7531 SW LANDAU STREET FILE NO.,314 q(_ -
LANDAU STREET -- 7531 STR. OPN. PERMIT
I
CrW OFTIGIWD
EXPENDITURE IUVJEST
This form is a Trulti-uz-.,� Appropriate receipts must be a,-tached. Doc Lmventation
is briportant, for all rAirprc-es. Staple docurentati-m to form.
VENDOR NO.: DATE: + -7—4S -C---)
PAYABLE T:): RB�(=ED BY:
7 Ci 7a iVI
-7 2 "-3' L Approved request due Ple Inesday
r 10:00 AM to A/P for checJ-.-. by
Friday.
MISC17 INEOUS EXPEND=IES:
Date Descril-nAon, Invoice No., etc. Accr-Nmt No. Amount
10 zz 00 C Zoo
r-
TUrAL
Mileage $0.255
APPROPRIATION RALNNCE: AS CF: SICWJWE:
(Up to $25-00) Section Manager '-Ourcb ,gent
($25.01-2,500.00) Division Manager
($2,500.01-7,'500.00) Dept. Head
($7,500.01-15,000.00) City Administrator
($15,000.01- ?) local Cortract Reviea Board
ke/1501F
APPL'I'ATION - STREET IMPRf TENT/EXCAVATION COPY TO:
ORDI I' -E NO. 74.14 Rl (WHITE)-FILE
(YELLOW)•INSP.
(INSTRUCTIOI. ON SEPARATE SHEET) IN IV K)-OTHER AGENCY—bldg
(BLUE)-APPLICANT
APPROVEL APPLICATION NO.:
NOT APPROVED (] ' t I : OF TIGARD, OREGON FEC AM f. t $.00
PENDING FEE. PMT. ❑ CITY HALL F?F.,:EIPT !'/- Z1,,
PENDING SECURITY (_J PUBLIC WORKS DEPARTMENTRATE_ 4 /,1-&L9L
PENDING AGENCY ''OK" O Application and Progress Record — — — — — — —
PENOIN- INFORMATION O FOR STREET IMPPOVEMENT/EXCAVATION MAIIASE EQU aE BONp *,
FD
PENDING VARIANCE ANNUAL One y r
EXPIRATI N AT Q��_�__
PERMIT NO.: /_
DATE ISSUEL`. 9L_ t31 - -
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR ANJ INSTALL ,I SAKI S
T FNER
AS DF_SCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
AFr'LICAN'f 1tobert B. Burnea�'j �, .y�'. Larl�t� St.
AbORESS - - - ____ T_]gdC�3�_ r9 ___ ._ �q(_
CONTRACTOR UNKNOWN
PHONE
PI ANS BY C17V
__P City andar�_�-Sueci c �i�r
NAME ADON 489
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): E
-- ---_ _t,_oLl_Ans
_- _-- FOR OFFICE USE�— CMIN_,
(21 EXCAVATION DATA 0.04 X = 200-M-_ _ :
STNEET DESCRIPTION PROGRESS_& INSPECTION STATUS
NAME SURFAI,;E CUT CUT CUT MATERIAL INSTALLED T-
TYPE— LENGTH WIDTH DEPTH ITEM a QUANTITY ITEM DATE REMARKS/T YPE BY
—+ STREET —
F
._ ee. a tached Ian
CSTIMATED OTREET OPENING DATF: -� /
ESTIMATE?ST'REFT CLOSING DATE: / / - ---- ---
_ E
(3) SECURITY NO. --.--__- SECURITY AMT S -_ 200.00 CSIREET
LASED
SURETY CO,: _ _ FINAL
_ r
HECK sDND c
INSPEr.. 1`i�'i( 1 �rrvea (� �J
(4) PLOT PLAN: INDIf ATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDITIONS:
f'EATUFtE3; El.,.4VA7'IJN LOCATION AND EXTENT.
J L_Ajj_XQCk_&.A l l conf orm t C'i
0 4104 X Standards & S cifications.
11 yl s5�0 i X SITE:C 7531 S-W LandaN St� , --
2. Notify city Inspector Carl Vieweg
y(#639-4171) 24 hrs.
1 1 ' prior to
PBIVArL DRIVE---
-- _ I ---- -
cups - ^' - - -" _ _ _ _ _ _ _ _ _ _ _ f� i _ starting work; also, prior to
hI __ covering work. r
- (see attached plan) __.-- a-
3. Excavator shall comply
ORS 757.541-.571 (util.ity
I �prelocati.on). --- -
I
(5) NOTE THL CITY OF TIGARL DOES NOT, HEREBY, GRANT PERMISSION ;O APPLIrANTS TO CONDUCT WORK WIIERE
RIGHT-OF WAY JURISDICTION IS THAT OF WASHINGTON COUNTY Op THE STATE OF OREGON.
THE APPLIC4PT ; RE4 O DEPOSIT I-HE REQUIRED SECURITIIi8, TO COMPLY WITH ALL PERTIN:NT LAWS AND
CONSTRUCT}6N SPECIFICA 1 NS PERTINENT T,Q CONDUCT OF TNB WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLO�fS A(.A'NAN IN RY-, A ,�� HICH MAY RESI,LT FROM APPLICANTS ACTIONS.
APPLICANY4 S O T �, �•— � / 7 "�'
DATE �� /
APPLICA-TION - STREET IMPR(` ^MENTJEXCAVATION COPY TO:
)N (WHITF_)-FILE
ORrjINIfiaCE NO 74-14 (YELLOW)-INSP.
(INSi RLJCTIO'VS ON SEPARATE SHEET) (PINK)-OTHER AGENCY-b1Cq
(BLUE)-APPI ICANT
APPROVED ] APPLICATION NO.:
NOT APPROVED [] (-I .' OF 'f1GARD, OR.E60%. FEL AMT. a 8.00
PFNDING FEE. PMT, [] ' CI I l IIALI. RECEIPT NO.: �} - ✓
PENDING SECURITY ❑ I P1/8L/C WORKS DE P,1RT,fEA1T BY ___;-__'__'__ UATC— I - IrL'
PENDING AGENCY "OK" ❑ \11Ili,cation and Projr-ss Record — — — -- — — — — — — —
PENDING INFORMATION r] FOP STREET IMPROVEMENT/EXCAVATION MAIASERANIRED
BON Q,s_ --
ANNUAL ❑
CIne PENDING VARIPNCE EXPIRATION DAZE: r —
PERMIT NO c --- DATE ISSUED: -�_ _1—�-��_r_ BY.
1 APPLICATION IS HEREBY MADE CO EXCAVATE FOR AND INSTALL. "fTI )+ SEWM
AS DESCRIBED HEREIN, IN FULL ACCORhANCE WITH CITY REQUIREMENTS.
APPLICANT - Robert 13. art: '.lea- 71531 S.W. Landau ,-,t. ['i:u:sr :, CT:t 97223 f 246"-1757
R ESS- ------- - -- CI'T'Y PHONE
tom —
CONTRACTOR—_ — • ' —_
AQOREf
DL' cit
PLANS BY .O_^ •Y iCat-.i.Uns
AD-"-p-RES•9 ...-PHONE
ESTIMATED .-ME'P•!T VALUATION ( COST): S 2W'W
DOL
(2) EXCAVA ! DAYP FOR OFFICE,
Vf,'::
0.04 X f — — ti = s DO
STRE'_T DESCRIPTION PROGRESS & INSPECTION STATUS
';UREA"'' CUT_ CUT CUT MA)LR L INSTALLED --
_TYPr '-rNGTI WIDTH DEPTH ITEM A Z4UANiIrY ITEM DATE REMARKS/TYPE BY
STREET �—
_... -.._._..1.�.. �_.. - -- �_—_..-_— P N �- 01/ �`
E 710N -_--_ —
. QU r-- _--
r
C'. : WATEDST'RF.EIOPENING DATE: E-. 1L S
�r i dTU+AI C D STREET ._ )SING DATE. _._ / / g --
.�' _
) 2CU• X)-- - sTHFESCCURITY SECL RITY AMT: E iLOSE TD
I.Fl: : Y (n
_-�
FINAL
CCRTIPIED CHR( U CASH Ll �ONp r IN9PEC.
- _--—_- _---. - -
I:il I'LO? PLAN" INDICATE SIT'. PEN rl -NT PHYSICAL SPECIAL PROVISION / CONDITIONS
FF'ATJF'ES; EXCAVAT Oti L:("• 'N AND EXTENT. A1.1 WOCk shall �UlIC.411: t�: City
x 9twy-lacda s Specification .
k e Specifications.Sim: Lawia►J �t j ; � 2.211 tify City lnapector Carl Viate
r VATS DRIVE 1 1 _ 0539-4171; iA hr9. prior to
cuR9 _ % - - - - - - - - - - - - ' ` ) starting work; a.l.so, prior to
- I; 1 ` - — covering work.
(saw attached plan) _ Exravator &hall callply with
- - - - - 1 _ 01V 757.541-.571 (utility
;..- - - - - -- -• - - - - -� t�' -- pr�T4:ate
Y
(5) NOTE THE co rV OF TIGARD DOES NOT. HEREBY. GRANT PERMISSION TO APPI-ICAN-; 10 CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRFD SECURITIES. TO COMPLY WITIi ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINFNT TO CONDUCT OF THE WORK, AND TO SAVE FtAr.MLESS 'THE CITY AND
E1.IPLOYEr:S AGAINST '~ INJURY OR DAMAGE WH,CH MAY RESUI.T FROM APPLICANTS ACTIONS
,
APPLICANTS SIGNATURE -_. DATE / _1_
CITY OF' T'IGARD - RECEIPT OF PAYMENT RECEIPT NO,. :91-21 =166
NAME : BURNESS, BOB ( rHECKI AMOUNT 208, oQ.
ADDRESS : 7531 SW LANDAU ST CASH AMOUNT ,
0. 017•.
PAYMENT DATE, 04/18/91
TIGARD, OR 97223- SUBDIVISION
STREET OPENING
PURPOSE OF PAYMENT AMOUNT PA I7 PURPOSE OF PAYMENT
AMOUNT PAID
PUBLIC IMPROV
8. 00 CUSTOMER DF.PO
PERMIT #414
TOTAL AMOUN- PAID 208. 00
r BUS 13URNESS 9 7 Q
CONSTRJCTION INSTRUMENTS
i
248-1757 _� 19JOVI 24-12/420
777 74TH 1210
P LA D OF 97223 7 07
PAY J11 $
0,96ER OF --
' Flf Inter ale Ban
of O,egon,N N.
First , Beaverton Bunch
P O Bow 10
e 9eavefton.Ufegon 9075
FOR -
1: L 2 3000 & 2 3+:4 a0 00G" 3 3 511 9
,rtc mf,rwuwi u
` j ....' VV VZ} �..VY, 4e cd Jam/
•. �, JLI/7 �� J
v h
col v
-912
err•�s��S7 -' � _ - �of 1�' ` ( '� SOd' h �1�i
"Z,
Eai_
or.?
LJ
� J I
< N*
V
wi
I
I
DUIL.DING SEWER PIPE, SILE AS SPECIFIED
PLANE FABRICATED TEE FITTING
ON SEWF;;;, ig" .^,ND SMALLER. BACKFILL. 2X4
FIELD TAP ON EXISTING SEWERS AGAINST PLUG a)
AND NEW SEWERS LARGER THAN i PREVENT PLUG
TIIAN 113 . I BLOWOFF & SECURE
2X4 IN PLACE 4!TH
TVENCH BACKFILL.
1 �^ �-SEWER ?"N
OR LATERAL PLAN I
I
EXTEND AT LEAST
GRCJND 12"ABOVE SURFACE
SURFACE /
MINIMUM °LOPE FOP
6" PIPE= C.010, FOR
4"P:PE 0.02.0. ! -SERVICE CONNECTION
�i MP'TKER:
VRAp 12-16 GAUGE
`-_,__ G REL v LOCATOR
WIRE ARIUND 2X R
i
PLUG
3/4"-0 PIPE: ZONE MATERIAL
AS SPECIFIED
^UPPORT TEE WITH
��. BEDL.44G GRAVEL,
kMNIMUM !"0" WIDE tt D
.0 I L D I NG r5 F W E F
Unified Seweracte Agency
of Washington County
Sac
MIN. 3" t'. r.; IN ?_ LIFT5
STREET AREAS I OUT OF_STREET AREAS
aAw -
EXISTING _
SECTION
RESURFACING /
tic.. - '��-fly--• '' ,'e• i / , r
c /
;'•. ! CLASS A
/ BACKFIL.L
' v
-lid- ' n• � � \
CLASS B
3/4*-C GRAI,ULAR U
BACKFILL 0
C') tp � ° 4\• � � � Ll �, tl 1 ,\� fit
W � �• 'e o o• ° •e ` Q
r
0
�4D o /
' ' �. •�
03
PIPE BASS
e
t
0.4rKFIL.L IN JTRE ARE:4J
L 1FAV IJ AGAINST CURB, FILL ROC.i TO
BA—CX nF S1 W
2.IF J/W IJ,HOT AOAINJT CUR 1, FILL ROCK
2'BIACK FROM ^.URB
PIPE BEDDING AND
C I T Y 0 F TI o.Its► _ BACKFILL DETAILS
.14 OREGON OF51GN PWY 4ppRCJVEO BY QaAL.IN �y�
-_ GA RF
rU nI.'.ALJING
NT*5