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Home My WebLink About14891 Wilds Parkway FF�OM (TUE) 10. 26' 04 8:45/ST. 8:44/NO. 4862350597 P 3 • ' C4MO249 ........ ......, � � ` SHKPMNSH � � pR �' �� i_� �J '''�7 � � � i 0 0 . �� : zM�`' •. � OCT 2 7° ZU04 ,�,,, _:� .�,a,.: �t � H `��`` , � � r .. ..,; � ►.y .°�,�-s��.`` y.;�? x u » V a y,J � �jN K E s a�� , PERNIIT TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS AND APPLICATION FOR INSTALLATION OF UTILITIES . 1. Location 14891 Wilds yarkway/Vi�1aQp ar rhP Wilds 2. Nahtre of Work Move fiber cable and �edestal • 3. Indicate below items to be affected and include a sketch or plan of work to 6e doae. Curb & Gutter 3treet Surface TraiVSidewallt 'I} Pond/Wetlands (Publically owned Traffic Control Devices/Signs or Privately owned _� � Drainage Utilities SttvctureBuildings Other Scrub �rass . � 4. Method of Installation or Construction Tren�h j�a,ckhoe 5. Work to start on or after: 10�/ 2Q04 and shall be completed by: 11�/0� / 2o(1G iu�less an extension granted to: by: DATE STAFF/DATE 6. Will detouring of tr�c be necessary? N� If necessary to detour traffic, describe suggested route: 7. Provide with this application a eopy of the contractors Publie Liability Insurance. DETOURS: The Director of Public Works shall be �otified in writine at least 72 hours in advance of any detow being es4blished, changed or discontinued. NAME OF APPLICANT Owest PHONE 612-861—A111 PLEASE PRINT FAX 612-861-8 t 73 ADDRESS 6244 Cedar Avenue South . Bichfield MN 554 3 STREET CITY � STATE ZIP NAME OF PARTY OR ORGANIZATION PBRFORMING WORK Qwest CONTACT PERSON: Dan Norman EMERGENCY (24 HR.) PHONE #:1-A �n-954-1211 ADDRESS �44 Ged�r Ave _ c_, Ri r}� f i nl rl � MN 5542,�AY PHONE612-861-87/.�4 STREET CITY STATE ZIP The undersigned herewith accepts the terms and conditions of this perntit by the City of Prior Lake as herein eontained and agree to fully comply therewith to the satisfaction of the City of Prior Lake. Signed: itle: Engineer Date:October 25, 2004 e�e�rc.noc Page 1 of 4 16`L00 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612j 447-4245 AN FQUAt_ pPPnRTI INITY FMPI f1VFR � FAOM (TUE) 10. 26' 04 8:45/ST. 8:44/NO. 4862350597 P 4 EXHIBIT "C" FOR CITY USE ONLY AUTHbRIZATION OF PERMIT FIIVANCIAL SECURITY: AMOUNT; TYPE: � (Cash, bond, LOC etc.) Fee: � d�.S� /9�� Receipt No. Z Z Permit No. V'G� ' LIABILITY INSURANCE PROVIDED: //'/y��/�' ��'!L In consideration of agreement to comply in all raspects with the rcgulations of the City of Prior Lake coveri�g such � operations, and pursuant to authorizaHon duly given by said City of Prior Lake; permission is hereby granted for the work to be done as describad in the above application, said work to be done in accordance with special provisions as hereby stated: � � APPROVED BY: DEPT. OF PUBLIC WORKS B �'��--- /l - 3 ' /DATE ALL LEGAL REQUIREMENTS SHOWN ON PAGE ONB (1) AND ON ALL "SPECIAL PROVISIONS" SHALL BE COMPLIED WITI-]. THE DATE WHEN WORK IS COMPLETED MCJST BE REPORTED TO THE C[TY OF PRIOR LAKE CITY ENGINEER. EXE�7TC_DOC Page 2 of 4 FBOM (TUE) 10. 26' 04 8:45/ST. 8:44/N0. 4862350597 P 5 EXHIBIT "C" CITY OF PRIOR LAKE REGULATIONS PERTAINING TO THE INSTALLATION OR REPAIR OF UNDERGROUND UTILTTIES IN CITY STREETS OR IN CITY RIGHT-OF-WAY/EASEMENTS The fol►owing 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 utility easement and the appiicant, i� 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 Bngineer when the work at each location is to commence; and, when requested by the Engineer, shall submit plans and specifications. � 2. Uoon com�lerion of thc prqject. the individ�A� �hA11 ��t�y notifv the �'iri��inePring�narhne^* f^• final insroection. 