PFI2018-00197 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
COMMUNITY DEVELOPMENT Permit#: PF12018-00197
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 07/30/2018
Parcel: SEG1558
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: Comcast
Project Description: SEG 1558.Adjacent to 6900 SW Sandburg Street. Comcast proposes to pull fiber through existing
underground facilities for a total of 206',then trench to place(1)-2"conduit for a total of 1'to exit City of
Tigard ROW.
Owner: FEES
Description Date Amount
PFI Permit Fee 07/30/2018 $300.00
PHONE:
Contractor:
TEXSTAR ENTERPRISES INC
17090 JORDAN RD
SELMA, TX 78154
PHONE: 210-656-8775
FAX:
Applicant:
DANIEL GRAHAM
11308 SW 68TH PARKWAY
TIGARD, OR 97223
PHONE: 503-596-3722
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 WORT(ON PRIVATE PROPERTY
Conditions for PF12018-00197
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
REEVED
City of Tigard
JUL 2 5 2018
�® PUBLIC WORKS —ENGINEERING CITU OF TIGARD
PLANNING/ENGINEERING
Public Fact Improvement (PFI) Per mit
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way)
0 'I'YI'E 1—Franchise Utility Work
Check one: ❑ Utilities ®Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE
Detailed description: Comcast proposes to pull fiber through existing under- and/or utility agency.
ground facilities for a total of 206',then trench to place(1)-2"Conduit for a total ❑ TYPE 2—Sidewalk/Driveway/Sewer
of 1'to exit City of Tigard ROW. Work performed for the purpose of:
• Sidewalk installation or repair.
Property address/location(s): 6900 SW Sandburg St, Tigard, OR 97223 . Driveway approach installation
and/or repair
�J • Sanitary sewer lateral installation
and/or main line tap
Applicant. Comcast El TYPE 3—Full scale Development
pp Work performed with Land use
Address: 11308 SW 68th Parkway approval which includes any of
City/state: Tigard, OR Zip: 97223 the following:
Phone: 503-596-3722 Email: Daniel_Graham@comcast.com • Subdivisions or Partitions
Contact name: Daniel Graham Phone: 503-596-3722 • Street widening
• 1\4ainline installation for Sanitary
Contractor: Texstar Enterprises sewer, Storm sewer, Tigard water
and/or Tigard Water Service Area
CCB#: 178798 Expiration: 10/10/2019
Address: 14122 Arndt Rd sUBMITCOMPLETEDAPPLICATION-TO:
City/state: Aurora, OR Zip: 97002 City of'Tigard
503 793-3109 im.miner texstarenter rises.com Planning/Engineering
Phone: ( ) Email:J @ p 13125 SW Hall Blvd.
Contact name: Jim Miner Phone: (503)793-3109 Tigard,OR 97223
Applications for"minor work in right-of-way"
Engineer: only may be emailed to:
g royMermits&tigard-or.gov
Address:
FOR ONLY
City/state: Zip:
Phone: Email: Case No.:
Contact name: Application submiftal fee(.007/6 of
Engineer s Estimate)
Estimated value of work is required(if over$5,000):$ Additional,fees: $
(within the public right-of-way) Apphcation:accepted:
By 3 Date:.
Is work related to a LAND-USE DECISION? ❑ Yes No
Application reviewed:
If so, please specify (MLP,SDR, SUB,etc.) case #:
By:P�r�e�A tR_�_ Date:
Is work related to a BUILDING PERMIT? ❑ Yes ❑✓ No Applicaritnotified:
If so,please specify(BUILDING PERMIT)case#: B�7: Date: (�
I:\ENG\PermitApplications\pfi_application,Rev.10/16/2017.
City ofI'igard 13125 SW Hall Blvd. • Tigard,Oregon 97223 www.tlgard-or.gov 503-718-2421 Page 1 of
APPLICANTS
NO'T'E: 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) SHALT.CERTIFY THAT:
• The above request does not violate an;recorded deed restrictions that 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 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.
