HomeMy WebLinkAbout13972 Kensington Ave ROW Permit 612 321 5480 P.02
RPR-15-2005 09�07 CENTER PT ENERGY .
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WORK OIiDER �1 3 7
� PERMIT
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TO 'WORK �S'I�H� CITY PROPE�TY/RIGHT�OF-WA�/EASENiF�NTS
AND
AI'PT,�CATION �OR 1NSTALLATION OF UTILITIES �
1. Locarion �� / 7� �'����/'����/" �L �
2, NatureofWork Install new 5/B" PlasCic gas service line. •
�R�i.� r.s� �
3. lndicate below items ta be affe�ced and include a sketch or plan of work to be done. 3 � ,�� � Q � L�
Cutb & Gutter � Street Surface UF ����J/^��� a "�
TraiUSidewalk _�___ Trees: RJ•'
Pond/Wetlands (Publitally ovmed
� Traffic Concro! Devices/Sig�s or Privately owned _}
� Drainage Utilicies
StructurelAuildiags Othec ���5 �'j��Qv�[..
4. Method of lnstallation or Conseuction �,_ � ��� �� `'
5, Work to start on or aftet: ���� �+d shall be completed by: `�'3/•'U.� unless en ezteosion
� � �nted to: bY�
DATE STAFF/DAT�
6, ��Il deteuring of araffic be necessary? �� If necessary to detour traffic, deseribe suggeseed
mute:
7. Provide wiLh this applicaeion a copy of the conasetors Publie Liabiliry lnsuran�e.
DETOURS: T'he Director oE Public Works shall be not�fied�n_writinQ at lea�t 7 ko �rs in advenee of
any detour being eslablished, changed or discontinued.
NAMEOFAPPLICANT CencerPo�,nt Energy . p�p� 612-321
PLEASE PRINT FAX 6 i 2��21-5480
ADD]tESS �00 Linden Avenue West� P.O. So� 1165, Minneapolis, !Q1 55440-1165
STREE'I' CITY STAT'E �
NAI� OF PAR?Y OR ORGANI2ATION PERFORMfNG WORK Michels Corp .
CONTAC'T PERSON: Sceve- Johnson. EMERGENCY (24 HR.) PHOWE �: 612--372—Sp50
ADDRESS DAY P�TONE 612-�2 L-50,�6 .
STREET CITY STATE Z1P
The undersigned herewith accepts the terma and conditions ef this permit by ehe City of Prior Leke as Inerein
contaiaed and a e to y omply therewith to the satisfaction of the Ciry of Prior Lake.
' En .� 4�ssis�. - 7 - ���/ �!'JJ.�
Siped. Tlde: , __Date•
� Page 1 of 4
16200 F,agl� Creek Aue. S.E., Prtor Lalce, Minnesota 55372•�714 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EAUAL f]PPf)RTI INT/ FMDI AVFv
HPR-15-2805 09�0? CENTER PT ENERGY 612 321 5480 P.03
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FOR CITY USE ONLY AUTHOKIZATION OF PERNQT
FfNANCUIL SECURITY: AMOUNT: 'I'YpE; ,
(Cash, bond. LOC etc,)
Ftc: S 2"� •�� Rtceipt No. Permic No. u P— 0'S —Z y
L1A9ILIZY 1NSURANCE PROVIDBD: Associ�ted ElectYic b Gas Insura�ce Services Limi
In eonsidera�ion of agraement to comply ir� a1l respeets with the regulakions of the City of prior �,ake eovering such
' operadons, a.ad pursuant io authoriration duly given by said Ciry of prior Lake; permission is hereby granted for the
wurk to be done as described in �he above applieation, said work to be done in accordance with specisl p�ovisions as
he�sby stated:
� APPROVED BY: D�PT. OT PUBJ��C WORKS
B /l�.*-.-- 6f-C�
,,; � �s-o5'
/DATE
�
Af 1- LEGAL REQUIREMENTS SHOV✓N ON PAGE ONE (1) AND ON ALL "5PECIAL PROVISIONS" SHA1.L
BE COMPLIED V�rl�i. TI� DATE WHEN WORK IS COMPLETED MUST BE REPORTED TO THE CITY
OF PRIOR LAKE CITY �TGlIVEER
��� Page Z of d 1
HPP-1�-2005 09�07 CENTER PT ENERGY 612 321 5480 P.04
� �7KHIBIT "C"
CITY OF PRIOR I,AKE
REGULATIONS P�R�'AINING TO IHE INSTAL�,ATION OR
1tEPA1R OF UNDERGROUND UTILITTES 1N Ct"fY STREETS
� OR TN CITY �tIGHT-OF-WAY/EASEMENTS
The following regulations and conditions constiNte a part of the application made by any i�nstaller or contractor for
�he ins�atlation of utilities in nny City street right- wAy or City u�ility easemen� and the applican�, in making his
application to do such work shall agree to abide by these regulations and condicions; '
1. 'The individual obtau�ing the permit shall, before commencing such work, notify the Ciry Engineer when
the wotk at each lo�ation is to commence; and, when requested by the E�ngineer, shall submit plans and '�
specifications.
2. Uoon corenletion of the oroi -ce t th�individ� I shall�IOm�� notif5t the Cit� F��eerin���amneei ior
Ilnsl insnec �on.
