HomeMy WebLinkAboutPermit Building 2001-01-03SPRINGFIELD
Job# 00-01816-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Buitding Safety
Page'1 of 4
IRANES:01-0004164
DATE:JAN 0l 2001
At'lI RE[0:2 $ ]7?5. ?6
IHftNEE:
IASHIER:004
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 397 S 00032nd St Spr
AssessorsMap#: 17023134
Lot: Block: Addition:
Job Number: 00-01 81 6-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 02702
Subdivision:
ctTY oF SPRTNGFIELD, OREoON
Owner: Marvin L. Adamo
Address: 4164 Marcum Lane
Scope Of Work: Single Family Residence
Contractor Type
GeneralContr
Electrical Contr
MechanicalContr
Plumbing Contr
Phone Number:
City/State/Zip:
New
541-461-2068
Eugene, OR 97402
Value: $67,947
Please note: As a requirement of the partition he must move the sanitary sewer line. He has
decided lo oul lhe water and stormlines in for hoth narcels al lhe same time. At time of nlans
Contractor Registration # Expiration Date Phone
Storybook Homes 541-461-2068
4164 Marcum Lane, Eugene, OR 97402
My Electrician lnc 87506 1112012001 541-741-6379
32316 Riley Lane, Cottage Grove, OR
97424
Storybook Homes 541-461-2068
4164 Marcum Lane, Eugene, OR 97402
Don Lewis Plumbing 33076 611012001 541-688-1931
500 Greenfield Street, Eugene, OR 97404
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
3RSC
1
(VN)Wood Frame
Electric
Office Use
-
Land Use: Single Family Dwelling
Zoning Code: LDR
Bedrooms: 1
Range: Electric
# Of Buildings: 1
Occupancy Group: Dwelling
Heat Source: Baseboard Electric
Sq. Footage: 924
To request an inspection call the 24 hour recording a1726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day.
Required lnspections
Footing
Foundation
Slab
Floor lnsulation
Geiling lnsulation
Framing
Walllnsulation
Drywall
-Aftertrenches.*#
-After forms are erected but prior to concrete placement.
-To be made after all inslab building service equipment, conduit piping, and other equipment iter
-Prior to decking.
- Prior to cover.
-Prior to cover.
-Prior to Cover
-Prior to taping.
Final Building
Rough Electrical
Electrical Service
Final Electrical
Underfloor Plumbing
Rough Plumbing
Water Line
Sanitary Sewer Line
Storm Sewer Line
Final Plumbing
Rough Mechanical
FinalMechanical
Street lmprovement:
Curb Cut?[
San Sewer Depth (Ft):
Storm Sewer Available?
Special Req.:
Security Required:
Bond Begin DateTime:
Specia! lnstructions:
Other Utilities:
Project Supervisor:
AC Mat
lmprovement Agr.?
6-4
Job# 00-01816-01 Page 2 ol 4
Required lnspections
Building I
-when all required inspections have been approved and the building is complete
Electrica! I
- Prior to cover.
-Must be approved to obtain permanent power,
-When all electrical work is complete.
Plumbins I
- Prior to insulation or decking.
-Prior to cover.
- Prior to filling trench.
-Prior to filling trench.
-Prior to filling trench.
-When all plumbing work is complete.
Mechanical
- Prior to cover.
-When all mechanicalwork is complete.
Sidewalk Type:Setback - 5'
Additional ROW?
Size Of Line (in): B
Downspouts/Drains: To Drywell-Provide DrywellEn
Enchroachment Permit:
San Sewer Tee (in):
00/00/0000 00:00 AM Bond End DateTime: 00/00/0000 00:00 AM
STORM DRAINAGE TO DRYWELL PER STD DWG 4-19 & 4-20 OVEF
Types Of Warning Devices Reqd.
