PFI2021-00177 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
= COMMUNITY DEVELOPMENT Permit#: PF12021-00177
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 05/20/2021
Parcel: 2S104DA16400
Jurisdiction: Tigard
Site address:
Subdivision: QUAIL HOLLOW-WEST Lot: S
Project: Tigard Kruger Creek Stabilization Design
Project Description: Geotechnical borings to support the engineering design of the enhancement of Kruger Creek to prevent
further severe erosion and to protect existing slopes and infrastructure
Class of Work: FEES
Type 2-Sidewalk/Driveway Approach Description Date Amount
Total
Owner:
REQUIRED INSPECTIONS
Call 503-639-4175 for the IVR inspection request line or visit the City of
PHONE: Tigard website at www.tigard-or.00v to schedule inspections online.
Contractor:
PHONE:
Applicant:
ERIC PASLACK
3990 COLLINS WAY
STE. 100
LAKE OSWEGO, OR 97035
PHONE: 5032104771
Please sign below to indicate acceptance of conditions and return a copy with the proposed work schedule along with names and contact
information of responsible parties before beginning work.
Permittee/Applicant
Signature: See application
Issued By:
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12021-00177
Type: Condition Name: Status: Severity:
PFI_Sidewalk/[ 01 -WORK SITE REQUIREMENTS Applied Notice
Applicant must comply with all applicable provisions of federal and state law,the Tigard Municipal Code, and the terms of
any agreement with the City of Tigard regarding work to be done pursuant to this permit.
PFI_Sidewalk/[ 02-WORK SITE AREA Applied Notice
The work area and approach roads shall be maintained in a clean condition,free from obstructions and hazards. The
spreading of mud or debris or storage of materials or equipment of any kind upon any public roadway is strictly prohibited
and violation shall be cause for immediate cancellation of the permit. The City may at any time order immediate clean-up
and suspension of work to accomplish clean-up.
PFI—Sidewalk/1 03-WORK SITE EROSION CONTROL Applied Notice
Prior to starting work, effective and approved erosion control devices must be installed and maintained meeting the Clean
Water Services and DEQ requirements. The City may at any time order corrective action and suspension of work to
accomplish effective erosion control.
PFI—Sidewalk/1 04-WORK SITE REPAIRS Applied Notice
Disturbed landscaped areas shall be restored or replaced. Existing signs, pavement markings, mailboxes,etc. shall be
reinstalled or replaced,with like kind of material. Obtain City approval of restoration work.
PFI—Sidewalk/1 05-TRAFFIC CONTROL SPECIFICATIONS Applied Notice
Applicant shall provide traffic control according to the current edition of the"Manual on Uniform Traffic Control Devices
[MUTCD]for Streets and Highways", U.S. Dept. of Transportation, FHWA, current edition,American Traffic Safety Services
Association[ATSSA], and Oregon Temporary Traffic Control Handbook[OTTCH].
PFI—Sidewalk/1 06-TRAFFIC CONTROL PLAN Applied Notice
Submit a job specific traffic control plan. A copy of the approved traffic control plan shall be readily available at the work
area. Traffic control devices,flag persons,etc., shall be in place prior to initiation of construction work and shall be
effectively maintained.
PFI—Sidewalk/1 07-TRAFFIC CONTROL ROAD CLOSURE Applied Notice
Public roadway shall not be closed to traffic, at any time,without obtaining written approval from the City Engineer. The
applicant is responsible to provide 48 hour advance notice of traffic flow disruptions to affected businesses, residents and
area wide Emergency Services: 503-629-0111 (Tigard Police Dept.,Tualatin Fire& Rescue)and to 503-962-8140 (Tri-Met)
and 503-431-2345 (Tigard School District)and other service providers impacted by such closure.
PFI—Sidewalk/1 08-TRAFFIC CONTROL ADVANCE WARNING Applied Notice
Advance warning of traffic disruption shall be provided to the public by placement of an approved advance notification sign
at each end of the construction area 72 hours (min.) before initiation of construction work.
PFI_Sidewalk/[ 09-TRAFFIC CONTROL PROPERTY ACCESS Applied Notice
Access to existing properties shall be maintained at all times, including normal delivery service and mail service. Obtain City
approval of any access closures.
PFI—Sidewalk/1 10-TRAFFIC CONTROL WORK HOURS Applied Notice
Work is permitted in daylight between the hours of 7:00 a.m.to 7:00 p.m. Mon-Fri unless otherwise authorized by the City.
PFI_Sidewalk/[ 11 -TRAFFIC CONTROL LIMITED WORK HOURS Applied Notice
Hours of construction work on collector and arterial roads will be limited to 9:00 a.m.to 3:00 p.m. unless authorized by the
City Engineer. Work will not be permitted on collector and arterial roads between 3:00 p.m.to 9:00 a.m. unless authorized
by the City Engineer.
PFI—Sidewalk/1 12-TRAFFIC CONTROL MODIFICATION Applied Notice
The City reserves the right to add to or modify traffic control requirements as necessary to effectively control traffic and to
assure public safety.
PFI—Sidewalk/1 13-DRAINAGE CONTROL Applied Notice
Drainage shall be controlled within the work site and shall not adversely affect adjacent private property, public property and
the receiving system. The City may at any time order corrective action and suspension of work to accomplish effective
drainage control.
PFI_Sidewalk/[ 14- UTILITY NOTIFICATION Applied Notice
Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR
952-001-0100 through OAR 952-001-0080. Copies of said rules may be obtained from the Center by calling 503-246-1987.
If you have any question about the rules,contact the Center. NOTE: Damage to utilities shall be corrected at the permit
holder's expense
PFI—Sidewalk/1 15-UTILITY LOCATION CONFLICT Applied Notice
Applicant must verify all existing utilities for both vertical elevation and horizontal location prior to start of work(pothole
before digging if necessary). Should conflicts arise and redesign or relocation of facilities be necessary, it shall be done at
the applicant's expense. Changes must be approved by the City in advance of work.Applicant shall coordinate the work
with affected utility agencies.
PFI_Sidewalk/[ 16-TEMPORARY PATCH Applied Notice
A temporary hard-surface patch shall be placed on trenches within roadways at the end of each work shift. Obtain advance
approval of patching method. No trench shall be left at any time in an un-safe condition. Applicant is responsible for and is
liable for hazards or damage resulting from the prosecution of the work.
PFI_Sidewalk/[ 17-REPAIR OF EXISTING FACILITIES Applied Notice
Work under this permit shall include repair of existing facilities(roads,ditches, etc.)as may be necessary, as determined by
the Inspector,to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit.
Corrective work shall be done at the applicant's expense.
PFI_Sidewalk/[ 18-SEWER SYSTEM TEST Applied Notice
A sewer system air-test and/or DVD T.V.test report and one set of"As-Builts"shall be provided for review and approval.
PFI—Sidewalk/1 19-PRECONSTRUCTION MEETING Applied Notice
Before initiating any construction activity,the applicant shall coordinate with the City's inspector, <Insert Name>at<Insert
Phone#>,to establish a preconstruction meeting.
PFI—Sidewalk/1 20-NOTICE TO COMMENCE WORK Applied Notice
The applicant shall notify the City's Inspector twenty-four(24) hours prior to commencing work, prior to any staged
inspection, and after completing work covered by the permit.
PFI—Sidewalk/1 21 -PERMIT/PLAN ON SITE Applied Notice
A copy of the permit including a Certificate of Insurance, and all attachments, and a copy of the approved construction plan
and all amendments shall be readily available at the work area. All work shall conform to the permit terms,conditions and
provisions and to the City approved permit plans, and approved plan amendments and to the City's standards and
specifications and to these General Conditions. Changes to any of these must be approved by the City, in advance of work
performance.
PFI—Sidewalk/1 22-DAILY INSPECTION REPORTS Applied Notice
Applicant shall submit daily inspection reports, on a weekly basis,to the City's Inspector.
PFI_Sidewalk/[ 23-MONUMENT PROTECTION Applied Notice
Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holder's
expense.
PFI—Sidewalk/1 24-VALIDATION OF MATERIAL/CONSTRUCTION Applied Notice
The City's Inspector may, at his discretion, require tests and or reports from the applicant to validate claims of material or
construction adequacy/compliance. Such tests/reports shall be provided at the applicant's expense.
PFI_Sidewalk/[ 25-EMERGENCY CONTACTS Applied Notice
Provide to the City inspector, in writing,the names and 24 hour emergency telephone number of two (2) persons who have
authority to resolve problems,take corrective action and, in general,will be responsible in case of any emergency. The
applicant shall notify the City Inspector, in writing, of any/all assignment changes.
PFI—Sidewalk/1 26-RIGHT OF ENTRY/EASEMENTS Applied Notice
Applicant to obtain proper right-of-entry and/or easements prior to starting work. Proof of right-of-entry or properly executed
easements,shall be provided to the City. The City shall in no way be construed to be liable for the applicant's failure to
obtain or provide for proof of right-of-entry or easements.
PFI_Sidewalk/[ 27- PRIVATE PROPERTY AGREEMENTS Applied Notice
Provide the City a copy of an executed agreement[s]from the owner for each private property disturbed by construction
activity.
PFI—Sidewalk/1 28-AS-BUILT DRAWING Applied Notice
One as-built drawing showing all new public improvements, including any revision made to the previously approved
construction plans and, also,any improvement which may impact an existing public system or facility, shall be provided to
the City by a registered civil engineer along with an engineer's certification of installation compliance(Certificate of
Compliance).
PFI—Sidewalk/1 31 -OTHER Applied Notice
Other
City of Tigard PFI #: PF12021-00177
ENGINEERING DEPARTMENT
Public Facilities Improvement (PFI) Permit
PROJECT INFORMATION
TYPE OF WORK
Project name: Tigard Kruger Creek Stabilization Design ❑ TYPE 1—Franchise Utility Work
Brief description of project: Geotechnical borings to support the Perfomted by NWN,PGE, or utility
agency
engineering design of the enhancement of Kruger Creek to prevent M TYPE 2-ROW Sidewalk/Driveway/Sewer
Work performed for the purpose of
further severe erosion and to protect existing slopes and infrastructure. . Sidewalk installation or repair
• Driveway approach installation and repair
SITE INFORMATION • Sanitary sewer lateral installation and
main line tap
Location (address if available):
❑ TYPE 3—Full Scale Development Work
Near SW Greenfield Dr and SW Benchview Terrace,Tigard, OR performed with land use approval which
includes any of the following
• Subdivisions or Partitions
APPLICANT INFORMATION • Street widening
Name: Shannon&Wilson.Inc. • Mainline installation for sanitary sewer,
storm sewer, Tigard water, and Tigard
Mailing address: 3990 Collins Way,Ste 100 water service area
City/State: Lake Oswego,OR Zip: 97035 ❑ TYPE 4—Small cellT'echnology
❑ TYPE 5—Tigard Triangle
Phone: 503-210-4750
Email: Phone: NOTE: Type 1 and 2 applications may be
emailcd to r(wpermitsCti ar,� d-or4L0 v.
Contact name: Eric Paslack
Phone: 503-210-4771 Email: ECPoshanwil.com
CON'TRACT'OR INFORMATION ❑ Same as applicant
Name: Western States Soil Conservation,Inc. CCB Number: 101628
Mailing address: 3100 Schmidt Ln,PO Box 428 City/State: Hubbard, OR Zip: 97032
Phone: 503-982-1777 Email: info(&westernstates.com
ENGINEER INFORMATION
Name: Eric Paslack,Shannon&Wilson,Inc
Mailing address: 3990 Collins Way,Ste 100 City/State: Lake Oswego,OR Zip: 97035
Phone: 503-210-4771 Ems: ECP@shanwil.com
ADDITIONAL INFORMATION
Estimated value of work is required(if over$5,000):$ N/A (within the public right-of-way)
Is work related to a LAND USE DECISION? ❑Yes ®No Case number:
City of Tigard • 13125 S\Y'Hall Blvd. • Tigard,Oregon 97223 • wwwdgard-ozgov • 503-718-2421 • Page 1 of 4
APPLICANTS
NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for
work,if required by the city pursuant to TMC 15.04.140.
* With the exception of a utility operating pursuant to a valid franchise or license with the City of Tigard,when the owner and the applicant
are different people,the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner
or an agent of the owner. The owner must sign this application in the space provided or submit a written authorization with this
application. Franchised or Licensed Utilities are not required to obtain the owncr s signature on the application.
I,the applicant,certify that:
• To the best of my knowledge,all the information provided within this application package is complete and
accurate.
• The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the
subject property.
• If the application is granted,I will exercise the rights granted in accordance with the terms and subject to all the
conditions and limitations of the approval.