GnTechnical luons,
ou,emai=glewilams@kbmaI.nat, UGIeW S DigaysignedbyGeWilimGlen
Iam
Williams 7/25/2018
Date2018.07.2513:5055-07'00'
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 ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tlgard-or.gov 503-718-2421 • Page Z of4
DEVELOPMENT ENGINEERING FEES OR STAFF USE ONLY
Public Facility Improvement(PFI)Permit:
DETAILED SUBMITTAL
REQUIREMENTS
APPLICATION FEE
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
submittal fee) Sketch
Engineer's estimate X 2%Plan Review (including information below)
❑ 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 22x34)
• Relocate or replace mailbox ❑ Cover-Site,Vicinity;Abbreviation,Legend
• Ditch cleaning that does not involve regrading. ❑ Ge.feral Notes (City,Water;Sewer,etc.)
• Weep hole repair ❑ Streef-(Plan;Profile)
• Curb repair or replacement(less than 20 lineal feet) ❑. Water;Storm and-Sanitary(Plan Profile)
• Lawn sprinkler system installation or repair Water Quahty.Facilities
• Street tree pruning or planting El Grad''
• Planter strip landscape maintenance ❑ Landscaping/Tree Plan
• Test wells ❑ Composite Utility Plan(Electrical,.Phone,:Gas,
Storni;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
❑ Engineers Construction Estimate
PUBLIC FACILITY IMPROVEMENT PERMIT
City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tlgard-or.gov 503-718-2421 Page 3 of 4
SAMPLE SKETCH:
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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 SSU Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 4 of4
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Page 80 2011 Edition
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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
cannot be maintained, or when traffic cannot 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)
Postedn, 5pacingtBetweenSigns �Buffer11N,
Speed x- A�" }
RITE-
20
20 50
25 100 100 100 75
30 100
35 350 350 350 125
40 150
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50 500 500 500 210
55 250
60 285
65 700 700 700 325
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Chapter 5 September 2016
2011 Edition Page 81
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September 2016 Chapter 5
Page 84 2011 Edition
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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
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
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.
5. Cones should be used to outline the work space when curves or other
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 September 2016
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And Rising.
a Tock All Pavement To Be Inlaid With Emulsified Asphalt.
o The City Engineer Sholl Determine the final Width and Length of the Inlay Patch
to Best Fit Travel Pattems.
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�� CITY OF TIGARD RIGHT OF WAY PERMIT
13
COMMUNITY DEVELOPMENT Permit#: PF12018-00197
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 07/30/2018
Parcel: SEG1558
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: Comcast
Project Description: SEG 1558.Adjacent to 6900 SW Sandburg Street. REVISION 1/9/19: COMCAST PROPOSES TO
DIRECTIONAL DRILL 190'TO PLACE(1)-2"CONDUIT.then trench to place(1)-2"conduit for a total of
V to exit City of Tigard ROW.
Owner: FEES
Description Date Amount
PFI Permit Fee 07/30/2018 $300.00
PHONE:
Contractor:
TEXSTAR ENTERPRISES INC
17090 JORDAN RD
SELMA, TX 78154
PHONE: 210-656-8775
FAX:
Applicant:
DANIEL GRAHAM
11308 SW 68TH PARKWAY
TIGARD, OR 97223
PHONE: 503-596-3722
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 PF12018-00197
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
RECEIVED
JAN 0 9 2019
City of Tigard CITY OF TIGARD
PUBLIC WORKS — ENGINEERING PLANNING/ENGINEERING
Public Facility Improvement (PFI) Permit
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way)
❑ TYPE 1-Franchise Utility Work-
Check
orkCheck one: 0 Utilities 0 Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE
Comcast proposes to directional drill 190'to lace and/or utility agency.
Detailed description: p p P
(1)-2"conduit,then trench to place(1)-2"conduit for a total of 1'to exit City ❑ TYPE 2–Sidewalk-/Driveway/Sewer
of Tigard ROW. Work performed for the purpose of.
• Sidewalk installation or repair.
6900 SW Sandbur St Tigard, OR 97223 • Driveway approach installation
Property address/location(s): g g and/or repair
SEG ppI SS • Sanitary sewer lateral installation
and/or main line tap
Applicant:
Comcast ❑ TYPE 3-Full scale Development
Work performed with Land use
Address: 11308 SW 68th Pkwy approval which includes any of
City/state: Tigard,OR Zip: 97223 the following:
Phone: 503-941-8656 Email: Alex_Silantiev@comeast.com • Subdivisions or Partitions
Alex Silantiev 503-941-8656 • Street widening
Contact name: Phone:
• Mainline installation for Sanitary
Contractor: Texstar Enterprises sewer, Storm sewer, Tigard water
and/or Tigard Water Service Area
CCB#: 178798 Expiration: 10/10/2019
Address: 14122 Arndt Rd SUBMIT COMPLETED APPLICATION TO:
City/state: Aurora, OR Zip: 97002 City of Tigard
503-793-3109 im.miner texstarenter dses.com Plan$/Engineering
Phone: Email: 1 @ p 13125 SW Hall Blvd.
Contact name: Jim Miner Phone: 503-793-3109 Tigard,OR 97223
Applications for"minor work in right-of-way"
only may be emailed to:
Engineer: rowPermits&jjgard-or.gov
Address:
City/state: Zip: 00i I
Phone: Email: Case No.: I �� �� CUru �
Contact name: Application submittal fee(.007%o� J
Engineers Estimate) $ aa._-a geiAzi s to mr
Estimated value of work is required(if over$5,000):$ Additional fees: $
(within the public right-of-way) Application accepted:
Is work related to a LAND-USE DECISION? ❑ Yes O No S
By: (- Date: f _Q
If so,please specify (MLP,SDR,SUB,etc.) case #: Application reviewed:
By: f'1 S1I-gi _ Date:
Is work related to a BUILDING PERMIT? ❑ Yes p No Applicant notified:
If so,please specify(BUILDING PERMIT)case#: By: �- Date:
I:\ENG\PermitApplications\pfi—application Rev.10/16/2017
- - c !! + �n
City ofTigard • 13125 SW Hall Blvd. • vTigard,Oregon 97223 wwwtigard-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 owner's signature on the application
BY SIGNING BELOW,THE APPLICANTS)SHALL CERTIFY THAT:
• The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject
ro e
• 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.
/-�C-�) Digitally signed by Jon
Date:2019.01 090723;"08'00' Jon Arend (For Alex Silantiev) 01/09/2019
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 ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 • Page 2 of4
DEVELOPMENT ENGINEERING FEES FOR STAFF USE ONLN
Public Facility Improvement(PFI)Permit: DETAILED StIBMaTAL
REQt)IRENIENTS
APPLICATION FEE
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
submittal fee) Sketch
Engineer's estimate X 2%Plan Review (including information below}
❑ 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 22x34)
• 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 of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 3 of4
SAMPLE SKETCH:
" Y �
Edge of Pavement
I
I "40- Ditch
Streetlight I --.—.—.—.—.—.—.—r—.—
I Radn rm
I I
•
Tl rop'os cr'SewerTinee
I I
IUN I
NI
NI Existing House
Existing
>r Driveway do
al c�i I 1
C •t I •
al i �I
�
�
I ! I
Vi
L �
I
a. I Existing Shop j
Powerpole
I I I g5' f------ ------ -—-
. I "property L ni e" —
' 0
Fire Hydrant(FH)
I
I I I
Scale: "=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 4of4
42
K
F O
W
W
2a 0f � a
3� W�
in
LL
U
FOC FOC 4 _
FOC
FOC
5
a
SW SANDBURG ST
6n'3e
34-F DIRECTIONAL DRILL TO RACE(1)-7'
30, CONDUITAMNIOF36'8ELOWGRADE
yww♦ _
E108TN G COMCABT PEDESTAL y y r . _ _y 11
y
OC w
S 8AN FOC t 3
OD LL
SSWY K SSW b b
BEGIN CONSTRUCTION AT EXISTING a
EXIT CITY OF TCARD ROW COMCAST PEDESTAL IN TIGARD ROW ¢ c
TRENCH AND PLACE(1)-J'CONOVITS
A MIN.OF 36'BELOW GRADE N
S w
E
NgZ;
1.ALL WORK AREAS TO BE 0 AE
RESTORED TO LIKE OR BETTER w�`'U-a'f,
• E CONDITION. �, p E
2.ALL OTHER UTILITIES ARE BASED ::E u s
OFF EXISTING LOCATES OR UTILITY
STRUCTURES. ( )U °1
v m
KALE_1ti17s 3.IT IS THE CONSTRUCTION
CONTRACTORS RESPONSIBILITY TO
�� CALL FOR LOCATES BEFORE
�m_ DIGGING.
RPI
4.DIRECTIONAL DRILL-
5.TRENCH
-
CMV2-119898660
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
cannot be maintained, or when traffic cannot 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
35 350 350 350 125
40 150
45 180
50 500 500 500 210
55 250
60 285
65 700 700 700 325
70 1 1 365
Chapter 5 September 2016
2011 Edition Page 81
Shoulder Work w/ Minor Road Encroachment Diag. 300
ROAD
WORK
AHEAD .jr
Initial
Warning A •
Sign
•
•
(Optional) •
•
•
Protection Vehicle
w/TMA(both Optional) _
See Chapter 4 - • Buffer
10' •
minimum • U3
•
A ROAD
7RROWS
(Optional)
B
- , ROAD
1 ' WORK
AHEAD
Initial
Warning
Sign
September 2016 Chapter 5
Page 84 2011 Edition
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
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
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
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.
5. Cones should be used to outline the work space when curves or other
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 September 2016
Cn Cl)
CD _o
jSingle Flagger Operation
3 O r
A 3
CL CL for Low VolumesCD PFEP (Optional) o a
of I (ADT 400) M arov iaw O
0 0 0 o D v �' I j B E
rn o+ h7AO°ER PREPARED ONE LANE
m ROAD
CL H s 10 c TO STOP AHEAD /r
V v+ W 1-+ N W ,Y
MML
— — —. . .r. .•— — — • ROAD CID
0 0 0 0 ^ ' •• WORK n
AHEAD
N
V.Omar* y
W W N N N N N N N V a C I \ \ v*lMA(
to to vi O O a a O O In 0 O n �' M 1, Bs•ChlipY�1
9 ^'
TO sror
o
PPWW t
------ ----1 ?
1 mile J -1
max. su
K K K K • • •
B B A
Buffer
Protection Vehicle
ROAD • w/TMA(both Optional)
WORK See Chapter 4
AHEAD BE (Q
OADNE LANE
,�,,°D To s oP Two Flagger Operation 3
C4
T, N co
cn
(Optional) p Cn
Machine Mil/ The Sand And SealPaving Joints With
_ 12" Area For A 1-1/2" Not Paving Grade
Exsting ic 12„ Min Blanket Inlay Oil (pg 64-22 Or
Concrete Min •h:. See Notes Below Equivclent)
Exsting
Roads �i� � �`� .. • l��y�. wry ��' .._,;
Base �.�i ; �.i`S�� �� ;1`-; � .'_ �� I-A
K Y
52
Non—Compressible
Backfill—Cement Slurry ----
fli' (for Major Roads Or As
Asphaltic Concrete Pavement --f ! Specified) . j Undisturbed
Patch, 6 Thick Or Match
Existing Pavement (whichever Is
Greater) Up To The Level Of - 11
Original Pavement. I ! •• f J i j
If
Crushed Aggregate
Or Granular Pipe
` Zone Backfill
Material ---
-If !_ =illi-
11-
p�
o Trench Width
w Per Plan or
As Specified
Notes:
CD
29
N & Blanket Patches To Be Constructed With Level 2, 1/2 Inch, Dense, Pg-64-22
o Hmac In Dry Pavement Conditions, Where Existing Pavement Is At Least 60• F
And Rising.
b Tock All Pavement To Be Inlaid With Emulsified Asphalt.
„ The City Engineer Shall Determine the Final Width and Length of the Inlay Patch
t Ll to Best fit Travel Patterns.