Zoning: LDR
FloodPlain?Wetlands? fl
Overlay District:
# of Street Trees: 0
Land Use: Single Family Dwelling
Pave Driveway? Z
Journal numbers
1: 97-06-139 Partition 2: 3:
Comments:Owner stated they are moving, filling or grading less than 50 cu yarc
Planner: Liz Miller Additional Requirements:
Urban Growth Boundary?! Glenwood Area? [ Required Attachments:
Quantity Of Fill: Source Locn:
Supplier: Material:
Drainage:
Floodway FEMA: Zone X White Flood Plain FEMA:Panel 1 161 of2975
Construction Types(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings: 1
# Of Bedrooms: 1
Handicap Access? f]
Area (Sq.
Main: 924 Accessory240
Job# 00-01816-01
Private Garage/Carp/Stor
# Of Stories: 2 Height (feet): 21
Current Units:O Proposed Units:1
Census Code: New SF - detached
Total:1164
Page 3 of 4
Fee Paid On Receipt# Value/Quantity Fee Amount
Plan Check
12t2012000 4093Residential Plan Check
Total Plan Check
67,947 $219.05
$219.05
Buildins
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
0110312001
01t03t2001
01/03/2001
00041 64
00041 64
00041 64
67,947 $337.00
$23.59
$1 0.1 1
$370.70
Electrical
Wiring Footage 1,000 Sq Ft or Less
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
0110312001
01t03t2001
01t03t2001
00041 64
00041 64
0004164
$85.00
$5.e5
$2.55
$93.50
Plumbinq
Minimum Plumbing Permit Fee
Minimum Plumbing Permit Fee
Two Bathrooms
State Surcharge - Plumbing
State Surcharge - Plumbing
Water Service Footage
Water Service Footage
Storm Sewer Footage
Storm Sewer Footage
Administrative Fee - Plumbing
Administrative Fee - Plumbing
Total Plumbing
1212012000
01t03t2001
0110312001
12t20t2000
0110312001
1212012000
01t03t2001
1212012000
0110312001
12t20t2000
01t0312001
4093
00041 64
00041 64
4093
0004164
4093
00041 64
4093
00041 64
4093
00041 64
130
50
135
50
$.00
$.oo
$160.00
$5.60
$7.70
$40.00
$-2s.00
$40.00
$-25.00
$2.40
$3.30
$209.00
Mechanical
Hood and Exhaust
Minimum Mechanical Permit
Administrative Fee - Mechanical
Vent Fan to One Duct
Dryer Vent
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
0110312001
0110312001
0110312001
0110312001
0110312001
0110312001
0110312001
00041 64
00041 64
00041 64
00041 64
00041 64
00041 64
00041 64
2
1
$4.50
$1.s0
$.45
$6.00
$3.00
$10.00
$1.05
$26.s0
System Development
Residential- Single Family - Storm
Sanitary Sewer
Residential Transportation
Residential Sanitary MWMC
Residential lmprovement MWMC
MWMC Administrative Fee
01t03t2001
01t03t2001
0110312001
01t03t2001
01t03t2001
01t03t2001
00041 64
0004164
00041 64
00041 64
00041 64
00041 64
$415.17
$635.80
$810.29
$285.91
$24.33
$10.00
1,532
17
1
1
1
1
1
1
1
Job# 00-01816-01 Page 4 of 4
Fee Paid On Receipt# Value/Quantity Fee Amount
System Development
SDC Administrative Fee
Property Annexed 1979 or Before
Total System Development
01t03t2001
01t03t2001
00041 64
00041 64 21
$104.00
$-101.44
$2,184.06
S.F. Residence - Willamalane
TotalWillamalane SDC
Willamalane SDC
0110312001 0004164 1 $1,000.00
$1,000.00
Grand Tota!
Plan Check Type Checked By Date Completed Comment
lnitial Review-Res Wendy Stanley 1212112000
Engineering-Res Steve Templin 1212612000
Planning-Res Liz Miller 1212812000
Structural-Res Don Moore 1212712000
By signature, I state and agree, that I have carefully examined the completed application and do
hereby certify that all information hereon is true and correct, and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made
of any structure without permission of the Community Services Division, Building Safety. I further
certify that only contractors and employees who are in compliance with ORS 701.055 will be used on
this project.
I further agree to ensure that all required inspections are requested at the proper time, that each
address is readable from the street, that the permit card is located at the front of the property, and the
approved set of plans will remain on the site at alltimes during construction.
4.r*rrs
Signature
$4,102.81
'^a3 -o/4 Date
CITY OF OBF".GOfU
SPR FIELO
zoning, and does not require
AHT HE n.n il ?rrntr r?-/U.. iP J l :/J, ftl
IHANGT:- IASHIER:004
apProval
Zoning
Date
Autflorlzed Signature
97 477
726-3769
LD (L
-0
225 FIFTE STREET
SPRTNGFTELJ, OREGON
INSPECTION REQTIEST:
OFPICE: 726-3759
ETECTRICAT PERUIT APPLICATION
Ci ty Job Nunber
COHPI,ETE FEE SCMDULE BELOII
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1 LOCATIONaqa OP3
LEGAL DESCRIPTION 703,7
JoD pEqcFrPrroN?ru<*
Permits are non-transferable and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
L80 days.
2. CONTRACTOR INSTAII,'ATION
Electrical Contractor
Address
Ci ty one
3
A
Sumg5:1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Sertice or Feeder
()\
Services or Feeders
Installation, Alterations
,1 $(-or Relocation:
200 amps or less
201 amps to 400 amPs
-401- amps to 600 amps
-
60L amps to 1000 amPs-
0ver 1000 amps/volts
-
Reconnect 0n1Y
c
D
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
Miscellaneous ( Service/f eeder
-Each installation
Pump or irrigation
-
$
sign/outline Lighting- $
l:.ili. ted Energy/Res
-
$
$ 40.00
s s0.00
s 60.00
s100.00
s130. 00
s300.00
s 40.00
$ 40.00
s ss.00
$ 80.00
s see ItBr aSoG-
not included)
40.00
40.00
20. oo
s5r5.q <
I $ Bs.oo
L g ls.oo
B
\
IC
Supervisor Lice
Expiration Date
nse Number
o
Constr Contr. Number
Expiration Dat
ture of 1 Electrician
ll'J
Ovners Name 0nA-x-o Ad
Address ,j te Llm G.>,au,&-|"
Ci ty
IJPhone l/
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
0vners Signature:
DATE:
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps''or less
201 amps to 400 amPs
-
Over 401 to 600 amPs
0ver 600 amps or fbOO voTt
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
Eqa.3J
E
?,.s 5?ssORBCEIVED BY:
5
INSTALI,ATIONia^oL
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
I BUILDING SIZE: 1164 SF LOT SZE: 8310 SF
$21,400
JOURNAL ORJOB NUMBER: 00-01816-01
LANE COI.'NTY ASSESSED VALUE (LAND)
NAME OR COMPANY ADAMS
LOCATION:397 S 32ND STREET
TAXLOTNUMBER:17 -02-31-34-02702
DWELLING UNITS
DEVELOPMENT TYPE:SINGLE FAMILY RESIDENCE
ANNEXATIONYEAR 1960
IMPERVIOUS S.F COST PER S.F
1532.00 $0.271 $415.17
I. STORMDRAINAGE
x
15.17ITEM I TOTAL - STORM DRAINAGE SDC
NUMBEROF DFU's COST PER DFU
t7 $16.ls 74.55
NUMBER OF DFU's
t7
COST PER DFU
$2t.2s $361.25
B.IMPROVEMENT COST:
x
x
2. SAMTARY SEWER - CITY
A. REIMBURSEMENTCOST:
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
