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Home My WebLink AboutEXCAVATION PERMIT - 22-00500 - 103 S 12th W - PLACING NEW CATV LINEExcavation Permit Application C1 r s a :: Public WorksIi n ra 35 North isi East keifhdt3re:rburg.org Phone: 208.359.3020 x2320 a,.R;u:'s rcnn:�j�Ccm..ej Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022 Applicant/Contractor: XM Service Company LLC nate: 7-6-22 Mailing Address: 1418 w rolnrado City: IDAHO FALLS state: in 83402 Primary Phone (13Hnme OWork IRCell) 208 521-3208 /BRETT Emafl: kmspntinprmmpaw(Dvahoo.Com Excavation Address: 103 S 12TH W Description: WE WILL BE DOING A ROAD BORE ON 12TH WEST FOR CABLE ONE Location of Excavation: IX Street D Alley ❑ Sidewalk O Undeveloped/Landscape Area Purpose of Excavation: PLACING NEW CAN LINE Exe.Date: Refund Recipient Name (if different from above): Refund Recipient Address: COISMMONS OF PERMTT: City: Phone #: Zip: 1. No excavation within city right of way limits shall take place prior to the issuance of an excavation permit 2. property owners must be made aware of work happening adjacent to tbehrpamels. An "Acceptance of Surface Repairs- form must be signed by the property owner(s) prior to the excavation work being signed off by the City. (See Attachment A) 3. This permit expires 30 days after the issue date. Any work started and not completed within 30 days will be assessed a $100 weekly inspection fee until work finalized. 4. The contractor is responsible for carrying a minimum of $500,000 general liability insurance coverage for possible damages during excavation or other accidents- A certificate of liability is required and must be submitted via email at custometservicestaxexbrne ora. 5. The public right of way fee is $1,200 for any work that will disturb less than 30 square yards of asphalt surfacing. A $200 portion of this fee will be retained by the city for initial inspection costs. 6. Excavation work which disturbs more than 30 square yards of asphalt surfacing must be individually assessed by the city for additional fees. 7. All utilities must be placed a minimum of 4 feet below the finished grade unless specifically authorized otherwise in writing. S. The contractor is responsible for contacting the city prior to placing backfill material and/or asphalt in city sheet locations. A city represeorative will then assess and, if acceptable, the excavation fee less inspection costs will be refimded within 30 calendar days of completion. 9. If permit conditions are not met the city will hold fees for I year from final asphalt placement If repairs are required, the contractor will be responsible for completing all repairs. If repairs are not made within 7 days, the city will complete repairs. The permit fee will be retained and any additional casts will be the responsibility of the permit holder. 10. The contactor must notify Dig Line at 1-800-342-1585 at least two (2) business days in advance of the excavation date. 11. The contractor is responsible for furnishing and maintaining all barricades, signs, and flagmen as required by the Manual on Uniform Traffic Control Devices (MUTCD). 12. Existing asphalt pavement shall be saw cutpior to placement of asphalt to provide a vertical surface. 13. Excavation and backfidl work is to be completed in accordance with the requirements of Sections 300 and 800 ofthe Idaho Standards for Public Works Construction MWC). (See Attachment 13.) 14. All excavated material, if acceptable for re -use shall be stockpiled or ifnot acceptable be immediately removed from the site. Excavated material needs to be kept a safe distance from trenches or traveled roadways. 15. All street excavations must be backfilled with 3 feet of fiowable fill, 4 inches of %inch crushed aggregate road base, and 2 h inches minimum thickness of plant mix pavement surface or equal to the existing material thickness, whichever is greater. No exceptions unless pre -approved by eitypublic wanks director - 16. Existing asphalt pavement shall be `tacked' prior to new, asphalt place^^^• 17. Final repair of asphalt surfaces most be completed within 10 calendar days of the initial excavation. 18. No excavation permits will be approved from November I" -March 3 1 F except in the case of an emergency which must be approved by the city public works director. Winter excavation requires a temporary cold mix paving to be placed and maintained by the contractor until the final paving is completed no later than May Is. In completing this application for an excavation permit, I hereby agree to all the above conditions as well as all applicable Cityof Rexburg ordinances. ///�I (r.Lft,/J w �✓ 9-4AZt ilei u2 7-6-22 Applicant Signature Date '.Applicmmt wilt be noted ofpe d application approval and requestfora deposit to be submured before ercamnon can begin. Revised 142/2021 (Attachment B) Backfill Material Reauirements Backfill material shall meet the above gradation requirements and be placed in 12 -inch maximum loose lifts and compacted to 95% of maximum density in accordance with AASHTO T 99. 1/2 -inch Class Ili Plant Mix Pavement shall be compacted to between 92% and 95% of maximum density in accordance with mix design. Asphalt surfacing must extend I foot beyond the trench sides in all directions or a minimum of 4 feet in width, whichever is greater. Minimum asphalt thickness shall be 2 %: inches or equal to the existing material thickness, whichever is greater Final surface deviation must be within +/- W' or less of surrounding surface conditions unless approved by the City of Rexburg Engineer. Damages caused by the excavation must also be repaired at contractors' expense. Excavation Permit Summary ✓ XI Obtain Permit prior to starting excavation ✓ X Notify Dig -line at 1-800.342-1585 ✓ )0 Provide Insurance ✓ Nl Backfilled with flowabie fill ✓ Xi Notify city prior to backfilling, or loose refund ✓ Compact all backfill- see attached specifications ✓ tX Fill and compact the tip of the trench with approved gravel ✓ N Notify city prior to paving, or loose refund ✓ XI Paving surface to be completed within 10 days, or city will complete ✓ A Paving to be done according to attached specifications ✓ )0 Fix surface repair if it fails or the trench settles ✓ ❑ Notify parcel owner ✓ ❑ Return signed parcel owner acceptance form to the city Revised 12/2/2021 Y Minus 3/4" crushed Road Base e 3 in. 100 I in. 100 314 in. 90-100 3/8 in. No.4 25-60 40-65 No. 8 30-50 No. 200 0-12 3-9 Backfill material shall meet the above gradation requirements and be placed in 12 -inch maximum loose lifts and compacted to 95% of maximum density in accordance with AASHTO T 99. 1/2 -inch Class Ili Plant Mix Pavement shall be compacted to between 92% and 95% of maximum density in accordance with mix design. Asphalt surfacing must extend I foot beyond the trench sides in all directions or a minimum of 4 feet in width, whichever is greater. Minimum asphalt thickness shall be 2 %: inches or equal to the existing material thickness, whichever is greater Final surface deviation must be within +/- W' or less of surrounding surface conditions unless approved by the City of Rexburg Engineer. Damages caused by the excavation must also be repaired at contractors' expense. Excavation Permit Summary ✓ XI Obtain Permit prior to starting excavation ✓ X Notify Dig -line at 1-800.342-1585 ✓ )0 Provide Insurance ✓ Nl Backfilled with flowabie fill ✓ Xi Notify city prior to backfilling, or loose refund ✓ Compact all backfill- see attached specifications ✓ tX Fill and compact the tip of the trench with approved gravel ✓ N Notify city prior to paving, or loose refund ✓ XI Paving surface to be completed within 10 days, or city will complete ✓ A Paving to be done according to attached specifications ✓ )0 Fix surface repair if it fails or the trench settles ✓ ❑ Notify parcel owner ✓ ❑ Return signed parcel owner acceptance form to the city Revised 12/2/2021