�r
t:
O�
ZR
��
U
O
`" CAPITAL CONSTRUCTION AND
q TRANSPORTATION DIVISION City of Tigard FIGURA,
a� :- 13125 S.W. HALL BLVD. Blanket inlay
�. 7EGON 97223
7CARD, OR
VOICE- 503-639-4171
4 FAX: 503-624-0752FiLE NO
1 AW 77CARD-oR.Gov Detail
n1c
Samuel Copelan
From: Samuel Copelan
Sent: Wednesday, January 9, 2019 2:52 PM
To: 'Jon Arend@kbmail.net'
Cc: Kenny Fisher; Gloria Pinzon-Marin
Subject: FW: Permit Revision - Comcast - 60098
Attachments: SKM_C554e18073011280.pdf; Cable-Fiber Plant Extension 60098_City of Tigard ROW
Permit.pdf; PF12018-00197 (Revised 1-9-19).pdf
Hello Jon,
Kenny reviewed your revised application; attached is a revised copy of PF12018-00197. Please note that SW Sandburg
Street is a no cut street until 2020. Coordinate with inspector if needed for asphalt repairs.
Please contact Kenny if you have any questions.
Sincerely,
Sam Copelan
Assistant Planner
City of Tigard; Community Development
13125 SW Hall Boulevard
Phone: (503)-718-2450
Email: Samuelc@tigard-or.gov
From: Samuel Copelan
Sent:Wednesday,January 9, 2019 7:39 AM
To: Kenny Fisher<Kenny@tigard-or.gov>
Subject: FW: Permit Revision -Comcast- 60098
Good morning Kenny,
Please review the following email and let me know if a new PFI needs to be created.Jon is referencing PF12018-00197.
Thanks,
Sam Copelan
Assistant Planner
City of Tigard; Community Development
13125 SW Hall Boulevard
Phone: (503)-718-2450
i
Email: Samuelc@tigard-or.gov
From:Jon Arend <Jon Arend@kbmail.net>
Sent: Wednesday,January 9, 2019 7:28 AM
To: ROW Permits<rowpermits@tigard-or.gov>
Subject: Permit Revision -Comcast-60098
Tigard,
I need to make a revision to this permit. The existing conduit along SW Sandburg St is full and a new 2" conduit will need
to be placed instead. I have attached the approved permit, a new application, and permit drawing showing where the
directional drilling will take place. Please review the attachments for further details.
Thanks,
Jon
Please call or email me with any questions or concerns.
Jon Arend Project Manager
6566 SE Lake Rd, Suite F, Milwaukie, OR 97222
(503) 65o-6041 Ext. 218 Office
(971) 282-2149 Mobile
Jon Arend(aD_kbmail.net
& From:Agnes Lindor<agnesl@tigard-or.gov>
Sent: Monday, July 30, 2018 11:28 AM
To: Glen Williams<Glen Williams@kbmail.net>; ROW Permits<rowpermits@tigard-
TECHNICAL SOLUTIONS or gov>
Cc: Ian Reed <Ian Reed @kbmail.net>
Subject: RE: Permit Request -Comcast- Fiber Enhancement 60098
Attached is your permit.Thanks,
Agnes Lindor Associate Planner
City of Tigard Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email: AgnesL@tigard-or.gov
From: Glen Williams [mailto:Glen Williams@kbmail.net]
Sent: Wednesday,July 25, 2018 1:58 PM
To: ROW Permits<rowpermits@tigard-or.gov>
Cc: Ian Reed <Ian Reed @kbmail.net>
Subject: Permit Request-Comcast- Fiber Enhancement 60098
Good Afternoon,
Attached is a permit application on behalf of Comcast to construct neve underground facilities on SW
Sandburg St. We will mail the permit application fee tomorrow with a hard copy of the application.
2
Please call or email me with any questions or concerns.
Glen F. Williams Metro-E/INET/Cell Backhaul Manager
6566 SE Lake Rd, Suite F, Milwaukie, OR 97222
(503) 650-6041 x216 Office
(503) 475-9232 Mobile
Glen Williams@kbmail.net
TECHNICAL SOLUTIONS 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