HomeMy WebLinkAbout16227 Franklin Trl ROW Permit .� _
EXHIBIT "C"
?l9S 7a�` Olo —OS 1 P
P�RMIT
TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS
AND
APPLICATION FOR INSTALLATION OF UTILITIES
1. Location �L�ZZ7 FRAA11C1.1 N TR,R1 L
2. Nature of Work ExPOSE A1�1D R'�PL.ACE F'IA1LI NC9 SEGTIO N C�F '[�LE. CA$�
3. indicats below items to be affecred and ir.clude a sketch or plan of work to be done.
Curb & Gutter Street Surface
TraiUSidewalk Trees:
Pond/Wetlands (Publically owned
Traffic Control Devices/Signs or Privately owned _)
Drainage Utilities
StructureBuildings Other $ l.. V D. ^
4. Method of Installation or Construction �-KHDE .� PHEu�mr�r►e. �aRC.
5. Work to start on or after: ��'$,�� and shall be completed by: � DAy unless an extension
granted to: by:
, DATE STAFF/DATE
' 6. Will detouring of traffic be necessary? NO If necessary to detour traffic, describe suggested
route:
7. Provide with this application a copy of the contractors Public Liability Insurance.
DETOURS: The Director of Public Works shall be notified in writing at least 72 hours in advance of
any detour being established, changed or discontinued.
NAME OF APPLICANT = N� E C��R TE..L �C�.� ��f�... PHONE R S Z' `��"37 SP..a
PLEASE PRINT FAX 952- 22.(0 - 375f�
ADDRESS '`�qp ����� �♦• S�E� P�tOR. I.AKf� MN 55372- A29�
STREET CITY STATE ZIP
NAME OF PARTY OR ORGANIZATION PERFORMING WORK
CONTACT PERSON: �N SARLRGE.. EMERGENCY (24 HR.) PHONE #: � � 2- 91 g - S 9 S l
ADDRESS DAY PHONE q52• 22(0 - 7flle4
STREET CITY STATE ZIP _
The undersigned herewith accepts the terms and conditions of this permit by the City of Prior Lake as herein
co ' ed an�.a e to fully comply therewith to the satisfaction of the City of Prior Lake.
Signe : Title: ����NEER--� Date: ��" Z?"��
79
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A
• E�LHIBIT'
CITY p� PRIOR LAKE
REGULATIONS PERTAINING TQ THS INSTALLA'F�ON OR
R�PAiR O� UNDERGROUND UTILTTiES IN CT`X`Y STREETS
� OR IN CITY' 1tiCrHT-OF-WA'YIEASEMBNTS
T'he fdliowiztg regulations and conditions consritute a part of the applicat[�n made by any inst�llcr or contractor for
ihe installation of utilities in a�y City street ri�ht-of-way or City utillty easemont and th,e applicant, in makit�g his
application to do such work, shall agree to abide by d�ese ragulations and cot3didons:
I. The individual obtaittitig the permit shall, before comm�cin� such work, notify the City Etyitu:�r when
the work ac each location is to c:onunence; and, wheu requested by the Engineer, shall submit plans and . •
specificadons. '
2. Tj�°n comjtj���, oi ■L��?,�4j�„ the a a: .�a ,� sheil � tiv noti th i ��ineer' p L�r»artmee! fer
fjnal �n i n.
3. The public is to be protected by the individusl, at all times, from thc commencement oFthe work untiE the
completion �d ac�eptance by the City. The installer or conVactor shall so caatduct his operntions as to
� csuse tlse minimum inconvenience to ttie pubiic. 'Y'he it�staller oc contractor si�all furnish, erx� and
maitttain, in accordance with the legally accepted standards, all t�ecessary wammg �nd traffic contr�l signs,
barricades, traffec cones, �nd flashing ligltts to direct and colth'ol the movement of traffc tht'ough the
project in all directions and at all tirnes.
•• The foregoing provisions shall n4t in any way r�lier+e the mstaller or contactor of sny of his legal
responsibilitiea or lisbilitios for the safety of tha public.
4. All openings in bitu�ninous surfaces shali be cut in a sttaight tirle with sidcs �nooih and vertical. Na ,
ra�ged �dges will be permitted. Gutting sha11 be done with a concrete saw, cuttina wheei, jack hau'►mer,
spades or similar approved toats.
Backfifl material shall be suitable fttr hlghway embankme�at No peat, frozen l�unps, broken
asphaIt, sod, roots, or other undesirable materisl sha11 b� permitted as backfill. Rocics larger tl�an six inches
{6'� in diameter shall not be used in back�illing af uenches.
The back#ill material shall be placed in layers not to exceed one f4ot (t') and mechsn[oally compacted t�o
not less thaci 95 percent of modified PracZor dansity.
