HomeMy WebLinkAboutEXCAVATION PERMIT - 22-00782 - ABOUT 260 E 4TH N - CONNECT SEWER SERVICEExcavation Permit Application
E CITY OF
Public Works $ REXBURG
35 North 1st East keithd@rexburg.org Phone: 208.359.3020 x2320 :. tt, yCvmmu"�er
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022
Applicant/Contractor: J2YOMe+ 4OVICy% Conl%k tJt IOy1 Date: I0I1S/2022
Mailing Address: ?,0. 66% q113 City: lZfYl3Lr4 State: TO Zip:13NyO
Primary Phone (.OHomeXWork OCell).%D15-S%-SI3'J Email: _ai&It --,,L ,wunc nSi ccyp
Excavation Address: AbOw� D L L1 t- N, "'_Ar cription: ii„ $tt x{ Service Cg"Y%,Cr}iovv i -a
Location of Excavation: EJ Street ❑ Alley &f Sidewalk ❑ Undeveloped/Landscape Area
Purpose of Excavation: Conrtec� SeyJtt' Serllte- lh LA' Exc.Date: �()-2i-%ZoY 10-24-22
Refund Recipient Name (if different from above):
Refund Recipient Address:
City:
Phone #:
State: 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 their parcels. 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 customerservices(la rexbure.ore.
5. Ilic 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 minimuat of 4 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 are not met the city will hold fees for 1 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 costs will be the responsibility of the permit holder.
10. The contractor 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 cut prior to placement of asphalt to provide a vertical surface.
13. Excavation and backfill work is to be completed in accordance with the requirements of Sections 300 and 800 of the Idaho Standards for
Public Works Construction (ISPWC). (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 backfilled with 3 feet of flowable fill, 4 inches of % inch crashed aggregate road base, and 2 %: inches
minimum thickness of plant mix pavement surface or equal to the existing material thickness, whichever is greater. No exceptions ualess
pre -approved 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 111 - March 31" 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 1".
hi completing this application for an excavation permit, I hereby agree to all the above conditions as well as all applicable City of
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lignature. Dated "` Ate✓
will be notified ofpermit application approval and request for a deposit to be submitted before excavation can egin. 0
Revised 12/2/2021