ROW2011-00079 CITY OF TIGARD RIGHT OF WAY PERMIT
COMMUNITY DEVELOPMENT Permit#: ROW2010-00079
13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 Date Issued: Yjl!.hb
Parcel:a e SEG3272
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: PGE
Project Description: In front of 13543 SW Piper Terrace, provide UG s/rvice to lot 3 Minor Partition. PGE to occupy
&install 142 AL JKT primary in customer provided and installed 2"PVC conduit
FEES
Owner: Description
� Date Amount
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
RALPH REISBECK
9480 SW BOECKMAN RD
WILSONVILLE, OR 97070
503-570-4409
y
Total 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)
0 Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
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- t'` '- z , R _
OCT 112011
C ity of Tigard F - ARD
CI i `� �, saw.
PL �� l GL I RING:
, ' - Application for work in the Right - of --� ay RO Permit
TLGAIRD p
General Information: FOR STAFF USE ONLY
Property Address /Location(s): S 'A) /A L'I. R N DER L Kt Right -of -Way
6 C V JI r Case No.: �0 �LO i ( ' 00 7?
/ f /
Receipt No.: / / 0
Date: *Di
a.. t I
*Applicant's Name: ELECTRIC LTG HT WII UE D ate: ion Accepted By: 1-e Address: 1201 NE LL O � D BUD S U�`TE � d a �a "�z `i� �?y�, i
City /State: PO E L H ND , OR Zip: '37232 R evised 7/1/11 ' ' c z 4
Primary Contact: FR S L N S N REQUIRED SUBMITTAL
Phone: X03 4 153 8320 Fax: S03 -153- 73 Z8.1 INFORMATION
Contractor's Name: S D UII LI T `� Submit a scaled sketch of the proposed
CCB# CD LO 9 8 �1 {� y� Expiration: OS` ZI "' ZO (2 work to be done
Address:) 205 E� I L EN ri2: N E
City /State: fl uR O'R- R OR Zip: q 7002 • Traffic Control Plan
Phone: S03 S 4 .1S 2E3 Fax:, 503- to 7$ - 2721
• Filing Fee $300.00
Plans By: PR L) L 2 v SEW I:curpin \masters \land use applications \row app.docx
Address:
City /State: Zip:
Phone: Fax:
Description of work: DIRECT 1ORE 331) OF a cc) muuZT 61\1 SW ELIf II DER LN
From iJ) STATE HW.1 (41 (SW Ham- SLUD) d -PLACE 0) 2A= TN KM,
EUIL DIN TO SERVE IS `1020 SW Wf7SHINGI7N S( UREE fE'__
Estimated value of work (within the public right -of -way): $ " i lp -00
Is work related to a LAND -USE DECISION? YES u NO
If so, please specify (MLP, SDR, SUB, etc.) case #:
Is the work related to a BUILDING PERMIT? YES NO IxI
If so please specify (BUILDING PERMIT) case #:
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503 - 718 -2468 I www.tigard- or.gov I Page 1 of 2
APPLICANTS:
To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as
described on the front of this application in the "Required Submittal Elements" box.
*NOTE: Person specified as "Applicant" shall be designated "Permittee" and shall provide financial assurance for the work.
*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.
BY SIGNING BELOW, THE APPLICANT(S) SHALL CERTIFY THAT:
• The above request does not violate any 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 in the 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.
i t3 1 I
Applicant's Signa r Date
Owner's Signature Date
Owner's Signature Date
Authorized Agent's Signature Date
Fr) UL 3&N .5V. ®S? ENC1NEER 53 -JYS3 --8320
Print Name Title Phone Number
Signatures of each owner of the subject property are required
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503-718-2468 I www.tigard- or.gov I Page 2 of 2
. • Lane Closure with Flagging
47320` ifitig ClosurewithfFlagging T r Deagram 320,x'
Diagram No. 320 covers total closure of one lane of a 2 -lane, 2 -way
r
I
oadway. The right -hand drawing illustrates the use of two flaggers, one for • `---,—) WORK
each approach. The left -hand drawing illustrates the use of a single flagger = - AHEAD A
to control both lanes of traffic on low volume (less than 400 average daily C
traffic) roads with good sight distances as discussed below. O NE ROAAD D -A I
AHEAD
1. Use truck - mounted high- intensity rotating, flashing, oscillating, or strobe (Optional) B
Posted Sign
warning lights with 360° visibility on all work vehicles. For added BE A 1 t Speed Spacing (ft) Buffer
visibility, truck mounted arrow panels or PCMS in the caution mode may P TO STOP B
A or less 100 100 100 100
ro 35 - 40 350 350 350 250
2. Flaggers at each approach are required if any of the following conditions ;=- A I as -55 500 500 500 350
exist: _
a. Night Operations or,
b. Work space is over 200 feet in length or, i - T / • 4 - 1' I °••
•
c. Sight distance is less than 750 feet from each approach through the . , --- - - / B \ . ® •
pp 9 .*. I \ • Protection Vehicle
/
lane closure or, ` \ • w/ TMA
\ • (Both Optional)
d. Traffic volumes are greater than 400 ADT. � A
3. The length between the flagger signs shall not exceed one mile. ���� II
.° Buffer
4. Cones should be used to outline the work space when curves or other • 1 —�
.' • r��� •
roadway alignments prevent clear direction for the motorists to pass the ) ° e b. I I I V V/
work zone safely. Cones along side the work space are recommended' , ' - °•
when posted speeds are 45 or greater, when working under heavy traffic
or when travel lanes are narrower than 11 feet. - y b 111 •
5. Extended queue signing (as shown on Diagram No. 001) should be used : •
when traffic queues extend beyond the initial advance warning sign. \ I ° °
6. When flagging near an intersection, the Flagger symbol sign should be - ` • • I " A BE
• PREPARED
visible to traffic entering from any side road. Additional advance warning : ( V
" / TO STOP
and Flagger symbol signs may be placed on the side road(s). \ I A / B
7. Sign set -up and flagger placement shown in Drawing No. 320 may be \ /
LANE
used for intermittent full road closures of 20 minutes or less. \ B I B ONE ROAD
ROAD
8. The ONE LANE ROAD AHEAD sign is optional and should be \ — L_ — I (Optional) AHEAD
considered on high volume or high speed roads, or when extended —
queues may be expected. '{ . Low Volume V
— Single Flagger Option I WOR
1 ..
_ , AHEAD K
7
', _ _ Diagram No 320 Two Flagger' Operation
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