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ROW2011-00012 ,� CITY OF TIGARD RIGHT OF WAY PERMIT I COMMUNITY DEVELOPMENT Permit #: ROW2011 -00012 Date Issued: 03/02/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: SEG2037 Jurisdiction: Site address: Subdivision: Lot: Project: PGE Project Description: PGE to dig up primary direct buried underground cable @ PGE pole #5213 and move 2 ft. to new pole bracket. In front of 15215 SW 100th Ave. Owner: FEES PGE Description Date Amount PHONE: OR i2ii T la • PHONE: ° 0-1) Contractor: PHONE: FAX: Applicant: PGE 9480 SW BOECKMAN RD WILSONVILLE, OR 97070 PHONE: 503 - 570 -4409 Ml Total $9:60 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: ALIA/A1 Atal Issued By: d Special Conditions (See Attached) Note: THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for ROW2011 -00012 Type: Condition Name: Status: Severity: ROW 01- CUSTOM CONDITION Applied Notice <Custom Condition goes here> ROW 02- PERMIT & PLAN REQ ON SITE Applied Notice A copy of the permit and all attachments, and a copy of the approved construction plan and all amendments shall be 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 the aforesaid must be approved by the City, in advance of work performance. ROW 03 -TRAF CTRL - SPECIF (CITY) Applied Notice The City's standard specification for traffic control is "Manual on Uniform Traffic Control Devices for Streets and Highways ", U.S. Dept. of Transportation, F.H.A., 1988 Ed. ROW 04 -TRAF CTRL -CONTR RESPON FOR Applied Notice Traffic control shall be provided for by the contractor in accordance with the City's standard specification and, also, in accordance with a City (job specific) approved traffic control plan. A copy of the approved traffic control plan shall be available at the work area. ROW 05 -TRAF CTRL -ROAD CLOSURE Applied Notice Public roadway shall not be closed to traffic, at any time, without having first obtained written approval from the City Engineer. The permit holder is responsible for provision of timely notification of traffic flow disruptions to area wide Emergency Services (Tigard Police Dept., Tualatin Fire & Rescue) and to Tri -Met and Tigard School District. ROW 06 -TRAF CTRL - ADVANCE WARNING Applied Notice Advance warning of imminent traffic disruption shall be provided to the general motoring public by placement of an advance notification sign at each end of the construction area 72 hours (min.) before initiation of construction work. ROW 07 -TRAF CTRL -PRIV PROP ACCESS Applied Notice Access to existing properties shall be maintained at all times, including normal delivery service and mail service and if not, shall be cause for work stoppage until effective access is established. ROW 08 -TRAF CTRL - DEVICES IN PLACE Applied Notice Traffic control devices, flagpersons, etc., shall be in place prior to initiation of construction work and shall be effectively maintained. ROW 09 -TRAF /NOISE CTRL -WORK HRS Applied Notice No work will be permitted during the hours of darkness, nor between 9:00 p.m. to 7:00 a.m. Monday through Friday, nor between 9:00 p.m. to 8:00 a.m. Saturday, nor between 9:00 p.m. to 9:00 a.m. Sunday. ROW 10 -TRAF CTRL -MIN LANE WIDTH Applied Notice Minimum travel lane width shall be eleven (11) feet; pedestrian travel shall also be provided for. ROW 11 -TRAF CTRL -CITY CAN MODIFY Applied Notice The City reserves the right to add to or modify traffic control requirements as may be necessary to effectively control traffic and to assure public safety. ROW 12 -INSP 24 HR NOTICE REQUIRED Applied Notice The permit holder or his contractor shall notify the City's inspector <name >, at <phone #> or email at <email address >, 'twenty -four (24) hours prior to commencing work, twenty -four (24) hours prior to any staged inspection, and after completing