This paper describes the design, construction, and monitoring of a permanent tieback retention system which permitted a 55-foot-deep excavation for an 16-story addition to the existing Good Samaritan Hospital in Cincinnati, Ohio. Tieback anchor capacity is developed in moderate-to-low-strength shale bedrock with intermittent thin limestone layers. The retention system provides temporary and permanent support for adjacent 5- and 10-story buildings and unbalanced lateral earth pressures due to sloping site topography. A permanently tiedback wall also supports a 17-to-33-foot-deep cut adjacent to the a-story parking structure in lieu of a conventional retaining wall
