11522 SW LAKEVIEW TERRACE-1 N , wp 400 .,p ,,ae y��y 0 +tlw ,r•
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ilf&pECTION NCYfJCJ
Ci." of Tigard Building DepartaaM:
33125 fw, Ball Blvd. ."igard, Oregon 9722]
Irspection W:a (Rcc-41-Phone): 639-4175 Businean Phowt: 639-4:11
Inspection: •
Footing P11sq. 4nderelab Mach. Rou-h-in k \
round. Pabq. 'ibp Out Cas Line E}
Post/Beam Struct. ban. fewer Fram'ng -Bldg.
Poet/Beam Mach. :Lain Drain Insulation -Plumb.
P1bq. Underfloor Na er Line Oyp. Rd. -Mach.
/-
Date Req,_estad: C l / ` ✓ Time. _ �_pM
Address: ..7 �.Z. GQ �wiLl /Permit is �, ? ■
Builder:
7111 FOLLOWING CORRRCTIONS ARE RE42UlRED:
/ �'f Y.
itkapmtol s 1. `!a 1t1 /i { - -- Date:
—APPROVED DISAPPRCVED AppROVED SURJRCT TO ABOVE
-_—C•i1.1 For Reinap.
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INSPECT-ON NOTICE
city of Tigard Building Departoent
13125 SW Hall Byrd. Tigard, Oregon 97223
Inspection Line (Rec-n-Phone)- 639-4175 Businees Phone: 6.19-4171 �
Inspections- - — �— --
Footing Plbg. Urderslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Tod_ Out Gas Line INALs)
Pop'-/Beam 3truct. San. Sewer framing -�9•�
Poet/Beam Mech.
Rain Drain Insulation C --Plumb.
- ��.�-
Plbg. Underfloor Va or Line Gyp. Bd. C MAC`
{
U 3 Timet _ 'AM PM ■
i�nt.e Requested: ------ 1'
Permit I s�'C)
• Addrees:ll�-��-- I.i-CJ�.J �_ i
:uirdgr:_ �L� ■
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THE FOLLOWING COFRECTIONS ARE REQUIRED: r
... � CT_��ate•--�- G-...t, � �wf "�� y•'t- �G�� � .t
Inspectors nates-7 z o-
APPROVED DISAPPROVED APPROVED SUBJir"T TO ABOVE
Call For Reinsp.
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CITY OF T l:I:r->'r ' F".I t:;F~N1 t:ll
1:11:;l:;Uf~'G1Nt7 Y
COMMUNITY DEVELOPMENT DEPARTMENT PE 1:4111 1 44. . » . . . . s Mia i'"�� ->ztldtkl ►
13125 8W Hall Blvd.Tigard,Onpon 97223+8199 (1503)839-1071
{AM' V iSOL:)w 04 :.'W'93
I...fliT, V':E W 'TC F2 F2 F'"F�f,'Cl i..a l!i1;: .s1�L IZr'S1 'k'►►11
iUHo I v.1 9I I:)N. . . . t VILLAGE A f:,l.)KiMt`Ft LAKE ZONING- P 4. 5
;�(_Ur,M. . . . . . . . . » a 1-01 . . . . .
,..:r_A'.P3 OF WC)F?I<. a N€"_I'.l
OF I YPE F USE'. . . :fir. rr
OCCUPANCY 611P. a k.? 1
JCL;U1='ANCY 1-17 V. t .1 6
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VENANT P411,11-
b 6,lPltl�tr^rtes F't+i'�II X � ■
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I•'ICJF�X�`;fil:.r_L.F:. Illai�ll;F. :
^`!JW {�11'.11:'+1..'f Fal 4, '01
Ilhrarr�� ftp I;1-
"lIN MOR IS' I':: ' TE E;Y11.01.I it INr
1-5555 SW HFINUY R1?. r
1 -'upalwv (.4 the IlE:►UyE" cl.t , air, And certifies
010 r:ampliar"I.e With P,hlf> Of 01-ellt►n for the gr-u'.sF►,
�C:CIA�Jd it jr} ti!:r ►A'>W„ 1.1 r1<�E"Y' INF'►:I.1' 1i 't:t'1P v.vuC ed Fle cm.1 C' w';I' (-,(:1.
