HomeMy WebLinkAbout14754 Timberwolf Trl ROW Permit � `. -
I • t
, o � . PRIO .
�, : �, MGC4t � 7�
. c r' . b
�� ��i
~ '�� ✓V
U , a �
��
WORK ORDER �� � r I �o (��Q��o
. a'�NNESO�P PERMIT
TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS
AND
APPLICATION FOR INSTALLATION OF UTILITIES .
�. ��on �1�7..�'�{ �i��d�n�a�F T/� /Vr.�
2. NatureofWork Install new 5/8" Plastic gas service line. .
3. Indicate below items to be affected and include a sketch or plan of work to be done.
Curb & Gutter Street Surface
TraiUSidewallc Trees:
Pond/Wetlands (Publically owned
Traffic Control Devices/Signs or Privately owned _,
Drainage Urilities
StructureBuildings Othe �/�ASs GRi4�0�L
4. Method of Installation or Construction ��/�/A� �
S. Work to start on or after: ���4� and shall be completed by: la -3/ °�?5 ' �less an extension
� � granted to: by:
DATE STAFF/DATE
6. Will detouring of traffic be necessary? N� If necessary to detour traffic, describe suggested
route:
7. Provide with this application a copy of the contractors Public Lia6ility Insurance.
DETOURS: The Director of Public Works shall be notified in wricinE at least 72 hoLrs in advance of
any detow being established, changed or discontinued.
NAMEOFAPPLICANT CenterPoint Energy _ p 612-321
PL.FASE PRINT FAX 612-321-5480
ADDRESS �00 Linden Avenue West, P.O. Box 1165, Minneapolis, MN 55440-1165
STREET CITY STATE ZIp
NAME OF PARTY OR ORGANIZATION PERFORMING WORK Michels Corp.
. CONTACT PERSON: Steve� Jahnson EMERGENCY (24 HR.) PHONE #: 612-372-5050
ADDRESS DAY PHONE 612-32 �-50.�,6
STREET CITY STATE ZIP
The undersigned herewith accepts the terms and conditions of this permit by the City of Prior Lake as herein
contained and a e to ly comply therewith to the satisfaction of the City of Prior Lake.
Signed T��e; Enq . As s is t. D c� �vZS �OS'
� Page 1 of 4
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
� GN FAt IAt AoDrlvrt tntmr e��e� r..,c., , �
• ..��
• � .
EXHIBIT "C"
FOR CITY USE ONLY AUTHORIZATION OF PERNIIT
FINANCIAL SECURITY: AMOLJNT: TYPE: . '
(Cash, bond, LOC etc.)
Fee: $ 0� Receipt No. !!y� Permit No. V_
LIABII.ITY INSURANCE PROVIDED: Associated Electric & Gas Insurance Services Limited
In consideration of agreement to comply in all respecu with the regulations of the City of Prior Lake covering such
operations, and pursuant to authorization duly given by said Ciry of Prior Lake; permission is hereby granted for the
work to be done as described in the above application, said work to be done in accordance with special provisions as
hereby stated:
APPROVED BY: DEPT. OF PUBLIC WORKS
By; �� 3 -i �
/DATE
ALL LEGAL REQUIREMENTS SHOWN ON PAGE ONE (1) AND ON ALL "SPECIAL PROVISIONS" SHALL
BE COMPLIED WITH. TF� DATE WI�N WORK IS COMPLETED MUST BE REPORTED TO Tf� CITY
OF PRIOR LAKE CTTY ENGINEER
.
�n+�.uoc Page 2 of 4
' EXHIBIT "C"
CITY OF PRIOR LAKE
REGULATIONS PERTAINING TO THE INSTALLATION OR
REPAIR OF UNDERGROUND UTILITIES IN CITY STREETS
OR IN CITY RIGHT-OF-WAY/EASENIENTS
The following regulations and conditions constitute a part of the application made by any installer 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 these regulations and conditions: '
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. Unon comnletion of the oroi�ct the individual shall romFti notifv the it� F� � ineering�enariment for
final msnechon•
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 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 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 or contractor of any of his legal
responsibilities or liabilities for the safety of the public. '
4. All openings in bituminous surfaces shall be cut in a straight line 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 for highway embankment construction. 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") of the backfill shall meet Minnesota Highway Departrnent Specifications for
Class 5 material and shall be compacted to not tess than 95 percent of modified Proctor density.
As soon as possible after backfill operarions aze 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 as removed from the roadway, except, that in no case,
will a plant mixed asphalt of less qua�ity than Minnesota Highway Department Specifications 2331 be
used. The finished surface of the patch shall conform to the surface of the undisturbed roadway.
No permanent asphalt patches shail be on any base whose temperature is 32 degrees Fahrenheit or less.
