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PFI2017-00182 � n CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT s COMMUNITY DEVELOPMENT Permit#: PF12017-00182 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 09/16/2017 Parcel: SEG2205 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Frontier PFI Project Description: Bore in conduit about 60'across SW Kable Lane Owner: FEES Description Date Amount PFI Permit Fee 09/15/2017 $300.00 PHONE: Contractor: PHONE: FAX Applicant: JOHN COUSINEAU 4155 SW CEDAR HILLS BLVD BEAVERTON, OR 97005 PHONE: 503-643-0371 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 Signature: .�- G(Dl2UC-e-; L- Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12017-00182 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. Ken Fisher 503 816 6146 or Kenny@tigard-or.gov 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 City of Tigard AUG 2 S 2017 PUBLIC WORKS —ENGINEERING CITY OF TIGARD I�JrPublic Facility Improvement (PFI) P'e"'�=" t NGINEERlNG TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) TYPE 1–Franchise Utility Work Check one: ® Utilities ❑Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE Detailed descriptionTO BORE IN CONDUIT ABOUT 60'ACROSS SW KABLE LN. and/or utility agency. FROM MH2/338 BETWEEN 7257&7337 SW KABLE LN.ACROSS TO PEDESTAL BBRIV ❑ TYPE 2–Sidewalk/Driveway/Sewer Work performed for the purpose of: 12326 WHICH IS BETWEEN 15605 SW 72ND AVE.7642 SW KABLE LN. • Sidewalk installation or repair. - Driveway approach installation 7342 SW KABLE LN AND 7337 SW KABLE LN. Property address/location(s): and/or repair • Sanitary sewer lateral installation and/or main line tap FRONTIER COMMNICATIONS/JOHN COUSINEAU ❑ TYPE 3–Full scale Development Applicant: Work performed with Land use Address: 4155 SW CEDAR HILLS BLVD approval which includes any of City/state: BEAVERTON Zip: 97005 the following. Phone: 503-643-0371 Email: john.cousineau@ftr.com • Subdivisions or Partitions JOHN COUSINEAU 503-643-0371 • Street widening Contact name: Phone: • Mainline installation for Sanitary Contractor: SONICOM sewer, Storm sewer, Tigard water and/or Tigard Water Service Area CCB#: 188116 Expiration: 09/24/17 Address: 1275 S Kodiak Circle SUBMIT COMPLETED APPLICATION TO: City/state: CORNELIUS/OR. Zip; 97113 City of Tigard Phone: 503-519-3445 Email:Pjfellows@sonicomcorp.com Planning/Engineering 13125 SW Hall Blvd. Contact name: PJ FELLOWS Phone: 503-992-7711 Tigard,OR 97223 Applications for"minor work in right-of-way" Engineer: JOHN COUSINEAU only may be emailed to: rowpermitsatiaard-or gov Address: 4155 SW CEDAR HILLS BLVD. City/state: BEAVERTON/OR. Zip: 97005 `�j Phone: 503-643-0371 Email:john.cousineau@ftr.com Case No.: �rT W I 1 —00)v Z Contact name: JOHN COUSINEAU Application submittal fee: $ 3CV. CW Additional fees: $ Estimated value of work is required(if over$5,000):$_1,000 Application accepted: -� � (within the public right-of--way) BY: io6 Date:' Application reviewed: Is work related to a LAND-USE DECISION? ❑ Yes ® No , If so,please specify (MLP, SDR,SUB,etc.) case#: By: l�• l�►S 444 Date: -3� Applicant