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P1 AC'F.
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[NSPECT 'O f NOTICF
city of Tigard liuildinq Dcpsrtment
{ 13125 8f! Hall Blvd. Tigard, ureyon 97223
Inspection Line (Rnc-O Phone): 639-4175 Business Phone: 639-4171
I
Inspection:_.-- — - - '--
Footing PLbg. ,nderelab Mach. Rough-in ppr/Sdwlk
i
Found. Plbg. Top Out Gas Line FINAL:
If
Poet/Beam Strt. San. Sower Framing -Bldg.
i
Poet/B,.am Mach. Rain Lrain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. ed. -Mach.
Date Requested: 362/2 —_ Time: -)LAM _ `PM
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Addraes:__�_�_y� Permit f:
Builder:
THY FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors _ /`l T/7�C%I( --�- Data:_
APPROVED DISAPPROVED APPROVED SUBJECT TO ADO"
Call For Reinep.
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I14SPECPION NOT_10E I
City of Tigard Building Department I 1
J�1
13125 SII 3x11. Blvd. Tigard, Oregon 9727.3 i I
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:—
Footing Plbc. Underslab Nech. Rough-in.++ CA;r/8dw1
Found. Plbg. Ton chit Gas Line FINALS
Y; Poet/Beam .truct. Sa%. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation
-Plumb.
Plbg. Underfloor Water Line r� ) Gy Bd. �MgCh
� ,
Date Requeetedtc Z �J Civ i- -�, `�CL� l/✓U - �( PM
Addreees /'/[ lr Permit #19-7,
Builder.: AV L, 7-3
THE FOLLOWING CORRECTIONS ARE REQUIRED:
C) PLS-M �'�►V1 L1i c '- £� �f L_,L ff'�n-
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Inspector: Date: ✓''GQ/ �J
APPR0V6b DIS7PRD APPROVED SUBJECT TO ABOVE
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For. Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 BN -all Blvd. Tigard, Oregon 97223
Inspection Line (Rr,:-O-Phone): 639-4175 ausineBB Phone: 039-4171
Inspection: ---
Focting Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Be m Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line Gyp. W. > -Mech. .
Dater Requested: /._' - /Times — Ali' PM
Address: � 21-17) C �/` �U�� Permit 1: ^�-
■
Builder:___ — —THE FOLLOWING rORRECTIONS ARE REQUIRED:
090
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InBpec t or• 1
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APPROVED DISAPFROVED v r APPROVEt: SUBJECT TO "WNZ
_Call For Reinap.
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�p�:ON Narks �
G.tT of Tigard Building Departrent
13125 BW Mall Blvd. Tigard, Oregon 97223 I
Inspection Line (Rec-o-Phons)s 639-4175 BusinNsr Phones 639-4171
Inspections
rooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found.
Plby. Tap Out Can Line FINALa
Post/Beam Struct. San. Bower Framing -Bldg.
Post/Beam Mec^'�. Rain Drainnion'+ -Plumb.
—.
Plbg. Underfloor VAter Lino Gyp. Bd. -Me:h.
DateA '� -l
equeatede�1 Tulse _ /�- AM PN
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Address:--// � 1"'� Permit ie `/� -�/ / ■
Builders"i
TEM FOLLOWING CORRECTIONS ARE REQUIREDt
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Inspectors Dater �r,�=�3
APP MD DISAPPROVED -- APPROVED SUBJECT TO ABOVE
Call For Rainsp.
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I"5PEC7ION NMICS
4 City of Tigard Building Departaoat ,
r - - 13125 BA Ball Blvd. Tigard, Oregon 97223
Inapection Line (Roc-O-Phona)s 639-4175 Busineee Phones 639-4371
1"specthon:_
Footing Plbg. Undorslab Meeh. Rough-in Appr/Sdwlk
Found. Plbg. Top Out /—Oaa LiM FINALS
' J Post/Beam Struct. San. Sower \ Framing -Bldg.