Cold weather patching shali be of temporary nature, using cold mixed asphalt, well graded crushed rock or
similar approved materia(s. Temporary patches shall be true to line and grade. Temporary patches shall be
replaced by permanent patches when weather conditions permit and notification shail be required as stated
in 2.
°°�'TG� Page 3 of 4
EXHIBIT �°C"
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 ali 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.
8. Permittee shall save the City 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 fumish evidence of public liabiliry insurance of not less than $100,000/300,000 and
property damage of not less than $25,000 issued by an insurance 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 Ciry, its agenu and its employees, the permittee 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 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 faciliry under this application and permit for
construcrion.
12. Existing Facilities - The utility faciIity and installations shali not interfere with any existing utility facility
on the City's right-of-way or easements. It is tl�e 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 allow the applicant to work on private property.
14. Cutting Trees - T'he permission herein granted does not confer upon the permittee the right to cut, remove
or destroy trees or shrubbery within the legal limits of the right-of-way, easements that are not specifically
identified 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 clean after construction is completed and left in a neat and presentable condition.
16. Replacement of Sod - Wherever top-soii 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 Ordinances.
DATE: a �°�s ��S SIGNED:
��� Page 4 of 4
. .
a ' y
�
�
m ; '
0
�
:�
�e _ � �
7
�. �..
.
� •
�
V ; �
�" r .._ ,-------..
.�ti ,�C--
. ' n �ti �
I
. I � �9 �
� 1^ �: :
a � �
i
�sW
�� , ta.
' �O
'�r
38^ri
a
'.��h `����'
�
/�R
D 9��1 �
L�1 �10Ma3
�lt �, ��'. by . _�_-
.- �
� / \
%,
�'
�r, � _�-.---""'_ - ....�� .
ti•
~ .9L
dt
a , ...
��1
%
�''�'; �
� �
"� �� '�1;'�.
p� �g s '° or ;' -- .�'„�,,,
r -
� �� NC �
�, '"�„�„_____�.�-'�� �
� C(� . �
/
� .__.._.._,_....,�/
�
.�' � �� o
,;� a �
n �
p m
� ^'�'. N(:fJ� �
ry � ..c �J-.v .. �
� _ a � �
: �. � � �
.�n ' $ ���
_ � "`, - � � � \ �JS p0
i � 1 _ ��F �
� �� n� ,-1
iia q�� y :o �'> � ��
N � = ,�: � �
if u n�aN g'� t: �m p r � � A� :.
m,� A,c Q' �' � �� ° : � �` ��'�L,. � �g \ � p s' ���'������ �
m0'a �..,' �,Aa h �, � J� /N � � s' ,q � +`�a�'
ni �$ ip �+ � / ` 1 �„ , \,� ^� ` t" f <,
1 � NO2'34'14"E 1}5.00 �j .�� _ wl8: ''�� /� o � �� '''s J
�; ' ;2 �
I � " f �` '' � `�; F1 `4 e' ^..
�'� �G '��^ � �° / �L v IN 00
� �' �' � � s=.e , a � � �� � � N
i i i`.� . 0 ` 6 <5 D l -� �\ a ' °�z�-° �� � 4 �'� s. M �p 0 l� 15y� �0 0� �,y'
Q i o�l' � d�; �."' � - y �SO, ° � �25. 52� N`.
+� � � � � - �/ �' ^ � „ ) �"{� @ r ��- y a.eal� . � OV �^
' � ` v ,, � ii� D U � � G � :; V � �� : `�L"601 � H � J' ���07�� � "
� ;'ON". �� ' � � A yo / 'o� C: �r i� <<.a:s�.�l F � � � 1 Tz �'�oo y
� a A � {wl 1 c 3 � � ,\ r c�. 1 i$ .
�+ 1o � r\ � s': jl.,i }ce �� ��\43 Q S
I J_lLiu_5o L �S N cj J 1 \\`�.
