11932 SW 125TH COURT I
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11932 9W L25TH COURT
CITY C* TIOA RD CRY TWARD
COMMUNITY DEVELOPME?rr DEPARTMENT 0��wl 7
11126 SW Hell Blvd. P.O.Bax 23397.Tigod.Oregon grM (SM)SID 4176 (TRTIFICOTE OF
OCCUPANCY
XXXX PERMIT #. , . . . . MST92-911
6.'34-4171
DATE IS''4jF'L,t
SITE ADDRSS. . . : .11932 SW IPS14A CT PIciRCELc
SUBDIVISION. . . . t VILL-lLiGE AT SUMMER LOKI- PORK 4 OWING: R-4. 5
BLOCK. . . . . . . . . , s L07.. . . . . . . . . . . . . : 144
CLASS OF WQRt;. %NEW
TYPE, Of USE. . . t bF,
OCCUPANCY GRP. R3
OCCUPANCY 1_OADi2iR6 is
TENANT NnME-
1�emiarl�s :
Uwner-.
DON MORiswm 131JILDER-G, INC:.
15555 SW N44NGY RD.
920 1
144KF O1,-,WFG'0 OR 970355
L wit rm(-t or;
DON 1110RIGGE1'TE BUILDERS, INC.
15555 SW BANDY RU.
Opo(
I-PRE c1swEbo OR 970Y-i
V-phone #.- 620-7'-*3F1
Re *. . I 35t33
or-cupancy of the above refevencled building is heruby wiven, and cert ifiv!
the compliance with the State Of Oregam Sporialty Cot.je-ij for• they, group,
occupancy, and use under which the referenced permit wal, IsrAlted.
F 1 RE 14PARTMV1111 BUII-DI14G INSPECTOR
--
SU11 DING OFFICIAL
POST IN CONSPICUOUS PLACE
�pSP$CfION NOTICE
City of Tigard Building Depart.pnt
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639--4171
Inspection•__ _-- —
Footing P1bg. Underelab Much. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. Shn. Sewer Framing 9
Poet/Beam Mech. Rain
Drain Insulation �--
Plbg. Underfloor water Line GYP• Bd. -Mech.
�� _
Date Requested Time: N�
/1 Permit
Addrere: G. Y�QI L1
Builder: —_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspect-or:_ -- y __ Date:
/APPROVED IIHAPPWWRD —__ APPROVED SUBJECT TO ABOVE
Call For Rainsp.
INSPECTION NOTICE �J i
City of Ti.ga Building
13125 SH Hall B - Tigard n+. goo 97223
Inspection Line (Rec-O-Pho {: 639,4175 Business Pt:on.?: 639-4171
Inspection:`_
Footing Plbg. U erelab Mech. Rough-in App[/Sdw1k
Found. Plbg. op Out Gas Line FINAL:
Post/Beam Stn.:^t. San. Sewer Framing -Bldg'
Poet/Ream Mech. Rain Drain Insulation
-Plumb.
Plbg. Underfloor /water Line Gyp- Bd- -Mech.
�L�.<f �j Time: AM _—PM
Date Requested: // -- -
�
Address,
h� Permit_ t: !L—=-
Builder: --
TILE teOLLONINGG CORRECTIONS ARE REQUIRED:
17
Inspector:
-APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
1
} For Reinsp.
_1' t
INSPwTION NOTICE G'v�
City of Tigard Building nepartment
1.3125 SW Hall Blvd. Tigard, Oregon 97223
Insp :tion Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspections^ --
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Fou,id. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
poet/Beam Mech. Rain Drain Insulation =pl—b.
Plbg. Undmrfloor Water Line Gyp. Bd. -Mech.
Date Requested:_��(��� Time: _AM PM
/,z '
Address: Permit
`� � � �~
Builder:-
-4THE .'-::.LOWING C3RRECCIONS AAE REQUIRED:
F It
__ -
A-t-
�
Inspectors
PROVRD DISAPpROV6D -- _ Aa-PROVF.D SUBJECT TO ABOVF
LIA�_
Call For Rei.nsp.
IkSC'P.CTION ;voTicr.
