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PFI2015-00188 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PFI2015-00188 . � 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 12/16/2015Parcel: SEG2468 Jurisdiction: Site address: Subdivision: Lot: Project: ELI-Integra Project Description: Starting 10'south of pole 7208 at approximately 525'south of intersection of SW Bonita Road/SW 74th Avenue overlash fiber(N) 1 00'to pole 39, then(N)241'of new strand and fiber to pole 4642,then(W)to private property(7440 SW Bonita Rd.). Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: DAVID MINER 18110 SE 34TH ST., BLDG 1, SUITE 100 VANCOUVER,WA 98683 PHONE: 503-710-6296 Total $0.00 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 Not Present Signature: Issued By: —� C Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12015-00188 Type: Condition Name: Status: Severity: PFI_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 08-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_Utilities 09-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_Utilities 10-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_Utilities 11 -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_Utilities 12-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_Utilities 13-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_Utilities 14-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_Utilities 15-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_Utilities 16-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_Utilities 17-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_Utilities 18-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_Utilities 19-MONUMENT PROTECTION Applied Notice Existing monuments, property corners,and survey markers shall be protected. Replacement shall be at the permit holder's expense. PFI_Utilities 20-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_Utilities 21 -OTHER Applied Notice RECEIVED DEC 14 2015 ICity of Tigard CITY -- M PUBLIC \FORKS — ENGINEERING PLAN!N''r, Public Facility Improvement (PFI) Permit DESCRIPTION OF WORK(in the right-of-way) REQUIRED SUBMITTAL Check one: R Utilities ❑ Sidewalk/driveway approach ❑ Street improvements ELEMENTS Starting 10'south of pole 7208 at approximately 525' El Minor work in right-of-way Detailed description: (sidewalk repair,curb cut,street South of intersection SW Bonita Rd/SW 74th Ave on SW 74th Ave overlash fiber(N)100' opening,etc.)requires: •Application form,completed to pole 39,then(N)241'of new strand and fiber to pole 4642,then(1N)to private property and signed •Submit one(1)copy of scaled sketch 7440 SW BONITA RD of the proposed work to be done Property address/location(s): •Submit one(1)copy of traffic TIGARD, OR 97224 control plan SEG d-+(v 8 —OR— ❑ Substantial project work requires Applicant's name: ELI-Integra- Dave Miner above items and professional Address: 18110 SE 34tStreet, g h Bldg One, Ste 100 engineered plans for: P. 98683 •Street widening Cin•/state: Vancouver,WA Zi •Subdivision infrastructure Phone: (503) 710-6296 Email: David.Miner@integratelecom.com •\Iain utility line extension: Storm Drain,Sanitary—Tigard - Water—Tigard Water Service Contractor's name: Standard Utility Attn: Darrel Williams Area(includes Durham,Icing city 66948 Ex iration: 5/29/2017 and a portion of unincorporated CCB#: P Washington County) Address: PO Box 1008 97308 DELIVER APPLICATION TO: City/state: Salem,OR Zip: City of Tigard Phone: (503) 849-4828 Email: darrel@standardutility.com Planning/Engineering 13125 SW Hall Blvd. Tigard,OR 97223 Engineer's name: Applications for"minor work in right-of-way" Address: only may be emailed to ...,,..�ermit8(Q7Lgi�-9LQo'y City/state: Zip: Phone: Email: Case No.: PFTa US —q01 be Estimated value of work(within the public right-of-way): Application submittal fee: Is work related to a LAND-USE DECISION? ❑ les B No Application accepted: If so,please specify (MLP,SDR,SUB,etc.) case #: By. Date: Application re wed: Is work related to a BUILDING PERMIT? ❑ Yes 8 No By: Q Date: If so,please specify(BUIMING PERMIT)case#: Applicant otified: I By: Date: I:\CUFIPMMasten\Land un ApOkAtkmn x.07/16/2014 City of Tigard • 13125 SW Hall Blvd. Tigard,Oregon 97223 wwwtigard-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%vork. *When the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in possession with written authoriration from the owner or;m agent of the owner. The owner(-)nutst sign this application in rhe space provided or submit a written authorization with this application. BY SIGNING BELOW,THE APPLICANTS) SHALL CERTIFY THAT: • The above i:cquest does not violate anN,deed restrictions 1hat may be attached to or imposed upon the subject property. • If the application is granted,the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. • All of the above statements and the statcments in the plot plan,attachments,and exhibits transmitted herewith,are true;and the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such statements are false. • The applicant has read the entire contents of the application,including the policies and criteria,and understands the requirements for approving or denying the application. SMNATURES of each owner of the subject property required. -L MEL �� }�I�LUPS /z, J t\p licant/A th rized Agent's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date Owners signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • «nvwtigard-or.gov 503-718-2421 • Page 2 of 4 I I DEVELOPMENT ENGINEERING FEES 1. Public Facility Improvement(PFI)Permit: Part 1: Required submittal fee$300.00 Part 2: All non-water system improvements Engineer's estimate X 5% (less$300.00 submittal fee) Engineer's estimate X 2%Plan Review Part 3: All public water system improvements Engineer's estimate X 12% Total Permit Fee = Part 2+ Part 3 I PFI Permit Fee Exemptions: There will be no permit fee charged,or assurance required for the following types of work: i • Sidewalk or driveway repair(less than 20 lineal feet) • Relocate or replace mailbox • Ditch cleaning that does not involve regrading. • Weephole repair • Curb repair or replacement(less than 20 lineal feet) F • Lawn sprinkler system installation or repair • Street tree pruning or planting • Planter strip landscape maintenance • Test wells PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov 503-718-2421 Page 3 of 4 SAMPLE SKETCH: T� 1 I. Edge of Pavement I +y-- Ditch _ Streetlight I r '— '— r >�nrdn 1 , � I -- 1 i i'moi'Cr os cf'Selw'e iTt n e i '-1 I Nj Existing House r' I �1 I Existing 1 >i Driveway ~ i oll a� ICT C 1 r `L ' I I a i � 1 tires I rs'$ 1 oExisting Shop S � J 2 1 Powerpole 1 o I o I — -Fogerty Line � I � I I Fire Hydrant(FH) � I I Scale: '1"=30' � I I � � I ' I I � I I � I MINIMUM SKETCH REQUIREMENTS(Put"N/A" if Not Applicable): North arrow Property lines&dimension Slope of property Street&street name(s) Existing building,structures Utility&street light poles Proposed work Existing curb or edge Trees Existing S/W or of pavement Existing utility locations D/W apron (sewer,water,storm) PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wmvwtigard-orgov • 503-718-2421 • Page 4 of 4 V CONSTRUCTION NOTES 1. ALL WORK AREAS TO BE RESTORED TO LIKE OR BETTER CONDITION. BOJ — 2. ALL OTHER UTILITIES ARE BASED OFF EXISTING LOCATES I PLACE NEW STRAND AND LASH FIBER. OR UTILITY STRUCTURES. 