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Home My WebLink About5724 & 5714 Fairlawn Shores ROW Permit5724 & 5714 � ini� c.� �.�c�� i� .. _ . . �. . . . _ _. . _. .. .- . .. . _. . . � . . , O� pRl��p - �, , �:. � - � � « » V� � �f�'N E s��P PE�ZMIT TO WORK WYT�TN C��'�' PROPERTY/RIGHT-OF-WAY/E,A,SEMENTS AND . . � APPY,ICATION �OR INSTALLATION OF UTILI'TYES . 1. LOCatipil �79G £�5716 Fairla�un Shnrac , ' ' 2. Nature df Work W�g,Y' and Gewer _from ma��g�o p r�t, perty .• 3. Indicate below items 10 be a.�'ettcd and include a sketch 4r plan of work to be done. . X Cvrb & Gutter X Street Surface �� TraiU$idewallc � Trecs: Pond/Wetlands (Publically own�d X _ X Traffic Control Devites/Signs or privately owmed �� Drainage Utilities � StructureBuildings Othcr ' 4. Method of �t�stallation or Conshvction Underground � . � . - Ex�ception eurb & blacktop � 5. � VVork to start on or aReri 3/ 2 7/ 06 ��d sh�ll be completed by: 3/ 28 / 06 / �� an extension � granted to: � by: ' � DAT� STAFF/DATE 6. Wi11 detouriag oftraffic be necessary? N� If necessary to derour tra�ic, describe suggcsted route: 7. Provide with this application a cop�+ of the contractors Public Liabilily Insurat�ce. DETOURS: Ttte Directar of Public Works shaU ba noti�ied '4R writin° leas� 72 o rs in advante of � any detour bcing established, changed ox discontinued. NAIViE O�' APP�.ICANT Stocker Excavat�ng �Inc. pHON� 952-890-4241 PLEASE PRINf ppX 952 � AD,DR�SS 12336 Boone Ave Savaee: NIN 55378 • STREET CT7Y STA?E ZIP NAM.� pF PARTX O�ORGANIZATIONPERFORMING WQRK Stocker ExcavatinQ Inc. CONTACT PEIiSON: Jo�nso.n. EMERGENCY (24 HR.) PHON��l�: .612-919-0524 __ ADDRESS 140�h Savage,, MN 55.378 � Dqy p�p� Same .�� STREET CT�'Y � STA?L ZIP � The unaersigned herewit'� �cegu thc �.erms snd cpnditions of this permit by ti►e C'tty of Prior Lake as herein contained d agree to fulty mpl therewith to tbe cisfaction of the City of Prior Lake. Si�ned' Title• ata `��% L�(O • Ex��rc.nx � Page 1 oF4 � � 16200 �agle Creek A��_ S.E., Prior L,ake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245 AN EQUAL OPPOR'iuNtTY �MPWYEFt MRR-23-2006 16�19 CITY OF PRIOR LAKE MAINT P.03i05 �XHYBIT "�" FOR CTTY USE ONLY AU?HORIZATION OF P�RMIT �'INANCIqZ. SECURIT'Y: AMOUNY': TYPE: . � � (Cash, bond, LOC etc.} � 0 4 _Ot ..., � Fee: $ ��d . � ReceiptNo. � O 22-� . permit Na V� b � LiA�ILYTY INSURANCE �RO�AEU: �Q�S N�BI'�„�6NG.�S In consideration of agreernent to•comply in all respects witl� the r�gulaticns o�the Ciiy of 1'rior Lakc covering suoh ' operations, aad pursuant to authorizacion duly given by said City of Prior Lake; petmission is hcrcby granted for the work to be don� zs described ia !Ae ��v� �pp;icstion, said woik to be done in aecordanee with specisl provisions as hereby stated: ��,�o�N� wd�,� �� - - c�� o� P,��o� �� , �EwN ,�LEis i �S2 - �9Z -/�5a � AppROVED �3Y: bEP7. O� FL1.�LIC WORKS ' 3 2� o� a. � . /DA AL�. L�GAL REQUIREMENTS SHOWN ON PAGS ONE (1) AND ON ALL "SPECIAL PROVISZONS" SHALL BE COMPLIEA WIT'�T. THE DA�'E �N WORK, IS COMPLL�TED M[,7ST BE REPORTED TO '1'T� CITY OF PRIOR LAKE CITY &NG}N�ER. . � , � �x�na�rc.00c Page 2 of 4 • � EXHIBIT "C" CITY OF PRIOR LAKE . • , .,� REGULATIONS PERTAII�TING TO THE INSTALLATION OR REPAIIt OF UNDE�GROUND UTILITIES IN CITY STREETS • OR IN CITY RIGHT-OF-WAY/EASEMENTS The following regulations and conditions consritute a�art of the applica6on made by any installer or contractor for the installation of utilities in any City street right-of-way or City utility easement and the applicaat, in making his application to do such work, shall agree to abide by these regulations and coaditions: • 1. 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. jj oo n comnletion of the A�ject the individual shall prom�,t��notifv the Gitv En '�meerin� Dgpartment for final in ection. 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 shall so conduct his operations as to � cause the �ninimum inconvenience to the public. The installer or contractor- shall 'fwnish, erect, and maintain, ia aceordarice with the legatly aecepted standards, all necessary warning and tc�affic control signs, : baaicades,: traffic cones, and flashing lights to direct and contiol the movement of traf�"ic through the project in all directions and at all times. � � � The. foregoing provisions shall not in any way relieve the installer ar contractor;of any of his legal � responsbilities or liabilities for the safety of the public. � � . .