11289 SW 95TH AVENUE-1 Y
P
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N
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Y
i
..... 11289 ew 95th AVEC -y-
H IN
INSPECTION NOTICE
City of Tigard Build ng Department
P.O. Box 93397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _
Date Requested q��" `f' Time r A.M. P.M.
Address _/ -- Permit
Owner - - ------ Lot --
Builder .�e� —
The following Building Code deficiencies are required to be corrected:
Presented to
-- ( Approved
--
Inspector _ ❑ Disapproved
Date. I �• �7-__Ll __— ___—. _..__
CALL FOR REINSPECTION
0 YE! 0 NO
12%04/89 16:49 '8`503 684 7297 CITY OF T I GARD f�j 001
ACTIVITf REPORT
TRANSMISSION OK
TRANSACTION # 2802
CONNECTION TEL 2755435
CONNECTION ID G3
START TIME 12/04 16:48
USAGE TIME 00' 33
PAGES 1
� � ? 9= F
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
/Phone: 639-4175
Type of Inspection �►�c�/
Date Requested Time A.M. P.M.
Address _t Permit # �S 70�
Owner Lot #
Builder �•C,rc-*�o-
The following Building Code deficiencies are required to be corrected:
Presented to v [I-Approved
Inspector [] Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone. 6--39-4175 /
Type of Inspection 4-�
Date Requested I 'rima / A �'� P.M.
Address _ rMit #
Owne; �l�'�"a f 3 -, Lot #_
Builder l,Z�'�The following Building Code deficiencies are required to be corrected:
Presented toF1Approved
Inspector �— e— Disapproved
Date
CALL F�ORR'REINSPECTION
L7 YEa ONO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 91223
Phone: 639-4175
Type of Inspection ./ --- --- -- —
Date Requested '5 `'S' Time __ A.M._ _P.M.
Address W�Z��d1 Permit # L 1?XL)9
Owner Lot # _
Builder �rLZ� L�ez)
The following Building Code deficiencies are required to be corrected:
Pretented to ❑��.A-'pproved
Inspector _ __�_____� rJ Dlsepproved
Date
CALL FOR REINSPECTION
IF-71- YES Gl NO
Ns ol► ■s s its it W
INSPECTION NOTICE
City of Tigard Building Department
P O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
r �
Type of Inspection Of
Date Requested Time_ A.M. P.M.
r'
, Z �
Address
Owner__ —/_ lot #
Builddr %��0-/1 • -zL'z __--The following Building Code deficiencies are required to be corrected:
Presented to /(pproved � J
Inspector Disapproved
Date"
CALL FOR REINSPECTION
❑ YES 0 NO
■UT
INSPECTION NOTICE
�'))!;{f�i� C� City of Tigard Building Dcpartment
' P.O. Box 23397
-aid, Oregon 97223
Phone:: 639-41'75
Type of Inspection _ ¢ �.1 VnC'-0n
Bate Requested C� ` C� Tfine 'I-'- A.M. P.M. 2 q
Address _ .Zfl1r-9 Permit #�7
Owner r Lin, _ Lot # 1 7& y
Builder _�_ \-�L cs-rjcLt-� b rcyc
The following Building Code deficiencies are required to be corrected:
Presented to --,I F1 Approved
Inspector [_ isapprnved
Date
CALL FOR REINSPECTION
Vr"YES ❑ NO
w wIwIw�wIwIaw
MFNDRANDUM
CITY OF TIGARD, MMN
TO: All Agencies Fbr Address Updates
FROM: Laura Freeman, Engineering Technician 1�
DATE: November 30, 1988
`'iJB=: Address Updates - November 1-30, 1988
NEW ASSIGNM V - KIL,TI-FAMILY REsiDE riAL
-- Durum Estates Apartments (WC-IM 2S1 1.200, TL 1500)
8363 SW Durham Rd
Tigard, OR 97224
- Durham Estates Apartments (WC1M 2S1 12CC, TL 1500)
8355 SW Duman RD
Tigard, OR 97224
NEW ASSI(NMU - SINGLE-FAMILY RESIDENrIM,
- 9050 SW 66th Ave (WCM 1S1 25DA, :brmerly TL 201 - MLP 88-08)
Tigard, OR 97223
CMA14M AS,SIC409M - SINGM-FAMILY RESIDENTIAL
- WCZM 1S1 35CA, TL 3600, Lot 8 Gearhart Acres Subdivision
QLD ASSIGNMENT NEW ASSTGNMERr
11209 SW 95th Ave 11289 SW 95th Ave
Tigard, OR 97223 Tigard, OR 97223
- WCIM 2S1 4AB, TL 1900
CID ASSIGNMENT NEW ASSIGNMENT
1.3230 SW Aberdeen Pl 12044 SW Morning Hill DR
Tigard, OR 97223 Tigard, OR 97223
(Note: This address change Eras listed in our September, 1986 listing
apparently, some agencies (lid not receive a copy of this list) .
