14932 SW KENTON DRIVE r
i
f
{
I
I
i
II
1
F
Z
Y
__ 14,j it SW KF,NTUq DRIVE
IF
CITYOFTIGrARD cffy J IWAD CERTIFICATE OF
onloo"
COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY MSTO I
13125 SW HWI SlYd. P.O.Sm 23397,TO". -V-07229(603)8W41781'.'E k M I T e. . . . . . .
LXXX
X.X
639-4171 DATE ISSUE Ds 04/P4/9P
PARCEL: :,,S I IRr
f.)DI)RF.13133. 14'.P32 G14 KENTON DR
ZONINR% R--7
SUBDIVISION. . . . : (4SHPORD UPKS 3
BLOC)./-._._,.._..__..._._. . . . . . . . A OT_.._,_. ....
T . . o140
CLASS OF WORK. sNEW
TYPE OF USE. . . a Sr
OCCUPAN07Y GRP. %R3
j.OADi22e, 4
TENANT NAME. g
""o,markst
Owners
JPY Mll..LER
Po BOX 23291
TIGARD OR 97281
phont? 0% 604-7543
Contractors
JAY M7LLER
Plu BUX 123291
lookD OR r,7i2, i
i'.',hono V; 684--7543
i2 eq fit. . t
r)c;:.,upiAn(-,y of the buildivill is hot-ebY givPl'), and cc"t 'f"
the compliamr-'@ with, the ata" (')f Ov't*goll Fper_Jalty Codes for the W43"P,
and w.tve o.mciv�- which the ref#.kv,pn(-.-,,Pd—,I permit was issued.
N 14. c. p
FiRr DFPARTMCNT
10
..-mt-�7 --
BLI.7 Nu. n7
r I C T M.
r-,os'r IN CONSPICOC US PLAC1.
M4199-T-LO 9-0 ICE
ACity of Tigard Building Departwnt
►\p 13125 SW Hall Blvd. Tigard, Oregon 97273
7_A1 Inspection Lina (Rei-U-Phono): 639-4175 Businean Mons: 639-4171
Inspections _
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gam Line FINALS
Poet/Beam Struct. San. Sewer Framing (/'�'
�_Bldg. 1
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plhg. Underfloor Nater Line Gyp. ea. Mach.
Date Requested: _Rimes AM PM
Adrjceens_ _1 Ole -4) L.�'• Permit
Builder:_
THE FOLLOWING OORRSCTIONS ARE RRQUIRED:
Inspectors Date$
APPROVED DIBkPPRDVRD APPROVED BUSM.T Tel ADM
Call For ROLM*.
IF
w P �1TI
Tl9ar
city of d wilding Depmrtas97223
131ial25 SN D
1 Blvd- Tigard. `
Inspection Line (Rer_-O-Phone): /O�9-4175 Bueinoee Phones 539-4171
±----------'--"•"._.`fir..----..�_
Inspec tions,—___— --- ( A r/gdwlk
footing
Ploy. ttnd lab Hech. Rough-in ````
flog To �Out hes Line
lItfALs
found. -Bldg.
San. sewer
Framing E
Poet/Berm Struct.. -Plumb. 4
Insulbtion v
Rair, Drain P,
rolst/Beam Rech. Bd. -Hoch.
clpp.Water Line
Underfloor F
AM PM
Requested:
�- Permit is�—
L
XI
Address:__. -
Builders
it ppLIUW1N0 Rg
poRCTIONS ARE R64UtRED1 — —
-
� 7tnspectors, � �
__APPROVED
DI8AP D APPROVRD SUBJECT 'TO M"
GICall For Reinsp.
INSPItM-011 NOTICR
City of Tigard Building Department
1.3125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-41,5 Business Phone: 639-4171
Inspect ion:
Footing Plbg. Underelab Mech. Rough-in Appr/BdMlk
Found. Plbg. Top Out Gas Line lINALt
Post/e.eam Struct. San. sewer Framing Bldfj.
Poet/Beam Meeh. Pain Drain Insulation -Plumb.