Post/Beam Koch. pain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lino Oyp. Bd. -Koch. .
Date Requested: -_J Tim$ AM PH
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Address: f����, �,�;- �,i.-`L/%c� Permit it _�-?�Qd' ,Z
Builder•_ _ B
THE FOLLOWING COP.,ZCTIONS AR3 REQUIRED:
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Inspectors nate:
APPROVED DISAPPROVED APPROVED SUB.7ECT TO ABOVE j i+
j` Call For Rel.a:ep.
14
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INSPECTION NOTICE
City of Tigard Building Depar-twent �
13125 SN Ball Blvd. Tigard, Oregon 97223
inspection Line (Rec-O-Phone): 639-4175 Business Phone: 539-4171 I
Inspect io-r:
root fig Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
J
40'
Sttu San. Sewer Framing -Bldg.
----�
Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. R.J. -Mach.
Date Raqueeted:..�_ Time: AM --PH
Ad:lreee: ? ^f/Iit-- Permit �: �/� 19VI)
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Builder:�t
THE FOLLOWING COIRECTIONS ARE REQUIRED:
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J Jr d p 7i.
Inspector:
------- .�-f.-_——— ----- n -S'3ate: 1 t�;
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APPROVED DISAPPROVED �
APPROVED SUBJECT TO ABOVE ^} { A M
('Fill For Reinsp. #r
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INSPECTION NOTICE
City of Tigard Building Dep—L—nt
13125 RW Hall Blvd. Tigard, Oregor_ 97223 I
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspecti an:_ --�- -- -------
Footing P -YOderaIab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL.*
Post/Beam Struct. San. Sew Framing -Bldg.
Post/Beam Mech. Insulation -Plumb.
Underf Water Lislr Gyp. Bd. -Mech. N
Date Requested: ` Tlm�D�r_AM _ _ PH
Address: / Z � �_ ;1] -- Permit #1 .1 _ C�o Ll G-
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
o, Inspector: - _
{ `l;; Dates ----L-
i; 1:.
APPROVED DISAI-PROVED APPROVED ZJBJECT TO ABOVF.
---Call For Reinsp.
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INSPECTION NOTICE
city of Tigard Building Department
1312K SW Hall Blvd. Tigard, Oregon 97223 A ,.
Inspection Line (Ree-O-I°hone): 639-4175 Business Phone: 639-4171
I
h:
Inspection --
Footing 01bg. Underslab Mech. Rough-in Appr./Sdwlk
�d) Plbg. Top Out Gas Line FINAL:
Poet/S"e"am Struct. San. Sewer Framing -Hl.dg.
Poet/Beam Mech. Ra1.n Drain Insulation -Plumb.
41
f�' ! Plbg. Underfloor Wator Line Gyp. Bd. -Meeh. .
T line: AM PM
Date Requested: -
addreeo: � �� perk
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9uildor:
THE FOLLOWING CORRECTIONS ARE REQUIPF.D:
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IneFector: Date:. _ L\ _ I -
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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il, is d„Nati :r �`
CITYOFTIGARD
OF � MASTER PERMIT
COMMUNITY DEVELOPMENT DEPAh', ZENT ORIOo" PERMIT t#. . . . . . . • MST93-0042 1
13126 SW Hell Blvd. P,O.Ba 23377,Tipnd,Orspon 07223(603)83"176
DATE ISSUED: 02/03/93
SITE ADDRESS. . . : 11522 SW LAKE...V I E::W T'E R R PARCEL: 1 S 133DD-0`5:'00
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 3 ZONING: R-4. 5
i
BLOCK. . . . . . . . . . . LOT'. . . . . . . . . . . . . :91
BUILDING
REISSUES DWELLING UNIT'S: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDR119:3 BATHS:2 GARAGE. . . . . . . . . . :506 s f
TYPE OF USE. . . :SF FLOUR AREAS---------- REQUIRED -
'TYPE OF CONST. ;5N FIRST. . . . .. 1629 sf LEFT'. . :5 ft RIGH r. :5 1'.t
OCCUPANCY GRP. :R3 SECOND. . . SO sf FRONT. :20 ft REAR. . -SO ft
STORIES. . . . . . . : 1 'rH I RD. . . . :0 S f REQU I RED
HEIGHT. . . . . . . . . 16 ft TOTAL------: 1629 sf SMOKE DETECTORS- :Y
f=L.(..)L ;' LOAD. . . . :40 psf VALUE. . . . . 134042 PARKING SPACES— : 1 ■
Remarks : PATH I
PLUMBING ----------------------------------------
SINKS. . . . . . . . . . Jli
______________--._____.._________-.___..SINKS. . . . . . . . . . : i FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. - :0
L.AVATORIES. . . . . 12. WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .0
TUB/SHOWERS. . . . ;2 LAUNDRY TRAYS. . . SO CATCH BASINS. . . . . . . :0
WATE=R CLOSETS. . :2 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . t O
h
DISHWASHER]. . . . - I WATER LINE (ft ) . : 100 OTHER FIXT'URES. . . ,. . :0
UARBAGE DISP. . . : 1 RATIN DRAIN (ft ) . :0
WELSHING MACH. . . : 1 SF RAIN DRAINS. . : i
MECHANICAL - -___________________._____.---___--- FEES ---.-._--
FUEL 'TYPES------------ UNIT HTRS. . :O type amount by date recpt
/GAS/ / / VENTS . . . . . :0 TIF $ 1460. 00 JH 02/03/93 -
MAX INPUT:0 BTU VENT FANS. - :3 BPRT $ 388. 00 JH 02/03/93 - I.
FURN ( 100K . . : 1 HOODS. . . . . . . 1 BPLC $ 252. 20 JLH 01/20/93 93-235805
FURN )-100K . . :0 WOODSTOVES. :O B51PC: $ 19. 40 JH 02/03/93 -
FLOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JH 02/03/93 -
BOIL/CMP ( 3HP:O OTHER UNITS: i PARK JH 02/03/93 -
CAS OUTLETS: i PIPR"I- $ 40. 50 JH 02/0.3/9;3 -
Owner: ----- _______..________.___._._____._._...___.HPLC $ 10. 13 JH 02/03/93 -
MORISSETTE HOPIKES M5PC $ 2. 03 JH 02/03/93 - ,)
15555 SW BANDY RD #201 E='PRT $ 11750 JH 02/03/93 -
P15EIC: $ `x. 88 JH 02/03/93 -
LAKE OSWEGO ul 37035 BPLC $ 15. 00 JH ''d/03/93 --
Phone di: 6c':0--7538
Contractor:
DON NORISSETTE BUILDERS, INC.
15555 SW BANDY RD. �
#201
LAKE OSWEGO OR 97035
Phone #: x.20- 7538
Reg #. . . 35533
9 3090. 64 T 0 TAL
This permit is issued subiect to the regulations contained in the -- -- -- REQUIRED INSPE=CTIONS ------
Tigard Municipal Code, State of Ore. Specially Codes and all other Foot/found Insp Fireplace Insp
apNl±rahlk li ,s. All work will be done in accordance with approved Post/Beam Struct Gas Line Insp
p..ns. This parait will expire if was,k is not started within 180 Post/Beam Mechan Insulation Insp
days of issuance, or if work is sp.nd for• more than 180 days. Plm/Undslab Insp Gyp Board Insp
PLM/Under,Floor Rain Brain Insp
f'Pi' niiILee SDiyllatuva: w4._� Mechanical Insp Water Line Insp
_. Plumb Top Out Appr/Sdwl1, Insp
_._._ _----..___ _ Framing Insp Mechanical Final k
[:all for inspection - 639-4175 l
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CITYOFTIGrARD SEWER CONNECTION
CnYOF TWARD
COMMUNfTY DEVELOPMENT DEPARTMENT oe,00i+ PERMIT #. . . . . . .
.
. : SWR 9 — (7r 5 9
13126 SW HV!Blvd. P.O.Bax Mir' T{pud,Orpon 07223(633)639-4175
6:39--'4171 DATE CSSUED: 02/03/9:3
SITE F1,'1LRE:SS. . . : 11522 SW LAKE V I E.W TERFi PARCEL:c 1 S 1 a DD- 0520 I
SURD I:V a'S 1 ON. . . . : VILLAGE AT SUMMER LAKE P'A1 K :3 ZONING: R--4. 5
PLUCK. . . . . . . . . . . LO. . . . . . . . . . . . . :9 I
USA NO. . . . . . . . . . : FIXTURE UNITS. . . c I
CLASS OF' I.;JRK. . , ;NEW DtJEI-L I NG UN I TS. . ; 1
1YPE OF USE. . . . .. :SF IvU. OF:. SU I LD I NGS: 1 r
I NSTAI_L TYPE. . . . :NUSWR I IYIP'ERV SURD ACE. . :S f
kemalrl<sc FIA-11A :C �
Owner --_ __ _ FEES
MORISSETTE HOMF:E S type amai.rnt by date rec•.Ypt
15555 SW PANGY RD #c.01 F'RIIT $ 2100. 00 JH 0r/Q)3,11)3 —
IIVSP $ 313). 00 JI-1 02/03/9:3 —
LAKE OSWEGO OR 970,35
Phone #: 620-.'.-7538
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CONTROCTOR NOT OIV FILE
1/10 TOTAL
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_._.._._...__. REQUIRED INSPECTIONS
_--_..._...
This Applicant egrees to comply with all the rules and regulations Sewer Tnspec tion
of the Unified Sewage Agency. The permit expires 180 days from
the date issued, The total amount paid will be forfeited if the
permit expires. The Agency doe, not guarartee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer sh,.11 prospect 3 feet in all directions from
the p ant. S given. If not so located, the installer shall purchase
a "lap ani Side Sewer" Permit and -tie cy will in all a lateral. •____..�_..__�_...__.__.�._._....... ._.___..______.__._...-_._._._..__._ '
r='e r m i.t t e e c-3 i y 1 r a l l_r r f-
7! _��___._______________ --_._...____.__._...- ..
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Call for-, irispection - 639--417 ;
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NEW
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ITY OF TIGARD 012S SW H, Bwa PLNCK,/RECT /C
I W-Im
PO Box 2"97 PERMIT / MJf
COMMUN[TY DEVELOPMENT DEPARTMENT 9ip"to-8-97m
(50)63M171 DATE ISSUED
JOB ADDRESS: �1— �— J _ - TAX MAP/LOT J�S/ -33 d0-v2 z
SUB: �� c +w%4,f�, LOT: _ ` i LAND USE: _
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VALUATION:
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OWNER SPECIAL NOTES
NAME: ����L_ ►'ISSP �� REISSUE OF: _ _
ADDRESS-• J S '02- LAST REISSUE:
FLOOD PLAIN/
PHONE: SENSITIVE LAND:
CONTRACTORPPPPROVALS REQUIRED
NAME: PLANNING:
ADDRESS: _ ENGINEERING:
FIRE DEPT:
PHONE: OTHER: _
CONTR. BOARD : EXP DATE:
TES REQUIRED
"UBCONT AC ORS: PLUMB: LIST/SUBCONTRACTORS:
MECH: AUS TAX:
BIRCH/ENGINEER T"P' CALCULATIONS:
c
NAME: ��1 Jr��' r1 , TRUSS DETAILS:
ADDRESS: OTHER:
D2-7
PHONE: —Lelo—3
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PROPOSED BLDG. USE:
COMMENTS: +
1 4.
