6560 SW ALFRED STREET-1 FILE NO. 479-92
i ALFRED STREET Stn' — E550 STR OPN PERMIT
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~bis form is a ouAti-lise form' - receipts must be attacbed' Dccuueotation
; important for all pucI»z-es' Staple' docunm�.Latin to form.
V!I,D)R NO, : �J
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Approved z/yq-iest due Wedne-sday
10:00 AM to All) for --becks- by
Fcidan^
4Z -
TOM
Mileage $0.255
/uoorOyyI»TI0N BALANCE: 83 OF: 8IGIAW8E:
(Op to $25'00) Section yamager -_-_-______-.________ Purob' /gent
($25'01-2,500'00) Division Manager ______..... __________ ____________-_-_-__--____-___- !
($2,500'01-7,500.00) Dept. Bead �
($7,500.01-15,000.00) ' -----'--'--
CityAdminiobcator _____________ ________.____________�______
_ ($15,000'01- ?) Ix»cal Oontzac'- Review [k0aod ___________ _______________
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APPI_ICA1 ION - STREET IMrr;1)! - MENT/EXCAVATION COPY TO:
� CS (WHITE)-FILE
OR LSI NA, E NO. 74-14 (YELLOW)-INSP.
(PINK)-OTHER AGENCY— b1.dC
(Ilv_TRJCTIONS ON SEPARATE SHEET) ® (BLUE)-APPLICANT
APPROVED Z
APPLICATION NO.: Sz¢
_._—_—
CITY OF "1'1G28.00
NOT APPROVED CI ARD, ORL-GON FEC AMT.: : q
PErJDING FEE. PMT. �] CITY Y HALLRECEXP ., 11-
~Z.Z�i35-3 —•
PENDING SECURITY (� PUBLIC WORKS DEPARTAIENT BYE- DATE-
1 -
PENDING AGENCY OK" ❑ %,)plication and ProgTcss Re.-cord MAIVTe:NANCE BOND 0
PENDING INFORMATION ❑ FOR STREET IMPROVEMENVEXCAVATION AS RLUUI HED
ANNUAL J
PENDING VARIANCE EXPIRAT ON DATE ---
PERMIT NO. -_97` -9Z DATE ISSUED -�_ ?C'� Z BY:
( I I APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL SANITAR _ SMER L ERAL AND —
MAINLINE TAT' AS DESCRIBED HEREIN, IN FULL AC.'ORDANCE WITH CITY REQUIREMENTS.
APPLICANT Canby Excavation. p.O. Box 848 _ Canby.. O$__27A�31TV —
NAME ADDRESS
CONTRACTOR -- (Same) - - CITY
NAME
PLANS BY _ City StandaLda and Specifications ---
NAME CITY
ESTIMATED lr'PROVEMENT TOTAL VALUATION ( COST): $ ___ _00.
00
DOLLARS
FOh •EPIC USE-
(2) EXCAVATION DATA. 0.04 x s_—_� s __'S .00
STREET ___ ,__ DESCRIPTIOP
_ N PROGRESS & INSPECT(O _STATUS
NAME SURFACECUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARK%'TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM AI QUANTITY _�s—^--
e_ I_---- -- --
STREET
OPENEO
- INSPEC- C r
Alfred St - see` attached- R TION 1 . /
U
ESTIMATED STREET OPENING DATE:.._,.______L__ I T _ - -
ESTIMATED STREET CLOSING DATE: L_ --L E
700.00STREET
(3) SECURITY NO. _ ___ .___ SECURITY AMT: E CLOSED—-
FINAL
SURETY CO.: — -__--- - INSPEC. 4 3 c Z c
CERTIFIED CI4ECK �I CASH U BOND ' -�.-A
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS / CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT. 1. Notify City Inspector Carl,
N Vieweg (#639-41'71) 24 ho-irs
1 I I I _before starting — any work.Y
I
I 1 1 2. All work shall conform to City _
— -- , - Standards/ Specifications.
CURB - - - - - - - - - - - - - - - - 3. O.R.S. 757.541•-,571 (Utility Co.
S.W. ALFRED STREET E� _' - —
�__-- - -- prenotification, etc. ) ap2lies-
x)�x4. A hard surface, patch is required
aC X at the end of each days work. _
I i work area i I 5. Traffic Control is required t,-)_be I
(SITE: 6560 S.W. ALFRED 5 ) I !provided for by the contractor.
1 — 1.V11.7 VL l"V.LVv-11pp1pr-
- .-a-permit .for the driveway "Tie" to
(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,
THE APPLICANT AGREES TO DEPOSIT THE REOUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS ANDD
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THIS CITY AN
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY REST/LT FROM APPLICANTS ACTIONS
-� - Alfred St. is required. 1
DATE
APPLICANTS SIGNATURE � +� ,
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BUILDING SEWER PIPE, SIZE AS SPECIFIED
—f[r_
\ PLANT FABRICATED TEE FITTING
ON SEWERS 18" AND SMALLER. BACKFILL 2X4
FIELD TAP ON EXISTING SEWERS AGAINST PLUG TO
AND NEW SEWERS LARGER THAN PREVENT PLUG
--- THAN 18~ I BLOWOFF 0 SECURE
2X4 IN PLAC'i WITH
TRENCH BACYFILL.
-SEWER MAIN
C PLAN
'OR LATERAL I
I EXTEND AT LEAST
GROUND 12"ASM/E SURFACE
SURFACE
MINIMUM SLOPE FOR �a
G" PIPE= 0.010, FOR
4"PIPE= 0.020. __-AWiCE CONNECTION
MARKER:
WRAP 12-16 GAUGE
GFEEN LOCATOR
WIRE AROUND 2X4
--PLUG
z •..
3/4--0 PIPE_ ZONE MATERIAL
p•_,� - r~ " AS SPECIFIED
�• �''•�� SUPPORT TEE WITH
:,�zY.• •t+_. BEDDING GRAVEL,
MINIMUM ?'(Y' WIDE S1 DE
BU I L. D I SVG S [---- "E R
of
Unified C ewerage Agency
of Washint ton County
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PVC SADDLE (TEE)
STRAP RETAINER RIDGES I
_ I
I I — ----RUBBER GASKET
SEWER P IPE
STEEL STRAP
■ PVC SADDLE SHALL BE ASTM 3034 SDR 35
s PVC COMPOUNDS SHALL BE .OSTM DY784 WITH CELL CLASS OF 12454-B/C
OR 12364-C
■ ALL EL.ASTOW7-RIC SEALS (RUBUER GASKETS) 3HALI_ BE ASTM F477'
■ STAINLESS STEEL BANDS SHALL BE 300 SERIES, FULL. 9/116w 's-110TH BAND.
5/16' SHOULDERED HEX HEAD, SLOTTED SCREW AND tS CADILRA PLATED,
I CARBON STEEL.
INSERTION POLE SPALL_ BE CORE DRILLED.
PVC GASKETED unWad
sow "o
SADDLE UfA, crjlwl"uc'y
DRAWING NO. 350
1 . COMPLETE RUBBER SLEEVE (ASTM C-4431
INCLUDI_S A MOLDED SEGMENT THAT HOLDS
IT IN PLACE.
2. STAINLESS STEEL BAND (9/16" SERIES 300) I
(✓ ^ ^1D SECURES UPPFR HALF OF RUBBER SLEEVE C 7HE
PVC HUB.
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3. PVC. HUB (ASTM 3034 SDR 35j
DRIVE INTO CENTER OF RUBBER
SLEEVE AFTER SLEEVE IS PLACED
IN HOLE.
3 1
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---CONCRETE PIPE
NOTE: ALL INSF.RTA-TEE HOLES SHALL BE MACHINE DRILLED.,
unified
INSERTA -- TEE UfA bgency
DRAWING NO. 360 �� _r_�_
0
y-
MIN. 3•• A c IN 2 LIFr.5 - - --
STREET AREAS ( OUT OF STREET AREAS
5Aiu
EXISTING
SECTfON __�' RESURFACING
°• CLASS A
• BACXFI L I.�
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F-
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BACKFILL 0 - lA-
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PIPE RAS--
BACXf1LL IN ETRE AREA)
IL IFS,* 13 AGAINST CIIRB, FILL ROC,% TO
BACK OF 3/W
2.IF 3/W 13 NOT AGAINST CURB, F ILL. ROCK
2'BACX FROM CURB
PIPE BEDDING AND
BACKFILL BACKFILL DETAILS
'
OREGON OE516N 5Y - APPROVED 6Y r)wAL.JN iw*
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APPLICATION - STREET IMPROV--ENT/EXCAVATION COPY TO:
® (WHITE)-FILE
ORDINAL . - c NO. 74-14 (YELLOW)-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) (PINK)- AGENCY— bl
® (BLUE)-AAPPLIPPLI CANT
APPROVED x ! APPLICATION NO.: ! Z4-
NOT APPROVED E3 I CITY OF I IGARD, OREGON FEE AMT.: S 25.00
PENDING FEE. PMT. ❑ CITY HALL RECEIP a,:'__ 1-2-7-5353
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY _' ' " DATE
PENDING AGENCY ''OK' ❑ Application and Progress Record
PENDING INFORMATION ❑ FOR STREET' IMPROVEMENT/EXCAVATION MAINTENANCE BOND
M
AS REQUIRED C
ANNUAL ❑
PENDING: VARIANCE ❑ EXPIRATION OAT
PERMIT NO.: ` DATE ISSUED: _I_ V_L__ +' BY. —
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR A14D INSTALL_ SAN
I'rAR.. SEWFF k iAsAiYU__--
-_MAINLINE TAP AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT Canby Excavation_ P.O. Box E:48 .':rir�ylOR 9701'A _��___ 266-2792
NAME ADDRESS CITY PHONE
CONTRACTOR- (fie)
NAM FE CITE– —� PHONE
Cit Standardand Specifications _
PLANS B Y�___ Ys -- --
-
NAME ADDRESS CITY ---HONE —
ESTIMATED IMPROVEMENT TOTAL 'VALUATION ( COST): $ 7(X).CC)
_ DOLLARS
FOROFFIC 5ut�,,F:�i = - I:MIN.
(2) ! XCA1%AT17N DATA: --� — o.oa x s W10 = s 28.00
�;Tf,FET __ _ DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
— --- -- —� STREET
PEN_§�_D__
Alfred :.'t I" INSPEC- —
- _ E TION �—
Q
— — _- _---- -- e I --
ESTIMATED STREET OPENING DATE: —L__—�_ _��_ _ Sr
ESTIMATED STREET CLOSING DATE: / E
D
7�.OQ STREET —_
(31 SECURITY NO. _—_ SECURITY AMT.: $ 7 __. CLOSED__
SURETY CO.: _ _ FINAL
CFRTIFIEDCHECK (1 CATH ❑ BOND INSPEC. �-3"q:��s,�w>Ll ✓
(4) PLOT PLAN: INDIC ATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS:
FE'A'TURES: EXCAVATION LOCATION AND EXTENT. 1. Notify City Inspeutor Carl
N Vieweg (0-39-4171) 24 hours
1 I Ibefore sti:utin9 Iiisnany work.
1 I 1
1 1 ( 2. All work shall conform to City
Standards/ Specifications.
CURB -
S.W. ALFRED S'I'E2EET
3. O.R.,S. 757.541-.571 (Utility Co.
- '—
->~----- - - -- prenotification, etc.) applies.
x)�x R
�,�s -,� _ _ _ - - - - - - _ _ _ _ _ 4• A hard cu.rface patch is required
at the tend of each days work.
( I work area i 5. Traffic Control is r uired to be
'49
1 (SITE: 6560 S.W. ALFREI; {) ''1 I r pra`vIN or By the con rac�oc.
07-cri latt1i- ,
to
(5) NOTE THE CITY aF TIGARD DOES NOT. HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY :URISOICTION IS THAT Or WASHINGTON COUNTY UR THE STATE OF OREGON,
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINFNT LAWS AND
CONSTRUCTION SPECIFICATIONS PER'INENT TO CONDUCT OF THE WORK, F.ND TJ SAVE HARMLESS THE CITY AN
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULTFROM APPLIC ANTS ACTIONS. f�
A1fucd St. is required.
APPLICANTS SIGNATOR;—_" OATr
i
.DEFINE:entrct=case->eng definition incorrect
ENGINEERING PERMIT
PERMIT #. . . . . . . : ENG92-0016 DATE ISSUED: 03/30/92 By:
PRIM. PERMIT #. : ENG92--0016
SITE ADDRESS. . . : 6560 SW ALFR.F:D ST PARCEL: 1S125DA-0 {500
SUBDIVISION. . . . : PA, TI:TION PLAT 1991-•092 ZONING: R-4 . 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :2
PERMIT TYPE. . : SOP IMPROVEMENTS : QUANT RATE VALUE
AGREEMENT DAJ'E: j / GRAD/EROS
ASSURANCE EXPIRATION--- STREET
PERFORMANCE: / % SAN SFW
MAINTENANCE: / / STM SEW
UTILITIES
ALL OTHER
TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
Remarks: STREET OPENING, TO INSTALL A SANITARY SEWER LATERAL AND TAP THE PUBLIC
SEWER MAINLINE.
