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HomeMy WebLinkAboutPermit_INDOT ROW Approval_11-19-07Reference pt. number STATE OF INDIANA INDIANA DEPARTMENT OF TRANSPORTATION THE APPLICANT AGREES TO INDEMNIFY, DEFEND, EXCULPATE, AND HOLD HARMLESS THE STATE OF INDIANA, ITS OFFICIALS AND EMPLOYEES FROM ANY LIABILITY DUE TO LOSS, DAMAGE, INJURIES, OR OTHER CASUALTIES OF WHATSOEVER KIND, OR BY WHOMSOEVER CAUSED, TO THE PERSON OR PROPERTY OF ANYONE ON OR OFF THE RIGHT-OF-WAY ARISING OUT OF, OR RESULTING FROM THE ISSUANCE OF THIS PERMIT OR THE WORK CONNECTED THEREWITH, OR FROM THE INSTALLATION, EXISTENCE, USE, MAINTENANCE, CONDITIONS, REPAIRS, ALTERATION, OR REMOVAL OF ANY EQUIPMENT OR MATERIAL, WHETHER DUE IN WHOLE OR IN PART TO THE NEGLIGENT ACTS OR OMISSIONS (1) OF THE STATE, ITS OFFICIALS, AGENTS, OR EMPLOYEES; OR (2) OF THE APPLICANT, HIS AGENTS, OR EMPLOYEES, OR OTHER PERSONS ENGAGED IN THE PERFORMANCE OF THE WORK, OR (3) THE JOINT NEGLIGENCE OF ANY OF THEM; INCLUDING ANY CLAIMS ARISING OUT OF THE WORKMEN'S COMPENSATION ACT OR ANY OTHER LAW, ORDINANCE, ORDER, OR DECREE. THE APPLICANT ALSO AGREES TO PAY ALL REASONABLE EXPENSES AND ATTORNEY'S FEES INCURRED BY OR IMPOSED ON THE STATE IN CONNECTION HEREWITH IN THE EVENT THAT THE APPLICANT SHALL DEFAULT UNDER THE PROVISIONS OF THIS PARAGRAPH. Miscellaneous RIGHT OF WAY PERMIT State Form 41769 (R5 / 3-00) Approved by Auditor of State, 2000 Approved by State Board of Accounts, 2000 Type of Permit: Excavation Pole Line Bridge Attachment Bond required: If Yes, Penal Sum Bond number District Subdistrict Telephone number Project locations: District Regulatory Supervisor District Director $ SPECIAL PROVISIONS: Name of company organization Telephone number Signature of permit applicant Printed name of permit applicant No $ PERMIT FEE: (Make check or bank draft payable to "Indiana Department of Transportation") Project description: Project purpose: Application number Road number County number Expiration date Issue date Permit number Address (number and street, city, state, ZIP code) Inspector Yes T0000025887 -- -- Cripe Architects + Engineers 29 Crawfordsville 11/19/2008 Paula Gibson ✘ 11/19/2007 55 E07C4CR0034 ✘ Sherri Wilson 765-361-5607 Automated carwash facility, roadways, and utility infrastructure. We are requesting to encroach in the right of way along Michigan Rd up to the existing swale flowline with an earthen berm and landscaping consisting of shrubs, flowers, and trees. 375 lineal feet south from the intersection of 106th St and Michigan Road. The site is located on the west side of Michigan Road from that point. To provide a service to the community's patrons and to establish a greenbelt buffer between the development and Michigan Road. US-421 90.24 State of Indiana Department of Transportation GENERAL PROVISIONS 1. All work described in the permit shall be subject to the inspection of the Department of Transportation and the permittee shall adjust or stop operations upon direction of any police officer or Department of Transportation employee. 2. The permit may be rescinded at any time by the Department of Transportation at its discretion or for noncompliance with any and/or all provisions of said permit. 3. The permittee shall notify the Department of Transportation Subdistrict five (5) working days preceding the beginning of any work activity. 4. The permittee shall notify the Department of Transportation Subdistrict that the work is complete and this notice is to be provided within seven (7) days from comp letion of all work on this permit. 5. The permittee shall have the permit complete with drawings and special provisions in their possession during work operations and will show said permit on demand, to any police officer or authorized Department of Transportation employee. 6. The permittee shall pay the Department of Transportation for any inspection costs where it is necessary to assign a Department of Transportation employee to inspect the work. The permittee shall immediately reimburse the State upon receipt of an itemized statement. 7. The permit is valid through the stated expiration date. If work is not completed within the allotted time, the permit is automatically cancelled unless an extension is requested prior to the expiration date and said request is approved by the Department of Transportation. If a permit is cancelled, a new application must be submitted and approved before the proposed work can be accomplished. 8. The permittee shall erect and maintain all necessary signs, barricades, detour signs, and warning devices required to safely direct traffic over or around the part of the highway where permitted operations are to be done so long as the work does not interfere with traffic, in accordance with Section “VI” of the Indiana Manual of Uniform Traffic Control Devices. 9. All construction and materials used within the highway right-of-way must conform to the current Department of Transportation “Standard Specifications” with the permittee being considered in the same status as the contractor. 10. The permitted operations shall not interfere with any existing structure on the Department of Transportation right-of-way without specific permission in writing from the Department of Transportation. In the event that any buildings, railings, traffic control devices, or other structures are damaged, said cost of the removal and/or damage shall be borne by the permittee. 11. This permit does not apply to any State roads or bridges that are closed for construction purposes, or to any county roads or city streets. 