CHANCE ASSIGNMENT - CI:IbIIr FWIAL
- WCIM 2S1 13AD, TL 1800, Bldg 14 Ciegon Business Park
CID PSS I G MERr NEW ASS IGNMLWP
16799 SW 72nd Ave Sonetics Corp
Tigard, OR 9722•# 16798 SW 72nd Ave
Tigard, OR 9722.4
- WCrM 2S1 14AL, 11, 700
CID ASS (MENT NEW ASSI044ENr
Jehovahs Witrr-.ss Church Jehovahs Witness Church
97SC SW Durham Rd 9450 SW Durham Rd
Tigara, OR 97224 Tigard, OR 97224
W W
INSPECTION NOTICE �lf�
City of Tigard Building Depa tment
P.O. Box 23397
Tigard, Oregon 97223
,,,Phone: 639-4175
Type of Inspection _ �;
Date Requested_ l Time A.M._W_P.M.
AddressC/ )4— permit #� 17 6�
Owner Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
-----
Presented to [J y
--- y - Approved
Inspector [—
_ Disapproved
Date �[ C / `
CALL FOR REINSPECTION
❑ YES ❑ NO
CITY OFTIC7A RD
4REOON
November 28, 1988
Meada%,'brook Development
9363 S.W. Beaverton-Hillsdale Hwy.
Beaverton, OR 97006
ATTN: Dan Anderson
RE: WCTM 1S1 35CA; TI, 360x,
Lot 8, Gerhart Acres Subdivision
It has come to o,ir attention the address used for building permits
at the above listed property is incorrect for the site location.
Effective immediately, the address of. 11209 S.W. 95th Ave. is
invalid. The following address correctly locates the home:
11289 S.W. 95th Ave.
Tigard, OR 97223
We apologize for any inconvenience this may have caused you.
Our Building Division has already made the necessary changes
to their records, and the local utilities, postal service, city
and county agencies have been informed of this change. If there
should be any questions, please give our office a call at 639-4171.
Sincerely,
Laura D. Freeman
Engineering Technician
LE/ ?h
13125 SW Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171 — ---
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 i
Tigard, Oregon 97223
Phone: 639-4175
Type of nsf;ection a-3 z DIZAIIr
Date Requested / / - / 19 Time �_.- A.M. eP.M.
Address �r=�0�� �` � Permit
Owner _ Lot #
Bvilder
The following Bui:ding Code deficiencies are requirad to he corrected:
Presented to _ FApprOeed
Inspector / ',t✓ if_ _ ❑ Dinppro"d
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
lNSPL.C'fION NOTICE
City of Tigard Building Department
P.O. Boy. 23397
Tigard, Oregon 97223
Phone:
639-4175
--__1�LL-=
Type of Inspection __ --
Date Requested
- 7 Ti"e A.M.�._ P.M.
