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12433 SW NORTH DAKOTA STREET i I I I� I 1 i 12433 SW North Dakota INSPCT�O NOTICE City of Tigard Building Department 1.3125 SM Ball Blvd. Tigard, oregon 97223 Inspoction Line (Rec-0-Pho �: 639•-4175 Business Phone: 639-4171 i I Inspection:__ Footing Plbg. dderslab Mech. Rough-in � lk i Found. Plbq Top Out Gas Line FINALt PostfDeam Strur..t. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbq. Underfloor Nater Line Gyp. Bd. -Hoch. Date Requestedt zz �__Tim9t _ AM PN Permit Builder: ((/ C, /-7f THE FOLLOWING CORRECTIONS ARE REQUIREDt �L" ._1 a y Cc c �tiAt.I.. lnapeCtPXf�L-L{. LL- •,(, L- y L� 1----..� betel __-__APPROVED , ISAPPROVj APPROV1tn S11H.71Sc'T Tin Anovp (2�Call For Reinsp. C'TYOF TIGARD CERTIFICATE OF WYO FMAIM OCCUPANCY COMMUNITY DEVELOPMENT DEPARTMENT OMG*N . . . . . . . i MST91--0050 13125 SW HWI 6W. P.O.&K 23397,Tip,Oregm 97 (603)eP4476 :'_ITE ADDRESS. . . 12433 SW NORTH DAKOTA G7 PARCELs IS134CO-07 LOCI ,:iUBDIVISION. . . . r AN'rol') PARK ZONINGe A-7 BLOCK* . . . . . . . . . r LOT. . . . . . . . . . . z33 LASS OF WORK. PNEW IIF OF USE. . . r 8 ,JCCUPANCY GRP. cR3 OCCUPANCY LOADv3�5 4 I'ENANT NAME. . . )�emarlf 6 1 JEFF OIDELL CMISTRUCTION 0 BOX 230273 fIGARD OR 97223 Flhone #% 50316206732 t.orpt %-,act or: -- ,JEF=F= Ork.1-L CONSTRUCTION 0 0 BOX 230873 YIHARD OR 972c.,3 F)hone 0: 6134-8158 Peg #. . 1 !!3603 Occupancy of the above referenced buildint., is hermby [liven, and certifie- the complianre with the "itate Of Oregon Specialty Codes for the group, ()uvi.tpency, and use kinder which the referent.-ed permit was issued. VIRE DEPARTMFNT I,/ BQL>PINKS I NSF Fij LITT POST IN CONSPICUOIA" PLACE IPSP&M V NOT 99 City of Tigard Buildinq Department 13125 SU Ball Blvd. Tigard, Oregon 97223 Inspection Lina (Roc--o-Phone): 639-4175 Business Phone: F.19-4171 Inspections Footing Plbg. Underalab Nect.. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL% Poet/Beam Struct. San. Sewer FramingBldg. Poet/Ream Mech. Rain D) .1 Tnaulation -Plumb. T11bg. Underfloor Water Line Gyp. Bd. -Meah.� Date Requested:__ r,:}dresst .-.��___._...._1— _ld�7(��E!Z/3,.c— Pexmit #t Builder:_ _ �: �.�C.�� —L..C! -• r- --- ;moi.-.._ THE FOLLOWING CORRECTIONS ARE REQUIRED: .. --� _ --. Inspectors y� Date, — -- -—/ APPROVID DISAPPROVED / APPROVRD SUBJRCT TO ADM _-Call For Reinep. 1 INIP39TION NOTICE i City of Tigard Building Department � 33125 811 Hail Blvd. Tigard, Oregon 97223 Inopection Line (Rec-O-Phona): 639-4175 Business Phone: 639-4171 Inspection. — Footing Plbg. Undorslab Mech. Rough-in Appr/Sdwlk Found. Pl.bg. Top Out Cas Line FINAL: Pont/Beam St.ruct. San. Sewer Framing -Bldg. Poet/Beam Mach. Rain Drain Insulation Plumb.' Plbg. Underfloor water Line Gyp. Bd. -Koch. Date Rraque9larii / Times AN PK Address:_ �_'2 y33 Permit ti Builder:!