PFI2018-00114 VOIDED
PF12018 00114
JOHNSON
h
City of Tigard
July 16, 2018
Northwest Natural
Attn: Aisha Rivers
220 NW Second Ave.
Portland, OR 97209
Re: Permit No. PFI2018-00114
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 13145 SW Ash Dr.
Project Name: Johnson
Job No.:
Refund Method: ® Check#228953 in the amount of$300.00.
❑ Credit card "return" receipt in the amount of$
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account "deposit" receipt in the amount of$
Comment(s): Per applicant's request as customer cancelled request for natural gas
installation. Refund 100% of permit fees paid.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 0 www.tigard-or.gov
City of Tigard
Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Request for PermitAction form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: NW Natural DATE: 6/22/2018
220 NW Second Ave.
Portland, OR 97209 REQUESTED BY: Dianna Howse
TRANSACTION INFORMATION:
Receipt#: 417376 Case#: PFI2018-00114
Date: 5/22/2018 Address/Parcel: 13145 SW Ash Dr.
Pay Method: CreditCard Project Name: Johnson
EXPLANATION: Per applicant's request as customer cancelled request for natural gas installation.
Refund 100%of permit fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
PFI Permit Fee 100-0000-43114 $300.00
TOTAL REFUND: $300.00
APPROVALS: SIGN ES DA E:
If under$5,000 Professional Staff
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: DaM-:
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMETr
r
=
Request for Permit Action �z ,
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • Nvww.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner 0< Applicant AContractor ❑ City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
City/State/Zip: Ing Y—AL2F
Phone No.:
PLEASE TAKE ACTION FOR THE ITEMS) CHECKED (✓):
CANCEL/VOID PERMIT APPLICATION.
REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #:
Site Address or Parcel #:
Project Name:
Subdivision Name: Lot#:
EXPLANATION:
C-Z)
Signature: Date:
Print Name: 5 Z
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
Route to Sys Admin: Date By Route to Records: Date 3 / B
Refund Processed: Date Zz l B Invoice Processed: Date B
Permit Canceled: Date B Parcel Ta added: Date B
I:\Building\Forms\RegPermitAction_0 2314. oc
Samuel Copelan
From: Al Dickman
Sent: Wednesday, May 23, 2018 9:25 AM
To: Samuel Copelan
Subject: RE: [External]RE: NWN permit request//13145 SW Ash Dr//WR#3541229
Categories: I will Reply
Sam,
Absolutely.
Dianna has the forms you'll need to make the request.
Al.
From: Samuel Copelan
Sent: Wednesday, May 23, 2018 8:36 AM
To: Al Dickman <AL@tigard-or.gov>
Subject: FW: [External]RE: NWN permit request//13145 SW Ash Dr//WR#3541229
Good morning Al,
Are we able to process a refund for this PFI?
Thanks,
Sam Copelan
Assistant Planner
City of Tigard; Community Development
13125 SW Hall Boulevard
Monday -Wednesday
Phone: (503)-718-2450
Email: Samuelcntigard-or.gov
From: NWN Permits<nwnpermits nwnatural.com>
Sent: Wednesday, May 23, 2018 8:17 AM
To: Samuel Copelan <samuelc@tigard-or.gov>
Subject: RE: [External]RE: NWN permit request//13145 SW Ash Dr//WR#3541229
Good Morning,
Could you please cancel and refund this permit and fee. Customer has decided to not go gas.
Thank you,
1
Aisha Rivers Engineering Technical Coordinator III,Permitting
NW Natural www.nwnatural.com
220 NW Second Avenue,Portland,OR 97209
v 503.226.4211 x4428 f 503.273.4822
aap@nwnatural.com
From: Samuel Copelan [mailto:samuelc@tigard-or.gov]
Sent:Tuesday, May 22, 2018 12:43 PM
To: NWN Permits<nwnpermits@nwnatural.com>
Subject: RE: [External]RE: NWN permit request//13145 SW Ash Dr//WR#3541229
Hello,
Attached is permit PF12018-00114, associated with 13145 SW Ash.
Sincerely,
Sam Copelan
Assistant Planner
City of Tigard; Community Development
13125 SW Hall Boulevard
Monday -Wednesday
Phone: (503)-718-2450
Email: SamuelcQtigard-or.gov
From: NWN Permits<nwnpermits@nwnatural.com>
Sent:Tuesday, May 22, 2018 11:47 AM
To: ROW Permits<rowpermits@tigard-or.gov>
Subject: RE: [External]RE: NWN permit request//13145 SW Ash Dr//WR#3541229
Good Morning,
This has been paid O
Aisha Rivers Engineering Technical Coordinator III,Permitting
NW Natural www.nwnatural.com
220 NW Second Avenue,Portland,OR 97209
v 503.226.4211 x4428 f 503.273.4822
aap@nwnatural.com
From: ROW Permits [mailto:rowpermits@tigard-or.gov]
Sent:Tuesday, May 22, 2018 10:51 AM
2
To: NWN Permits<nwnpermits@nwnatural.com>; ROW Permits<rowpermits@tigard-or.gov>
Subject: [External]RE: NWN permit request//13145 SW Ash Dr//WR#3541229
Hi Aisha,
Your permit is ready for $300 fee payment. You can pay this fee online here:
https://aca.accela.com/tigard/, go to the "Engineering" tab, search for record number PFI2018-00114.
Then, go to the "Payments" tab and click "Fees" to submit your online payment. Please notify us once
you've paid, and we'll e-mail you back with the permit.
Thanks!
City of Tigard
Public Facility Improvement (PFI) Permits
Phone: (503) 718-2421
E-mail: rowMermitsktigard-or.gov
From: NWN Permits<nwnpermits@nwnatural.com>
Sent: Wednesday, May 16, 2018 9:49 AM
To: ROW Permits<rowpermits@tigard-or.gov>
Subject: NWN permit request//13145 SW Ash Dr//WR#3541229
Aisha Rivers j Engineering Technical Coordinator II1,Permitting
NW Natural (www.nwnatural.com
220 NW Second Avenue,Portland,OR 97209
v 503.226.4211 x4428 f 503.273.4822
aap@nwnatural.com
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule."
3
;� CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
!Z
COMMUNITY DEVELOPMENT Permit#: PF12018-00114
13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Date Issued: 05/22/2018
Parcel: SEG1292
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: NW Natural
Project Description: SEG 1292, associated with 13145 SW Ash Dr. Install short side svc; main is on the 7' in ROW under
earth/WR#3541229
Owner: FEES
Description Date Amount
PFI Permit Fee 05/22/2018 $300.00
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
AISHA RIVERS
220 NW 2ND AVE
PORTLAND, OR 97062
PHONE: 503-226-4211
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:
Issued By:
Special Conditions(See Attached)
Note: THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12018-00114
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
City of Tigard MAY 16 2018
e PUBLIC WORKS — ENGINEERING CITE'L�T I aARD
IASININ�'�A--t`yC1-11N HE
Public FacilityImprovement PFIPleffffif
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way) ltd TYPE 1-Franchise Utility Work
Check one: W Utilities ❑ Sidewalk/driveway approach ❑ Street improvements performed by NWN, PGE
Detailed description: Install short side svc; main is on the 7' in
and/or utility agency.
ROW under earth//WR#3541229 ❑ TYPE 2-Sidewalk/Driveway/Suver
Work performed for the purpose o£
• Sidewalk installation or repair.
R S E G iZ�iZ • Driveway approach installation
Property address/location(s): 13145 SW Ash Dr and/or repair
• Sanitary sewer lateral installation
and/or main line tap
El TYPE 3-Full scale Development
Applicant: NW Natural Work performed with Land use
Address: 220 NW 2nd Ave approval which includes any of
City/state: Pnrt•1 anti,OR Zip: 97209 the following:
Phone:S n 3-2 2 6-4 2 i l Email: • Subdivisions or Partitions
nwnnPrmi t-_�Ca?nwnat•�iral _r.om
• Street widening
Contact name: Ai sha Rivers Phone: S03-22(;-4211 x4 4 2 8 Mainline installation for Sanitary
sewer, Storm sewer, Tigard water
Contractor: _Loi Clark and/or Tigard Water Service Area
CCB#: 522 1Expiration:
Address: Po Box i69 SUBMIT COMPLETED APPLICATION TO:
City/state: Tualatin, OR Zip: 97062 City of Tigard
Planning/Engineering
Phone:
971-806-2841 Email:Tade ram 13125 SW Hall Blvd.
Contact name: Jacip r,eec7y Phone: Tigard,OR 97223
Applications for"minor work in right-of-way"
only may be emailed to:
Engineer: R Z(,h C,i ra rd ro3Tpermits e tigard-or.gov
Address: 2 2 0 NW 2nd AvP
City/state: Portland, Or Zip: 97209 FOR s'rAFF USE ONLY
7 ,1/�
Phone: 36-921-0314 Email: r2g@nwnatural .com Case No.: P FlU I40-vU I I
Contact name: Application submittal fee(.007%of
Engineer's Estimate) $
Estimated value of work is required(if over$5,000):$ Additional fees: $ I _
(within the public right-of-way) Application accepted:
S�-
Is work related to a LAND-USE DECISION? El Yes El No By: Date:
If so, please specify (MLP, SDR, SUB, etc.) case #: Applicati re wed: �f
By: Date: {
Is work related to a BUILDING PERMIT? ❑ Yes ❑ No Applicant notified:
If so,please specify(BUILDING PERMIT)case#: By: k-1 Dater
is\ENG\PermitApplications\pfi—application Rev.10/16/2017
City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of4
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 owners signature on the application
BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT:
• The above request does not violate ani-recorded deed restrictions that may be attached to or imposed upon the subject
ro er
• 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.
Aisha Rivers NW Natural/Aisha Rivers 5/6/18
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
RVAINUMMOMMEW
PUBLIC FACILITY IMPROVEMENT PERMIT
City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 • Page 2 of4
DEVELOPMENT ENGINEERING FEES FOR STAFF USE ONLY
Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL
APPLICATION FEE REQUIREMENTS
Part 1: Required submittal fee$300.00 (minimum) FRANCHISE UTILITY AND SIDEWALK/
DRIVEWAY AND UTILITY
PERMIT FEE CONNECTIONS,ETC.
Part 2: All non-water system improvements (work in the right of way)
Engineer's estimate X 5% (less $300.00 minimum
Sketch
submittal fee) (including information below)
Engineer's estimate X 2%Plan Review
❑ Dimensions
WATER SYSTEM FEE ❑ Street Name
Part 3: All public water system improvements ❑ Site Address
Engineer's estimate X 12%
FULL SCALE DEVELOPMENT
PFI Permit Fee Exemptions: (Subdivisions/Partitions and Street Improvements)
There will be no permit fee charged,or assurance required
for the following types of work: Design Plans
• Sidewalk repair (less than 20 lineal feet) (6 sets,24x36 or 2204)
• Relocate or replace mailbox ❑ Cover—Site,Vicinity,Abbreviation,Legend
• Ditch cleaning that does not involve regrading. ❑ General Notes(City,Water,Sewer,etc.)
• Weep hole repair ❑ Street(Plan,Profile)
• Curb repair or replacement (less than 20 lineal feet) ❑ Water,Storm and Sanitary(Plan Profile)
• Lawn sprinkler system installation or repair ❑ Water Quality Facilities
• Street tree pruning or planting ❑ Grading
• Planter strip landscape maintenance ❑ Landscaping/Tree Plan
• Test wells ❑ Composite Utility Plan(Electrical,Phone,Gas,
Storm,Sanitary,Water,Signage,Street Lights,etc)
❑ Details
Note: A cash/bond assurance maybe ❑ Traffic Sight Distance
required per TMC 15.04.140. ❑ Signing and Striping
(customer deposit) ❑ Street Light Plan and Photometric
❑ Engineers seal/signature
❑ Sheet label(project land use name,revision and
plan log block,dates and sheet numbers.)
Additional Submittals
(per Land Use conditions)
❑ Traffic Report
❑ Storm water Drainage Calculations
❑ Geotechnical Report
❑ Preliminary Access Report(Sight Distance)
❑ Proposed Plat
❑ Pathway Design(if applicable)
❑ Water Department Approval
❑ Engineer's Construction Estimate
PUBLIC FACILITY IMPROVEMENT PERMIT
City ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tlgard-or.gov • 503-718-2421 • Page 3 of4
SAMPLE SKETCH:
Edge of Pavement
I -'Q- Ditch -op
Streetlight
Fir T RaJn Drain
+ 4
I TI
► I ,� Existing House •
Existing
. ii Driveway01
�
al �I
CLI �t
I I t--
�I � I
ON ' •
I
(5' I� I
IU
>� I 1
a
I Existing Shap
I CA J
Powerpole
77operty Line-
Fire Hydrant(FH)
I � I
Scale: I"=30'
� � I
I I 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 ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 4 of4
13145 SW Ash Dr, #3541229
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NW Natural PLAT: 1-044-019 COUNTY: WASHINGTON 05/15/18 15::
15031226-4211 TOWNSHIP: T02S RANGE: R01 W SECTION: 2SW SCALE: 1 IN = 100 FT USER 1D:aao
2011 Edition Page 95
Self-Regulating Lane Closure Diagram 350
ROAD --J
WORK B
AHEAD •
Initial
Warning •
Sign •
A •
•
ONE LANE ® vvROAD
AHEAD •
Protection Vehicle • TO YIELD
w[MA(both Optional) ONCOMING OR TO
See Chapter 4 • TRAFFIC ONCOMING
TRAFFIC
• Buffer
••
50'-100'
�ORV—`-5'
A
ONE LANE
B ROAD
AHEAD
ROAD
C WORK
AHEAD
Initial
Warning
Sign
December 2011 Chapter 5
Page 94 2011 Edition
Self-Regulating Lane Closure Diagram 350
Use this detail for closures of one lane of a low-speed, two-lane, two-way
road.
1. Use this diagram only if all of the following are true:
a. Work space is less than 200 feet.
b. The posted speed is 40 mph or less (unless not posted and
speed governed by basic rule).
c. Average Daily Traffic (ADT) is less than 400.
d. Sight distance (in feet) is more than 750 at each end.
2. Use truck-mounted flashing warning lights on work and protection
vehicles. See Section 4.3— Lights and Lighted Signs for exceptions.
3. For added visibility, a truck-mounted arrow panel or PCMS in caution
mode may be used.
4. A "Lane Ends (Right)" (W4-2R) symbol sign, or"RIGHT LANE ENDS"
(W9-1 R) sign, may be placed inside the cone taper for more emphasis.
Sign Spacing and Buffer Lengths (feet)
Posted S acin 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 L250
Chapter 5 December 2011