Address �� Z-��� �7��7 Permit #_ �40�
Owner.- _ Lot #
Builder —
The follow"„g 'iuilding Code deficiencies are required to be corrected:
CON
IF f
Presented to ❑ Approved
Inspector Lo�isapprt-)ved
Date -g-9,Q9
CALL FOR REIVN
'ION
F-1YES
ml
INSPECTION NOTICE ftv�_-
City of Tigard 9uilaing Department
P.O. Box 23397
Tigard, Oregon 97' _3
Phone:: 639-4175
h
Type of Inspection ;
ld l� Time A.M. P.M.
Date Requested (� 7
Permit # �J
Address
Lot #
Owner
Builder
The following Building Code deficiencies arerequiredto be corrected:
' I
Presented to ❑ Aoproved
El Disapproved
Inspector
Date --
CALL FOR REINSPECTION
❑ YES ❑ NO
H(.11 L.IJ1 N(:; Nk F2M:f.1
CITY OF T'VA PI-.PM:I* 1' NO . 109
RD CITIMI'MAN
OREGON
COMMUNITY DEVELOPMENT DEPARTMENT c)Aa. 10 C36
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)6394175 F"N TRn 1:Lja�L_
,106 ADOPESS I:iW AVIS
(AX MAP/LOT 151. 3'5CA 3600 SUB 1, N'PES LT 8 1:3K 1
LAND USE : (:4*12
1_01, SIZE : VOLL)ATION: 671111.1. SETUAGKS
FIRUNT : 20 R It"A P : 15
WORK CA.ASS : NEW DWEI L. .UNITS : :1. i..Eir : 5 PT(A.IT 1.5
I-ISE TYPE : SYNGl E.* F'A M I L Y NO. F3k*-[)WO(:)MS : '.3 EX I .WALL CONST :
(','ONS'T' . TYPE:: VN NO . BATHS : P N : 5 : W :
()0(_'1.1p .(.71PP . : P3 GIRO T . (JPENINGS :
LOAD N : S : E : W .
TOTAL AVOKA ; .1.4190
NO. STORIES : I ts jr : IZI90 ROOF' (:,ONS'T' : C FIRE:
HET 8ND: AWLA SEPAR? RATED :
13ASEMEN'T'7 3PD: Cl(:CLIP' PA I E.1)
MEZZANINE? BASEM' 'T
F LOOP I (:)At) /10 GARA(:;E : 0 I-*,':I:Pl'--" SIPPIKLI417 Al AAM7
FLOW(GPM) DETECT? YES
HFA"r ryjnw' t;nu HDD V) AL'UL'5(57
01..44N CHECK UY . t- 'l 4,
REISSUE OF NO.
I AST PEISSUE
FEE S
r',114DERSON
W . DAN E PE,rm I 1, 1111337 . 00
N 9.56A S',J F.IL-*:AVF-.:P*t*UN—Fi]:LLb-I)Al,.I;.:. PLAN PEV3A;..W 111111el-9. 05
E :
1.)fe oL v tv I,t n n i31^ 1-
!i'l ATE TAX 815
C DEVELOPMENT CJ-lAPt-A:.S :
0 AN17E14S(IN DAN 1:-* 4.50( (S TO P M 1 111250 . 00
N
T Mr.-:4)DOWHNOOK DEVE-1.01P)MEN't SiDE.(STr4EF.-*1') $600 . 00
R 9363 4iW POU1101. 1 *P50 ' 00
A
C I.Xvil1vetrAIJI-1 nr- 197006 ;)Rl--,;)AIU < $100 . 00)
T PHONL 11 ,1503) 297-7666
0
R PLA.,1STPATION NO, -1631.1 TOTAL. : $1 9()
This permit is issued subject to the regulations contained in Title 14 raxEIPT NO.1D100,')_)
..........
