HomeMy WebLinkAboutPermit Encroachment 2019-09-04SPRINGFIETD
aDEVELOPMENT AND PUBLIC WORKS
ENCROACHMENT PERM!T
OREGON
CITY OF SPRINGFIELD, OREGON
APPLICANT: Harvey & Price
LOCATION : s55 lnternationat way
PERM lT:ar r -1 g-ooo2s8-Pw
DATE:e/a/1e
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAB
952-001-0010 through 952-001-0090. You may obtain copies of the
rules by calling the center. (Note: The administrative telephone
number for the Oregon Utility Notification Center is (800)332-2344.
GONDTTIONS OF APPROVAL
Contact Todd Thompson at (541) 9t2-L389 a minimum of 24 hours prior to beginning work, for scheduling of all other
inspections, and for all construction related questions.
Refer to City of Springfield Municipal Code 3,208 for information on Encroachment Permit requirements.
Work within public right-of-way shall only be performed only by contractors and employees certified pursuant to ORS
70L.026. All materials and workmanship shall, at a minimum, meet City of Springfield, Department of Public Works
"Standard Construction Specification s, L994" as amended in 1998 (or current edition). The City has the right to require
additional work not shown/described here in but necessary for the restoration of the City's ROW infrastructure.
A spill kit is to remain on-site for the duration of all construction activities. The spill kit shall, at a minimum, contain
absorbent, spill booms, and spill pads. The spill kit is to be placed in an area where it is easily visible and accessible in case
of a spill emergency.
Applicant shall maintain oversight of all contractors and sub-contractors performing work authorized by this permit and shall
be responsible for ensuring all work is performed in accordance with City of Springfield Standard Specifications and the
specific conditions of approval contained in this permit.
Traffic Control
During construction or maintenance or performing utility work in the ROW, the work area shall be protected in
accordance with the current MANUAL ON UNFORM TRAFFIC CONTROL DEVICES (MUTCD).
Flaggers must have a current card or current certificate indicating their completion of an approved work zone traffic
control course.
All traffic controldevices shall be maintained according to the American Traffic Safety Services Association
(ATSSA), Quality Standards for Work Zone Traffic control Devices handbook.
"As a condition to receive and retain this permit alltemporary traffic control shall conform to the Oregon Temporary
Traffic Control Handbook with Errata, dated September 2016. The permit holder is solely responsible to provide and
maintain appropriate temporary traffic control for the duration of the work. Failure to provide and maintain temporary
traffic control is grounds for revocation of this permit. The handbook is available for download at
https://www.oregon.gov/ODOT/Engineering/Docs_TrafficEng/OTTCH-v2011.pdf. Printed copies of this manual can
be ordered from Chemeketa Community College Center for Business & lndustry, 503-399-5181 ."
Refer to Diagram 430 of the Oregon Temporary Traffic Control Handbook
Otyof Springfield . 225 Fifth Street . Springfield,ORg7477 . 541.726.3753 . 541.735.1021 Faxwww.sprinsfield-or.sov OFFICE COpy
By signoture, I stote I hqve corefully exomined the opproved permit ond do hereby ogree to comply with
the requirements of the permil ond I certify ony ond oll work performed sholl be done in occordonce with
the Ordinonces of the City of Springfield, opplicoble City Stondord Specificotion ond Drowings, ond the
lows of the Slole of Oregon pertoining to the work described herein. I further certify only controctors ond
employees who ore in complionce with ORS 701.055 will be used for this proiect.
I ogree for myself, my controctors, ond employees, thqt the opprovol of the right of woy permit in no
monner presumes or implies the opprovol or terms of opprovol of ony other future permit required by the
City for the site ond indemnifies ond holds hormless the City regording ony future opprovol of o future site
plon, portition, subdivision, or ony other required permit thot moy cquse qny work completed in
complionce with the right of woy permit to be oltered to conform to fie finol permit opprovol.
I understond ond ogree the City moy inspect the work site described in this permit ol ony time during o
one-yeor period following the receipt by the City of nolice of completion of the described work ond
specify, qt the Cily's sole discretion, ony odditionol restorqtion work required to return the site to o
stondord occeptoble to the City. I will be notified in writing of ony work required qnd will hove 30 doys
from the dote of the notice to complete the work. Work not completed ot the end of the 30 doys will be
performed by the City ond the costs will be billed to me.
I furlher ogree lo ensure oll required inspeclions ore requesled ot the Ploper time ond the opproved
permit qnd sel of plons will remqin on the site ot cll times during conslruclion ond until removed by
the City.
I sholl defend, indemnify ond hold hormless the City from ond ogoinst oll liobility or loss ond ogoinst oll
clqims or qctions bosed upon or orising out of domoge or iniury to persons or property coused by or
sustoined in connection with performonce if this Controct by the permittee except, Pursuqnt to ORS 30.140,
for losses, cloims, or octions resulting from the sole negligence of the City'
I sholl qssume oll responsibilities for the work, ond beor oll losses ond domoges directly or indireclly
resulting to the permittee, the City, or to others on occount of the chorocter or performonce of the work,
unforeseen difficulties, occidents, or ony other couses whotsoever. I sholl ossume defense of, indemnify
ond sove hormless the City, its officiols, ogents, ond employees from oll cloims, liobility, loss, domoge, ond
iniury of every kind, noture ond description, directly or indirectly resulting from octivities in the
performonce of the Controct, the ownership, mointenonce or use of motor vehicles in conneclion therewith,
or the octs, omissions, operotions, or conduct of the permittee or qny Subcontroctor under the Controct or
ony woy orising out of the Controcl, irrespective of whether qn oct, omission or conducl of the City
connected with the Controct is q condition or contributory couse of the cloim, liobility loss, domoge or iniury
ond irrespective of whelher oct, omission, or conduct of the permittee or Subcontroctor is merely o
condition rother thon o couse of o cloim, liobility, loss domoge or iniury. I sholl not be lioble for, nor be
required to defend or indemnify, the City relotive to clqims for domoge or domoges resulting solely from
octs or omissions of the City, its officiols, ogents, or employees. The permittee's obsence of or inodequocy
of the liobility insuronce required by the City of Springfield sholl not negote permittee's obligotions in this
ogreement.
PERMITTEE,
Printed
Signoture:
Dote:
City of Springfield o t25 Fifth Street r Springfield,ORg7477 . 541.726.3753 . 541.736.1021 Fax
www.spri ngfi eld-or.gov
225 Fifth Street
Springfi eld, Oreg on 97 47 7
Engineering & Transportation Services Division
Phone (541 ) 726-3753
Step 1-Location of Work
Who is fillinq out the application?
lnthissection,youwill needtoidentirytheApplicant,Owneroftheabuttingproperty, andtheContractor,ifapplicable.
Example:
John Doe is the owner ofthe abutting property. You would need to put name, address and contact information.
Jane Doe is the Applicant. This is the person filling out the application and filing for a permit. You would put in the contact information.
Utility Doe is the utility company that is doing work in the right of way and would be an considered an applicant. You would put in the
contact person's information.
Contractor Doe is the contrador who will be doing the work in the right of way. You will need to put this contact and license information.
Site Address or Location: 555 lnternational Way, SpringfieldOR9T4TT TaxMap 1703154000700
Applicant:Harvev & Price Co Tax Lot
Email Address: bmcmanus@harveyandprice.com Phone:541 -990-91 37
Owner:
Address:
City:
PacificSource
555 lnternational Way
Springfield State: OR ZIP: 9ll7t
Phone:
Contractor: Harvey& Price Co Phone:541-746-162t
Contractors Registration (CCBI #t Oo77
Project Supervisor: Brandon McManus
lnsurance
lX Proof of lnsurance, minimum 5500,000 coverage limit
Expiration Datei 1o/31 /2020
Phone: 54.l -990-91 37
Utilities
Does your utility company have a franchise ogreement or license with the City?
Please identifo which type of agreement you currently have with the City. f- Franchise Agreement l-- License
Name of other utilities if this is a joint project
lntent of project for other utility who will
own any facilities placed in right of way:
Step 2: Description of Project
What tvoe of work do vou need to do?
ln this section you will describe the location, intended use, and what measures you are implementing, such as traffic control
measures, dust control measures, and types of backfill material to be used'
-Provide the start and end dates, start time of day and end time of day, ofyour project. lt is important that you give
time of day that you are requesting for your project work. There are codes and inspections that are time sensitive.
-ldentify your method of intrusion into the surface of the right ofway, such as cut, bore, or drilling.
-Describe the surface area length, width, depth, and height of your project.
{dentiry what type of surface material is currently there, what you will do with this material, what is the replacement type
of surface material you will use, and what type of backfill material you will be using.
-Any required separation from other facilities.
[- Placing new facilities in the right of way
l- Repairing/maintaining existing facilities
& Price to remove/replace two large condenser coils on existing RoofTop Package units at the
facility on International Way,Harvey & Price Co and Oldham Crane will need to occupy the bus turn-out lane
the West bound lane on E Game Farm Road. The proposed crane requires a 28 ft swing radius which requires the
of both the turn-out lane and the West bound lane. Harvey & Price intends to install lane closed signs on the
Project
Description:
from the traffic circle @ deadmond ferry & E Game Farm in addition to signs on the East bound lane of E Game
We intend to close the sidewalk on the East side of Game Farm from the traffic circle upto the proposed N
lntersection
Period of use or time of construction: 7am to 6 pm only. unless it's an emerqencv.
FromDate: CQ-Ob-tq roDate: 6q- A6-tq
Daily Start Time:Lxtn Daily End Time:4pn
%"
STOP: Answer these questions next
you working in the right of way or connecting to City facility? lf yes, continue at Step 2a: Work Site Area
T Are you storing material/objects in the right of way other than during hours of work? lf yes, continue at Step
3:5ubmit a Work Plan
Step 2a: Work Site Area
l- Cut [- 8or9 Other:
Length Depth Width Height
Existing Surface Material:
Surface replacement materialto be utilized:
Backfill material to be utilized:
System Connections to City lnfrastructure
Directions: Submit plans that identify in detail the scope of work to be performed in the City right of way/easement. The work shall be
performed by a licensed contractor that is aware of wastewater spills/overflow reporting requirements and City design standards. Your
permit shall have specific instructions from the City inspector on how to perform the work. Keep these instructions on site.
T Wastewater Connection
[- To Stub
[- Main Line
l-- Other:
l-- Stormwater Connection
l- Catch Basin/Bubbler
[- Stub
l- Main Line
Description:
Safety and Environment i Vou are ,equired to call: Tlre Lane Utititrei-oordinating Cou.t(ils One Call NurnbeL
I 81 1 or 1-800-332-2344
Air Quality 48 hours before digging
Type of Dust Control to be utilized:
Stormwater Pollution Prevention
Directions: The City is required by Federal and State law to monitor the discharge of construction stormwater and site runoff. Applicants
shall develop and submit a Stormwater Pollution Prevention Plan (SWPPP) that minimizes to the maximum extent practicable the
discharge of sediment and other pollutants to the public stormwater system. Call LDAP with questions, 541 726 5489.
Listed below are some of the most common issues on right of way construction projects. How will you address these items on your
SWppp? Please be aware that each project is unique and may present challenges not addressed in this set of examples.
[- Dewatering l- Soil Erosion l-- Hazardous material storage/spill prevention
l- Sawcut slurry runoff [- Site runoff/sedimentation
Wastewater Spill/Overflow Prevention
Directions: City policy requires that all work performed in the City right of way/easement is in full compliance with DEQ and EPA
regulations. l,iospilligeofrawsewageshalioccurduringconstruction,includingspillageinanopentrenchorexcavation' Thecontractor
shill take all reasonable precaution t6 avoid spills and shall immediately notify City of Springfield Maintenance 54 '1 126 3615 ot
541 726.3761:After horrrs I nrergency Response I earn 541 953 3428 in the event ofa spill.
Plan submittalfor Wastewater main line work
l- Bypass pumping l- Temporary plugging of sanitary main
Traffic Control Plan Criteria for City of Springfield Traffic Control Plan Submittals
Directions: you will need to submit a Traffic control plan, which will need to be in compliance with the Manual on Uniform
Traffic control Devices (MUTCD) and Oregon Temporary Traffic control Handbook.
Plan Submittal requirements:
Submit your Traffic Control plan OCp) with the following information on 8.5"x1 I " or 1 I "xl 7" paper. Fill out and submit this form with
your TCP.
Page 2 of 3
The TCP shall be a legible hand drawing, or a computer aided design with the following information:
Traffic Control Plan form is located at www.sorinqfield-or.oov/menuonlineforms
A vicinity map;
That includes the north arrow, road names, intersection/driveway access points, curb lines, the work zone, and any special features such
as buildings, access points, sight obstructions, that could affect the TCP.
Location:
Where will the TCP be active? This can be a line drawing of the work zone(s) and/or a map that clearly indicates where traffic control
devices will be placed, including spacing and cone,tapers.
Attachments of the appropriate traffic control diagram(s) as shown in the current MUTCD and/or the ODOT Oregon Temporary Traffic
Control Handbook that reflect the work zone may be included as a standard reference. oDoTs Traffic control Handbook website: www.
oreqon.oov/ODOT/HWY/TRAFFIC-ROADWAY/docs/odflOTTCH o5.odf ?oa=t
lX Traffic Control Plan attached in email to Land Development; LDS@springfield-or.gov
No Traffic Control Plant-I There are no traffic issues with this
a n
What kind of work plan do you need?
You will need to submit a copy of the work plan, which includes:
- Site location and vicinity map r ldentify extent of excavationsl^ include North arrow. I or bore locations.
r Outline limits of disturbance/, of work area Show location of utilities within right of way. ldentifi pipe
r identiry staging/material l-- size and type' mainline connection location' and
, storage arear. ''="'' connection type'
Work Plans attached in an email to Land Development; send to LDS@springfield-or.gov. Reference site location and tranre in subject line.
