HomeMy WebLinkAbout5307 Lemley Cir Right of Way Permit � .
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WORK ORDER �� d3� a � 3
. M�NNESD�P PERMIT .
TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS
AND
APPLICATION FOR INSTALLATION OF UTILITIES .
1. T.ocation 33 0'7 L. EMGE1/ L� //2 S�:
2. NadueofWork Install new 5/8" Plastic gas service line. .
3. Indicate below items to be affected and, include a sketch or plan of work to be don,e;
,
Curb & Gutter Street Surface
TraiUSidewalk Trees:
Pond/Wetlands (Publically owned
Traffic Control Devices/S6gns or Privately owned _)
Drainage Urilities
Structure/Buildings � !�/1��5 G'�v�[
4. Method of Installation or Construction �D/L/lt/C�
S. Work to statt on or after. '7 '' 0� aad shall be completed by: /a -3/-�O (o unless an . extension
" granted to: by:
DATE STAFF/DATE
6. Will detouring of traffic be necessary? N� If necessary to dewur traffic, describe suggested
m�ate:
?. Provide with this application a copy of the contractors Public Liability Insurance.
DETOURS: The Director of Public Works shall be notified in wririn� ac least 72 hoLrs in advance of
any detour being established, changed or discontinued.
NAMEOFAPPLICANT CenterPoint Energy _. .. p 612-321
PLEASE PRINT FAX 612-321-5480
ADDRESS �00 Linden Avenue West, P.O. Box 1165, Minneapolis, MN 55440-1165
STREET CITY STATE Z�
NAME OF PARTY OR ORGANIZATION PERFORMING WORK Michels Corp.
. CONTACT PERSON: Steve� Johnson. EMERGENCY (24 HR.) PHONE #: 612-372-5050
ADDRESS DAY PHONE 612-3� �-50.�,6
STREET CITY STATE ZIP
The undersigned henwith accepts the terms and conditions of this permit by the City of Prior Lake as herein
contained and ee to y c mply therewith to the satisfaction of the City of Prior Lake.
Signed' 'Iitle• Eng . As s is t. Date. ��°� a ��
;
� Page 1 of 4
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. i612) 447-4230 / Fax (612) 447-4245
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EXHIBIT KC"
FOR CITY USE ONLY AUTHORIZATION OF PERNIIT
FINANCIAL SECURITY: AMOiJNT: TYPE: `
(Cash, bond, LOC etc.)
F�: $�� 0 ��� Receipt No. / $ OI Pennit No. 'O6 "
LIABILITY INSURANCE PRQVIDED: Associated Electric & Gas Insurance Services Limited
In consideration of agreemenc to comply in all respecu with the regulations of the Ciry of Prior Lake covering such
opetations, and pursuant to authorization duly given by said Ciry of Prior Lake; permission is hereby grauted for the
work to be done as described in the above application, said work to be done in accordance with special provisions as
heraby stated:
APPROVED BY: DEPT. OF PUBLIC WORKS
sY: ' `�-�-
/DATE
ALL LEGAL REQUIREMENTS SHOWN ON PAGE ONE (1) AND ON ALL "SPECIAL PROVISIONS" SHALL
BE COMPLIFD WITH. Tf� DATE WI�N WORK IS COMPLETED MUST BE REPORTED TO THE CITY
OF PRIOR LAKE CITY ENGINEER.
� Page 2 of 4
t
� EXHIBIT "C"
CITY OF PRIOR LAKE
REGULATIONS PERTAINING TO THE INSTALLATION OR
REPAIR OF UNDERGROUND UTILITIES IN CITY STREETS
OR IN CITY RIGHT-OF-WAY/EASEMENTS
The following regulations and conditions constitute a part of the application made by any installer or contractor for
the insta(lation of utilities in any City street right-of-way or City utility easement and the applicant, in making his
application to do such work, shall agree to abide by these regulations and conditions: �
L The individual obtaining the permit shall, before commencing such work, notify the City Engineer when
the work at each location is to commence; and, when requested by the Engineer, shall submit plans and '
specifications. .
2. Unon comnletion of the oroi�ct the individLal thail orom„��v notifv the C'iry��ineerin� Dgnartment for
fie_a_l� �on
3. The public is to be protected by the individual, at all times, from the commencement of the work until the
completion and acceptance by the City. The installer or contractor shal! so conduct his operations as to
cause the minimum inconvenience to the public. The installer or contractor shall furnish, erect, and
maintain, in accordance with the legally accepted standards, all necessary warning and tra�c control signs,
bazricades, traffic cones, and flashing lights to direct and control the movement of traffic through the
project in all directions and at all times.
The foregoing provisions shall not in any way relieve the installer or contractor of any of his legal
. responsibilities or liabilities for the safety of the public. '
4• All openings in bituminous surfaces shall be cut in a straight line with sides smooth and vertic�l. No
ragged edges will be permitted. Cutting shall be done with a concrete saw, cutting wheel, jack haznmer,
spades or similar approved tools.
