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PFI2015-00121 CITY OF TIGARD RIGHT OF WAY PERMIT COMMUNITY DEVELOPMENT Permit#: PF12015-00121 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 09/03/2015 Parcel: SEG2124,2125, 3026 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: Adjacent to 15233 SW 81 st Avenue. Service to 12-lot partition. OH to UG conversion/removal/install. Hoggans Park/Corbin Estates. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX Applicant: TSAHAI ANDERSON 10800 SW AVERY ST TUALATIN, OR 97062 PHONE: 503-612-6106 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. Permittee/Applicant Not Present Signature: h � Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12015-00121 Tvpe: Condition Name: Status: Severity: PFI_Utilities 01 -WORK SITE REQUIREMENTS Applied Notice Applicant must comply with all applicable provisions of federal and state law, the Tigard Municipal Code,and the terms of any agreement with the City of Tigard regarding work to be done pursuant to this permit. PFI_Utilities 02-WORK SITE AREA Applied Notice The work area and approach roads shall be maintained in a clean condition, free from obstructions and hazards. The spreading of mud or debris or storage of materials or equipment of any kind upon any public roadway is strictly prohibited and violation shall be cause for immediate cancellation of the permit. The City may at any time order immediate clean-up and suspension of work to accomplish clean-up. PFI_Utilities 03-WORK SITE EROSION CONTROL Applied Notice Prior to starting work,effective and approved erosion control devices must be installed and maintained meeting the Clean Water Services and DEQ requirements. The City may at any time order corrective action and suspension of work to accomplish effective erosion control. PFI_Utilities 04-WORK SITE REPAIRS Applied Notice Disturbed landscaped areas shall be restored or replaced. Existing signs, pavement markings, mailboxes,etc. shall be reinstalled or replaced,with like kind of material. Obtain City approval of restoration work PFI_Utilities 05-TRAFFIC CONTROL SPECIFICATIONS Applied Notice Applicant shall provide traffic control according to the current edition of the"Manual on Uniform Traffic Control Devices [MUTCD]for Streets and Highways", U.S. Dept. of Transportation, FHWA,current edition,American Traffic Safety Services Association[ATSSA], and Oregon Temporary Traffic Control Handbook[OTTCH]. PFI_Utilities 06-TRAFFIC CONTROL PLAN Applied Notice Submit a job specific traffic control plan. A copy of the approved traffic control plan shall be readily available at the work area.Traffic control devices,flag persons,etc., shall be in place prior to initiation of construction work and shall be effectively maintained. PFI_Utilities 07-TRAFFIC CONTROL ROAD CLOSURE Applied Notice Public roadway shall not be closed to traffic, at any time,without obtaining written approval from the City Engineer. The applicant is responsible to provide 48 hour advance notice of traffic flow disruptions to affected businesses, residents and area wide Emergency Services. 503-629-0111 (Tigard Police Dept.,Tualatin Fire&Rescue)and to 503-962-8140(Tri-Met) and 503-431-2345(Tigard School District)and other service providers impacted by such closure. PFI_Utilities 08-TRAFFIC CONTROL PROPERTY ACCESS Applied Notice Access to existing properties shall be maintained at all times, including normal delivery service and mail service. Obtain City approval of any access closures. PFI_Utilities 09-TRAFFIC CONTROL WORK HOURS Applied Notice Work is permitted in daylight between the hours of 7 00 a m. to 7 00 p m Mon-Fri unless otherwise authorized by the City PFI_Utilities 10-TRAFFIC CONTROL LIMITED WORK HOURS Applied Notice Hours of construction work on collector and arterial roads will be limited to 9:00 a.m.to 3:00 p.m. unless authorized by the City Engineer. Work will not be permitted on collector and arterial roads between 3:00 p.m. to 9:00 a.m. unless authorized by the City Engineer. PFI_Utilities 11 -TRAFFIC CONTROL MODIFICATION Applied Notice The City reserves the right to add to or modify traffic control requirements as necessary to effectively control traffic and to assure public safety. PFI_Utilities 12-UTILITY NOTIFICATION