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PFI2016-00277 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT ■ • COMMUNITY DEVELOPMENT Permitil: PF12016-00277 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 12/28/2016 Parcel: SEG200 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Comcast Project Description: Overlash 463 ft of new 48ct fiber optic cable to existing aerial facilities and push/pull 275 ft of 48ct fiber cable through existing underground conduit. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: SCOTT SARBER 11308 SW 68TH PKWY TIGARD. OR 97223 PHONE: 503-596-3819 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 Signature: Not Present Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12016-00277 Type: Condition Name: Status: Severity: 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 503-816-6146 or Kenny@tigard-or.gov. TRAFFIC RESTRICTION: NO WORK ON GREENBURG RD BEFORE 9AM OR AFTER 3PM 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 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. RECEIVED City of Tigard DEC 2 7 2016 41 PUBLIC WORKS —ENGINEERING CITY OF TIGARD ' LANNING/ENGINEERING Public Facility Improvement (PFI) PerIAM DESCRIPTION OF WORK (in the right-of-way) TYPE OF WORK Check one: 8 Utility Connection 8 TYPE 1—Franchise Utility Work ❑ Sidewalk/driveway approach Work performed by NWN,PGE ❑ Street improvements and/or utility agency. Detailed description: Comcast proposes to overlash 463'of new 48ct ❑ TYPE 2-Sidewalk/Driveway/Sewer fiber optic cable to existing aerial facilities and push/pull 275'of 48ct fiber Work performed for the purpose of: cable through existing underground conduit. Sidewalk installation or repair. • Driveway approach installation Property address/location(s): 9445 SW Locust St,Tigard, OR 97223 and/or repair • Sanitary sewer lateral installation and/or main line tap ❑ TYPE 3—Full scale Development Applicant: Comcast Project#: 51025(5585) Work performed with Land use Address: 11308 SW 68th Parkway approval which includes any of the following: City/state: Tigard, OR Zip: 97223 Subdivisions or Partitions Phone: (503)596-3819 Email: Scott_Sarber@comeast.eom Street widening Contact name: Scott Sarber Phone: (503)596-3819 Mainline installation for Sanitary sewer,Storm sewer,Tigard water Contractor: Texstar Enterprises and/or Tigard Water Service.Area CCB#: 178798 Expiration: 10/10/2017 SUBMIT COMPLETED APPLICATION TO: Address: 14122 Arndt Rd City of Tigard City/state: Aurora, OR Zip: 97002 Planning/Engineering Phone: (503)776-5049 Email: jimminer@texstarenterprises.com 13125 SW Hall Blvd. Tigard,OR 97223 Contact name: Jim Miner Phone: (503)793-3109 Applications for"minor work in right-of-wap" only may be emailed to: Engineer: K&B Technical Solutions rowTermits(ktiga_�d-oror.gov Address: 6566 SE Lake Rd Milwaukie, OR City/state: Zip: 97222 FOR STAFF VSE ONLY Phone: (503)650-6041 Ex.204 Email: Jack-Nygard@kbmail.net Case No.: 6%2A4W_9LFr 1 a20 6"Ud X77 Contact name: Jack Nygard Application submittal fee: _ Additional fees: Estimated value of work is required(if over$5,000):$ Application accepted: (within the public right-of-way) By: Date: Ii -a 7- b Is work related to a LAND-USE DECISION? ❑ Yes V No Application reviewed: By:J6;S1-- Date: If so, please specify (MLP, SDR,SUB, etc.) case #: Applicant notified: l� Is work related to a BUILDING PERMIT? El Yes ❑■ No By: Date: -C If so,please specify(BUILDING PERMIT)case#: I:\CURPLN\Masters\Land Use Applications Rev.07/09/2015 City of Tigard • 13125 S\X'Hall Blvd. • Tigard,Oregon 97223 wwwtigard-or.gov • 503-718-2421 • Page I of 4 TOA Ff I C 2Esr e 1 C T f aNS No Dark o• Gvwe­�-km 01 b�Qe Q4, o v 1 ' -r,,- 3 p n.