The URL can be used to link to this page

10265 SW MILLER STREET FILE NO. -83 -fW LER ST. 10265 STR. OPN. PLRMT? APPLICATION — STREET IMPRr =MENT/EXCAVATIO; COPY TO: ORDINr,,.CE NO 74-14 E] (SLATE)•FILE (INSTRUCTIONS ON SEPARATE SHEETI 1] (YELLOW)-OTHER AGENCY ❑ (PINK)•APPLICANT APPROVED APPLICATION NO.: c L ' NOT APPROVED2 CITY OF TIGARD, OREGON _' ❑ FEE AMT.. >I � J. PENDING FEE. PMT. ❑ CIT•i KALI. RECEV'T NO.: PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY_ i _-_- DATE PENDING AGENCY -OK" ❑ ApF:ication and Progress Record MAINTENANCE BONY PENDING INFORMATION ❑ FOR S'i REET IMPROVEMENT/EXCAVATION AS REOUIR[D ANNUAL PENDING VARIANCE ❑ EXPIRAT ONpATES: "�'� e"2r PERMIT NO.: �—,,. DATE ISSUED: . --___- BY: l �• y�=�- —/ (1) APPLICATION IS HEREP MADE TO EXCAVATE FOR AND INSTALL - _ -211-le' 0I - /0.41 rr_ t ;Y- AS DESCRIBED HEREIN, IN FU(.L ACCORDANCE WITH CITY REQUIREMENTS. APPLICANT r-2Alrl' NAM[ -- CIT .� PHONE CON i RACTOR :\ _ NA [ 1 ADCR -� ITY PHONES PLANS BY_- < <e . NAME NADDRIV �. CITYESTIMATED IMPROVEMENT IMPROVEMENT TOTAL VALUATION ( COST): S . .. _._-----.. ------- DOLLARS FOR OFFICE USE, OMIN. 12) EXCAVATION DATA: STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT I CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYTE BY TYPE LENGTH, WIDTH DEPTH ITEM 4 QUANTITY STREET OPENED /1� L- R TION U ESTIMATED E.'ED STREET OPENING DATE: L1S ESTIMATED STREET CLOSING DATE: T/ / E - - - STREE (3) SECURITY NO. SEIr'_'RITY AMT: - =� ��._ CLOSET -A ' -- SURETY CO.: FINAL-_- � � �-_ CERTIFIED CHECK 1 CASH ❑ SUN INSPFC• (4) PLOT PLAN" INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS: FEATURES; EXCAVATION LOCATION AND EXTENT. CURB - CUR! -. .- - - - - -` - - ._ •- � - 1 I 1 (5) NOTE THE CITY OF TIGARD DOES NOT, HERESY, GRANT PERMISSION TO APPLICANT- T^. �UNDUCT WORK /VHERE RIGHT-n' WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE SATE OF OREGON. -I'He APPLICANT AGREES TO DEPOSIT THE: REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND CONSTRUCTION SPECIFICATIONS PERTINE.N'1 TO CONDUCT 0- THE WORK, AND 'i0 SAVE HAIfMLESS THE CITY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RFSULT PROM APPLICANTS ACTIONS. APPLICANTS SIGNATURE. LL_.(„_��,; e DATE I.ITY OF TIGARD- 12o:0 S.W.MAIN�—TIGARD,OREGON 97223 DA f[ RECEIPT AMOUNT: 9 � _ NAME ---_._ -- -' - DOLLARS ADDRESS:._ CASH: _----- ACCT, r PERMITS SUftNA"E AMOUNT` SEWER BILLINGS 40-364 _ _ --- BUSINESS LICENSE 05-331 PLUMBING PERMIT 05-332 '-"`------- MECHANICAL PERMIT --'—`-- 05-332 $ BUILDING PERMIT 05-333 ------ SEWER CONNECTION 40-363 `~ ------- SEWER INSPECTION 40-365 —`-�----- SYSTEM DEV. CHARGE 25.366 — PARK DEV. CHARGE #1 30-367 PARK DEV. CHARGE 02 30-368 --- ZONING ADJUSTMENTS 05-362 TOTALS RECEIVED 8V: _ =---s! SCJ PERMIT NUMBERS A= Number Amount Number Amount Number Amount __ - S---- S-- I RECEIPT # LTN ITER F CIVIC I1\T8T_T1R,.&1TC- HOME OFFICE, TACOMA, WASHING-rON LICENSE OR F'ERM11 BOND KNOW ALL MEN BY THESE PRESENTS: That we, P. Mi]-ler & Suns Contractors, Inc. as Principal, and UNITED PACIFIC INSURANCE COMPANY, a corporation organized under the laws of the State of Washington having its principal office in the city of Tacoma, Washington, and authorized to transact the busi, ness of Surety in the State of __ Oregon__ _ as Surety, are held and firmly bound unto_ City cf Tigard, I-------- Oregon- as Obligee,in zenal sum of Fivl:! Hundred Thirty and No/100------------------------------ ($ 530.00-------) Dollars lawfiil money of the United States, for which payment, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns,jointly one severally, firmly, by these presents. WHEREAS, the said Principal has applied to said Obligee for a license or permit -Sewer- Construction located at 10265 SW View Terrac�Robert Stack)_,_._________—____ - - - -- -- (Descr[��w+ Mrccenne of pwm NOW, THEREFORE, 1HE CONDITION OF THIS OBLIGATION IS SUCH, That if the said Principal shall in- demnify said Obligee against all loss to it caused by said Principal's breach of any ordinance, rule or regulation relating thereto, then the above obligation shall be void, otherwise to be and remain in full force and effect. PROVIDED, THE L IABILITY OF THE SURETY upon this bond shall be and rerrlain in full force and effect for thefull period of the certificate, license, or permit issued to the Principal above named but not beyond April 14th 19 84, or ten days after receipt bythe Obligee of awritten notice signed by such Surety,or its authorized agent, stating that the liability of such Surety is thereby terminated and canceled. Provided further, that nothing herein shall affect any rights or liabilities which shall have accrued underthis bond prior to the date of such termination. This bond may be extended for a further term by the issuance of a Continuation Certificate signed by the Surety. Dated April 14th 1983 P. Miller & Sons Contractors, Inc. – PRINCIPAL UNITED PACIFIC INSURANCE COMPANY t Cts C eoua� t�Y t En �.