HomeMy WebLinkAbout14113 & 14149 Ash Cir ROW Permit r Jun, 6. 2006 2:1$PM ; • No, 1465 P. 2
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PRIOR,LAKE, PUBI.�C,�, ,�, , S DESIGN MANUAL
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P�RMI7 TO WORK WITHIN'CITY.�'R , � � 'T�.�RIGHT-OF-WAY/EAS�M�NTS
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APPL.ICATiON FOR�INS� ��('ON OF•UTILI7IES
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1. Locatia.� �r�d` y . • ' ��r;'�;�`L.• � .
2. Nature of Work . . c�;4� .'� .�:�. �"':: '. �� �
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3. Tndicate below it�rc�s to be affected and incl,ud6 �.� '� _.�`� r•.�plan.of work tn bs done. '
� � •�c��, ° r�� �; �-•�' �;��. ��•.: .
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Curb & Gutter �,:;:',' ��^� ;'�� 'Sfreet
. � C.iti:��� �..��.�w .
• �.t���� �'�fv�,j': ..
. TraiUSidewalk ,. ;•; , , .• �Trees:
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Pnnd/Wedands ' . ";:;,�: �.'�� .:;':;�;'����'ublically owned
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� Traffic Control bevices/Signs.`•�.�� ��� 4r..Privately owned�
. �•�' ` •� �:;��_ � `
Drainage � � � � . ;.,;.:�' v'tilities
• . . �1.. . . . � '
. Structure/auildings � � � Othgr� �
4. Meth;od o£ Installation or Constructian. T✓�-C•�+.�r�!� -�`�� p��t1" :
5. Work to start on or aftez: 6-- i a-06 `� .atid shall be completed by: 6 — 3�C� fO � unless an
extension granted to: � �� � 6y: .
DATE•� �� •.. .. � STAFF/DATB
6. Will detoutirig of traffic be necessary? ��d '' If necessary to detout tcaffic, describe suggested
route: ' � � � �
7. Provide with this application a copy Qf the coi�tractdrs,P..yb�ic, �,iability Insutance.
DETOURS: Tfie Director of Public Wor�CS shall f� �:otified in �tina at least 721�ou�in advance of any
detour beizxg estabtished, chan�ed or discondnued.
NAN� OF APPLICANT S� a k ap e e: ,�� ��,'c U T'/; fi es PHONE y.�a - 4 yS �� 9��
PLEASE PT�INT
ADDRESS �� Qo 1r y �0 �,S"S Sq�r4�2i n�� -S�+<�k e e �''l� .S .5�.��9
. STREET , • _ . . CITY STATE �iIP
NAME OF PAR'I'X OR ORGAN2�A,TION PERFORMING WORK .S� a k e,o � C, P, v �,
CONTACT'PERSON Mar y i r� /4 tk' �,..N.w EMERGENCY (24 HR.) PHONE#: 9 5a-�9a - 8'0 B�
ADDRESS: �3 s.Sa c �-z .' � �•�•� r►� SSfJpDAY PHON� 9sa ^.l3 3 i3a �
STREET CII'Y S'F�TE ' 7�Ip :� . '':'"
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The undersi harawith acee ts the texms and cqnditiazu aPthis r:`: ':
gnad P permit 6y the City of Prior Lakc as herein cancainad and agcee to
fv►ly comply thexewith to the tisfaction of the City of Ptior �.ake. .�
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Signed: � �it�a: , ��,�" Date: .S � )1- O (o
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f2UdminlFORAQSEXtIlHCC C AFPLIC FOR INST�LL. VP U]'WTILS�
Jun, 6, 2006 2;1$PM No. 1465 P, 3
EXMIBIT "C"
TO
PRIOR LAKE PUBLIC WORKS DESIGN MANUAL
PERMIT TO WORK WITHIN CITY PROPERTY RIGHT-OF-WAYIEASEMENTS
AND
APPLICATION FOR INSTALLATION OF UTILITIES
PAGE 2
FOR CITY USE ONLY AUTHORIZATION OF PERMIT
FINANCIAL SECURITY: AMOUNT: TYPE:
(Cash, Bond,
LOC, Etc,)
Fee: $ Receipt No. Permit No. V 'O�/ of c
LIABIILITY INSURANCE PROVIDED:
In consideration of agraement to comply in atl respects with the regulations of the City of Prior Lake covering such operaGons,
and pursuant to authorization duly given by said City of Prior Lake; permission is hereby gra�ted ior the work to be done as
described in the above application, said work to be done in accordance v�Iith speaal provisions as hereby stated;
APPROVED BY; DEPT, OF PUBLIC WORKS
e �:.� G �7� -o�
/DATE
ALL LEGAL REQUIREMENTS SHOWN ON PAGE ONE (1) AND ON ALL "SPECIAL PROVISIONS" SHALL BE COMPLIED
WITH. THE DATE WHEN WORK IS COMPLETED MUST BE REPORTED 70 7HE CIlY OF PRI�R LAKE CITY ENGINEER.
Qwemin�FORt�tS18XfDBlT C AF�T.1C POR INbTA1.I.OP tmlAiRS.doc
Jun, 6. 2006 2:1$PM No, 1465 P, 4
EXHIBIT "C"
TO
PRIOR LAKE PUBLIC WORKS DESIGN MANUAL
REGULATIONS PERTAINING T� THE INSTALLATIpN OR
REPAIR OF UNDERGROUND UTfLITIES IN CITY STREETS
OR IN CITY R1GHT-OF-WAYIEASEMENTS
The foilowing regulations and conditions �nstitute a Rart of the appiicatlon made by any instalier or contractor for
the installation of utilities in any City street right-of-way or Gity utiliry easement and the applicant, ln making his
application to do such work, shall agree to abide by these regulations and conditions:
1. The individusl obtaining the permit shall, before commencing such work, notifjr the City Engineer when the
work at e�ach location is to commence; and, when requested by the Engineer, sha{I submit plans and
specifications.
2. Upon completion of the proiect. the individual shall nromptiv notifv the Citv Enqineerina Deaartment for fin I
insoection.
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 sha11 so condud his operations as to
cause the minimum inconvenience to the public. The installer or contractor shall furnish, erect, and
maintain, in accordance wikh the legally accepted standards, all necessary warning and tra�c cont�ol signs,
barricades, t�affic 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 o� contractor of any of his legal
responsibilities or liabilities for the safety of the public.
4. All openings in bituminous suifaces shall be cut in a straight li�e 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
similar approved tools.
Backfill material shall be suitable far highway embankment consVuction. No peet, frozen lumps, broken
asphalt, sod, roots, ar other undesirable material shall be permitted as backfill. Rocks larger than six
inches (6") in diameter shall 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 backfill shall meet Minnesota Highway Department Spec�cations for Class
5 material and shall be compacted to not less than 95 percent of modified Proctor densiry,
As soon as po$sible after backfill operations are completed, the cut bituminous edges of the trench shall be
painted with an asphalt emulsion such as SS-1. Immediataly thereafter, the patching material shall be
placed and mechanically 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 qualiiy than Minnesota Highway Department Specifications 2331 be used.
The finished surface of the patch shall conform to the su�face of the undisRurbed roadway.
No permanent asphalt patches shall be on any base whose temperature is 32 degrees Fahrenheit or less.
Cold weather patching shall be of temporary nature, using cold mixed asphalt, well graded crushed rock or
similar approved materiats. Temporary patches shall be true to line and grade. Temporery patches shall
G;�Mmia�FORM318Xi�IT C A1�4LIC P6]t WgTALI, OP VTILiI1ES.Aa
Jun, 6, 2006 2:1$PM No, 1465 P, 5
be replaced by permanent patches when weather conditions permit and no6fication shall be required as
stated in 2.
5. Other areas may be required to be compacted at the direction of the City Engineer.
6. Such permittee to be responsible for maintenance and repair of all t�enches for a period of one (1) y@ar and
if settlement occurs or excavation caves in, the same shall be promptly indicated by adequate waming
signs and shall be restored to proper condition in accordance with speci�cations above provided as soon
as conditions permit.
7. All culverts and ditches shall 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, Permittee shall save the Ciiy harmless from all third party claims for injury or damage which may occur
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 pt,blic liabiliiy insurance of not less than $100,000/300,000 and
property damsge of not less than $25,000 issuad by an insurance company authorized to do business In
the State of Minnesota on which tha City is named as an additional insured party.
11. Except for the negligent acts af the City, its agents and its employees, the permittee shall assume all
liability for, and save the Ciiy, its agents and its employees, harmless and defend same at its sole cost and
expense frorn any and alt 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 facility under this application and permit for
construction.
12. Existing Facilities — The utiliry facility and installations shall not interfere with any existing utility facility on
the City's right-of-way or easements. It is the responsibility of the applicant to call for necessary locations
of existing utilities. (Gopher One)
13, Private Property — The work permit or permit for construction as issued does not in any way imply that the
appropriate easement exists to aflow the applicant to work on private property.
14. Cutting Trees — The permission herein grented does not confer upon the permittee the right to cut, remove
or destroy trees or shrubbery within the legal limits af the right-of-way. Easements that are not specifically
identffied on the plan attached to this permit or relieve permittee from obtaining any consent otherwise
required 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
and swept c�ean after construction is completed and left in a neat and presentable condition.
16. Replacement of Sod — Wherever tap�oil and sod are disturbed, they shall be replaced in klnd and
maintained satisfactorily until the turf is established.
The undersigned hereby daclares he/she has read and will comply with all the PERTINENT REGULATIONS as
stated above and ralevant Ciiy �rdinances.
DATE: S"/I' O G SIGNED: �
Ct,lAdmirtFORMutE)(Ffle1T C APPUC PUR INSTALL OP Ui1LlT'1F$.doe
� Jun, 6. 2006 2:14PM No.1465 P, 6
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