' D a e� � ' _� 's�. =� u0'�9 '.H�. 7' 1 ! v I 1° � t
T +6 1 \ ir a .J a , �f._ eC.w.�S� ��,v �`��
�� p �L z � y ,�` � ,�, ?�� /,. � � cc N `! �� ` R A � �1 1 I
\ ' o ,�`� / �,' ,.. � � 1 y :, 4 ?� ' '� � � p � /y � � ,� \ `</ _ P j L e ea� :
� '�i' o �'" 4 N� f �: ` q c` �� r bJ � 7 io� � � - .��.`r`=- ^�wFsss. _�
l � 69N � /� ,c�i I�� � �oa� _ ���"�v '� �� I j � `:\�� .1�" p yazron� o , �; ��
„ � ,� 0 O, k.�000 :f" . '. � ) � ,•
� = O 4 yS. ��. / F m7x�wcq..c "� " i a�t..t�.c , �. ! 1 r � � ��o / �`' �
�� o � CQ �i y5. t ! =' o, a , •I ti � �'� J�'-�>_..is'ce ' f f `� �� �. Sz��. .. \Q
8 � 'r- 0� L'� � / �: N01OS'.7�"E � �eam��., r zs ' a �1s__ -- - -' ` � �� � � „ �.�
s `, 'l, . �,� pti• -�-�` * -y4 'r a �0..7'�e-w` "' - + N y a \ � . uo a , . '.,,s
� J •� � O r ."'�__� - �1 r , �BjO • �z. ht �iBB.1f 'l � � �� . �a���J l \ M• y ��55 �
��.,7 .� '` - � � �N � N „'1 r ¢n a � 4 � OP ! � ` ^ �M ''ii�W � 1 J v' �., ai � ` $ o� . ` p \ Av
` t..' p �8 a e � ��;�v`. 1�„ � � \ , • ,� ' � ti� i ' c" � �Y; �
¢ c] � 1 ,ou � 8' �'.. 9`y. A V.� 5 .�d' . ,� .'�.� •
��"�� •_�f m�� N� u� up` � � �.� � � �'.7' d�`I��'19�j�'� f i �96�, /d� MQ
� I J' ,�- �� 1] � J 1-r. _` jOJ�h x� 4♦ / J��..
� � + �• J °� �\ .��� ��3� iVG D%f � i!
_ U � s ��_ _ � MHCS�.a�q iaa,oz u � �' � � � � � \ \ � � o9r4 �i " � �� ,'� .� � v
j � •'�:' � � � _ ° li ea� , 3.so.ao.sos ./ .o ` � , � %, � �' �
\ "� �, - - - e �
��ps �� ` a; \ efiFY1 rrAa� ;�,��\ �� � _ ._�� ` �� ����1- .�1 ! n r ; � � .h' / r o� ,\�
r � \ Q .+^. + < � � �, � ;5� J �a �o � \
I ` � 4 ` � � �\ � � r-- , �z ��' M � � ��. �� f '�;� .
\ � � O .t U �: ' \ \ �° � I 1 `� (1� , 1'v. D � i w / �. \ �
i a v� � � b }., �,�t • �` � �i� gi , r� � 1 ,N. � V", " � ,�', a' �` a �'c � q° °• � ��
� wa � � Q �;: \"Q �! � 1 � `�on � 7u 1 ' 1', � �� • .�,� o �. ' � w Y\, \ ,-.
( m " �� �-�� f t� ,,W� , � �� '��!�� I i' '� � �' l"' � \ �, M1 � ° - \ V
1:'
i =* � � . � C7 1 ,' , � { j `� � �� a � � �, '�v qo . f n�' ' ;,� �� � ._ -.
IM x \ ����. 1 j �e.ex r _-_ I � I: �� I ���4 �\ 1 �� ,✓° � � �� O
� � � �, � \� � � � -� -1 � �9��� ti n, l �` � 'L ;� �� � 3-
- -'�� .'"' n '� �` - - �
� � � 'Y��N: �i \� �a �i� i ��4�s pp'LC1�-�__�.' O ..G, , ' �6'G yiB __``,
� �i i' iA 1 l f �.v.. ( g 9C�L y �l :.� � � ".�� � ,� N N �,' ai0' a ' � .. ^ t . ! . � --.
� / �1. e.'b�' � N � � .'� re �if `s"� �` � ' I y }' 1 y, , . � � w \
�s. l 5 W �r'a J` y � i; '���t+���l�11�� i �� .
� /i N" � iCi3 1 D� F , p { T1f Qa'� � S'.� ,.q5 �� Y" .�j, � FI \ ��
i, a'• �, l �� I = � � '� � `�`>e a ` � + 0 1 � �''s'�� * � n � �`
/ 'fie o e. � � , � ,` . M; �t,.. a� i . ___
r o � ' �� �� j 1 � 9yi,��. + . '� ,y. �y�ab _ � � ` J�•,`� �
I � �. v'o� ,u � • d�" a. 1 Y � 9 ..t i� °�'� -� � �i9os `.{ � 1 � � F . � • ,
� � u 1 �� - � � F `�'J� ° q 5 a` °° -+ � � . E y 1 � � ts°� � � /�7 �, � � ��
M n �' ���"6'�� ���s � 1� \.� r } /� 1 ti t m�' � ���� � iy �i
+a � \ i �, _59Wi �,: �- `zi "� m � . � �V 4 � l l :$ � � 1� O'��.
� V V '� � s L,a :' s ee • V l�' : l 1 � �� 1 � 's �� 4�.6
� � ' �: `� " �����' ����, r . €� =e � � v t � � �� � u ���,��� .,��"
' � -��� � �:- - �'/` �i z tt
N �
_ _ ^ ,LI.SO ` �': iO r . 1�.1 I.�i�l 1 ^5 'ml V �� �\
r- H01.6 lt' 0 "n0� ,� � vd� � � il l �`�� Q 7
i u ! u V �} -- 1 l� -00ivio� � V� p o �� i R7 l m P1 � �, ;� � �
N w ad i �'� � � m� � o a�• „l � ^1 1 �P �� � r
k c: m m� �� ,�cc. � P � Ni i g .► t 1 � l V w � 1
i w ie�l 1--- ��, ;�''=�a �s� >� � i � � � a� i tO � s � 7 t y t � 1 •
� •° --o "� � .�t0' '+ ` �� w �� �,, �� �
� y^ � �'g! I�g�� J���us � F a z u3js� s j i a �� � �� a `� �l i%;
����� I �I }� I_ X.. y -� 9 i�Jll H51tl,� C'�I 1 �_ - - �� - l l �� .4'
_':tStL�_-,e�.II�.9E.vi+__._� � �r� �U \ „� A11 , ?I l i�� � �1� �
- �m'za'asrr -' ` - Yrc7r' ^ :1 �II� Ip" � � i � �.^ `� w1 y �:J � „ _ ��� �� �, y /
U °� j ��� � � j � � I �� ' � ! 1 � �� l 1 � �� . \ .�
�� i �, _ �rs.�s �J i i.os ' . � 4 -- � �' 1 � /
� N �f. h --- s,x:aa��c____ �
\ n� 'IT�+ „. r.il,s� � V \ ~ � �1 1 ,� � /
llmw'esw -.aD� � [•� `� !
a � \ ��� Vi & � i ''7' T' � _. � �' 7/ T� L _ �
A A� T �S�Tf6N N / � �1 � � `°'�3.'2C0 • ._ li9 l i �` � �1 i
�� l �� � �� �.� ' C � ! i� • � f 1 � ss � -��� � ,\ /
� ,` "� _ �� � I � � � \: i 4 � I 7 '9. � � 1. � �x' �' - \ u� � � �� � /
• _. '� a.00 i �\ i x ec�, (�
`\ � Ly �%��'7�SIICET�'`�G�N .. 1 1�=;-' Q i 5' `� �ru� SEE O�- �,= r�` 9 J.�) _�~\ � i(
,a T -'.,�� s ` r +'"tf l �
� 4 . � � , �. --
� �'{• � ., s�;� ?��•�, . `--- �
� ;� _ � s 5� � �__� _:• s� ------ +�Y=--, ti�
\ ���1 ^ 1 4 a`. :' / h� 1 !a .� � � t � i �� i 4.
en�pr y � -� ; �tiopc.� � ��1� h�.� � / U � q,� y l S :, / . .. \ � �� � .. i �v
�• �: "_. �Ob✓NQ . �Y � / / � D / b ! � `� �J � /
/ � (�� . ` ..l� `' � J I
,�/ rj � � fo �� �� l,: pL N f ! � ; �l � l /o- 4n • � � !
, o�o i
1.�`� � '��' .� -'�`, •�- \ i�r: �`� + � `� :7 i i�aF` rn � .i�, i
�� � d \ � � � J / � 1�• �'hj� 1 �9 �J �
� r`' � �� H `"aa�` ����rc�., `.. � � � 7 �°� J ��< <cy ti U b M b j ` � . � .\ .
ry -Ly' �a� /�y a io� �`-. � �^zi�^ '. � s { t , C . I , I ��yN � or � c J � , ..-.
� �S� �(�-" y; ''�� �� •�. a d� : i �_'�� oc r y' f >-'
'�� �,',�^ c, '�' n � s� !' o� �~ � I / s�_'o o a` � i n J�
.(� 3 p , ��� � � 61p � � ^ t ,, ' fr � `+ . �
° � ' �a � ° �� o 'z _ ^` .z �. y; . �
� �1 m O�� � OQ ( ' ] �� i ry ` �^�95.sg.lr.n i ,� 'Y� �,� /
yw` � . � � '%Q'> � � ' ........�. 4E$ \%�`r /
��i
� � .` � � t o '� � /A � i `"/ aA�oc�an �:� 1a /
'4`�., . ' � . � '�I' ` . �e , /
07.r .. � i \ � � � A� �'�Z
'ys` il �f �` • �., �' r �B o�2:C� , � -- .oza•.sz=c - ; , c ' ` M1_ , i
3� ^v ^ 1
�JO�J �q '�'�` \� J �,�,/ iv � i �' 9 y[ � a�.l r '� ~ �+� /
) �� �' rr�' e�� in e: �ai`� - --- `--J .
)QMQ1IMe J) 4�, c N x n � N . �� � � �- � 6 ti y . ia 3 .cr,�r.c o „ -�
. r4� ./:o' 4' .. I /� A1 ! �Q� . �l _ ii�. 1 f. /
.