` 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(%)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 ay be attached to or imposed upon the subject propem,. • 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. Y-A,it ,�7j� Jack Nygard for Scott Sarber 12/23/16 ` pplicant orized Agent's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date Owners signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SCI Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES FOR STAFF USE ONLY Public Facility Improvement(PFI) Permit: DETAILED SUBMITTAL REQUIREMENTS APPLICATION FEE Part 1: Required submittal fee$300.00 FRANCHISE UTILITY AND SIDEWALK/ PERMIT FEE DRIVEWAY AND UTILITY Part 2: All non-water system improvements CONNECTIONS,ETC. Engineer's estimate X 5% (less $300.00 submittal fee) (work in the right of way) Engineer's estimate X 2%Plan Review Sketch (including information below) WATER SYSTEM FEE ❑ Dimensions Part 3: All public water system improvements ❑ Street Name Engineer's estimate X 12% ❑ Site Address PFI Permit Fee Exemptions: There will be no permit fee charged,or assurance required FULL SCALE DEVELOPMENT for the following types of work: (Subdivisions/Partitions and Street Improvements) • Sidewalk repair (less than 20 lineal feet) • Relocate or replace mailbox Design Plans • Ditch cleaning that does not involve regrading. (6 sets,24x36 or 22x34) • Weephole repair ❑ Cover—Site,Vicinity,Abbreviation,Legend • Curb repair or replacement(less than 20 lineal feet) ❑ General Notes(City,Water,Sewer,etc.) • Lawn sprinkler system installation or repair ❑ Street(Plan,Profile) • Street tree pruning or planting ❑ Water,Storm and Sanitary(Plan Profile) • Planter strip landscape maintenance ❑ Water Quality Facilities • Test wells ❑ Grading ❑ Landscaping/Tree Plan ❑ Composite Utility Plan(Electrical,Phone,Gas, Note: A cash assurance maybe required per Storm,Sanitary,Water,Signage,Street Lights,etc) TMC 15.04.140.(customer deposit) ❑ Details ❑ Traffic Sight Distance ❑ Signing and Striping ❑ 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 PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 3 of 4 SAMPLE SKETCH: S W 19T r» St _ Edge of Pavement I Ditch Streetlight I - -----------_ —r--- Rain r 1 I � � fitr Tragi � a 1 I I C�ft0 9 a 1 ' Tl�ro'pos d'SSw`er'Crne'a 1 Existing House I I I Existing 1 �� I �� Driveway CI w I CC)01 - 0 d a, I i >� I i 0 Existing Shop I Powerpole I I I a I C) 0 I --------7ropertyLine----------- � I 1 I I Fire Hydrant(FH) � � I Scale: 'I"=30' � 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 of Tigard - 13125 SW Hall Blvd. - Tigard,Oregon 97223 - wwwtigard-or.gov - 503-718-2421 - Page 4 of 4 1 z 2 Z LU M LU N� OF rn 00 za U �p U) NLD m C7 ~ Q N T U O U END PUSH/PULL OF 40CT FIBER CID OPTIC CABLE THROUGH EXISTING CONDUIT AT EXISTING PEDESTAL. L(/ END PUSFVPULL OF 18CT FIBER OPTIC CABLE THROUGH EXISTING BEGIN H C� CONDUIT AT EXISTING PEDESTAL. CABLLEE THROUGH GH EXISTING CONDUIT.OF 4BCT FIBER OPTIC + EXISTING CONDUIT L � co Y3 BEGIN AERIAL OVERLASH OF NEW 48CT 3 FIBER OPTIC CABLE TO EXISTING STRAND S IN THE WASHINGTON COUNTY ROW. SW LOCUST ST ' S 102 '-61' 200' d 5120/10245 0—-- 18 -- - - 1➢ 157719580 39509578 /4590/9496 SHINGTON COUNTY ROW. O25 E%ISTING CONDUIT END AERIAL OVER / ®25 EXIT WA BEGIN PUSH/PULL OF 4BCT FIBER OPTIC JJJ N a � CONTINUE AERIAL OVERLASH IN CABLE THROUGH EXISTING CONDUIT. CITU OF TIGARD ROW. E g gw �8 SCALE:t+w 1.ALL WORK AREAS TO BE ( ' r o RESTORED TO LIKE OR BETTER ^V -� CONDITION. N �a 2.ALL OTHER UTILITIES ARE BASED =° y OFF EXISTING LOCATES OR UTILITY U �I STRUCTURES. N 3.IT IS THE CONSTRUCTION CONTRACTORS RESPONSIBILITY TO CALL FOR LOCATES BEFORE DIGGING. RPI 4.EX.STRAND- S.EX.CONDUIT- CMPA-8325-5585 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 can not be maintained, or when traffic can not 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 ERRATA: 25 100 100 100 75 30 100 SupplementTable 125 40 350 350 350 150 Updated:February 12, 2016 45 180 8y:000i Traffic Roadvray 50 500 500 500 210 Section 55 1 250 Sign Spacing and Buffer Lengths (feet)Supplement Posted Spacing Between Signs "Buffer" Speed A B C