HomeMy WebLinkAboutPermit Encroachment 2019-07-26
CITY OF SPRINGFIELD, OREGON
DEVELOPMENT AND PUBLIC WORKS
ENCROACHMENT PERMIT
APPLICANT: NWN
LOCATION: 170 43rd Pl.
PERMIT: 811-19-000196-PW
DATE: 7-26-19
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 requi re
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 required 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
#4360 #4370 #4350 #4350 #B #170-43 154' #4395 #3 (#4395-5) 1' 4' R.1"(W)'79 99' 205' 3' 0' 150'
155
0' 0'
1"(P)
R(W)'00
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161' 195'
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NW Natural
(503)226-4211
PLAT: 1-234-001 COUNTY: LANE
TOWNSHIP: T17S RANGE: R02W SECTION: 32SW SCALE: 1 IN = 43 FT
07/09/19 13:03
USER ID: blc
Page 80 2011 Edition
Chapter 5 December 2011 2-Lane, 2-Way 5.3 Two-Lane, Two-Way Roads
Shoulder Work w/ Minor Road Encroachment Diag. 300
Use this detail for non-freeway work which extends into a travel lane and
maintains a minimum 10 foot travel lane. If a minimum 10 foot travel lane
can not be maintained, or when traffic can not safely pass by in both lanes
simultaneously, use the appropriate lane closure diagrams – for example,
Diagrams 310 through 350.
A lane closure may be appropriate for conditions such as high traffic
volumes, high speeds, and inadequate approach sight distance to the work
space, or heavy equipment adjacent to the travel lane.
1. Use truck-mounted flashing warning lights on work and protection
vehicles. See Section 4.3 – Lights and Lighted Signs for exceptions.
2. For added visibility, a truck-mounted arrow board or PCMS in caution
mode may be used.
3. Cones shall be placed along the entire length of the work space. If a
protection vehicle is used and work is in place one hour or less, the
taper and tangent devices may be omitted.
4. If the speed is 45 mph or higher, volumes exceed 2000 ADT, or there
is limited sight distance, consider placing cones or tubular markers on
centerline.
5. An arrow board in caution mode or truck-mounted PCMS with
“SHOULDER WORK” or other appropriate message may be used for
higher visibility.
Sign Spacing and Buffer Lengths (feet)
Posted
Speed
Spacing Between Signs Buffer
SpaceABC
20
100 100 100
50
25 75
30 100
35 350 350 350
125
40 150
45
500 500 500
180
50 210
55 250
2011 Edition Page 81
December 2011 Chapter 5 2-Lane, 2-Way Shoulder Work w/ Minor Road Encroachment Diag. 300