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PFI2021-00250 City of Tigard PFI#: ENGINEERING DEPARTMENT . Public Facilities Improvement (PFI) Permit PROJECT INFORMATION TYPE OF WORK Project name: 692608 - Ash Avenue Pavement Repair � ❑. TYPE 1—Franchise Utility Work Brief p description of project: Pothole to verify the depth and location performed byN N,PGE, or utility p agency existing underground Comcast lines. ❑ TYPE 2—ROW Sidewalk/Driveway/Sewer Work performed for the purpose o£ • Sidewalk installation or repair • Driveway approach installation and repair SITE INFORMATION • Sanitary sewer lateral installation and Location (address if available): SW Ash Ave & SW Ash Dr main line tap ❑ TYPE 3—Full Scale Development Work Tigard, OR 97223 performed with land use approval which includes any of the following: • Subdivisions or Partitions APPLICANT INFORMATION • Streetwidening Comcast • Mainline installation for sanitary sewer, Name: storm sewer, Tigard water, and Tigard Mailing address: 11308 SW 68th Parkway water service area City/State: Tigard, OR Zip. 97223 ❑ TYPE 4—Small Cell Technology Phone: (503) 798-5785 ❑ TYPE 5—Tigard Triangle Mircea—Burghelea@cable.comcast.com (503) 798-5785 Ercall: Phone: NOTE: Type 1 and 2 applications may be Contact name: Mitch Burghelea emailed to rowpermits@tigard-or.gov. Phone: (503) 798-5785 Email: Mircea_Burghelea@cable.comcast.com CONTRACTOR INFORMATION ❑ Same as applicant Name: Texstar Enterprises, LLC, Attn: Scott Boyles CCB Number: 228361 Mailing address: 14122 Arndt Rd City/State: Aurora, OR Zip: 97002 Phone: (503) 793-3140 Email: scott.boyles@texstarenterprises.com ENGINEER INFORMATION Name: K&B Technical Solutions, Attn: Kyle Browning Mailing address: 6566 SE Lake Rd, Ste. F City/State: Portland, OR Zip: 97222 Phone: (719) 244-1608 Email: Permits@kbmai1.net ADDITIONAL INFORMATION Estimated value of work is required(if over$5,000):$ (within the public right-of-way) Is work related to a LAND USE DECISION? ❑Yes ❑■ No Case number: City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 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 owner'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. Kyle BrowningKyle Browning 6/30/21 Applicant's or authorized agent's signature Print name Date Property owner's signature (if required) Print name Date STAFF USE ONLY Case No: Permit fee: Received by: Date: Approved by: Date: Notified by:---j-Date: City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 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 10%of the Net PFI Permit Fee.See below for calculations.Minimum of$300. NET PFI PERMIT FEE Part 2: All non-water system improvements engineer's estimate X 7% (less the initial PFI Pen-nit Fee). WATER LINE CONSTRUCTION FEE Part 3: All public water system improvements engineer's estimate X 12%. FOR STAFF USE ONLY • ' STAFF USE ONLY TYPE 4: SMALL WIRELESS FACILITY TYPE 1-3:DETAILED 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 SW Edge of f avement Ditch ---4P Streetlight I •—•—.—•—•—• —r—•— f. i s � I ' T–�iojaos cf'SeliveiTine-- � I .;i Existing House Existing Driveway 01 IL I I � L afl 1 o Existing Shop 1 Powerpole I = I Q 1 I� 1 7roperty Line II Fire Hydrant(F H) � � I Scale: 'l"=30' � I I � � I � I I � � I d REQUIREMENTSTYPE 1 AND TYPE 2: MINIUM SKETCH pp North arrow Property lines&dimensions Existing utilities locations (sewer, storm,water) Street&street names All existing structures Proposed work Existing curb or edge of pavement Utility&street light poles Existing S/W or D/W apron Slope of property Trees City of Tigard • 13125 SW Hall Blvd. Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 4 of 4 00 � 9304Ix ! ° 13125 \ eo po pA s LLQ 90� / A U) N °a I (0 � 0 W oO W �Oh / N LU �° D � 0 Fp° / Q < LUQ (n Q o Q LL C7 POTHOLE TO VERIFY 9c7, / s LOCATION AND DEPTH G O ?y \ o� / d 13115 �o Q °° e ° < 13070 U l o \ s POS 8' cl J° \ ^ of o POTHOLE TO VERIFY LOCATION AND DEPTH od \ e F Z o ol b 13118 \ w o o 0 °° Powe w W POTHOLE TO VERIFY m o ° ° LOCATION AND DEPTH e �o� \ ° a c � o � P e \o ° °� 1` / /y� / \ Lo Row. cu '! FOC dos a5 0� \ o o! JD v O e s u) m .� U._ N O .. Z N N m'm ti Om Y W W ! O 2 0� �b o-, s ° `yJ e \ 9400 0 m POTHOLE TO VERIFY s .1 O/ \ 13110 LOCATION AND DEPTH G� \ �O� ��^S Lo e°� \ V■ ti E 0 < 3 \ �o s m VN \ \ 0) cca - L N p) / o 13120 y am \ I �J c � W E e° eo \ 1.ALL WORK AREAS TO BE RESTORED TO LIKE OR BETTER SHEET NO S eo°' �pQ \ � CONDITION. 0 10' 20' oG G� RPI ALL OTHER UTILITIES ARE BASED OFF EXISTING LOCATES 13140 O OR UTILITY STRUCTURES. SCALE: 1 s ppspwv. 966pps.pp p.rw.,,yewr. PERMIT NO 3.IT IS THE CONSTRUCTION CONTRACTORS RESPONSIBILITY TO CALL FOR LOCATES BEFORE DIGGING. CMFR-36905-14315 weRk.ur.o.wr►qom xta i asp a e„y 0 U) N W J H Q Q 0a_ U � oo _j >_ 06 0 � xs Ly rn DESCRIPTION: EXAMPLE: DESCRIPTION: EXAMPLE: Q Q U Z BORE/DRILL —--— — — JOINT USE POLE LLJ Q H OW 0 J TRENCH ------------ JOINT USE POLE W/TRANSFORMER ® U) EXISTING CONDUIT POWER POLE W/TRANSFORMER STRAND AND/OR CABLE POWER POLE X RIGHT OF WAY ROW CABLE POLE 0 PROPERTY LINE TELEPHONE POLE 0 PUBLIC UTILITY EASEMENT RUE POLE CONDUIT RISER ®XX' 0 0 CENTER LINE _c/L PEDESTAL,VAULT © O 0 m FACE OF CURB —FOC- MANHOLE w EOP PAVEMENT T-CUT SECTION = U 0 EDGE OF PAVEMENT CATCH BASIN ® 02 NOTES o PAVEMENT RESURFACING WIDTH OLD EDGE LINE OF 1. ON ALL STREETS, USE A MINIMUM 6" OVERLAP T-CUT DOWN U ❑ EDGE OF GRAVEL EOG VALVE WATER,GAS,ETC THRDUGH THE BASE MATERIAL UNLESS OTHERWISE SPECIFIED. y w w ( ) EDGE OF E T-CUT TLITHE BE MEASURED FROM THE INITIAL SAWCUT OR EDGE �- ❑ O EDGE OF STREET K OQ OO OF UNDERMINED PAVEMENT, WHICHEVER RESULTS IN A WIDER m O EDGE OF SIDEWALK s/W METER(WATER,GAS,ETC) 0 rcur 07 INITIAL SAW CUT T-CUT REPLACEMENT SECTION. w EXISTING PAVEMENT 2, A MINIMUM 3' PAVEMENT RESURFACING WIDTH ON ALL LOCAL W NDN-RESIDENTIAL AND HIGHER CLASSIFICATION STREETS. ❑ EDGE OF DRIVEWAY D/W FIRE HYDRANT 3, IF NEW EDGE OF PAVEMENT IS LESS THAN 2' FROM ANOTHER PATCH, CURB OR EDGE OF STREET, REPLACE THE PAVEMENT w N REMOVE&REPLACE LIMITS, w BETWEEN. 0 BORE PIT 4, IF MORE THAN ONE EXISTING PATCH EDGE IS WITHIN THE 2' ZON10 6"MIN. 6"MIN.(I BASE MATERIAL PREEEXIST�GE PATCH. MENT TO THE FAR EDGE OF THE SEWER S IF<2' 5. T-CUT SHALL NOT BE MADE UNTIL THE TRENCH IS FULLY O UNDERMINED REPLACE �3 BACKFILLED AND COMPACTED STORM SD PAVEMENT PAVEMENT 6. FOR PAVEMENT RESURFACING REQUIREMENTS SEE DRG. �7 � BACKFILL w O V ©PAVEMENT IF<2' NOS. P-515, P-Sl6 AND P-517. 2 cu RESTORATION O N E WATER W PAVEMENT REPLACEQ 7. FOR PAVEMENT CUTS IN CONCRETE, SEE DRG, NO, P-514. IC £ E` J y V O cc w GAS GAS co N 0 -6 ¢ U c E TRENCH 04 3a POWER P WIDTH' = Lo cli co TELECOMMUNICATION TEL w O Y w m O CL CATV CATV E TRAFFIC CONDUIT TFC m N U L N STEAM S CD Doo " E FENCE LINE _X_X m 00 U too a> w 0) � �►! (} GUARD RAIL c" ❑ ❑ � Mo � m IIIIIIIIIIIIII U RAILROAD TRACKS � ami U 0 BUILDING FOOTPRINTco C maml C N O L U SHEET NO RP-L PERMIT NO CMFR-36905-14315 Page 84 2011 Edition Stationary Lane Closure with Flagging Diagram 320 Diagram 320 covers total closure of one lane of a two-lane, two-way roadway. See the detail inset for the layout if using a single flagger to control both directions of traffic on low volume roads (less than 400 ADT)with good sight distance as discussed below. 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. Flaggers at each approach are required if any of the following conditions exist: a. Night Operations. b. Work space is over 200 feet in length. c. Sight distance is less than 750 feet from each approach through the lane closure. d. Traffic volumes are greater than 400 ADT. 4. The length between the Flagger Ahead signs shall not exceed one mile. Use Diagram 340— Lane Closure with Pilot Car if exceeding one mile. 5. Cones should be used to outline the work space when curves or other roadway alignments prevent clear direction for the motorists to pass the work space safely. 6. Cones along the work space are recommended when posted speeds are 45 mph or greater, when working under heavy traffic or when travel lanes are narrower than 11 feet. 7. Extended queue signing (see Diagram 5-4) should be used when traffic queues extend beyond the initial advance warning sign. 8. When flagging near an intersection, the "Flagger Ahead" (CW23-2) sign should be visible to traffic entering from any side road. Additional advance warning and Flagger Ahead symbol signs may be placed on the side road(s). 9. Sign set-up and flagger placement shown may be used for intermittent full road closures of 20 minutes or less. 10. The"ONE LANE ROAD AHEAD" (W20-4) sign is optional and should be considered on high volume or high speed roads, or when extended queues are expected. Chapter 5 September 2016 2011 Edition Page 85 Stationary Lane Closure with Flagging Diagram 320 0 ooh � �3 ¢ o c� L W C] Q O' ZIM \ 0 M �a A 1 t O L0, 1-11c, m LU a Q • $$ I •• r nv o 3 • >O a U t IC °$0 7 U"N mA1 1 I E (L -Ot �.. • �V I ca o aI 9�� i I • >_ rm � Q W a �p aw COr 1 t �� m W (n r° a of I I m Sign Spacing and Buffer Lengths(feet) _ Posted Spacing Between Signs "Buffer" Z o t0 Speed A B C Space V g Q O 20 50 Zcc Q 0 25 100 100 100 75 O 30 100 35 125 40 350 350 350 150CC p Y 45 180 O O 50 500 500 500 210 55 250 60 285 65 700 700 700 325 70 365 September 2016 Chapter 5 Page 118 2011 Edition Lane Closure at Intersection with Flagging Diagram 620 Diagram 620 covers work within an intersection when normal traffic control must be interrupted. Work vehicles may or may not be in the work space. 1. During flagging, traffic signals shall be turned off. Contact the road jurisdiction for approval and assistance (see Chapter 3). 2. For multi-lane facilities, traffic approaching the intersection shall be reduced to a single lane on each approach. See Chapter 3 for information on flagging through intersections. 3. There should be one flagger for each approach. One flagger may control two adjacent approaches if sight distance, low volumes on side roads, and flagger position allows for safe operation and clear direction to motorists. For low traffic volume intersections (fewer than 400 entering vehicles per day), one flagger may be used. 4. The "ONE LANE ROAD AHEAD" (W20-4) sign is optional and should be considered on high volume or high speed roads, or when extended queues may be expected. Sign Spacing and Buffer Lengths(feet) Pasted Spacing Between Signs "Buffer" Speed A B C Space 20 50 25 100 100 100 75 30 100 35 125 350 350 350 40 150 45 180 50 500 500 500 210 55 250 60 285 65 700 700 700 325 70 365 Chapter 5 September 2016 2011 Edition Page 119 Lane Closure at Intersection with Flagging Diagram 620 ROAD WORK AHEAD ONE LANE 1 T (OptiODal) ROAD AHEAD B BE PREPARED TO STOP B A (Optional) • • . ONE LANE ROAD 100ft.Max. • PREPARED AHEBE AD ROAD WORK • TO STOP AHEAD • A B BC Buffer • • 100 ft.Max. C B B A I T ROADBE WORK PREPARED • 1001t.MmL AHEAD TO STOP ONE LANE • ROAD • AHEAD (Optional) A B BE PREPARED TO STOP B (opBonaq ONE 1 1 ROAD V ROAD WORK AHEAD September 2016 Chapter 5