRT" $ 140. 00 PLL 01/226 /94
1:15PC $ 7. 00 PLL 01/2'6/94 -
TIGARD OR 97281
Phine #: 684-•7543
Contractor: -•..___.___.____---_______.__._______
.TAY MILLER
PO BOX 23291
T 1 GARD OR 97281
F-'hane #: 684-754.3
Reg #. . . 30109 --------- ---------------------
$
-------- -.------------------_$ 3147. 86 TOTAL
This permit is issued subject to the regulations contained in the ------- REQUIRED INSPECTIONSi -- -----
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All Mork will be done in accordance with approved Post/neem Struet Lias Line Insp
clans. This permit will expire if work is not started within 180 Post/Beam Mechan Insulation Insp
!lays of issuance, or if work is suspended for more than Ill@. s. Pim/undslab Insp Gyp Board Insp
PIM/Underfloor Rain drain Insp
PP, mi t; 1,ef, 5i gnature: < ' . 'l�- Mechanical Insp Water Line Insp
�. Plumb Top Out Appr/Sdwlk Insp
Issued LAY : :_ _. ._ Framing Insp Mechanical Final
Call for inspection 639-4175
CITY OF
T SEWER CONNECTION
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : SWR94-0031
13126 SW 140 Blvd.Tlgari,Oregon 97223*e10VI'"i97471 DATE ISSUED: 01/26/94
PARCEL: 2S112BB--CC124
0- tE ADDRESS. . . : 08364 SW CHAR CT
SUBDIVISION. . . . = COLONY CREEK NO. 6 ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 124
------------------------
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELLING 1JN I TS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTILL TYPE. . . . :BUSWR IMPERV SURFACE. . : : sf
Remarks. : PATH I
Owner: ______.__---_._____------__.--•--____.________---------- _—•-- FEES ------------•---
,JAY MILLER type amount by date recpt
P 0 BOX 23291 PRMT t 2200. 00 PLL 01/26/94 —
INSP 4 35. 00 PLL 01/26/94 —
TlGAR►.` OR 197281
Phone #i 684-7543
Contract o—• ----------__----._.-------------
CONTRACTOt' NOT ON FILE
!-'t)o n e #: S 2235. 00 TOTAL
Rey #. .
-------- REUU I RED INSPECTIONS
— ------
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unitied Sewage Agency. The permit expires 180 days from
511� date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side serer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewir" Permit and the'gency will install a lateral.
Permittee Si gnat ur•e: ��
I %sued By
Call for inspection — 639-4175
' t
CITY OF TIGARb _ RECEIPT OF= PAYME=NT RECEIPTNO. 04--24130138
CHECK AMOUNT t 513a. 86
Jfll�F a JAY MILA.ER BLDR. , 114C. CASH AMOUNT a 4b. 00
DI)P2ESS a PO BOX 23P91 PAYMENT DATE a 01/26/94
13U81)1 V IS ION a
f I[iAR1), CIR 97cPSt-•
rlMPOSP OF POYMF NT AMOVINT FAIR PURPOSE OF PAYMF'NT AMOUNT PAID,
:U11_bINp P'E'RM M91.94-9Oc'9 -:3%9. 00 FaL.1JMF31N(3 F'f f1M -u _ -~ 140. 00
L-134 TNICAL. PF 43. 50 ST. HUIL.0 PER es. 13
L..PN CHECK FF 7. R3"3 SEWER USA S3WR94--0031 2200.(he
EWER R I NSPECT :35. ON PARKS SIA', `lalA. ow
TORM DRAIN Fink; N0 FRF=SIDEN1 INL. TRA14IC: FF fwP) 1410. NSI
A!31.3 'T-RANGI C TIF F=f"VJ-7 1 t0. 00
334 SW CHAR f-;T. COL.ONY CREEK EST'AT•FSt 06, LATr
c.'•4
OI AL AMOUNT PFS T V ._ _ __F 15 132. 86
Residential Building Permit Application
City of T4ard
13125';.ZW Nall Blvd.
Tigard; 017 97223
(503) 639-4171
Jobsite address:
Cti✓
Y 4;
rr II ffs` t�ftic#Use_0�
Subdivision: bh J X� lA(tS �p Lot #
Valuation:
Owner:
Address: -- —. `
>. iy
x: w , y
Phone:
f<} ty p $ tR C
Contractor:
Address lb VI /1t J ,
��,,,, ,.��� --�� �r�
Phone: �L1_1_ s�m rY
Contractor's License# al�� y
(attach copy of current Ofrpon license)
Subcontractors. /
Plumt;ing:._ --u) W S
Mechanical: bell fft
(attach copy of current OR Cor�actorls I_kaBrrse)
Architect/Englrtevr• _
Address:
Plxme:
l
COMMENTS: L2e` sdIi2Z1 .(� li �A-, P I U s e .pti..CC z
75V 3_
Applicant Signature & Phone number
Received by: _-- Cate Received: r-0'.0
Permit # Account Description Amount Amt. Pd. Sol Due
Bldg. Permit (BUILD) _ r-'
Plumb. Permit (PLUMB) vo / Ui
Mech. Permit (MECH) 4 3•>1. /e 3 J"v
State Tax (TAX) ��/3 / �- • 13
Bldg:
Plumb: 7;
Plan Check (PLANCK)
. ? 3
Bldg: 3a�
Plumb:
Mech: _ o'5T
Sewer Connection (SWUSA) -;z 2d-v
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) / 5 c-U
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
i
Nass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0) _
Water Quality (WQUAL)
Water Quantity (WQUANT) '' r
Fire District (FIRE)
TOTALS:
i
CITY OF VICARD RECEIP,'r OF` PAYMENI Rkl:f- I PT N0. s94-2479). j
(1-HECK AMC)tlNr a •.*1514. 160
OWE— MILLER, JAY I.-,AWA AMQIJN 1 0. 0111 If
DDH( PAYMENT 1,)141t- (h1/2.(7 1),(i
SUBDIVISION
LIRPOSE OF PAYMENr AMOUN T PA I D PURPOSE OF PAYMENT AMOUNT PAID
1_10,1 CHECK F-E 2 qi. 00
OT 124 COLONY CREEK ESF #6
"'34 F3W CHAR Cl'
(Iln(. tiMUUNT PPID 00
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