3. °Rie public is �o ba proteeted by the individual, at alt times, from �he commencement of ehe work until rhe
completion and acceptance by the Cpry, The installer or contraccor shall so conduct his operations as to
cause �he minimum inconvenienee co the public. The installer or contractor shall �umish, erecy a�d
maintain, in uecordanee with the legally aecepred standards, all necessary warning and traffie con�ot aigns,
barricades, traffic eones, and �lashing lights to ditect And eontrol the mo�ement of traf�ic through che
project in all directions and at all times. .
The foregoi�g provisions shall not in any way rclieve the installer or contraetor of any of his lcgal
reaponsibilities or liabilities �'or che safoty of the public. '
4. All openings in bituminous surfaees shall be cuc in a straight line with sides smooth and vettieal. No
rogged edges wi11 be permiaed. Cutting shall be done with a concrete saw, cuning wheel, jaek hammer,
spedes or similar approved cools. �
Backfill material shall be suitable tor highway embankment construction. No peat, �roun lumps, broken
asphalt, sod, roots, or o�her undesuable material shall be permitted as back�ll. Rocks larger chan six inches
(6") in diamecer shall noc be used in back�lling of trenches.
The back�ll material shall be placed in layers not te exceed one foot (1') and mechanically compacted to
noc less than 95 percent of modified Proctor densiry,
?he upper six inches (6") of the baekfill sha11 meet Min�tesota Highway Deparmient Specificatione for
Class S material and shall be compacted to not less than 95 percent of modified Proctor density.
As soon as possible after backfill operations are ooitnpleted, the cut bituminous edges of the Qcnoh shall be
paineed with an asphalc emulsion such as SS-l. immediacely thereaRer, the patchin� material sha11 be
placed and mechanically eom,pacted to not less than 95 percent of modifed Proctor densiry. 71ie asphaltic
material used in patchio� shall be of the same type as removed from the roadway, exeept, thac in no case,
wilf a plant mixed asphalt of less quality chan Minnesota Highway Department Specifications 2331 be
used. The Finished sur#ace of the patch shall conform co the surface of the uhdisturbed roadway.
No permanent asphalt patches shall be on any basa whose temperature is 32 degrecs Fahrenheit or less.
Cold weather patching shall be of temporary nacure, using cold rttixed asphalt, well graded crushod tock or
similar approved materials. Temporary patches shall be true to line and g�ade. Temporary pacches sha11 be
replaced by permanenc parches when weather conditions permit and notification sha11 be required as stated
in 2.
�'T��c Page 3 of Q
APR-15-20�5 09�07 CENTER PT ENERGY 612 321 54B0 P.05
�XHiB�T "C"
S• Ocher areas may be required to he compacted at the direction of tl�e Ciry Engineer.
6. Such permiRee eo be responsible for maintenance and repair oF all irenches for a period of one (!) year and
if settlement occurs or excavation ea�es in, the same shal! be promptly indieated by adequate warnine signs
and shall be restored to proper eondition in�accordance with specifieations abo�e provided as soen as
conilations permit,
7• A11 eulverts and ditches shall be replaced in their original position and condition existing prior to
conscruccion and no change shall be made in drainage without approval of the Ciry �ngineer,
$• Fermiace shafl save the Ciry harmless from a11 third parry claims for injury or damage which may oceur
becweer� the time the work commences and the time ic is final(y aceepted by �he City_
9. The permittee may be required to jack ot bore under certain screets, as determined by the Ciry Eogineer.
10. The applicant shall Fumish evidence of public liability insurance of not less than SIOO,OUO/300,000 ar�d
property damage of noc less then 525,000 issued by an insurance company authorized co do business in che
� State of Minneso�a on which the City is named es an additional insured party.
11. Except for t6e negligent act5 of the Ciry, its agents and its employees, the permiaee shall assume all
(iability for, and save the City, its agents and ics employees, hormless and defend same at its sole cos� and
expense from any and al[ cJaims for damages, setions or causes of action arising ou[ of the work to be done
herein and the eontinuing uses by the permittee, including but not limited to tha placing, conshvetiAg, and
reeonsttucting, maintaining, protect�ing and use of said faciliry undor this application and permit for
cons�ruction.
12- Existing Facilities - The utility fecility and installations shall not interfere with any existing utility Facility
on the Ciry's right-of-way or easements. It is the responsibiliry vF the epplicant to eall for necessary
locations of existing utilities. (Gopher One)
13, Private Property .'i'he work permit or perrttit for eons[ruction Qs issued does not in any way impfy that che
appropriate easement axists �o allow the applicant co work on private property.
14. Cutting Trees -11�e permission herein granted does not confer upon the permittee the right to cut, remove
or destroy Rees or shrubbery within the legal limit� of the right-of-way, easements that ate not specifically
ideneified on tf�e plan attached to this pernnit or relieve permlRee from obtaiaing any consent otherwise
required from �ho owner of the properry adjacent thereto.
I5. Clean-Up - Street, hailways and affected right-of-way shall be scraped cle�n at the end of each work day
atid swept clean after conshvction is completed and !eR i� a neat and presentable eondieion.
16. Replacement of Sod - Wherever top-soil artd sod ere disturbed, they sha11 be replaeed in kind and
maintained satisfactorily until the turf is esta6lished.
Tha undersigned hereby dedares he/she has read and will comply with all lhe P,ERTINENT R�CULAT,(ONS as
scated above and relevant City Urdinances.
DAIE: / ��3 � UJ'� StGNED:
��� �'age 4 of 4
APR-15-2005 09�08 CENTER PT ENERGY 612 321 5480 P.06
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