10900 SW SUMMERFIELD DRIVE FILE NO.
73MVERFIELD DR. - 10900 STR. OPN. PERMTr
1
LiTYO TIGARD /\
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EXPENDITURE REIMBURSEMENT REQUEST
This form is a mulct-use form. Where appropriates receipts must be attached.
Documentation is important for all purposes. Staple documentation to form.
VENDOR NO: 7�
PAYABLE 1'0: J�vv>Ctic '7v� Jar } S �" wN`� -IA(: Requested by:
%
...... ............•..............�._
HISCELLANLOUS (parking, books, subscriptions, dues, memberships, etc. ) :
Date Description _ Accuunt No. _ Amount
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ek r -� enc rw�st=�p� E3
•••....•••••...................c...cmc............ .........................
G,-NERAL MEAL EXPENSE:
Date Descri. tion Amount
Account Number to be charged: TOtAI _
...
.......................c............C c c^4 C S........!..............
MILEAGE:
Dace Description: (Include end/start readings and total miles) Amount
Account Number; __ _~_ _ Total _ miles x . 20
0000.0............. ..
APPROPRLA1loN MAI.A14CE: _AS OF: _ Signature _
APPkOVALS ( t ( 1",. 11U t,r under maty he reimbursed through petty cast,)
(up to $50o, Ut))' t kon Man.vgel I'utch, Agent _-- -
( 350U.01 -15,000.00)uent Head/Porch .
F=l LE
,%-dY OF T1�,4 RD
EXPENDIT'1RE REIMBURSEMENT REQUEST
This form is a multi-use form. Where appropriate receipts must be attached.
Documentation is important for rll purposes. Staple documentation to form.
/� ha
VENDOR NO: ' DATE:
PAYABLE TO: _ A�, �1 �N �'y ���w,�� ��` Requested by:
139-7 5 5,ftp, P�xICL
-
Ott ck br, 9-77-13
...............e.....r...r..wr..e.e..e................e...r....................
MISCELLANEOUS (parking, books, subscriptions, dues, memberships, etc.) :
Date Descri tic.n 1 Account No. Amount
IV A1 U Z inIOC�`vt
5ti-ee� o4e s. wa n. ZOt3-$5
GENERAL MEAL E"PENSE:
Dale Description Amount
Account Number to be charged: Tonal
.e...e..s....ere......e...lsee.G..Gerr.seen.lseeleer..e.l.wesv.....cc.ac..r__ccc..
MILEAGE:
Date Descri tion: (Include end/start readings and total miles) Amount
-- -
Account Number ; _ _--Tc,tnl -_-^ - tniles x . 20 _
........v.............oe■.e...v..n.a................r.......wr.......
........
•
APPROPRIATION BALANCE: _ _ AS OF: Signature
APPROVALS .UU lit und, t ncly hr i e Imhursrd tlit uugh per t y cash)
(up to 1500. UU15i i t iun Mallagrl Pul rh Agrnt
( 1500.01 -15,000.00)Dept He.,d/I't,Ich Agent �__.. — .—.-•--•-__.__-__
1 /
AMERICAN
P.ARTHSTATIONS, March 18, 198
INC.
0h%S.W Bancroft Street
Portland,Oregon 97201
(.145)222.6 Ml
City of Tigard
12755 S.W. Ash
Tigard, Oregon 97?23
A-tention: Mr. Randy S. Clarno PLS
Engineering Services Manager
Subject: Opening Permit # 208-85
You have been holding our cash bond for one year on the subject permit.
We would appreciate it's prompt return to the above address.
Yours truly,
AMERICAN EARTHSTATIONS, INC.
Norman G. Hotz
President
NGH/mab `(J
1 ,
1017 � � � 4� C.-
T
r
April 2, 1985
American EaPa Pacific
Hwy. Inc. CITYCW TKARD
13975 S.O. Pacific Hwy. WASHINGTrJP1 Cr-UNTY,OREGON
Tigard, Oregon 91223
Attention: Larry
Reference: Final Inspection and Bond
Release Request on Street
Opening Permit 208-85
Dear Larry:
On April 2, 1985, we conducted a final inspection of the above referenced
permit. The work appears to be acceptable with one possible exception. On
March 25, 1985, our field inspector, Bob Thompson, made contact with your
contractor at the site, and was informed that the first boring attempt was
unsuccessful rid penetrated the road base. Bob was then informed that this
void undor the road could not be repaired and shouldn't affect the stability
of the rn''_. After discussing th,r matter with the City Engineer, we've
decided 'chat a potential problem could exist and therefore, we want to retain
your ct sh bond (as provided by the Tigard Municipal Code) for up to one year.
However , you may replace this cash bond with a surety bond if desired.
Please contact me if you should have any questions.
SI-ace)rely,
Ra dy S. a). o,(P.
Engineering Services Maneger.
(RSC:br/1.155P)
----- 12755 S W ASH PO, BOX 23397 TIGARD,OREGOO 97223 PH:.539-4171
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APPLICATION - STREET IIAPR( 'MENT/EXCAVATION COPY TO:
❑ IWHITEI-FILE
ORDIN ArvCE 140. 74-14 ❑ IOLUE1 -INSP.
❑ IVB - AGENCY
(INSTRUCTIONS ON SEPARATE SHEET) ❑ (PINK) -AP�LICANT
APPROVED 1_�r APPLICATION NO.: 237
NOT APPROVED ❑ CITY OF TIGARD, OREGON FEE AMT.: S
PENDING FEE. PMT. ❑ CITY HALL. RECEIPT NO.: — 40(03
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY — DATE__-6 11L_L lgg
PENDING AGENCY "OK" ElApplication and Progress Record MAINTENANCE BON M r_
PENDING INFORMATION El FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED p _
ANNUAL U
PENDING VARIANCE ❑ EXPIRATION DATE:
PERMIT NO.: -_Z08_"95-__._ DATE ISSUED: . __.L._L(_l.._8r-� BY:
(1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL i.>._W po or_cable
AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICAI'T American Earthstations, Inc.. 13975 S.W. Pacific tivy Tigard OR. 97223 520-4463
NAME 'Awo-w-fis-9 CITY PHONE
CONTRACTOR_ same
NA lADORE3i5 CITE- PHONE__
PLANS BY . ___ Q!IMP —
NAME — ADDRESS CITE— _ — PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ 300.00
COLLARS _ _ __
FOR OFFICE USE. JMIN
(2) EXCAVATION DATA: ill efforts wij l be used to bore in 0.04 x
STREET _ DESCRI TION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITeM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM 91 QUANTITY _
Summerfield DR As hal all' 1 ' l' S PENE D —
INSP C-
R TION
Q
ESTIMATED STREET OPENING DATE: 1-13 AS I _. L —. FT Y --
ESTIMATED STREET CLOSING DATE:
_ D _
-�----_-- ----_' _- STREET
(3) SECURITY NO. SECURITY AMT.: $ CLOSE
SURETY CO.: - --- — FINAL
CERTIFIEDCHECK ❑ CASH BOND t INSPEC. '� —
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/COIJDITIONS:
FEATURES: EXCAVATION LOCATION AND EXTENT.
w l V bore
Summerfield DR.
ty I
1 I
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.
THE APPLICANT AGREES TO 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
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS
APPLICANTS SIGNATURE `�' '�� '— DATE.
l
CITY OF TIVARD No. 3063
12755 S.W. ASH
j P.O.BOX 23397 Date
TIGARD, OR 97223
i
Name
Address ^
Lc' BlocklM bdivisionlAddre s
Permit N's BIt;(t. Plumb Cash Check
r
Sewer Other Other " Rec. 8
Acct. No. Description Amount
10.432 Building P 363 _
10.431-600 Plumbing Penna Fees
10-431.601 Mechanical Permit Fees
10.230.501 State Bidg. Tax
10.433 Plans Check Fee _
10.435 Jther Licenses & Permits
30.443_ Sewer Connection
30-444 Sewer Inspection
24.448 Street Syst. Dev. Charge _
25.449.610 Parks I Syst. Dev. Charge
25.449.620_ Parks II Syst. Dev. Charge
31.450 _ Storm Drainage Syst. Dev. Charge
1U-430 Business fax
10.434 Alarm Permit
10.227 Bail
10.455- _ Fines-Traffic/MisdlParking
10.230- CPTA TrafficlMisd'vic. Asst.
10.456 Indigent Defense
30.446.401 Sewer Service/USA
30.446.402 Sewer SnrvicelCity
31.417 Storm Drainage _
40 475 Bancroft Prin. P mt.
40-471 Bancroft Int. P mt.
10.451 Other Chargeq Chargefor Services
G+0 U
-U v
TOTAL
+r-
DEPT. �— )