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HomeMy WebLinkAbout3072 Bobcat Trl ROW Permit , , e� . , o � . PR jo � � ,,. � MGC4� !�+ '';� •� � � ,:�,;..�, x c� � U �� WORK ORDER ����I �0 �i �v �� MJ �' N E S ��P PERNIIT � TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS AND APPLICATION FOR INSTALLATION OF UTILITIES . 1. Location .� � 70� ,(g v,(� �,'� % �� 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 DeviceslSigns or Privately owned _) Drainage Utilities StructureBuildings Othe �i�s.5 G/�/4(��[, 4. Method of Installation or Construcrion �6���� 5. Work to stazt on or after. ���and shall be completed by: l0 :3/�'�25�unless an extension • � granted to: by: DATE ' STAFF/DATE 6. Will detouring of traffic be necessary? NO 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 wricin� at least 72 hours in advance of any detour being established, changed or discontinued. NANIEOFAPPLICANT CenterPoint Energy P HO� 612-321 PLEASE PRINT FAX 612-321-5480 ADDRESS �00 Linden Avenue West, P.O. Box 1165, Minneapolis, MN 55440-1165 STREE'T CITY STATE ZIP NAME OF PARTY OR ORGAIJIZATION PERFORMING WORK Michels Corp. CONTACT PERSON: Steve� Jahn�on 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 agree to co ply therewith to the satisfaction of the City of Prior Lake. Signed:, ��e; Eng.Assist. Date: a '`�"s �c��. �noc Page 1 of 4 16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. i612) 447-4230 / Fax (612) 447-4245 � CN FA1 IAI ADDAD'R O�tITJ e�m� i+vcn • M' [' EX�IIBIT �°C" FOR CITY USE ONLY AUTHORIZATION OF PERNIIT FINANCIAL SECURITY: AMOLJNT; Typg; - (Cash, bond, LOC etc.) Fee: S 2SC�D� Receipt Na 0 OD Permit No. - LIABILITY INSURANCE PROVIDED: Associated Electric & Gas Insurance Services Limited In consideration of agreemenc to comply in all respects with the regulations of the City of Prior Lake covering such ' operations, and pursuant to authorization duly given by said City 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: .��/ ���_� /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 NNST BE REPORTED TO THE CITY OF PRIOR LAKE CITY ENGINEER �� Page 2 of 4 .� � '� ' EXHIBIT "C" CITY OF PRIOR LAKE REGULATIONS PERTAINING TO THE INSTALLATION OR REPAIR OF UNDERGROUND UTILITTES IN CITY STREETS � OR IN CITY RIGHT-OF-WAY/EASEMENTS The following regulations and conditions constitute a part of the application made by any installer or contractor for the installation of utilities in any Ciry street right-of-way or City utiliry 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 Ciry Engineer when the work at each location is to commence; and, when requested by the Engineer, shall submit plans and " specifications. � 2. Uoon comnletion of the oroiect the individ�al shall prompti notifv the itv Fn �ineerin� Dgp$rtment for final �n ect�on. 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 con�ol 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 hatnmer, 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 densiry. The upper six inches (6") of the backfill shall meet Minnesota Highway Department Specificarions for Class 5 material and shall be compacted to not less than 95 percent of modified Proctor density. As soon as possible after backfill operarions 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 materiai 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 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 shalt be true to line and grade. Temporary patches shall be replaced by permanent patches when weather conditions permit and notification shall be required as stated in 2. �R��� Page 3 of 4 . �. s . EXHIBIT "C" 5. Other areas may be required to be compacted at the direction of the Ciry Engineer. � 6. Such permittee to be responsible for maintenance and repair of all trenches for a period of one ( i) year and if settiement 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 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 pazty claims for injury or damage which may occur between the tirne the work commences and the time it is finally accepted by the City. 9. 'fhe permittee may be required to jack or bore under certain streets, as determined by the City Engineer. 10. The applicant shall furnish evidence of public liability 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 parry. 11. Except for the negligent acts of the City, its agenu and iu employees, the permittee shail assume all liabiliry 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, acrions 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 constiuction. 12. Existing Facilities - The utility facility and installarions shall 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 - The permission herein granted does not confer upon the permittee the right to cut, remove or destroy trees or shrubbery within the legal limiu 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-soil and sod are disturbed, they shall be replaced in kind and maintained satisfactorily until the turf is established. The undersigned hereby deciazes he/she has read and will comply with all the PERTINENT REGULATIONS as stated above and relevant City Ordinances. v �`� DATE: o� '0�-5 ' 0 :7 SIGNED: ��� Page 4 of 4 i ♦ . t . ♦ w ! GENERAL LOCATION ONLY. DO NOT USE TO LOCATE FOR EXCAVATION. CALL 1-800-252-1166 FOR ONSITE LOCATIONS AND STAKING. i 18' .�._�. . . ..... _. . , . . . . ..... . . . . N � / ,.i e� f },. NIC N ', � 3072 ,� � , ,. _.,.. ,,,,, • ' 3 ; PrT __ ...... _ . . _ _- . s.�, ,. __l-_r� _ _ � A 6168 20D12' TR CL-6 � � 7YHD N ..... . . ......... . ...... . .... ` �..,, � 9 s'�� w �1 l '� Plotted by: i213254 CENTERPOINT ENERGY Scale: 1" :100' Plot Date: 2/9/2005 Field2: �h .. . • • „ '�. .