16100 SW 76TH AVENUE FILE NO. Z01 8cJ _
nth AVE. - 16100 STR. OPN. PERMIT
APPLICATION - STREET. IMPRf -MENT/EXCAVATION COPY TO:
IK (WHITE) - FILE l
ORDINN.aCE NO. 74-14 (BLUE) 'INSP.(Bldg. Dept. )
I
INSTRUCTIONS ON SEPARATE SHEET YELLOW) -OTHER AGENCY
( � PINK) -APPLICANT
a
APPROVED x APPLICATION NO.: 236
NO Cha:
NOT APPROVED 11 CITY OF TIGARD, OREGON 'FEE AMT.: f g
CITY HALL � RECEIPT NO.: N.A.
PENDING FEE. PMT. ❑ --- --
PENDING SECURITY ❑ PUBLICWORKS DEPARTMENT BY . DATE _l___.1-__
- - - - - - - - - -
PENDING AGENCY ''OK'' ❑ Application and Progress Record N.A
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION MAINTENANCE BOND
A3 REQUIRE[:!
ANNUAL
FENDING VARIANCE EXPIRATION DATE:
207-85 Jan. 21 85 JSH
PERMIT NO.: DATE ISSUED: � L« , BY: . __—__
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALLra�e� ur__fang
material s _ _ AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT Waverly_ Construction Co. 10185 SW Riverwood Ln. Tigard Olt. 62.0-8129NE,
N ME ADDRESS CITY PHO
CONTRACTOR Same __
NAM[_ ADDRESS CITY PHONE
PLANS BY_ (d _City Engineers Direction
NAME ADDRESS CITY PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): E
DOLLARS
FOR oFPICE usE:
(2) EXCAVATION DATA: M1+
_ o.oz_xf = f N.A.
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAI4E SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
STREET
OPENED
SW 76th Avu. Kocl, 500' 511' Z' ()i I & Rock I TPa
E — -
Q
U —.
ESTIMATED STREET OPENING DATE: (:iLy to lip NoLiAled 8
ESTIMATED STREET CLOSING DATE: / E _
N.A. S'T'REET
(3) SECURITY NO. __ SECURITY AMT: E _ CLOSE _
SURETY CO.: - FINAL
FINAL
CERTIFIEDCHCCK U —CASH U ■ONO U INSPEC. _
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT. 1 . ) Work is limited to SW 76th Ave. ,
from Durham Rd. to North Boundary
I I z 1 In 1
of Bond Park # I (SBDV.); within
Lhe R/W of 76th.
-044. , — -—- ------ - - I ---
t7 o
CURB -
2. ) All work shall conform to
w S.W. 76th Ave.
City Engineers Direction &
m -
o t, Satisfaction.
3.) Traffic control is to he providt '
I I I I for byContractor.
Special conditintis (continued);
(4) NOTE: THE CITY OF TIGARD DOES NOT. HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUcr Wol4i- N'Nt 111
RIGHT-OF-WAY JURISDICTION 15 THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES 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.
(5) The City will not accept responsibility io: maintenance of 76th Avenue upon completion of th,
aforsaid work since said work is oftk3 012 Sm n&ance) nature and, further, since 760
Ave. is not a County or City Rd
APPLICANTS SIGN MME: �r), ■- - �✓ DAT[_ 781�tiIlL J *S
1/15/85
John:
Kenneth Waymire (620-8729) has talked to
Frank about grading, gravel and oil on SW 76th.
The street is a public right-of-way, according
to Frank, which would make i-*plocal jurisdiction.
Frank has requested that since Mr. Waymire is
paying for this on his own, we issue a permit at
no charge, with the following on the permit:
"The City will not accept any responsibility for
the maintenance, as this is not a County Road, nor
a City Road, and this work is a temporary and
maintenance nature."
Billie