Plbg. Underfloor /Neter Lino / Gyp. Bd.
Date Requeatedt_ LI �� ! Timet IW PM
Addcases Pervit is
builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
LZL t� ---,----
Z111e 7—e
a?pG
Inspectors J — Datu: - C
APPROVED `*Call
—_ APPROVED SUBJEfT TO ABOVE
For Reinap.
1.NspgglION NOTICE
City of Tigard Ballding DepartOent
13 .25 OW Hall Blvd. Tigard, Oregon 97223
Inspection 1.1m. (Rec-o-Phone): 639-4175 Business Phones 639-4171
Inspect:ion:,_--
Footing P)bq. Underslab Mech. Rough-in :A—pp�.r/SSddw.1k
Found. Plby. Top Out.
Gan Line \1 �lR�s J/
Poet/Beam 3truct. San. Sewer
Framing -Bldg.
Insulation -Plumb.
Poet/Beam Mach. Rain Drain
Plbg. Underfloor Water L'ne Gyp. Bd.
ech.
/'�,_- AM `PM
Date Reduested:�,_,-- Time
Permit #:
Addrrse:
Builders
THE yOLLOWING CORRECTIONS ARE REQUIRED:
f
P
inspectors a1' -'1s' G�C^G --- Date: -3jet _
APPROVED DISAPPR �APPROVED SUBJECT TO ABOVE
call For Reinsp.
A
I��$4� ON NOT�C�
City of Tigard guild
13125 8M Hall al-A. Tigard. Oregon 97223
Inspection Line (Roc-o-Phone)s 639-4175 Business Phones 639-4171
1nepection:,_-____.---- _ -
ply Underslab
h. Rou9h-i Appr�Sdwl.k
Footing
I?lbo. TOP Out C�Oas Line
Found. dINALs
')
Fresuis:g -Bldg-
Posk;Peam Struct. San. Sewer
-plumb.
Rain Drain
Tneulation y.
POet/Beam Mech.
plbg. Underfloor t]ats� Line
dyp. ea. -x.ch.
_ /� Time
Date P queeteds„ __"k_: /
i/: 7 �• -G�/�t� Permit 0. /
put.ider:
TRY FOLLOWING CoRRSCTTONS AAE REQVIRFDs
---_.�----`-__---- is
`
Inspecorr s
_ �. ------. _
DISAPPROVED APPRf1VEn SUBJECT TO ABOVE
�--- _APPROVED __._
Call For Rei.neP.
INSPF,.CTTON�OTICE
city ••t Tigard Bullding CepartiMent
13125 nM hall Blvd. Tigard, Oregon 9�2'l�
Inspection Line (Rec-O-Phons): f39--4175 Rus;[n p0dj;&: 639-4171
Inspoctions_-- ---- -- � --
Footing Plbg. Underalab Ner_h. Rough-in Appr/Sdwlk
Found. Plbg. Top O::t Cas Line FINAL:
Post/.Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor water LineOL yp. Bd. -lush.
Date Requested:' Timet _, 11M PH
Address:_ y� — lS� i17�� Permit et,,,.,,�.,.� _7
Builders
THE FOLLOWING CORRECTIONS ARE RRQUIRED:
Inspectors _ Date:___ ____
0 PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_-Call^Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
33125 FM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phonet 39-4171
Insp*ctionz_, ___
Footing Plbg. Underalab Mach. Rouqh-in Appr/Sdwlk
Found. Plhg. Top Out Cas Lina FINALt
Poet/Beam Struct. Smn. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain lnsulution -Plutab.
Plbg. Underfla,)r Water Line Gyp. Bd. -Meeh.
Date Requestedds ) �� o " Z Timet / AM PM
Addrwees 'n1v�.t`����"L //�� Permit
Builders-a' y o
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inapectort
PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
City of Tigard Bui.ldi.Lg Department
13125 Sid Heli. Blued. Ti.garcl, Oregon 97223
Inspecti-on Line IRec--o-Phone)t 639-4175 b. :4nee;'�hoiA 6�i�9-4171
Inspections_- _ - ---
Footing
--Footing Plbg. Underelab Mech. Rough-in Apps:•/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Pont/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain neula�tion ) -Plumb.
Plbg. Underfloor Nater Line Gyp. ad. -Mech.
Date Requested: --3 Timet PH
_—?s — ��
Addrees:_r_��� _ Permit �t
Builder: 2-21,,- J
THF FOLLOWING COMMONS ARE REgUIREDt
T
inspector:--..L natal
TAAPPROVED DISAPPROVkD APPROVED SUBJECT TO ABOVE
_call For Rjinsp.
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested, Time A.M. P.M.
Address Permit
OwnerLot
Builder
The following Building Code deficiencies are required to be corrected:
L
J
Presented to L'�'�Approved
Inspector - I
Disapproved
Date
CALL FOR REINSPECTION
E-1 YES 0 NO
k
i
i
tAment
city of Tigard Building DOP"
13115 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phonw)s 639-4175 Business Phone: 639-4171
Inspocticn: _
c
Footing Plbg. Undarelab Mech. Rough-ln A PP /Sdwlk
Found. Plbg. Top out
Gan Line FINALS
Framing -81dg.
Past/Ream Struct. San. Sewer
lost/Beam Mech', -Plumb.
Rain Drain Insulation
-= -Mech.
Plbg. Onderrlcoa ater L�iinne' GYP• Bd.
- - 7
Date Requested:
Permit
Address*
Rudder:
THE FoLLOHIN(S CORRECTIONS ARE REQUIRED: i
Dates Z
Inspectj"peRCMxD7DISAPPR11VXD
APPROVED SUBJECT Tt` ABOVE
Call For Reinap.
r
1�,skECTiV11NOTICE
City of Tigard Building Departs-nt /
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Li.ue (Rua--G-Phone): 639-4175 Bussiaees phone: 639-4171
Footing plLg. undertlab Mech. Rough-in Appr/Sdwlk
Found.
Pl.bg. TCP Chit Gas Line FINAL:
?naming -Bldg.
Poet/Beam St.ruct. (, San. 8SWO
-P1.nmb.
Poet/Beam Mech. gain Drain) insulation
ir>!� Gyp• Bd• -Mech.
Plbg. underfloor toz L
a,
- _ Time: AN y) PM
Date Requesteds
Permit
Addreess
THE P,l,lX)HING CORRECTIONS ARE REQUIRED:
Date:
InrFecto/r:
r/ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
��/\\\ Call For Reinsp.
w•�••�. +...uw.•,:,.Nbeu..,WeWnW,ew r.,o.rviun,:.:esr.u.u..Wia.gn ..•r:Annwr„....+.w.entLMVAMYMAKV
•M'+•'n1MYnw...HY'Mw.wvxraw,ew•.n.rV'Fwn+wra4+w.w. ........•u-v. .u,,.r.n.uwaww:.eY...._.._..,.._..._..
�e
INSPECTION NOTICE `
I
City of Tigard Building Department
T
P.O. Box 23397 / �
Tigard, Oregon 97223 I /
Phone: 639-4175
Type of Inspection
Date Requested
A.M. P.M.
Address 1 %j Z s�. ' ,ti'r ry�"�!A.f Permit #
Owner _ _
Lot #
Builder ----- — —77 --
Tho_ following Building C,)de deficiencies are required to be corrected:
_ I
b
P,esented to
Approved
Inspector _,-
_.' 1-1 Disapproved
Date
CALL FOR REINSPECTION
C7 YES L-1 NO
i
i
CIT 'C* TIFARDRMPEMIT #M. . .. ..
. . . . . . . ; MST9
Q[ BING PERMIT
cffyoF 0
COMMUNrff DEVELOPMENT DEPARTMENT eat ooee
41,258WHOONd P.O.Bcm23307,T1pA,Om9Dn 9=(W)&*4175 DATE ISSUED! 01130Y92
;L'-'%ITE-- ADDFESS. . . a 14f03! r-,)W KE.J,11-0N DR PARCEL : 21,13112C9-A0140
9 J S D I V I S 10 N. A S H F 0 R D 0 A i"S) _3 70NING: R- 7
FLOG:. . . . . . . . . . s LOT. . . * . . . . . . . .