work covered by the permit. ROW 13- HAZARDS -CERT OF INS Applied Notice Maintenance of the work area and approach roads is the responsibility of the permit holder. The work area and approach roads shall be maintained in a clean condition, free from obstructions and hazards. A copy of the permit holders Certificate of Insurance shall be available at the work area. ROW 14- DEBRIS - MATERIALS .Applied Notice 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 cleanup and stoppage of work to accomplish cleanup. ROW 15- EROSION CTRL REQ Applied Notice Effective erosion control is required. Erosion control devices must be installed and maintained meeting D.E.Q. requirements. The City may at any time order corrective action and stoppage of work to accomplish effective erosion control. ROW 16- REPAIRS -LIKE MATERIALS REQ Applied Notice Property disturbed by construction activity shall be seeded with a standard grass mix; shrubs, flowers, barkdust, existing signs, pavement markings, mailboxes, etc., shall be reestablished, reinstalled or replaced, with like kind and material. ROW 17- DRAINAGE CONTROL REQ Applied Notice Effective drainage control is required. Drainage shall be controlled within the work site and shall be so routed that adjacent private property, public property and the receiving system is not adversely impacted. The City may, at any time, order corrective action and stoppage of work to accomplish effective drainage control. ROW 18- UTILITIES PRELOCATION REQ Applied Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. Copies of the rules may be obtained from the Center by calling (503) 232 -1987. If you have questions about the rules, contact the Center. NOTE: Damage to utilities shall be corrected at the permit holders expense. ROW 19- UTILITY LOCATIONAL CONFLICT Applied Notice Contractor 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 permit holders expense. Changes must be approved by the City in advance of work performance. Contractor shall coordinate the work with affected utility agencies. ROW 20- TRENCH - PATCH /SAFETY /LBILITY Applied Notice A temporary hard - surface patch (Cold mix A.C. or Hot mix A.C. base paving) shall be placed on trenches within roadways at the end of each day's work. No trench, on site or off site, shall be left at any time in an unsafe condition. The permit holder is responsible for and is liable for hazards or damage resulting from the work. ROW 21- REPAIRS REQ - INSPTR OPINION Applied Notice Work provided for under the permit shall include repair of existing facilities (roads, ditches, etc.) as may be necessary, in the City Inspectors opinion, to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit. Corrective work shall be done at the permit holders expense. ROW 22 -AS- BUILT /ENGR CERTIF REQ Applied Notice At the end of each year, or an a mutually agreeable yearly date, any entity making changes to its facilities in the public right -of -way shall submit complete "as- built" drawings showing all new public improvements, including any revision made to the previously approved construction plans and, also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineers certification of installation compliance (form attached). ROW 23 -DAILY INSP REPORTS REQ Applied Notice The permit holders Engineer /Inspector shall submit daily inspection reports, on a weekly basis, to the City's Inspector. (see Developer- Engineer Agreement note #5). ROW 24- TESTS /REPTS TO VALIDT CLMS Applied Notice The City's Inspector may, at their discretion, require provision of tests and or reports from the permit holder, permit holder's engineer or contractor to validate claims of material or construction adequacy /compliance. Such tests /reports shall be provided at the permit holder's expense. ROW 25- RELEASE - WAIVER REQ Applied