7645 7715 SW BONITA ROAD-1 FILE NO.
BONITA RD. -7645 & 7715 ST. OPN. PERMIT
APPLICATION - STREET IMPPr -MENT/EXCAVATION COPY TO:
ORDINA-CE NO. 74-14 ([�, (WHITE)-FILE
(elUE-•-NSP.
(INSTRUCTIONS ON SEPARATE SHEET) [:1 (YELLOW)-OTHER AGENCY
[.j (PINK)-APPLICANT
AF'PROV^D
APPLICATION NO,:
NOT APPROVED ❑ CITY OF TIGARD, OREGON FEE AMT.: S
PENDING FEE. PMT. ❑ CITY HALL REC NO.: G4D4 _
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT B DATE 3 1�'�i17`,1
PENDING AGENCY ''OK" ❑ Application and Progress Record
MAINTENANCE BOND M
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED ❑
ANNUAL ❑
PE:NDIIJG VARIANCE ❑ EXPIRATION DATE:
c ;
PERMIT NO. -- DATE ISSUED: _ �L _�'.L-_�-- - BY:
(1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL -
-_ _
AS DESCRIBED HEREIN, IN FULL ACCORDANCE II1(ITH CITY P.ECiUIREMENTS.
APPLICANTI __,,, :1 � '`l �<I, 1yrG-122
A (' 1iDDRE55� =,
/q-�/ 7z!/, CITYPHONE
CONTRACTOR _
,/ // -NATY[ ADDRESS CIT FHONEC'�IA /
PLANS BY ---�"L' /i t '�.LL_ - -- I"Gt:v�.d�4�` Gj`J�-- am
NAME ADDRESS CITY PHONE,
ESTIMATED IMPROVEMENT 'iOTAL VALUATION ( COST): $
DOLLARS
Fn_R OFFICP USF ❑MIN
11.02 X .
(2) EXCAVATION DATA.
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM Q QUANTITY
STREET —y
OPENED — _
INSP C-
R TION
E —
Q
U _
ESTIMATED STREET OPENING DATE:--`I— / ,� l: / s
.T
ESTIMATED STREET CLOSING DATE: /1 / r E
(3) SECURITY NO. T_L 4_/ SECURITY AMT.: $.�4,!ZZ� CLOSE
SURETY CO "_kAl yW-' (� , FINAL
_ CERTIFt D CHECK ❑ CASH ❑ BONDA INSPEC.
(4) PLOT PLAN INDICATE SITE PERTINENT PHYSICAL �CIt SPECIAL_PROVISIONS/CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT. 94 j .x 7 �� -
(100,
114
CURB
1 I I I
(J) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION '.O APPLI ANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICr10N IS THAI' OF WASHINGTON COUNTY OR THE STATE OF GREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIrICATIONS PERTINI:'NT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAN' RESULT FROM APPLICANYS ACTIONS.
APF LICANTS SIGNATURE:
DATE _
I
L �
1
CITY Of TIGARD—12420 S.W.MAIN--TIGARD,OREGON 97223
RECEIPT
DATE:„ - �— — AMC-)UN 1
)r l
NAME: �,� vac _� CASH: }
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ADDRESS: C 2 Z J tJ �C�t c�1 �5[�s[r�' CHEC
V 7 2 / _ M.O.:
I OF
FOR: ACCT. # PERMITS SURf:NARQl AMOUNT
SEWER BILLINGS 40-364 $
BUSINESS LICC.NSE 05-131
PLUMBING PERIv',!T 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 #2 30-363
ZONING ADJUSTMENTS 05-362
05-337
TOTAlb� y
RECEIVED BY: --
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PERMIT NUM9E1113 ASSIGNED:
Numbor Amount Numbor Amount Numbw Annoy, I
go
v�
RECEIPT I 24104
�
Perlar ...Bond
PEERLESS INSURANCE COMPANY
KEENE, NEW HAMPSHIRE
Bond No 12 09 18
KNOW ALL MEN By THESE PRESENTS, THAT WE,
Nendel's Management & Supply, Inc.
as Principal,and Peerless Insurance Company,a corporation duly organized and doing business under and by virtue of
the laws of the State of New Hampshire,and duly licensed for the purpose of making,guaranteeing or becoming sole surety
upon bonds or undertakings required or authorized by the laws of the said State, as Surety, are held and firmly bound unto
City of Tigard, Oregon
(Hereinafter celled the Obligeel,
in the sum of One thousand seven hundred and no/100-------------------
---------------------------------------- DOLLARS IE 1,700.00----r
for the payment whereof well and truly to be made we and each of us bind ourselves, our heirs. executors, administrators,
successors anJ assigns, jointly and severally,firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH THAT, WHFREAS, the above bounden PRINCIPAL entered
into a contract dated fq
with the said Obligee to do and perform the following wr,rk,to-wit;
cutting road S. W. Bonita Rd. at S. W. 7th
Marciene Terrace
Ordinance No. 7414
a wpy of which contract is or may be attached hereto, and is hereby referred to and made a part hereof.
NOW,THEREF:,`PF,if the above bounden Principal shall well and truly perform the work contracted to be performed
under said contract,then this obligation to be null and void;otherwise to remain In full force and effect. No right of action
shall accrue under this bond to or for the use of any person other than the said Obligee.
SIGNED AND SEALED THIS 21St day of March
A.D. 1919
WITNESS endel's Management &/S'uppl�y, Inc.
Peerless Insurance Company
WITNESS ..... .., . ........ By................ ".....rel ` +'...
Afforney•in-Fact
G. M. Dunning
form PSBUS
WILLIAM N. KEEFER
Architect / Consultant / Planner
P. O. BOX 1390 112 W. 12th ST., RM. 206A
VANCOUVER, WASHINGTON 98660
(206) 694-4941
March 21, 1979
Robert Hawkins
Robert Hawkins Construction
5340 S. W. 141st Street
Beaverton, Oregon 97005
RE: Marciene Terrace
Bob:
Projected cost of construction for sewer connection
and road cut:
$1,700.00
Sincerely,
r
Architect, William N. Keefdr
WNK: gs
MEMBER OF AMERICAN INSTITUTE OF ARCHITECTS
CONSTRUCTION SPECIFICATIONS INSTITUTE