City of Tigard Building Department Thr'
13125 Sid Ball Blvd_ Tigard, oregnn 97223
Inspection Line (Rec-o-Phone): 639-4175 Bun.inAee Phone: 639-4171
InepectLon:____
Footing Play. Underslab Mech. Rough-in r/Sdwlk
Found. P1bg.�,Top Out Gas Line FINAL:
Post/Beam Struct, San. Sewer Framing --Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Li�ne Gyp. Bd. -Mech.
Date Requeeted: L7-7- /"- 92- ____Time: __ )<- M _PM
Address: yit� -1 __ Permit r:--. -�---
builder:_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_ � /�}� Dates
APPROVED DISAPPROVED L1/APPROVED SUBJECT TO ABOVE
Call For Reinep.
jKSpECTION NOTICE
City of Tigard Building Departzsent
13125 SW ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-C-Phone): 639-4175 Business Phone: b39-4171
Inspection: --
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
round. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain InsulatLon -Plumb.
Plbg. Underfloor WatelBd r Line Oyp. -Neth.
Date Requested• �s7 �_�2 _Times AM PM
Address:
�` .Z— '1'-o�fllPermit
Builders Otki
THE FOLLOWING CORRECTIONS ARE REQUIRED:
inspectors
_ _ _--- Date:
!/ APPROVED nINAPPROVSD APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
City (,, Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection . ---_ -- — ---- — ---
Date Requested— _ Time— A.M. ___P.M.
Address 1 .Z ��.�---- — Permit # d
Owner--- ------ ---._._.. _ __ _ Lot #---- —
Builde: __-- ---- — - .--
The following Building Code deficiencies are required to be corrected:
Presented to ___ -- ISI Approved
Inspector - --. I Disapproved
Date —
CALL FOR REINSPE!i lON
1 YES ❑ i40
iNSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-1'171
Inspection:__
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer [ Frami� -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
P1bg. Underfloor WateL Liney7 Gyp. Bd. -Mech.
Date Requested: _ l o-4, . _ TiMt AM PM
Addreest 1 J�s Perri t 1,/'�--
Builders ,
THE )OLLOWIIIG CORRECTIONS ARE REQUIRED:
Inspectort___ _ Date Z Z_- Z' y'
APPROVED DISA✓PPROVED APPROYRD SU&MCT TO ABOVE
Coll Fa. Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection•
Foocing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Post/beam Struct. San. Bower n - Framing -Bldg.
Post/Beam Mech. Rain Drain J Ineulatio -Plumb.
Plhg. Underfloor Nater Line Gyp. Bd. -Koch.
Date Requested t— _42L � Time: AN
/ PK
Address: Permit #s�/� Z)/
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
L _
- .p ----�
Inspector: Dater y
APPROVED d_,`DIBAPPROVED APPROVED SUBJECT TO ADWS
r Call For Reinap.
INS��CTION NO'I_I('E
City of Tigard Building Department.
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec--O-Phone): 639-4175 Business Phone: 639-4171
Inspectionz
Footing Plbq. Underslat Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line tINALt j
Post/Beam Struct. San. £ewerFralsi^ n� -Bldg.
Post/Beam Mech. Rain Drain Insulation - v,
Plbg. Underfloor Water Line Gyp. Ed. -Meeh.
Data Requested:_- - - `! Timm AN /--)LPN
Addrens:__ — Permit #t
Bu:.lder: ��_
i
TIM FOLLOWING CORRECTIONS AAE REQUIREDt
�J
Inspectors Dateey` 3 7
APPROVED ! DISAPPROVED APPROVED SUBJECT TO ABOVE
•• Ca11 For Reinsp.
I
f'.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171
Inspe'7tion:___
Footing Plbg. Underslab 41echn. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb. JI
Plbq. Underfloor Water Line Gyp. Bd. -Koch.
Date Recruented:_ ri`� ;' Timet AN PM
Address: L, `L � -� Permit tl, U
Bu f.i dor•
'THE FOLLOWING CORRECTIONS ARE R RED:
I
Inspectors Datst
-� APPROVLD DISAPPROVED APPROVED SUBJECT TO ABOV=
J Call For Reinsp.
4
1"SEzCTION
City of Tigard Building De—tmr_nt
13125 Sit Ball Blvd. Tigard, orsgon 91223
Inspection Line (Roc-o-Phone): 639-4175 Business Phone: 639-4171
Inspect ion: -- !--—
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Founds. Plbg. Top Out Gas Line FINAL=
lo-.t/Beam Struct.— ban. Sewer Framing -Bldg.
Beam Necc Rain Drain Insulation -Plumb.
Plbg. Underfloor Water/Line Gyp. Ed. -Mech.
AM
Date Requeatad: . -' ____Ti.- �-- ----PH
Addreans l Y JZ /��� Permit
I
Builders--.—
THE FOLaOW1Nr CORRECTIONS ARE REQUIRED:
Inspectorf
APPROVED DISAPPROVRD v_ APPROVED SURIECT TO ABOVE
Call For Reinsp.
IMSP;CTIOM NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk j
Found. Plbg. Top Out Gas Line FINAL:
Poet:/Beam Struct. San. Sewer Framing -Bldg.
PPooet/Be�am�Merhh. Rain Drain Insulation -Plumb.
P1t�q. Underfl Water�ins/ Gyp. Bd. -Meeh.
�ul��-lfequeeted:_ / ! Z Tune: AM PH
7PM
Address L 12 Permit ti-',L?
Builder•
THE FOLUM IiG IORRECTIONS ARE REQUIRED:
001,
Inspsator4� — — Date: ,g L
X APPROVED —— nISAPPFOVED _ APPROVED SUBJECT TO ABQVR
✓/ Call For Reinsp.
INSPECTION NOTICE
city of Tigard Building Dem went
13125 S*, Ball Hlvd. T+gard, oregon 97223
Inspection Line (ReC-O-Phone): 639 .4175 BuOine.. Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appy'/Sdwlk
Found. Plbg. Top Ou
Cas Line FINALt
Posit/Beam Stcuct. an. Sewer 1 Framing -Bld g'
Post/Beam Mech.
Insulation -plumb.
Plbg. Underfloor water Line -Hach.
.' CYP• Bd. U
Times/ i ��Am PM
Date —
G/ j�� r= Permit
AddresesL // J"�—
Huildor• �� !tel/ � _ -�—.— '—.,� 'f
THE FOLLOWING CORRECTIONS; ARE REQUIRED., 3
Inspector:__
`APPROVED _— DISAPPROVED APPROVED SUBJECT TO ABOVF.
< Call For Aeinsp.
INSPE ION NOTICE
City of Tigard Building Depart-went
13125 SW Ball Blvd. Tigard, Oregon S '7
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —- --
Footing Plbg. Under.slab Mech. lough-in Appr/Sdwlk
, o nd Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Franinq -Bldg.
Poat/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Une Gyp. Bd. -Nech.
Date Requested: ``L _T = _Z /IAM YN
Address: f- -��� � _,�=__ Permit is
Builders-
THE FOLLOWING CORREc'TTONS ARE REQUIRED;
Inspector1 Dates_._
y APPROVRD DISAPPROVED APPROVED SURJEM TO ABOVE
Call For Reinsp.
CITYOF TIGARD
01YOFTM MASTER PERMIT
COMMUNFTY DEVELOPMENT DEPARTMENT 0014M
I+1ST9c Qi 10
13125 SW Hodl Blvd P.O.Box 23397,TigaM,Orepn 97223(603)639-4175 C7 PERMIT #. . . . . . .
639-4171 DATE ISSUED: 09/21/92
SITE ADDRESS. . . : 11932 SW 125TH CT PARCEL.- IS133DD--10700
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . * 144
-------------------.._.__.—•-•--•--___._._ BUILDING
MOUD WORK. :NEW UNI��f&:3
TYPE OF USE. . . iSF FLOOR AREAS------------- REUUIRED SETBACKS----------
TYPE OF CONST. :5N FIRST. . . . :949 sf LEFT. . . 1---' ft RIGHT. :5 ft
OCCUPANCY GRP. :R3 SECOND. . . t945 sf FRONT. -20 ft REAR. . a25 ft
STORIES. . . . . . . :2 THIRD. . . . 10 sf REQU I RED------------------------
HEIGHT. . . . . . . . .26 ft TOTAL------: 1894 sf SMOKE DETEC'TORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $P 94354 PARKING SPACES. . :O
Remarks;
PLUMBING ---------------.----------..-----
SINKS. . . . . . . . .
---------------------------------
SINKS. . . . .. . . . . . : 1 FLOOR DRAINS. . . . sO BACKFLO14 PREVNTRS. . :@
LAVATORIES. . . . . e3 WATER HEATERS. . . : 1 TRAPS. . . . . . . . :V&
TUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . . :0 CATCH
WATER CLOSETS. . a3 SEWER L114E (ft) . :O GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . a wA'TER LINE (ft) . - 100 OTHER FIX TURES. . . . . :O
GARBAUE RAIN DRAIN (ft) . iO
WASHING MACH. . . : 1 % SF RAIN DRAINS. . : 1
----------------- MECHANICAL ----------------- FE.LS
FUEL TYPES------------- UNIT HTRS. . 10 type amount by date reept
/GAS/ VENTS . . . . . a0 TIF $ 1380. 00 JH 09/21/92
MAX INPUT:O BTU VLNT FANS. . :4 BPRT $ 418. 00 JH 09/21/92
t URN ( 100K . . : I Huuljs. . . . . . 11 BPLL $ 271. 70 JLH 06/05/92 22
FURN ) =100K . . .0 WOUDSTC)VES. s0 B5PC $ 20. 90 JH 09/21/92 —
FLUOR FURN. . . . :0 CLU DRYERS. : I SSDL $ 280. 00 JH 09/21/92 —
BolL/CMP ( 6HP:0 OTHER UNITSiO PARK $ 250. 00 JH 09/21/92 —
GAS UUTLETSs1 MPRT $ 39. 00 JH 09/21/92 —
Owner s
Owners MPLC $ 9. 75 JH 09/21/92 —
DUN MURIbbETIE BUILDLRS9 INC. M5PL $ 1. 95 JH 09/21/92 —
15555 SW RANGY RD. PPRT $ 132. 50 JH 09/21/92 —
#201 P5PC $ 6. 63 JH 09/21/92 —
LAKE OSWEGO OR 97035
Phone #o 620-7538
LGntractort -----------------------------
DON MORISSETTE BUILDERS, INC.
15555 SW BANDY RD.
#201
LHKE OSWEGO OR 97035
Phone #: 620-7538
Reg #. . .- 35533
2810. 43 TOTAL
This ptreit is issued subject to the regulations contained in the ------- REUU I RED INSPECTIONS
---
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Struct Gas Line Insp
plans. This pervit will expire if work is not started "itli IN Post/Beam Mechan Insulation Insp
bays of issuance, or if work is suspended for more than IN sys. PIM/Undslab Insp Gyp Board Insp
PLM/Underfloor Rain drain Insp
[,ei-ini. ttee Signature- 0�1 Plechanical Insp Water Line Insp
I- r- lumf- lop Out (1ppr/L_)dwIk Insp
J ,.ist-ted By : Framing Insp Mechanical Final
[.All---for inspection -- 639-4175
AL
SEWER CONNECTION
CITY OFTIFARD Ai�AND PERMIT
�clRmoon COMMUNrTY DEVELOPMENT DEPARTMENTPERMIT #. . . . . . . : SWR92-0209
13126 SW Hell BW. P.O.Box 23397,T1901d,Or"w 97223(603)639-4175
G 3 T-4-T7 T--- DATE ISSUED: 09/iz!1/9c
SITE ADDRESS. . . L 11932 SW 125TH C1 PARCEL. IS],--.s3DD--10700
SUBD I V I S I 01\1. . . . : VILLAGE AT SUMMER LAKE PfIRK 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . : 144
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF WORK. . . :NE=W DWELL INU UNlTS. . : 1
0 PL OF USF_. . . . . :51- 1\10. OF BUILDINGS: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : - sf
kemarks :
Owner: ------------------ FEES ----------------
DON MORISSETIE BUILDERS, INC. type amount by date recpt
15555 SW BANUY RD. PRMT $ ':*,100. 00 JH 09/21/92 —
#L01 INSP $ x. 00 JH 09/21/92 —
LHKE OSWEGO OR 97035
Phone #: 620-7538
Lontractor: ----------------------------------
C-ONfRACTOR NOT ON FILE
2135. 00 TOTAL
kei,l
REUUIREL) INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 160 days from
the date issued. The total amount paid 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 directioi,c from
the distance given. If not so located, the installer shat purchase
a "Tap and bide Sewer" Permit and the Agency will insta tral.
I-erni i L t e _4 Ti a t i.t r e
1 s s i.t e d By
Call for inspection 639-4175
CITY OF TICARD RECEIPT OF PAYMENT RECEIPT NO. :92--23184S
CHECV, AMOUN'r 46457. 93
NOME MCIPISSE TTE, DON CASH AMOIJNT n 0. oel
PAYMENT DATE 09/21/92
SUBDIVISION
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
BERM- 418. 00 PLUMBING PERM 132. 50
MECHANICAL PE 39. 00 ST. BUILD DER 29. 4A
Pl-AN CHECK FE: :31.. 9S SF-WEI lJc.2'A 211211A. 00
SEWER INSPECT 35. 00 PARL E-11 C.;Dc 250. 00
STORM DRAIN SDC x'80. 017..1 RESIDE.-NTIAL TRAFFIC FEES las-111. 00
MAF39 "TRANSIT TIF" FFE.!3 100. 00
LOT 144 VILLAGE AT qUMMf*R LAKE 4
11932 SW 125TH CT
f0TAL AMOUNT P(-')LD 4695. 13
CITY
u125SW HDU Bhvd PLNCK/RECT 0 OF TIGARD roBmnm PERMIT #
LOMMiTNMDEVELOPMENT DEPARTMENT Twr4o--B-v '
(m)6'x'171 DATE ISSUED
JOB ADDRESS: J� % 3 2 `J� lc� S CT TAX MAP/LOT 1,51-33 /7!1._/U oy
SUB: OF AOT: LAND USE:
VALUATION: �/L/ S Y"
OWNER SPECIAL NOTES
NAME: ED-a_AlDrJ 255 REISSUE OF:
ADDRESS: I�JSsS E� LAST REISSUE:
FLOOD PLAIN/
PHONE: — SENSITIVE LAND:
CONTRACTORPA PROVALS REQUIRED
NAME: PLANNING: OV-
ADDRESS:
V ADDRESS: ENGINEERING:
_ FIRE DEPT:
PHONE: OTHER: Tir-
CONTR. BOARD 0: EXP DATE:
ITEMS REQUIRED
SUBCONT C ORS: PLUMB: .� LIST/SUBCONTRACTORS:
MECH: US TAX:
ARCH ENGINEER o ��fi?P' CALCULATIONS:
NAME: ��G� J`Tl� ��'�l.[ i r I TRUSS DETAILS: _
ADDRESS: OTHER:
PHON L: tsZL� `� --- — -
PROPOSED BLDG. USE: —
COMMENTS: _
APPL�Ih�JATURE
Received By: _ _ Date Received:
r • R
r �`l:.h � I iN?, (�
':.J' 1^`Y• L1� ..,1 L�� [�4dYYuk I�. M {r.J: ...., .�.
'1
PERMIT R ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
r-�.Yv7 10-432 00 Building Permit Fees i (K%
10-431 00 Plumbing Permit Fees 1S� • s� / l �Z 7�
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5X)
Building cam' YU
Plumbing
Mechanical
r
10-433 00 Plans Check Fee 4
Building 42 7 • 70
Plumbing
Mechanical i' 'S 1-Z
10-230 06 Fire
5e-,Azuaoi 30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees '!u �
52-449 00 Parks System Dev Charge (PDC) �` �
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
\y1
TOTAL
rim/3`031P.WPF
CITY OF 11GARD RECEIPT OF PAYMENT RFCFIPT NO. a 92-287824
CHECK AMOUNT 1150. olb
NOML. r MW, SSETTE, DON CASH AMOUNT = 0. oel
1-1 T)D R 1-:7,9 9 r PAYMENT DATE 05/28/9; '
q1JEAD I V I S I ON
Fl
-jRr,(JSE OF PAYMCNI AMOUNT PAID PURPOSE OF I"AYME- --:NT AMOUNT P141D
I-1-Ahl CHECK FF 250. 00
I-OT 144 VILLAGE AT SlJMME'Rl-AKE #4
11930 SW 125TH CT
TOTAL. nMOUNT PAID 00