CLASS OF WORK. . :NEW GAROAUE DISP03ALS. . 91
TYPE OF' USE. . . :F-;F WASHING MACH. . . . . . . it BACKFLOW PRF"VNTRS. 0
OCCUPANCY GRP. . tR3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . .. I cA,rCH BASINS. . . . . . . 90
F I X LAUNDRY TRAM'S. . . . . . :0 SF RAIN DRAINS. . . . . s 1.
SINKS. . . . . . . . . . 11 GREASE TRAPS. . . . — :0
LAVATORIES. . . . . 14 O1 HCR FIXTURES. . . . . .13
TUB/SHOWtRS. . . . s SEWER LINE (ft ) . . . . 'O
WATER CLOSETS. . L3 WATER LINE (ft ) . . . . 41CIO
DISHWASHERS. . . . 91 RAIN-DRAIN t
OWNER:
JAY MILLER TIF $ 1380. 00 JLH 01/30/92
PO BOX 23291 Bf-"R,r s 480. 50 JLH 01/30/92
RPLC ".I 312. 33 JLH 12/30/91 22130�*-'
TIGARD OR 972P-3 135PC $ 24. 03 JLH 01/30/92
Phone #.- 684--'7543 c1sric $ 280. 00 JLH 01/30/92
DARK $ 500. 00 JLH 01/30/92
i-'IuMbing MPOT $ 40. 50 JLH 01/30/9E
MP!-(, Q 10. 13 JI-H 01/30/92
Name a KEN WATTS 00475r m5pc 2. 03 JLH 01/30/92
P.O. 13OX 230925 PF".40 1, 140. 00 JLH 01/30/9E
Addrells 1---TIGAAD,OR 0;M---'----- P5rz 1, 7. 00 JLH V1 1/30 9
zipl..
REQUIRED TNS'PECTIj)NS
ij-jl-, permjt is issued sul.,3,ject to the veq •
-
-lat. ions containtl in the "rigarci municipal Foot/faund Insp Rain drain iwnp
oclu-, State of Ore. Sipecialty. Codes and all post./DeAm Struct Water Line Insp
11ther applicablo laws. All w0t'k - Will � t)P d0n#-'Pdst/B"A1h Hechlgn APpi~/9dw1k 1"sP
in aur-ordance with -Approved plana. This Plm/iAndslab Insp Mechanical Finai
If.,I'M'At will expire if work to not started PLM/Under-f 1c,or Plumb Final
wt-rhlin Ino days of isslAance, or if work is mechanical Insp Building Final
.1spelidpci for mr.-re than 180 days. Plumb Top Ol.tt Erosion Control
Framing Insp
Fireplar-e InE,p
GAr, I-Ane Insp
Inuulati-im Jr7sp
...... Gyp Board 1113P
,lutharized PItAmbinn i Tr�&T U v I
Call for inspection 639-4175
!.ontractor Notes ......
T'GARD CrTYOF 10 MAF,TER !"LRMIT MST()1-0257
COMMUNITY DEVELOPMENT DEPAWMENT MOM E R M I'T #. . . . . . .
13126 BW HWI Blvd. P.O.Bac 2W,DOOM,OVOW WW ifiW)6394176
SSU1� L) /30/9
14 0
'-'C L
P A R L :'�S112CB-A0140
W KENTON DR N
E ADDRESS. . . : 14932 S ZONING: F�7
SUBDIVISION. . . . : ASHFORD OAKS 3 : 140
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . .
BUILDING -------BAF:)EMENT. . . . . . . . 10 sf
E I F 3UE DWELLING �JNITS: l GARAGE.. . . . . . . . . . :410 s f
t�LAE'S 9F WORK. :NEW BEL)RM�;:3 BATHS:3
FLOOR REDUIRFD SET BACKS- f-t
TYPE OF USE. . . :SF FIRST. - - - - 1622 sf LEF'T. . :6 ft RIGHT. 16 f
1'Y,E OF CONST. -5N �-3EGPND. . . : 788 sf FRONT. :20 -Ft REAR. - :24
Cr;C'JPA1\1Cy GRP R3 REO.UlRED-
'THIRD. -0 s
'JORIES,. . . . . . . :,-.' - 112 sf 1,511OKE. DE'TECTORG. :Y
HEIGHT. . . . . . . . E-A ft 'J'0TAL
-- ------- 118240 PARK ING l,'3r-,ACES.
LOOK LOAD. . . . :40 Psf VALUE. . . . . $ :
e mark si PLUMBING ---------
BACK,-LOW PREVN'TR5. - -0
IINIK S. . . . . . . . . . : 1 Fi-nOR DRAINS. . . . :0 TRAPS. . . . . . . . . . . . . . .0
AVATORIES. . . . . :4 WATER HEATPS. . . : 1 CATCH BASTNS. . . . . . . tO
ULA/SHOWERS. . . . :2 LAUNDIRY TRAYS. . - :0 GREASE TRAPS. . . . . . . 30
APIEP CLGS,'.ETS. - :3 SEWER LINE (ft ) . :0
DISHWASHERS. - L4plFp LINE (ft ) . '. too OTHER FIxi'URES). . . . . :0
AARBAGE RAIN DRAIN (ft) - t0
4ASHING MACH. . . : 1 SF RAIN DRAINS. . : 1 FEES)
MECHANICAL typ Amount by date rept17UEL UNIT HTRS. - :0 T I F $ 1380. 00 Jl'_H 01/30/92 -
/GAS/ VENTS . . . . . :0 ,71..F1 0 1 0 2 -
Ll T U VENT' FANS. . .4 SPRT $ 480. 50
MAX INPU1_-0 HPLC $ 312. 33 JLH 12/30/91 22130"--'
FURN < 100K HOODS. . . . . . . I
`4. 0
.3
wOODSTOVES. -0 B5PC $ J1,H
17LJRN ) =100K CLO DRYERS. I SSDC, $ 00 it.-H 01 /30/92
-
FLUOR FURN. .0 7PARK $ 500- 00 JLH 01./30/`32
SGIL/CMP ( 3HP-.0 OT H[ p UN I TS-0 40- 50 JLH @1/30/92
GAS OUTLETS: 1 MPPI $
MPLC, $ 1.0. 13 J[_H 01/30/92
Owner: M5PC $ 2. 03 JLH 01/30/92 -
j(4Y MILLER PPRT $ ! 40. 00 JLH 01/30/9c". -
P0 BOX 23291 P5PC $ 7. 00 JLH 01/30/92
TIG3ARD OR 97223
p1lone, #: 684--7543
Coyltract ar :
�,U,,,%�ILER
_) 0XIL2:,29
I GARD
' ' C)" 9722.5
phone #: 684-7543 ______-____-__--._____-_-__._____.__._____
r?e q : 30109 s 3176. 52, TOTAL
is issued subject to the regulAtions Contained in the REQUIRED INSPECTIONS
Foot/found InSP Fireplace Ins
-hl' other Gas Line Insr)
Tigard Municipal Code. Stgte of Ne. specialty Codts and all Post/jApA "itrUCt
applicable laws. All work will be done in accordance with approved - m S:
Post/BeL4,n Mechr.ii Intulation I n s
olan-_ This permit will expire if work is not started within 18@
for more than 180 day�- Plm/UnCiSlab I ,1sP C'3'y;) Board 'nsP
d;vs of issuance, or if work is suspender; I -LM/Undey-f I Our Rain drain I r,s 0
1inical Insp Water Line 111sp
I-er,mittee 5iqt r eTr4 Nz;;, Plumb -I'OP Out Appr/Sdwlk Insp
x eclaM e c I i a 11 1
F V'affl 1 n N I 11 S P
cal Final
y : -1--- .1-11_
(,All for inspection - 639-4175
SEWER CONNECTION
CITY OFTIFARD Oma
INN P,ERMIT
COMMUNITY DEVELOPMENT DEPARTMENT ON0001 P,ERMIT #. . . . . . . : SWR92-0029
13125 BW 14WI Blvd.P.O.Bac 23W,TOW,Orepn ur (SM)6394176 C*n
DQIL TQGjjrn. x171/q.t. -
ti�`ITEE ADDRESS. . . : 1493E SW KENTON DR PARCEL: 2F-.')112CS—AO140
ITE`
. . . . .. ASHFORD OAKS 5 ZONING: R-7
BLOCK. . . . . . . . . . :* LOT. . . . . . . . . . . . . .. 140
TENANT NAME. . . . .