� 4. All openings in bituminous surfaces shall be cnt in a straight tine with sides smooth and vertical. No � ragged edges will be permitted. Cutting shall be done with a concrete saw, cutting wheel, jack hammer, � spades or samilar approved tools. . � Backfill mateiial shall be suitable for highway embanlrn�ent construction. No peat, frozen lumps, broken _ : asphalt, sod, roots, or other undesaable material shall be permitted as backfill. Rocks larger than six inches ' (6") in diameter shall not be nsed in bacicfilling of trenches. . The backfill material shall be placed in layers not to exceed one foot (2') and mechanically compacted to not less than 95 percent of modified Proctor density. .. The upper six inches (6'� of the backfill shall meet Minnesota Higtiway Department Specifications, for .� Class 5 matcFial and shall be compacted to not less than 95 percent of modified Proctor density. � As soon as possble after backfill operations are completed, the cut bituminous edges of the trench shall be painted w�th an asphalt emulsion such as SS-1. Immediately thereafter, the patching material shaII be � placed and mechanically compacted to ndt less than 95 percent of modified Proctor density. The asphaltic material used in patching shall be of the same tj+pe as removed from the roadway, elccept, that in no case, will a plant mixed asphalt of less quality than Minnesota Highway Department 3pecifications 2331 be used. The finished surface of the patch shall conform to t�e surfaca of the undisturbed roadway. No permanent asphatt patches shal! be on any base whose temperature is 32 degrees Fahtenheit or less. Cold weather patching shall be of temporary nature, using cold mixed asphalt, well graded crushed rock or . , simila� approved materials. Temporary patches shall be true to Iine and grada Temporary patches shall be replaced by permanent patches when weather conditions permit and notification shall be requirad as stated �� in 2. �*�'�� Page 3 of 4 ' EXffiBIT KC" ' s• Other �reas may be required to be co�pacted at the direction of the City Engineer, " 6. Such p�rmittee to be responsble for maintenance and repair of all trenches for a period of one (1) year and if settlement occurs or excavation caves in, the same shail be promptiy indic�� by adequate warning sigos and sh�ll be restored tu proper condition in.ac�ordance with specifications above provided as soon as ` conditions permi� . • , � . . �. All culh+erts and ditches sha11 be replaeed in thoir orig_inal position and condition existing prior tc� . constru '�tion and no change sha11 be made ia drainage without approval of the City Engincer, � 8• Permitt�e shali save the City harmless from all third party �claims for injury or damage which may occur �, betwee� the tune the work commences and the time it is finally accepted by the City. 9. � The per�nitte� ma be re ; ? y quired to jack or tiore under certain streets, as determined by the City Engineer, i 10. The appl�icant shall fiunish evidence of p�blic liability insur�nce of not less than �100,000/300,000 and •• propeity� damage ofnot less than $25,000 issued by an insurance company authorized to do busines`s in the ; 1 � State of Minnesota on which the City is named as an additional insur�d party, : � . 11. Except $'or the negligent acts of the City, its agents and its employees, the pennittee shall assume all � liability for, and save� the City, its agents and its employees, harmless and defend same at its sole cost and expense from any and all claims fo'r damages, actions or causes of action arising out of the work to tse done � }►erein �d the coatinuing uses by the permittee,• including but not limited to the placing, constructir�g, and ' reconstructing, maintaining, protecting and :use of said facility under this application and pen�uit for �`. constructiion. . � . , 12• E�cisting �acilities - The utility facility and . installations shall not interfere with any existing utility facility �_ on the C�ty's right-of-wa y or easements. � It i s t