FRANKLIN STREET & SW 66TH AVENUE FILE NO. 477-92
66th AVE. @ FRANKLIN ST. STR OPN PRMT
J
COPY 'i0:
APPLICATION - STREET IMPRC:' -MENT/EXCAVATION (WHITE).FILE
ORDINA,..E NO. 74-14 (YELLOW)•
(PINK)•OTHER ER AGENCY
(:NSTRUC'iIONS ON SEPARATE SHEET)
(BLUE)-APPLICANT
` APPLICATION NO.:
APPROVED 18.00 --
NOT APPROVED 13 (:I I N' (?I' TIGARD, OREGON FEE AIAT.: S --PUBLIC CITY Y IIALL RECEIPT�7�Jp]!/� _q 2'—4-L46I_/
eY
PENDING FEE. PMT. ❑ -^=1,t DATE_aL—L—•�
PENDING SECURITY (_j BLIC WORKS DEPARTMENT - I�_}+f� - - - - - - - - -
-
PENDING AGENCY ''OK" C3 Application a•ul Progress Record MAINTENAIJCE BOND ,►.— -- -
PENDING IN7'ORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS RE VUINeOANNUAL `-�
EXPIRATION DATE
PENDING VARIANCE
9 Z. - ----- �'
PERMIT NO _ 4'77 - 9Z__ DATE ISSUED: -3 __hL: i BY: — _—.
(,RO DWATER�- --ILS
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTAL-_ REMENTS.
-
TEST BORINGS AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REOUi
APPLICANT FITANI HILTS & ASSOC., INC. 2255 *W Ol 223-014 -
IJJNE
NAM►i ADORE55
CONTRACTOR - _— �_—'_— ---
--
NAME ADDRESS
CITY STANDARDS & SPECIFICATIONS ----- clty ---VH 0 A—If
PL-ANS BY -- �ooReS'S
NAME
ESTIMATED IMPROVEh1EN T TOTAL VALUATION ( COST): $ 450.00
"__-- FOR OFPIC S[•
i MIN.
F - ).o4 X S �--' f 18.00
(2) EXCAVATION 'DATA: _ —
-- DESCRIPTION PROGRESS & INSPECTION STATUS
STREET - ITEM DAT[
JSURFACEUT CUT CUT MATERIAL INSTALLED REMARKS/TYPE BY
NAME NGTH WIDTH DEPTH ITEM & QUANTITY-- kEET
_66TH AVENU )Ae a tached E TION
_ Q
U --
— _ E
S
ESTIMATED STREET OPENING DATE:_ 1 - T
� E
ESTIMATED STREET CLOSING DATE: 1
STREET
(3) SECURITY NO. 450.00 - C-LOSED
SECURITY AMT.: t _
FINAL LAr ej
r
SURETY Cly : �--_ _�_ - INSPEC.
'iEr_k ✓� CASH ll
•OND_ _ --
T � SPECIAL PROVISIONS/ CONDITIONS:
(4) PLOT PLAN. INDIC,%TE SITE PERTINENT PHYSICAL SPECIAL
shall conform to Clty
FEATURES; EXCAVATION LOCATION AND EXTENT.
I.AllStandards & specifications.
I I
2.Notif%r City Inspector Carl Vieweg
-----
I 639--4171. 24 hrs. before starting
' - - work.
'URS _ - _ _ r— - - -� - ,' �- . - m 3.ORS 757.541-.571 applies (Re:
- ___ SSW. �6t�► HVENIIIi__..A _1al - utility's prenotification, etc.,_)
G _ .Traffic control to be provided
for by applicant/applicant's
-
t - 1_ k___.. -T- i i con rector.
(see attached) I I epafr-3 s a One O?`'ice
=pec .ors sa s ac ion.
(5) NOTE THE CITY OF TIGARD DUES NOT HEREBY. GRANT PERMISSION TO APPLICANTS TO CONDUCT WURK WHERE
RIGHT OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE: OF OREGON.
THE APPLICANT AGREEt; TO DEPOSIT THE REQUIRED SECURI"IES, TO COMPLY WITH ALL PERTINENT LAWS ANn
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK. AND TO SAVE HAP+•ALESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMA(:;E WHICH MAY RESU'_T FROM APPLICANTS ACTIONS
APPLICANTS SIGN ATUR�`/�G4 - -
I ,
ce
c a cv
I!I � o � �
K 315 7
I ,
P A v r o P A a K I N 0
c s 1
I\ ,• 'T ,
•A� L D
f iARKI Na ,� \ fro 1,
\ 10
le
c I + • a
ce
Nl
PAVEMENT DIG OUT REPAIR DETAII
-=DIG OUT REPAIR
f---SAW CUT OR GRINDING
EXISTING PAVEMEN-1-
�11%%��1
O G o —AGGREGATE BASEROCK
COMPACTED SUBGRADE
MINOR COLLECTOR :;TREETS=
AC-7"ASF'fIAurIC CONCRETE
AJ3- 11/2"-0" AGGREGATE" BASEROCK
C11YOFTIrARD
Vlls sw tw_L BLVm DESIGN dY —
I'-"BOX 23397 _ APPROVED BY DRAWN BY
li��ormoom ur,= GA SRS
Com)csa-ssat
SCALE nerc Dw1WING NO.
