ROW2014-00045 CITY OF TIGARD RIGHT OF WAY PERMIT
t Permit#: ROW2014-00045
1° • COMMUNITY DEVELOPMENT
.
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 05/28/2014
TEGr1.FLLf Parcel: SEG885
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: PGE
Project Description: Adjacent to 12150 SW 124th Avenue. Vault 6340-replace bad order lid. Sidewalk replacement. SEG
885
Owner: FEES
Description Date Amount
ROW Permit Fee 05/28/2014 $300.00
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
TOD SHATTUCK
2213 SW 153RD DRIVE
BEAVERTON,OR 97006
PHONE: 503-672-5466
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
Sign ature: � po9s-e r i
Issued By: Alnd
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for ROW2014-00045
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 Kenny Fisher at 503-816-6146 or email at
kenny @tigard-or.gov,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
MAY 122014
City of Tigard CITY OF TIGARD
71 P� ENGINEERING
. Application For Work In The Right- '—N ay
•
TIGARD ROW Permit
b3e4- Is-2179
Property Address/Location(s): ab-t /A150 sc.) l Y u i9v. FOR STAFF USE ONLY
S
ESS Right-of-Way
Case No.: 94.W2D14— 0-7 0 44)
*Applicant's Name: Po rt IPA&CMEr}e rs_( E 1e.G`f'r1'C. Application Accepted:51 IL By: —
Address: aA 13 5 tJ f 53 t-ae-bri/e Application Reviewed: i f By:Af
City/State: cg e of ue r on, OR. Lip: 7004 Application Fee Due:
3001519
Primary Contact: T D GQ S4.)0-1-tti Applicant Notified:^512D(I 4 — fkr-
Phone: 50 3- 6 7a -.542,6,f o Fax: Receipt No.: 1-I1Y-
Email: T D' Ire:A- -a G. pgn .COM►ry REQUIRED SUB I AL
Contractor's Name: N14 J • 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: p qe. • Subdivision Infrastructure
• Main utility line extension
Address:
Deliver application to rowpertnits(a;tipanl-ur.gov or to
City/State: Zip: City of Tigard Planning/Engineering,13125 SW Hall
Phone: Fax: Blvd.Tigard,OR 97223.
Rev.12/10/2013
Email: I:\CURPLN\hlastets\land Use Applications\Rightof-way Permit
r q( Application.docx
Description of work: VOLE, It 4.3`jO - re.f1jcare 1cJL o•-d.h.t Lid( . S; ew _(c Ceio LceMeet,
Estimated value of work(within the public right-of-way): $
Is work related to a LAND-USE DECISION? YES zr--
If so, please specify(MLP,SDR,SUB,etc.)case#:
Is the work related to a BUILDING PERMIT? YES _ NO
If so, please specify(BUILDING PERMIT)case#:
Signature of Applicant/Permittere''`��' Date: -3-8' -20I 1
Print Name: To d S t-lat .Ck Title: SM P"1
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2464 I www.tigard-or.gov
Page 84 2011 Edition 2011 Edition �,/�#' `7� 7 R� I Page 85
Stationary Lane Closure with Flagging Diagram 320 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 o o
both directions of traffic on low volume roads(less than 400 ADT)with good Q o
0
sight distance as discussed below. iti
1. Use truck mounted flashing warning lights on work and protection p o E a
vehicles. See Section 4.3-Lights and Lighted Signs for exceptions. o 0 6 o
O
I ' { $. 1 zi-)
f)
m 0)2. For added visibility, a truck-mounted arrow board or PCMS in caution W a FL
mode may be used. � . mg_ m o
3. Flaggers at each approach are required if any of the following . E° 4,0 ,
conditions exist: 0018411 a
.�
a. Night Operations. L.1.�
b. Work space is over 200 feet in length. arose _
c. Sight distance is less than 750 feet from each approach r• • r I itl
m 0
�• U O,
through the lane closure. � � • >o
d. Traffic volumes are greater than 400 ADT.
b • C'E L
000411 A ' • / m..:40 m
4. The length between the Flagger Ahead signs shall not exceed one .x 4 1 m
mile. Use Diagram 340-Lane Closure with Pilot Car if exceeding one x-i .E •
E I. a§to
® <
mile. 3
5. Cones should be used to outline the work space when curves or other 0041 o
I • 1 f
roadway alignments prevent clear direction for the motorists to pass •%
the work space safely. (2 co 1 iG i I •
rom -
6. Cones along the work space are recommended when posted speeds 0 • •.2. 1 I .... ._,_ e
� o
are 45 mph or greater, when working under heavy traffic or when travel ! � (D>)
lanes are narrower than 11 feet. LL-
r �o.
