HomeMy WebLinkAboutFremont Ave & CR 82 ROW Permit .SEP-19-2006 10�32 CITY OF PRIOR LAKE MAINT P.02i07
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�. PERNIIT �
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TU �VOR� WITHIN CTTY P�tOPER'1"YIRIG�X''-OF-WAX/EASEN�NTS
AND . .
APP�ICAxION �'OR II�STALLA'�'ION (�F U'�;�'Z']f�S
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1. F ooat�os� �„�,r � M T -- �
.� �� _ ��.�. �./�s �� � ca � ��� ►- .� �z��t
2. Nature of Woxk „l°e� f
3. }�mdieate belovv iter�s Co be affect�d end i�elnde a sketcb. or plan of wprk to be done. ��
Ctiarb & Gutter _„^ Stteet 3urfaco
T � 'IralUSide'wallc � Txees: ,
� . Pond/Wetlands (Pubiieally nwned
� 'S�affic Gor►�vl be�i,ces/Sigs�s , oz Privat�ty ovmed �,_,_,�
. ���� Udlities � .
� � StructurelSui(d'uags Othar
4. Mctl7od of �nstallation or Cons�-tiction _�� P e�- � f ar`c. � --
5. Work tv stsrt o� or aftcr: � 3�`�'�' and sball be completed by: �,D 3Q��e � unless an extension
gxa�ted to• . -� by; , �
DATE ST'AFF/Dt1TE
b. tiVill detouriug of traff'ic be necessary? �, � a ---- If nccessary W detour traffic, descrzbe suggested
r�ute: �
7. Provide with this applic�'tion a copy of #he �ontraatarg Publie Liability �nsurance:
DETOU�tS: The Director af Public Warks sh�ll bc ' in ''nQ ea ut advance of
s,ny dctour being established, changed or discdntinued.
NAME �P A�'�'LICAN'Z' _, �G� .°'� s� ,�� � _PHONE Z— �'l�/~'�S�
PLE./�SE PR'[N'�' FA3i , ,,.�-�'� S!�` ^
: �3 �/ w �/s,� �..-� �rN � 3�6 ;
� ADDIL�SS CITY � STATE �
3TREE'�
NAME QF PAR'�"X QR O�tGANIZATI0P PF.�O�NIING WORK
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CON�'AC'� PERSON: sS EN�ERG�NCY E24 HIt.) PI-�dNE #: ,��� ���
ADD�'tESS �.t� .-J `" f L— LAY PHONE ,
P� 13a+�' !�5's��T CYTY STA'1'E ZIP�,S7RS� �
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'� ",e w-ru�rri�ad �ercwiti ac�epu tl�c teerus �ud uunciitivns oi'tnis pdxmit by tt�e Cixy or �rior'LaKe as l�ereist
ppnta.i�ed and agrEe to ft�l�y comply therex'ith tv t�►e satisfactioz� of thC City of prior Y,ake.
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SEP-19-2006 10�33 CITY OF PRIOR LAKE MAINT P.05i07
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�XMt�IT "C"
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PRiOR IAKE PUBLlC WORKS DESIGN MANUAI.
PERMIT TO WORK WITMIN CETY PRUP�R'�Y RIGWT-�� WAY/EAS�AA�PITS
AND
APPLiCATlON FOR INSTALLA'�ION OF UTILITIES
PAG� 2
�dR CtTY USE ONLY AUTHORIZATION O� PERMIT
FINANCIAL SECURITY: AMOUNT: TYPE:
(Cash, Borid,
LOC, EtC.)
Fee: $ _ Receipt No. Permit No. �l �" �� '" ��
UABiILITY INSUFtANCE PRUVID�D: j�,�,,�rr�`s A��,�.c�,_�
In considerati�n of agreement to oompty in all respects with the reguiations of the City o# prior lake covering such operaiions,
ar�d pursuant to authorization duEy given by said City ot Prior L�ke; permission is hereby graMed for the work to be done as
dascribed in the above appliaation, said woric to be done in accordance with special provisions as hereby stated:
APPROVED BY: pEPT. OF PUBLIC WORKS
s
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/DATE
ALL LEGAL REQUIREMENTS SHOWN ON PAGE 4N£ (1} AND ON ALL aSP�G1AL P�iOVISIQNB" BHALL BE COMPLIED
WI7H. 'iM� DATE WHEN WOt�K IS CUMPL�7�D MUST BE REPOR7Et� TO THE CITY 0� PREaR t,.AIC� C1TY ENGINEER.
G.N'ERMkT31ROW_UtiMy�RO� PERMITS.due
.SEP-19-2006 10�33 CITY OF PRIOR LRKE MAINT P.06i07
- Ex��Yr �c��
CITY OF PRIOR LAKE
RBGULATIONS PERTAINING T4 THB iNSTALLATION OR
�,EPAIIt OF UNDERGROUND LT'�7LTfIfiS IN CITY S'X'REETS
. OR IN CITX RIC�HT-OF-WAY/EASEMEI�TS
'�'he following regulatians and conditions constitute a part of the application made by any installer or contractor for
the installation of ntilities in any Ciry street righ[-of way �r City utiliiy easemettt and the applicant, ix► making his
application to da such work, shall agree ta abide by these reguIatians and conditions:
X, The individual obtaining the permii sha[l, befor� commencing suah work, nbtify the City F.ngineer when
tlte work at each loca�ion is to cqmmence; and, when requested by the Engineer, shall submit plat►s and •
speciftc�tions. �
2. e' e 1 a t'
_final ins�eciiQn.
