HomeMy WebLinkAboutEXCAVATION PERMIT - 22-00779 - 15 W Main St - water line repairs[0 � 1
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Excavation Permit Application
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Public Works RMUwi
35 North Ist East ketthdt➢rexbu
Rexburg, 10 a3440 �.� Phone: 2 ox., 2.3020 x2320 „ , r - • _.
www.mzburg.arg Fox., 201359.3022
Applicant/Coatrnctor. Jo fit(} yy(}Y1CS
Date: 9-9-2022
Mailing Address: _jU1p4 C\woe t K l.Q,t
-,o, City: P-QXhuxcState: IV) Zip:13-lif0
Primary Phone( []HomeOWorkZCell) Email: 'Idd)rl-vvorigsldchiAtl•Cwn
Excavation Address: IS tN Mo L% l Sl -yea} Description l xCClVOtit\(rn SS'h'en ChtnO OF Nm
ixQEcra-ter uFtivaurl,r.e repatrinfivnt UFSmoh.yun21As%oCiwes
Location of Excavation: ❑ Street ❑ Alley ASidewalk ❑ Undevelope&Landscape Area
Purpose of Excavation: Qp(Lctttxs, nF I ljjj =r Isxa r(0a It Exe,Date: Q'14-zo22
Refund Recipient Name (if different from above): Phone N:
Refund Recipient Address: City; State: _Zip:
CONDITIONS OF PERMIT:
I . No excavation within city right of way limits shall take place prior to the issuance of an excavation permit
2. Properly owners must be made aware of work happening adjacent to their parcels. An "Acceptance of Surface Repairs" form must be
signed by the property owners) 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 gm ml liability insurance coverage for possible damages during
excavation or other accidents. A certificale of liability is required and must be submitted via entail atcusmnrcrservice'(irtrexbure Ore.
5. The public right of way fce is $1,200 for any work that will disturb less than 30 square yards of asphalt surfacing. A 5200 portion of this
fce will be retained by the city for initial inspection costs.
6. Excavation work which disturbs mom than 30 square yields of asphalt surfacing most be individually assessed by the city for additional
Fees.
7. Ali utilities must be placed a minimum of4 feet below the finished grade unless specifically authorized otherwise in writing.
8. The contractor is responsible for contacting the city prior to placing backfill material and/or asphalt in city street locations. A city
representative will then assess and, if acceptable, the excavation fee less inspection costs will be refunded within 30 calendar days of
completion.
9. If permit conditions me not met the city will hold fees for 1 year from final asphalt placement. If repairs am required, the contractor will
be responsible for completing all repairs. If repairs are mat made within 7 days, the city will complete repairs.ne permit fee will be
retained and any additional costs will be the responsibility of lite permit holder.
10. The contractor most 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 Ragmen as required by the Manual on Uniform
Traffic Central Devices (MUTCD).
12. Existing asphalt pavement shall be saw cut prior to placement of asphalt to provide a vesical surface.
13. Excavation and backfill work is m be completed in accordance with the requirements 0aSections 300 and 800 of the Idaho Standards for
Public Works Construction (1SPWC). (See Attachment B.)
14. All excavated material, if acceptable for re -use shall be stockpiled or if not 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 backfil led with 3 feat of ilowable fill, 4 inches of'% inch crashed aggregate road base, and 2 Yz inches
minimum thickness of pint mix pavement surface or equal to the existing material thickness, whichever is greater. No exceptions unless
pre-appmvod by city public works director.
16. Existing asphalt pavement shall be "tacked" prior to new asphalt placement.
17. Final repair of asphalt surfaces must be completed within 10 calendar days of the initial excavation.
18. No excavation permits will be approved from November I" — March 31° except in the case of an emergency which most be approved by
the city public works director. Winter excavation requires a temporary void prix paving to be placed and maintained by the contractor
until the final paving is completed no later than May I ".
In completing this application for an excavation permit, I hereby agree to all the above conditions as well as all applicable City of
Rexburg mrllmances.
cli& 9-9-2022
p Ircanl Sr um Date
"Applicanuvifl be rmrifred ofpemrii applimlion apptrotol and refit yr for a depmit m be submitted Gefore erearion can b,g