N:1::j_
f
}`
r
A4'
--- .
- �J _
it
1 z'AfiN s
4
RA
----- - - -
160
4f IN
CT-1'Y OF TIGARD
I�CPIT'DI'IURE I2D�UL.Sr ����
glih; form is a r,._:lti.-use forts. Appropriate receipts must be attached. Docimmnt_-ition
!nWrtant for all pur.-poses. Staple docLmicntatior to tonr..
VU=P NO. : — DATE: _—� q- ILL,
PAYAu_T M: -�A yNl 'il� ZHC� RD,-XJL"3I'LD BY:
Approved requestue Wednesday
10:00 AM to A/P for checks by
Friday.
Date D-.-4=iption. Invoi<x No., etc. Acxxunt No. Amount
_-- orh1['F D Z DCVOC9 0
iso
�+ 9Z-7646,(.7 13 L
eage $0.255 $_.—. - - - -- --=--J
APPROPRIATION BAT;'&TCE: — _ IV, OF: _ SIGNA'IIW-:
(Up to $25.00) Section Marlacrer Purch. '\gent
($25.01•-2,500.00) 'Division Manager -_— -- -- - __
($2,500.01-7,Z'90.03) D%,t. Head
($7,500.01-15,000.00) City Admi.nj Lratni
($1!',000.01.-• ?) Local Contract Review TJojrd ----_-
'1501F
APFLICATION -- STREET IMPRO\ -VENT/EXCAVATION COPY TO.
(WHITEY-FILE
OR DI NAI -E. NO. 74-14 (YELLOW)-INSP.
(PINK)-OTHER AGENCY
(INSTRUCTIONS ON SEPARATE SHEETS (BLUE)-APPLICANT
APPROVED LI APPLICATION NO.: AZAT
CITY OF TIGARD, OREGON FEE PMT.: f
NOT APPROVED �] -
PENDING FEE, PMT. LlCI"TY I-IALL RECEIPT NP.: �'z' ALL---
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY jjj�-- DATE -=
PENDING AGENCY ''OK" ❑ Application and Progress Record MAINTENANCE BOND * --
PENDING INFORMATION D FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED
ANNUAL
PENDING VARIANCE ❑ EXPIRATI N DATE:
PERMIT NO.: _ mo w q� _ DATE ISSUED: __ _1 A L-_-=?_r----- , BY:
(1) APPLICATION IS HEREBY MADE. TO EXCAVATE FOR AND INSTALL SIX ZR(kTiDWATERAOILS
TEST BORINGS AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT ?Wj=ANI QTS & ASSOC:_., INC. 2255 SV; --22a-§19Z----- -
NAME ADDRESS CITY PHONE
CONTRACTOR clTv
NAME AIIDRESS
PLANS BY STANDARDS & SPECIFICATIONS — PHONE_.._—_-
-- NAME _—� ADDRESS CITY
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): i 4'50-Q0 ----
DOLLARS
---_�---'-'-' --- s= --�__�----'-=-- —_. {� `yam -__-
DOOR XFf IC4,LjEN
(2) EXCAVATION DATA:
_
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPF. BY
TYPE LENGTH WIDTH DEPTH ITEM 6 QUANTITY
—
STREET
OPENED
-- ---- --
66TI1 IAVENU : see a taches: R TION
TION — --
E _�
Q
U — —
E:
ESTIMATED STREET OPENING DATE: S
T
ESTIMATED STREET CLOSING DATE: ._ I 1— E
D
-� -- a 450.00 STREET
(3) SECI PITY NO. ��� SECURITY AMT: _— — . CLOSED _I
SURr- i Y CO.. oe - FINAL INSPEG (�'(
. �_J 1L C7L>D v
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDIT ONS:
FEATURES: EXCAVATION LOCATION AND EXTENT. L .All work shall conform to City
Standards & Specifications.
I 1 I %.Not fy City Inspector Carl Vieweg
I Ir
1 1 639-4171 24 nrs. before starting
—#w --r-- --1-- — -- - --- — ---- work.
CURB _ _ _�- - ab- -� - - -� - �- -� _ _ _`_ -mL ;.QRS 757.541--.57.1 applies Re:
S.IId. 06th AVENUE _--__-_- —_-- utility's prenotification, atc.)
I.Traf f is control to be provided__
j,e fnr by applicant/applicant's
I '
contractor.
1 I ) I
1 I (Dee attached) I I .K6p&j - snall be aonCe to r-1Zy-
1
-Tospectorig sa s .ac .on.
(S) NOTE THE CITY CII' TIGAND DOES NOT, HEREBY, GRANT PEP.MISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIr.HT-OF•WAY JU171SDICTION IS THAT OF WASHINGTON COUNTY CR THE STATE OF IREGON
THE APPLICANT .AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SII'ECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAII14ST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ArTIONS
w.