The apper six iriches (6") of the backfill shall meet Minnesota Hi$l�way Depasiment Specificat�ons for
Class 5 materiai and shall be compaCted ro not iess thar► 95 porcent of modif4ed Prociar density.
As soon as possible after baelcfill operations are completed, the cut bitucninc►us edges of tha trettc�h ehall be
painted with an asphalt emulsion such as SS-1. Immediately thereafter, t3ze patolilnS materEaZ a��1� be
ptaeed and meehanteally cotnpaeted to not less ihan 9S pereant of mod�ed Proctor density. The asphaltie
material used in patching shall b� of the same type as remaved fi'om the roadway, excapt, that in no case,
w�ll a plant mixed asphalt of lcss qua�ity tltar Minnesota Highwsy 77eparmuent SpeciScsttons �331 h$
, uaed, Tiie fenished sarface of the patch shail confo�n ta tl�►e surface of the u�istnrbed ibadway.
No permanent a�phalt patches shall be on any base whose temperature is 32 degrees Fa�u�eit or less.
Colct weather patchiag shail be of temporary nahtre, vsing coId mixed asphalt, weA gr�cied arushed tock or
similar approved materisls. Temporary patChcs shall be ttuc to Iine and grade. Te�po.rarY Patchos shall be
rcplaced by permznent patches when weather eanditions pecmit atsd notification shall be �uirrtd as stated
in 2. .
��,� , Page 3 of 4
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Fi}Q��� a`'n
5. Othec areas may be required to be compacted at the direction of the Cfty Engineer.
� 6. Such perntittee to be nsponaible for mainienaace and repair of all trenches for a period of one (t) year and
if settlemGnt occurs or oxcavation caves in, the aame shatl be promptly indlcated by ndequs�e warniAg siigns
and shall be restored to proper cqndltion in • accordaace with spxlIIcatfons above provided as soon as
conditivas permit. ,
7. All culverts snd ditc.hes a�all bc replacad in ttieir ori�inal positian and condition existiag prior to
construction and no chan�e sball be made in draitt�ge without approval of tha City E»gincor.
8. Permittee shall save the City hai7nlcss from all t�ird perty etaims for iq�ury or damage wt�ich may occur "
between the tftue the woric eommences and the time it is fmally acc�pted by the Gtity.
9. The permiaee may be requind to}ack or bore under certain stnets, as det�rrmmiaed by the C�y Lngine�r
10. Tbe appticant shall fumish evidence of public liability insurance of not less thnn � 100,000/300,000 and
properry damu�e of not iess than $23,000 issued by sm insurance comg�y authorind to do buslness in the
� State of Minneaoui on wh�ch the City is namod as er, additional inaurod psny.
11. Bxcept for the ne�ligent acts of the City, its �gent� and ib employees, the permittee shall assume ali
iiabiliry for, end save tho City, its agtnts nnd its dnployees, haimleas and dafend samo at its aole cost �d
expense from any and all etaicns for damages, actions or causes of action arismg out of the work to be done
•-• hGreiu and the continuine uses by the pa'miitee, ineludleg but nat limited to the placin4, conaicucting, end �
reconstructittg, maintaining, protectir�g and usc of said facitiry wtda' tl�fs application and permit for
� con�trttction.
12. k�cisting Facilities - The utiliry f�cility and i�nstatlations shell not interfero with any existing utility faoiUty
on the City's r�ght-of-w�y ar �assements. It is t�e responaibllity of tbe applicant to eall for necessary
locations of existing utilities. (Oopher One)
13. Private Properly - The wark peimit or permit for construction as issued does not in a�y way imply that tha
appropriate �asement exista to allow the applicant to work on pmate property.
14. Cutting 'IYees - Ttie pe�missiot� herein grant�d doos not corcfer upon tlte pw�mittee the right to cttt, x'emove
or dostroy hees or shrubbery witi�in the legal timits of the nght of-way, easaments thai are not apeci�cally
identi�ied on tl�e pian attached to this pexmlt or relleve peamittee from obiaini�g any consent othawise
reqt�it'ed from ibe owaer of the property adj�ctnc theroto.
1S. Clean-Up - Street, trniiways and affected rlght-of�wny shall be sciaped elean at the end of each work dary
and swept cleaa aft�r constcnction is completed aac! left in a neat and pzeseatable condition. . .
16. R,eplacement of 5od � Wh�+er top-soil and sod are dtsturbed, thoy shall be raplaced in lctoc! and
maintained satisfaotority unt[1 tha turf is ostablfshed.
The uttdersigned bereby dcclaras hdsbe has read attd wiil comply with all the PERTII�iSIJT REGULATtQNS �s
stated above a��i nolevai►t City.Ordinances.
DATE• !� - Z fo - D[0 3IGNED:
��,� psge 4 af 4 •
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