12. Approval of the permit application shall be subject to the permittee obtaining all necessary authorizations from local authorities and complying with all applicable laws. The issuance of the permit shall in no way imply Department of Transportation approval of, or be intended to influence any action pending before a local board, commission, or agency. 13. The permitted operations shall be allowed on state highway right-of-way only between sunrise and sunset and shall not be performed on Saturdays, Sundays, or during the period beginning at 12:00 Noon on the last weekday (Monday through Friday) preceding and continuing until Sunrise on the day following: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas. 14. In accordance with the notice requirements of Indiana Code 4-22-1-25, any objection to the conditions and provisions of an approved permit must be submitted in writing to the Department of Transportation within fifteen (15) days from the issue date. Approved INDOT Permit Number E07C4CR0034 STATE OF INDIANA INDIANA DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY PERMIT SPECIAL PROVISIONS State Form 3321 (R4 / 2-00) 1. All existing utilities and other underground facilities such as traffic signal appurtenances must be located prior to commencing excavation. 2. The permittee shall not disturb nor manipulate any existing traffic control devices. Any damages to a traffic control device shall be repaired immediately at the permittee’s expense by a State prequalified contractor. Contact the Signal Technician at the appropriate District Office (see telephone numbers on page 3) five days prior to doing work in the right-of-way that will effect any existing traffic control devices. 3. All cuts and trenches in and across the Right-of-Way of the State Highway shall be made by the permittee. After the work of installation of the project, the permittee shall restore all pavement surfaces and Right-of-Way according to requirements, specifications, and under the inspection of the Department of Transportation. 4. If private drives or commercial drives with a paved surface are to be open cut, a letter of approval must be obtained from the drive owner. 5. Pavement Removal a) Bituminous Pavement – The trench or area to be removed shall be sawed to a minimum depth of 2 inches. Breakage shall be confined to required lines. The edge of the area after removal shall be such that the maximum variation from the vertical will not exceed 1 ½ inches. In trimming and straightening these edges it may be necessary to use hand methods. Methods and equipment used in cutting, breaking, and removal shall not cause undue breakage, excessive shattering or spalling of the bituminous pavement to be left in place. b) Concrete Pavement – The depth of the concrete pavement shall be the same as the removed pavement except it shall be a minimum of 9 inches. Anchor bolts shall be placed along all sides of the removed area. The spacing shall be 3 feet center to center on the transverse side and 5 feet center to center on the longitudinal side with a minimum of 2 anchor bolts on a side. The anchor bolts and steel reinforcing shall be the same type and shall be placed as specified in Department of Transportation Standard Sheets. The concrete used shall be high early strength as set out in the Indiana Standard Specifications, except test beams will not be required. c) Bituminous Pavement over Concrete Pavement – The concrete pavement replacement shall consist of 9 Inches of high early strength concrete placed so the top elevation of the new concrete is the same as the top elevation of the original concrete payment or original brick pavement. The concrete used shall be high early strength as set out in the Indiana Standard Specification, exc ept test beams will not be required. The portion of the pavement replacement, from the top of the new concrete pavement to the present pavement elevation shall consist of a bituminous base mixture placed in thoroughly compacted lifts of no more than 3 inches in depth, and the top lift of 1 inch shall be a bituminous surface mixture properly compacted. All exposed bituminous edges shall be treated with bituminous tack. A “Wacker-Rammer” compactor or equivalent shall be used for compacting the bituminous mixtures. The surface course shall meet Department of Transportation Specifications for smoothness. SUB-GRADE The sub-grade on which the concrete or bituminous mixture is to be placed shall be compacted thoroughly prior to the placing of the pavement. 6. All cuts in the pavement area shall be opened to traffic at all times except when the permittee is working at the site. If the cut in the pavement cannot be completed in the working day, it shall be temporarily backfilled, with the top 3 inches consisting of a temporary bituminous mixture, or the cut can be covered with a steel plate of Application number Road number County Expiration date Issue date Permit number T0000025887 US-421 29 11/19/2008 11/19/2007 E07C4CR0034 Approved INDOT Permit Number E07C4CR0034 sufficient size and thickness to satisfactorily carry the traffic. The steel plate shall be properly fastened down so as not to create a hazard. A steel plate shall also be used to cover any concrete area during the curing period. All steel plates must be labeled for emergency notification. Utility company name and 24 hour notification telephone number shall be visible at all time. 7. (A) All excavation from cuts in the pavement and shoulder area shall be removed from the Right-of-Way. The backfilling of this area shall be Compacted Aggregate Base or “B” Borrow. The compacted aggregate base or “B” Borrow shall extend beyond the shoulder line at a slope