Space 60 285 Chapter 5 December 2011 65 700 700 700 325 70 365 2011 Edition Page 81 Shoulder Work w/ Minor Road Encroachment Diag. 300 ROAD WORK • AHEAD > I • Initial Warning A • Sign • • • (ppItionan • • Protection Vehicle w/TMA(both Optional) See Chapter 4 • Buffer 10' • minimum • L/3 A ROAD NARROWS (Optional) B ROAD WORK AHEAD Initial Warning Sign December 2011 Chapter 5 Page 108 2011 Edition 5.5 Multi-Lane Roads Right Lane Closure, Multi-Lane Non-Freeway Diag. 500 Diagram 500 covers work which closes the right lane of a multi-lane non- freeway road. If closing more than one lane on a multi-lane road, provide a minimum tangent distance of 2L between the end of the first lane closure taper and the beginning of the second lane closure taper. 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. When the posted speed is 40 mph or less, the RIGHT LANE CLOSED AHEAD signs may be omitted. 4. Placement of signs in a non traversable median or other median that is not a two-way left turn lane is required for lane closures any time there is room for a truck to be parked on the left, out of the travel lane. When there is no room for a truck to be parked on the left an additional RIGHT LANE CLOSED AHEAD sign should be placed on the right side and placement of signs in the median is optional. 5. If flagging is needed for work vehicle ingress/egress, use Flagger Layout Detail (see Inset). Sign Spacing and Buffer Lengths (feet) Posted Spacin Between Signs Buffer Speed A B C Space 20 50 ERRATA: 25 100 100 100 75 30 100 Supplement Table 35 125 40 350 350 350 Updated:lebuary 12, 150 2016 45 180 By;O By:OD01 lrific Roadway 50 500 500 500 210 Section 55 1 250 Si n Spacing and Buffer Len the feet Supplement Posted Spacing Between Signs "Buffer" Speed A B C Space 60 285 65 700 700 700 325 Chapter 5 70 365 December 2011 2011 Edition Page 109 Right Lane Closure, Multi-Lane Non-Freeway Diag. 500 1 4 t t • Protection Vehicle • w/TMA(both Optional) • See Chapter 4 f I � I I I . • BURK ••+ tTt I n I B,a r I � A I � I B BE •. L L STOP I -1 -1---- --� (OP111«w► FlaggerDetLayout La ail A * I i■ B * See Note 4 nor LANE * - CLOSED 414 t It ALHEAD ROAD * WORK AHEAD December 2011 Chapter 5 Page 118 2011 Edition Lane Closure at Intersection with Flagging Diagram 620 Diagram 620 covers work within an intersection when normal traffic control must be interrupted. Work vehicles may or may not be in the work space. 1. During flagging, traffic signals shall be turned off. Contact the road jurisdiction for approval and assistance (see Chapter 3). 2. For multi-lane facilities, traffic approaching the intersection shall be reduced to a single lane on each approach. See Chapter 3 for information on flagging through intersections. 3. There should be one flagger for each approach. One flagger may control two adjacent approaches if sight distance, low volumes on side roads, and flagger position allows for safe operation and clear direction to motorists. For low traffic volume intersections (fewer than 400 entering vehicles per day), one flagger may be used. 4. 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 may be expected. Sign Spacing and Buffer Lengths(feet) Posted Spacin Between Signs Buffer Speed A B c Space 20 50 ERRATA: 25 100 100 100 75 30 100 Supplement Table 35 350 350 350 125 40 150 Updated:Tebwa y 12, 45 180 2016 ay:000T Tratfic Roadw y 50 500 500 500 210 Section 55 250 Sign Spacing and Buffer Lengths (feet) Supplement Posted S acin Between Signs "Buffer" Speed A B C Space 60 285 65 700 700 700 325 70 365 Chapter 5 December 2011 2011 Edition Page 119 Lane Closure at Intersection with Flagging Diagram 620 ROAD wDRlc I AwaD l 4 t Aw�D B PREPARED ro eroP � B A (oma (ARE ROAD 100&Ms ' PREPE AHED ROAD ' ros oP vMW . AIGD A B B C Amer : e K K K K -100L MML c B4 B A ROAD BE wow( PREP AHEADro Stop loot.M- • • RDAD • FIG AD ,1 (00-00 A B eE PiO:PMED ro sroP (OP WW 1 t C Aw:AD December 2011 Chapter 5