h e r e s p o n s i bi li ty o f t he app licant to call for neeessary :: � locations'lof existing dtilities, (G�pher One) . - . - 13. Private Pij�operty _ Th� work permit or permit for construction as issued does not in any way imply that the appropriake easement exists to atlow the applicant to work on private property. ' 14. Cutting T�rees _ The permissio� herein granted does not confer u on i�he � � P permittee the right to cut,� remove " or destro}! trees or shrubb�ry within the legal limits of the right-of-way, easemeats that are not specifically - idenrified', on the plan attached to this permit or relieve permittee from obtaining any consent otherwise required from the owner of the property adjacettt thereto. _ 15. Clean-Up - Street, trailways and affected right-of-way shail be scraped clean at the end of each work day and swept clean atter construction is completed and left in a neat and presentable cundition. , 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 declazes he/she has read and will comply with �all e PERTINEWT RBGULqTIONS as stated above and relevant City Ordinances. � .. DATE: SIGNED: � , �. � �" �� Page 4 of 4 � ACORD CERTIFICATE OF LIABILITY INSURANC� CSR PJ DATE(MM/DDM') OCK-3 04/28/05 PRODUCER ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ross Nesbit Agencies, Inc . HOLDER. THIS CERTIFICATE DOES NOTAMEND, EXTEND OR 7500 Flying Cloud Dr, Ste 950 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Eden Prairie MN 55344 ',�ne: 952-941-9418 Fax:952-941-9615 INSURERSAFFORDINGCOVERAGE .;RED INSURERA: W2St Bend Mutual iNSUReR e: American Interstate Ins . Co . Stocker Excavating, Inc . INSURER C: 12 3 3 6 Boone Ave INSURER D: Savage NIld 55378 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. � TYPE OF INSURANCE POLICY NUMBER LTR DATE MM/DD/YY DATE MM/DDm) N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1� OOO � OOO A X COMMERCIALGENERALLIABIIITV BCN063222400 04/25/05 04/25/06 FIREDAMAGE(Anyonefire) S2QQ�QQQ CLAIMS MADE � OCCUR MED EXP (My one person) 3 1 O� O O O PERSONAL & ADV INJURY $], � O O O� O O O GENERAL AGGREGATE 3 2� O O O� O O O GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OPAGG $ 2� OOO � OOO POLICY PR � LOC JECT AUTOMOBILE LIABILITY A X ANYAUTO BCN063222400 04/25/05 04/25/06 COMBINEDSINGLELIMIT $ 1�000� (Ea acddent) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per pereon) X HIRED AUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Peraccident) PROPERTY DAMAGE $ (Per acddent) „ARAGE UABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN �` ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ 1 OOO � OOO A X OCCUR � CLAIMSMAOE CIIN0641580 04/25/05 04/25/06 AGGREGATE $ 1� QQ� � �� a DEDUCTIBLE a X RETENTION $ O � WORKERS COMPENSATION AND TORY LIMITS ER B EMPLOYERS'LIABILITY AVWCNIDi1368972005 04/27/05 04/27/06 E.L.EACHACCIDENT a 500000 E.L.DISEASE-EAEMPLOYEE SSOOOOO E.L.DISEASE-POLICYLIMIT $ r jOOOOO OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER N ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CITYPIO SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION . . � DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL �� DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE IEFT, BUT FAILURE TO DOSO SHALL Ci ty o f Prior LBaCe IMPOSE NO OBIIGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 162-00 Eagle Creek Ave. SE Prior Lake MN SS372 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Daniel L nch ACORD 25-S (7/97) OO ACORD CORPORATION 1988 . + ��"C� � �S �" ' �..��i � I �� °�, C� I � � � � � � � ( � ' � � � , � � � �� s s; , � � `��, � " ��'s� ��-_ � _ -� U G � � ��r� �0�� ' � � � �� 3 a -�----_ ��'� �� s�t� /�� i ! '4 ��'6 4,,� � �� c� � S 1 I �� .e� T �p� � -P �.� �p � S � � � ��t � ,� r"' S> c�� • ,�� " � `C �O � � I � ��i � � � � i h � � �� . � } � � �,��-�,, ; � I �a �� , � � � v� � � � r �� ,, y � r' � i �'-� �c� � � z �. �, �' �� s � � � � . �-�,� �,�� s `� �, , ' �� "" �� G°s � � C s �,. � �' ; z �5t C� ' � '�,` -� ; '�. .� � �� a ; c � � i i I� i ', i � I I I, I.. I � I I � � � I I' � j: � . j �� I I 1I � c /� d ,� p /� e �� ..� o,� �c. -�`� � ��fJ��l �� 1�E5 R�,� p � �os�D � � �' � � �� ar C.'1 � �� Pa,� �'c,� Q e d�S �°s �� '� �4 s '� � � �� i9� �.a ! ;