HomeMy WebLinkAboutEXCAVATION PERMIT - 22-00204 - 76 W 2nd S - INSTALL CABLE TV SERVICEExcavation Permit Application,�=a�4<,, C t r OF
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Rexburg, ID 83440 www.rexburg.org Far. 208.359.3022
ApplicantlContractur: KM Service Company LLC Date: 3-25-22
mamng-Address: 1418 w Colorado City: IDAHO FALLS State: ID Zip: 83402
Primary Phone ( ❑Home ❑work MCeU) 208 521-3208 /BRETT Email: kmseryicecompany-(EDyahoo.com
Excavation Address: 76 W 2nd S /CAFE RIO Description: WE WILL BE BORING DOWN THE R.O.W.
THEN CROSSING THE ROAD
Location of Excavation: M Street ❑ Alley I( Sidewalk ❑ Undeveloped/Landscape Area
Purpose of Excavation: CABLE TV SERVICE Exc.Date: 3-30-22-4-10-22
Refund Recipient Name (if different from above):
Refund Recipient Address:
CONDITIONS OF PERMIT:
city:
Phone #:
State: Zip:
I. No excavation within city right of way limits shall take place priorto the issuance of an excavation permit.
2. Property owners must be made aware ofwork happening adjacent to the rparoels. 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 customerservicesPrexburg.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 aminimum 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 andfor asphalt in city street locations. A city
representative will then assess and, if acceptable, the excavition 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 I year from final asphalt placemenL If repairs are required, the contractor will
be responsible for completing all repairs. Ifrepairs 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 contactormust 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 famishing and maintaining all barricades, signs, and flagmen as required by the Manual on Uniform
Traffic Control Devices (MUTCD).
12. Existing asphaltpavement shall be saw cutprior 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 sheet excavations must be backfilled with 3 feet of fiowable fill, 4 inches of/, inch crushed aggregate road base, and 2 Yz inches
minimum thickness of plant mac pavement surface or equal to the existing material thickness, whichever is greater. No exceptions unless
pre -approved by citypublic works director -
16.
rector16. Existing asphak pavement shallbe `tacked" prior to new asphak placement
17. Final repair of asphalt surfaces must be completed within 10 calendar days of the initial excavation.
18. No excavation pemrits will be approved from November la—March 31s 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 lg.
In completing this application for an excavation penni; I hereby agree to all The above conditions as well asall applicable City of
Rexburg ordinances.
a-� 3-25-22
Applicant Signature Date _ v
*4p7irn,:r,, W be aottfred ofpermit applicati., appmvat and reyuestfor a deposit to be submitted before excavation can begin
Revised 12/2/2021
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