of the TMC, State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances. and It is hereby REQUIWE'D INSPE.ICTIONS
agreed that the work will be done in accordance with the plans and FOOT I NG !:I P".W F A
specifications and in compliance with all applicable codes and F(JUNDAT ION WAI L. RAIN DPAINS
ordinances The issuance of this permit does not waive restrictive P(')S T a REAM WATER I I NE
covenants Contractor and subcontractors shall have current city 1-)LU. UNDR.PSLAS CITY APPRL;H/SW
business tax permits This permit will expire and become null and
void it work Is not started within 180 days.or it work is suspended or 1.A8 F 1.NAL
abandoned for a period of 180 days any time after work has PL.H . VOPOUT
commenced It shall be the responsibility of the permittee to assure l-;*RAM TNC,
all required inspections are requested and approved
FT 14C.*11P1,_ACE
('.;AS I INE
INSULATION
BOAPL)
Permittee Signature
Issued By nv..L 11- 1 T FJ17 I'yFrTTM /,;' 9 •71 7 7) _J
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TIGA RD PEPIVII'T NO . 51:.'.081762 1 ,:
CITY01FTWARD
COMMUNITY DEVELOPMENT DEPARTMENT N Q(YTE T!:i5LJI:"I) : 1-0/ '7188
13 125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 C,-0700 P1,11' .NO . OWL 709
"Q
JOH A013PIESS : 1-13ZW SW 9,5TH AVE
'I AX MAP/L.0'T 151. I.SUB : GM'.APHAPI A("PE.1i) I a ICK
I-AND USE:: P1.2
L-01* SIZE :
SW C:'T'I ON: ;35 'TWP: 1.is IING: 1.w
WUPK CLASS : NEW
IJ15E 'TYPE : 4aINGLE F--AMIL.Y
e nip p 1.j Q111 rl 1, lit in P3.y w J.-t.1-1 im].:1. r,1.1:1.ci,q. ilti-KI cif 1-110. U I I i Ti fp(:I
C
Agal-lcy . pq.m-Ini-L expil,wis 120 (firtym fi-tam th *? c1raje et t t:)t lit 1.
ULIAOLIIII, J.41 thcr., I:)*)t`MJ-1, Aje)r1c.:y ckjc,>%; 1-1 C)1, c i'l 11L r.
lltllte-!1:7) thc? cif 0.1c., 3.0c atiul-I ri-F If thf.-F rsew'F4?1-` i!l;
licit, 114.1, thc! 1n*-lIkfI41.1 wwm*)ri1, qj.veii , M-Iel 3 ft:rVi!t, 111
ift:11.3. fr-0110 givmt-i . If fri(It Ilic) J-CWNat-6ild , the
C)LI r,Q 141 lit Ili r
Tillp 1,kilcl 5:1-clivif al. IoLl,cor,illA .
IYPE.'- : 9171171.oiNc GF.wET IMPIX14VIDLIS APEA:
-----
1• IX'TURE UNITS . 'rENA- N'1 111PROVEMI:'KINIJ .
1.)W 1.-.1..I ING UNITS : 1.
NO. OF BLUGS ,
0 ANDEPS014 VAN I- PEPM11,
w 936.3 43W CONNE:L'TION CHARGE 1.00 . 00
N 17*1 lit v e,i c)n nr LINK 'TAP IN5*TALL .
E
R
UTHER
C ONDEPSON DAN U
0
N HE"ADOWEIPOOK UL
EVEOPMEN'T'
T 9,363 W Sr-EAVEWTON I-III.A..SDAI F:
H boavel-•tail or, 9*7006
A
C 11,11-ICINE llt$03) P9•7....766 te)
T
0 nF-"Gis,niA'rwN NO . 463-41-el rOTAL: 111135 00
R
PECRIPT N0.
This permit Is isnued subject to the regulations cu.-,I—oned In Title 14
of the TIVIC. State of Oregon Specialty Codes.zoning regui 111lons P F. R E:Dr,N S i P E.C 3'.C)N 5
and all other Applicable codes and ordinances, and it Is he.iby POLIGH—IN
Agreed that the work will be done in accordance with the plans 9. d
specifications and in compliance with all applicable codes and
ordinances. The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void If work is not started within 180 days,or if work Is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to Assure
all required Inspections are requested And approved
Permittee Stqnitijrf,
Issued By: GAI .I FAJP INSPF-J","TION 639--4175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
F__
J
h-1111" I F.4,1MI F W.) . PLA301760
CITY OF T IFA RD 'E FIM:IT
(CITY CO),F TWA RMD
COMMUNITY DEVELOPMENT DEPARTMENT IWITL 10/
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)6394175 1.M 1:,M 1' . No .. 00 My .