_ �.— TAE FOLLOWING CORRECTIONS AR= RAQUIREDs Inspector: �7 APPRiIVFD DISAPPROVED APPROVRD SUBJECT To ABOVF. call For Reinip. i INSPECTION NOTICE Citp of Tigard Building Departmnt 13125 SW Hall Blvd, Tigard, Oregon 97223 Inspection Line (Ree-O-Phone): 639-4175 Business Phone, 639-4171 Inspection: Footing Plbg. Underelab Mech. Rough--in /-1 Appr/Sdwlk Found. Plbg. Top Out: Cas Line FINAL, Poet/Ream Strurt. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfl.00r Water Line Gyp. Bd. ,-Mach Dr t:e Requested: /0-A0 " _TLne: /,AN __PM Address:- Permit 1: i Builder: THE FOLLOWING cORRECTIONS ARE REQUIRED: a Inspector: 7L,I, Z=4t� ,late:APPROVETD APPROVED 3U8.1Et'7 n ABOVE Call For Reinep. ei � Iyer cee en It s� ser w INSPECTION NOTICE City of Tigard Building Depart—t 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 634-4171 Inspections Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet./Beam Struct. San. Straer Framing -Bldg. Post/Beam Mach. Rain Drain Ins�ulatiioon -Plumb. Plbq. Unuerflcor Nater LiinneO' yp. Ed. -Mesh. Date Requested: �T/� Nimes _X_—AM PM Address:-- 1 33 _7& permit Builder: .J:.G. Ltl -- — W— -----THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspectors _L�_11PPROVED DISAPPROVED APPROVED S11MIECT TO ABOVE Call For Rainep. j!SPECTION NQTICE City of Tigard Building Department 13125 SN Ball Blvd. Tigard, Oreton 97223 Inspection Line (Rec-U-Phone): 639-4175 Business Phone: 639-4171 Inspection:. _ Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plty. Underfloor Water Line Gyp. Rd. -Mash. Date Requested: S ,_,.__Time: All Address: Permit f: Builder: TRIC FOLLOWING CORRECTIONS ARE REQUIRED: tnnpectuc:___ � Date:__ .___ "PROVSD 01ORPPPNOVRD APPROVED SUBJECT TO AROVE ►!call For Reinap. INSPECTION NOTICE city of Tigard Building Department 13125 SW Ball Blvd. Tigard, Orogon 97223 Inspectl.on LLne (Rec-O-Phone): 639-4175 Business Phone: 639-41'71 Inspection:__ Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top Out Cas Line FINAL% Post/Beam Struct. San. Sewer Framing -Bldg. Post/Bnam Hoch. Rain Drain Insulation -plumb. Plby. Underfloor Water Line p. -Hoch. y7 Date Regusetsds IL y2_3 �*� �_Tt AM PM Address: Permit #: Builder: /J CDC �lC7 THE POLL04ING CORRECTIONS ARE REQUIRED: L.. ----------------- ------ - - -- inspector:___— /-- -�-----.._. _ Dater APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Neinap. I i I.RBPECfION NOTICE Y City of Tigard Building Department 13125 Bt Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phone(t 639-4175 Busineae Phones 631-4171 Inspection:__ Footing Plbq. Underslab Hoch. Rough-in Appr/sdwllt Found. Plbq. Top Out Can Line FINAL: Post/Boam Struct. San. Sewer Framing \) -Bldg. Com. -� Post/Ream Mech. Raln Drain Insulation -Pltwb. Plbq. Underfloor Water Line Gyp. ad. �Mtl11. Date Requested t —Times AM PM Addreses �- '� _--J� _ Permit Builder:__ fL..