Permittee: ----------------- FEES --------------
CANBY EXCAVATING type amount by date recpt
PO BOX 848 OPEN $ 28 .00 JSH 03/30/92 225353
CANBY OR 97013
Phone #: (503) 266-2792
Engineer:
ENGINEER NOT ON FILE
$ 28.00 TOTAh
Phone #:
------ - 'REQUIRED INSPECTIONS -------
Permittee/Agent Signature: ---STORM SEWER-- -----STREET-----
,__ _ M.H. & C.B. CRB LINE & GRADE
PIPE LN & GRD SUBGRADE
BCKFLL & CMPCT PASS ROCK
AIR & TV TEST LEVEL COURSE
City of Tigard, Oregon WEARING COURSE
13125 S.W. Hall Blvd. ---SAN. SEWER--- TRArF & PED CONT
P.O. Box 23297 M.H. & C.O. MONUMENTATION
Tigard, Oregon 97223 PIPE LN & GRD ST'REETLIGHTING
Phone # : 639-4171 BCKFLL & CMPCT WALK/APRON/RAMP
AIR & TV TEST
FOR INSPECTION, CONTACT: -•----GRADING------
Carl Vieweg #639-4171. (office) --REPR'S/ADJ,S-- CONTOURS
#780-2647 (mobile) DRAINAGE
----FAIRWAYS---- EROSION CNTL.
CITY OF TIGARD - RECEIPT OF PAYMENI RECEIPT NO. :92-•225353
CHFCK AMOUNT : 7�::8. 00
NAME : CANDY EXCAVATING CASH (4MOUNI X11. 04.1
ADDRESS : PO BOX 848 PAYMENT DATE 0;3/30/9:'
SUBDIVISION
CANNY. OR 9701,3•-
-'URPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
]USTOMER DEPO 700. 00 PUBLIC IMPROV 28. 00
STREET OPENING PF_RMIT 479-92
TOTAL_ AMOUNT PAID - - - -> 7c-'8. 00
1W1W+tMkfu�+usll,pglW +�iApis,�i;flif��+� WNu�a;+HNi uutiµwgM+gMY�N�Wk+u+„wwWi+a+►45.,M:�,Nr>,t}xbbllltM4Bi61
.. .,�i..a�x��r_w.�.�a._Y�^c:�.,.�rr.=...e
CAABY EXCAVATING 594
O. BOX 840 PH 286-279?
CANBY, Or. 97013 � 24-201/1M
1
PAY TO rilE _`\d/ $ � o�
ORDER O —_
f
�-1)LLARS
s -- Nay a"of aqo^ -
oaar Canby Office
� K200 NW 2nd Avenue.P O H3 x 010
Canby.oft97013
MEMO_
: L23002010: 71 10 �9 1 9110 00141
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`
CITY OF T16ARD - AEC6IPT OF PA%fMENT RECE%PT NO. x92-225353
CHErK AMOUNT 818. 0(A
NAME CANBY CASH AMOUN1u8. mm
PPYMEN�� D�T� x o3/3o/9
ADDRESS : P0 BOX 84�
SUBDIVISION ;
CANSYr OR 17013-
PURPOSE OF' PAYMENT AMOUNr v,(.)11) PURPOSE OF ;7�,AYMENT AMOUN7 PAID |
|
-----'---- -------------'------- -- |
—'---------------- -'
��y�. �� PU�|
CU8TOM�R �E�O 'I� IMPNUU .
/
�
STREET OPENING PERMIT 47%)-92
TOTAL AMOUNT PAID
CITY OF TIGARD
STREET OPENING PFRMIT
APPLIATION
DATE—
• APPLIANT';i NAME (f-( vt I�� � vc���� �y i_ = /
ADDRESS !O 65c C — --
7-•�I1 ZIP -
PHONE
• CONTRACTOR'S NAME
ADDRESS —_—
ZIP
PHONE
• PLANS BY =�C'P 5, ��� (0—7 i�";c k- ___—_--
ADDRESS
ZIP
PHONE
• DESCRIPTION OF V,GORK PROPOSED 1-0 BE DONE: 74 fix, • s ?Lc•w - /7'k 1'I
• ESTIMATED VALUE OF WORK (within public right-of-way) : $ 7c)(J-
• WORK LOCATION/SITE ADDRESS'
• IS THIS WORK RELATED TOA LAND-USE ACTION? IF SO SPECIFY (MLP, SDR, ETC.) NO.
• IS THIS RELATED TO A BUILDING PERMIT? IF SO, SPECIFY (BLDG, PERMIT) NO.
- -01J� -- -- -- _
d✓" am (OVER)
SKETCH:
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