�t By: �— `� � w. — George A. Mansfield TTOQN[V•IN-Ir AC7 �assw UNITED ' 1CIFIC INSURANCE '0C)IMPANY HEAD OFFICE,FEDERAL WPY, WASHINGTON POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, That the UNITED PACIFIC INSURANCE COMPANY,a corporation duly organized under the laws of the State of Washington,does hereby make,constitute and appc.nt GEORGE A. MANSFIELD of PORTTAND, OREGON------- its true and low, Attvrney-in•Fact,to make,execute,not and deliver for an; .Sir its behalf,and as ns act and deed ANY AND ALL BONDS AND UNDERTAKINGS OF c'URETYSHIF----- and tobind the UNITED PACIFIC INSURANCE COMPANY thereby as fully and to the same extent as if such bonds and undertakingsand other writings obligatory in the nature thereof were signed by an Executive Off;cer of the UNITED PACIFIC INSURANCE COMPANY and sealed and attested by one other of s,,ich officers,and hereby ratifies and confirms all that its said Attorney(s)in Fact may do in pu•suance hereof This Power of Attorney is granted under and by authority of Article VII of the By Laws of UNITED PACIF IC INSURANCE COMPANY which became effective September 7, 1978,which provistuns are now in full force and effect,reeding as follows ARTICLE VII EXECUTION OF BONDS AND UNDERTAKINGS 1 The Board of Directors,the President,the Chairman of the Board,any Senior Vice President,any Vice President or Assistant Vice President or other officer designated by the Board of Directors shall have power and authority to Jai appoint Altorneys-m Fact and to authorize them to execute on IKhall of the Company,ponds and undertakings, recognizance%, cor•trects of indemnity and other writings obligatory in the nature thereof,and Ib) to remove any such Attorney in Fact at any time and revoke the power and authority given to him 7 Attorneys in Fact %hall have power and authority,subject to the turms and limitations of the power of attorney issued to them, to execute anddeliver on behalf of the Company,bonds and undertakings,recognizance%,contracts of indemnity and other writings obugatory in the nature thereof The corporate seal is not necessary for the validity of any bonds and undertaking.,recogmzances,contracts of indemnity and other writing%obligatory in the nature thereof 3 Artorn•ys in Fact shall have power and authority to exec-ite affidavits required to be attached to bonds,recogmzances,contracts of indent fifty or other conditional or obligatory undertakings and they shalt also have power and authority to certify the financial statement of the Company and to copies of the By Laws of the Company or any article or moron thereof. This power of attorney is signed and sealed by facsimile under and by authority of the fnitowing Resolution adopted by the Board of Directors of UNITED PACIFIC INSURANCE COMPANY at a rriesting held on the bits day of June. 1979,at which a quorum vitas present,and said Resolution has not been amended or repeated 'Resolved,that the signatures of such directors and officers and the seal of the Company q*v be affixed to any such power of attorney or Any certificate rotating thereto by facsimile.and any such power of attorney or certificate bearing such facsimile signatures or facsimile seat shall be valid and binding upon the Company and any such power so executed and certified by facsimil, signatures and facsimile seal shall be vofid and binding upon the Company in the future with respect to any bond or ,inderialimg to which it is attached- IN WITNESS WHEREOF,the UNITED PACIF IC INSURANCE COMPANY has caused these presents to he signed by its Vice President,and its corporate seal to be hereto affixed,this 5th day of January 1y 83 .�.; UNITED PACIFIC IINNSUHaNCE COMPANY 000 .,. ''i:' ? Vice President r STATE OF Washington COUNTY OF ss Kinn* On this 5th day of January 19 83oersonanvamwested P. Keith •t hr n m me kn.,wn to be the Vice President of the UNITED PACIFIC INSURANCE COMPANY, and acknowledged that he e■eruted and attested the fore going rnsltumenf and affixed the sees of said corporation thereto, and that Article V11, Section ', 7, and 3 of the By Laws of said Company and the Resolution.get forth therein,are still in full force y� My Commission Expires v•.�,, t1 .j/�eJ r✓��}^'2 July 20 ,19 R(, Notary Public in and for State of t. ! •4 Residing at Churl es .1. FRI sk,)w Assistant Secrerary of the UNITED PACIFIC INSURANCE COMPANY, do hereby certify that the above end foregoing is a true and correct copy of a Power of Attorney executed by said UNITED PACIFIC INSURANCE COMPANY,which is still in full force and effect IN WITNESS WHEREOF,I have hereunto set my hand and affixed the--set of said Company this 14th day of April 19 83 i %EAI ,CZ116 [ // mea.••� ROU 1431 Fd 4180 ,,, Assistant Sactary—._ _