HomeMy WebLinkAboutFish Pt Rd & Fairlawn Shores Trl ROW Permit EXHIBIT "C"
PERMIT
TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS
AND
APPLICATION FOR INSTALLATION OF UTILITIES
1. Location FTSN PDj'NT R,D S.E. AlIlO F�JIRt/-1GUl'l/ SHOi?ES TRA2L S.L-.
2. NatureofWork REPL/!Cg �1U0 RLLD�'A7�' CABLES AS NFCESSA�Y TD F��ILITATE
CITY PRO.TEGT D5-/l
�. Tn�ieate bel�w i±ems tc� be aff�cred and ir.clude a s?ceteh cr nlsn of wock to be done.
Curb & Gutter Street Surface
TraiUSidewalk Trees:
Pond/Wetlands (Pubtically owned
Tra�c Control Devices/Signs or Privately owned _�
Drainage Utilities
StructureBuildings Other `
4. Method of Installation or Construction D.TRECTZDIVl�L BJR� ALCIIU BACK HDE
5. Work to start on or after: -��3/ 5 and shall be completed by: 11- 30 -DS unless an extension
;ranted to: by:
DATE STAFF/DATE
6. Will detouring of traffic be necessary? ND If necessary to detour traffic, describe suggested
route:
7. Provide with this application a copy of the contractors Public Liability Insurance.
DETOURS: The Director of Public Works shall be notified in writi�g at least 72_ o�rs in advance of
any detour being established, changed or discontinued.
NAME OF APPLICANT = N T� Ca�R ��L ��U ���� PHONE �S Z - "`� 7-375P �
PLEASE PRINT FAX 452- 22.l0 - 375f3
ADDRESS �qD CDLbR14'0b St. S�IE, PR1Q'f� 1.Al2E. hnN 553'iZ
STREET CITY STATE ZIP
NAME OF PARTY OR ORGANIZATION PERFORMING WORK
CONTACT PERSON: �N $�`��'��- EMERGENCY (24 HR) PHONE #: �! 2� 9lpl - SP ��
ADDRESS DAY PHONE q5 z2t° -7��n'4'
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 fully comply therewith to the satisfaction of the City of Prior Lake.
Signed: ��- �1+,+^^^+�► '�— Title: �� �� N�E� Date: S � e / -O S
79
�XHIBIT "C"
FOR CITY USE ONLY AUTHORIZATION OI' PERMIT
FINANCIAL SECURITY: AMOUNT: TYPE:
(Cash, bond, LOC etc.)
Fee: $ �A Receipt No. ?ermit No. Ul" "�S ^ 39
LIABILITY INSURANCE PROVIDED: SRp]"",pv0 /'�'I/DDLETaN (it/SuR��/CE
In consideration of agreement to comply in alt respects with the regulations of the City of Prior Lake covering such
operations, and pursuant to luthorization 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 �vith special provisions as
hereby stated:
�o�v/iv�TE �,,ii�H C�TS/ �°Ro✓EcT {�05-!/
APPROVED BY: DEPT. OF PUBLIC WORKS
, s ��.�.: — 9(��.� 5- 23 —� 5
/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 TO THE CITY
OF PRIOR LAKF C?TY ENGINEER.
, 80
EXHIBTT "C"
� CITY OF PRIOR LAKE
� , _ „�
REGULATIONS PERTAINING TO THE INSTALLATION OR
REPAIR OF UNDE�GROUND UTII,ITIES IN CITY STREETS
� OR IN CITY RIGHT OF-WAY/EASEMENTS
The following reaularions and conditions consritute a�art of the applicafion made by any installer or contractor for
the installation of utilities in any City street right-af-way or City utility easement and the applicant, ia malcing his
application to do such work, shall agree to abide by these regulations and conditions: '
1. The individual obtaining the permit shall, before commencing snch work, notify the City Enaineer when
the work at each location is to commence;. and, when requested by the Engineer, shall submit plans and �
specifications. ��
� 2. �T,,00n com�letion of the g�oiect the individual shall �rom�tl notify the Citv Engineering De�artment fQr
final in�ecdon.
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 ;ninimum inconvenience to ihe public. The installer or contractor shall `fumish, erect, and
maintain, in accordarice with the legaIly accepted standards, all necessary waming and traff c control signs,
barricades,: traffic cones, and flashing lights to direct and contirol the movement of �affic through the
project in all directions and at all times.
The. foregoing provisions shaIl not in any way relieve the installei or contractor : of ariy of his legal
� responsibili'ties or liabiliries for the safety of the public. � � .
4. All openings in bituminous surfaces shall be cut in a straight tine with sides smooth and verticat. No
� ragged edges will be permitted. Cutting shalI be done with a concrete saw, cutting wheel, jack hauuner,
spades or samilar approved tools. . __,_ __ -
� Backfill material shall be suitable for highway embanlan�nt construction. No peat, frozen lumps, brokea
: 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 mechanicaIly compacted to
not less than 95 perce� of modified Proctor density. '
The upper six inches (6") of the backfill shall meet Minnesota Highway Departrnent Specifications _ for
' Class 5 mate�ial and shall be compacted to not less than 95 percent of modified Proctor density.
As soon as possible after backfill operations are completed, the cut bituminous edges of the �ench shall be
painted w�th an asphalt emulsion such as SS-1. Immediatety thereafter, the patching material shalI be
placed and mechanically compacted to noi less than 95 percent of modified Proctor density. The asphaltic
material used in patching shall be of the same tj+pe as removed from the roadway, except, that in no case,
will a plant mixed asphalt of Iess quality than M'uinesota Highway Department Specifications 2331 be
used. The finished surface of the patch shall conform to thesurface of the undisturbed roadway.
No permanent asphalt patches shall be on any base whose temperature is 32 degrees Fahrenheit or less.
Cold weather patch�ng shall be of temporary nature, using cold mixed asphalt, well graded cnuhed rock or
_ similar approved materials. Temporary patches shaIl be trae io Iine and grade. Temporary patches shall be
replaced by permanent patches when weather conditions permit and notification shall be required as stated ••
in 2.
n�nc.noc Page 3 of 4 -
E�IT "C" " ,
5. Other areas may be required to be co�pacted at the direction of the City Engmeer
� s. Such permittee to be responsble 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 }� Promptly indic�ted by adequato v� s�g�s
and shall be restored to proper condition in. accordance with specificahons above provided as .soon as
conditions permit. •
�� All culverts and ditches shail be replaced in their original pos�hon and condition existing prior tc# .
cons�vction and no change shal] be made in drainage without approval of tlie City Engineec, -
8. Permittee shaiI save the City harmless from all third party claims for injury or damage which may occur �
beiween the time the work commences and the time it is finally accepted by t6e City.
9• � The permittee may be required to jack or iiore under certain streets, as determined by �e City Engirieer. _
10. The applicant sha11 fumysh evidence of pi�blic liabi ' � �
�Y ��ance of not less than �100,000/300,000 and �•
P�PertY damage of not less than $25,000 issued by an insvrance company authorized to do business in the :.
State of Minnesota on which the City is nained as an ad�tionaI insured pa�y,, '
11. Except for the negiigent acts of the City, its agents and its emp�oy�� �e p��ttee shail assume all �
liability for, and save; the City, its agents and its employees, bar��� �d defend same at its sole coy�t and
expense from any and all claims for damages, actions or causes of action arising out of the work to lse done
�erein and the continuing uses by the permittee; including but not limited to tho placing, construc�g� �d `
. reconstructing, maintaining, protecting and :use of said facility under this application and � �.
construction. ' perqait for � }.
, I2- Existing Facilities - The utility faciIity and .install�ons shaIl not interf�e with aay existing uq'lity facili ,
on the City's right-of-way or easements. � It is the responsibility of the applicant .to caU for ne�essary �-
Iocations of existing u"tilities. (G�pher One)
- 13. Private Property - T3e work permit or permit for construction as �ssued does not in an wa .
appropriate easement exists to aIlow the applicant to work on private property. Y Y�ply �t the
14. Ctitting Trees - The permission hereia granted does not confer u on the �
or destroy trees or shiub p P�ittee the right to cut; remave ,
bery within the legal limits of the right of-way, easements that are not specifically
identified on the plan attached to this permit ar relieve permittee $am obtaining any conse�t o��L
required from the owner of the property adjacent thereto.
I5. Clean-Up - Street, trailways and affected rig�t-of-way shail be scraped clean at the end of each work da
. and swept clean after cons�vction is completed and left in a neat and presentable condition. y
I6. Replacement of Sod - Wherever top-soil and sod are disturbed, they shall be r�p�� ��d �d
maintained satisfactorily tmtil the M�f is established. .
The undersigned hereby declares he/she has read and will compiy wit� � � p�� �G�TTONS as
stated above and relevant City Ordinances,
DATE: SIGNED:
�mrrc.aoc .
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