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HomeMy WebLinkAbout5175 & 5153 Brooks Circle ROW Permit - : Z'N TE �KA �o �3 � `�a 3 . ' $� �Ro''t E � ����� � � OC� 3 i 2006 PERMIT TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EAS AND APPLICATION FOR INSTALLATION OF UTILITIES I. Location S� 75' ANv S/ S'3 81�DOKS Gllc'CLL�.' 2. Na�reofwork EXPoSE �'XI57'I�I� �P�P�E AA1l� Bol�E � IVE WA.Y AT 5�53��';BRboC,� PLOW �PR T� �A L; TC5 �175 aROOK CI�GL� 3. lndicate below items to be: affecrad and include a sketch cr pian of work to be done. Curb & Gutter Street Surface TraillSidewalk Trees: Pond/Wetlands (Publically owned Traffic Control Devices/Signs or Privately owned ) Drainage Utilities StructureBuildings Other ��.0 ��. 1 l� � F" 4. Method of Installation or Construction C_A B L C- P L o w /4 �� � 14(►� �'�' ��. 5. Work to start on or after: � �'� 3 ` ��and shall be completed by: � D�Y unless an extension granted to• by: , DATE STAFF/DATE ' 6. Will detouring oftraffic be necessary? N� 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 �tified in writin� at least 72 hours in advance of any detour being established, changed or discontinued. NAME OF APPLICANT Z N����� T�L��-� ��-. PHONE ° �SZ-`�' 4 ' 7-37 5 E , � PLEASE PRiNT FAX q 52- 22.fo - 375� ADDRESS �`�D COLGRt4d6 st. S,E, P�1AR. LA{2'� MN 55'S72-QZ9�t STREET CITY STATE ZIP NAME OF PARTY OR ORGANIZATION PERFORMING WORK CONTACT PERSON: �N $A�-�G'� EMERGENCY (24 HR.) PHONE #: �� Z q► g ` 5 P+ a1 ADDRESS DAY PHONE Q52- 22(0 -'7OW4- STREET CITY STATE ZIP _ The undersigned herewith accepts the terms and conditions of this permit by the City of Prior Lake as herein cont ' ed a a ree to fully comply therewith to the satisfaction of the City of Prior Lake. Signe Title: F-u���EE� Date: 1 79 oa - � . . . � •u��w�r�a� �.i.i� �xvz �oixa 30 A.LI� 3H.L O.L 4�.LZiOd�ZI �II .LSf1W Q3.L3'IdWO� SI �RIOM J�I�HM �.Lda 3l-I.L 'H.L1M a3I']dWO� 9g '1'7bHS ..ShiOISIAO?Id'IVI��dS„'I'7d Pl0 aPld (I) �110 3J�d t10 NMOHS S.LII3W�I1f1�32I'IdJ�'I'I'Id �idai � . ° � O , -/: : :,ce . .:� S�I210M �I'Igfld 10 'Zd�Q �1�fl Q�AO?Iddd - • , . � :palels �tqa�ay se suo►sino�d le►�ads yain� a�uep�oo�� u� auop aq oa x�on+ p�es `uoilL�i�ddu anoq� ay� u� paq���sap se auop aq oa x�om ay1 �o� pa�uel� �Cqa�ay si uo�ssruuad :a�e� aoud,}o ,tji� pies �tq uani� �S�np uoiaeziaoyane o3 auensand pue `suoqcaado y�ns �u��ano� ax�� �oi�d 30 ,C�i� ay� �o suoi�e�n�ai aya y�cro sa�adsa� ��c ui r(�dwo� o> >vawaa��e 3o uoq�apisuoa ul �Q�QIA02Id ��t�Id2If1S1�1i A.Li'IISb'I'I S$ , �� _�h '�I1 �iwaa� •o� 3dta�a� $ :aa3 ('�aa �O'I 'Puoq `yse ��dJI.L �.LPI(10Y�I`d �Jt.LI2If1��S 'I`dI�t�itrt�I13 .L1NRI�d 10 I�IOI.LdZI?IOH.Lfl`d J�'II�lO �Sfl A.LI� ?IO� «�» ,LI�[IHX� . ` . • E�LC3IBIT'�C" CITX pF PRIOR LAKE REGC�LATIONS PERTAINING TQ TFIB INSTALLATiON OR R�PAIR OF UNDERGR4UND UTILTTiES IN CI'FY STREETS - �R IN CITY' XtICyHT-OF-WAY/EASBMENTS The fdllowiz�g regulations and condltions consritute a part of the applicatIan made by any installer or conkactor for the installation of utilities in auy City sEreeE ri�ht-of-way or Cfty ntility easement and tl�c applicant, En makitig his applic�tion to do such work, shall a�roe to abide by these Xegulations and condidons: 1. The individu&1 obtainitig the permit shall, before comm�eing such work, noi�fy the City En�ine�r when the work ac each location is to commenee; and, when requested by the Engineer, shall submit plans and . � specificarioas. • 2. on c �� '�F 'ro��e .�lse a.,.r: st±ati j�m�ptl ne i the ', F,,Y�Q�SlCIIIg��tlt for ft�a� insnectien. 3. Thc public is to ba protected by the individual, at all times, from tho commencemtnt oF the work unt�l the completian and accept�»ce by the Ciry. Tha installer or contractor shall to conduct his operstions as to . csuse the mFnimum ineonveniettee to the gubliC. Tlie in�tatler ar eonnaetor shall furnish, erect, nnd maitttain, in accordance with the legally aacepted standards, all necessary wammg �nnd tra�c con�l si�s►s, barricades, traffic cones, and flashing li�his to direct and control the movement of traffic through the project in all directions and at all times. •� The foregoing provisions shail nat sn any way relior+e the inst�ller or contractor of any of his lagal responsibilities or lisbilities far the safety af the public. 4. All openinas in bitumindus surfaces shall be cut in n straight line witti ssdes smooth �ttd vertical. No , ra�ged edges wiil be permitted. Gutting shall be done witlz a concrete saw, cuttin� wheel, jack hammer, spades or similar approved tools• Backfill material shali be suitable for highway embankrne�t constructaon. No peat, froten lumps, broker� asphait, sod, roots, or other undeairable material shatl be permitted as backfili. Rocks largar than six inches (fi'� in diameter sha.11 not be uscd in back�illing of u�nches. 'I't�e backfill material shait be placed in layers not to accead one foot (1') and usechenically compaeted t+o not iess th�n 95 percent of modiffed ProCtor density. The upper �ix inches (6") of the bacicfill shall maet Minneeota HlEhway Depast�nent Specifications for Class 5 materiai and shalt be compactad to not iess tha� 95 parcant of mod�ed Procior density. As soon as pos�ible after backfill operations are completed, the cut bituminous edges of the trenc�h ahall be painted with an asphalt emalsion such as SS-i. Ymmociiate�l► ihereafter, the petchin$ msterial shall be pfaced and mechanicaliy compacted to not less thaa 95 p�cent of modified Proctor densiiy. 'Tha asphaltie material used in patching shall b� of tite same type as roraoved from the roadway, excxpt, that in no case, wiil a plant mixed asphalt o� less guality '�I�an M�nnosota Highway �epat�ettt Spec'�f'iCations Z331 he • usett, The finished surface of the patch shail confo�rn ta the surface of the undisturbed roadwaY• No permanent asphalt patches shail be on any base whost tertiperature is 3Z degrecs Fa�°n O ��' Cold weother patching shall be of terr►porary nature, using cold mixad asphalt, well �d arushad roek or similar approved mat�rials. Temporary patchcs sha11 be true to Iine and grade• Teml�oraTY Pa�� �� �e repIaced by permaneni patches when weather conditions permit and notffication shall be required �s stated uz 2. . �m.nac . PagC 3 of 4 �. EXHIBIT "C" S. Uther areas may be required to be cottzpacted at the direction of the City &ngituer. � 6. Such permitt�e to be responaibte for mauntenance and repair of all treacltos for a period of one (i) year and if settlement occura or oxeavation caves in, tt►e same shall ba promptly indic�bed by adequAte warning si�s and shall be testored to proper co�tdition in•accordance with speciIIcations above providod as soon as conditions permi� . 7. AII culverts �nd ditches shall be replaced in their ori�inal position and condition existiqg priar to constructio� and ao change ah�ll be mado in drain�tge withaut approval of tAe City Enginear. 8. Permittee shall save the Ciry ha�miess f�om all third party claims for iqjury or damage which may occur ' between the time the work eommences and the time it is finally acceptocl by the Gity. 9. The permittee may be required to jack or bore under certain stroets, as determiued by tha CYty �ngin�er. 10. The appticant shall fumIsh evidence of public llability insurauce of not less ihaa S104,000/300,OQ0 and property damage of not Iess then �23,000 i4sued by an insunmce comp�u►y �uthorired to do busiaess in the �� Stat$ of MinuesotA en whtch the City is named as � edditional inaurod pnrty. 11. Bxcept for the neglige»t acts of the City, its ageats and ib employees, tbe pmmittoe shall assurna all liability for, and save iho City, its agents and {ts empioyees, harcriless aed defead samo at its sole cost �nd expense from any and all elalms for damages, actions or canses of action arisii¢�g out of th� work to be doae �-� herei� and the contlnuitb uses by the p�rmittee, including bvt not limited to tbe placinp, constructing, and � recons'tructing, maintair�ing, protecting and usc of said facitiry unda' this appIIcation and permit f�or � construction. 12. k�cisting Facilities - Tho uteliry facility and instatiations shalI not interfere with any existing ui�lity faoility on the City's r�ght-of-way or easements. It is the responsibllity af the appticani to eatl for necessauy locations of existinm atilities. (Gopher One) 13. Private Property - Tha work pennit or pern�it for con�truction as issuod does uot in aay way imply that the appropriate easement exists to allow the applicant ta work on privata property. 14. Gt�tting Trees - Tiie peimissiot� herein grantad does not ooitfcr upon tho permittee the right to cttt, temove or destroy trees or shntbbery within the legul limits o£the right-of-way, easamer�ts that are not spacific�lly identi�ed on the plan attached to th�5 pamit or relieve permittee from obiaining any wnsent otherwise required from ibe pwaer of the properiy adjtaocnt theroto. iS. Clean-Up - Street, trailways and affected right-o�=way shaEl ba scraped elean at the end of esch work day and swept clean atier constraction is completed and left 9n a neat and psesentabla conditioa. . . 16. Replacement of Sod - Wh�ever top-soil and safl are dtsturbed, they sha11 be replaced in kind and maintained aatisfac�tortty until t�e turf is establishod. The uttdersigned hereby declaras kdshe has read and will comply with s1l the PfiRTIlJEIVT REGULA'fIONS as stated above an�i relevai�t City;Ordinances. DATE• � � � � - o (d 3IGNED: Q� ��,� page 4 of 4 � TOTAL P.63 � ... Q .a- �� ay. � on .. �� � �€� c4 � a x o ° ';�4� �����`' .�� J Pd�VD � � , ,., �� � 8 � � , ,� EM C g �+ g 4 P � � .:. r BUirEAF . V. �• '�. Y� � 3 � �� � p �� : �cxxnH � k � / �� �,� LdW�R PRkC1R LA14E ) p (i : �y' .' � _ ' ^ ' � 4 �� } �� ; � ... . •,. •;." ^ .� ': � :•:.... : � ' :: Q � � , �IDV1��lRL .. .. ' i ..:.. ..� .. . Ask. ..::',.." .,. ...� .: I . ' . .. . .. - . . ..... ir1 � < . .i :'f . . . ..� . . . h : wqYl�li�rt: -i 5' I . � IkMN�1�11 ......� :::.': . ....,. 'i: : � r 6 i�£ , � ..... . . , ♦ :. .- '�' `� . ! . , 0 � ' � AI °v` . 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