E3 9
J01'.1 ADDAEESS : 1A.P" SW 9,541-1 AVE.'
A
H'APHA141' ACA',11::�':) L 1 13 UK :
'TAX MAP/I 01' 151 :3 WA 3600 SULt I*.,
I.-AND USE : 1:4 1.2.
LOT SIZI�,: .
NO NO
WORK CLASS ; NLEW WATEP CI..(SF_-:T 1.2 TPAI.)
USE TYPE; SINGL.E F-AMII Y LIP.I.NAI PPIJIS11,14
CONST .TYPE: VN L.AV0RATt*.,.:4Y P. r ftAf> Prl.'LMEP
0CQ'1JP.GRP . : P3 TUH 51-IL)WER 2 (:;I:*11I:_**A5E TA1011:55
1:11 SHWASI-IF.i.r.4
GAP113(-)G*117'.' DIA-iPOSAL 1.
NO. STORIES : I WASH.I.W., MAMUNE I
DWELL. .UNITS I LAUNDRY MAY !-'I L)(., . DPA IN I DTA
FLOLM D14AIN
SINK 1. 5L.WER (F*I'll
WATEP 1. STO 14 M W A I N F T 1.
OTHER
0
W ANI)EPSON 1)A N F FERMIT $1.1 1 0
N 936.3 SW WriF AVE PTOW-1-4 I L L.S DAI_L
E
R b ivi ot v r,-r t c i n FIXTUIPIKS
S I'ATI-E. 'TAX
01 HER
C
0 11411131 MITI' PLUMBING
N
T WOLCOTT PL(IMUT.M.',
R 1:)u Box 872
A
C !.)r lm%I I a M or 97030
T
0
R NO. P-343-17 TOTAL : >Y 123 , 38
L I
This permit Is issued subject to the regulations contained In Title 14 IIELEIPT NO.
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and It Is hereby RE'QUIPEM INSPECTIONS
agreed that the work will be done in accordance with the plans and ;-`L.B .UNDLMSLoB
specifications said in compliance with all applicable codes and r*,(,.)sr & IREAM
ordinances The issuance cf this permit does not waive restrictive WAI EA I X NE
covenants. Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and 1•'1...18 . MPUUT
yid if work is not started within 180 days,or if work Is suspended or PAIN UPAINIi
abandoned for a period of 180 days any time after work has F Y NAI
commenced. It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved
Permittee Signature
-slued BY: k)
FUR IN-hPIE-GlION 639 411.75
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
W
V:IERKIA
CITYOFTIGARD F NO.
CITYOFTWAltD
COMMUNITY DEVELOPMENT DEPARTMENT 01100ft
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard.Oregon 97223.(503)639-4175 rwl I:;- /H6
;_:M F
JOH ADDRESS : 11.1�_-asw
VAX MAP/I O'T- 1-5:1. Z55(,',A 3600
LAND LISE : L.T . 8 i'il<
S:L Z I-: :
WOPK CA.-A55 : NEW NO : NO:
<100K :1. AJ'P HANIA 1.4 <1.0
USE TYPE: '1.0 0 14+ Air-4 HANDLIQ 10K
(:101451'. TYPi-_-:: VN I::'LO0R F l.JWq(V:'L* EVAVI. A
()('.CUP. HEATER VENT PAN 3
k)F:.*NT VENT' - SYS'T'EM
NO. BLI-WCUMP <31-fl::- HOOD 1
DWEL-I.. .3011F)
J'.N(:.1Nr-'PATOI4((:,(:)m
11A)KIL TY14-: GAS 1:31...P/(:;OMI"! 30 501.1pi
MAX . ):NPIJI' C-311 R/(:'(IMI:) 50+1-4p OTHER
UN11-9
F'Ird;: umpwiq OTHER .1
GAS I-)'.I:PINC; IIJLJTLETi 1.
