8959 SW COMMERCIAL STREET elLE NO.
COMMEPCIAL ST. - 9959 STR. OPN. PERMI`!
APPLICATION — STREET IMPR =MENVEXCAVATION COPY TO:
(WHITE)-FILE
ORDINMIgC)_ NO. 74-14 (] (SLUE)-INSP.
E] (YELLOW) OTHER AGENCY
(INSTRUCTIONS --N SEPARATE SHEET) [] (PINK)-APPIf�ICAN-r
APPROVED x APPLICATION NO.: _LSA
NOT APPROVED ❑ CITY O I'IGARD, OREGON FEE AMT.: S
PENDING FEE. PMT. ❑ CITY HALL RECEIPT NO.:
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT DY _ DATE I
PENDING AGENCY "OK." ❑ Application and Progress Record MAINTENANCE BOND #
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED n
ANNUAL
PENDING VARIANCE ❑ EXPIRATION DATE:
PERMIT NO.: /tib j-- _-Z_—___ , DATE ISSUED: __1^1'�LT' E-tY ��.
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL
AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT 1`��R/9/ G` t'i�� �'�3 ' �`'• s //4S� TS;. 'l1 -
NAME AVURE9S CITY- -- PHONF
CONI RACTOR �e/f �.s,G_ CG , �%.3. 1J✓_C E'y�Y _ �
A E
ADDRESS CITY PHONE
PLANS BY...--- >�`/� }�L _s..�b..c.>, Cc — - ---- ---
NAME ADDRESS CIT�T1 'y--�_T--PHONE
O
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ ........
DOLLARS
(2) EXCAVATION DATA: FOR OFFICE USE: - ---_ nmm.
—STREET DESCR:^TION PROGRESS & INSPECTION gTATUb _
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE r Y
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY _
0 <I:LJJ,�t, -' .� / i - f Q SPRNEID _
INSPEC-
R TION
Q
U
ESTIMATED STREET OPENING DATE: Z y _. _ E* _
ESTIMATED STREET CLOSINGDATE: ED _
(3) SECURITY NO.4AP!- &�O SECURITYAMT S $C0 A _— CLOSED r"
SURETY CO.: _�—. FINAL
CERTIFIED CHECK d CASH r] BOND INSPEC.
(4) PI OT PLAN: INDICATE SITE PEFITINENT PHYSICAL SPECIAL, PROVISIONS/CONDITIONS.
FEATURES; EXCAVATION LOCATION AND EXTENT.
( 1 I 1
uRP - - _ _ _ .. _ .. _. _ _�� ♦ _
-CUR! �. � r � � � �. � � � �. .� - � .• ____-r�.�.
1
(5) NOTE. THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORN WHERE
RIGHT OF WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WO'1K, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE: 'a&'L Z DATI'.
1
BOND
'�• NO.400 GP 0250
ST. PAUL
N " F UNDE
I R E a n d M A R I N E gTLAWS O,'TNEY$T�[�NIZED Of MINAIMTATME
SAINT PAUL, MINNESOTA
KNOW ALL MEN BY TfiESF. PRESENT'S, That we..................................................................................
f. F Plumbing Co. , of
....I............................. .................................................................................................
-tr, N. AloLon Avenno, Pori land, Oregon, 97217 as Principal,
.................................................I.—..,............... .......................................................................
.wd 5t Paul Fire and A rine Insurance Company, a Minnesota Corporation, and having its principal office in
the Cit> of St. Paul, Minnesota, as Surety,are held and firmly bound unto., . -1. 1................... ...
City of Tigard hereinafter called the Obligee,in the nasal sum•of
************Three hundred and No/100************************* I)ollart (6.700.00..............)
lawful money of the United States of America to be paid to said Obligee, for which payment well and truly
to h; made, we hind ourselves, our heirs,executors, administrators, successors and assigns,*iointly and sever.
Ill , firmiy by these presents.
Signed with our hands and sealed with out' seals this, the.........19th day of.........November
A D. W ..1982.
1\'M-'REAS, a LICENSE or PERMIT has been granted by the Obligee to the above bounden
Principal authorizing him
Street Opening - Commerrisi Street
Now therefore, the Condition of this Obligation is such, that if the said Principal shall faithfully ob-
serve the provisions of the Laws, Ordinances, and Resolutions, governing the issuance of this License or
Permit,then this Obligation shall be null and void,otherwise to remain in full force and effect.
Liability under this bond shall terminate as of the 1,9111 day of..............No.ve her. ............x1afk..1.983.
as to any acts subsequent thereto, unless said bond is continued in force from year to year by the issuance of
a continuation certificate signet P. the Surety.
The Surety may ranrrt this bond at soy time by filing with the Obligee thirty (30) days written
notice of its desire to be relieved of liability.The. Surety shall not be discharged from any liability already
al.:rued under this bond, or which shall accrue hereunder before the expiration of the thirty day period.
_._....... ._ ........ _.................. ....
.....................
Principal
5T. PAUL FIRE ANL MARINE INSURANCE COMPANY
' 1
4 �r�I
By.4,�of C '�... .. .... .....................0 .................
Audrey J n Attorney-in-fact.
n.lr: i.rt+r:d.t•w i