Notice The permit holder shall provide a copy of a properly executed Release & Waiver document to the City for each ownership disturbed by construction activity, as evidence of disturbance resolution and owner satisfaction. ROW 26- MONUMENT PROTECTION REQ Applied Notice Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holders expense. ROW 27 -PROB SOLVING - RESPON PARTY Applied Notice The permit holder shall 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 an emergency. The permit holder shall notify the City Inspector, in writing, of any /all assignment changes. ROW 28- CONSTR SAFETY - RESPON PARTY Applied Notice The permit holder shall cause his contractor to provide to the City Inspector, in writing, the name and 24 hr emergency telephone number of a designated "Competent Person" responsible for construction safety as per OR -OSHA, Chap. 437, Div. 3 Construction, Subdivision P - Excavations. The contractor shall notify the City Inspector of any /all assignment changes. ROW 29- ESMT /RT OF ENTRY - RESPON Applied Notice It is the sole responsibility of the permit holder to provide for proper right -of -entry and /or easements prior to starting work. Proof of right -of -entry, or properly executed easements, shall be provided to the City. The City shall in no way be construed to be liable for the permit holder's failure to obtain or provide for proof of right -of -entry or easements. APPLICATION FOR RECEIVE I 11 111 WORK IN RIGHT -OF -WAY (ROW) PERM', = • 2 4 2011 CITY OF TIGARD T I GARD Development Engineering �AN7"di1�GlENGINEERI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX (503) 624 -0752 FOR STAFF USE ONLY General Information: 634003 Right-of-Way .{ �� , 0 I( - 1 00 { Z Property Address /Location(s): 15215 SW 100 TH AVE. Case No.: / w SG 4 &a3'1' t f Receipt No.: Date: 31I II `Applicant's Name: Portland General Electric Application Accepted By: t 1 P ReV1CPd 3i4i11e Address: 9480 SW Boeckman Rd REQUIRED SUBMITTAL INFORMATION City /State: Wilsonville OR Zip: 97070 Primary Contact: Ralph Reisbeck Phone: (503) 570 -4409 Fax: (503) 570 -4420 Submit a scaled sketch of the proposed work to be done Contractor's Name: N/A CCB# Expiration: Professional Engineered Plans are Address: required for: City /State: Zip: • Street Widening Phone: Fax: • Subdivision Infrastructure • Main utility line extension: Plans By: Address: City /State: Zip: Phone: Fax: Description of work: PGE to dig up primary direct buried underground cable PGE pole # 5213 and move 2ft to new pole bracket. Estimated value of work (within the public right -of -way): $ Is work related to a LAND -USE DECISION? YE-5". NO If so, please specify (MLP, SDR, SUB, etc.) case #: Is the work related to a BUILDING PERMIT? YES NO ■ If so, please specify (BUILDING PERMIT) case #: *NOTE: Person specified as "Applicant" shall be designated "Permitee" and shall provide financial assurance for the work. • c: Wsers\knstie\appdataVocalThcrosoft\windows \temporary internet files \conte nt. outlook \k664vfyw \city of tgard permit wr 634003.docx m LEGEND C 15 41577 INSTALL 1 - °4/0 AL UG SECONDARY IN 3" PVC CONDUIT, PROVIDED & INSTALLED BY CUSTOMER 1 01145 1989 - 45 REMOVE PGE FACILITIES 4/0 TX 01847 O _ J147258.97 00720/ RIGHT - OF - WAY PERMIT NOTICE: PL 01145 01847- 01000/ A PERMIT FROM THE LOCAL JURISDICTION IS REOUIRED BEFORE ANY SW rJ A r r L E 5 TPL81000 HE O PERFORMED. POE APPROVED CONTRACT IN T ORS AND RIGHT - CONTRACTORS F -WAY MAY BE WHO HAVE MADE ONLY OTHER SPECIAL AGREEMENTS WITH PGE WILL BE ALLOWED TO WORK UNDER PGE'S PERMIT. THE CONTRACTOR MUST NOTIFY THE LOCAL JURISDICTION 48 HOURS Q BEFORE WORK IS TO BEGIN. A COPY OF THE PERMIT MUST BE ON SITE. U L. a Q 81000 1985 -20 <ZE x i l , I N to Cr V n 1 -2 AL -T U N .1 1 -10 CU -0X CO - 1521 pL -5213 200V 01847 15211 01010/ I NSTALL 3" CONDUIT UNIT & "L > PL 81010 WEATHERHEAD ON EXIST , Q BRACKETS. C 50 255 ' SPLICE C PHASE PRIMARY, zoon _ • & MOVE 2" TO BRACKET, WR CHECKLIST MOVE 3" CONDUIT UNIT zD7 200H O 2 - 4/0 AL & I - 4CU TO NEW ITEM YES COMMENT 0.72n0 � � O BRACKET. HOLEDIGGER 2.61 IT NOTE: OPEN @ PD - 7814 ON 26tH nlc �o LAKESIDE DR E/0 98TH AVE. BOOM 1 5215 15215 : SEE ONE - LINE BACKHOE X PD 08796 PGE TRENCH o . , MOVE 2" GACAGE Q NEW 3" TO BKTS .- A � CONDUIT •` LOCATES X 1 - 10 CU - OX STAKING Q _01 847 PGE 2.5" • • . FRONTIER ERECTING 05213 O1 020/ TREE TRIM 1965 -40 PL81020 0 COMCAST LANDSCAPE POLE °5213 EASEMENT 1 5285 CO PERMITS X TIGARD 1 -143 CUTSHEET A 25 45251 F65T UG CIR. VER. PL0521 ___ TRANSMISSION 1 - SHUTDOWN CUSTOMER F65T SHUTDOWN X SDPM PL0521 4 DOOR HANGER X CONTACT f COMPANY A�DB PH' C' C - 2 SW KA5L-E 5r DATE TIME 01847 A - 2 CU - DB 01030/ CONSTRUCTION NOTES: SFEXT -N PL 81030 - (ij I. CUSTOMER TO PROVIDE ALL TRENCHING AND BACKFILLING. TRENCH TO BE O 36 INCHES DEEP AND 24 INCHES WIDE, MEASURED FROM FINAL GRADE. 05214 1966 2. CONDUIT (IF NECESSARY) WILL BE GRAY, SCHEDULE 40, ELECTRICAL GRADE. - PVC CONDUIT WITH NYLON PULL STRINGS (MIN, 500 LBS. TESTI. F4OT PGE TO DETERMINE THE SIZE AND NUMBER OF CONDUITS REOUIRED. P L0521 4 MAINTAIN 12 VERTICAL INCHES AND 24 HORIZONTAL INCHES CLEARANCE BETWEEN GAS AND OTHER UTILITIES. ALL ELBOWS TO BE 36 INCH (MINI RADIUS. ALL BENDS MUST BE FACTORY MADE. RIGID STEEL OR PGE APPROVED FIBERGLASS BENDS ARE REQUIRED FOR RUNS OF 151 FEET OR LONGER. OR FOR ANY LENGTH RUN WITH MORE THAN 180 DEGREES IN BENDS. PVC SCHEDULE 40 BENDS ARE ACCEPTABLE FOR RUNS OF ISO FEET OR LESS. THE MAXIMUM TOTAL BENDS IN ANY CONDUIT RUN IS 270 DEGREES 3. CUSTOMER RESPONSIBLE FOR ROAD CROSSINGS. USE ONLY GRAY, SCHEDULE 40. ELECTRICAL GRADE, PVC CONDUIT WITH NYLON PULL STRINGS (MIN. 500 LBS. TEST). 4. SINGLE PRIMARY INSTALLATIONS CONDUIT TO EXTEND A MINIMUM OF 10' FROM TRANSFORMER PAD. CALL BEFORE YOU DIG: OREGON LAW REQUIRES YOU TO REQUEST UTILITY LOCATION 46 HOURS PRIOR TO EXCAVATION. FOR LOCATES CALL THE OREGON 5. ALL PGE TRANSFORMERS TO BE INSTALLED 8 FEET (MINI FROM ANY COMBUSTIBLE UTILITY NOTIFICATION CENTER AT Bu, BUILDING. WALL OR OVERHANG AND 4 FEET (MINI FROM ANY FIRE HYDRANT. CONTACT SERVICE COORDINATOR FOR PGE TRANSFORMERS MUST BE WITHIN 15 FEET OF A DRIVEABLE AREA. ry TRENCH AND CONDUIT INSPECTION PRIOR Ill I ALWAYS MAINTAIN 10 FEET CLEARANCE IN FRONT OF ALL TRANSFORMERS. . TO BACKFILL. POE WILL NOT INSTALL WIRE '° UNTIL TRENCH IS 1001 BACKFILLED. SERVICE COORDtNAT OR Knew wMW4 below'' / !4' 6. CUSTOMER TRENCH AND ELBOW CONFIGURATIONS MUST BE INSPECTED BY POE PRIOR 503 - 736-5450 Call before You dig. TO BACKFILLING. PLEASE CALL 503- 736 -5450 TWO DAYS PRIOR TO INSPECTION. . 7. DESIGN IS BASED ON STANDARD UNDERGROUND EQUIPMENT. NON- STANDARD UNOGERGROUND EOUIPMENT MAY BE AN OPTION AT AN ADDITIONAL COST TO THE CUSTOMER. AS — BUILT VERIFICATION This document accurately �I & NESC VIOLATIONS CORRECTED represents FIELD construction. . I o Foreman: Date: I- f t17 SM./Engineer: Date: MC DONALD Designer: Date: www.Por tIondGenerOl.com www.POr tIOndGeneril biz www.Ear th Advontage.com BON I TA TITLE JOB NO. JONATHAN AHD 634003 JO: SITE . _ C SIZE o Q DURHAM - SATTLER 13KV IIxl7 o J DESCRIPTION SCALE a o __I o P OH TO UG SVC CONVERSION I' =60' 3 = 2 ^ 15215 SW 100TH AVE, TIGARD; WASH CO SW DURHAM RD WILSONVILLE DATE SECTION(51 WORK WITH SHEET LINE CREW CENTER 2/4/2011 C21 IIC 1 OF 2 , ---, DESIGN BY PHONE (503) DRAWN BY T , S GUIDE 9480 SW BOECKMAN RD RALPH REISBECK 570 -4409 K.RUTHERFORD WILSONVILLE OR 97070 :-D7 VI )NIT • •MAP © PORTLAND GENERAL ELECTRIC CO. - ALL RIGHTS RESERVED CITY OF TIGARD RECEIPT s 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 182303 - 04/27/2011 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ROW2011 -00012 ROW Permit Fee 1003100 -43114 $300.00 Total: $300.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 081026 STREAT 04/27/2011 $300.00 Payor: Brian Moore PGE Total Payments: $300.00 Balance Due: $0.00 e d olt- c t/ — Page 1 of 1 q CITY OF TIGARD RIGHT OF WAY PERMIT 1 4 I COMMUNITY DEVELOPMENT Permit #: ROW2011 -00012 iiGARE) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Date Issued: 03/02/2011 Parcel: SEG2037 Jurisdiction: Site address: Subdivision: Lot: Project: PGE Project Description: PGE to dig up primary direct buried underground cable @ PGE pole #5213 and move 2 ft. to new pole bracket. In front of 15215 SW 100th Ave. Owner: FEES PGE Description Date Amount PHONE: OR 200 ( l) PHONE: !/v Contractor: PHONE: FAX: Applicant: PGE 9480 SW BOECKMAN RD WILSONVILLE, OR 97070 PHONE: 503 - 570 -4409 MMl� Total $9'SO 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: �� �� *�' ALAL9 Issued By: dAtor r Special Conditions (See Attached) Note: THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for ROW2011 -00012 Tvae: Condition Name: Status: Severity: ROW 01- CUSTOM CONDITION Applied Notice <Custom Condition goes here> ROW 02- PERMIT & PLAN REQ ON SITE Applied Notice A copy of the permit and all attachments, and a copy of the approved construction plan and all amendments shall be • 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 the aforesaid must be approved by the City, in advance of work performance. ROW 03 -TRAF CTRL - SPECIF (CITY) Applied Notice The City's standard specification for traffic control is "Manual on Uniform Traffic Control Devices for Streets and Highways ", U.S. Dept. of Transportation, F.H.A., 1988 Ed. ROW 04 -TRAF CTRL -CONTR RESPON FOR Applied Notice Traffic control shall be provided for by the contractor in accordance with the City's standard specification and, also, in accordance with a City (job specific) approved traffic control plan. A copy of the approved traffic control plan shall be available at the work area. ROW 05 -TRAF CTRL -ROAD CLOSURE Applied Notice Public roadway shall not be closed to traffic, at any time, without having first obtained written approval from the City Engineer. The permit holder is responsible for provision of timely notification of traffic flow disruptions to area wide Emergency Services (Tigard Police Dept., Tualatin Fire & Rescue) and to Tri -Met and Tigard School District. ROW 06 -TRAF CTRL - ADVANCE WARNING Applied Notice Advance warning of imminent traffic disruption shall be provided to the general motoring public by placement of an advance notification sign at each end of the construction area 72 hours (min.) before initiation of construction work. ROW 07 -TRAF CTRL -PRIV PROP ACCESS Applied Notice Access to existing properties shall be maintained at all times, including normal delivery service and mail service and if not, shall because for work stoppage until effective access is established. ROW 08 -TRAF CTRL - DEVICES IN PLACE Applied Notice Traffic control devices, flagpersons, etc., shall be in place prior to initiation of construction work and shall be effectively maintained. ROW 09 -TRAF /NOISE CTRL -WORK HRS Applied Notice No work will be permitted during the hours of darkness, nor between 9:00 p.m. to 7:00 a.m. Monday through Friday, nor between 9:00 p.m. to 8:00 a.m. Saturday, nor between 9:00 p.m. to 9:00 a.m. Sunday. ROW 10 -TRAF CTRL -MIN LANE WIDTH Applied Notice Minimum travel lane width shall be eleven (11) feet; pedestrian travel shall also be provided for. ROW 11 -TRAF CTRL -CITY CAN MODIFY Applied Notice The City reserves the right to add to or modify traffic control requirements as may be necessary to effectively control traffic and to assure public safety. ROW 12 -INSP 24 HR NOTICE REQUIRED Applied Notice The permit holder or his contractor shall notify the City's