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HomeMy WebLinkAboutPermit Encroachment 2019-03-08 CITY OF SPRINGFIELD, OREGON DEVELOPMENT AND PUBLIC WORKS ENCROACHMENT PERMIT APPLICANT: NWN LOCATION: 5300 High Banks R. PERMIT: 811-19-000043-PW DATE: 3-8-19 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 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. CONDITIONS OF APPROVAL Contact Todd Thompson at (541) 912 -1389 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 701.026. All materials and workmanship shall, at a minimum, meet City of Springfield, Department of Public Works “Standard Construction Specifications, 1994” 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. General Requirements Restoration work shall conform to City of Springfield Standard Specifications. All planted areas disturbed within right -of-way shall be fully restored. Impacts to sidewalk shall require removal and replacement of full panels. 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 indicatin g their completion of an approved work zone traffic control course. All traffic control devices 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 all temporary 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 & Industry, 503 -399-5181.” By signature, I state I have carefully examined the approved permit and do hereby agree to comply with the requirements of the permit and I certify any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, applicable City Standard Specification and Drawings, and the laws of the State of Oregon pertaining to the work described herein. I further certify only contractors and employees who are in compliance with ORS 701.055 will be used for this project. I agree for myself, my contractors, and employees, that the approval of the right of way permit in no manner presumes or implies the approval or terms of approval of any other future permit required by the City for the site and indemnifies and holds harmless the City regarding any future approval of a future site plan, partition, subdivision, or any other required permit that may cause any work completed in compliance with the right of way permit to be altered to conform to the final permit approval. I understand and agree the City may inspect the work site described in this permit at any time during a one-year period following the receipt by the City of notice of completion of the described work and specify, at the City’s sole discretion, any additional restoration work require d to return the site to a standard acceptable to the City. I will be notified in writing of any work required and will have 30 days from the date of the notice to complete the work. Work not completed at the end of the 30 days will be performed by the City and the costs will be billed to me. I further agree to ensure all required inspections are requested at the proper time and the approved permit and set of plans will remain on the site at all times during construction and until removed by the City. I shall defend, indemnify and hold harmless the City from and against all liability or loss and against all claims or actions based upon or arising out of damage or injury to persons or property caused by or sustained in connection with performance if this Contract by the permittee except, pursuant to ORS 30.140, for losses, claims, or actions resulting from the sole negligence of the City. I shall assume all responsibilities for the work, and bear all losses and damages directly or indirectly resulting to the permittee, the City, or to others on account of the character or performance of the work, unforeseen difficulties, accidents, or any other causes whatsoever. I shall assume defense of, indemnify and save harmless the City, its officials, agents, and employees from all claims, liability, loss, damage, and injury of every kind, nature and description, directly or indirectly resulting from activities in the performance of the Contract, the ownership, maintenance or use of motor vehicles in connection therewith, or the acts, omissions, operations, or conduct of the permittee or any Subcontractor under the Contract or any way arising out of the Contract, irrespective of whether an act, omission or conduct of the City connected with the Contract is a condition or contributory cause of the claim, liability loss, damage or injury and irrespective of whether act, omission, or conduct of the permittee or Subcontractor is merely a condition rather than a cause of a claim, liability, loss damage or injury. I shall not be liable for, nor be required to defend or indemnify, the City relative to claims for damage or damages resulting solely from acts or omissions of the City, its officials, agents, or employees. The permittee's absence of or inadequacy of the liability insurance required by the City of Springfield shall not negate permittee's obligations in this agreement. PERMITTEE: Printed Name: Signature: Date: City of Springfield Application to Work in the Right of Way Once the application has been approved, a permit will be issued 225 Fifth Street Springfield, Oregon 97477 Engineering & Transportation Services Division Phone (541) 726-3753 Step 1-Location of Work Applicant: Phone: Site Address or Location :Tax Map Owner:Phone: Address: Tax Lot City:State:ZIP: Contractor:Phone: Contractors Registration (CCB) #:Expiration Date: Project Supervisor:Phone: Email Address: Step 2: Description of Project Project Description: Utilities Name of other utilities if this is a joint project : Intent of project for other utility who will own any facilities placed in right of way: Franchise Agreement License Does your utility company have a franchise agreement or license with the City? Who is filling out the application? In this section, you will need to identify the Applicant, Owner of the abutting property, and the Contractor, if applicable. Example: John Doe is the owner of the 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 contractor who will be doing the work in the right of way. You will need to put this contact and license information. What type of work do you need to do? In 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, of your project. It 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. -Identify your method of intrusion into the surface of the right of way, such as cut, bore, or drilling. -Describe the surface area length, width, depth, and height of your project. -Identify 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. Please identify which type of agreement you currently have with the City. Insurance Proof of Insurance, minimum $500,000 coverage limit Placing new facilities in the right of way Repairing/maintaining existing facilities This application can be emailed to LDS@springfield-or.gov. You will need to complete application, save as, then attach to email or print and bring to Public Works City Hall. You will need to come to Public Works, City Hall to process permit. Page 2 of 3 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. Safety and Environment Type of Dust Control to be utilized: Stormwater Pollution Prevention Air Quality Traffic Control Plan Criteria for City of Springfield Traffic Control Plan Submittals Wastewater Spill/Overflow Prevention Description: To Stub Wastewater Connection System Connections to City Infrastructure Other: Stormwater Connection Catch Basin/Bubbler Stub Main Line Backfill material to be utilized: Existing Surface Material: Surface replacement material to be utilized: 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. 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. Directions: City policy requires that all work performed in the City right of way/easement is in full compliance with DEQ and EPA regulations. No spillage of raw sewage shall occur during construction, including spillage in an open trench or excavation. The contractor shall take all reasonable precaution to avoid spills and shall immediately notify City of Springfield Maintenance 541 726-3615 or 541 726-3761; After hours Emergency Response Team 541 953-3428 in the event of a spill. Sawcut slurry runoff Dewatering Soil Erosion Bypass pumping HeightWidthLengthDepth Other:BoreCut Step 2a: Work Site Area Temporary plugging of sanitary main Main Line Plan Submittal requirements: Submit your Traffic Control Plan (TCP) with the following information on 8.5"x11" or 11"x17" paper. Fill out and submit this form with your TCP. You are required to call: The Lane Utilities Coordinating Council's "One Call Number" 811 or 1-800-332-2344 48 hours before digging. Site runoff/sedimentation Plan submittal for Wastewater main line work Are you storing material/objects in the right of way other than during hours of work? If yes, continue at Step 3: Submit a Work Plan Are you working in the right of way or connecting to City facility? If yes, continue at Step 2a: Work Site Area STOP: Answer these questions next From Date:To Date: Period of use or time of construction: 7am to 6 pm only, unless it's an emergency. Daily Start Time:Daily End Time: Hazardous material storage/spill prevention You are required to call: The Lane Utilities Coordinating Council's "One Call Number" 1-800-332-2344, 48 hours before before digging. Date: Page 3 of 3 Fee Encroachment/Placement Permit $267.00 Fees that may apply -A 5% Technology Fee will be applied to the total cost of the permit for processing the application. -A $880.00 Asphalt deposit is required when the asphalt will be disturbed. -Additional financial security may be required. Work Plans attached in an email to Land Development; send to LDS@springfield-or.gov. Reference site location and name in subject line. Show location of utilities within right of way. Identify pipe size and type, mainline connection location, and connection type. Identify extent of excavations or bore locations. identify staging/material storage areas. Outline limits of disturbance/ of work area. Site location and vicinity map include North arrow. What kind of work plan do you need? You will need to submit a copy of the work plan, which includes: Step 3-Submit a Work Plan Traffic Control Plan attached in email to Land Development; LDS@springfield-or.gov No Traffic Control Plan There are no public traffic safety issues with this application. Signature Step 5: Signature Information 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. Financial 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. When do you need an Encroachment permit? Municipal code 3.208 Work On or Under Surface—Encroachment Permit Required (http://www.qcode.us/codes/springfield/) defines when you need an encroachment permit. When do you need a Placement permit? Municipal code 3.224 Placement of Devices or Structures in the Public Way ( http://www.qcode.us/codes/springfield/) defines when you need a placement permit. Restoration of City facilities It will be determined by the Public Works Director at the time of the 11 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 3.210 (2). Owner Applicant Contractor Utility Project ManagerCheck one: The TCP shall be a legible hand drawing, or a computer aided design with the following information: 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. ODOT's Traffic Control Handbook website: www. oregon.gov/ODOT/HWY/TRAFFIC-ROADWAY/docs/pdf/OTTCH_06.pdf?ga=t Traffic Control Plan form is located at www.springfield-or.gov/menuonlineforms FACE OF CUR B LINE HWY PERMIT #M35362 HIGHBANKS ST. EASE. #4172 EASE.#4178 EASE.#4168 RD. (C.R. 440) #5233 117' #5250-520-530 #5050-540 #5250-440-450 #5250-420-430 #5250-350 #5250-210 #5250-220 #5250-100-110-120 4' 20' 6' B.F.O.C. 4"(P)'93 1"(P)'06 1"(P)'06 1"(P)'06 2"(P)'06 4"(P)'93 4"(P)'93 477' 342' 2"(P)'06 365' 80' 152' 153' 590' 517' 297' 357' 186' 282' 281' 196' 249' 250' 845' 166' 0' (P ) (P) 1"(P) 1"(P) 1"(P) 1"(P) 1"(P) (P) 1"(P) 1"(P) 1"(P) 1"(P) 292'- M.BALL ON MAIN END CAP HIGHBANKS & 53RDHIGHBANKS & 53RD NW Natural (503)226-4211 PLAT: 1-232-003 COUNTY: LANE TOWNSHIP: T17S RANGE: R02W SECTION: 28SW SCALE: 1 IN = 87 FT 11/14/18 08:44 USER ID: blc 2011 Edition Page 55 December 2011 Chapter 5 Typical App Details Pedestrian Accommodation, Mid-Block Diagram 5-7 The sidewalk should be closed at the nearest intersection on each side of the work area when a safe, ADA-compliant path through the work area of is not available.