Backfill material shall be suitable for highway embankment construction. No peat, frozen lumps, broken
asphalt, sod, roots, or other undesirable material shall be permitted as backfill. Rocks larger than six inches
(6") in diameter shatl not be used in backfilling of trenches.
The backfill material shall be placed in layers not to exceed one foot (1') and mechanically compacted to
not less than 95 percent of modified Proctor density.
The upper six inches (6") of the backfiIl shall meet Minnesota Highway Department Specifications for
Class 5 material and shall be compacted to not less than 95 percent of modified Proctor density.
As soon as possible after backfill operarions aze completed, the cut bituminous edges of the trench shall be
painted with an asphalt emulsion such as SS-1. Immediately thereafter, the patching material shail be
placed and mechanicalty compacted to not less than 95 percent of modified Proctor density. The asphaltic
material used in patching shall be of the same type as removed from the roadway, except, that in no case,
will a plant mixed asphalt of less quality than Minnesota Highway Departinent Specifications 2331 be
used. The finished surface of the patch shall conform to the surface of the undisturbed roadway.
No permanent asphalt patches shall be on any base whose temperature is 32 degrees Fahres�heit or less.
Cold weather patching shall be of temporary nature, using cold mixed asphalt, well graded crushed rock or
simitar approved materials. Temporary patches shali be true to line and grade. Temporary patches sltall be
replaced by permanent patches when weather conditions permit and notification shall be required as stated
in 2.
�ac.noc Page 3 of 4 _
� �
EXHIBIT "C"
5. Other areas may be required to be compacted at the direction of the Ciry Engineer.
6. Such permittee to be responsible for maintenance and repair of all trenches for a period of one (1) year and
if settlement occurs or excavation caves in, the same shall be promptly indicated by adequate warning signs
aad shall be restored to proper condition in � accordance with specifications above provided as soon as
conditions permit.
7. All culverts and ditches shaq be replaced in their original position and condition existing prior to
construction and no change shall be made in drainage without approval of the City Engineer.
8. Pecmittee shall save the City harmless from all third party claims for injury or damage which may occw
between the time the work commences and the time it is finally accepted by the City.
9. The permittee may be required to jack or bore under certain streets, as determined by the City Engineer.
10. The applicant shall furnish evidence of public liabiliry insurance of not less than $100,000/300,000 and
property damage of not less than $25,000 issued by an insurance company authorized to do business in the
State of Minnesota on which the Ciry is named as an additional insured party.
11. Except for the neg(igent acts of the City, its agenu and its employees, the permittee shall assume all
liability for, and save the City, its agents and iu employees, harmless and defend same at its sole cost and
expense from any and all claims for damages, actions or causes of action arising out of the work to be done
herein and the continuing uses by the permittee, including but not limited to the placing, constructing, and
reconstructing, maintaining, protecting and use of said faciliry under this application and permit for
conswcrion.
12. Existing Facilities - The utility facility and installations shall not interfere with any existing utility faciiity
oa the City's right-of-way or easements. It is the responsibiliry of the applicant to call for necessary
la�tions of existing uulities. (Gopher One)
13. Private Properry - The work permit or permit for construction as issued does not in any way imply that the
apptopriate easement exisu to allow the applicant to work on private property.
14. Cutting Trees - The permission herein granted does not confer upon the permittee the right to cut, romove
or destroy trees or shrubbery within the legal limits of the right-of-way, easements that are not specifically
identified on the plan attached to this permit or relieve permittee from obtaining any consent otherwise
t�equired from the owner of the property adjacent thereto.
15. Clean-Up - Street, trailways and affected right-of-way shall be scraped clean at the end of each work day
aad swept clean after construction is completed and left in a neat and presentabie condition.
16. Replacement of Sod - Wherever top-soil and sod are disturbed, they shall be replaced in kind and
maintained satisfactorily until the turf is established.
The undersigned hereby declares he/she has read and will comply with all the PERTINENT REGULATIONS as
stated above and relevant Ciry Ordinances.
DATE: �� °� °� � �O SIGNED:
��� Page 4 of 4
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V WORK ORDER � 3�'� ?�y,"� 7
�. PERNIIT �
'�t�N1VESp'� .
TO WORK WI'THIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS
t�ND
APPLICATION FOR INSTALLATION OF UTILITIES •
1. Location c « , .
, � .
2. Nature of Work
�� 3��I�dicate below items to be affected and include a sketch or plan of work to be done.
� g �� Street Surface
TraiUSidawalk T��
Pond/Wetlands (Publically owned
4 Traffic Conirol Devices/Si�s or Privately owned _)
Drai�age . �C_ Utilities
Structure/Buildings Other
4. Method of Installation or Construction �� ���'� ��� � �-i/�
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5. Work to start on or after: q-�� D S and shall be completed by: l7. -�i •.8�� unless an extension'
' '. granted to: by:
DATE _ � STAFF/DATE .
6. Will detouring of traffic be necessary7 V`� O If necessary to detour traffic, describe suggested
route•
7. Provide with this application a copy of the contractors Public Liabiliry lnsurance.
DETOURS:. The Director of Public Works shall be notified in writjp� at least 72 hours in advance of
any detour being established, changed or discontinued.
� NAME OF APPLICANT CenterPoint Energy, �o PHONE �OLZ - 3Z� -�y$Z-
PLEASEPRINT FAX 612-321-5480
ADDRESS �00 Linden Avenue West, P.O. Box 1165, Minneapolis, I�1 55440-1165
, ' STREET CITY STATE �
NAME OF PARTY OR ORGANIZATION PERFORMING WORK �'''"- ��
CONTACT PERSON: EMERGENCY (24 HR.) PHONE #: 612-372-5050
ADDRESS DAY PHONE
g��g'I' CITY STATE ZIP
The u�dersigned herewith accapts the terms and conditions of this permit by the City of Prior Lake as herein
contained and agree to fully comply therewith to the satisfaction of the City of Prior Lake.
Signed: YSLih.La1'�y����,_Title• �.C�.—Date• � ' � - O?��_
� ��,� Page 1 of 4 �
16200 Eagle Creek Ave. S.E., Prtor Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
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FOR CITY USfi ONLY ' AUTHORIZATlON OF PBRMIT �
• FINANCIAL SECURt'!'Y: AMOiJNT: ' _—TYPE: � .
(C7ash, bond, LOC etc.)
�O. fl� Receipt No. �� ,_ I Permit No. V� �
Fee: � •
L�pg�,�y�SURANCEpROVIDED: Associated Elc�ctric & Gas Insurance Services Limited
In consideration of agreement to comply in all respects with the iegulations of the City of Prior Laka coveriag such
� operations, and pursuant w authorization duly given by said Ciry of Prior Lake; permission is h�reby granted for the
work to be done as described in the above application, said work to be done in accordance with special provis�ons as
hereby stated:
' APPROVED BY: DEPT. O� PUBLIC WORKS '
� B /.� � - 22 - D b � .
y � /DATE .
ALL LEGAL REQUIREMENTS SHOWN ON PA�G�E OINE ( � 1 �LE�T�ED MUST BE REP RTED �NS�. �L
BE COMPLIED WITH. THE DATE WHEI� W .
� OF PRIOR LAKE CITY ENGINEER. •
� , Page 2 of 4 .
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NOTE: BORE ALL PAVED STREETS AND DRIVEWAYS
Minimum depth requirements for pneumagopher crossings
of state highways and county roads is 60". Minimum a*o*� `'' N C CenterPoint
depth requirements for pneumagopher crossings of city T���� Ejjg�y
streets and township roads is 48". Minimum depth for W E
parallei installations on state highways and county "'�"°E
roads is 36". Minimum depth for parallel installations �x „,,,,�, ,r,r"N�" $ PROPRIETARY
on city streets and township roads is 3U". Q „- � D
`�`"s"" �°�°� 1" : 150 � AND
INSTALL 2" TR CL-6 MAIN 6'-7' BACK OF CURB ��� "'"�""�`°°"""�"°"
� �, ������ CONFIDENTIAL
�—�� --� 38673472
T= INSTALL 2" TR TEE
E= INSTALL 2" TR 90 DEG ELL M27100 PRIOR UvcE
C= INSTALL 2" TR CAP AT LOT LINE OR SINGLE MAIN IN BOULEVARD
TO COVER SERVICE ON CUL-DE-SAC
i hereby certify that this plan, specification, or report � �"
was prepared by me or under my direct supervision and that I am � N1N27T115/R22
a duly Licensed Registered Professional Engineer under the * a this page
laws of the State of Minn sota.
Signature• �
Type Pri ted N�n D vid Hennin s aard p�pE ��p
Date ��^��,,,� REG. No. 22174 2z53' 2"rnGl-6
2253' PIPE
DESIGN11fPE:Mafn
__ __ . ..._.. CSAH ---_ _ � _ --�-- --- - --- - - MNN DEPTH: min 3 R
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MAP WORK NEEDED?: Yes
SURVEYOR REQUIRED?: No
COPIES TO CORROSION�: No
�' CORROSION APPROVAL:
WA
EXISTING DD NUMBERS:N/A
6" TR CL-6
A6365-2003 ADDAION: WIlDS RIDGE NORTH
65' SCL COUNN RD 42
12' S OF BOC TYPE:NBRE
INSTALL MAPS: 2-27
6"X2" TR HVPT
CONTINUE �� ����
2" TR SOUTH �M�����'
PERMlTS: PRIOR UI�, SOOTT COUNIY
� DESIGNED 81f:
^ rlarda Kolsted
$ 612-321-5482
PROPOSED � PROPO ED ��
5' CONCRETE SIDEWALK 8' BITU INUS TRAIL �
WEST SIDE EAST SI E ��; f�..
10' FROM BACK OF CURB 7' FRO BACK O� CURB
TO SIDEWALK TO TRAi
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PROPOSED
2" TR CAP, CL-6
36539234
� INSTALL . ..- --
2" TR 9A DEG ELL ----JEFFERSFKWY--- -----._..__..__._._.i
CONTINUE E
� 2" TR WEST
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Q = 4" PVG SLEEVE
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