HomeMy WebLinkAbout15271 Fairbanks Trl ROW Permit ' W/Of� 20050635 FEE $250.00 � MVEC PAY ❑ MEMBER PAY (check
one)
EXHIBIT "C"
TO
PRIOR LAKE PUBLIC WORKS DESIGN MANUAL
PERMIT TO WORK WITHIN CITY PROPERTY RIGHT-OF-WAY/EQSEMENTS
AND
APPLICATION FOR INSTALLATION OF UTILITIES
1. Location:
2. Nature of Work: Bore roadway for underground electric to 15271 Fairbanks
3. Indicate below items to be affected and include a sketch or plan of work to be done.
❑ Cwb & Gutter � Slreet
❑ TraiUSidewalk ❑ Trees:
❑ Pond/Wetlands ❑ (Publicly owned ❑ _
❑ Traffic Coirirol Devices/Signs ❑ Or Privately owned [])
� �.�� ❑ Utilities
❑ StructureBuildings ��'
4. Method of Installation or Conshuction Bore
5. Work to start on or after: 511/OS and shall be completed by: 6/15/OS unless an extension granted to:
by: I
DATE STAFF/DATE
6. Will detouring of traffic be necessary? NO If nece.ssary to detour txa�c, d�scribe suggested route:
'7. Provide with this application a copy of the coatractors Public Liability Insurance.
DETOURS: The Director of Public Works shall be notified in writin� at least 72 hours in advance of any
detour being established, changed or discontinued.
NAME OF APPLICANT MINNESOTA VALLEY ELECTRIC COOPERATIVE PHONE 952-492-2313
PLEASE PRINT
ADDRESS 125 MINNESOTA VALLEY ELECTRIC DRNE JORDAN MN 55352
STREET CITY STATE 7
NAME OF PARTY OR ORGAIJIZATION PERFORMING WORK: Minnesota Vallev Electric Coo�ative
CONTACT PERSON: Bob Fenner
EMERGENCY (24 HR.) PHONE#: 952-492-2313
ADDRESS: 125 Minnesota Vallev Electric Dr Jordan MN 55352 DAY PHONE 952-492-2313
STREET, CTTY STATE ZIP
The undersigned h�ewith accepts the teims and conditions of this permit by the City of Priar Lake as h�ein contai�ed and agree to
fully compl therewith to the satisfacti of the City of Prior Lake.
Signed: � �-e�t//t•�/►� Date:4t26/2005
Bob Fenner
H:\Utility P��Ciry of Priot Leke\15271 Fattlmnlm.doc
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EXHIBIT "C"
TO
PRIOR LAKE PUBLIC WORKS DESIGN MANUAL
PERMIT TO WORK WITHIN CITY PROPERTY RIGHT-OF-WAY/EASEMENTS
AND
APPLICATION F�R INSTALLATION OF UTILITIES
PAGE 2
FOR CITY USE ONLY AUTHORIZATION OF PERMIT
FINANCIAL SECURITY: AMOUNT: NPE�
(Cash, Bond,
LOC, Etc.)
Fee: $ �5�6f� Receipt No. ��� 7s��.._Permit No. Cl��� ��
LtABIILiTY INSURANCE PROVIDED: ���/al�cd �I�Si�+''�eCt
In consideration of agreement 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
gy: � y �/ �
1DATE
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 LAKE CITY ENGINEER.
H:\Utility PecmiYs�Cily of Pcior Leke\I5271 Faubenks.doc
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EXHIBIT "C"
TO
PRIOR LAKE PUBLIC WORKS DESIGN MANUAL
REGULATIONS PERTAINING TO THE INSTALLATION OR
REPAIR OF UNDERGROUND UTILITIES 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 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 ���� ������ �s �h� M; �;�� +ho ��.��.a.����� �n�u .,���„�,�ri� �nt� the Citv Ens�ineerin� DepartmeM for final
insqection.
3. The public is to be protected by the individual, at all times, from the commencemerrt of the work uMil 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 corrtractor shall fumish, erect, and
maintain, in accordance with the legally accepted standards, all necessary waming and traffic coMrol signs,
barricades, traffic cones, and flashing lights to direct and controt the movemerrt 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 ragg�f
edges will � 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, s�, 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 madified Prodor density.
The upper six inches (6'� of the backfill shall meet Minnesota Highway Department Specifications for Class 5
material 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 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 modfied 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 quality than Minnesota Highway Department Specifications 2331 be used.
The finished surface of the patch shall conform to the surFace of the ur�istur�d roadway.
No permanent asphalt patches shall be on any base whose temperature is 32 degrees Fahrenheit or less.
Cold weather patching shall � 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 be
replaced by permanent patches when weather conditions permit and notiflcation shall be required as stated
in 2.
5. Othe� areas may be required to be compacted at the diredion 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 prompdy indicated by adequate waming signs
H:\Utility Pemub�City ofPrior Leke\I5271 Faubenks.doc
` ' 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 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 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 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, inGuding but not limited to the placing, constructing, 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 easements. It is the 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 prnrate property.
14. Cutting Trees — The permission herein granted does not confer u�n 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 othervvise
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. ReplacemeM of S� — Wherever top-soil and sod are disturbed, they shall be replaced in kind and
maintained satisfadorily until the turf is established.
The undersigned hereby declares he/she has read and will com�y with all the PERTINENT REGULATIONS as
stated above and relevarrt City Ordinances.
DATE: SIGNED:
H:\Utility PamifslCity of P�mr Lel�e\15271 Feabenks.doc
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