+Construction of ADA ramps or other ADA facilities require submittal of detailed topographic survey and design sheets stamped
byaProfessional EngineerlicensedintheStateofOregon. DesignofADAfacilitiesshall ataminimummeetthecurrentfederal
Technical Requirements as described in the United States Access Board's 2011 Proposed Accessibility Guidelines for Pedestrian
Facilities in the Public Right-of-Way Notice of Proposed Rulemaking (NPRM).
lnformation
Fee
EncroachmenVPlacement Permit 5335.00
Fees that may apply
-A 5olo Technology Fee will be applied to the total cost of the permit for processing the application.
-A S1030.00 Asphalt deposit is required when the asphalt will be disturbed.
-Additional financial security may be required.
Deposits and Financial Security
Projects involving work within public right of way in the City of Springfield are subject to deposits or other approved forms
of financial security that may include performance bonds, set-aside letters, or irrevocable letters of credit. The type of
financial security is determined by the project's size, scope, and potential impact to public infrastructure. Examples of typical
impacts that will require financial security include asphalt trench cuts and sewer repairs that involve cuts to a main line.
Warranties
Financial security is held by the City during a warranty period that typically lasts one year and begins when the project
passes final construction inspection. The warranty period allows the City to monitor the structural integrity of repairs and
determine their long-term viability. Financiat security provides the City with the means to repair infrastructure should
failures that remain uncorrected by the applicant or applicant's representative occur during the warranty period. A final
warranty inspection will be conducted eleven months after the final construction inspection. Financial security will be
released when the warranty period has passed final inspection.
Restoration of City facilities
It will be determined by the Public Works Director at the time of the 1 1 month inspection as required in Municipal
Code 3.222 that the work area in the public right-of-way is in as good a condition or better than it was before the
issuance of the encroachment permit. . Municipal Code 3.21 0 (2).
When do you need an Encroachment permit?
Municioal code 3.208 Work On or Under Sudace-Encroachment Permit Required (http://www.ocode.uslcodes/sDrinofield/)
defines when you need an encroachment permit.
When do you need a Placement permit?
Municioal code 3.224 Placement of Devices or Structures in the Public Wav ( http://www.qcode.uslcodes/sDrinofield, defines
when you need a placement permit.
Step 5: Signature
Signature Date:
l's "One Number" 1are required to call: The Lane
48 hours before before digging.
Ch€tkone: [, Owner l- Applicant X Contractor T UtilityProjectManager
N
t't
[i -,-
[r --\r\) --{\}
N.
er"}lfil€L-.r-l> 6r,sV,6tr>alqAtka4rwtt*r+1
B
Oo ood.r a)o @ o Djea e
bv'P(uU (t2w?tra(z
o8 (soir*tal
A COMPANY YOU CAN BUILD ON
HARVEY & PRICE
541-7 46-16Z^1
@ *pE €-t r-4wt€
@ *rra:o*a*d*eu
(Dfzoaohrare[<\'/ A-+L >
&ncrr"rabaTUfl*M>
t
L-b
\
eqg tr*Pgr1 Pb
baurtrrl€ ru
lrt>
SaeP
+
NS
.4f
rl\)
V)\' .J4
\$d
qldlsl
Y
?&b,ltr6brb'Ferznv f?a,
aa{so[zatai
A COil?ANY YOU CAN BU'LD ON
HARVEY ,& PRTCEcoxTn.\croAs
t h,reu?t:f {2.b
s47 -7 46-1621
!
!!!
I'l
I
\
SS
f/rsrr {o he
Vs?uat b
555 t nfefasA-ttofi*rA.t- lA]&Y
I
r l-2-DI,I I --l(ranna ia'rzt*t (2b aru nb*wC
C{zA4$€
oelzufzori
A COMPANY YOU CAN BUTLD ON
1
s41-7 46-162-1
t
I
JABUSCH Brock
Sent:
lo:
Cc:
From:Jeff Martin < J MARTI N @harveyandprice.com >
Friday, August 30,2019 11:21 AM
JABUSCH Brock
George Geiger; Brandon McManus
Application to Work in the Right of Way 555 lnternational Way, Springfield Tax Map#
1 7031 54000700
Brock
Please see e-mail below for LTD regarding the bus pull-out on E Game Farm Rd. We hope this is sufficient to issue the
permit Thanks for your help
Jeff Martin
Harvey & Price Co
(s4t1.746-t62L
---Origina I Message---
From : Ma rk Johnson [mailto : Ma rk.Johnson @ ltd.org]
Sent: Wednesday, August 28,2Ot9 2:2O PM
To : jma rtin@ha rveya nd price.com
Subject: LTD bus pull out on E Game Farm Road
HiJeff,
The bus pull out on E Game Farm Road on the South side of the Symantec property is currently not in use by LTD. Any
temporary closure will not have an impact on LTD operations. Please let me know if you need additional information.
Mark Johnson
Lane Transit District
Assistant General Manager
(s41)682-6193
Contact us at LTD.org
Subiect:
1