APPLNT IG ATURE
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Received By: Date Received: ' -�
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PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BA2LG.�JDdE
j
Z, 10-432 10-432 00 Buildinj Permit Fees —_ --
10-431 00 Plumbing Permit Fees '
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10-431 01 Mechanical Permit Fees U U,)-p 14 U. >U-
10-230 01 State Building Tax (5%) 7, -L 2 3�
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Building
Plumbing S,
Mechanical ,c'3
10-433 00 Plans Check Fee '3.' -7- 0 a 3 j
Building 2-5z • zQ
Plumbing
Mechanical /v,i 3
10-230 06 Fire — -
.5-aLl 3u-2O? 0^ 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 /-55 /jsu
25-448-05 Mass Transit TIF Fees //6)
52-449 00 Parks System Dev Charge (PDC) J o o Sou
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) — --
TOTAL
nm/3587P.WPF
d r"�wllml �'��" 1GE7a(`• E�IL� ttw+Cvx+u+MMw, •wrw
»>u sw tisn iiwa. PLNCK/RECT # ,
CITY OF TIGARD Oregon9 PERMIT # —
COMMUNITY DEVELOPMENT DEPARTMENT TiFacd )639-4 71
(503)639-4171 DATE ISSUED
JOB ADDRESS: —
TAX MAP/LOT
--
OT: —_ — LAND USE:
SUB:
VALUATION:
SPECIAL NOTES
OWNER
REISSUE OF: ----
NAME:
LAST REISSUE:
ADDRESS: -------^
FLOOD PLAIN/
SENSIT'VE LAND:
PHONE:
C T LCI
LR APPROVALS RE UQ IREO
PLANNING:
NAME: .—__ — —
ADDRESS:
ENGINEERING: -
— -
FIRE DEPT: -
OTHER: _
PHONE: — ---
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ LIST/SUBCONTRACTORS:
MECH: BUS TAX:
RCH ENGIU R CALCULATIONS: _—
TRUSS DETAILS:
NAME:
ADDRESS:
OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIGNATURE
Received By: _ __ _` --_ _ Date Received:
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CITY OF- TICIARD — RE::C:'EIPT OF PAYMENT RECEIPT NO.
r CHECK AMOUNT r 47:`';5. r•4
NAME;. r I,I0RIS"!3ETTE, DON CASH AMOUNT r 1Z1, 00
AT)nRESV r PAYMENT DATE r 02/03/93
SUBDIVISION
V I ION e J
p `> 1
PURPOSE tall' PAYMENT AMCJUIV I Pw o P URIDOI.iE' UF PAYMENT i-IMt:1UNT PAID
K; BUII_UINd F'EF?M 388.00 f�l_UMF�INF3 PERM 117. 50
MV.47HAN I L;AL. PE': 40. `50 FjT. BUILD F'"L Ft 27. 31 I �
s='I_.IAN C:I-iECK F"f* .'37. 33 SEWER USA 14'.'1121. 00
`
1:4_IJF:R I NSPE:t:J ;tis. 00 PARKS SDIL. e:;O. 00 a
�3Tt:1RM DRAIN SLwL 00 RESIDENTIAL. TRf-WFIC F'111-::1, 1350. 00 �
Mill"r 'I RANSiiJ:T TIFF110, 00
LOT 91 V I L.L.A13E AT �lJIH14t Rt_f11if
I 1-1f'22 ISW LAKFVIEW CT
TOTAL. AMOUNT' PAID - - ; 4 i "_. F:4
A
_ r ...�..�...�. �.��.�... . ....�..-..�.•�...��r .n.r...r..�� w...+�.r��.�.�� �.rte,r.e.....'-a»wa...wv-.acz--c.�c-:R..w.rv��,r ,L
1
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C,'I'T'r' OF- T'It•i 1p'D - W C-FIPI (.A- 141YMPJI RLCE.U.1' NO. 315) 1VI5
l:_I-tLAJ'. AWILIN F s .50. 00 y
i'JAME s Mt:1R I9SUTE, 01-111 CW:.3H AM(JUN I" s 0. 00
►1,X>RE.L1�r s F41.,ME:NT L(.ITt,. r 171:1 t20 92. 1
t�tJErD I II.:p I ON n
C'i PPILY"3E UF PAYMP14T wlll*)1 II'J T PA I I) F'I_I7C'I:,:C` OF PAYMENT AMI:IUN'T F-'1)I r.1
PLAN CHECK FIE
i I
t 1
I,-OT 71 VILL.AGF- AT 'JMML`_RI_AN,F
1C-6c:'3 CSW SRIDGFVIEW CT
TOTAL AMUUNT PATQ 4141
INoW L 04.4 ,
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