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ROW2012-00064 CITY OF TIGARD RIGHT OF WAY PERMIT - COMMUNITY DEVELOPMENT Permit #: ROW2012 -00064 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Date Issued: 07/11/2012 TIGARD Parcel: SEG1586 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: TW Telecom Project Description: Adjacent to 7409 SW Tech Center Dr. Over lash existing twtc fiber cable along SW 72nd Ave. to SW Tech Center Dr., intercept existing twtc 1.25 inch HDPE to right of way. Owner: FEES Description Date Amount ROW Permit Fee 07/16/2012 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: KEVIN O'CONNOR 520 SW 6TH AVE, SUITE 400 PORTLAND, OR 97204 PHONE: 503 - 416 -1546 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 4 Signature: Issued By: 0 Special Conditions (See Attached) Note: THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for ROW2012 -00064 Type: Condition Name: Status: Severity:, ROW 01- CUSTOM CONDITION Applied Notice Do not obstruct traffic in SW 72nd from 7:00 to 9:00 a.m. and 3:30 to 6:00 p.m. 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 Kenny Fisher, at 503 - 816 -6146 or email at kenny@tigard- or.gov, 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. 11 a q City of Tigard T'IGARD Application for work in the Right -of -Way ROW Permit SIMAIMENIMINEEMMININIEN General Information: FOR STAFF USE ONLY Property Address /Location(s): 7409 SW TECH CENTER DR Right -of -Way TIGARD, OREGON 97223 CaseNo.: Receipt No.: *Applicant's Name: Kevin O'Connor (tw telecom) Date: Address: 520 sw 6th Ave, suite 400 Application Accepted By: City/State: Portland, Oregon Zi 97204 Revised 7/1/11 Primary Contact: Kevin O'Connor 5 0 3- 416 -15 4 6. REQUIRED SUBMITTAL Phone: Fax: INFORMATION Contractor's Name: Joe Kuenzi (North Sky Comm) Submit a scaled sketch of the proposed CCB# 141171 Expiration: March 1st, 2 014 work to be done Address: 10860 Clutter Rd City/State: Sherwood, Oregon Zi 97140 • Traffic Control Plan Phone: 5 03 - 6 4 7- 99 91 Fax: • Filing Fee $300.00 Plans By: Engineering Associate l masters \land use applications \ row app.doc_. Address: 10860 Clutter Rd City/State: Sherwood, Oregon Zi 97140 • Phone: 503 - 550 -3249 Fax: Descriptionofwork: over lash existing twtc fiber cable along SW 72nd Ave to SW Tech Center Dr, intercept existing twtc 1.25" HDPE to right -of -way. Estimated value of work (within the public right -of -way): $ 0 Is work related to a LAND - USE DECISION? YES ri NO Hsu please specify (MLP, SDR, SUB, etc.) case #: Is the work related to a BUILDING PERMIT? YES NO If so please specify (BUILDING PERMIT) case #: City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2468 I vww.