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10345 SW MCDONALD STREET-1 FILE NO. 332-- STR. OPN. PERMIT MCDONALD STREET - 10345 CI OF T117APD EXPENDITURE REIMBURSEMENT REQUEST This form is a multi-use form. Where appropriate receipts must be attached. Documentation is imporl.ant for all purposes.. Staple documentation to form. VENDOR NO: DATE: g e' PAYABjE T0: Requested by: Z4_ GCGaca@@GQcec¢caGc¢caaaasa@ar.cr=v=-a=,==¢aac.=a-c_L=-a=acct=cea¢a==¢_=a.=caeGccr_a MISCELLANEOUS (parking;, books, subscriptions, dues, memberships, etc. ) : Date Descrir ion Account No. - Amount40 3 - S&PI -- —-- U17 GGaaGC@QQ¢CSRQ�@lfGa�a�CG�aa IIa�e-':.as=C.ai C.-..'CGCII a.:=aa CC@ SCGLTCIIQaGc¢CC�CTaaaQCG6Q6 GENERAL MEAL EXPENSE: -Date Description Amount Account Number to be charged: Total _ asQaca QGQaa.GG.Gsn acGceaG@eeeeei:,.GeeacIIr_;acaa== ccc=a=c .IIGaaIIec.=-=c,-a.ccaaeacaII MILEAGE: Date Uescriprian: (include end/start readings and total miles) Amount Accoun - Number: �— Totalmiles x$.21 aaOQGe GsceG GGQaII Qm¢GGGrr_c--a--r_=ra�-c.IIaa:aave IIc;-_eca IIat .Ga Gs�aac IIGccaa.xueaet'IIxa=a APPROPhIATION BALANCE: AS OF: - Signature APPROVALS (if $25.00 or under nay be reimbursed through petty cash) : (up to $500.00)Section Manager a Put-ch. Agent ($500.01-$5,000.00)Dept. !lead/11 :rch. Agent i NWO RTANT ML SAGEM pT...MT MIffA8AR�i FOR FOR DATE— -TIME- P.M. DATE TIM M - M_ -- Hca- 3w4 OF------ ------ OF PHONE L -L i �`"' PHONE_ AREA CUBE NUMBER FXTENSInN AREA CODE NUModR EXTENSION TELEPHONED PLEASE CALL `^ TELEPHONED 8E CALL r CAME TO SEE YOU WILL CALL AGAIN CAME 1TJ SEE YOU WI'T3 ALl AGAIN WANTS TO WE YOU RUSH WANTS TO SEE YOU RUSH ~'. RETURNED YOUR CALL SPECIAL ATTENTION _ RETURNED YOUR L'ALL 6Pl9LAt UjTENT10N MESSAGE— MESSAGE__ bz, L _ 1 -- SIGNED SIGNED—__— _ LITHO IN U.B.A. l ITHO IN U.BA TOPE 9 FORM 3002P TOPS It FORM 301112 �e.ca�rcc i/+sus 0*"ade 4V /oz "OLA-5 /! 7//e �0 /►7 lam__ r 1 t>3 ~ s C4k4 -- `F 37 / E APPLICATION - STREET IMPP EMENT/EXCAVATION COPY TO: ORDINr,NCE NO. 74-14 (WHITE)-FILE G] (YELLOW)-INSP. (INSTRUCTIONS ON SEPARATE SHEET) ® (PINK)-OTHER AGENCY bldg ITCj (BLUE)-APPLICANT APPROVED Ind APPLICATION NO.: 3~77 NOT APPROVED ❑ �I hY OF TIGARD,OREGON FEC AMT.: __34_00 T PENDING FEE PMT. ❑ CITY HALL RECEIP PENDING SECURITY ❑ PUDL/C WO R KS DEPA R TMEN T By ._. DATE -7 13 PENDING AGENCY ''OK" ❑ application and Progress Record _ MAINTENANCE BOND PENDING IN'•ORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS IMQUIREU x ANNUAL PENDING VARIANCE n EXPIRA IO DAT _one� ar ,.— PERMIT NO 33Z Jz OATS ISSUED' --I�_LL_ BY __ - (1) APP)IC:ATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL_ --SWi _ Connection AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS, APPLICANT Val & Jema Morley 10345_SK McDonald St Tigard NA1.,F D 97224___._6 _4937 1TPHONE . CONTRACTOR _- NAME AUOR[53CITV --- --- �T'NONE --- PLANS BY __Per_City_Standards_& NAME ADDRESSESTIMATED IMPROVEMENT TOTAL VALUATION ( COST: S .