USA NO. . . . . . . . . . . FIXTURE UNITS. . . .
CLASS OF WORK. . . :NEW DWELL I NG U111 I TS. . : I
T*Y1-'1E OF USE. . . . . :SF NO. OF' BUT,_DINGS: I
I fel STALL TYPIE. BUF7WR IMPIERV 1;t.JRFACE. f
klemar-ks :
Owner-. -------------------------------------- FEES
JAY MILLER type arnol-int by date t-eept
PO BOX 23291 PIRMT $ 1900. 00 JLH 01/30/92 —
I NSP, $ '35. 00 JLH 01/30/92 —
TIGARD OR 97223
1--Thune #: 684-7543
Cont t-act or-: ......
CONTRACTOR NOT ON FILE
-----------
lDtione #s t 0Q) TOTAL
Req #. . -
REQUIRED INSF,ECTIONS
,his Appikint agrees to comply with all the rules and regulations Spwer- Inspection
of the Unified Sewage Ag.ncy, Tte permit expires 160 days from -------
the date issued. The total amount oaid will be forfeited if the
permit expires, The Agency does not guarantee the accuracy of the
side sewer 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 Ehali pumhase
"Tap and Side Sewer" Permit and the Agency will install a lateral.
Per-mittee SirjtiAtUVe -.
:,,..ted BY :
Call for- insportiort 639-41
%
CITY OF TIGARD RECEIPT 01" PAYMENT RECEIPT NO.
CHECK AMOUNT 4861. 52
4 NAME, t MILUF7R, JAY CASH AMOUNT s O. Ot
PAYMENT DATE r 01 /30/42
SUBDTVIGION
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
480.50 PLUMBING PERM 140. 00
Olt:'V,HAN I CAL. PE 40. 50 97. bUILD PER 3311. 06
Pl0
_i�N CHF FE 72. 46 SEWE R USA 1900.0
t3t.WER INSPECT 3115. 00 RE:SIDFNTInL TRAFFIC Frr,"�» 1200. 00
PAWS SDC 1500. 042.1 6TOPM DRAIN RDC 'PAA. 00
MA14,S) YBANS i"r TIP' 100. 00
149V:.' SW KENTON
L. 140 03j4F-()RD LJAIIF; 3
Tfj'TAL PMOUNT PAID 4861. 51�.'
b
e to t
v
KN
C:z 1 Y �If T I(3F+RU �- ? GE I E''Y (11 F IPYME NT RE I*,'[:.I V-"U N(1.
CHECK AMOUNT 3 25 10
h► Mf< s
MY M I LLEP F3LDR. , INC, cA,,314 flr OUN T s 00
Fie I)FI SS 0. bob 830%,91 r.',PYME:.NT DATE'. s 12/30/91
SUBDIVISION
I
PUR3-00SE CSF' f-',AIYMF NI AVIOUNA' PAID PURPOSE OF POYMLNT AMOUNT PA 1,D
r,-141O!3 _....,...._ µG:'�i�►. @� ..�_...,,�..._.�....._............._ ..,.... � .... .....,._...._.._..w.....__......
i
�`1 )IF-C RS C1�41a�
If 1, 101' 04 ti;bJ VENTTON DRIVE)
J i i4L AMt:N..N'T PAI I L► /_./ ._ y c":503 ON