HomeMy WebLinkAboutEXCAVATION PERMIT - 19-00512 - STOKS AVE- WATER LINE INSTALLExcavation Permit ..an
Public Works a,'Vv"„ CIYYOP
REXBURG
35 North Is East Johnm®rex
burp.wp Phone: 208.359.3.20x2373 APm¢Rslamgycweav�ry
Rexburg. 8J 83440 www.rexbtag.wg Frac 203.359.3022
Time Received:y t 8 Starting Date & Time:
Date Issued: Area of Street Repair: 5 S p � (So y
IZ�1
AUTHORATION IS HEREBY GIVEN TO — Phone No. J - '-' 59
CnntrmnttcMA.,.,,1�„'_ s 3
To make an excavation in �uablic pz6t ofway at ( nc1M for the
purpose ofJnkl fB- l_rnP �17fml Location of
excavation: u+aspnmt street
❑ alley 0 in lawn El behind sidewalk 11 undeveloped
Refund to: Amount Refunded:
CONDITIONS OF PERMIT
1. No excavation shall be made in any city street orright ofvrey without fust obtaining an excavation permit end paying the
required fees.
2. This permit is good for 30 calendar days after issuance.
3. Contractor is to carry a minimum of$500,000 in general liability insurance to cover possible damages that maybe caused by the
excavator, or any aceidentcaused by the work
4. The permit fee Within the public right ofway is 51000 for any excavation that will disturb leas than 30 square yards ofaspielt
surfscmg. A fee of$100 will be retained from the permit fee to cover city inspection coats.
5. For excevatons that will disturb more than 30 square yards ofasphaa surkeing, the permit fee will be determined by the city on
an individual basis.
b. The contactor is in notify the city prior m placing backfill material and final asphalt placement. Ifthese conditions are
acceptable ce the city enginar, $900 ofthe permit fee will be refunded within 30 calendar days ofcompletion.
7. Ifsated conditions are not ma; the city may hold the permit fee for ora year from final asphalt placement. In the event repair;
are needed, the contractor will be responsible for the repairs. Ifcontmmor fails to make the repairs, the city may do the repairs and
remin the permit The and permit holder is responsible for my coat overruns.
S. The contractor is to notify Dig Line at 1-800-342-1585, at least two (2) business days in advance ofan excavation.
9. The coatracmr shall famish and maintain all barricades, signs, and flagrnen as required by the Manual on Uniform Traffic
Control Devices (MUTCD).
10. Existing asphalt pavement shall be saw cut in provide a vertical surface.
11. Excavation and backfill work shall be completed in accordance with the requteaams, of Sections 300 and 800 ofthe ISPWC
(Idaho Standards mrPubhic Works Constractien). 8ce summary attached.
12. All excavated material "I be stockpiled for rause or immediamlyremoved&amthe sits ifit is meaceptable fm reuseas
backfill. Keep excavated material safely away from the trench and from the traveled roadway.
13. lixeavadons made in all stream shall be backfilled with 3 feet of flowable 311, 4 inches of314 inch emahed aggregate mad haw,
and 2 Y. inch minimum thickness ofpleat mix pavement surface or equal to the exiningmaterial thinkuws, whichever Is greater.
14. Exis&gwphaltpavementshellbe''tacked"priormmwasphaltplce .
15. Final repair of asphalt surfaces is to be completed within 10 calendar days ofthe initial excavator, In the winter, a temporary
mid mit paving must be placed and maintained by the contractor mill final paving is completed as soon as weather permits in the
spring.
In making application for this permit, I hereby agree to the above conditions of the permit and applicable City
Ordinances.
Contract, Address: �OX /1 By:
Approv day of 20_ Office of th City Clerk
Issued by:
AUG 1 d 2019
Office Use Only: CIt/ O[ I Rex°c, (' Revised 2/1/11
Receipt Codes: [ ] $900=5DEP [ ] $100-iMISC
Xpress Bill Pay - Payment Processing
s REXBURG
XBP Confirmation Number: 86800834
City of Rexburg
36 N tat East I PO Box 280
Rexburg, ID 83440
2W369-3020
ub@mxburg.org
Page 1 of 1
o Transaction detail for payment to City of Rexburg. Date: 08/19/2019 -4:20:32 PM
Transaction Number: 110324539PT
Visa — XXXX.XXXX.XXXX-1763
Status: Successful
Account# Item Quantity Item Amount
Excavation Pen -nit Fee 1 $100.00
Excavation Pennit Dep 1 $900.00
Notes: 1154 BOND AVE MOUNTAIN VALLEY CONSTRUCTION
TOTAL: $1000.00
Billing Information Transaction taken by: mananna
JODY BUTLER
.83440
https://secure.xpmssbillpay.com/co=on/payment_process.php 8/19/2019