ADT TRIP RATE OF UNITS COST PERTRIP NEWTRIPFACTOR
9.57 I $68.ss 1.00 $656.02
ADT TRIP RATE
9.57
NUMBEROFUNITS
I
COST PERTRIP
$ 1 6.12
NEWTRIPFACTOR
1.00 $r54.27
B.IMPROVEMENT COST:
x x x
x x x
3. TRANSPORTATTON
A. REIMBURSEMENT COST:
0.29ITEM 3 TOTAL - TRANSPORTATION SDC
$ 10.00
NUMBEROF FEU's
I
COSTPERFEU
$28s.91
NUMBER OF FEU's
I
COST PER FEU
$24.33
$28s.91
33
101.44
B.IMPROVEMENT COST:
x
x
4. SANITARYSEWER-MWMC
A. REIMBURSEMENT COST:
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
18.80ITEM 4 TOTAL . NTWMC SANITARY SEWER SDC
.06SIJBTOTAL (ADD ITEMS l, 2, 3, & 4)
SUBTOTAL ADM. FEE RATE
$ 104.0080.06 5%
5. ADMINISTRATIVE FEE:
x
$2,184.0612t26t00tlr,wTur.l,l;,t-
SDC COORDINATOR
TOTAL SDC CHARGES
DATE
t lru
NUMBER OF NEW FIXTURES X UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NoTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL !III!rRE!)
NO. OF FIXTURES DRAINAGE
FIXTURE
LTNITSFIXTURE TYPE ( +xew - #oLD ) x UNIT
EOUTVALENT
BATHTUB (
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
I )x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
)x
3 J
DRINKING FOUNTAIN I 0
FLOORDRAIN J 0
INTERCEPTORS FOR GREASE I OIL I SOLIDS / ETC.J 0
INTERCEPTORS FOR SAND / AUTO WASH IETC,6 0
LAUNDRY TIIB 2 0
CLOTIIESWAS}IER / MOP SINK I J J
CLOTHESWASmR- 3 ORMORE (EA)6 0
MOBILE HOME PARK TRAP (I PER TRAILER)t2 0
RECEPTOR FqLREFRTG / WATEB. SlA:UqN/ ETC.
RECEPTOR FOR COM. SINK / DIS}IWAS}IER / ETC.
I 0
3 0
SHOWER, SINGLE STALL 2 0
SHOWER, GANG G\UMBEROF HEADS)2 0
SINK: COMMERCIAL/RESIDENTIAL KITCIIEN I J J
SINK: COMMERCIAL BAR 2 0
SINK:DOMESTIC BAR I 0
WASHBASIN 2 0
LAVATORY I 2
I-IRINAL, STALL/WALL 5 0
TOILET, PUBLIC INSTALLATION 6 0
TOILET PRTVATE INSTALLATION 2 J 6
MISCELLANEOUS DFU TYPE NTIMBER OF EDU's*
(_ )x 2o :
TOTAL DRAINAGE FIXTIJRE T]NITS :
0
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
t7
DRAINAGE FIXTURE UNIT CALCULATION TABLE
MWMC CREDIT CALCTILATION TABLE: BASED ON COUNTY ASSESSED VALTIE
10r.44
IF IMPROVEMENTS OCCLIRRED AFTERANNEXATION DATE, CALCULATE CREDIT SEPARATELY
CREDIT FOR LAND (IF APPLICABLE)
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
$ 101.44
$0.00
YEAR
ANNE)(ED
CREDIT RATE PER $I,OOO
ASSESSED VALI.,TE
YEAR
ANNE)(ED
CREDIT RATE PER $I,OOO
ASSESSED VALUE
I979 OR BEFORE $4.74 l 990 $1.96
1980 $4.6s l99l $l.ss
198 l $4.59 1992 $1.36
t982 $4.46 I 993 s 1.23
I 983 $4.30 1994 $1.05
I 984 $4. l4 1995 $0.90
I 985 $3.93 1996 $0.7s
l 986 $3.63 1997 $0.57
l 987 $3.26 I 998 $0.3s
l 988 $2.8s 1999 $0.15
I 989 $2.40
TOTAL IVIWMC CREDIT =
0.000 x 54.74
VALUE / IOOO CREDITRATE
21.400 x $4.74
2
TRANpS:01_-0004164
DATE:JAN O] :CI01
ftHT RE[D:? $ 3?95.76Willamalane
Park & Recreation DistriCt CHANGE:
IER:004Job. No.