7. Extended queue signing (see Diagram 5-4)should be used when f_.-w m `o `
traffic queues extend beyond the initial advance warning sign. O- II v 1 m m a 0
1 t is
fp is we iT)8. When flagging near an intersection, the"Flagger Ahead"(CW23-2) I m
sign should be visible to traffic entering from any side road. Additional
Sign Spacing and Buffer Lengths(feet) 1 1 w N
advance warning and Flagger Ahead symbol signs may be placed on FS, C
Pasted Spacing Between S18ns Buffer p o
the side road(s). Speed A B C Space V o Q 4 0
9. Sign set-up and flagger placement shown may be used for intermittent 20 100 100 100 75
full road closures of 20 minutes or less. ego. _ 30 100
40 350 350 350 150 O O E
10. The"ONE LANE ROAD AHEAD"(W20-4)sign is optional and should 45
180 ¢3
be considered on high volume or high speed roads, or when extended Pls. 55 500 500 500 210
queues are expected.
Chapter 5 December 2011 December 2011 • Chapter 5
r
LEGEND
06854
1973-20
imr 018 3- - ---- --
I=INSTALL ADDITIONAL FACILITIES/MODIFY FACILITIES
00620/
PL 06854 w •-2 AL-DB VT 06340
Q ' :-2 AL-DB REPLACE R'O LID
AL-DB WITH 660 TOP FOR
�I 2 SUBMERSIBLE TRANSFORMER
#64-332P-332GV-PGE
N
r
I
• PRE LANDSCAPE TO REMOVE
y SIDEWALK AROUND VAULT
• POST: REPAIR SIDEWALK
06855
1981-20 , VT 06340 J L, Li
01823
it SW KA R1N \
00625/
PL 06855 Ir
0 WR CHECKLIST I ,E-
l-
1 1 10 CU-0 ITEM YES COMMENT ^ I 1- -
B 75 3760 r) HOLDIG GER /� 4-1 BOOM X
`
8601101 /1-ID CU-1 PGE TRENCH , �Q S I I r// r-
L ) LOCATES X •' •.
ril
S ,�•
STAKING .
FLAGGING ^yn inc---
S'
_
TREETRIM
LANDSCAPE X PIE R POST Haws GUIDE
EASEMENT 655-134 VICINITY MAP
PERMITS X CITY OF TIGARD
TRAFFIC PUN PGE CONSTRUCTION DRAWING
RIGHT-OF-WAY PERMIT NOTICE: UG CR
A PERMIT FROM THE LOCAL JURISDICTION IS REQUIRED BEFORE ANY CRt AS-BUILT VERIFICATION & NESS VIOLATIONS CORRECTED
TRANSAIISSON WORK IN THE RIGHT-OF-WAY MAY BE PERFORMED. ONLY PGE APPROVED This document accurately represents FIELD Construction.
CONTRACTORS AND CONTRACTORS WHO HAVE MADE OTHER SPECIAL CUSTOMER Foreman: Date:
AGREEMENTS WITH PGE WILL BE ALLOWED TO WORK UNDER PGE'S PERMIT. CUSTOMER
SHUTDOWN
CONTRACTOR MUST NOTIFY THE LOCAL JURISDICTION 48 HOURS TDOWN General Foreman: Date:
BEFORE WORK IS TO BEGIN.A COPY OF THE PERMIT MUST BE ON SITE DOOR HANGER (Signature only required for field construction changes.)
CONTACT SDPMrENG REVIEW: IASBUILT BY DESIGNER:
COMPANY DATE. 42644 SCALE: 1':60' (ACCOUNT 5930001 I AWO: 7000001906 1)0B HO'757999
Mr CR TITLE
DATE TIME N. PGE
CIRCUIT SIZE
TIGARD -13362 11517
THINK ATTENTION: CALL 811 BEFORE YOU DIG PG/ LOCATION
OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED ` 12150 SW 124TH AVE,TIGARD
SAFETY BY THE OREGON UTILITY NOTIFICATION CENTER. DESCRIPTION
CONTACT GENERAL FOREMAN THOSE RULES ARE SET FORTH IN OAR 952-001-0010 - a REPLACE BO VAULT LID
FIRST! ANDOR CONDUIT INSPECTOR 3 TO 5 WORKING DAYS PRIOR THROUGH 952-001-0090.YOU MAY OBTAIN COPIES OF I COUNTY SECTIONS) IWORK WITH SHEET
TO EXCAVATION.CONDUIT INSPECTION REQUIRED PRIOR TO BACKFILL. THE RULES BY CALLING THE OREGON UTILITY Y WASH C21-03B
PGE WILL NOT INSTALL WIRE UNTIL TRENCH IS 1003/4 BACKFILLED. NOTIFICATION CENTER ADMINISTRATION @ (503-232-1987) BEAVERTON I OF I
LINE CREW CENTER DESIGN BY PHONE(503)I DRAWN BY
JAYDEE PICKERILL TO REQUEST UTILITY LOCATES CALL THE OREGON 1213 SW IvRO DR TOD SHATTUCK 672-5466 DUMITRU ILIOI
GENERAL FOREMAN UTILITY NOTIFICATION CENTER,811 AT LEAST ��who,before yo below. BFAVERTOH.OB•7006
CELL 503-049 742 2 BUSINESS DAYS PRIOR TO EXCAVATION. COIL IIe10rB Yoa dlg. p PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED