HomeMy WebLinkAboutCarriage Hills Pkway ROW Permit • P�ay. 11, 2006 7;15AM . No, 1417 P, 2
EXHIBIT "C"
TO
PRIOR LAKE PUBLIC WORKS DESIGN MANUAL
PERMIT TO WORK WI7HIN CITY PROPERTY R1GHT-OF-WAY/EASEMENTS
AND
APPLICATION FOR INS7ALLATION OF UTILITIES
l. T.ocation Ca� �' � � n oT�_ L� J � I�S /�A �' kW a y (.t�� 5 7�' O� /V �' e l '1 t►' u a� �c �,
2, Nature of Work /yc v� S C� ;' r . o r /1/e•,� A r h�• � s�' .�e r a r � `� �
3. tndicate below items to be affectad and include a sketch or plan of work to be dane. �� ,' d/` �.. a k� � �� �� �° r
Curb & Gutter Street
TraiUSidewa.lk Trees:
Pond/Wetlands (Publically owned
Tr�c Control Devices/Signs Or Privately owned _�
Dcainage � Utilities
Struccure/Bwildings Other
4. Method of Ynstaltation or Construction �%99 e r,�er r �' ��< 7� v �f�
5. 'W'ork to start on ar after: S`� �. ,� � and shall be completed by: 3-- �`— G 6 unless an
extension grantad tu• fsy:
AATE STAFF/DATE
6. Will detouring of traffic be necessary? N� If necessary to detour traffic, desotibe suggested
route:
7. Provide with this applicxtion a copy of the contractors Pubiic Liability Insursnce.
D�TOLJRS: The Director of Public Works shall be notified in writing ac least 72 hours in advance of any
detow being estsblished, changed or discontinued.
NAML� OF APPLICANT S h A h b�O rc' e Pd d I� c U?'I; I i es pHONE 9�R - y yS ` l`I ��
PLEASE PRINT
ADDRESS / QoX y70 a,�SSare��2i n -S�►t kop C e }'�I ►� .s .�'..�� �
STREET CITY STATE ZIP
N� OF PARTY OR ORGANIZATION PERFORMING WORK ��i a k o�v � c, P, 1� .
CONTACT PERSON: Mar �� � A 1'�. .hw EMERG�NCY (24 HR.) PHONE#: 9 5?-�9.� -�'0 B'0
ADARESS: �� S_S. �m �:., �,�i �eee 1'9� SSf�DAYPHON� 9�5'� - R33- �50�
STREET CITY STATE ZIP
The undersigned hctewich aoctpts ths terms and conditio�,s of thia petmit by the City of Prior Lake as herein coc►tained and agres w
Pully comply thctewith W the tisfaction of the City of p[inr Lake.
.� D�te' S`Il'OG
Signcd• � el�Gkw�w� Title: �.'�`
G.1Admin�FORMSIEX$IBIT C APPUC FOR INSTALL OF V1TL1Tl2S.doc
P�ay. 11. 2006 1;15AM No, 1411 N, 3
�XHIBIT "C"
TO
PRIOR LAKE PUBLIC WORKS DESIGIV MANUAL
PERMIT TO WORK WITHIN CITY PROPERTY RIGHT
AND
APPLICATION FOR INSTALLATION OF UTILITIES
PAGE 2
FOR CITY USE ONLY AUTHORIZATION OF PERMIT
FINANCIAL SECURITY: AMOUN7: TYPE:
(Cash, Bond,
LOC, Etc.)
Fee: $ R�ceipt No. Permit No. �"�%?S
LIABIILITY INSURANCE PR4VIDED: l��+4t�t__� /��11� ��+x��S
�
In considereGon of agreement to comply in ail respects with the regulations of the Ciry of Prior Lake covering such operaUons,
and pursuant to authorization duly given by said City of Prior Lake; permission is hereby granted for the work to he done as
described in the above applicetion, said work to be done in accordanoa with special provisions as hereby stated:
APPROVED BY� DEPT. OF PUBLIC WORKS
B /� � - G-�2�vb
IDATE
ALL LEGAL REQUIREMENTS SHOWN ON PAGE ONE (1) AND ON ALL "SPECIAI PROVISIONS" SHAI,L BE COMPLfED
WI7H. THE DATE WHEN WORK IS COMPLETED MUST BE REPORTED TO THE C�TY OF PRIOR IAKE CITY ENGIN�ER,
CiM4mleff0RMS1PXFa91T C,�1P1.�C POR INSTALL OF UTILI'fIF$.doe
- �lay. 11. 2006 1:15AM No, 141I r, 4
EXHIBIT "C"
TO
PRIOR LAKE F'U6LIC WORKS D�SIGN MANUAL
REGULATIONS PERTAINING TO THE INSTALLATION OR
REPAIR OF UNDERGROUND UTILITIES IN CITY STR�ETS
OR IN CITY RIGHT-O�-WAY/EASEMENTS
The following regulations and conditions can$titute a part of the application made by any ingtaller or contractor for
the installation of utilities in any City street right-of-way or City utility easement and the applicant, in making his
application to do such work, shall agree to abide by thesQ regulations and conditions�
1. The individual obtaining the permit shall, before commencing such work, notity the City Engineer when the
work at each location is to commence; and, when requested by the Engineer, shall submit plans and
specifications.
2. Uaon comaletion of the p�oject the individual shall oromptiv notitv the Citv Enaineerina Denartment for final
inspection.
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 cont�actor shall so conduct his operations as to
cause the minimum inconvenience to the public. The installer or contractor shall furnish, erect, and
maintain, in accordance with the legally accepted standards, all necessary warning and traffic control signs,
barricades, traffic cones, and flashing lights to direct and control tha movement of traffic through the project
in all directions and at all times,
The foregoing provisions shall not in any way relieve the installer or contractor of any of his legal
responsibili6es or liabilities for the safety of the public.
4. All openings in bituminous surtaceg shall be cut in a straight line with sides smaoth 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 for highway embankment constru�tion. No peat, frozen lumps, broken
asphalt, sod, roots, or 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 "j of the backfill shall meet Minnesota Highway Department Specifications for Class
5 material and shall be compacted to not less than 9S percent of modified Proctor density,
As soon as possible aRer backfill operations are completed, the cut bituminous edges of the trench shall be
painted with an asphalt emulsion such as SS-1. Immediately 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 ag removed from the roadway, except, that in �o case,
will a plant mixed asphalt of tess quality than Minnesflta Highway Department 5pecifications 2331 be used.
The finished surFace of the patch shall conform to the surtace of the undisturbed roadway.
No permanent asphalt paitches 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 materials. Temporary patches shall be true to line and grade. Temporary patches shall
QiAdmin�F07GlS{p7GFd8lT C APPUC FOAlNSTALL pp ViI[,Pt7ES.doc
. iMay. 11. 2006 7:15AM No. 14�� r. �
be replaced by permanent patches when weather conditions permit and notification 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 trenches for a period of one (1) year and
if settlement occurs or excavation caves in, the same shall be promptly indicated by adequate warning
signs and shall be restored to proper condition in accordance with specifications 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.
S. Permittee shall save the City harmless from all third party claims for injury o� damage which may occur
batween the time the work commences and the time it is finally accepted by the City.
9. The permittee may be required to jadc or bore under certain streets, as determined by the City Engineer.
10. The applicant shall fumish avidence of public liabiliiy insurance of not less than $100,000/300,000 and
property damage of not less than $25,000 issued by an insurence company authorized to do business in
the State of Minnesota on which the City is named as an additional insured party.
11. Except for the negligent acts of 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 from any and all claims for damages, actions or causes of action arising out of the wo�k to be
done herein and the continuing uses by the permittee, including but not limited to the placing, conatructing,
and reconstructing, maintaining, protecting and use of said facility under this application and permit for
construction.
12. Existing Facilities — The utility facility and installations shall not interfere with any existing utility facility on
the City's right-of-way or easementa, It is the responsibility af the applicant to call for necessary locations
of existing utilities. (Gopher One)
13. Private Property — The work permit or permit for const�uction as issued does not in any way imply that the
appropriate easement exists to atlow the appficant to work on private property,
14. Cutting Trees — The permission herein granted does not confer upon the permittee the right to cut, remove
or destroy trees or shrubbery within the legal Iimits of the �ight-of-way. Easements that are not apecifically
identified on the plan attached to this permit or relieve permittee trom 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 clean after construction is Completed and left in a neat and presentsble condition.
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 declares he/she has read and will comply with all the PERTINENT REGULATIONS as
stated above and relevant City Ordinanc�s.
DATE: S"I�' � � SIGNEQ:
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