Eric C Paslack
"�""�" '•�`"`" " "" Eric Paslack 5/17/2021
o.rsnuics•mv
Applicant's or authorized agent's signature Print name Date
Property owner's signature (if required) Print name Date
STAFF USE ONLY
Case No: PF12021-00177 Permit fee: _ Received by: NT Date: 5/18/2021
Approved by: Date: S/I 9 I ZD ZI Notified by: 4L Date:
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigatd-orgov • 503-718-2421 • Page 2 of 4
DEVELOPMENT ENGINEERING FEES
Public Facility Improvement(PFI)Permit:
INITIAL PFI PERMIT FEE
Part 1: Required submittal fee is 101/c of the Net PFI Permit Fee.See below for calculations.Minimum of$300.
NET PFI PERMIT FEE
Part2: All non-water system improvements engineer's estimate X 7%(less the initial PFI Permit Fee).
WATER LINE CONSTRUCTION FEE
Part 3: All public water system improvements engineer's estimate X 12%.
FOR ONLY • ONLY
TYPE 4: SMALL WIRELESSFACILITYDETAILED SUBMITTAL
CHECKLIST REQUIREMENTS
Does applicant have a right-of-way license? ❑Yes ❑No TYPE 1 AND TYPE 2-Must include a sketch
showing:
Under the wireless facilities standards,is the proposal ❑ Dimensions
considered?(check all that apply): ❑Small Cell ❑Macro
❑ Street Name
How many install sites are proposed as part of this permit ❑ Site Address
application?
TYPE 3 -Must provide 4 sets of plans (sized 24 x 36
or 22 x 34) and an electronic version of all submittal
The proposed equipment is located on which of the following. items. The plans must that include:
❑Public Right-of-Way ❑Private Property
❑ Cover—Site,Vicinity,Abbreviation,Legend
If equipment is to be located on private property,describe the ❑ General Notes(City,Water,Sewer,etc.)
type&use: ❑ Street(Plan,Profile)
❑ Water,Storm and Sanitary(Plan Profile)
❑ Water Quality Facilities
❑ Grading
❑ Landscaping/Tree Plan
❑ Composite Utility Plan(Electrical,Phone,Gas, Storm,
Sanitary,Water,Signage,Street Lights,etc)
❑ Details
❑ Traffic Sight Distance
❑ Signing and Striping
❑ Street Light Plan and Photometric
❑ Engineers seal/signature
❑ Sheet label(project land use name,revision and plan
log block,dates and sheet numbers.)
❑ Engineer's Construction Estimate
Additional Submittals
(per land use conditions,if applicable)
❑ Traffic Report
❑ Storm water Drainage Calculations
❑ Geotechnical Report
❑ Preliminary Access Report(Sight Distance)
❑ Proposed Plat
❑ Pathway Design
❑ Water Provider Approval
City of Tigard 13125 SW Hall Blvd. Tigard,Oregon 97223 • www..tigard-or.gov • 503-718-2421 • Page 3 of 4
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City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 0 www.dgard-or.gov • 503-718-2421 • Pdge 4 of 4
SHANNON 6WILSON, INC.
now .. � . r' ' .. 4, t 1,r: 1 . .
May 17, 2021
City of Tigard
13125 SW Hall Blvd
Tigard, Oregon 97223
Attn: Andy Newbury
RE: CITY OF TIGARD PFI PERMIT APPLICATION
GEOTECHNICAL INVESTIGATION FOR TIGARD KRUGER CREEK
STABILIZATION DESIGN PROJECT
Shannon&Wilson, Inc., submits the attached City of Tigard Public Facilities Improvement
(PFI) Permit Application for geotechnical drilling for review. The proposed geotechnical
drilling is required prior to construction of the Tigard Kruger Creek Stabilization Design project.
The City of Tigard is planning to make enhancements along Kruger Creek to prevent further
severe erosion and to protect existing slopes and infrastructure.
The following borings, summarized in Table 1, are located in the City of Tigard right-of-way
(ROW). The boring locations are shown on the attached Site and Exploration Plan, Figure 1.
Table 1 summarizes the explorations,proposed traffic control requirements, and proposed
working hours.
TABLE 1: PROPOSED BORING SUMMARY
Bong Design Structure Anticipated Depth Traffic Control Shift Hours
Designation (feet)
B-2 Retaining Wall 40 N/A 8 am—5 pm
B-3 Pipeline 30 N/A 8 am—5 pm
B-4 Pipeline 30 N/A 8 am—5 pm
B-5 Overflow Culvert 25 Shoulder Closure 8 am—5 pm
B-6 Pipeline 30 Single Lane Closure for Drill Rig 8 am—5 pm
Loading and Off-Loading
B-7 Pipeline 30 Single Lane Closure for Drill Rig R am—5 pm
Loading and Off-Loading
Borings will be drilled using a track-mounted drill rig. The borings will be initiated using mud
rotary drilling techniques. A Shannon& Wilson representative will be on site throughout the
3990 COLLINS WAY,SUITE 100
LAKE OSWEGO,OREGON 97035-3480
503-210-4750
www.shannonwilson.com 106096-002
City of Tigard SHANNON MMLSON,INC.
Attn: Brady Bullinger
May 17,2021
Page 2 of 3
exploration program to locate the borings, observe drilling, collect soil samples, and log the
materials encountered. Drilling is scheduled to occur May 24, 2021 through May 26, 2021.
Traffic Control
Traffic control will be required for some of the drilling operations. Traffic control will consist of
a single lane closure of SW Gaarde Street just north of the intersection with SW 1291h Avenue to
off-load and load the drill rig from a trailer to drill borings B-6 and B-7. We anticipate the single
lane closure of SW Gaarde Street will last one day between the hours of 8:00am to 5:00pm. Site
traffic control will be subcontracted to D&H Flagging (D&H), of Portland, Oregon. D&H has
prepared a traffic control plan for SW Gaarde Street,which is attached to this permit application.
The traffic control for boring B-5 on SW Greenfield Street will consist of a self-regulating
shoulder closure in accordance with Diagram 210 of the 2011 Oregon Temporary Traffic Control
Handbook,which is also attached to this permit application.
We understand the City will close the pedestrian path along Kruger Creek during drilling. In
addition,we will place cones around the work area and"Sidewalk Closed Ahead" signs at each
end of the path.
When the trailer and support vehicles for the drilling are not in use, they will be parked along the
shoulder of SW Greenfield Street at the location shown on Figure 1. Cones will be placed
around the trailer and other vehicles.
All traffic control devices will be set up and in place before any personnel or equipment enter the
work area. Likewise,traffic control will be removed after all other personnel and equipment
have left the right-of-way(ROW) at the end of the work period. Surface restoration will be
performed at the end of each work period.
Best Management Practices
The Shannon& Wilson drilling subcontractor will abide by industry Best Management Practices.
Plastic will be placed under all drill rigs at locations susceptible to fluid leakage. Spill kits will
be present and readily available on every drill rig. When drilling near rivers or other bodies of
water, silt fencing or straw bales will be used as a safeguard against drill fluids entering the
City of Tigard ROW Pcrmit Application 106096-002
City of Tigard SHANNON 6WILSON.INC.
Attn: Brady Bullinger
May 17, 2021
Page 3 of 3
water. All drill fluids and cuttings will be drummed and removed from drill sites. Moist areas
will be protected from vehicle and foot traffic using landing mats.
Investigation-Derived Waste Handling and Disposal
IDW generated during the subsurface exploration program will include drilling mud and soil
cuttings from drilling. IDW at boring locations will be handled by the drilling subcontractor.
The drilling subcontractor will provide 55-gallon steel drums at drilling sites prior to the start of
drilling. Our drilling subcontractor will remove the drums after the boring is completed.
Installations and Borehole Abandonment
A vibrating wire pressure transducer(VWP)will be installed in boring B-6 to measure
groundwater levels. The piezometer will be finished and covered at the surface with a flush-
mount monument set in concrete. VWP installation will be performed in accordance with
Oregon Water Resource Department regulations. All other boreholes will be backfilled with
bentonite chips or a bentonite-cement grout in accordance with Chapter 690, Division 240, of
Oregon Administrative Rules (OAR), Construction and Maintenance of Monitoring Wells,
Geotechnical Holes, and Other Holes in Oregon. Any paved surfaces penetrated by the
boreholes will be restored using ODOT-approved"Instant Road Repair,"a polymerized asphaltic
patching material, or cold patch.
Please contact Eric Paslack at 503-210-4771, if you have any questions about this permit
application.
Sincerely,
SHANNON &WILSON, INC.
L
, L
Eric Paslack, PE
Associate
Enc: Figure 1 —Site and Exploration Plan
Attachment A—Traffic Control Plans
City of Tigard ROW Perrin Application 106096-002
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