__._85000 DOL_LA R S _--_-. r�-.---. —._, - COR 1FF I U5E- - - - MIN. (2) EXCAVATION DATA: _ o.n4 AS 850.00 _ ;_�4�Q�T._.__ STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY TYPE LENGTH WIDTH DEPTH ITEM A QUANTITY STR�7• OPMID INS R TIO E Q U ESTIMATED STREET OPENING DATE: _�_. / / E S ESTIMATED STREET CLOSING DATE / / TE STREET (3) SECURITY NO. SECURITY AMT: E 850 __. CLOSED SURETY CO.: 17INAL �, •l SCN[CM _. CASH U BOND , INSPEC. , GJ '.7P t4 , (4) PLOT PLAN; INDICATE SITE PERTINENT PHYSICAL �. SPECIAL PROVISIONS/CONDITIONS: FEATURES: EXCAVATION LOCATION AND EXTENT. All_work to_,.confc�rm to City Standards & Specifications. 11 1 2) [Notify Mike Kills City Inspector -.gav I I 1 I --(1639-4171) 24 hrs. before ,ae - `� _ _ _ _ _ _ _ _ ._ _ � 1� _-� - __starting work in street. 31 8copy of a release & waver shall - -- _ he_. oyitind 1-n the City,jay _ 'Re '• - - -- - - - - - - - _ a�f,l iran� fnr wnrk a^_maa - - - - _ ,..� �_ Rteryiewinq properties. Also, 1 __aplcant must assure an easement gbtairged for the line across -:- -_--- - ----ilntervi.ewing--parcels) and must (5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE RIGHT-OF-WAY JURISDICTION IS THAT OF WAS14INGTON COUNTY OR THE STATE OF OREGON, THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS ANY_: CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HAVMLESS THE CITY ANG EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTT SNS. have a connection permit. APPLICANTS SIGNATURE L�(�l. 1- DATE V,A't MFI I'T P4 0.0 p F. fa rL.11 '=i'T I. 11F hl`f j*T pp I J,) FI.IRP043K.' i.)F h,AYIIIEW r CUSTOMER, r)EPO",11'S' 8 0 Cit.i PUIA—IC 111PROAM (7,72—VY) TOTAL AMOUNT PAID — ———————————————— 'INWAAM' JEMA M. ORLL"rwww. W,,M WNALD,Sl' 684-493 T D,76P 97024 121431 wl THE: LLARS wry rlrvt Interests Rank of O;egon,N.A. TiUmsd Branch 0.Box 21216 4 `'i4 �( �n'. 2HA 2 �L hAlk 'N v , ►ky � � yg - 31 :35 � Per �vkh,ik' O E �avtd - N wev_ 6. ek C, I- I Cd'--�cln ► N 2 � er � � r �"�' few «• q !' `� � C G i ►'� j -� M ►" 3 A, -f �I y e �r Q i ✓►6 � 2 �. Is, rdc. ra55 th � a � G � eliK J<'r nv 7 o 4e ,� �• Pr Jy : 5cwa r V4_ I Near 3-ewe, �� N " •j",far � Nam b�' W 913 1 ba �J8n5 45f- t Vi n u wr b a r s. -b Cr 1p L STR LET Vt%l Vi eta ov. LLU--4. I TPI t E T 44001 Q 3M3AV N o M OD n ) inw N I \ m kD U y O A �I 7 O \ ' n p �W N S '-- - - -- -- - --v'0GL N Ocr O � N o WI « _ cn Ilii3 90oi k -.-. 3,70 ON z �,�OaIOM Fr AIIN3Ad PUZOI M S x w rri r, ` ^,. r„,L pig O e • O s .�r in U r a O y N ------�6L`ell G t B l Ilk I O N Cj __.._.3y/GpON — /GOI• i ,. blb (n ♦[1- 7-�iIOM � R O of o - _ Q LL NI 6 it . s 0904 ! V a a O n O H i 0 ^ w O r rn J !r _ _MyGBI /1,GOp04 i�►'. [C'SBI ~9..CI,WoION 1.. .,,N LLI: n C, - 4JnN3Ad 4 V 0 1 M'S K colt i CLASS D CLASS C ,SURFACE RESTORATION MOUND EXCESS NATIVE MATERIAL C SPECIFIED • — -OVER TRENCH TO ALLOW FOR SETTLEMENT UNDISTURBED UNDISTURBED EARTH EARTH COMPACTED 3.14"—O CRtr;HED N A T I V E R)CK MATERIAL 3/4~--0 CRUS?