inspector <name >, at <phone #> or email at <email address >, twenty -four (24) hours prior to commencing work, twenty -four (24) hours prior to any staged inspection, and after completing work covered by the permit. ROW 13- HAZARDS -CERT OF INS Applied Notice Maintenance of the work area and approach roads is the responsibility of the permit holder. The work area and approach roads shall be maintained in a clean condition, free from obstructions and hazards. A copy of the permit holders Certificate of Insurance shall be available at the work area. ROW 14- DEBRIS - MATERIALS .Applied Notice 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 cleanup and stoppage of work to accomplish cleanup. ROW 15- EROSION CTRL REQ Applied Notice Effective erosion control is required. Erosion control devices must be installed and maintained meeting D.E.Q. requirements. The City may at any time order corrective action and stoppage of work to accomplish effective erosion control. ROW 16- REPAIRS -LIKE MATERIALS REQ Applied Notice Property disturbed by construction activity shall be seeded with a standard grass mix; shrubs, flowers, barkdust, existing signs, pavement markings, mailboxes, etc., shall be reestablished, reinstalled or replaced, with like kind and material. ROW 17- DRAINAGE CONTROL REQ Applied Notice Effective drainage control is required. Drainage shall be controlled within the work site and shall be so routed that adjacent private property, public property and the receiving system is not adversely impacted. The City may, at any time, order corrective action and stoppage of work to accomplish effective drainage control. ROW 18- UTILITIES PRELOCATION REQ Applied Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. Copies of the rules may be obtained from the Center by calling (503) 232 -1987. If you have questions about the rules, contact the Center. NOTE: Damage to utilities shall be corrected at the permit holders expense. ROW 19- UTILITY LOCATIONAL CONFLICT Applied Notice Contractor 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 permit holders expense. Changes must be approved by the City in advance of work performance. Contractor shall coordinate the work with affected utility agencies. ROW 20- TRENCH - PATCH /SAFETY /LBILITY Applied Notice A temporary hard - surface patch (Cold mix A.C. or Hot mix A.C. base paving) shall be placed on trenches within roadways at the end of each day's work. No trench, on site or off site, shall be left at any time in an unsafe condition. The permit holder is responsible for and is liable for hazards or damage resulting from the work. ROW 21- REPAIRS REQ - INSPTR OPINION Applied Notice Work provided for under the permit shall include repair of existing facilities (roads, ditches, etc.) as may be necessary, in the City Inspectors opinion, to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit. Corrective work shall be done at the permit holders expense. ROW 22 -AS- BUILT /ENGR CERTIF REQ Applied Notice At the end of each year, or an a mutually agreeable yearly date, any entity making changes to its facilities in the public right -of -way shall submit complete "as- built" drawings showing all new public improvements, including any revision made to the previously approved construction plans and, also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineers certification of installation compliance (form attached). ROW 23 -DAILY INSP REPORTS REQ Applied Notice The permit holders Engineer /Inspector shall submit daily inspection reports, on a weekly basis, to the City's Inspector. (see Developer- Engineer Agreement note #5). ROW 24- TESTS /REPTS TO VALIDT CLMS Applied Notice The City's Inspector may, at their discretion, require provision of tests and or reports from the permit holder, permit holder's engineer or