3, IT IS THE CONSTRUCTION CONTRACTORS RESPONSIBILITY TO CALL FOR LOCATES BEFORE DIGGING. LEGEND EXIT CITY OF TIGARD ROW POLE NUMBER: 4642 7440 SW BONITA RD 45' INTEGRA HOA: 21'-11" EXISTING UTILITY POLE TIGARD, OR 97224 COMPLIANT FACE OF CURB V� I EDGE OF PAVEMENT 8 $ EDGE OF SIDEWALK w RIGHT-OF-WAY UNE R OVERLASHED FIBER ON EXISTING I STRAND. o PLACE NEW STRAND AND LASH FIBER. NEW STRAND AND LASHED FIBER. w R - R x g �' R POLE NUMBER: 3115 RECEIVED foc'0� INTEGRA HOA: 21'-5" COMPLIANT DEC 14 2015 CITE` ;. = �;ARD \ R e PLANNINc _;•,;ViNEERV= JQ JOJ BOJ ` z W 2 H O z 8� inteqra 0 PLACE NEW STRAND AND LASH FIBER. \ \ ` J M Contact:David Miner Title:Sr.OSP Engineer ph:(360)558-4213 POLE NUMBER: 39 cell:(503)710-6296 INTEGRA HOA: 19'-11" email:David.Miner(ainteg_ratelecom.com COMPLIANT Po BOX 2529 Clackamas,OR 97015 8. Design By:K 8 B(503)650.5041 TECHNICAL SOLUTIONS Finail:Justen_Phillips@kbmail.net OVERLASH FIBER TO EXISTING STRAND $ rn REV. DATE ms(_RIVnON DRAWN DESIGN 1 12/8/151 CITY OF TIGARD PERMIT DRAWING RAS J.R POLE NUMBER: 7208 INTEGRA HOA: 20'-5" COMPLIANT SCALE PROJECT NUMBER. BEGIN FIBER ENHANCEMENT PROJECT $ 1"= 50' ES015-2471 ES015-2471(INT-5921-4000) SHEET NUMBER TITLE: Fiber Enhancement Project 0' 50' 100' a 740 SW Bonita Rd Tigard, Or 97224 SCALE: 1" = 50' E"E"AME OF 1 INT-5921-4000 3 Page 80 2011 Edition 5.3 Two-Lane, Two-Way Roads Shoulder Work w/ Minor Road Encroachment Diag. 300' Use this detail for non-freeway work which extends into a travel lane and maintains a minimum 10 foot travel lane. If a minimum 10 foot travel lane can not be maintained, or when traffic can not safely pass by in both lanes simultaneously, use the appropriate lane closure diagrams—for example, Diagrams 310 through 350. A lane closure may be appropriate for conditions such as high traffic volumes, high speeds, and inadequate approach sight distance to the work space, or heavy equipment adjacent to the travel lane. 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. Cones shall be placed along the entire length of the work space. If a protection vehicle is used and work is in place one hour or less, the taper and tangent devices may be omitted. 4. If the speed is 45 mph or higher, volumes exceed 2000 ADT, or there is limited sight distance, consider placing cones or tubular markers on centerline. 5. An arrow board in caution mode or truck-mounted PCMS with "SHOULDER WORK" or other appropriate message may be used for higher visibility. Sign Spacing and Buffer Lengths(feet) Posted Spacing Between Signs Buffer Speed A B C Space 20 50 25 100 100 100 75 30 100 35 40 350 350 350 125 150 45 180 50 500 500 500 210 55 250 Chapter 5 December 2011 2011 Edition Page 81 Shoulder Work w/ Minor Road Encroachment Diag. q0 ROAD - WORK �� • AHEAD • Initial Warning A • Sign • • • (Optional) • • Protection Vehicle • w/TMA(both Optional) See Chapter 4 • Buffer 10' • minimum • U3 • •I • A ROAD NARROWS M (Optional) B i ROAD WORK <,AHEAD Initial Warning Sign December 2011 Chapter 5 Cheryl Caines From: Justen Phillips <Justen_Phillips@kbmail.net> Sent: Monday, December 14, 2015 3:04 PM To: ROW Permits Cc: Miner, David (David.Miner@integratelecom.com); Roy Spaulding;Jeff Mettert Subject: ELI/Integra Fiber Enhancement permit application Attachments: Permit Application_ES015-2471(INT-5921-4000) signed.pdf; Permit Drawing_ES015-2471(INT-5921-4000).pdf; Diag 300 - Shoulder Work with Minor Road Encroach ment.pdf Good Afternoon, Attached is a permit application, Drawing, and TCP for ELI/Integra.They are proposing to place new aerial facilities along the East side of SW 74`h Ave south of SW Bonita Rd. Please see attached application and drawing for more details. Please call or email me with any questions or concerns. Thank you, Justen Phillips Project Manager K&B Technical Solutions 6566 SE Lake Rd Suite E Milwaukie, OR 97222 Office - (503)650-6041 Fax - (503)650-7390 Mobile - (971)271-9317 i