notified: Is work related to a BUILDING PERMIT? ❑ Yes ® No By: Date: S If so,please specify(BUILDING PERMIT)case#: I:\ENG\PermitAppliations\pfi_applkatlon Rev.12/16/2016 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 15.041.140. * With the exception of a utility operating pursuant to a valid franchise 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(s)must sign this application in the space provided or submit a written authorization with this application. Franchised Utilities are not required to obtain the owner's signature on the application BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT: • The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject prope • 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 statements in any 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. JOHN COUSINEAU 02/17/17 Applicant/Authorized Agent's signature Print name Date SIGNATURES of each owner of the subject property, if required. Owner's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 • Page 2 of 4 APPLICANTS NOTE: Person specified as`Applicant"shall be designated"Permittee"and shall provide financial assurance for work,if required by the citta pursuant to'I'1\4C 15.0.41.140. " A nth the exceprion of a utility opmAting pursuant to a valid franchise with the City of'I'i�nnl,wiaen the owner Pill(the applicant are different people,the applicant must Ix.the purchaser of record ora lessee in possession with written authoAzatiun from the owner or an agent of the owner. "Iltc owner(s)must silnt this application in the space provided or submit a written authorization with this application. Itranchiw. d Utilities arc not required to obtain the ovine s signature an the application BY SIGNING BELOW,THE APPLICANT(S)SHALL CERTIFY THAT: • The above request does not violate any recorded deed restrictions that tna),be attached to or imposed upon the subiect propea. • 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 statements vi any plot plan,attachments,and exhibits transmitted herewith,are true;and die 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. JOHN COUSINEAU 08/28/97 �pplicant/Authorized Agent's signature Print name Date SIGNATURES of each o-Amer of the subject property, if required. Owner's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT Cityof Tigard • l 3125 SLS`l-laU I31vd. • 'Tigard,Oregon 97223 • w%w.tigard-or gov • 503-71$-2421 • Page 2 of 4 51351-5208154-WO551566 CONSTRUCTION NOTES TGRD-BUS FIGS-BORE PATH AND PLACE DROP-WDI CO OF OREGON 1.BORE FROM MH 2/338 ACROSS SW KABLE LN.TO PEDESTAL -aums.NQ ADDRESS: 7342 SW KABLE LN. T-12326 AT 15605 SW 72 AVE.WITH 1.25"SUBDUCT CONTACT: STEVE HOFFMASTER503-684-4934 CALL FIRST 2•PLACE DROP H3017:38 FROM FDT-65588 AT 7337 SW KABLE @ LN.THRU MH2/338 THRU PED 12326TO CUSTOMERS DMARC AT BEFORE STARTING WORK 7342 SW KABLE LN. TOTAL ALLOTTED HOURS ADDITIONAL FRONTIER CONTACT: DONNY SALINAS @ 503-484-3806 �QRA�TE�PER.QRl"MEI MAS HOURS ARE REQUIRED TO COYRLETE" ECT. CAP. X-TIME AINT. CREW 1 24 0 1 0 SEVERAL CABLES AND ANNOTATIONS SPLICING 1 0 D 0 TToQ I LEFT OFF FOR CLARITY I ' ND DRIVER LOC QO I I I ❑=TTP GROWN TNOM45 EROS. T ' Fy��FTTP OVERLAY MAP A ' 'V\OOn��- I I I W FIBER s 4-1 0 7337 SW KABLE LN I I I ' ONSTRUCTION START D8/22/17 7257 SW KABLE LN I I IN SERVICE DATE 08131/17 f \1 � I \I, CONSTRVCTION COMP1E1E09✓31/17 I ' MH2/338 I I 19. 