HomeMy WebLinkAbout150th St & Estate Ave ROW Permit ` o� ,�::�.��j°� ,
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- . �f N�v � s ��P PERNIIT
TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS
AND
A.PPLICATION FOR INSTALLATION OF UTILITIES
1. Location ! 5 Q u=_. ST/�' �T fl N'l� ES i,c�TE fq�l£ • �
A
2. Nature of Work 1�� �ACE �.(� �64 (� LE '
3. Indicate below items to be affected and include a sketch or plan of work to be dona
Curb & Gutter Street Surface
TraiUSidewallc Trees:
� Pond/Wetlands (Publically owned �
Traffie Control Devices/Sigas or Privately owned )
� Drainage ' Utilities �
� Structure/Buildings Other 5 a � .
4. Method of Installation or Construction ��� C'
5. Work to start on or after: � O and shall be'completed by: �� d•L � unless an extension
granted to: by.
DATE STAFF/DATE �
6. Will detouring of traffic be necessary? �� If necessary to detour traffic, describe suggested
route: ' �
7. Provide with this applicarion a copy of the contractors Public Liability Insurance:
DETOURS: The D'vector of Public Works shall be notified in writing at least 72 hours in advance of
any detour being established, changed or discontinued.
NAME OF APPLICANT M� i.A��n ,� � �. �- C" PHONE �( - 0�' `�014 3
. PLEASE PR1NT FAX s' °�$ (o O
� ADDRESS O C I �- kl � �I ' � � � SJ` 3 � � +
STREET CITY STA ZTP
NAME OF PARTY OR ORGANIZATION PERFORMING WORK M�SI��H �l' .
CONTACT PERSON: Z+� Q a� � EMERGEN Y 24 HR.) PHONE #: - S� '� 7 0�-(
ADDRESS �d � 0 -� QK (J 2 w s I oe.� ��.f e,� �� DAY PHONE .� - K 7a y
� � TREET CITY STATE ZIP � . '
.�O�C f�� �795
iii8 uiiu8i5i�ilZ�;' wii accep�s itie tcniis attd �unuiiions oi in�s permit by the City oi Prior l.ake as herein
cont ined o� ply therewith to the satisfaction of the City of Prior Lake.
---,._ n .
Signed: Title: `--�� S�' � Date: � � ��
�crc.noc Page 1 of 4
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
EX�iIBIT "C»
FOR CITY USE ONLY AUTHORIZATION OF PERMIT
FINANCIAL SECURITY: AMOUNT: TYPE: �
(Cash, bond, LOC etc.)
Fee: $ � S� . °" Receipt No 7 � � 7 Permit No U P — � � ` � �
LIABILITY INSURANCE PROVIDED: 1�'E l-�A�2.PI5' ���ve y /,�/
� 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:
�/�E'� Tio�v�L �o�eC f�oTy sT ,4 T Es7� /9VE �iv0 PI�L(..
� . N �.V Jv/ T, r L�ASCC 7i � APPROVED BY: DEPT. OF PUBLIC WORKS
�G�i�v ;,�cErs � � 452- 29'Z -i35 o g ` -/ -o G .
/DATE ;
l�/�.v Guo,r1,� wi�� /,�E � i
��Fa,Q.n�A. .. ;
ALL LEGAL REQUIREMENTS SHOWN ON PAGE ONE (1) AND ON ALL "SPECIAL PROVISIONS" SHALL
BE COMPLIED WITH: TI� DATE WHEN WORK IS COMPLETED MUST BE REPORTED TO THE CITY i
OF PRIOR LAKE CITY ENGINEER '
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i
EXHIBIT "C"
� CITY OF PRIOR LAKE .
, , .,�
REGULAT'IONS PERTAINING TO TF� INSTALLATION OR
REPAIlt OF UNDE�GROUND UTTLTTIES IN CITY STREETS
• OR IN CITY RIGHT OF-WAY/�ASEMENTS
The following regulations and conditions constitute a�art of the application made by any installer or contractor for
the installation of utilities in any City street right-of-way or City urility easement and the applicant, in making his
application to do such work, shaU agree to abide by these regnlations 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. UFon comnletion ofthe ry�'ect the individual shall promnt]X,noti the Citv Engineeri DeAartment for
final insne�don.
3. The public is to be protected by the individual, at all times, from the commencement of the work uniil the _
completion and acceptance by the City. The installer. or contractor shall so conduct his operations as to
; cause the �ninimum inconvenience to the public. The installer or contractor- shall 'fumish, erect, and
maintain, in accordarice with the legally accepted standards, all necetsary waming and traffic control signs,
: barricades,; traffic cones, and flashing lights to direct and contiol the movement of traffic through th�
project in all direetions and at all times.
� The. foregoing provisions shall not in any way relieve ihe in'staller 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 tine 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 samilar approved tools. .
� Bacicfill ma#erial shall be suitabk for highway embanlQnent construction. No peat, frozea lumps, broken
_ asphalt, sod, roots, or other undesirable material shail be permitted as backfill. Rocks larger than six inches
(6") in diameter shall not be used in bacicfilling of trenches. .
The backfill material shall be placed in layers not to exceed otte 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 Department Specifications, for
� Class 5 matetial aad shall be compacted to not less than 95 percent of modified Proctor density. �
As soon as possible after backfill opentions aze completed, the cut bituminous edges of the trench shall be
painted w#th an asphalt emulsion such as SS-L Iwmediately 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, �xcept, 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 t�e surface of the undistiubed madway.
No permanent asphaIt patcbes 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 gradBd crushed rock or
. . similar approved materials. Temporary patches shall be tive to tine and grade. Temporary patches shall be
replaced by permanent patches when weather conditions permit and notification shall be requiread as stated •�
in 2.
�irc.noc Page 3 of 4 .
EXI�BIT "C" '
5• Other areas may be required to be cor�pacted at the direction of the City Engineer,
� 6• 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 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 permi� � ' .
7. All culverts and ditches sha11 be replaced in theu originai pasition and condition existing prior tct .
construction and no change shall be made ia drainage without approval of the City Engineer, �
8. Permittee shall save the City harmless from ail third party �claims for injury or damage which may occur :
between the tune the work commences and the time it is finally accepted by the City.
9• � The permittee may be required to jack or t�ore under certain streets, as determined by ihe City Engineer. ;
10. The applicant shall furaish evidence of t�blic liabi ' � �
P. 1�Y ��nce of not less than 5100,000/300,000 and � a
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 narned as an additiona� ��d p �,. . '
l l. Except for the negiigent acts of ihe 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 tse done �
herein and the continuing uses by the permittee,• ineluding but not limited to the lacin co � '�
. reconstructing, maintainin ' P g. nstrUCti�S. and :
g, protecting and :use of said facility under this application and per�jnit for �'
construchon. ' � �
, 12• Existing Facili6es - The utility facility and shall not interfere with any existing uti�it�, facility �_
on the City's right-of-wa y or easements. � I t i s t h e r e s p o n s i b i li ty o f t he app licant to ca11 for neeessary "-
locations of existing u"tilities. (G�pher One) -
- 13. Private Property - The'work permit or permit far construcrion as issued does not in any way imply that the •.
appropriate easement exists to aIlow the applicant to work on private property. �
14. Cutting Trees _ The permissioa herein granted does not confer u on the �• �
or destroy trees or shrubbery within the legal litnits of the right f way, easem�ents that a e ot spec�fi' cally
idenrified on �e 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 shail be scra . �
, and swept clean after construction is completed and left in a neat and� c1 � � the end of each work day .
presentable conditioa.
_ 16. Replacement of Sod �- W}lerever top-soil and sod are disturbed, they shall be replaced in lcind and �
maintained sa6sfactorily tmtil the turf is established,
The undersigned hereby declares he/she has read and will comply wit1� �ajl the pERT71�. �G�,q�ONS as
stated above and relevant City Ordinances.
DATE: SIGNED: .
�'��� Page 4 of 4 .
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� � � ��s� � � � ,' � Mike Meier Cunstrucuon Coordi�z;unr
1�3U9 �lunzingtun Aveuue Sav�ige, MN �5378
Date 2/1U/OS
TO K� �in Klei st
To Cit} of Priur Lake
To
To
RE: 1:s0�' S� & Estate Ave. Cabte repair.
Dear K R;vin,
Uur te�;d into Es�tate Ave. runs up the West side of Estate with the o�ther utilities. The b�d spot in
the cable has been detenrrii�ed tu be in the rvadway. To minimize the repair and rather than
replace ali the way isrto Estxte Ave. to replace ju�t the damaged portiun �under the south end nf
Est�te)would seem tv be our best vption.
This minimizes the boring, cre�tes the least amaunt c�f area disturbed, and keeps all ofthe cables
in � co mmnn trench.
We du have customers cunernly disrupted, so yow earliest considerativn would be appfeciated.
Thank �!
Mike l �(eier
e la mmunic�tions
E: Mail MIvleier (tr; MediacomCC.com
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