?' 1
s }
L
APPLICANTS SIGNATOR , �� �t I f""-'' DAT
i
1
.DEFINE:entrct=case->eng definition incorrect
ENGINEERING PERMIT
PERMIT #. . . . . . . : ENG92-001,j DATE ISSUED: 03/13/92 By :
PRIM. PERMIT #. : ENG92-004
SITE ADDRESS. . . . SW 66T1,4 AVF./FR.ANKLIN PARCEL: 2S101AA-STR
SUBDIVISION. . . . : ZONING:
BLOCK. . . . . . . . . JOT. . . . . . . . . . . . .
PERMIT TYPE. . : SOP IMPROVEMENTS QUANT RATE VALUE
AGREEMENT DATE: / / GRAD/EROS
ASSURANCE EXPIRATION--- STREET
PERFORMANCE: / / SAN SEW
MAINTENANCE: / / STM SEW
UTILITIES
ALL OTHER
TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
Remarks: STREET OPENING, TO INSTPLL SIX GROUNDWATER/SOIL TEST WELLS.
Permittee: ---------------- FEES ------------- -
FU,',ITANI HILTS & ASSOC. , INC. type amount by date recpt
2255 S.W.CANYON ROAD OPEN $ 18 .00 JSH 03/13/92 224617
PORTLAND OR 97201
Phone #: (.503) 223-6147
Engineer:
ENGTNEFR NOT ON FILE
$ 18 .00 TOTAL
Phone # :
------- REQUIRED INSPECTIONS -------
Permittee/Agent Signature: ---STORM SEWER-- -----STREET-----
M.H. & C.B. CR.B LINE & GRADE
PIPE LN & GRD SUBGRADE
BCKFLL & CMPCT BASE ROCK
AIR & TV TEST LEVEL COURSE
City of Tigard, Oregon WEARING COURSE
131.25 S.W. Hall Blvd. ---SAN. SEWER--- TRAFF & PED CONT
P.O. Box 23397 M.H. & C.O. MONUMENTATION
Tigard, Oregon 97223 PIPE LN & GRD STREETLIGHTING
Phone #: 639-4171 BCKFLL & CMPCT WALK/APRON/RAMP
AIR & TV TEST
FOR INSP;,CTION, CONTACT: ----GRADING-----
Carl. Viewer; #639-4171 (office) --REPR' S/ADJ,S-- CONTOURS
#780-2647 (mobile) DRAINAGE
----PATHWAYS-.--- EROSION CNTL.
CITY OF T I GARD - RECEIPT OF PAYMENT RE I t•'"f NO. :9 '22,4 6 1.-i
CHECK 0MOUN I' : 468. 00
NAME : FUJ I TAN I, HILTS & CASH AMOUNT 0. 00
ADDRESS . ASSOCIATES, INC. PAYMENT DATE 03/13/92'
SW CANYON ROAD SUE':D I V I S I ON
PORTLAND, OR 97201 -
SUPPOSE OF I-,AYMENT AMOUNT PAID OF G,AYMENT AMOUNT PAID
�USTOMER DEPO^ SOF' 9E-477 450. 00 PUBLIC IMPROV
1
I
OTAL AMOUNT PAID - 468. 00
,.. .•...'dJH'
_ siAilit<!�4�tIIi�+iAT>fi.�il Q7�R/iM1��71fTs�f'.*�
03570
FUJITANI, HILTS & ASSOCIATES INC. q
2255 SW CANYON ROAD 223-6147
PORTLAND.OR 97201 c.� mie.�u A
F� f1�11s� S W lilh.M K4 .1—816-"
P 0 so,3"?
Bank P rlc a uw—977W$W
24.12/1230
79182.111
PAY**Four Hundred and sixty Light and no/100** DATE I AMOUNT
F March 13, 1997_ Is**408.00**
TO
City of Tigard
THE
DROP% 7
OF
Vic P sident
><�Ns�.�r�taiesa9+�s e•�wlai�9».>v!•�•:a�s9�stm ti.�s.�mwiw�s��a3+��M►�»s�sr�r
03/12/92 14:32 $`503 684 '7297 CITY OF TIGARD 001
ALTIVITY REPORT
RECEPTION OK
TRANSACTION # 16828
CONNECTION TEL 503 223 6140
CONNECTION ID G3
STAF:T TIME 03/12 14:30
USAGE TIME 31' 48
PAGES 2
r1AR IE '92 14:29 FUJITANI
FUJITANI HILTS ASSOCIATES, INC far
Geotechnical Consultants
2 .2.55 S.W. Canyon Road (2"Y
Portland, OR 97201
NEW FAX NUMBER IS;
(503) 223-6140
Company Name: ';
Contact Name:
Fax Number:
Sender: �"i"�,,�� � '`'��•------- -----------____.-_--__�.�
Descriptior: -�n� r,1e�.eQ Mr i7lS r TiX
TL Wx4j ee..S
3'
Number of a es:
P 9 Including Cover_ ( Z )
t
Date Sen?:
It there are any problems v III this transmission, please Call:
S
a At (503)123 6147 immediately.
P.2
MAR 12 '92 14130 FUJITANI
ID o \
I
Kr
1J
x � olezx
OM _ iY
i \
r f I Wo
r —
0 N 114 v v d
IN I N tl e n s v e
191¢ x I
41
I 1