SYSTEM DEVELOPMENT CI{ARGE
WORKSHEET
NAME:fYl
ADDRESS:STATE: CP ZIP.
LOCATION OF PROPOSED BUILDING SITE:
Street Address:?5#^#
Plat Name:?- Tax Lot Number: )a*O 7
1' DEVELOPMENT-IYPF (ch.*$ appropriate dwelling(s). sDC catcutarions anct dweuing rype detinitlons are on the 6ack.)
Single Family home
NO. OF UNITS
Manufactured home not in a park
)X $t,000 per unit = $
B. Single-Family Attachect
NO. OF UNITS X $gz+ per unit
C. Multi-Family Apartment
NO. OF UNITS X $6ge per unlt
D. Manrrfac{ured Home park
?
A.
$
$
NO. OF UNTTS
WILLAMALANE SDC
Development Se
X $699 per unlt $
$
2' sDc CREDIT (rr appricabre) SDGpayer must rumrsh proof otwiltamalane credit approvar. see sDC credit workshoet. $
3. TOTAL WILLAMALANE NET SDC ASSESSED(f SDC reduced (or Credit) $
20
City of Springfield
S nt Date
oa
/am
PHoNE: 'f (- ) ;&
Jz-r
si_7355
IMPROVEMENT AGREEMENT
(In Lieu of Immediate Construction of Public includes Waver of Right to Remonstrate)
IN CONSIDERA TION 'of the covenants the City of Springfield, hereinafter referred to as
City,and hereinafter
referred to as Applicant(s), do covenant and agree
follows:
respect to the real property described below as
l. Applicant(s) warranis and represents to the of Springfigld that it is the owner of the properly
more particulally desoribed and set forth in
into this Improvement Agreement with the
7 below and, as owner, has the authority to enter
City of
2 Applicdnt(s)desires the City with respect to the following
Development App I ication o lgEsEc.29',97#05REC
$E3DEC . ?9' 97ff t)SPFt JND
3. The development will cause both an
facilities of City and Lane County including
development as set forth in paragraph 6.
and long-term demand oirl the various public
the public implovements necessitated by the
4.This Improvement Agreement is an to impo'sing a condition on Applicant's
development approval that the Applicant make
the development necessitates. The objective is to
construction of any public improvement that
effrcienby,'coordination, and spread costs by
providing an opportunity for a district wide mechariism where construotion occurs in a
other properties in thp are4 instead ofcoordinated projeot with the participation of adjacent
requirini immediate improvement in conjunction eaoh development application. There is no
guarantee, however, that such a coordinated project be possible and the City reserves the right to
requirc oonstrubtion of the improvements in the at City discretion.
5. (a) . Applicant and City agree that will pay the cost of the following public facility
improvement$ described in Paragraph 6 in with respective cost assumption policy established
by City at the time tho City determines to undertako complete such public improvements.
(b) Applicant and city acknowledge and
portion thereof to be paid by Applicant are presently
that the cost of such impiovements and the
and may be greater that the cogts thFt
would be apportioned if tho improvements were immediately or by Applicant now qr later.
(c ) Applicant acknowledges that the of the conskuction of such improvements is
with in the sole and exclusive diregtion of the City.
6. . (a) STREETIMPROVEMENTS along frontage of 5ou* srd S*gr
to include: (.y$ surface paving; ( ) storm sewers;( ) sanitary sewers;
(f) sidewalks, .