59' CUTS REQUIRED _\ I I ' YES N NO CONSTRUCTION 111t It Sf�l�,ed�y a i� 1 i -- 1__25"SUBDUCT I� OIOINT TRENCH 0 DIAL. A DIG L— -- ------ ' ❑YES 01 NO FLAGGING L-- II Q 0 BRUSHING SCCN REQ'D SW KABLE LN. -- ❑CONTRACTING ,�I )' i �/• II�Z ❑YES W NO REQ'D N t 7342 SW KABLE LN 1 332' 3 MUNICIPALIPERMITS Y n IGARD AE 300 24 IN MUNICIPALITY I 1 ORK ?� � i 1 / / l� �i XD,1-100+ �� j� I ❑ BLANKET I I TCP/TRAFFIC 4� 5 fi I BBRIV 5R1,701-775+ i� I S Q' I II -] 1 Q4 DETAILED (NOT BLANKET) I �tnil ' ' I-- - - 493' 08.2017 Ji o XD,776-800+ h � III II NO PERMIT REQUIRED I' 1 I I � XD,201-300 w „r ti + UNK SERVICE DROP 2 III TGRDORXA H3017,38+ I � III II JOINT POLE AREAS 1 I (f 1 JFN/NJUNS t N/A XD,2 II 15605 SW 72ND AVE 1 III II I JFN/NJUNS #N/A t 1 II •I j �`r'}:1! i+ � _ I, IIIIII 1 Il III M NO JPN M REQUIR ED 386' POLE JPN JPNUNKONT 4OWNER TO FRO ❑ O O PTGRDORXA H3017,38+ ONT BBRIV 581726-775 D'2 [3 [3 E3 FRONTIERWDI CO OF X OREGON O•( �� IIIII I POINT OF CONTACT ww QR��5 i NAME 25lk'2 III it I 123-456-7890 SCHEDULING � .• � yUSS MAN PHONE No-_3-6b---9W-_22B0 EwGiNEE 425 PHONE rvo. 525 4019 I• `I �• I I PHO EEC.No. PATR 4251 263-4010 j + • I` �`��` FIELDED BY FRONTIER CONTACT INFORMATION yffianfier• ENGINEERING MANAGER:CHUCK ROBERTS @ 425.261-8888PLANNER:JOE VANDECOEVERING @ 503-626-3270 munications NETWORK ENGINEER:JOHN COUSINEAU @ 503.643-0371 TGRD-BUS FIOS-BORE FOR PATH CONSTRUCTION SUPERVISOR:MICHAEL SHANNON PLC DROP-WDI CO PROJECT C.O AREA: CONSTRUCTION COORDINATOR:RON SITTEN NUMBER: EXCH.CODETIGARD FACILITIES TECHNICIAN:MICHELE CRISMAN @ 503-643-0180 DRAWN DATE: ENGR: COUSIN EA NTY:WASK PHONE: FILE: r"vf': OPCEN SCHEDULER:RYAN ROBERTS @ 503-643-3713 SCALE: TAX DISTRICT: DWG OF TWNSHP: RNG: SEC: �r + . FRONTIER PEDESTAL FRONTIER MH FRONTIER WORK ORDER 51351 -5208239-WO551566 Page 84 2011 Edition Stat onatry Lano Closure with Flagging�;-.;,�0_ agram 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 j 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 1 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. 1 5. Cones should be used to outline the work space when curves or other i 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 December 2011 FRONTIER WORK ORDER 51351-5208239-WO551566 2011 Edition Page 85 Stations Lar�e;_Cl0SU W h_ lagging Dai gram 320] __ rY.._ <0 Q � ro C1 ZIcn J ro U, a 'i' ti r o �5N log J 3 o ' o Y rimanc • 3 ori N oo w N _ r • � R C � sT �$ S ESM • v C 11!! I I •® $�U UO OC C � ! 11 t I � o , II• Q C Gl w Vl I EE h Z �y Z ' rH -0 O ` U p C IMw 0 � 0 c I •• ki ! W r L'OU 20 u o d • ani 0 W d a CL 1� I LL dy0 0 0 _ c V (aoa � � I Z � 00 rLL`v V 2 I P a I <�R>j In I N ! ,+ Sign Spacing and Buffer Lengths(feet) v I I 1 Posted S aci Bshll S ns a ffer •� 9 Speed A B I C Space O 20 50 I \ 25 100 100 100 75 \ 30 100 p 40 350 350 350 155 40 3rd 45 180 SO 500 500 500 210 55 250 I I December 2011 Chapter 5 I i