10505 SW TIGARD STREET-1 FILE NO. '
TIGARD ST. - 10505 STR. OPN. :'ERMIT
Multn.0ma6lX C140u3lt. Oxrago=a
Date iim,
WHILE YOU WERE OUT
of__f;1r�� Cale -
Phone_.
TELEPHONED PLEASE CALL [ (/
RETURNI?D YOUR CALL WILL CALL AGAIN
WAN1S TO SEE YOU RUSN
' 111
Message
Vb-21
F',,#41 it"routing iequeal pad 7884
ROUTING — REQUEST
P(I�aso M
l TI FEAR To �1
f� 1 HANDLE -
L__I APPROVE
and
1 �
LJ FORWARD 24
Cl RETURN
Il KEEP OR DISCARD _ �ykt
ElREVIEW WITH ME
� n
F,om
OREGON
Pole Structures Inc.
13015S.W.Pacific Hwv.
Tigard, Oregon 9722.E
(.503)139-3602
Mr John Hagman, June-1 , 1988
This letter is to request the refund of $200.00 paid in lieu
of a bond for. Street Opening Permit #277-87. This can be
referenced to reciept # 28091 (City of Tigard) . All. work was
completed several months ago. Thank_you for your attention to
this matter. .
John -Boutinen
Oregon Pole Structures Inc.
6925 SW 160th
Beaverton, Oregon. 97007
I
CITY OF TIGARD
F-XPENDr1URE RDQUL'ST
This form is a multi-use form. Appropriate reoeipts must be attached. Documentation
is important for all purposes. Staple documentation to form.
VENDOR NO.: ,1 DATE: — 17-_C)J— `
PAYABLE TO: _ CI S-Y' �,e Sr!rv�� �teS ,�v��. REX_-AJE= BY:
--- f. Z5 S 0i
e r. 5700-7 _ * Approved request due Wednesday
10:00 AM to A/P for checks by
Friday.
fMISCELIANEOUS EXPENDITURES:te Description, Invoice No., etc. Account No. IUrrxu�t
REFUN�cc, , , 'asSLkr c -ZZ000 ZOOe!'
fit,�a►n,tt� " Z77-`d 7
TUrAL $ 200 �a
Mileage $0.255
APPROPRIATION BAIIANCE: — AS OF: ------- ---- S.(MIU IE: - —
(Ufi to $25.00) Section Manager _ Purch. Agent.
($25.01-2,500.00) Division Manager
($7.,500.01-7,500.00) Dept. Head
($7,500.01-15,000.00) City Administrator
($1.1,000.01- ?) Izl Contract. Review Board
ke/1501F
i
0 ,
Ail i !q VA" C
t C -e-".
7
�1/ `C,4-i C A-i o--
,r-4( .41,
eNl-
ho
/h
APRLICA_TION - STREET IMPRq -MENT/EXCAVATION COPY TO:
(WHITE)-FILE
ORDINA.,,cF NO 74-14 (YELLOW)-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) (PINK)-OTHER AGENCY/i
(BLUE)-APPLIC'ANT
APPROVED APPLICATION NO.: 3
1.3
NOT APPROVED C) CITY 01. 1 IGARD, OREGON s
FEC AMT.: : � __ _
PENDING FL•E. PMT. ❑ CITY HALL. RECEIPT Z•45 011
PENDING SECURITY [] PUBLIC WORKS DEPARTMENT BY -- DATE IL I l�7
PENDING AGENCY "OK" U Application and Progress Record
PENDING INFORMATION O FOR STREET IMPROVEMENT/EXCAVATION MwI ASEREQUREUBO ND
RE
ANNUAL 10C'.
PENDING VARIANCE ❑ _ --� —_ EXPIRATIO
PFR'"IT NO Z22 [.TATE ISSUED 7 BY: ZZ
(1)AAPPI ICAT OWN IS H RE Y M DE TO EXCAVATE FOR AND INSTALL_ — % � _.5;9_40
C` AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
_ --' t -APPLICANT 6Z5 SW l6 -
NAME
1+ 1
ADDRESS °1D7
+►" HN
CONTRACTOR 0 � 525-5,W, V94-NeS q� .
& Fs+•!9�t� X039.7'f/9
ME C ADDR ! --
PLANS BY ___ar
N ME - � AD6REl9 A� CITY
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $
DOLLARS
FOR OFFICE USE: 6"v MIN,.
(2) EXCAVATION DATA: 0.04 Xs ��•—
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT I CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
STREET
MD
Nc� EZOI.t> C-
R TION
E
Q
pa U
ESTIMATED STREET OPENING DATE: - 431-f l g
ESTIMATED STREET CLOSING DATE: —JA 11 / / `�� _ ED anY /�►(�_ /f��l�
— — —
(3) SECURITY NO. _ SECURITN'AMT: E _ > eL STREET
��. L..osED
SURETY CO.: NRAT
GHF_EK CASH O SOND r.
_. .._.� �i
(4) PLOT PLAN. INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISION /CONDITIONS-
FEATURES;
CONDITIONS:FEATURES; EXCAVATION LOCATII:N AND EXTENT.
•wA� '� --+ ._. /s� " sew..,No,.i 4171 /% Al, G
I
T IF �. ._ _ _ �l \ _ /'// S 1 //?S_ s?
•case ` r ll`/ _�__� -- 1 L1 I `_... ^_-_._ ------
1 I I I I
(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 REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE MURK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE DATE
r LONA RADIUS
DENDS NOT LONG RADIUS SERVICE
BENDS AS CONNECTION
GREATEN THAN 45
0
M Rf.OUIHED ` PIPE
20°MIN.
PREFER 30°
TRUNK, MAIN, OR WIRE SERV;CE TO
U LATERAL SEWER a CONTINUOUS At.4
` TRENCH WALL L
OR 2"1, 6" TEE FRAME.
4
MUST EXTEND FROM
NL f �t�PE �• SEWER TO UNDISTURBED
C. M�St P i' , EARTH.
_ e _
- a
— 4"1 4" BRACE
20° TO 700 COMPACTED GRAVEL
y RACKFIL L TO UNDISTURBED
. •„• EARTH, MINIMUM 2'-0” WIDE
MAIN, TRUNK, ORI (A ) R MAIN, TRUNK OR LATERAL
LATERAL SEWER �8
USE ONLY WHEN WORKING AREA
PROHIBITS USING (A)
COMPACTED GRAVEL UNDER 12r.
COMPACTED GRAVEL OR CONCRETE
ENCASEMENT BETWEEN 12' AND 16',*
DEPENDING ON SOIL CONDITION
CONCRETE ENCASEMENT OVER ISS
OVER 12' USE CAST IRON AND
COMPACTED GRAVEL IN LIEU OF
CONCRETE ENCASEMENT. ,•� I (•i
kMAY GO TO 24' DEPTH IF THE �I
TRENCH ABOVE THE PIPE IS
LIMITED TO 30, ACCORDING TO COMPLETE
BACKFILL CALCULATIONS. —CONCRETE
!;( ENCASEMENT
.I
r•'
I-,
VERTICAL _ POUR BASE FULL
(CONCRETE �� �.,A" �).� WIDTH OF TRENCH
ENCASEMENT)
t 1
TO BE USED ONLY
WITH PRIOR AGENCY r ��
APPROVAL..
I
SIDE SEWER l
CONNFOMONS ufo
Unlllod Sewors"AQMLy
CLASS D CLASS C
CQE�UI�-�D 1� J4L_L_ PU'TaL�c � w��"H�Iv �.sehe►.�r5�
R.pA� r_4C kv •GF' LON'(
(SURFACE RESTORATION MOUND EXCESS NATIVE MATERIAL
AS SP£CIFIED[STvtcE'r OVER TRENCH TO ALLOW
s Dc�a�K E.�•� FOR SETTLEMENT
1
UNDISTURBED • UNDISTURBED
EARTH •� •� EARTH
COMPACTED
CLEAN
WELL-GRADED .
3/44-0CRU9HM NATIVE
ROCK... . MATERIAL
r
• SELECT MATT:RIAL
' (CLEAN WELL-GRADED 3/4••-0
CLEAN WELL-GRADED CRUSHED ROCK REQUIRED WITH
3/4" -0 CRUSHED ROCK PIPE O.D. I PVC PIPE) d
PLUS 6"
N
PIPE BASE n
USE TO PIPE r
PIPE SPRINGLINE
BASE � •�: .' I \
4 ML4. FOR PIPE SMALLER THAN 24••
6•'M14. FOR PIPE 24' AND LARGER
PIPE BASE.