contractor to validate claims of material or construction adequacy /compliance. Such tests /reports shall be provided at the permit holder's expense. ROW 25- RELEASE - WAIVER REQ Applied Notice The permit holder shall provide a copy of a properly executed Release & Waiver document to the City for each ownership disturbed by construction activity, as evidence of disturbance resolution and owner satisfaction. ROW 26- MONUMENT PROTECTION REQ Applied Notice Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holders expense. ROW 27 -PROB SOLVING - RESPON PARTY Applied Notice The permit holder shall 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 an emergency. The permit holder shall notify the City Inspector, in writing, of any /all assignment changes. ROW 28- CONSTR SAFETY - RESPON PARTY Applied Notice The permit holder shall cause his contractor to provide to the City Inspector, in writing, the name and 24 hr emergency telephone number of a designated "Competent Person" responsible for construction safety as per OR -OSHA, Chap. 437, Div. 3 Construction, Subdivision P - Excavations. The contractor shall notify the City Inspector of any /all assignment changes. ROW 29- ESMT /RT OF ENTRY - RESPON Applied Notice It is the sole responsibility of the permit holder to provide for proper right -of -entry and /or easements prior to starting work. Proof of right -of -entry, or properly executed easements, shall be provided to the City. The City shall in no way be construed to be liable for the permit holder's failure to obtain or provide for proof of right -of -entry or easements. • 5 APPLICATION FOR Wi 1 WORK IN RIGHT -OF -WAY (ROW) PERMI , Q = -b 2 42011 CRY OFTAi TIGARD Development Engineering PIA k4 €TEN t _ , 3 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 624 -0752 FOR STAFF USE ONLY General Information: 634003 Right -of -Way Property Address /Location(s): 15215 SW 100 AVE. Case No.: PA■A ,I 1! - 000 `Z S6 61 4031 „yY F, i ; Receipt No.: Date: 30 *Applicant's Name: Portland General Electric Application Accepted By: rC 1P Reviced 1/4/99 Address: 9480 SW Boeckman Rd REQUIRED SUBMITTAL INFORMATION City /State: Wilsonville OR Zip: 97070 Primary Contact: Ralph Reisbeck Phone: (503) 570 -4409 Fax: (503) 570 -4420 Submit a scaled sketch of the proposed work to be done Contractor's Name: N/A CCB# Expiration: Professional Engineered Plans are Address:. required for: ;ity /State: Zip: • Street Widening Phone: Fax: • Subdivision Infrastructure • Main utility line extension: Plans By: Address: City /State: Zip: Phone: Fax: Description of work: PGE to dig up primary direct buried underground cable O. PGE pole # 5213 and move 2ft to new pole bracket. Estimated value of work (within the public right - - way): $ Is work related to a LAND -USE DECISION? YES NO If so, please specify (MLP, SDR, SUB, etc.) case #: Is the work related to a BUILDING PERMIT? YES NO ■ If so, please specify (BUILDING PERMIT) case #: (I *NOTE: Person specified as "Applicant" shall be designated "Permitee" and shall provide inancial assurance for the work. It c' \users\kristie\appdataVocar icrosoft \windows \temporary internet files \content.o utlook \k664vfyw \city of tgard permit wr 634003.docx - LEGEND C 15 41577 INSTALL I - AL -TX UG SECONDARY IN 3" PVC CONDUIT, PROVIDED & INSTALLED BY CUSTOMER 01145 1 1989 REMOVE PGE FACILITIES 4/0 TX 01847 O JW7258 - 97 00720/ RIGHT - OF - WAY PERMIT NOTICE: PL 01145 01847 01000/ A PERMIT FROM THE LOCAL JURISDICTION IS REOUIRED BEFORE ANY SW 5 A T T L E K 5 EPL81000 WORK IN THE RIGHT -OF -WAY MAY BE PERFORMED. ONLY PGE APPROVED CONTRACTORS AND CONTRACTORS WHO HAVE MADE OTHER SPECIAL AGREEMENTS WITH PGE WILL BE ALLOWED TO WORK UNDER PEE'S PERMIT. THE CONTRACTOR MUST NOTIFY THE LOCAL JURISDICTION 4B HOURS lJ BEFORE WORK IS TO BEGIN. A COPY OF THE PERMIT MUST BE ON SITE. UU ¢ 81000 985 -20 Un O' J a 1 -10 CU 1 -2 AL -T U , cv CO -- 5211 200A 0 o1e47- � L -5213 15211 01010/ ' INSTALL 3" CONDUIT UNIT & > PL 81010 WEATHERHEAD ON EXIST Lk _ BRACKETS. 