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ROW2014-00013 �� CITY OF TIGARD RIGHT OF WAY PERMIT II s COMMUNITY DEVELOPMENT Permit#: ROW2014-00013 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 03/24/2014 Parcel: SEG2496 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: NW Natural Project Description: Adjacent to the intersection of SW Durham Road and SW Upper Boones Ferry Road. Vac-X over main to verify pipe fitting location and depth. SEG 2496/2822 Owner: FEES Description Date Amount ROW Permit Fee 03/24/2014 $300.00 PHONE: Contractor: PHONE FAX: Applicant: CHRIS WILES 220 NW 2ND AVE PORTLAND 97209 PHONE: 503-226-4211 Total $300.00 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 flv l Signature: p(estvd- ri J Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for ROW2014-00013 Type: Condition Name: Status: Severity: ROW 01-CUSTOM CONDITION Applied Notice <Custom Condition goes here> ROW 02-PERMIT&PLAN REQ ON SITE Applied Notice A copy of the permit and all attachments,and a copy of the approved construction plan and all amendments shall be 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 the aforesaid must be approved by the City, in advance of work performance. ROW 03-TRAF CTRL-SPECIF(CITY) Applied Notice The City's standard specification for traffic control is"Manual on Uniform Traffic Control Devices for Streets and Highways", U.S. Dept. of Transportation, F.H.A., 1988 Ed. ROW 04-TRAF CTRL-CONTR RESPON FOR Applied Notice Traffic control shall be provided for by the contractor in accordance with the City's standard specification and, also, in accordance with a City(job specific)approved traffic control plan.A copy of the approved traffic control plan shall be available at the work area. ROW 05-TRAF CTRL-ROAD CLOSURE Applied Notice Public roadway shall not be closed to traffic, at any time,without having first obtained written approval from the City Engineer.The permit holder is responsible for provision of timely notification of traffic flow disruptions to area wide Emergency Services(Tigard Police Dept.,Tualatin Fire&Rescue)and to Tri-Met and Tigard School District. ROW 06-TRAF CTRL-ADVANCE WARNING Applied Notice Advance warning of imminent traffic disruption shall be provided to the general motoring public by placement of an advance notification sign at each end of the construction area 72 hours(min.)before initiation of construction work. ROW 07-TRAF CTRL-PRIV PROP ACCESS Applied Notice Access to existing properties shall be maintained at all times, including normal delivery service and mail service and if not, shall be cause for work stoppage until effective access is established. ROW 08-TRAF CTRL-DEVICES IN PLACE Applied Notice Traffic control devices,flagpersons,etc.,shall be in place prior to initiation of construction work and shall be effectively maintained. ROW 09-TRAF/NOISE CTRL-WORK HRS Applied Notice No work will be permitted during the hours of darkness, nor between 9:00 p.m.to 7:00 a.m. Monday through Friday, nor between 9:00 p.m. to 8:00 a.m. Saturday, nor between 9:00 p.m.to 9:00 a.m. Sunday. ROW 10-TRAF CTRL-MIN LANE WIDTH Applied Notice Minimum travel lane width shall be eleven(11)feet; pedestrian travel shall also be provided for. ROW 11-TRAF CTRL-CITY CAN MODIFY Applied Notice The City reserves the right to add to or modify traffic control requirements as may be necessary to effectively control traffic and to assure public safety. ROW 12-INSP 24 HR NOTICE REQUIRED Applied Notice The permit holder or his contractor shall notify the City's inspector<name>, at<phone#>or email at<email address>, twenty-four(24) hours prior to commencing work,twenty-four(24) hours prior to any staged inspection, and after completing work covered by the permit. ROW 13-HAZARDS-CERT OF INS Applied Notice Maintenance of the work area and approach roads is the responsibility of the permit holder.The work area and approach roads shall be maintained in a clean condition,free from obstructions and hazards.A copy of the permit holders Certificate of Insurance shall be available at the work area. ROW 14-DEBRIS-MATERIALS Applied Notice 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 cleanup and stoppage of work to accomplish cleanup. ROW 15-EROSION CTRL REQ Applied Notice Effective erosion control is required. Erosion control devices must be installed and maintained meeting D.E.Q. requirements.The City may at any time order corrective action and stoppage of work to accomplish effective erosion control. ROW 16-REPAIRS-LIKE MATERIALS REQ Applied Notice Property disturbed by construction activity shall be seeded with a standard grass mix; shrubs,flowers, barkdust, existing signs, pavement markings, mailboxes,etc., shall be reestablished, reinstalled or replaced,with like kind and material. ROW 17-DRAINAGE CONTROL REQ Applied Notice Effective drainage control is required. Drainage shall be controlled within the work site and shall be so routed that adjacent private property, public property and the receiving system is not adversely impacted.The City may, at any time, order corrective action and stoppage of work to accomplish effective drainage control. ROW 18-UTILITIES PRELOCATION REQ Applied Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center.Said rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.Copies of the rules may be obtained from the Center by calling(503)232-1987. If you have questions about the rules, contact the Center. NOTE: Damage to utilities shall be corrected at the permit holders expense. ROW 19-UTILITY LOCATIONAL CONFLICT Applied Notice Contractor 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 permit holders expense. Changes must be approved by the City in advance of work performance. Contractor shall coordinate the work with affected utility agencies. ROW 20-TRENCH-PATCH/SAFETY/LBILITY Applied Notice A temporary hard-surface patch(Cold mix A.C. or Hot mix A.C. base paving) shall be placed on trenches within roadways at the end of each day's work. No trench, on site or off site, shall be left at any time in an unsafe condition. The permit holder is responsible for and is liable for hazards or damage resulting from the work. ROW 21-REPAIRS REQ-INSPTR OPINION Applied Notice Work provided for under the permit shall include repair of existing facilities(roads,ditches,etc.)as may be necessary, in the City Inspectors opinion,to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit.Corrective work shall be done at the permit holders expense. ROW 22-AS-BUILT/ENGR CERTIF REQ Applied Notice At the end of each year, or an a mutually agreeable yearly date, any entity making changes to its facilities in the public right-of-way shall submit complete"as-built"drawings 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 engineers certification of installation compliance(form attached). ROW 23-DAILY INSP REPORTS REQ Applied Notice The permit holders Engineer/Inspector shall submit daily inspection reports,on a weekly basis,to the City's Inspector. (see Developer-Engineer Agreement note#5). ROW 24-TESTS/REPTS TO VALIDT CLMS Applied Notice The City's Inspector may, at their discretion, require provision of tests and or reports from the permit holder, permit holder's engineer or contractor to validate claims of material or construction adequacy/compliance. Such tests/reports shall be provided at the permit holder's expense. ROW 25-RELEASE-WAIVER REQ Applied Notice The permit holder shall provide a copy of a properly executed Release&Waiver document to the City for each ownership disturbed by construction activity, as evidence of disturbance resolution and owner satisfaction. ROW 26-MONUMENT PROTECTION REQ Applied Notice Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holders expense. ROW 27-PROB SOLVING-RESPON PARTY Applied Notice The permit holder shall 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 an emergency.The permit holder shall notify the City Inspector, in writing,of any/all assignment changes. ROW 28-CONSTR SAFETY-RESPON PARTY Applied Notice The permit holder shall cause his contractor to provide to the City Inspector, in writing,the name and 24 hr emergency telephone number of a designated"Competent Person"responsible for construction safety as per OR-OSHA, Chap.437, Div. 3 Construction, Subdivision P-Excavations.The contractor shall notify the City Inspector of any/all assignment changes. ROW 29-ESMT/RT OF ENTRY-RESPON Applied Notice It is the sole responsibility of the permit holder to provide for 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 permit holder's failure to obtain or provide for proof of right-of-entry or easements. RECEIVED City of Tigard FEB U5 2014 I/ NI CITY TIARD Application for Work in the Right-Of Wft NI GG/ENGGNEERING TIGARD ROW Permit Property Address/Location(s):Intersection of SW Upper Boones Ferry FOR STAFF USE ONLY & SW Durham Rd SCC1 20 1(40 Right-of-Way Case No.: 12-CA/N2011- --( )I'� *Applicant's Name:NW Natural Application Accepted:2 114 By: AY--Address:220 NW 2nd Ave Portland, OR 97209 Application Reviewed:3' 1. /i By: City/State: Zip: Primary Contact: Chris Wiles $300.00 Application Fee Due: YesY No❑ 503.226.4211 x4360 Applicant Notified: 3.20.114 A-lL Phone: Fax: Email: caw@nwnatural.com Receipt No.: - REQUIRED SUBMITTAL Contractor's Name: INFORMATION CCB# Expiration: • Application form,completed and signed Address: • Submit one (1) copy of scaled sketch of City/State: Zip: the proposed work to be done Phone: Fax: • Submit one (1) copy of traffic control plan Email: Professional Engineered Plans are required Plans By: for: Address: • Street Widening City/State: Zip: • Subdivision Infrastructure Phone: Fax: • Main utility line extension Email: 1:cutplo\masters\land use applications\row app.docx Rev.7/19/12 Description of work:vac-x over main to verify Pipe fitting location and depth. Estimated value of work(within the public right-of-way): $500 Is work related to a LAND-USE DECISION? YES n NO is If so, please specify(MLP,SDR,SUB,etc.)case#: Is the work related to a BUILDING PERMIT? YES D NO NI If so, please specify(BUILDING PERMIT)case#: cz—e, Digitally signed 05 09 19 Wiles 2/5/2014 Signature of Applicant/Permittee: Date: Print Name:Chris Wiles Title:Integrity Management Specialist 3. d•r4 D '-. . 4.0 > City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2464 I www.tigard-or.gov o vo-7 ( f3 00.20 v D or re 41 d ...4' 4. .'4 r v• . 74TH AVE. `, `.`,• r 1 NiN a `�Se IM Z�'7/1 i `�. ~".ti Rw.EnmU c' 6 P 19.� Dv�:11a6C"--T-Ifigilig2-4: �" �•x:q, 'P2o ZOII�'� L,,,bw —°INIPI tfr C Sri'• b �• fur a, ` ,1 I I ro FIrD ��}7�'�vc� A 'I" BUI7DAG Or' 0'64) `f, ,,, .. .1♦ M140Pq n nna •°u P9 14°4 OP 6 "p mm / d" 1 1 --) Y� ` y — +iwo i rnna BLVD.n. N. • /I. ,...4. NN a, 54 '' 0. 9lSWC99 O 1 :" aid /� a p� 1 a €€g MB J NW O QIIF MOO 1 t ROM I' m�9 11120.11 .i ]9( NW Natural PLAT:1-047-022 COUNTY:WASHINGTON !,r 01129114 13:1! (503)226-4211 TOWNSHIP:TO2S RANGE:R01 W SECTION:13NE SCALE:1 IN=100 FT 1 USER 10:ric www.iovarion.com NORTHWEST Notes: Or 1. Maintain ped.access to NATURAL and through crosswalks ' 1 2. Maintain Min.10'lanes ��;�, ........SERVICE CENTER: 3. Maintain local access 4. Notify Trimet at least W20-I 48 hrs.of bus stop closure _ !. �� (503-962-8117) �1 3 0 CONTACT:-4504642ichael Smith ^ ' 5. Traffic control plan and all ,�° � <,�\II j/J�nr • devices shall comply with ft MUTCD and ATSSA LOCATION:Durham&Upper i�' 5 6. Adjust to field conditions Boones Ferrry Rd Portland OR �'W20- (NOT TO SCALE) DATE: JOB# INVENTORY: 1/22/14 5 Road Work Ahead K&D SERVICES <� OF OREGON,INC A V 3-Bikes Merge PHONE:503-723-7287 .` ♦ w1-4 1-Lane Shift Left FAX:503-723 8750 W20_1 �! 2-No Left Turns DRAWN ALAN WARD ��''�;� 1 n;� 1 1 30-Cones a` m TCS#04456 • "It*611 �' ,,,1 1 1 1 1 1 I Whirl,1 1�1.1�1 1 Legend �1�1�1�1�1�1 \ ■ 11 yr Cone • 1. 1 ® ::n /b sign direction ;•�:., Nit y road work ahead W20-1 : Q,// �,SIGN SPACG 1 , ��i 1 MPH SPACING 5 ooh ,V, 30&under 100' 35-40 350' ., W20-t 45-55 500 Cone Spacing Notify Fire/EMS,EPD and LTD 48hrs ( . Tangent:Double MPH before begining work Taper.225' A- 74-014✓"L 4 4-t- www.invarion.com K&D Services NORTHWEST , ♦ Notes: Or ROAD NATURAL o • 1. Maintain ped.access to ^° V SW . ♦ and through crosswalks MPH��'�,�� > � ♦ 2. Maintain Min.10'lanes SERVICE CENTER: m "`"' r- CONTACT: wzc-t ♦ 3. Maintain local access t wzo-t 4. Notiy Trimet at least ao ♦ 48 hrs.of bus stop closure Michael Smith 360-450-8842 roVhRED• ♦ (503-962-8117) 411,'wzo-t ,�� °.4 ♦ 5. Traffic control plan and all ♦ devices shall comply with LOCATION:Durham&Upper w20-7b ♦ MUTCD and ATSSA w20-7b ) 6. Adjust to field conditions (NOT TO SCALE) Boones Ferrry Rd Portland OR Q ♦♦ - .,E AE°. DATE: JOB# I N. °"« INVENTORY: 1/22114 C9A . . • w20-7b K 8 D SERVICES y 6-Road Work Ahead OF OREGON,INC • �` ♦ r 1-Bikes Merge ROAD PHONE:503-723-7287 „E•• s \ ♦ C9A 7-Be Prepared to Stop 1 FAX:503-723-8750 rog,o�° • 6-Flagger Ahead w2 0-1 7o, jn;r wb`°,.`::"0° TS# 58 a !jr 4. R Legend 4'�4 Cone • °„� N.. ► / • W20-7b / ® , £ ,47 sign direction • :!��— I OF 4 road work ahead W20 1 • �A ` �'°`T:� WORK ® Work Area • + L �� "E Q' be prepared to stop W20-7b • • /1 1 t£�� o-t california flagger C9A L • A• � ..0 aie S • 0 MPH SIGN SPACING ♦ . /� C9A MPH SPACING 7,,e, to pro. •30&under 100' Eo.o wzo-7b 35-40 . 350' • L"ORN 45-55 500' Cone Spacing W20-1 Tangent:Double MPH Notify Fire/EMS,EPD and LTD 48hrs Taper:225' before beginirg work f i S www.invarion.com NORTHWEST Notes. Or �{///// 1. Maintain ped.access to i J and through crosswalks NATURAL 2. Maintain MM.10'lanes p#111. 11114404 SERVICE CENTER: 3. Maintain local access 'iI4 4. Notify Tnmet at least et4 W20-1 Ir' 48 hrs.of bus stop closure a CONTACT:Michael Smith i' .a� `/ (503-962-8117) 4.1fr IF p Q 5. Traffic control plan and all r 360 450-8842 ,11--'a f * devices shall comply with 4400 J MUTCD and ATSSA LOCATION:Durham&Upper - . .''h� 6. Adjust to field conditions Boones Ferrry Rd Portland OR '- '` W20-1/ (NOT TO SCALE) I DATE: JOB# ��-/ INVENTORY: '1122114 5-Road Work Ahead K&D SERVICES - , 3-Bikes Merge OF OREGON,-728 . * ,t h ^ PHONE:503-723-7287 -, y /tt1 Wl-4 �,, 1-Lane Shift Left 1 FAX:503-723-8750 ' W20_1 %''''''.....„.. 4..._ ��1 r�2�� t f' 2-No Left Turns 4 = DRAWN LAN WARD :./. +1' rr ��® ! 1 QI // 30-Cones v1;o.uwoEV TCS#04456 . 1 17/ • rA 1 1 1 I r. 411 . 11S/�'S/ 1 l 1 '. la 1 Legend • 1!,1wilt, ( 1 r' • Cone .• IrI�IS�/ JJ ?/�] sign direction ,/laQ •s:,...11� •• w road work ahead W20-1 ,. W`�_ _ /1.‘;' :, 1---/-..„3/4. Work Area® Q , f1 20 1 W1-4LW1-4 (L) .� ?t,� ���" 1 1 /1/ �U� no left turn R3-2 .� A 1 �``'.� �/1�'� R3-2 MPH . ,(/.• SIGN SPACING ' + ,„.„,„ 30&under 150' W20-1 35-40 350' i /Qet 45-55 500' 4 f Cone Spacing Notify Fire/EMS,EPD and LTD 48hrs ' ' r Tangent:Double MPH t before begining work It ' Taper.225' /i• -- *pot &out.. .....4e.. ...2 - ,./.8r 4,1-12 112 C,4 n Opd7 Work to be www.invarion.com done between 7pm and 6am NORTHWEST I ♦ Notes: Or NATURAL no�o ♦♦ 1• Maintain ped.access to 1 w ♦ W R« and through crosswalks \35, �`�,� •"E . > 2. Maintain Min.10'lanes MPH SERVICE CENTER: Q wzo-1 4.111P 3. Maintain local access no.n At Q W20-1 r 4. Notify Tnmet at least �°"", ( rte-J Y t ♦ 48 hrs.of bus stop closure \�/ CONTACT:Michael Smith ti .E ♦ (503-962-8117) w20-1 J*AliM,360 450 8842 ,3 "E.� y 7—'4 ♦ 5. Traffic control plan and all ® to devices shall comply with 7 / LOCATION:Durham 8 Upper a� W20-7b o MUTCD and ATSSA Boones Ferrry Rd Portland OR W20-7b I Q ♦ 6. Adjust to field conditions o.,aE OT TO SCALE • DATE: JOB# I Nb' I INVENTORY: 1/22/14 C9A W20-7b co •♦ S 6-Road Work Ahead K&D SERVICES ♦ / 1-Bikes Merge OF OREGON,INC �® ♦ / PHONE:503-723-7287 ''7 V ♦ C9A 7-Be Prepared to Stop FAX:503-723-8750 410' 0 6 Flagger Ahead DRAWN BY: ' ♦ Turn off ° /1 5-Flaggers �.,,...,, ALAN WARD W20-7b - K A O YC0.V1oltl TCS#04456 C9A 4. A.1#7,0- Signal /1 •jr 40-Cones • J eM^NU4`YLegend �♦ ► t � j +1►,1/' la r A Cone ♦ o,.00 .1 it 1. • 1./ ° /b sign direction ♦ w20-7b 1 Y aE 'r�i / 1 1 1 - v.: . • road work ahead W20-1 C9A ` .i qo. Work Area ♦♦ 1 1 /` � � � j• be prepared to stop W20-7b / ► w Y2o-1 1 california flagger C9A ♦5 1• ,//// \ ti \\ 83— • ° 'h. 35 �I //�� MPH SIGN SPACING ♦ , C9A ` 5 e 1•3 O RO' MPH SPACING ,0° i 0 4i 30&under 100' e�' no,,o w20-7b 3540 350' ♦ "x 45-55 500' wzo-1 1 Cone Spacing Notify Fire/EMS,EPD and LTD 48hrs C3 Tangent:Double MPH before begining work 9 Taper:225' vV Agnes Kowacz From: Wiles, Chris <Chris.Wiles @nwnatural.com> Sent: Monday, May 19, 2.14 2:3: PM To: ROW Perm. Subject: NW Natural '! e ' a%; • •n s ment Attachments: TCP.pdf;Tigard_permit Durham rd.pdf; Sketch 201141.pdf Follow Up Flag: Follow up Flag Status: Completed Categories: Misc. Correspondence Amending existing permit that was not used. 41) NW Natural Chris Wiles Phone: 503.226.4211 x4350 Cell: 503. 0.3t r mail; caw@nwnatural.corn �_. .._ NWN integrity Management Pipeline Integrity S tia st v Please consider the environment before printing this e-mail 1 Work to be www.invarion.com done between 7pm and 6am K&D Services NORTHWEST , ♦i Notes: Or k ' i ROAD 5 1. Maintain ped.access to ,' NATURAL -J., m W°° , and through crosswalks 35 p�;4 SERVICE CENTER: > Q W20-, , 2. Maintain Min.10'lanes MPH Q wzo 1 3. Maintain local access • 4. Notify Trimet at least : III w 48 hrs.of bus stop closure CONTACT:Michael Smith ^ PREPARED (503-962-8117) w20-1 / ,� IV 360-450-8842 ' �• h .°.:w 5 5. Traffic control plan and all y .,,EPAS D 1 devices shall comply with LOCATION:Durham&Upper STOP w20-7b 5 MUTCD and ATSSA Boones Ferrry Rd Portland OR wzoab I � 6. Adjust to field conditions PREPARE° (NOT TO SCALE) DATE: JOB# I ,gar °.,a. 1/22/14 C9A SS wzo-7b INVENTORY: s' 6-Road Work Ahead K&D SERVICES •y I 1-Bikes Merge OF OREGON,INC PHONE:503-723-7287 C9A 7-Be Prepared to Stop FAX:503-723-8750 �� • 6-Flagger Ahead W20-1 TO n°. 0 a U DRAWN BY: ® • D 5-Flaggers ALAN WARD w20-7b . Turn off 4l`..,, T.'"°t a TCS#0445 C9A �►4 ■L • Signal • `I;, j 40-Cones 2o• 20 K. 1 cc Legend ♦ * -,_ C Cone Legend °.,a ,. ?, `� ` � Er . . W20-7b /b sign direction .:y�� 0 y���r M � road work ahead W20-1 C9A l' '` � ; wo ® Work Area • \/ j O' be prepared to stop W20-7b • �� A A i1 20-1 ▪ california flagger C9A • ,(,A • /4ke-4 � 35• MPH SIGN SPACING • C9A RENRE° ,00 MPH SPACING, , op °'T°° 30&under 100' , ROAD W20-7b 35-40 350' , /get ►WOea� 45-55 500' . 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I DIDIDVM "1O aa.11D.>m R20 ran 05/14/2014 SW DURHAM RO. OM,W, WI NAM P11 HP 10"(W)ABANDONMENT DIAITP. earn PIPEIJNE ID. MIT. TI 1-047-021 TO2S RO1W NW 13 Pil a .wwrocmsrom.MID 1-047-022 TOTS RO1W NE 13 3412014 201141