�, The public is to be protecied by the istdividual, at a1i times, from tho commencement of the wark until the
eompletion and acceptance by the City. 7"he installer or contractor shall so eonduct his operations as to
. cause the minirnurn incanvenience co the publlc. "t'he installer or cantractor shail furnish, ercet, and
maintain, in accorciance with the legally accepted standards, all nccessary warning and traftic control signs,
barrieados, traffic Cones, and flashing lights to direct snd contral the movement of treffic throu�h the
project in a11 directions and at all timos,
•• The foregoing pr4visions shall not in any wa.y relieve the installer ar contractor of �tny of his legal
responsibilities or liabilitiss for tho safety of the public.
4. All openir►as in bitumir�ous surfaces shafi be cut in a straight line with sides smooth and vertical. No .
ragged ed�es wiii be permitted. Cuttin$ shall be done with a concrete saw, cutting whee3, jack hammer,
spades or similar epproved tools.
Backfill r�►ateria! shail be suitabls for highway embanlanent constntction. No peat, frozen Eumps, broken
asphalt, sod, roots, or other undesirable material shall bo permitted as backf il. Roclrs larger ttrarl six inches
(6") in diameter sholl not be used in backfilling of trenches.
The backfill material shall be placed in fayers not to exceed one fooi (1') and mechanically compacted to
nat iess than 95 percent of znodified Proctflr density.
The upper six inches (6'� of the back�U shall mcet Minnesota Highway bepartrnent Specifications for
Class S materiat and shall be compacicd to not less than 95 percent of modified ProcMr density.
As soon as possible after lsackfill operations are completed, the cut bitunniriaus edges of the trench shall be
painted rviih an asphalt emulsion such as SS-3. Immedistely thereafter, the pa�ing material shatl be
placed and rnechanically compacted tn n,at less than 95 p�rcenE of modified �'roctor density. 'T'he asphaldc
material used in patching shali be of the same type as removed from tho roadway, except, that itt no case,
wiE! a plant tt'iixed asphalt o€ less quality than Minnesota Highway Depariment 5pecifics�ians 2331 be
- used. The finished surface af the patch shali conform to the surface of the undishtrbed raadway
No per�»snent asphalt patches shall be on any basc whose tamperature is 32 degrees Fahrehheit or less.
Cold weathcr patching shalt be of temparary nature, using cold mixed asphalt, well graded crushed rook or
similar approved materia�s. Temporary pxtches shall be true to line and grade. Temporary patches shall bo
replaced by permanent pacches when weather cpnditions permit and notefication shall tae ret�uired as statcd
in 2.
��� . Fage 3 of 4
•SEP-19-2006 10�33 CITY OF PRIOR LAKE MAINT P.07i07
EXHI�IT "C"
S, Other areas may be required ta be campacted at the direcEion of the City fingineer.
- 6. Such permittee to be responsible for maintenance and repair of all trcnchrs far a period of one (i) year and
if settlement acet�rs or excavation eaves in, the sarne shall be promptly indicated by adequate warnin� signs
and shall BE res#ored to proper condition in � accordance with specifieatic�ns above pravided sis soan as
conditions pezrniL ,
7. All culverts and ditches shall be replaced in their original positiar► and condition existing prior to
col3shuction and no change shall be made m drainage without approval of the City Sngineer.
8. Pannittee shall save the City harmless from all third pa► claims for injury or damage v�+hich may occur
between the time the work cammences and the tima it is �'inalty accepted by tha City.
9. 'I'hc permittee may be required to jack or bore under cer�in streets, as determined by thc City Bagineer.
10. The applic�nt sh�ll furnish evidenca of public liability insurance of not less ihan $1DU,000/�00,000 and
property damage pf not Eess than $25,000 issu,ed by arl ix�surance company auiht�rizcd to do business in the
' State of M�nttesota on which the City is namcd as an additioAal ins�ared pariy.
11. Except for the negligent acts of the City, its agents artd iis employees, the perntittee shall assume al1
liability for, and save the City, its agents and its employees, harmless and defend same at its sote cost �d
expense fxom any and ali claims for damages, actions or causes of action arising out of the work to be done
•- herein and the car�tinufng uses by the permittee, includin�; but nvt liTnited to the placing, construetin$, �nd
reconstructir�g, maintairii,ng, protecting �td use of said facility under this app3ication and permit for
construction.
l2. Existing Facilities - The utility faeility and installs�tiot�s shall not interfere with any existing utility facility
an the C.�ity's right-of-way or easements, 1t is the responsibility of the applicant to catl far necessary
loeations of existinp utilities. (Gopher One)
13. Private Property -'i"he work pamit or permit for construction a's issued does noi in any way imply that the
apptopriate easement exists to �llow the applicant to work on private properry,
i4. Cuttir�; Tr�es -'The permission herein �ra�ted daes not confer upon the p�rntittee the right to cut� remove
or destroy trees or shrubbery w'stt�in the legal limits af'the right-of-way, easements that are not speci�cally
identified on tlie ptan attaohed to this pexmit or relieve permittee from obtaining any consent otherwise
required from tEie awner ofthe property adjacent thereto.
15. Clean-Up - Street, trailways and affected right-of=way shal[ be scraped c[cut, at the end of each work day
a�d sw�pt elean after consdvetion is completed and left in a neat attd prese�table condition. .
16. Replacement of Sod � Wherever top-soil and sod are disturbed, the°y shsll be raplaced in kind and
mai�tained satisfactorily until the turf is established.
The undersigned heteby declares he/she has re�d and will comply with a1i the PERTiN�NT REGL3I-A'CIONS as
stated above an� relevant Gity Ordin�r►nes•
,
DATfi: - ,��,�. ^D � .,,,,� SIGNED; 4
��n�noc Page 4 of 4 •
TOTAL P.0'7
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