3. The public is to be protected by ihe individual, at all times, frorn 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 fumish, erect, and rnaintain, in accordance with the legally accepted standards, all necessary warniag and tcaffic control signs, barricades, tra�c cones, and flashing lights to direct and conh�ol the movement of traffic through the project in all directions and at all times. The foresoing provisions shall not in any way relieve the installer ar contractor of any of his legal � responsibilities or liabilities for the safety of the public. , 4. All openings in bituminous surfaces sha11 be cut in a straight line with sides smooth and verticat. No ragged edges will be permitted. Cutting shall be done with a concrete saw, cutting wheel, jack hammer, spades or sirnilar approved tools. Backfill material shall be suitahle 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 sha11 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 Deparhnent Specifications for Ctass 5 material and shall be compacted to not less than 95 percent of modified Proetor 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 3S-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 quality than Minnesota Highway Department Specifications 2331 be used. The finished surface of the patch sha11 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 shull be of temporary nature, using cold mixed asphalt, well graded crushed rock or similar approved rnaterials. Temporary patches shall be true to line and grade. Temporary patches shall be replaced by permanent patches when weather conditions permit and notiftcation shall be reqvired as stated in 2. ��TC.00c Page 3 of 4 FAOM (TUE) 10. 26' 04 8:45/ST. 8:44/NO. 4862350597 P 6 EXHIBIT ��C" S• Other areas may be required to be compacted at the direction of the City Enginecr. 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 promptly indic�ted by adequate warning signs and shall be restored to proper condition in•accordance with specifications above provided as soon as conditions pertnit. 7• All culverts and ditches shall be rep(aced in their original position and condition existing prior to construction and no change shall be made in drainage without approval of the City Engineer. $• 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 fmally 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 nat less than 5100,000/300,000 and property damage of not less than $25,000 issued by an insuraace company authorized to do business in the � 5tate of Minnesota on which the City is named as an addiNonal 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, including but not limited to the placing, constructing, aod reconstrucring, 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 -'Ihc work permit or permit for construction as issued does not in any way imply that the appropriate easemeni exists to aqow the applicant to work on private property. 14. Cutting Trees - The permission herein granted does not confer upon the permittee ihe right to cut, remove or destroy trees or shrubbery within the legal limits of the right-of-way, easaments 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 rnaintained 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: SIGNED: e�irc.noc Page 4 of 4 ♦ . FAOM (TUE) 10. 26' 04 8:46/ST. 8:44/NO. 4862350597 P 7 � , , . � f Ll�A-� e � . �� 2 Lvi l-b s , � � w � \ ride the l�ght ,..">� ., � �---�w�� ` QWeS�. y • � WORK LOCATIOP�: � / �/'�q/ wl �er � ��KW,4 � �JOv�e ��f`��G �/��eR � � Q�. �N/VEcR D �! (r',�' ' ,�il�'TD U7YNT y f C l�� /v✓, � �t ��✓'r.,%. �.•Y� p�'�'P��t�.v� o By �0 �e1� � R W ! DRAWING DISCLAIMER • FACITILY LOCAYIONS ARE GENERAL � IN NATURE Qwest WILL NOT BE HELD � � ACCOUNTABIE FOR THE ACCURACY 3 � OF•THE INFORMATION PROVIDED ON � THESE DRAWINGS �A/1 L 19f �/�/ � . ( I�R�� - i Restore all disturbed surfaces to � original or better condition GOPHER STATE ONE CALL � W 1 800 252-1166 � �wsst Engineer: GARRY YOHN I 6244 Cedar Av S � Richfield, MN 55423 Telephone Number 612-861-81 1 1 Fax Number 612-861-8173 � .._ --- -�1- � — � P r � n t - P ro po�s � i-o 1 e � � � � �,' _� �.� � , � ?r C�le - ��u�� ' --� . 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