MATERIAL"
t
TRENCH BACKFILL DETAILS
Unified gowws"Agony
Moore emmefor,r.,
I
CITY OF TIG' RD No. 2800
13125 S.W. HALL BLVD �f7
P.O. BOX 23397 Date Z- '3l v/
TIGARD,OR 97223
Name
-54r, b
Address
Lot Block/Map Subdivision/Address
=> >oc, oC
Permit M's Bldg. Plumb Cash Check
r �l
Sewer Other Other Rec.
Acct. No. Description Am A
10.432 Building Permit Fees
10.431.600 Plumbing Permit Fees
10-431-601 Mechanical Permit Fees _
10.230.501 State Bldg. Tax i
10.433 Plans Check Fee
30.443 Sewer Connection
30.444 Sewer Inspection
51.448 Street Syst. Dev. Charge
52.449.610 _Parks I Syst. Dev. Charge
52.449.620 Parks 11 S�st. Dev. Charge
31.450 Storm Drainage Syst. Dev. Charge
10.430 Business Tax
10-434 Alarm Permit _
10.227 Bail _
10-455- Fines- TrafficfMisd/Parking
10.230- _ CPTA Traffic/Mild/Vic. Asst,
10.456 Indigent Defense
30-122.401 Sewer Service/USA
30.122-402 Sewer Service/City 30%
30 123 Sewer Sevice/City Maint.
30-125 Unmatched
31-124 Storm Drainage
40.475 Bancroft Prin. Pymt.
40.471 Bancroft Int. Pymt.
v- to 1
TOTAL _
ACCOUNTING COPY ( j
r>_er�.aztrexe�l•.:_.z1_�rr.�.rx�u r__-..+rx�llrr.����lu�..:.:�»-:�Inw�orrc s-�ar'.:cr�a�le�R:.a._:,rru:aa�r�.r.._�wrw�!•_..:-�Ils r.i
!
OREGON POLE STRUCTURES INC. 1250
6925 SW. 160TH 649.4392
BEAVERTON, OR 97007
9E-800/1232 PAY
TOTHE
ORDER OF.._
DOLLARS
kBR I
Plow
«Ike e
�nu IMPlow ti w W tkn.r-
FOR
n6pp 1 2 Soo ". 1 2 3 2060061: OL 203a 7116
_-�Irw�r--'--ial�nc-Ye-"'-.—"-w-=",....+.-� rl+�t�,,.,�.,. S-�oeuee�.•� ,aea-'v•,e�an... .r..�.zt�
Head Office No-023973
�J��l\ 1:22 S.W.Sixth Avenue•Suite?00
PnAlend,Oregon 972(N
December 31, 19 87 24-201
,230
PAY TO THE * * * * * * * *1 ,t * k * * 4r * * * * * IF * * * * **
ORDER OF * * * City of Tigard $ 200.00i
�r!/•�,, It�lll 11R 111 111111 .,4 y1 ••
�� �I'!I:II 711111 ' 111 1,1 1 1�
I +oml oum 11111111e1,1
DOLLARS
PURCHASER Oregon. Pole Structures, Inc. AUTHORIZED SIGNATURE
CASHIER'S CHECK
116023973116 1: 12300201, 11: 2L 99230 0116
,n PIEA,E TAKE THIS TO THE CASHIER FOR A RECEIPT
NAME: e`. la���� DATE: /z-
-7 7
_77 7
ACCT. # DESCRIPTION )MOUNT
_10-22000 Refundable Performance Bond Deposit $_ zl'
10-43500 Sign Permits HOP TU $
10-43600 Public Sewer Plan Check/Inspection Fee.— $
10-43'600 nublic_Storm Plan Check/Inspection Fee $
10-43600 Street Dedication/Public Improvement Fea $
C,r
0-43600 Street Opening Permit Z'77 7 $ c f
10--43601 Street and Traffic Marking $
21-44200 _ Street Light Fee $
10-43700 Subdivision Applications:
—� S MLP $
10-43800 Zoning Applications:
7-C CPA Z_OA PD Misc
SCE _ CU SLP V
10•-44000 Other Planning Fees:
SDR
Non refundable portion of Appeal Fees $
10-22000 Refundable portion of Appeal. Fees
10-45100 Document Sales:
_
Engrg. Planning Bldg. $
10--43000 _ Business Tax - - $
TO-,"AL
1045P/002.3P ,