2D0A e--------- C 50 255 C SPLICE C PHASE PRIMARY, - S MOVE 2" TO BRACKET. WR CHECKLIST 1207240 \- • MOVE 3" CONDUIT UNIT & 200A 0 2 -4/0 AL & I -4CU TO NEW ITEM YES COMMENT 0.72ZVO o BRACKET. 2. 61 TFLKR NOTE: OPEN @ PD -7814 ON HOL[DIGGER 3 "16IA AIC o o — LAKESIDE DR E/O 98TH AVE. BOON 15215 15215 SEE ONE -LINE BACKHOE X a PD 08796 PGE TRENCH 6ARA6E • , MOVE 2" NEW 3" TO BKTS v Ali r CONDUIT LOCATES X 1 -10 CU -DX ` STAKING ______________e 01847- PGE 2.5" ! Oh � FRONTIER FLAGGING 05213 01020/ TREETRIM 1965 -40 PLOT 020 �02'COMCAST LANDSCAPE POLE 8 5213 EASEMENT 15265 0 PERMITS X TIGARD 1 -1 43 CUTSHEET A 25 45251 F65T UG CR. VER. P L 0521 3 TRANSMISSION 1 - 1 4 - SHUTDOWN F65T CUSTOMER SHUTDOWN X SDPM PL05214 DOOR HANGER X CONTACT COMPANY PH' C. C A DATE TIME 5W KA6L-E 5T 01847 - A-2 cu -OS 01030/ CONSTRUCTION NOTES: SFEXT -N PL 030 • /- I I. CUSTOMER TO PROVIDE ALL TRENCHING AND BACKFILLING. TRENCH TO BE 36 INCHES DEEP AND 24 INCHES WIDE. MEASURED FROM FINAL GRADE. 05214 1966-40 2. CONDUIT (IF NECESSARY) WILL BE GRAY, SCHEDULE 40. ELECTRICAL GRADE. - 1 43 PVC CONDUIT WITH NYLON PULL STRINGS (MIN. 500 LBS. TEST). F4OT PEE TO DETERMINE THE SIZE AND NUMBER OF CONDUITS REOUIRED. PL0521 4 MAINTAIN 12 VERTICAL INCHES AND 24 HORIZONTAL INCHES CLEARANCE BETWEEN GAS AND OTHER UTILITIES. ALL ELBOWS TO BE 36 INCH (MINI RADIUS. ALL BENDS MUST BE FACTORY MADE. RIGID STEEL OR PGE APPROVED FIBERGLASS BENDS ARE REQUIRED FOR RUNS OF 151 FEET OR LONGER. OR FOR ANY LENGTH RUN WITH MORE THAN 160 DEGREES IN BENDS. PVC SCHEDULE 40 BENDS ARE ACCEPTABLE FOR RUNS OF 150 FEET OR LESS. THE MAXIMUM TOTAL BENDS IN ANY CONDUIT RUN IS 270 DEGREES 3. CUSTOMER RESPONSIBLE FOR ROAD CROSSINGS. USE ONLY GRAY, SCHEDULE 40. ELECTRICAL GRADE, PVC CONDUIT WITH NYLON PULL STRINGS (MIN. 500 LBS. TESTI. 4. SINGLE PRIMARY INSTALLATIONS- CONDUIT TO EXTEND A MINIMUM OF IO' FROM TRANSFORMER PAD. CALL BEFORE YOU DIG: OREGON LAW REOURES YOU TO REQUEST UTILITY LOCATION 46 HOURS PRIOR TO EXCAVATION. FOR LOCATES CALL THE OREGON 5. ALL PGE TRANSFORMERS TO BE INSTALLED B FEET (MIN) FROM ANY COMBUSTIBLE UTILITY NOTIFICATION CENTER AT 64. BUILDING. WALL OR OVERHANG AND 4 FEET (MINI FROM ANY FIRE HYDRANT. , t TRENCH TRENCH AND SERVICE DUIT D INAT OON FOR PRIOR +I f e ;E: PEE TRANSFORMERS MUST BE WITHIN 15 FEET OF A DRIVEABLE AREA. `" ALWAYS MAINTAIN 10 FEET CLEARANCE IN FRONT OF ALL TRANSFORMERS. TO BACKFILL. PGE WILL NOT INSTALL WIRE Gu ? I UNTIL TRENCH IS 1002 RACKfILLED. ' 6. CUSTOMER TRENCH AND ELBOW CONFIGURATIONS MUST BE INSPECTED BY PGE PRIOR SERVICE COORDINATOR XAewwho% SILL 503 - 736 -5450 Call Wan you tag. TO BACKFILLING. PLEASE CALL 503- 736 -5450 TWO DAYS PRIOR TO INSPECTION. 7. DESIGN IS BASED ON STANDARD UNDERGROUND EOUIPMENT. NON- STANDARD UNDGERGROUND EQUIPMENT MAY BE AN OPTION AT AN ADDITIONAL COST TO THE CUSTOMER. AS — BUILT VERIFICATION This document accurately & NESC VIOLATIONS CORRECTED represents FIELD construction. = o Fore Date: 1— n Il � 3 �° (1 , SDGEngineer: Date: MC DONALD g Designer: Date: www.Por tlondGeneral.com www.Por llondGenerol.biz www.Ear lhAdventoge.com BON I TA TITL JOB NO. JO NATHAN AHO 634003 J0 SITE ■ Cu CIRCUIT 512E O ¢ DURHAM - SATTLER 13KV 11x17 o � / `/ GE SCALE DESCRIPTION SCA 3 ¢ ° OH TO UG SVC CONVERSION P= ALE 1 = N LOCATION N. 15215 SW 100TH AVE, TIGARD; WASH CO U DATE SECTIONISI WORK WITH SHEET SW DURHAM RD WILSONVILLE 2/4/2011 1C21 -IIC LINE CREW CENTER I OF 2 • DESIGN BY PHONE 15031 DRAWN BY T oi4is GUIDE 9480 SW BOECKMAN RD RALPH REISBECK 570 - 4409 K.RUTHERFORD • -D7 VI )NIT • MAP WILSONVILLE. OR 97070 ID PORTLAND GENERAL ELECTRIC CO. - ALL RIGHTS RESERVED