14295 SW 112TH AVENUE FILE NO. STR. OPN. PERMIT
112th Avenue - 14295
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GITYC* TIGARD
September 30, 1988 OREGON
Mr.. Kenneth Sisco
9765 SW Frewing St
Tigard, OR 97223
RE: Street Opening Permit No. 267-87 Assurance
Gentlemen:
In the matter of the Six hundred forty dollars 3640.00) letter of agreement
with depositor and trustee on savings accounts or deposits (Account No.
5241.-949) between Kenneth Sisco and Far West Federal- Rank and the City of
Tigard, Oregon; this is to serve as a letter of authorization to allow Said
bank to release to Kenneth Si.aco all of the deposit entrused to said bank.
City of Tigard, Oregon
By:
City Engineer
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13125 SW ilall Blvd ,p 0 Box 23397,Tigard,Oregon 97223 (503)639-4171 - ----
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APPLICATION -- STREET IMPRC --MENT/EXCAVATION COPY TO:
OR DINi,..( E NO. !4-14 I� W4.ITE)-FILE
[y� (YELLOW)-INSP.
;INSTRUCTIONS ON SEPARATE SHEET) ® (PINK)-OTHER AGENCYB1da.
® (BLUE)-APPLICANT
APPROVED X APPLICATION NO. _. 303
NOT APPROVED LILY OF TIGARD, OREGON FEE AMT.. s _2L-60 _
PENDING FEE PMT. ❑ CITY HALL RECEIPT .. _ 2SIyZ.Z
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY--/� - DATE GS' ! W/ 7�
PENDING AGENCY ''OK'' ❑ Application and Progress Record _
MAINTENANCE BOND201 min_
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVACION AS HEQI��kr=1� yp
ANNUAL
PENDING VARIANCE ❑ EXPIRATIONDATE: on . year
PERMT NO 2E]-$]___ DATE ISSUED: BY
(1) AFPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INST^.LI- _unit r-Y-Sewer- erViee__ __
Lateral AS DESCRIBED HEREIN, IN FELL AC-ORDANCE WITH CITY REQUIREMENTS.
APPLICANT620-4304
I;eru�eth Sisco .
NAME ADDRESS --_—' CITY_-- ---- PHONE!
CONTRACTOR- Paul Miller Rt. #5 Box 62Sherwood, OR 625-6562
NA E ADDRESS _ CITY ' PHON!
PLANS BY Pe r Cit U.S.A._ Standards & Specifications
NAME ADDRESS CITY PHONE�i_--
ESTIMATED IMP.IOVEMENT TOTAL VALUATION ( COST): $ 640.00
DOLLARS
(2) EXCAVATION DATA: FOR OFFIC! SE: ----� [ MIN.
I,04 X 3 ;,4 .00 a = 25.60
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM A QUANTITY
STREET
P;NED
S.W. 1121_r Avenue (See sk: tch be ow) INSPEC-
R TION
E -
Q
_ U
ESTIMATED STREET OPENING DATE:-- _ S
ESTIMATED STREET CLOSING DATE: _�_ / ED
STREET G G
(3) SECURITY NO. SECURITY AMT.: S _ 4Q.00__ CLOSED
SURETY Co.: -._Fir_,?Iest Fetal $ FUndS FINAL
CERTIFIED CHECK _ CASH_u _ •014DX INSPEC.
(4) PLOT PLAN' INDICATE RITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS:
FEATURES, EXCAVATION LOCATION AND EXTENT.
1 14295 S.W. 112th
1 Contractor to assure traffic
I I � 1
I h� I cn , r control.
s 3r1 ' I 21 Prior to connection of a.
-mow,• _ , --- --- - ---____ - r
structure to this lateral, a
irk San Sewer __ Sewer Connection Pern:it is
— — `- rcjuired to be obtained.
__1L. Call 639-4171 Mike Mills) for
- ---- - ----_.-._.. — — ins;,lection prior to comsnence--
in �rark�_ --
(5) NOTE. THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THIL APPLICANT AGREES 70 DEPOSIT THE REQUIRED SECURITIES. TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEEq AGAINST ANY INJURY OR DAeIAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
v
A^PLICANTSSIGN AtUFaI _ �•� GATE
PLIW�J TAKE THIS TO THE CASHIER FOR A RECEIPT
NAME: DATE: — Z� -sf
ACCT. # DESCRIPTION
AMOUNT
10-22000 Refundable Performance Bond_Deposit__
10-43500 Sign Permits I-lop TU
10--43600 Public-Sewen.-Plan Check/Inspection Fee
10-43600 Publ-*c Storm Plan Check/Inspection Fee
10-436(,O Street Dedication/Public Improvement
L6-43600 Street ORqrlinq Permit 24, —,:13 7 s z L- -
10-43601 Street and Traffic Marking
21-44200 Street Light Fee
U-43700 I;j I k.4' ' * 142
XaNst"'TI,M. SISCO
RrVA B- SISM 24-7040/1230
67n.4304
9765 SW FHFWINC
51'TIGAItt),OR 97223 $ CJ
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oAr-GON V"'
311'
3 2 lo?01,0 310. 303?
Tol 01
$ 2S GO
1045P/0023P
R
CITY OF TIIFA RD N o. 25122
13125 S.W.,xlAII BLVD: c�
P.O. BOX 23397 Date20
TIGARD,OR 97223
/i
Name
Address
t or
Block/Map SubdivisionlAddress
Permits Flldg. Plumb Cash Cher�k ,
Sewer Other Other Rec. By �
Acct. No. Description —^ Arnount-
10432 Bu!lding Permit Fees
10.431-0_00 Plumbing Permit Fees
10-431-601_ _Mechanical Permit Fees
10.230.501 State Bldg. T�tx ---
10 433 B,ia Ifliak re_e_.
30.443 r COiffi ,1(t n
30-444Iil!M loll
51
52-449-020 Parks It Syst. ltev,.Cha_qu -
3 i-4 �y Storm_ Drainage Syst. Dev. Charge
10.430 9uslness Tax --10.44- _ Alerm Permit T —
10.455- Fines TrafficlMlydlParkln
104' CPTATraf icI_ isd/Vic. Asst.
70•f'Sf _.Indigent Defense ----_,-_-- -- -
30.1'2-401
Illy j
�-
4 - �}annroTl Int. Pymt.
TOTAL
DEPT.
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A",
AGREEMENT WITH DEPOSITOR ANU '.RUSTEF. ON SPVINGS ACCOUNTS OR DEPOSITS �
This agreement ie for the purpose of fulfilling the requlrementu of y`'.t�g
Opening Permit Agreement dated 1987 bevieen the City of Tigard
and Far West Fe eral Bank/IUnds sferi Pt• xatered into b�S th
Depositor Kenneth Sisoo and rar West Federal Ba^k�Ftutdsll"rua�ee reixpt.
The undersigned depositor and trustee do hereby assign the right to the
City of Tigard to determin^ at its discretion the payment of all funds or
.;ecuritfes held by Far West Federal Bank Funds Transfer Dept., 425 SW Washington, Portland
ae trustee in the amount of_jQ40.Q.0_in Savings Account No. 5241-949 or. M. 97204
Deposit No. or Time Deposit No. in
the in accordance with and for the purpose of Bonding
L)uhl -- improvements described in the above statedStrep-* ning P-nait _
Agreement.
It is understood and agreed that the Far West i)Lderal Bank twirls 1'i`tnsfer
will hold such funds or securities in the amount of S 640.00 until en
authorization or direction for payment is received from the City of Tigard and
that the City of Tigard has the right to withdraw rrinicipal Funds with City
of Tigard signature only, in the event of Non-Performance.
All fund deposits shall to renewable at maturity and at rates and terms in
effect at the time of renewal, and all interest shall be paid to or accrued as
directed by the Depositor notwithstanding anything contained nerein to the
contrary.
That the account is to remain open until such time is all Public
Improvements are completed and acceptad by the City of Tigard.
Signed and dated at King City Oregon.
Thts25th day of August , 19 87
Signature Gf Depoetto 16L41,
Address 9765 SW Frewing
Tigard, Or. 97223
Signature of City of Tigard _
Address
ACCF.FTANCF.
The undersigned hereby accepts the funds or securtties deposited in the
amount of $ 640_e,�,_ thio �5�day of Ari(tj Lit , 19 87 , and
hereby acknowle qes receipt o t e asxboo4 9s.9nge�r.count o. 524]-
or the Certificate for Deposit F-%. • or certifias that there is
no Passbook feeued fogy this account It is agree.! t1st said account
will bc. held for the inns and purposes shrive, ■ta,ed until .iuthnrizatl�:: for
disposition to granted by the City of Tigard.
Aothnrfzed S'gnit.0:e`