Luw pnrs_c.'?
lAI:::MAPKS .
0 1 InES :
W ANUKASON 1.)A N E
N '9363 SW *10 . 00
E I AN AE'Vir-':w at,0, ,7�.
R L)r4* FIXTUPE's :1.0 J.'j
'�TATE' TAX 111130 . 50
(11 Htrp $2 Op
G
0
N
T FOUL SEALK)145 I*'::AT1NL; A134 CON()
R 1-10I3(:Ix60,-q09
A
C r-'al"t1fitild Or' Y72.66
T C)HUNIE: ( 50,3) 7-7!5_--,nj9.t9
0
I4PA*-'-:I57*PA1J:ON NO. AFI2r.-j*.J
TUTAI 5 El 6 5
This permit is Issued subject to the regulations contained in Title 14 NO
of the TMC. State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances, and it Is hereby "liMUTWE) I:N!jPE(:'J'T(:)N%
agreed that the work will he done in accordance with the plans and ( AS L.J:NE.
specifications and in compliance with all applicable codes and POS T 1% FWAM
ordinances The issuance of this permit does not waive restrictive put-161-4--1N
covenants Contractor and subcontractors shall have currentCity
business tax permits This Permit will expire and become null and
I "I NAL
void if work Is not started within 180 days.or If work 19 Suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Per,41%esagnatli
Issued By
__r_TTTT__TT41TPFTTT FW
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITYOFTIGArRD PLAN CHECK APPLICATI
COMMUNITY DEVELOPMENT DEPARTMENT �o�E00Gi�IRD PERMIT
LAANN ?i
CHECK # U
13125 SW RVABlvd. F.O.Boat 2 97,Tig M.Onpon (5M)0"41751
DATE ISSUED
P,-
JOB
q►
JOB AODR SS: , - __ - TAX MAP/LOT -� -
oC 3100SUB: 70L pL LOT: Q
LAND USE; Z.
VALUATION:
OWNER SPECIAL NOTES
NAME: .� .� Lr-:feat) f-�I,yC REISSUE OF:
ADDRESS: �_ -� LAST REISSUE'
FLOOD PLAIN/
PHONE- .z9SENSITIVE LAND:
APPROVALS REQUIRED
CONTRACTOR PLANNING: _
NAME: L� _ ____ ENGINEERING:
ADDRESS: FIRE DEPT
OTHER:
PHONE: ITEMS REQUIRED
ARCH/ENGINEER LIST/SUBGONTRACTORS:
--- �„r�_- BUS TAX:
NAME: CALCULATIONS:
ADDRESS: TRUSS DETAILS: _
PARKING PLAN: —_
LANDSCAPE PLAN: —
PHONE: ,(,� OTHER:
COMMENTS:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
'y
'-' 10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees
¢"1-Ltd 10-431 01 Mechanical Permit- Feesi-V�j 10-230 01 01 State Building Tax (5X) Z —
Building ---
Plumbing a ,
Mech
10-433 00 Plans Check Fee
Building
Plumbing
�j Mech �-
0
30--202 00 Sewer Connection
30--444 00 Sewer Inspection
51--448 00 Street System Dov Charge (SDC) -
52--449 01 Parks I System Dev Charge (PDC) _
52-.449 02 Parks II System Dev Charge+ (PUC)
31-450 00 Storm Drainage Syst Dev Chrg (SSDC)
10-230 09 TRFD — - -—
10--230 06 Washington County Fire N1 (95X) - v -
10--220 00 Am rt-/Wedgewood —
L' TOTAL
REC # '
APPLICANT SIGNATURE -
Received fly: ' Date Received:
ht/3587P/18P