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. s 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. / 14- 2 • Appl ant's Sign • tgre ate ` J -� c /o,• Ow, • is Signatl9* Date Owner's Signature Date Authorized Agent's Signature Date 1 1 Otj J QP 5 e, oo -41ca- ! CP 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 of2 CITY OF TIGARD RECEIPT - '1 _ g 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 187539 - 07/16/2012 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ROW2012 -00064 ROW Permit Fee 100 - 0000 -43114 $300.00 Total: $300.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 014370 HWATKINS 07/16/2012 $300.00 Payor: Engineering Associates, Inc Total Payments: $300.00 Balance Due: $0.00 Page 1 of 1 CITY OF TIGARD RIGHT OF WAY PERMIT COMMUNITY DEVELOPMENT Permit #: ROW2012 -00064 13125 SW Hall Blvd Tigard OR 97223 503.718.2421 Date Issued: 07/11/2012 TIGARD Parcel: SEG1586 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: TW Telecom Project Description: Adjacent to 7409 SW Tech Center Dr. Over lash existing twtc fiber cable along SW 72nd Ave. to SW Tech Center Dr., intercept existing twtc 1.25 inch HDPE to right of way. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: KEVIN O'CONNOR 520 SW 6TH AVE, SUITE 400 PORTLAND, OR 97204 PHONE: 503 - 416 -1546 Total $0.00 Please sign below to indicate acceptance of conditions and return a copy with the proposed work schedule along with names and contact information of responsible parties before beginning work. a1!l Permittee /Applicant 1. / " � Issued By: Special Conditions (See Attached) V)°/12--- 9 ;04 it Note: THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for ROW2012 -00064 Type: Condition Name: Status: Severity: ROW 01- CUSTOM CONDITION Applied Notice Do not obstruct traffic in SW 72nd from 7:00 to 9:00 a.m. and 3:30 to 6:00 p.m. 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 Kenny Fisher, at 503 - 816 -6146 or email at kenny @tigard - or.gov, 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. iii CITY OF TIGARD RECEIPT q 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 187539 - 07/16/2012 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ROW2012 -00064 ROW Permit Fee 100 - 0000 -43114 $300.00 Total: $300.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 014370 HWATKINS 07/16/2012 $300.00 Payor: Engineering Associates, Inc Total Payments: $300.00 Balance Due: $0.00 Page 1 of 1 RECEIVED JUL 092012 CITY OF TIGARD PLANNING /ENGINEERING ■ N City of Tigard i e - TIGARD Application for work in the Right -of -Way ROW Permit General Information: FOR STAFF USE ONLY Property Address /Location(s): 7409 SW TECH CENTER DR Right -of -Way TIGARD, OREGON 97223 5fG 1580 CaseNo.: MO V 0la- 000 (4 Receipt No.: *Applicant's Name: Kevin O'Connor (tw telecom) Date: 7 - 9- 1a Address: 520 sw 6th Ave, suite 400 Application Accepted By: C • City/state: Portland, Oregon Zi 97204 Revised 7/1/11 Primary Contact: Kevin O'Connor key, el. Ocannor Wag L 4'30n Phone: 503-416-1546 Fax: { w l eco,� ['o - REQUIRED SUBMITTAL INFORMATION D B KeA lea -qtr c o..' • co Contractor's Name: Joe Kuenzi (North Sky Comm) Submit a scaled sketch of the proposed CCB# 141171 Expiration: March 1st, 2014 work to be done Address: 10860 Clutter Rd City/State: Sherwood, Oregon Zip: 97140 • Traffic Control Plan Phone: 503-647-9991 Fax: 57) 3 t /aJ 7 997/ • Filing Fee $300.00 Plans By: Engineering Associate I:curpin \ masters \Land use applications \row app.docx Address: 10860 Clutter Rd City/state: Sherwood, Oregon zi 97140 Phone: 503 - 550 -3249 Fax: Description of work: over lash existing twtc fiber cable along SW 72nd Ave to SW Tech Center Dr, intercept existing twtc 1.25" HDPE to right -of -way. Estimated value of work (within the public right -of -way): $ 0 Is work related to a LAND -USE DECISION? YES 111 NO IWT If so please specify (MLP, SDR, SUB, etc.) case #: Is the work related to a BUILDING PERMIT? YES n NO If so please specify (BUILDING PERMIT) case #: City of Tigard ( 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2468 I www.tigard-or.gov I Page 1 of2 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. / , 7tS I 2 Appl ant's Sign re ate 7 e/ '2 Ow 's Signal Date Owner's Signature Date Authorized Agent's Signature Date IL 0 OP PI e. 005--41c.0- I *' Print Name Title Phone Number Signatures of each owner of the subject property are required City of Tigard I 13125 SW I Iall Blvd., Tigard, OR 97223 I 503 - 718 -2468 I www. tigard- or.gov I Page 2 oft CONSTRUCTION SET CONSTRUCTION NOTES O I EXISTING 3- 125" HOPE SDR11 CONDUIT PL NEW 24F ARMORED FIBER CABLE IN EXISTING 1-1.25" UTILIZE 5 24F AR ORED FIBER CAABLE STUBBED 1-1.25" O HOPE SDR11 r CONDUIT / O OPEN TRENCH. NEW CONDUIT 4F ARMORE LOCATION. ER CABLE IN NEW 1 SDRII j /// / / / / / / / / / / / / / / / / / / / / / / / / / / / / // PL NEW 1-1.25" HDPE SDR11 CONDUIT FROM Y-CAST EXISTING 1-4" CONDUIT OWNED BY OTHERS. PL NEW 24F ARMORED FIBER CABLE IN NEW F-CAST. O FL NEW 24F TO CUSTOMER F CABLE IN EXISTING 1 -4 " CONDUIT OWNED BY \ \C4,,,, / / / / / / / / / / /// BEGIN BUILD SEE SH ANCE 6 E 0 \T / 7405 SW TECH CENTER DR 4. \ HOPE SDRll CONDUIT S 1 - 1.25 "HOPE SDR11 CONDUIT \ EXISTING EXISTING 2-4" PL NEW 4EXITING 3- 1.25" PL MUQMORED HOPE SDR11 PL NEW 24F ARMORED CABLE SDR11 CONDUIT OWNED BY OTHERS 0 OO FIBER CABLE CONDUIT • TAPE j///// / / / / / / / / / / / / / / / / / / / / / / / / / / / /A. EXISTING 24F PI MULE EXISTING 24F 7409 SW TECH CENTER DR ARMORED FIBER CARLE TAPE ARMORED 24 BER CABLE ARMORED CFFIIBER FIBIERCABL4F ARMORED SW CONDUIT TECH CENTER S DR /74095W TECH CENTER OR ® ��///////////////////////////////////////////// / / / / / / / / / / / / / / / / / / / / / / / / / / / / // % %/////////////// f/////////////////////////. 0// Y /l% / / / / / / / / / / / / /////// / / / / / //f SCALE: NTS ©== o �� , O 3 © a . v rz N - 11 ' v r v - FTC RAN — 71T am `_' _ . z o SNG D UI 6' / OWNE BY 4 OTHE CON T m l \mom _ yam - "` W • E� �� s s 0 5 5 � —~ SW TECH CENTER DR 55 e PL NEW 4" EXTENSION WITH w— I O O r+ ©' 9 W 1.25 " EXTENSIO 0 a 1 - _ �A _ s\ z co, '� �. -+I. — — — S - AST355'— — CSW CSW T ;, aw aw RN/ T err INN "m 4, I S Q UNDERGROUND DETAIL \ Y -CAST DETAIL SW TECH [ENTER DR ® • N SW TECH CENTER DR ® sc. 3 1 40' SCALE: NTS ENGINEERING ASSOCIATES. INC. DESIGNED Br: D RYRERR APPROVED BY: B H0DruP5TDN ACS TESTING Communications C OAHU Engineers CHECKED BY: p 9.01 Ft TON DRAWNRY: VA CAD 7409 SW TECH CENTER DR, OREGON A !RV lICls COMPANY REVISIONS //�_ R ■/� ■/�■ 121001d Aloha,ettn Rd 108605W Clutter Rd REV DESCRIPTION DATE BY APP jv to e _o 1 1 UNDERGROUND DETAIL Suite 390 Sherwood, OR 91140 te �VVV/ V CITY: 116/1H0 COUNTY WAS IIINGT,)tI Alpharetta, GA 30005 (360)112 -2143 - (618)465 -72I6 _ PATE:o/ll /1011 VCAIE: Sit PRINT PROIECTR'AC5_TESTING FItFNAMEAC.S_TESTING.DWG 5.0 OF 7.0 • • CONSTRUCTION SET CONSTRUCTION NOTES 0 EXISTING 3- 1.25 "HDPE SDR31 CONDUIT. PL NEW 24FARMORED FIBER CABLE IN EXISTING 1-1.25" HOPE 5DR11 CONDUIT. 3. 1.25 "HOPE 50R11 CONDUIT DETAIL PL 1-4" PVC CONDUIT SLEEVE, PL NEW 3- 1.25 "HDPE $01111 CONDUIT PL NEW MOR EF HDPE EXISTING 50111115" I IN NEW I -4 "PVC CONDUIT SLEEVE ARMORED HDPE SDR3] FIBER CABLE CONDUIT \i• TIGARD CITY PERMIT - PL MULE I' /II TAPE £ EXISTING 24F ml . EXISTING 6 "PGE RISER ARMORED FIBER CABLE CONDUIT DETAIL ® i RISER DETAIL SW TECH CENTER DR SCALE: NTS ' a � Il•IIE�(f#l� X34 EXISTING POLE � P.O.A. � 10• -10" L' IIL 'Tl�iilR•7FS�FJ /1��1 If1TM65IFt FIBER CABLE r, F1LI��ili 1= li PPI N (V� M � 1-4" PVC CONDUIT SLEEVE i _ CSW —_ EXISTING GROUND I 1 -4"PVC CONDUIT SLEEVE w s ss- s. s j s " U. —s - SW TECH CENTER DR 36"MINIMUM DEPTH 0 w '-:---w " = w , , RISER DOWN EXISTING 4" 48' SWEEP •�O FE. - — _ �. CONDUIT RISER W /3- 1.25" Z ryCIBT�3S.��_ CSW HOPE SDRI1 CONDUIT CSW aw 0 \ s P POLE DETAIL a,w ww � \ r. c . POLE # 05221 • a " . . \ 4 SCALE: MS J n/ Q - o POE POLE 405II3 \ / END UNDERGROUND \ 01 SEE AERIAL PLAN SHEET3.0 / UNDERGROUND DETAIL ■Ii • SW TECH CENTER OR .."- SCALE: 1 " = 40' 0 I / \ • ENGINEERING ASSOCIATES. INC. DESIGNED8r: n RYKFRr APPROVED BY: B ' 5111. ACS TESTING Communications B{Me,rs CHECKED Br: A HUM FSTON DRAWN BIS EAIAD A OUARTA MI/1M COMPANY REVISIONS ' EVISIONS 7409 SW TECH CENTER DR, OREGON 220 OIAaIpho,vrn, Rd 10860 SWCIUtterFd REV DESCRIPTION DAD PS APP �W to I e co m UNDERGROUND DETAIL Suite 390 Sherwood, OR 97140 Alpharctto. GA 30005 (360)772 -2143 - - CIiY; TIWRD COUNTY: WASHINGTON (61R, 455 -11 :6 .. r l i 4.0 OF 7.0 DATE: 6 /1]/1011 S(Ll �.. Al PROTECT 4: ACS_TESTING FILENAME: ACS_ TESTING DWG CONSTRUCTION SET 1 -4" PVC CONDUIT SLEEVE, EXISTING 3425" \i HDPE 501711 CONDUIT IN EXISTING 1 -4" PVC II CONDUIT SLEEVE • „ EXISTING 6" PGE RISER RISER DETAIL EXISTING POLE I