(r) curbs; (><) gutters;
( ) planter strips; ( ') street trees; '(
) street
(b) TRAFFIC SIGNALS at the of Nart€
(c )OTHER ef wA{Vt tb / 4z
w/4 6E
AppJicant acknowledges that the list of marked reflect those lhat would currently be
required under the appropriate City codes and Applicant acknowledges'that it understands
that the impiovements made will be those required to the street to full urban standards for the then
current functional classification of the street as those r exist at the time ihe improvements are
checked herein.made and may, therefore, differ from the list of
7 LECAL DESCNPTION:' .$eu*t !/z c>f L)r.4,Ezocrc /o, /oct614J 4ia4/Etts'
+ , PaaZ 73. ,/.al/ -c>c*zza,.RS r?c <.e 4 AEr'6 ao K
Of?€a*.,1 Fz .1 /Ra b/
AKA o al y'.*. Z-r ZZq fiA?,t7oz-i/-3*
Property Address Tax LotNo.
CITY OF SPRINCFIELD. PUBLIC WORKS DEPT. .FIFTH STREET - SPRINGFIELD - OF,: -'97477
10,00
10.00
)
a
8. This agrcement is enforceable by the State of
9. APPLICANT AGREES TO SIGN AI.TY AI{D
ALL OT}IER DOCUMENTS NECESSARY TO
UNDER ANY IIVTPROVEMENT ACT OR
COUNTY, OR CITY A}.ID TO WAIVE ALL RIGTil
IMPROVEMENTS. Applicant does not waive any
the assessment thcrcof, if the same shall appear to tho
properly of Applicant. Applicant's acceptance of the
the City's waiver of he requirement for the immediato
development necsssitates. This improvem,ent
written remonstration. trt does not waive a property
any related matters orally or in writing.
10. City agrees that Applicant's execution and
deemed to be in compliance with City's policy
complies in every respect with all other applicable
Applieant shall be entitled to Development Approval,
forth therein.
I l. It is the intention ofthe parties hereto that the
herein dcscribed, and shallbe binding upon the heirs,
ofthe parties hereto, and shall be construed to bo a
described. This Agreement shall be recorded in the
WHEREFORE, the parties have set their hand this
91-7355
n c appiicani
By By
STATEOFOREGON )
) ss.
County of Lane )
On this day of
the
City of Springfield
Dan E. Brown - Director of Public Works
STATE OF OREGON
County of Lane
r9-I
On this -- day of q@Z-
beforo me Dan E. Brown, the Directoror Public W
document.
.n, -
ss.
)
)
)
.E'o -c8.5 6
9 oEi:4 o5;E
dE3!| '-Et- I E i.gg,Ex;$
Ei3$ s
:is:EE:.95E6d:E E
T'
o()
q)E
Jsotr{[L a,ooaacca1ooUOq, o)ccJJ
trc)t\
CDot
5
a,&,
u.,lr'at€o
a<E(,1
C\J(J
lrJc:Fu)
\
s
-Y
0)o
;!0
Lane County or City.
WAryERS, PETITIONS, CONSENTS AND
ilTT, ABOVE LISTED IMPROVEMENTS
OF TI{E.STATE OF OREGON, LA}IE
REMONSTRATE AGAINST SUCH
to protest the amount or manner of spreading
to bear inequitability or unfair upon said
condition is ih consideration for
of the public impiovements that the
waives the property owner's right to'file a
right to comment on thc proposed district or
of the terms of the Agreement will be
to improvement requirements,and if Appl icant
the State of Oregon,Lano County and City
to the terins and conditions of approval set
herein contained shall run with the land
assigns, administrators, and succossors
antl a burden upon the property herein
County Deed Records.
of Dgz.
L9 there appeared
the
fli
My
, 199-? . there pgrsonally appeared
for the City of Springfield and signed the above
Notary Public for
| ^G -9?My Commission Expires
STREET - SPRINGFIELD. OR. .97471DEPT..225
OFFICIAL SEAL
MY 28,1999
By
I