Applied Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR 952-001-0100 through OAR 952-001-0080. Copies of said rules may be obtained from the Center by calling 503-246-1987. If you have any question about the rules, contact the Center. NOTE: Damage to utilities shall be corrected at the permit holder's expense. PFI_Utilities 13-UTILITY LOCATION CONFLICT Applied Notice Applicant must verify all existing utilities for both vertical elevation and horizontal location prior to start of work(pothole before digging if necessary). Should conflicts arise and redesign or relocation of facilities be necessary, it shall be done at the applicant's expense. Changes must be approved by the City in advance of work.Applicant shall coordinate the work with affected utility agencies. PFI Utilities 14-TEMPORARY PATCH Applied Notice A temporary hard-surface patch shall be placed on trenches within roadways at the end of each work shift. Obtain advance approval of patching method. No trench shall be left at any time in an un-safe condition. Applicant is responsible for and is liable for hazards or damage resulting from the prosecution of the work. PFI_Utilities 15-REPAIR OF EXISTING FACILITIES Applied Notice Work under this permit shall include repair of existing facilities(roads,ditches,etc.)as may be necessary, as determined by the Inspector,to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit. Corrective work shall be done at the applicant's expense. PFI_Utilities 16-PRECONSTRUCTION MEETING Applied Notice Before initiating any construction activity,the applicant shall coordinate with the City's inspector, <Insert Name>at<Insert Phone#>, to establish a preconstruction meeting. PFI_Utilities 17-NOTICE TO COMMENCE WORK Applied Notice The applicant shall notify the City's Inspector twenty-four(24)hours prior to commencing work, prior to any staged inspection, and after completing work covered by the permit. PFI_Utilities 18-PERMIT/PLAN ON SITE Applied Notice A copy of the permit including a Certificate of Insurance, and all attachments, and a copy of the approved construction plan and all amendments shall be readily available at the work area. All work shall conform to the permit terms, conditions and provisions and to the City approved permit plans, and approved plan amendments and to the City's standards and specifications and to these General Conditions. Changes to any of these must be approved by the City, in advance of work performance. PFI_Utilities 19-MONUMENT PROTECTION Applied Notice Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holder's expense. PFI_Utilities 20-EMERGENCY CONTACTS Applied Notice Provide to the City inspector, in writing,the names and 24 hour emergency telephone number of two(2)persons who have authority to resolve problems, take corrective action and,in general,will be responsible in case of any emergency. The applicant shall notify the City Inspector, in writing, of any/all assignment changes. PFI_Utilities 21 -OTHER Applied Notice RECEIVED City of Tigard AUG 2 7 2015 PUBLIC WORKS —EN0TLY1@&VPARD PGE WORK ORDER# M1586096 _ ,PLAN NG/ENGINEERING Public Facfty improvement (PFI) Permit DESCRIPTION OF WORK(in the right-of-way) REQUIRED SUBMITTAL Check one: 8 Utilities ❑ Sidewalk/driveway approach ❑ Street improvements ELEMENTS Detailed description: Service to 12 lot partition ® Minor work in right-of-way (sidewalk repair,curb cut,street OH to UG conversion/Removal/install. Hoggans park/Corbin estates. opening,etc.)requires: •Application form,completed and signed •Submit one(1)copy of scaled sketch Property address/location(s): 15233 SW 81 st Ave, Tigard of the proposed work to be done �� 21�� (,..\�'/ •Submit one(1)copy of traffic �C / - �Y control plan —OR— Applicant's name: Tsahai Anderson for Tod Shattuck ❑ Substantial project work requires PP above items and professional Address: 10800 SW Avery Street engineered plans for: •Street widening Ci /state: Tualatin, OR Lip: 97062 •Subdivision infrastructure Phone: 503-612-6106 Email: T&DSupportAvery@pgn.com •Main utility line extension: - Storm Drain,Sanitary—Tigard - Water—Tigard Water Service Contractor's name: Area(includes Durham,King City and a portion of unincorporated CCB#: Expiration: Washington County) Address: City/state: Zip: DELIVER APPLICATION TO: City of Tigard Phone: Email: Planning/Engineering 13125 SW Hall Blvd. Engineer's name: Tod Shattuck (Project Manager) Tigard,OR 97223 Address: 10800 SW Avery St Applications for"minor work in right-of-way" only may be emailed to: City/state: Tualatin, OR alp_ 97062 ro ermitsktigard-or.gov Phone: 503-672-5466 Email: Estimated value of work (within thePright-of-way):ublic $ Case No.: Application submittal fee: Is work related to a LAND-USE DECISION? ❑ Yes N No Application accepted: If so,please specify (MLP,SDR,SUB,etc.) case #: By: Date: P ?/� Is work related to a BUILDING PERMIT? ❑ Yes 8 No Application reviewed: • �S' If so,please specify(BUILDING PERMIT)case#: By:t�8 Date: gJ•1 Applicant notified: /�Nw'�"P'�H'► a PF`Z By: Date: /� 1:\CURPLN\Masters\land Use AppRmdons Rev.07/16/2014 City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 0 www.tigard-or.gov • 503-718-2421 • Page 1 of 4 APPLICANTS NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for 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 APPLICANTS) SHALL CERTIFY THAT: • The above request does not violate any deed restrictions that tnay be attached to or i=osed upon the subject pLQp . • 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 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. SIGNATURES of each owner of the subject property required. DVA.My"p by TSARAI ANDERSON TSAHAI ANDERSON emaN=TSA 4V ANDERSON®PfiNCOM,cvUS Tsahai Anderson 8/26/15 Dal.2015 NT6 11:05.38-07W Applicant/Authorized Agent's signature Print name Date Owners signature Print name Date Owner's signature Print name Date Owner's signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 • Page 2 of 4 RECEIVED AUG —9 7 2015 CITY OF TIGARD PRST iuEDFA 151TIF ip BLION END ... _ rte' wT C-61w urr w � ..... rtisr.[LL:D .. �•AWLSY.2� �r SAPBTY — � = a•iVR)dn^ ,.,,,, NING/ENGINEERING In,31—J'"E CONDUl OH r7•eEACKETS rem„DIR w'+' Salim A' �rauu.eoanme nu,ra o.rs rou•r J"'CONDUIT r�iwrae rarE Eerrr •�.4Md.r -. �n�....�..- .. r\ MT •.ea r x. .erre, _ me.0., �..'1 ��'•I '�— MD]IDl ro emN » r•e•.•xew w � .,rerm.w..�.r.w ter. reD rom)r "'r I •'re rover roiE r'0ar�nsp w _ ,ar• ca i r10aV fo tW e _ ..v•wr.um., .... \17.0 LMT 73 B rla7Mv M7 Bt xarm a.o•em w�.m+.. rpf. e..: i r• raef eeH eew etaiwr.+ur i er DN eE._rDE yrue--- n LDz a on wp rEMI DFAUND:b � u wwn— xaxrenrow -----.....w'.6r'e:,:r:weLp'xO1rwroer••`m.eer r tyro • --"—........ .....—__ _--_ ar rw -- — — .n)ws ..move.w•. !e••063 A .or V7 OOtBd 73e-r•E MIre.I x m.or.wws _� er G3 _____-- __ Mre•ron s,n --_ e •Mr +.ararma,rrrN ' .mrma•r exw xL.°.em ro.errr a. m .r rnfae a .. __ a>.•^.--.-:�:-- )r�+)n>, .; •-.--� � r,,,,,.r,Rm�arrr..., i.ni urns ... emn nWN v • rrrrwo m� aow rw name. r• 113 • � ) fpmTMit Hm : rfrw rio _J rlep nrOeTM N 000rrT euv O rrvr{p CONSTIEUCTION NOTES: xra �Yw: i. .r�i�rE roan Bea r•w t�.�x.% l e =zF's"•�wr�a?$s qac i roup .�' . .,� �irr ca".•r'iroe.°erua C:'fir.. °:e� �34'a°.�s^y�'.cx w�wu r ) "° {j. .-- -•-��' � nanw ..oe�errD�° uo e' :e •r rm a) ro eer rrwa '- ro ro))r..... VT 00278 ••- .aL„a •p•e �'�... LJ ew Naou,w ... nr .n over •�..:,.=•�-�,s.......��ax^-.- ,�w ea•eew .e rer _._..-. � .�,...^...... r.D E9�� Ter >ot sni` ML )m oa. r E PID M) so a izoa.m w wove Nr rwr.arn mw wrxo 01 ro,NS a buJGF N x xwxP�m.r —I^� Di—I]eW s•��a DD wrlX 16M0)e eDVrE rileW., rw�Y ova ".eel[w wry xSa2l4C,ICN_YQDi Me'IN=l�N. S-!Ul[i VEdr1UiEDN 8 N6C NOTATIONS CORKCRO rrarwo e ro WEST )f]-EO[vWt _ Y��.. :Y::v• �-'�7 'i rr..... 4 Gmrmwr..,m,: wrp:4,?w.^ {L - �,w. � eoD'rr, � :�J.�M'��''i"•r rrw•L ro �� ` � � -ter• �.r�.T'—•".�w�ti:'$` ,a.N.ra er�rex TVT 00789 Deu w r••w ro•uv --�— ..�.o a .".rT.r':1"x•'.r:Ce.Sf:? �'• BOOSit run.. �e.G'R9. `/ r.wn,m m� •pro• sa r• _:_?= .+.+rer m RECEIVED AUG 2 7 2015 CITY OF TIGARD PLANNING/ENGINEERING 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 December 2011 2011 Edition Page 85 Stationary Lane Closure with Flagging Diagram 320 �3 o ui 19 CL ui 0 CD � l t LL a. 0 0 00 • a. 1 i ----- ------ I •• V Opp I I •• >O1i • CL W 12 e 11t I E£ M a W 1 I 1 • 1 o I.® � I • m • 2 Z� I • moi j v 1I N-90Y 1 TVI W. V. ————————————— Sign Spacing and Buffer Lengths(feet) I t c Posted PACIM ii tween ns Buffer LU Speed A 8 C Space ¢ O 20 50 25 100 100 100 75 30 100 125 40 350 350 350 150 O O P�5 180 ¢�as 50 500 500 500 210 55 250 December 2011 Chapter 5