11632 11634 SW 98TH AVENUE EII,E NO. . j-1 til _
=t 11 AVE. - 11632/34 STR. OPA. PERMIT
NOTICE OF CANCELLATION
NATL BONDING E ACCIDEivf INS CO 4242 LINDELL BLYU ST LOUIS MO 63108
DATE OF NOTICE BOND NUMBER TYPE OF BOND PREMIUM EXPIRATIOP
4/18/77 298081L SEWEk I 5/14/77
kE CEI veo
L CITY
BOX 23397D 2�
AP 1917
E TIGARD OR 97223 CITY or. TIGgkU
E
GENTLEMEN:
THS ABOVE COMPANY HEREBY NOTIFIES YOU THAT IT HAS ELECTED TO CANCEL SAID 6JND IN ITS ENTIRETY.
SUCH CANCELLATION TO BECOME EFFECTIVE 30 DAYS AFTER RECEIPT OF THIS NOTICE.
THIS NOTICE IS GIVEN TO YOU IN ACCORDANCE WITH THE CANCELLATION P90VISION IN ABOVE MENTIONED
BOND.
BY
ATTORNEY-IN-FACT
R DECAL CLNSTRUCTION AND
'PLUMBING COMPANY
N 317 S W FL.UWER
C
I PURTLAND Ok 97201
P
A
L
TYPE OF CANCELLATION: NON—RENEWAL 1004
P
R
J
D HANSLN 6 kUWLANL 1NL
u PC BOX 1.633
C
E 1ALUMA WA S84U1
q
OBLIGEES COPY
cc Insco Insurance 3orvlon,Inc.
I
APPI_IC',T-ION — STREE- IMPF 'EMENT/EXCAVATION COPY TO:
ORDINmNCE NO. 74-14 U (WHITE) FILE
❑ (FLUE{-INSP.
(INSTRUCTIONS ON SEPAR fE SHEET) �] (FELLOW) -OTHER AGENCY
❑ IPINK) - APPLICANT
APPROVED APPLICATION NO.: _ 39
NOT APPROVED ] CITY OF TIGARD, OREGON FEE AMT.: S
PENDING FEE. PMT. ❑ CITY HALL RECEIPT
/NO.:
PENDING SECURITY ❑ PUBLICWORKS UEPARTMENT BY __ DATE�Z / 7fIB
PE VDING AGENCY ''OK" r_1Application and Progress Record — — — — — — — — — — — — — — — —
MAINTENANCE BOU
F_NDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED _6n.J
ANNUAL
SJ<�-
PENDING VARIANCE ❑ EXPIRATION DATE:
PERMIT NO.: _ _` �" - DATE ISL`UED: Z�_1 ti'° BY: _
(1) APPLICATION IS H •R BY MADE TO EXCAVATE FOR AND INSTALL — S,D 7 Le.2C f-
Se f ✓ICC 2 ,AS DESCRIBED HEREIN, IN FULL ACCORDANCE WI H 11Y REQUIREMENTS.
APPLICANT GI L 6q t�( l � '�GtJ FLVai-C C
NAME 1 Aj3DRE 5 CI PHONE
CONTRACTOR
�� _ / --
'ApOP[Yf-S-S C17V PHONE
PLANS BY _ _
�_
-- NAME-------"�-- ----AppRtS9 CITU �� — PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST):, I
f DOLLARS
(2) EXCAVATION DATA: FOR OFFICESE:
0.02 X $---fit! I= S—
STREET DESCRIPTION _PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE By
_ TYPE LENGTH WIDTH DEPTH ITEM A QVAN"'ITY
C STREET —
R TION
Q
E
ESTIMATED STREET OPENING DATE: g
ESTIMATED STREET CLOSING DATE;
E
U
STREET
(3) SECURITY "10. _ __ SECU IT AMT.: t. CLOSED
SURETY CO.: 14, 51�— w� c u a �4{.� FINAL --
CERTIFIEDCHECK it C SM a BOND d INSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINrNT PHYSICAL SPECIAL PROVISIONS /CONDITIONS.
FEATURES; EXCAVATION TICIF AND EXTENT.
1 I M rn u
-----
T -- -
(5( NOTE THE CITY OF TIGARD DOES NOT, HERESY, GRANT PWRMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-or-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 SPtCIFICATIONS PERT:IlZNT TO CONDUCT OF THE WORK. AND TO SAVE HARMLEIS 'rHE CITY AND
EMPLOYEES AGAINST ANY INJURY OA DAMA GE WHICH IAAY "TRULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE - � �J fy 0ATE I
SEWER w,4NTRACTOR %j LICENSE
UNIFIED SEWERAGE AGENCY NC. ,Z S'
WASHINGTON COUNTY, ORF_GON DATE June 1 , 1976
I Pursuant to application ai,d under the terms ano conditions of
the ordinances and regulations of the Agency,
___DE CAL_CONSTRUCTION AND_PLUMBING
Name
0317_S_ W. FLOWER, PORTLAND,_ORE._97201-_246-3895
Address Phone
is hereby granted a license as a sewer contractor revocable
without notice to said licensee upon failure to comply with
the terms and conditions of said or-linarces and regulations.
Thiel licensk- is a personal license and is not transferable.
Receipt is ?iereby acknowledged of payment of the- sum of
� q L1a for this license.
UNIFIED SEWERAGE AGENCY
Expiration Date June 1 , 1977 BY l/ 4_
j c;y
J,.
VASHINGTON 1
7 V n rz 0 0.j
S
P,
�j..,'..EWER CC rjo�kj'�
j
KNGW ALT, MEitj ry -,7y,7-r mr�
Via
:1 r)2cal
ConntructicM & Plumbing Jo,.,jn T-r4n4r!A,j
a .corporation duly organized nnd
-at
------21PW Tork �'tn Or. -0 of
and Irt ",
the State of Ore—gin—p —aO 2JUTety p-,! in
Sewerage Agency, a munj.cj1)21 7, .._111d r
�
Of Oregon, in this penalO:� Ont State
($2,5nn.o0), lawfl!,.
And truly to be made, via b!r.4 ni,, G� will
assigns, and wiccessorr, jointly r-1 f4 r-C-ni-alatrators,
"'Y thesa rrcoonts,
Now, nmrmrij, 7 QT.1-7AT!1n 73 rUC!I, that
if Lho said prinelpal abon,:3 naw..,j cOMP
sewer regulations of the Tinl!lcd 17 with nl). ol tj-,3
or havir.-I P 14
4CA to corply,
will correct any defective Morknat."
unable time cat forth by the Un"r-!, JqJ. &,hfn a rias_1^
save harmless the Unified !.n-cry nna
of violation of any of the q 313VOT Cn account
. -i V2 to ab?-',Tjt!.O.j r1hn1-1 be
null and void, othejn-yjsq to rem3ln . -i
any property owner or other and c�l%xt;
have n right of action on V-119 its i"n7 be Cj:,cnrnnd shall
-jr :)2
Sewer Re8l"Ationis in an a=unt C.,
Of th3
This bond shall be oni r-,,,,
of the surety for the sgg-'ngv.t, r -.1 E:.? VI:Y "X!
under shall in no event exceed ,
The tja�jlity of th-1 00,3
In full force and cf1C Phrl! ?.--I end
effect Car a r 7T
vc; haarco" -.lith
annual newal neceadtiry. -717 o
_rminr
1iR0"' Otyupc
b�o n 7tir n�� tke Ono Year rr! d'.1yn nftnr reenn
by the obligee of a 1171ritteM,n int
agent stating that the ljmjjl. it-, i'-liorfnad
cancelled; and provided f�lrth'31,
n r cry rf.rb#,
or liabilities which shall lieve o(,,. pxij�c '0 L:,3 of
Sur., termination.
instrument X' WITNESS WMREorl ila-,!n Cec.-ited t..!,13
h in 10th day of
PR I
Aoant for, Oreron
5 24 gate: