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BOX FOR OFFICE USE ONLY EXCAVATION / ENCROACHMENT PERMIT & AGREEMENT Murray City Public Services Department 4646 South 500 West Murray, UT 84123 Application Date: Issued: Work Location: Purpose of Excavation: Name of Applicant: Billing Address: City/State: Zip: Phone: ( ) Name of Contractor: State License Number: Responsible Party: ( ) Cell Phone: ( ) Pavement Type: Approx. Size: Length Width Depth Construction Start Date: proposed Comp. Date: Time: Applicant agrees to meet all Murray City Public Works Road Cut Standards & Specification as published by Murray City Engineering Department. This permit is valid forty-five (45) days from issue date. Authorized Signature: N O T E PERMITS MUST BE TAKEN OUT 48 HOURS IN ADVANCE OF ANY CUTS AND PRESENT AT THE WORK LOCATION AT ALL TIMES. CONTRACTOR SHALL NOTIFY INSPECTOR 24 HOURS IN ADVANCE BEFORE ANY WORK CAN PROCEED. FAILURE TO ACTIVATE PERMIT MAY RESULT IN A CITATION. To activate permit contact Lynn Potter, (801)270-2402 or [EMAIL REDACTED]. Special Conditions: BOND INSURANCE □ TRAFFIC CONTROL PLAN □ Permit Fees: - $200.00 asphalt, curb & gutter, sidewalk Permit Fee: - $100.00 park strip, unpaved right-a-way, Encroachment (NON-REFUNDABLE) ---PAGE BREAK--- MURRAY CITY EXCAVATION / ROAD CUT REQUIREMENTS 1. Excavation Permit & Agreement. The applicant must complete the Excavation Permit & Agreement form, and be familiar with Murray City Standards and Specifications. 2. Access Agreements. This Permit is only valid for work in City Right-of-Ways. The Applicant / Contractor must obtain easements and or access agreements for all work outside of the City Right-of-Way 3. Bond. The applicant, in conjunction with their surety company, is required to complete a Murray City Corporation Excavation bond form. Murray City requires the use of their bond form and the bond needs to be continuous until cancelled in the amount of $10,000.00. The bond guarantees that the excavated street or public right-of-way is restored or repaired by the applicant in accordance with city specifications, or, if the repair work is done by the city, to guarantee reimbursement to the city for that work. The amount of the bond may be increased or decreased at the discretion of the City Engineer whenever it appears that the amount and cost of the work to be performed may vary from the amount of the bond. The bond shall be conditioned that the applicant shall guarantee the materials and workmanship for a period of three years from completion of such work, reasonable wear and tear excepted. 4. Insurance. The applicant must furnish a certificate of insurance in a company authorized to issue insurance by the state showing that the applicant has a comprehensive general liability and property damage policy that includes contractual liability coverage with minimum limits of $1,000,000.00 for injuries, including accidental death to any one person; in an amount not less than $2,000,000.00 on account of injuries sustained in any one accident; and property damage insurance in an amount not less than $1,000,000.00 for each accident. Murray City shall be named as a named insured on the policy. 5. Permit Fees. The applicant shall pay the Public Services Department the following fee deposit before a permit will be issued, these fees are nonrefundable. A. For excavations within asphalt or concrete, $200.00 minimum. B. For Encroachment or excavations within park strip or unpaved right-a-way, $100.00 minimum. 6. Activation/Inspection. Activation of permit must be scheduled with the inspector 24 hours prior to commencing work, 48 hours if work is scheduled on weekends or holidays. Failure to activate may result in a citation. 7. Noncompliance in work zone. If permit holder fails to comply with Murray City requirements, specifications or instructions pertinent to the permit, subsequent permits may not be issued. 8. Traffic Control Plan. The applicant shall also submit a formal traffic control plan which must meet the department's approval as a condition for the issuance of the permit. (Must meet MUTCD standards). Failure to comply with Murray City Code 12.16.060 (Traffic Control Devices Required around Excavations) may result in a citation. 9. Trench Backfill. All trench backfill material shall be a 3” minus imported granular backfill meeting AASHTO M 145 classification A-1-a. (Do not use gravel or sewer rock). Place material at a maximum lift thickness of 8” before compaction. Back fill material shall be compacted to 95% of the modified proctor density as determined by ASTM 1557. Compaction testing may be required and shall be conducted by a certified materials testing lab at the contractors/permit holders expense. Should applicant find it necessary to change this method or any part of it, approval must be obtained from the City Engineer. 10. Flowable Fill. Use flowable fill in excavations that are too narrow to receive compaction equipment. Provide 28 day 60 psi controlled low strength material as specified in Section 31 05 15 of APWA 2012 Standard Specifications. 11. Asphalt Saw Cut. All excavations in roadways shall be saw cut at least 1 foot beyond the excavation in all directions to form a patch. Remove additional pavement to a painted lane strip, a lip of gutter, a curb, an existing pavement patch, or an edge of the pavement if such street feature is within 2’ of the second cut. 12. Asphalt Patchwork. All Asphalt patchwork shall be done by an approved asphalt paving company or by Murray City Street Department. Provide full tack coat coverage on all vertical surfaces. Asphalt patch material for all roadways shall be AC-20 DM A Performance Grade asphalt mix may be required on high traffic roadways as determined by the City Engineer. Patch thickness shall be existing thickness + 1” min. residential, 6” min. arterials and collectors). Compaction testing may be required and shall be conducted by a certified materials testing lab at the contractors / permit holders expense. Do not patch if surface is wet or weather is unsuitable (no frost in ground, 46 degrees F and rising). Do not patch if wind or ground cools mix material before compaction. Paving standards are as outlined in Section 32 12 16.13 of APWA 2012 Standard Specifications. 13. Winter Moratorium. Between November 15th and March 15th, Road Cut Permits will only be issued for emergency utility repairs and will be reviewed on a case by case basis. Any exceptions will need to be approved by the City Engineer and Public Services Director. It’s the responsibility of the applicant / utility company to comply with any special conditions imposed by the City regarding restoration of the roadway for emergency cuts. Asphalt placed between November 15th and March 15th will be considered temporary and will need to be replaced when weather conditions are suitable. 14. No Cut Roads. Murray City has a NO CUT policy on roads newer than 3 years. If a road cut is absolutely necessary, extreme measures must be met to ensure that the road cut is placed back in the same or better condition, which may include mill and overlaying the proposed road cut area. (Reference Murray City Moratorium Standard and Restoration). 15. Concrete Placement. Before any concrete is placed the contractor must call for an inspection 24 hours prior to placement. It is the contractor’s responsibility to adhere to Murray City Standards and Specifications regarding concrete placement. If Murray City Standards are not followed, the concrete done will be removed and replaced at the expense of the applicant. (Reference Murray City Cold Weather Concrete Placement). 16. Painted Traffic Lines and Markings. Any Painted traffic lines and markings disturbed during the excavation shall be re-painted in the same location with materials meeting City Standards. 17. Storm Water Pollution Prevention. Catch basins and storm drain inlets within 300 feet of the excavation location must be protected from dewatering, sediment, excavated materials, and general construction debris. 18. Clean Up. Upon completion of the excavation and patchwork the area shall be swept and returned to original condition. ---PAGE BREAK--- Murray City Moratorium Standard This standard applies to new streets, streets that have been reconstructed, overlaid streets and streets that have been slurry sealed. New Streets/Reconstructed Streets: New streets/reconstructed streets shall not be cut for years from the time of completed construction. Overlaid Streets: Overlaid streets shall not be cut for year from the time the street was overlaid. If an emergency utility cut is absolutely necessary within the three year moratorium period, the Special Restoration Standard will apply. This Special Restoration Standard continues for years after the moratorium ends for all New Streets and Overlaid Streets. The engineer reserves the right to require an overlay over the full width of the street to restore the roadway to the original condition Special Restoration Standard This standard applies to new streets, streets that have been reconstructed, overlaid, and slurried street. Prior to the mill and overlay, the trench will be reconstructed per City Standards. The patch shall be placed in compliance with APWA plan no. 255 entitled 'Asphalt Concrete Patch. New Streets/Reconstructed Streets: (For Three years after moratorium ends), the asphalt surface shall be milled down a minimum depth of two inches fifteen (15) feet each way of the edge of the cut. Milling shall be done in widths equivalent to existing striped traffic lanes. The engineer reserves the right to require an area length greater than fifteen (15) feet each way of cut or a depth greater than two inches if deemed appropriate to restore the roadway to the original condition. Overlaid Streets: (For three years after moratorium ends), the asphalt surface shall be milled down a minimum depth of two inches fifteen (15) feet each way of the edge of the cut. Milling shall be done in widths equivalent to existing striped traffic lanes. The engineer reserves the right to require an area length greater than fifteen (15) feet each way of cut or a depth greater than two inches if deemed appropriate to restore the roadway to the original condition Slurried Streets: (For one year after placement only), an area not less than fifteen (15) feet from the edge of the cut (full traffic lane width) shall be re-slurry sealed with an approved Type II slurry. Between November 15th and March 15th/Emergency Permits Only Between November 15th and March 15th, Road Cut Permits will only be issued for emergency utility repairs and will be reviewed on a case by case basis. Any exceptions will need to be approved by the City Engineer and Public Services Director. It’s the responsibility of the applicant / utility company to comply with any special conditions imposed by the City regarding restoration of the roadway for emergency cuts. Asphalt placed between November 15th and March 15th will be considered temporary and will need to be replaced when weather conditions are suitable. For more information, contact the Engineering Department at (801) 270-2440. ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK---