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ROW2014-00020 CITY OF TIGARD RIGHT OF WAY PERMIT COMMUNITY DEVELOPMENT Permit#: ROW2014-00020 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 05/14/2014 TtGARD Parcel: SEG236 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Teleport Communications of America, LLC Project Description: Adjacent to intersection of SW Nimbus and SW Scholls Ferry Road. Install new 264-To utility vault with sidewalk lid(NS)at SE corner of SW Scholls Ferry Road&SE Nimbus Ave and connect via open trench to existing vault around corner on SE Nimbus Ave. SEG 236/177. Owner: FEES Description Date Amount ROW Permit Fee 05/14/2014 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: SHAWN DALBEC 10340 SW NIMBUS AVE TIGARD, OR 97223 PHONE: 503-495-0112 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. Perm ttuApplicant Sign ature: ,^(I pfescni--' 9TIA Issued By: j Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for ROW2014-00020 Type: Condition Name: Status: Severity: ROW 01-CUSTOM CONDITION Applied Notice Before beginning work,confirm approval of a Washington County permit to work in Scholls Ferry. 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 2 7 2014 s A pp lication For Work In The Right- IINEERING ltooko ROW Permit Property Address/Location(s): SE corner of SW Scholls Ferry and SW Nimbus FOR STAFF USE ONLY S 2.34 l i Right-of-Way ( Case No.: W-cW 201 LI i *Applicant's Name: Teleport Communications of America,LLC Application Accepted:2 j 27/i�y: AV-- Address: 10340 SW Nimbus Application Reviewed:Z' 27`"tBy:,14 City/State: Tigard,Oregon Zip: 97223 Application Fee Due: 5 300 Primary Contact: Shawn Dalbec,Outside Plant Manager Applicant Notified:3131 ILi Phone: 503-495-0112 Fax: Receipt No.: 161(002-5 Email: dalbecs @att.com REQUIRED SUBMITTAL INFORMATION Contractor's Name: TBD • Application form,completed and signed CCB# Expiration: • Submit one (1) copy of scaled sketch of the proposed work to be done Address: • Submit one (1) copy of traffic control City/State: Zip: plan Phone: Fax: Professional Engineered Plans are required Email: for: • Street Widening Plans By: Commstructure Consulting,LLC • Subdivision Infrastructure • Main utility line extension Address: 811 Railroad Avenue Deliver application to rowpermttsatigard-or.gov or to City/State: Oregon City,Oregon Zip: 97045 City of Tigard Planning/Engineering,13125 SW I Tall Phone: 505-343-4134 Fax: Blvd.Tigard,OR 97223. Rev.12/10/2013 Email: annette @commstructureconsulting.com 1:\CURPLN\Masters\land Use.lppl. noes\Right-of-aay Permit Application.docx Description of work: Intall new 264-Ta utility vault w/sidewalk lid(NS)at SE corner of SW Scholls Ferry Rd&SW Nimbus Ave and connect via open trench to existing vault around corner on SW Nimbus Ave. Estimated value of work(within the public right-of-way): $ Is work related to a LAND-USE DECISION? YES NO X If so, please specify(MLP, SDR,SUB,etc.)case#: Is the work related to a BUILDING PERMIT? YES n NO If so, please specify(BUILDING PERMIT)case#: Signature of Applicant/Permittee: Date: Print Name: Title: City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2464 I www.tigard-or.gov .4%.14, 14- 4u-ki-- / Letter of Transmittal coMMS' L,t_a . coNsi4LnH4.LLC- ! Date: February 27,2014 To: From: City of Tigard Commstructure Consulting,LLC 13125 SW Hall Blvd. 811 Railroad Ave. Tigard,OR 97223 Oregon City,OR 97045 Attn:Annette Dexter Re:Utility Permits Utility Coordinator/ Permit Specialist This Application for Permits to occupy and perform operations within City of Tigard Rights of Way is being submitted on behalf of: Permitee: Contact: Teleport Communications America,LLC(TCA) Shawn Dalbec(503)495-0112 10340 SW Nimbus dalbecs®att.com Tigard,OR 97223 Project Description:This project will create one(1)new underground Fiber Optic Network connection in the Tigard area of Washington Co.,OR. Scope: The proposed underground fiber optic network