*�ROCK PIPE O.D.: ,' ° PIPE O.D. PLUS G" '. V •� PLUS G• PIPE __:..:�_:. ,.� .Y .�:�.::�l•�'.:f; ,'i BEDDING 4 MIN. FOR PIPE SMALLER THAN 18" G"MIN. FOR PIPE 18"ANDLARGER TR E N C H BACK E I L. L DETAILS Uf Unifies!Sewerar; Agency I I 1 BUILDING SEWER PIPE, SIZE 43 SPECIFIED i PLANT FABRICATED TEE FITTING BACKFILL 2X4 ON SITNERS 10" AN') SMALLER. AGAINST PLUG TO FIELD TAP ON ZXISTING SEWERS PREVENT PWG AND NEW SEWERS LARGER THAN I BLOWOFF © SECURE THAN 19" 2X4 IN PLACE WITH _ I TRENCH BACKFILL. i SEWER MaN L A N I AR LATERAL1 I EXTEND AT LEAST GROUND 12-ABOVE SURFACE _ SURFACE MINIMUM SLOPE FOR G� I 6" PIPE= 0.010, FOR _ CONNECTION 4 PIPE= 0.020_ MARKER WRAP 12-IG GAUGE n GREEN LOCAMR410f' ]1 ---WIRE AROUND 2X4 WG PIPE ZONE MATERIAL AS SPECIFIED :�iR_ l�'►r__ SUPPORT TEE WITH BEDVING GRAVEL, MINIMUM :!'d" MRDE. S1 DE B U, 1 L. D1 NG SEWER I 1 UfUnifSewerage Ag,-my of w3shingtm County ��I NOTE: THIS TYPE OF MANHOLE SHALL HE USED ONLY FOR PIPE SIZE OF 24" OR LESS. LOCATE MANHOLE CO Q FRAME UPSTREAM OF MAIN SEWER LINE FLOW AS SHOWN_ STEPS MAIN SEW R LINE I CAST IRON COVER _� rV MATCH FINISHED GRAVE OF STREET- ay S F RAME -� (See Standard Plan E ) SET FRAME IN RISER RINi S VARIABLE r- it{I NON-SHRINKING /" _ (Maxinum 1 0") GROUT ECCENTRIC MANHOLE TOP. STANDARD 48" MANHOLE RISER -i PREFORMED PL.AS'TIC GASKET 48" �. FOR I`1 PE , ilriuui.i z 24"OR LESS COMPILCTED Cotj :.' -��• :: CftlJ`...31ED ROCK FOR PIPE y 27" OR LARGER MAX UNDISTURDED EARTH Ti 7 'l: :i J*..'tl�!�: •':;=`_ ,�: SET IN FRESH INSIDE DROP: o . - o 0 o Q CONCRETE EI MAXIMUM 2'0" �`:'4 o GROUT. VERTICAL DI.ITANl:i: "6�0" Q, le LAYER IMPORTED INVERT TO INVERT MIN. BASE MATERIAL(3/4" 0) STANDARD MANHOLE f Unifled Sewerage Agency 01 i 12 SEWER PIPE I I I MIN. SIZE VARIESTI I I 8" TEE OUTLE11 UNDISTURBED EARTH� w 8" `;EWER PIPE I G" MIN. CONC. ENCASEMENT �' .` ; Al I ALL SIDES CONCRETE PIPE DROP PIPE CLOSURE CO(AAR 2 I OR APPROVED MIN. C,I.M-J. TEE COUPLING 8" OUTLET 11 I I � (3 UNDISTURBED EARTH �oC) COMPACTED GRANULAR BACKFILL UNDER PIPE � I rr ��• - - - •I I C.1 MLJ. 90' BEND —-- � 1--. CONC. EASE_ CAST IRON PIPE DROP STANDARD MANHOLE OUTSIDE DROP OONNEOTION'S u I f(m 4 Unified Sewerage Agef" I 100 STANDARD EAST IRON FRAME ® COVER FINISH CtRADE1 WATERTIGHT PIPE PLUG Jft ►;. • :14`MIN. v/<J �00 4�• • ,QO ` / OOH" 0 O 6� °o•o• STANDARD MANHOLE d� MIN. c!0u GRADE RING �o NOT08° o a; i CLEANOUT /NSTALUTIONS ARE �'o o a 0 •o PROVIDE 3/4"-0 FOR A LIMITED TO EASEMENT AREAS �o c v oo MINIMUM OF 6" ARMNO OR MAY BE ALLOWED ON A y o°0 0000 CLEANOUT TEUPORARY BASIS /N RIGHT-OF-WAYS. — 00 o• 0070 J Y/ �— 0 000 0 170 00.0 0 0 C)o .o° . 0 0 �Oo o0�0 aoo � o• .� ob°oo y 000 0 0.00 040 o po OV o ,•:: ►.' 0 Doo 00 O 0000 •. . '• •: :4^::; X00 a1000 �•`'� •J CONCRETE ENCASED WYE. _ 3/4"-O STANDARD CLEAN OUT Uf Unified Sewefag9 Agency 1.10