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PFI2018-00010 s CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT li COMMUNITY DEVELOPMENT Permit#: PF12018-00010 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 01/22/2018 Parcel: SEG1394 Jurisdiction: Site address: Subdivision: Lot: Project: NW Natural Project Description: Located at the corner of Wall and Hunziker, SEG 1394. Replace vintage 2"(w)main with 2"(p)main due to RM improvements. See attached sketch. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: LORENE NOCHOLS PORTLAND, OR 97209 PHONE: 503-226-4211 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 r. � l� Signature: 6"k Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00010 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. Call Ken Fisher at 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 REGE' City of Tigard JAN 16 2018CITY OF-i'IGARD PUBLIC WORKS — I;NGTNT:ERTNG PLANNING/ENGINEERING Public Facility Im (PFI) Permit a.am.. TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) [D TYPE 1—Franchise Utility Work Check one: ❑r Utilities ❑Sidewalk/driveway approach 0 Street improvements performed by N\VN, PGE Detailed description: replace vintage 2"(w)main with 2"(p)main due to and/or utility agency. RNV Improvements. See attached sketch. ❑ TYPE 2–Sidewalk/Driveway/Sewer Work performed for the purpose of. • Sidewalk installation or repair. i 1 Driveway approach installation Property address/location(s): / and or repair SW Wall St @ SW Hunziker St SEG 11V Sanitary sewer lateral installation and/or main line tap Applicant: NW Natural-Lorene Nichols � ❑ TYPE 3—Full scale Development pP 1 Work performed with Land use Address: 220 NW 2nd Ave approval which includes any of City/state: Portland OR Zip: 97209 the following: Phone: 603-226-4211 x4372 Email: eln@nwnatural.com Subdivisions or Partitions Contact name: Lorene Nichols Phone: 503-226-4211 x4372 I • Street widening • ;Mainline installation for. Sanitary Contractor: same as above sewer, Storm sewer, Tigard water fand/or Tigard Water Service Area CCB#: Expiration: Address: SUBMIT COMPLETED APPLICATION TO: City/state: "Lip: City of Tigard Planning/Eagrnecrrng Phone: Email: 13125 SW Hall Blvd. Contact name: Phone: Tigard,OR 97223 i\pplicatiuns for"minor work in right-of-way" Engineer same as above only may be emailed to: rown�ts@tiga,� fd-ar.gov Address: FOR STArt,USE ONLY City/state: Zip: Phone: Email: Case No. e CZ X19– 000)Q Contact name: Application submittal fee(.007°0 of Engineer's Estimate) Estimated value of work is regtured(if over 55,000):S Additional fees: $ -9 (within the public right-of--way) Application accepted: // p (- Is work related to a LAND-USI; DECISION? ❑ Yes O No By: Date: If so,please specify (NILP,SDR,SUIS,etc.) case #: Application reviewed: By: Date: Is work related to a BUILDING PERMIT? ❑ Yes No Applicant notified: If so,please specify(BUILDING PERMI'l)case#: By: Date: 1:\ENG\PermitAppiicitions\pfi application Rev.10/16/2017 City ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 wwwtig rd-or.gov • 503-715-2421 • Page 1 of 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'Iigard,when the owner and the applicant arc different people,the applicant must be the purchaser of record or a lessee in possession with written authorisation from the owner or an agent of the owner. The owner(s)must sign this application in the space provided or submit a written authorizapon 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 unposed upon the subject proper • 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 requireme for approving or denying the application. Lorene Nichols 01/10/2018 Applicant/Authorized gent'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 CityofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 Page 2 of4 Page 94 2011 Edition �Xt6fi�o"n,a' ^y, � � �� r� '` 20 jig Diagram 32Ocovers total closure mYone lane oYahwcAane. two-way roadway. See the detail inset for the layout ifusing esingle Oaggartocontrol both directions oftraffic onlow volume roads(less than 4OOADT)with good sight distance amdiscussed below. 1. Use truck-mounted flashing warning lights onwork and protection vehicles. See Section 4.3—Lights and Lighted Signs for exceptions. 2. For added visibility, otruck-mounted arrow board orPCK88 |ncaution mode may bmused. D. F|oggmnoateach approach are required |fany oythe following conditions exist: o. Night Operations. b. Work space imover 20Dfeet inlength. o. Sight distance ialess than 75Ofeet from each approach through the lane closure. d. Traffic volumes are greater than 400 AOT. 4. The length between the F|aggerAhead signs shall not exceed one mile, Use Diagram 34O—Lane Closure with Pilot Car ifexceeding one mile. 5. Cones should bmused booutline the work space when curves orother roadway alignments prevent clear direction for the motorists to pnoa the work space safely. G. Cones along the work space are recommended when posted speeds are 45mph orgreater, when working under heavy traffic orwhen travel lanes are narrower than 11feet. 7. Extended queue signing (see Diagram 5'4)should beused when traffic queues extend beyond the initial advance warning sign. 0. When flagging near anintersection,the ^F|oggarAhead" (CVV23-2) sign should bevisible totraffic entering from any side road. Additional advance warning and F|aggerAhead symbol signs may beplaced on the side rood(o). 9. Sign set-up and floggerplacement shown may baused for intermittent full road closures of2Ominutes orless. 10. The "ONE LANE ROAD AHEAD"( V2O'4)sign |ooptional and should baconsidered onhigh volume mrhigh speed roads, orwhen extended queues are expected. Chapter December 2011 CD �:7o I------------------------1 V). No CD 0 L L"0 = I I Single Flagger Operation rn 1 ;o Q j for Low volumes ( o v (ADT 'o° M C? OI I BE nwooE, NEIANE a. , ■ a e I PREPARED ROADTt 3• �•_30 36 TO STOP MEAD r: CL .,r. ., I • ROAD j ♦ ® I WORK ` v w a I c s ■K N I AEEA/ �. nor ! 0 w j Tf rTw►�e+a�.o B ------------------------ Tt i ? r max. ,y K K K � Buffer Protection Vehicle w/TMA(both OptionaO ROADWORK • See Chapter 4 D O3 Al•iEAD BE ONE tAt1E ROAD PSTOP° Two Flagger Operation � � AHEAD >3 n� CA) `(D L, (Opttor%4 O Ln N INSTALL: WE - p d TL J'' ❑1#1#Anode F ~a Ary°•� s s/ CUT&CAP~' �1 ` / CO •P ,'/ Jr % r 3Rr ,r INSTALL: / p LW CROSS SECTIONS. GENERAL NOTE$ t CA fdk, Ubkv<.Nn.6<,msc<m f41t-0tl / 7a 1-04"21 1a 10' 10' 4a JJ 2 ATTENTN,N t'hgoa l,..,prnFo..o I. d y C ±� 6 .rn doNdb a<thq"n UWw!Nn9fiokn ,' Cme Tbwniu v<rn feN m..A[9'Aol- E ¢g B L a<anx.fNn<a<r<kPkw<rke r.a<o<gw / rc d.xNrot`,.�,r...<.i.Isnn u:.iveTmsrr7 ! a� Z' ,FM mn c.ueEv.4w h<.A,Nmk<grkd WS SW WALL ST EIS `INSTALL: 24•ra ae<...�.ew..w.« p LW t S'I s' I Is. 1a s s LHJ uCLv I'4ryer and 4'uO,v^_.tAl C E dne czar.se F•nnn+mw s.lm,dva mrna Tn� sten mdmm fn T.,.'van.h,OF<a_wks. i P nbrre'ur and mdmw f.d.. man M1 OF 2S EX MAIN .wt n<.m<.,ma<w rt<....<.nd v Fn nK.c"nyn<.e<.«.o<.vn n«nmm„na �+ +<' INSTALL: H7d .R—p as SW MUNZIKER ST NIS p LW ❑1p Anode %0MANCE s Class"D"PR ESSU R E TEST INFORMATION(drde 4 Y.bd r ted ee on w-0rA1 dsvAq) `1 N5 TALL: Test by PING-0144, / pTW w A S D F r INSTALL: INSTALL: Order Street Description Plat m nl6e C *V f"PE INLET VAL Pipe size Type p LW VE 3529066 7904 SW HM ikw St 14)44-021-M-01 1-044021 2023 WA SM10 1-041-021-M-02-V-A _ 3528950 7904 SW FMsezikw St Replace P(w)svc v✓1"(p)sw 1-044-M Z314 P-0100 SM99 / 3529065 7904 SW Humiker St 14)44404A.02 1-044021 ZC23 WA SM99 / 3526954 7910 SW Hutziker St Replace 1•(vw)sw v4 1•(p)sw 14)44421 Z314 P-0100 SM99 ; 3528955 7920 SW Fkmvikw St Replace V(w)sw v/V(p)sw 1.044-021 2314 P-MOO SM99 ; 3528959 79W SW Hk ker St Replace V(w)sw v4 1"(p)sw 14)44.021 2314 P-0MOD SM99 ♦% 3528956 7940 SW Munzikw St Recomect 1"(p)sw to new Z'(p)main 1-044144 7314 P-01 OD SM99 INSTALL: E3 TFw/LWA TL s WELDS OPER. Pw ql tet.♦♦ MODIOE�IS P GRADE W.T. YAOPNOP ACTWIYN ORDER N 4�`Y INSTALL 21»'r P G P24 .219 S.0 07 45 191 07526946 AERN low r w G M1� 0 50 100 4S NW Natural Feet Engineering Department 1 in-100" mn rm.eKoos.w 1 SW WALL ST ""ARD WASHINGTON OR www NDC ..*of ♦3 wns r SW NUNZ/RER ST M20 asw 01/70'441 >'f• WALL ST 2' MAUI INSTALL: ❑LW 1-0/.1-021 T02S R01W NW 1 2IO'IO �MAINS �� ❑144 Anode ou o21 Ton Rmwsw 1 026~ "low