<aL�y _---��.--�-- THE FOLLOWING CORRECTIONS ARE REQUIRED: - T 1 C k Inspectors r' Dates- APPROVED DISAPPROVED _ APPROVED SUBJECT TO ABOVE Call For Reinsp. xNS_ JqN NOTICE City of Tigard Building Department 13125 SM Hall Rlvd. Tigard, Oregon 97223 Inspection Line (Ree-O-PhnnP;. 639-4175 Business Phone: 639-4171 Inspection:_ Footing Plbq. Under s. ab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post./Roam Hoch. Rain Drain Lneclation -Plumb. Pl.bg. Undorfloor Watcr Line Gyp. Bd. -Mach. r.. Date Requested: l _Time: AM PM Address:_/--'-`7 Permit i Buildert__�_z_ THE FOLLOWING CORRECTIONS ARE REQUIRED: i Al1 I Inspectors Date: _APPROVED DISAPPROVED APPROVED SUBJECJ To ABOVE `iCall For Reinsp. 9 1 ttt. set a tae t� tw e� � tier 7`"� INS PzCTIOII IIOT 1 CE City of Tigard BV=ldinq Departaent 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line�(Rec-O-Phone)s 639-4175 Business Phones 639-4171 InspectiontJ2% .5�.�c� Footing Plbg. Underslab Mech. Rough-in) Appr/Sdwlk Found. Plbg. Top Out /-Mas Line FINALt Poet/Beam Struct. San. Sewer Framing -Bldq. Post/Beam Mech. Rain Drain Insulation .-Plumb. Plhq. Underfloor Water Line Gyp. Rd. -Mech. Date Requested: Times _ AN rrPH Address:__2L.) Permit p Builders � '�„r� -- •-- THE FOLLOWING CORRECTIONS ARE REQUIRED: Inepectors�/ �7 7r` Date: APPROVED DISAPPROVED DISAPPROVED —. APPROVED SUBJECT TO ABOVE Call For Reinsp. w w w w w s w w w 1NGU„F9TION_N0TI^E City of Tigard Building Departsent 13125 BN Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspections Footing Plbg. Underslab Mech. Rough--ir Appr/Sdwlk Found. Plbq. Top Out Cas Lia-- FINAL: Poet/Beam Struct. g San,. e7W! Framing -Bldg. Post/Beam Mech. in Drain Insulation _ulumb, Plbg. Underfloor Nstar L •> Gyp. Rd. -Mach. Date Requested ss ��,�J Time:-444'e'.'I pM Address: �e(�� �• �L�/�w-�a Permit 1: — Builder: THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector: Datee_a ' ✓ �Z� APPROVED DISAPPROVRD APPROVED SUBJECT TO ABOVE Call For Reinsp. j(I�g��O(i P10TICE City of Tigard Building Department 13125 SN Nall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Busi.neas Phone: 639-4171 Inspection: A� Footing Plbg. Undorslab Meeh. Rough-in Appr/Sdwlk Found. Plbg. Top Out gas Lind FINAL: Pont/Beam Struct. San. Sewer PALPI -Bldg. Rain Drain In.ulation -Plumb. Plbg. Underfloor Nater Line gyp. Bd. )!tech. Date Reguestedt 5 7� �_ T1A:et %,ZAN PH 3 Addceee: /` 41 � ��, .� Pb:-mit f t1�r �•,v Builders— THE uildert—THE+ FOIZOWING CORRECTIONS ARE REQUIREDt r Apolz / u,✓g:2 Is" A005. i.vSu.4Aroti./ C -��krgg- of r7ej2 IA.A.S o IT Inspector: Date: T APPROVED ✓ISAPPROVRD__ APPROVED SUBJECT TO ABOVE Call For Reinap. inspWrioN NotCE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phone: 639-4175 Business Phones 639-4171 Inspection:_ Footing Plbg. Underelab mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Strum:.-, San. Sewer Framing -Bldg. Poet/Beam Hoch. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line / Gyp. Bd. -mech. Date Requeeted: �7 // __�___r1�= AM PN Addreee:—��`1 �� ZZ, Permit Builder: -- THE uilders_THE FOy.I.ONING CORRECTIONS ARE REQUIRED- I- /U JT 1G��v y wNG L T iel✓S GS ATv� !% Inspector: Date: __APPROVED i� DISAPPROVED I_— APPROVED SUBJECT TO ABOVE Call For Rei.nep. IMSPEG 100 NOTICR City of Tigard Building Department 13125 ON Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phones 639-4175 Business Phones 639-4171 X 1 Inspections Footing Plbg. Underslab Mech. Rough-ir Appr/sdwlk round. Plbg. Top Out Gas Line FINALS Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor WaterLineGyp. Bd. -Mach. Date Requesteds_S / /�� _Timer _ AM PM Address: n/�r/- � /y. / </ Cc�+- Permit 9 t 7 ' 0o Builders o`L THE FOLLOWING CORRECTIONS ARE REQUIRED: 3SGb ?ter Inspectors APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE ----Call For Rainap. t i 1 i i INSPECPIQN NOTICE City Of Tigesd Building Departaioet 13125 BW Ball Fled. Tigard, Oregon 97223 Inspection Line (Roc-O-Phone)t 639-4175 Business Phone3 639-4171 Inspections Footing Plhg. Underelab Hoch. Rough-in Appr/Sdwlk Pound. Plbg. Top Out an@ Line FINALt Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Hoch. Cain bra- Insulation -Plumb. `lbg. tlnderfloo;. Nater Ling. Gyp. Bd. -Mach. Date Requestodt _Z(/ z _ Timet _-AM PN Address: Nc,r _--A Permit ftm'.5147 __ Builders TRE FOLLOWING CORRECTIONS ARE REQUIREDt dw j 27 a Inapectort Dater 4 ^1 APPROVED DISAPPROVRD APPROVED SU&71tCf TO APOVE ---,---Call For Reinsp. IRBP=CTTQN NOTICE City of Tigard Building Department 13125 M Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 639-417 Inspections — � P1 Underslab Mech. Rough-in Appr/8dwlk �. noting I bg Found. Plbg. Top Out Gas Line FINALS Post/Beam 8truct. Ban. 8ewsr Framing -Bldg. Post/Beam Koch. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line Gyp. Rd. -Koch. t- 5'q P,1(- Date Requesteds ��l — / _Times —i+K PK Addreses y3 I Permit r Bx.ilders — -- TNN FOLLOWING CORRNCTIONB ARN RNQUIRND' 27w� f ell '4e4D - ,Y C y. Inspectors --- — Date: APPROVED DISAPPROVED APRM95 SUBJECT TO ABOVE Call For Reinsp. CITY OF T I GA Rn 4fMASTER PER111 'r COMMUNITY DEVELOPMENT DEPARTMENT CrrYOFTWID ERMIT #• • • • • • • : MST91 --0(050 ond �' 13126 SW HmIl Blvd. P.O.Bac 2W97,Tigaid,Oregon 97223(M)63D4175 I i--,f1 /1 DAIL ISSUE b : 03/27­/,.)l_ I i L HLURLb,-i. SW 140R]H DAKOTA ST PARCEL: I51.34C13­0/ 100 SUBDIVISION. . . . : ANTON PARK ZONING: R-7 PLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . BUILDING REISSUE: DWE-LL.ING UNITS: 1 BASEMENT. . . . . . . . :0 5f CLOSS OF WORK. eNEW BEDRMS:2 BATHS:2 GARAGE. . . . . . . . . . :436 I YPE OF USE. . . :SF FLOOR AREAS------------- REQUIRED SE iY►-If. UF- r0NF)T. :5N F I RST. . . . .224 S f LEFT. . :5 ft R I GHT. 20 ft OCCUPANCY GRP. :R3 SECOND. . . :59E s F RONT. :;20 ft REAR. . 15 f t. STORIES. . . . . . . s3 T'HIRD. . . . :611 sf HE I GHT. . . . . . . . ..2S ft TOTAL-­-­: 1431 s SMOKE DETECTORS. :Y FLOOR LOAD. . . . :40 psf VALUE. . . . . $ s 73674 PARKING SPACES. . :@ PLUMBING SINKS. . . .. . . . . . . tl FLOOR DRAINS. . . . :13 BACKFLOW PREVNTRS. 0 LAVATORIES. . . . . 12 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :N TUB/SHOWERS. . . . :2 LAUNDRY TPAYS. . . -. I CATCH BASINS. . . . . . . r WATER CLOSETS. . -2 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . .0 DISHWASHERS. . . . : 1 WAIER LINE ( ft ) . - I 1Z.10 OTHER FIXTURES. . :0 GARBAGE DISP. . . : 1 RAIN DRHIN (ft ) . :O WASHING MACH. . . : 1 SF RAIN DRAINS. : 1 MECHANICAL ------------------- FEES FUEL UNIT HTRS. . :0 type Amot.int by riate t'ecpt /GAS/ VENTS . . . . . .0 DAYM $ 100. 00 JLH 03/05/91 210292 MAX INPUT-VA BTU VENT FANS, . :2' BPRT 1- 13515. 00 TURN ( 100K . . : I HOODS. . . . . . : 1 HPLC $ x'30. 75 VURN ) =100K . . :0 WOODSTDVES. :0 SF)PC 1 17. 75 F-LU(JR FURN. . . . :0 CLO DRYERS. : I SSDC $ 37c. 00 BOIL/Cmp ( 3HP;@ OTHER UNITS:0 PARK t 1100. 00 GAS OUTLETS: 1 Ml,'.',RT $ 33. 00 0,,vner-- 21 5 JEFF O' DELL. CONSTRUCTION m5pC $ 1. 65 P 0 BOX 230273 PPRT $ 125. 00 P5PC $ A_ K-5 TIGARD OR 97223 Ilf- $ 1350. 00 F-11ione #! 50362916732 F-A Y M $ L90ii'. 65 JLH 03/27/91 JEFF O' DELL CONSTRUCTION P 0 BOX 230273 TIGARD OR 970-_'23 Phone #: Reg #. . : 53603 $ 300:. 65 TOTAL- This pewit is issued subJect to the regulations contained in the REQUIRED INSPECTIONS Tigard Municioal Code. State of Ore. Specialty Codes and all other Foot/fotmd Insp Fireplace Inso applicable laws. All work will be done in accordance with avoroved Post/Seam StrLict Gas Line Insp plans, This Deroit will expire if work is not started within 1W Flost/1-AeAm Mevhan InsiAlation InsF, days of issuance, or if work is suspended Pllm/Lmdslab Insp Gyp Board Insp PLM/Underfloor-, Rain drain Insp Permittee Mechanical Insp Water- Line In 1 1-7 n FIJUMb Top OLtt Appv-/Sdwl k Insp 1sr".1e(j Bv - Framing Insp Mechanical Final L—a-*1 T T—or- —i,r-i--,;--r)-L--t2 t i:n- SEWER CONNECTION C'1YCNTIFARD J�IWND P F-.'R M I T CITY Twilm -,FRMIT #. . . . . . . . S W R 9 1—0 171,� COMMUNITY DEVELOPMENT DEPARTMENT opoWN 9,25 SVI HWI Blvd. P.O.Box 23397,TipM,Oregon 97 (SM)630.4175 11Fq11Fn- �ITE ADDRESS. . . : 12433 SW NORTH DAKOTA ST PARCEL: IS134CB-0-711?1N ',UBDIVISION. . . . : ANT'ON PARK ZONING.- R--7 ,..,,LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :33 ENANT NAME. . . . . : JSP NLJ. . . . . . . . . . :43605 F'IXTURE UNITS. 'LOSS OF WORK. , . :NEW DWELL I NG UN I TS. I YPE OF. USE. . . . . :SF= NO. OF BUILDINGS: 1 iNSTALL TYPE. . . .. :BUSWR I11PERV 311FRFACE. S f i-lpmarks: ,-)wn er s ---------------------------------------- FEES .,'EFF O' DELL CONSTRUCTION type amol.int by date recpi. 0 BOX 230273 PRMT $ 1500. 00 I NSP $ 35. 0121 IGARD OR 97E,=:3 PAYM $ 1535. 00 JLH 03/2*7/9t 'fione #i 503620673P CIONTRACTOR NOT ON FILE PI-ione #: 1535. 00 TOTAL REUUIRED INSPECTIONS APPIlLant agrees to cemnly with all the rules and regulations Sewer Inspet-,tion the Unified Sewage Agency. The permit exn�.rps 120 days from the date issued. The total amount oaid will be forfeited if the Dereit expires, The Agency does not guarantee the accuracy of the tide sewer laterals, if the sewer is not located at the measurement riven, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall ourchase a 74D. and Side Sewer' Permit and the Agency will all a late - isi-ted By - Lall for inspectioli 639-4175 CITY OF TIGARD RECEIPT OF PAYMENT RECEi rT NO. 9 1--c:I I CHECK nMOUNT 01 DEL-I-, JEFF CASH AMOUNT 0. 00 ADDRESS PAYMENT DATE r 03/P7/91 SUBVIVtGION 12433 NORTH DPKOTf) PLIRPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID BUll-DING PERM MST's 1- 355. 00 PLUMB ING PERM I P 03. 00 MEUHANlCAL PF 33. 00 ST. BL)IL.D PER 25. 65 PI,,AN CHECK FE 139. 00 SRWER USA 1.17,00. 00 PpEW1-*_'R INSPECT 35. elo RESIDENTIAL. TRAFFIC FEES 1.2:50. 00 PARKS soc rift. 00 STORM DRAIN SDC 375. 00 MASS 'TRANSIT TIF FEES 100. 00 TOTAL nMOUN"r PA 11) 4437. 65 i Building Permit No. COUNTYWIDE TRAFFIC IMPACT FEE Planning File No. — PAYMENT OPTION FORM Tax Map&Lot No. Dat/e, Project Name I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore I request the following (Choose whichever option or options are applicable): Cash or Check Credit Voucher LlBancroft or Installment Payments and/or (~1 The Ordinance allows for deferral of payment of the TIF until issuance of the occupancy permit if the L� TIF is greater than$5,000.00. If the TIF meets this requirement, I also request this option. I under stand the TIF must be paid prior to issuance of an occupancy permit. I also understand that the TIF will be recalculated based on the prevailing rates at time of payment. Please be advised that TIF rates may increase up to six percent each July 1 st. This rate increase is not subject to appeal. OWN P (CANT OWNER/APPLICANT CC Building Permit Filo Payment Option Notebook frim liff)? i I C:I TY OF T I GARD - REC:F I pT OF PAYMENT V C:E=I AT NO. A 91--i I A� CHECK AMOUNT a 100 { IIJAME, ODEL L ! nNSTRUCT I mi CASH AMOUNT 0: oo I ADDRESS PgYMEN'T DATE 03/Q15 9:1 SUBDIVISION m l.OT 33 ANTON PARK `uwCIsr OF PAYMENT AMOUNT PAID PURPOSES OF PAYME:.NT AMOUNT PAID P!-AN CNI.IE.CK E='E.._3. +R ..... .._.._ 100. 00 ....w..._..__....__._.._.._._......._._.w.__.__.. ......w..,....�._._____..�. i -V O T At_ AMnUNT PAID T _ _ _.y ION. 00 i