P.O.A. = 20' -10" r FIBER CABLE Ij N C - 3J " PVC CONDUIFSLEEVE % IV 2 O D G T EXISTING GROUND II 1 <" PVC CONDUIT SLEEVE J 36 "MINIMUM DEPTH EXISTING TNT FIBER CABLE 48 "SWEEP POLE DETAIL DOLE 405121 ® C., AERIAL DETAIL SCALE: NTS SWTEN =4 S 0 CALE: } " =40' LASH NEW 24F 05+87 / s ` \ ARMORED FIBER a • F G cR CABLE TO EXISTING 4 N A ,,F �' 6.6M STRAND A'4 NT POLE CLASS 30 3 2009 fltELC41u1 MISC END AERIAL h:f� SW TECH CENTER DR SEE UNDER GROUND OVERLASH TO EXSITING WT FIBER CABLE AT SHEET 4.0 CT 6K ' 05+87 l 7 - 06 +34 QT� POLE4 05221 - • MAP# C21-01D \ POLE CLAS 01 01 Br 06 + ,•"' ELIE }SIIL`M . N UT Z6.9 • STREETLIGHT 24' -5" RS \ 14 . • ELI 22' -6" RS • i ' l OVERLASH NEW24F ARMORED FIBER ^ \ CABLE TO EXISTING 6.600 STRAND \ i ■ \ ,�� MATCH LINE - SEE SHEET 2.0 ENGINEERING ASSOCIATES, INC. DESIGNED BE 1 900066 APPROVED BY B HN6DI11006 ACS TESTING Communications Enginnnn CHECKED BY: B HIIONFRTON DRAWN 81 FA ran • -••• REVISIONS 7 409 SW TECH CENTER DR, OREGON 1220014 Alphnretto R# 10860SW Clutter RE ter Rd DESCRIPTION DATE IN APP Z telecom AERIAL PLAN Suite 390 Sherwood, OR 97110 Ow PGA RD COUNTY: WASHINGTON Alpharetta, GA 30005 13601772 -2143 (678)455 DATF _ - MC; 3.0 OF 7.0 ' c /IJ /JO]] Sc C: cFF P01111 PRDIF(i a: ACS_ TESTING F IL E NA A[5_IESTING.OWC. ■ r • MATCH LINE - SEE SHEET 3.0 CONSTRUCTION SET 04 +51 ® 04 +51 POLE0 984 FRONTIER# 500669 5+ MAP Pt C21 -01D POLE CLASS 45 4 1984 • ' e , T 5 eA WRM MIRI1 u TWT 24' 6" RS OVERLASH TO EXISTING TWT FIBER CABLE Jjp, FIBER AT24' -6" c„ 03+41 Izn GlirdailtLAINII OVERLASH NEW 24F ARMORED FIBER II � EOP CABLE TO EXISTING 6.6M STRAND \ e. 03+41 LIELT II_1_1i1L•1'_ „ Will■INFAIF1711111111111 A OVERLASH TO EXISTING TWT FIBER CABLE \ FIBER AT 22 S 02 +02 ...... l i11 Uf -f I239.111t1 1OF F.G11311∎PP O 10 I •L FlF -'LL C1 MCTC/ `i 4. MMUINMEiU1711LLD341 VITY PZ16NillIM ® 02+02 OVERLASH TO EXISTING TWT FIBER CABLE FIBER ON TOP OF THE OS/RS OF PUPPY ARM c,. OVERLASH NEW 24F ARMORED FIBER 00+00 CABLE TO EXISTING 6,6M STRAND POLE4 1735 FRONTIER a 500666 PO C 437 A 006 AERIAL DETAIL E. ATTACHMENTS HOA POSITION 1 MISC SW 72ND AVE ® T IN T 23' RS SCALE: 1 "e 40' Cm ��♦` EXISTING TWT FIBER CABLE "x.00 +00 LEAVE 200' FSL IN NEW 24F ARMORED FIBER CABLE OR MATCH EXISTING 0,2,. SPLICE NEW 24FARMORED FIBER CABLE WITH EXISTING TWT SPLICE ENCLOSURE / 4 V 0 I • ENGINEERING ASSOCIATES. INC, DE5IGNEDBY: ° RYk001 APPROVED Br R mow,'yTrYO Communications Engineers CHECKED Br R HIM. FSMN DRAWN BY: f r.° AC'S TESTING •n "•M• SW/ICES COMPANY AEVIC 7409 SW TECH CENTER DR, OREGON REV DESERIPi " - '° DATE BY APP �w telecom AERIAL PLAN 1220 Old A!phorettp Rd IMO SW Clutter Rd Suite 390 Sherwood, OR 97140 Alpharetta, GA 30005 (360)172 -2143 CITY: TIGARD ■ >UNITY: WASHINGTON - - .7F/ 45,7116 - - - - - DATE 6 /27/1011 SCALE: SEE PRINT PROJECT n: ACS_ TESTING FILENAME ACS_TESTING. OWE 2.0 OF 7.0