route runs longitudinally along the south side of OR-210 /Scholls Hwy within the ROW at a point 70'NE of the intersection with SW Nimbus Ave. A new utility vault will be placed along this route within The City of Tigard boundary.This fiber installation is being permitted for ROW access through Washington County.The route rounds the corner onto SW Nimbus and runs along the east side of Nimbus to a tie-in point 112'south of centerline with Scholls Ferry Rd. (see plan detail) Enclosed: -City of Tigard ROW Permit Application -Detail Drawings If you have any further questions please contact me at(971)266-4433 or annette@commstructureconsulting.com.I appreciate your assistance with this request. Sincerely, C Annette Dexter Commstructure Consulting,LLC Planning I Design I Implementation 811 Railroad Ave . I Oregon City, OR 97045 I (503) 343-4134 www .commstructureconsulting. com 53_ CONSTRUCTION NOTES 0 EXISTING TCA 467TH UTILITY VAULT-p23. W CORE"DRILL& TERMINATE NEW PVC CONDUITS IN EXISTING VAULT. RE-SEAL OPENING MTH CONDUIT SEAL OR EOLRVALENT. j , LEAVE SLACK IN NEW FIBER CABLE CONED AN VAULT AS REQUIRED. D: 8..t; O O Pat OTMNEE(I) NEW SDR11 HOPE CONDUITS& IN NEW 1 CONDUIT.OCA>£IRE. CC ■ rr3' A . ■� © 0 PL NEW 264TA UTILITY VAULT IN SIOEIWA(K IWTH NON-SUP SIDEWALK LID. TERMINATE NEW CONDUITS IN NEW VAULT. I r V,i _--• 1,,-4. RE-SEAL OPENING MIN CONDUIT SEAL OR EQUIVALENT ■ ' ; 0 :� LEAVE SLACK IN NEW FIBER CABLE COILED IN VAULT AS REQUIRED. 0 O EXISTING TCA OWNED T.5'PVC CONDUIT LOCATED IN LEVEL 3 QUAD DUCT CONDUIT ALIGNMENT. E 1 V i 0 TCA CONDUIT IS DESIGNATED AS THE ORANGE I.5'CONDUIT LOCA TED ON THE TOP OUTSIDE OF / l a I THE LEVEL 3 DUCT BANK. / _ Os PL NEW 1.3"PVC coypu'''. / --- ( . • INTERCEPT AND CONNECT TO EXISTING AT&T CONDUIT IN LEVEL 3 ALIGNMENT. -__ ___ . -'_ .:. • L "v' © In O SWEEP NEW CONDUIT OUT OF MAIN TRENCH ALIGNMENT MTH 45 DEGREE BENDS AS REQUIRED I eo N AND EXTEND TO NEW DUCT VAULT LOCATION. 1. .. PL NEW LS"SPLIT DUCT AND CONDUIT AS REQUIRED TO REPAIR CONDUIT OPENING. 1 1 S'�q^lam RESTORE AREA TO OTY/COUNTY SPECIFICATIONS. �— — — — -•)_ 0 REMOVE/REPLACE SIDEWALK AS REQUIRED. wxn FULL PANEL REPLACEMENT. 52\00 SW NIMBUS AVENUE I 1 SW NIMBUS AVENUE ____, - -I - r- - +_- 1 1- _ —r----'— _ _i - - I • r • } SIDEWALK /w SIDEIWLK I ""- b O / ♦ K I (U LL.Lc \ 4'11 d V)U / _.. J O CDMSIIIIK110N NOBS 0\ / L ALL AEN WITS X) 'WEE(3)SEW"L.YS•MOPE WAU.RPCTS(CAESs U OD111WSE SPECIFIED)I A COPPER IOGIRG WAE. ALL MKIIOUCTS ARE ♦\ S'i OJ En I TO E EprPRD NUN PULL-ROPE OR MAE TAPE AND PLIXWEU R/JACK ! NODE ALMS OR ECIAVAIdT. 1 lREESS ORERWSE WORM !]ryAR,. W 5CR raw./SERA/GROW 0? OE/RAM AS TAO OUT MUM AUDId12A INN mow ORNER. CONDUIT PLAN 1 1001 DAOSSWC ORER NRORES AT DE(At Of CWSmucnEN AS RAT SW NIMBUS AVENUE/SW SCROLLS FERRY ROAD DOWNERS WOAD 1E PAWS AS TO DE unu IV AND ME ACTUAL ,fu! r•=}O. >DARATIW We.TINE PENT A DEPTH of Co1Q ROM fAOun S. ♦ALL DEPTHS or ttwour oR orao,RURED rawRoucr MAmAENT wit BE RECORDED AT ME WE of CeMSTRUCROY. S MAR Contour N LOCABW SRO*W PRA I6 war Amu.cOVER C'M' ON PUBLIC RIGHT-OP-WAY ALAI 36'W PRIVATE PROPERTY LUMINAIRE.1805 IN SPLICE DE9ol AR R.RAPP( OIE01®BD E Oeld TIGARD BACKBONE OVERBUILD: TOTAL TRANSMISSION POLES_-- IRRIGATION VALVE '":=,, DRAW or A.NEws CATCH BASIN ® TIBER SYMBOL NORTH CONNECTION TO SCROLLS FERRY ROAD TOTAL DISTRIBUTION POLES--- SIGN 0 WATER METER TIBER SYMBOL GAS VALVE CABLE DATE BY NEWSIOM APPR TOTAL NEW STRAND____-- BONIER VAULT LUMINAIRE O'/n/EA mw PERWT — CABLE' TOTAL AERIAL PLANT_-__-_ PEDESTAL TELBPoRT ■COMMUNICATIONS TCA tem.()S.W.NIMBUS _ WATER VALVE - -CONDUIT - :�`� AMERICA. LLC TIGARD OR 87229 TOTAL U.C. PLANT_ - FIRS HYDRANT CONDUIT '_ PERMIT PLOT DATE: SCALE: 'FILENAME& SHEET NAME SHINER MANHOLE ".p`.1 ! LLD L r_$ TOTAL SLACK - ❑ EXISTING GUST, VAULT ® STORAGE - - - - - 01/08/14 108/2014 "-3Q' NV U6 W TOTAL CABs - ® NEW VAULT STORAGE - - - --- .T""'c,.M.. .Sl' „n . 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