of 1 to 1. This backfill shall meet Department of Transportation Standard Specifications. (B) Backfilling of all trenches outside of the shoulder lines on State Highway Right-of-Way shall be made with pit run sand and gravel mixture or with material acceptable to the Department of Transportation, except for the Top 12 inches which must be filled with top soil and compacted. Grass seed and fertilizer shall then be placed on the top soil which has been prepared in accordance with Department of Transportation Specifications on seed bed preparation. a) When the trench is excavated or plowed in a lawn area that is moved, the applicant shall replace all disturbed areas with sod. The sod shall be place and maintained according to the Department of Transportation Specifications. b) Sod may be required at other areas where erosions may be a problem. 8. The permittee shall at all times protect the pavement surface and right-of-way from damage due to the use of heavy equipment, and shall provide and use approved pads, planks, or dirt cushion to protect against other damage. Immediately before any section of the highway is to be placed back in use for traffic, the permittee shall remove all excess dirt and sweep the pavement surface to eliminate unnecessary dust hazards. 9. The Permit Inspector in the local subdistrict or district office shall be notified 24 hours in advance of the pouring of concrete or the placing of bituminous mixture. (see telephone numbers on page 3) 10. Tunneling under State Highway pavements will be allowed when approved by the Department of Transportation. Pipe for such tunnels shall be approved pipe as specified on the plans, inserted in the tunnel lining and the excess space filled wit concrete as specified on the plans. Tunneling methods, supports and operations shall be subject to the approval of the representative of the Department of Transportation assigned to inspect the work. Proper backfilling must be done around the tunnel lining in order to prevent any settling of the pavement and Right-of-Way. 11. The top elevation of all manholes shall be held to ground or road surface level. 12. The permittee shall be responsible for the proper replacement of any driveways, driveway pipes or sidewalks That are disturbed during the permit work. 13. Drainage on shoulders, ditches, or otherwise on the Right-of-Way shall not be obstructed. Appropriate control measures shall be followed to protect the right-of-way from erosion. 14. All permits shall conform to the current INDOT Utility Accommodation Policy. 15. Within seven (7) days after a new installation or repair to an existing installation is performed, all excess dirt or obstruction caused by the installation or repair must be removed and the area must be restored to a condition by the permittee so as not to interfere with mowing the Highway Right-of-Way. 16. Upon completion of all pavement cuts and before work crew leaves the work area, the permittee shall furnish and place the appropriate color spot on the existing road surface next to the side of cut nearest the edge pavement. 17. The permittee agrees, as a condition of approval of this permit, to move or remove any structures installed under this permit, at the permittee’s own expense should future traffic conditions or road improvement necessitate and when requested to do so by INDOT except for on the National System of Interstate and Defense Highways as outlined in the Indiana Code. 18. Work shall be performed in accordance with the attached plans. 19. If at any time in the future, this installation should become damaged due to normal maintenance or roadwork Approved INDOT Permit Number E07C4CR0034 by the INDOT, the permittee shall be responsible for all repairs, and cost of repairs that may arise from such damage. 20. Any poles installed under this permit, including brace poles and guy poles should be placed within 1’6” of the Right-of-Way line. Exceptions to this placement policy will be granted only for special conditions and must be explained on the application. 21. Any pole line installed under this permit will comply with all regulation outlined in the National Electrical Safety Code, and any other handbook issued by the Department of Commerce Bureau of Standards, which refers to the installation and maintenance of communication lines. 22. No trees or plants on the Right-of-Way of any State Highway will be trimmed or removed without written permission from the Department of Transportation. 23. Work performed under his permit will not interfere in any way with any pole line or other existing structure along or across the State Highway. 24. Work within the sodded areas of the Right-of-Way is not to be performed during wet periods. Any damage to the sodded areas of the Right-of-Way must be repaired and properly seeded. 25. If traffic is to be stopped on the highway the applicant must notify State Police for assistance in traffic control within five (5) days prior to construction. Traffic will not be stopped longer than five (5) minutes. INDOT DISTRICT OFFICES Crawfordsville District Fort Wayne District Greenfield District P.O. Box 667 5333 Hatfield Road P.O. Box 667 Crawfordsville, IN 47933 Fort Wayne, IN 46808 Greenfield, IN 46140 (765) 362-3700 (219) 484-9541 (317) 462-7751 LaPorte District Seymour District Vincennes District P.O. Box 429 185 Agrico Lane 2526 N. 6th Street LaPorte, IN 46350 Seymour, IN 47274 Vincennes, IN 47591 (219) 362-6125 (812) 524-3700 (812) 882-8330 Approved INDOT Permit Number E07C4CR0034 Frankfort Doug Gendron 7172 Graham Road Indianapolis, IN 46250 317-845-7119 Approved INDOT Permit Number E07C4CR0034