HomeMy WebLinkAboutEncroachment Permit - INDOT
RIGHT OF WAY PERMIT
STATE OF INDIANA
INDIANA DEPARTMENT OF TRANSPORTATION
State Form 41769 (R5 / 3-00)
Approved by State Board of Accounts, 2000
Approved by Auditor of State, 2000
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Type of Permit:
~ Excavation D Pole Line 0 Bridge Attachment D Miscellaneous
District Subdistrict Telephone number
Crawfordsville Frankfort 765-361-5607
Projecllocations: Reference pI. number
375 lineal feet south from the intersection of 106th 8t and Michigan Road, The site is
located on Ihe west side of Michigan Road from thai point. 90,24
Project description:
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,
Project purpose:
To provide a service to the community's patrons and to establish a greenbelt buffer between the development and
Michigan Road,
Bond required: rfyeS, Penal sum$ Bond number
DYes [KINo -- --
PERMIT FEE' (Make check or bank draft payable to "Indiana De'partment of Transportatiorl" $ 55
SPECIAL PROVISIONS:
THE APPLICANT ,ll,GREES 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 CASUAL TIES 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
Signature of permit applicant I Printed name of permit applicant
Sherri Wilson
Name of company organization ITelePhone number
Cripe Architects + Engineers 317-845-7119
Address (number and street, cily, stale, ZIP code)
7172 Graham Road Indianapolis, IN 46250
Inpeclor
aula Gibson
District Regulatory Supervisor
Doua Gendron
District Director
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State of J ndiana
Department of Transportation
GENERAL PROVISIONS
I. All w,ork described in the permit shall be subject to the inspection of the Department of Trans po nation and the permittee shall
adjust or stop operations upon direction of any police officer or Department ofTransporlation employee,
2. 'fhe permit may be rescinded at any time by the Department of Transportation al its discrction or for noncompliance with any
and/or all provisions orsaid pcrmit
3. The permittee shall notify the Department of Tra nsportation Subdistrict fivc (5) working days precedi ng the beg11l11i ng of any
work activity.
4. The permittcc shall notify the Department of Transportation Subdistrict that the work is complete and thlS notice is to be
pi'Ovided within seven (7) days from camp letion of all work on this perm it.
5. The permittee shall have the permit complete with drawings and special pl"Ovisions 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 Tr3nsportation 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, Irwork 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 submitled and approved befor'e the
proposed work can be accompl ished.
8. The permittee shfIll erect and maintain all necessary signs, bar1'lcades, detour signs, and warnmg devices l"equired to safely
direct traffic over or around the part ofthe highway where permitted operations are to be done so long as the work docs not
interfere with traffic. in accordance with Section "VI" of the Indiana Manual or L1ni form Traffic Control Devices.
9. All construction and materials used within the highway I'ight-of-way Illust conform to the current Depariment of
Transportation "Slandal'd Specitications" with the pelmittee being considered in the sallle status 3S the contractor.
10. The permitted opemtions shall not interfere with any existing structul-e on the Department of Transportation right-of-way
wilhoutspeeific permission in writing from the Department of Transportation In the event that any buildings, millngs,
trarrie con1rol devices, or other structures arc damaged, said cost of the removal and/or damage shall be borne by the
permittee,
] 1. This permit does 1101 apply to any State roads or bridges that are closed for construction purposes, or to any cOLmty roads or
city streets.
] 2. Approval of the permit application shall be subject to the permittee obtaining all necessary authorizations from local
authoi'ities and complying With all appl icable laws. The issuance of the permit shall in no vvay imply Department of
Tr'ansportation approval of, m 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-or-way only between sunrise and sunset and shall not be
performcd on Saturdays, Sundays, m during the period beginning at 12:00 Noon 011 the last weekday (Monday through
Friday) preceding ahd conti nuing unti I Sunrise on the day following: New Years Day, Memorial Day, I ndependenee Day,
Labor Day, Thanksgiving, and Christmas.
] 4. In accordance with the notice requirenlents of Indiana Code 4-22-] -25, any objection to the conditions and provisions of an
approved permit ITlust be submitted in writing to the Department of Transportation within f1"lteen (15) days from the issue
date.
STATE OF INDIANA
INDIANA DEPARTMENT OF TRANSPORTATION
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RIGHT-OF-WAY PERMIT
SPECIAL PROVISIONS
State F0l111 3321 (R4! 2 -DO)
]. All existing lltilities and other underground facilities such as traffic signal appurtenances !lUlst 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 I'e!)aired immediately at the permittee's expense by a State prequalified contractor.
Contact the Signal Technician at the appropriate District Office (see telephone numbet"s on page 3) five days
prior to doing work in the right.of.way that will effect any existing tt'affic control devices.
3. All cuts and trcnehes in and across the Right-oi:Way orthe State Highway shall be made by the penniuee. After
thc work of installation of the projeet, the permittee shall restore all pavement surfaces and Right-of-\Vay
accord1l1g to requi rements, spec i fications, and under the in spection of the Department of Transportati on.
4. If pfi vate dri ves or commercial dri ves with a paved surface are to be open cut, a letter of approvalm ust be
obtained fro111 the drive owner.
5. Pavement Removal
a) Bituminous Pavemellt- The treneh or area to be removed shall be sawcd to a minimum dcpth 0,.2 inches.
Brcakage shall be confined to required lines. The edge of the area aftcr removal shall be such that the maximum
variation from the vertical will not exceed 1 '/, inches. In trimming and straightening these edges it may be
necessary to use hand methods. Methods and equipment used 111 cutting, breaking, and removal shall not cause
undue breakage, excessive shatteri ng or spall ing of the bttum inous pavement to be left in place.
b) Concrete Pavemcnt - The depth oUhe concrete pavement shall be the same as the renlovecl pavement
exccpt it shall be a minimlllll of 9 inches. Anchor bolts shal I 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 centcr' to center on the longitudinal side with
a minimum of2 anchor bolts on a side. The anchor bolts and steel relnfOl'cing shall be the same type and shall be
placed as specified in Depar1ment of Trans pOI' tat ion Standard Shects. The concrete used shal I be high early strength
as set out in the Indiana Standard SpecifIcations, except test beams Will not be required.
c) Bituminous Pavement over Concrete P,wcmcnt - The concrete pavement replacement shall consist of 9
I nches of high early strength concrete placed so the top elevation of the new concrete is the same as the top elevation
of tile original concrete payment or original bl'ick pavement. The concrete used shall be high eal"ly strength as set
out in the] ndiana Standard Speci fication, exc ept test beams wi II not be required. The portion of the pavement
replacement, from the top oflhe new concrete pavement to the present pavement elevation shall consist ofa
bituminous base mixtme placed in thoroughly compacted lifts ofl1o more than 3 inches in depth, and the top lift of I
inch shall be a bituminous surface mixture properly compacted. All exposed bituminous edges shall be treated with
bituJlllnous tack. A "Wacker- Ram mer" eom pactor 01' equivalent shall be used for compacting the bi luminous
mixtures. The surface course shall meet Department of Transportation Specifications for smoothness.
SUB-GRADE
The sub-grade on which the concrete or bituminous mixtlLre is to be placed shall be compacted thoroughly prior
to the placing of the pavement.
All Cllts 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 II1ches conSisting of a temporary bituminous III ixture, or the cut can be covered with a steel plate of
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sufficicnt size and thickncss 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 tIle curing period. All
steel plates must bc 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 lhe Right-of-\Vay. The
backfi Iling ohhls area shall be Com pacted Aggregatc Base or "B" Borrow. Thc compacted aggregate base or
"B" Borrow shall extend beyond thc shouldc[' linc at a slope of 1 to 1. This backfill shall meet Department of
Transportation Standard Spccifications.
(B) Backfilling of all trenches outside of the shoulder lines on State Highway Right-of-Way shall be madc with
pit run sand and gravel mixture or with material acceptable to the Department of Transportation, except for the
Top 12 inches which musl 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
preparati on.
a) When the trench is excavated or plowed in a lawn area that is moved, the appl ieant shall replace all disturbed
areas with sod. The sod shall be place and maintained according to the Department of Trans po nation Specifications.
b) Sod may be ['equired at other areas where erosions Illay be a problem.
8. The permittee shall at all times pl'Otect the pavement surface and right-or-way from damage due to the use of
heavy equipment. and shall provide and use approved pads, planks, or dirt ellshion to prote:ct against other
damage. Immediately before any section of the highway is to be placed back in use for traffic, the permittee shall
remove all e.J;cess dirt and sweep the pavement surface to elimll1ate unneCessar'y dust hazards.
9. The Permit Inspector III the local subdistrict or district office shall be notified 24 hours in advance of the pouring
of concrete or the placing ofbituminous 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
inspcet the work. Proper backfill ing must be done around the tunnel lining in order to prevent any settling of
thc pavement and Right-of-Way.
I ]. The top elevation of all manholes shall be hel d to ground or road surface level.
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12. The permittee shall be responsible for the proper replacement of any driveways, driveway pipes OJ" sidewalks
That are disturbed during the permit work.
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13. Dr'ainage on shoulders, ditches, or otherwise on the Right-of-\Vay shall not be obstructed. Appropriate control
measurcs shall be followed to protecl the right-of-way from erOSlOn.
14. All permits shall conform to the current INDOT Utility Accommodation Pol icy.
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15. Withi n seven (7) days after a new installation or repair to an existing Il1stallation is performed, all excess dirt or
obstruction caused by the installation or repair must be removed anclthc area Illust be restored to a condition by
the permittee w as not to interfere with mowing the Highway Right-ot:Way.
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16. Upon completion of all pavement cuts and before work crew leaves the wad, 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 f,lture traffic conditions or mad improvement m:cessit8te and
when requested to do so by INDOT except for on theN8tional System of Interstate and Defense Highways as
outlin.ed ill the Indiana Code.
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] 8. \Vork shall be performed in accordance with the attached plans.
19, 1 fat any time in the future, this installatIon should become damaged due to normal maintenance or roadwork
by the IN DOT, the permittee shall be responsible for all lepai ['S, and cost ofrepai rs that may arise froni such
damage.
20. Any polesinstal]ed under this pcrmit, including brace poles and guy poles should be placed within 1'6" of the
Right-ofeWay line. Exceptions to this placemcnt policy will be granted only for special conditions and must be
explained on the appllcatioll.
21. Any pole line installed under this pemlir wi]1 comply with all regulation outlined in the National Electrical
Safety Code. and any other handbook issued by the Department ofColllmerce Bureau of Standards, which
refers to the installation and maintcnance of communication lines.
22. No trees 0[' plants on the Right-of-Way of any State Highway \vill be trimmed or removed without written
pcrm i ssi on frolll th e Depal1ment of Transportation .
23. Work pei'formed Linder h is perm it will not interfere in any way wilh any pole I inc or other existing structure
along or across the State Highway.
24. Wmk withm thc sodded areas of tile Right-of-Way is not to be performed during wet periods. Any damage to
the sodded areas of the Right-of-Way must be repait"ed and properly seeded.
25. I ftraffic is to be stopped on1hc highway the applicant Illust notify State Pollee fOt" assistance in tt'afflc control.
within five (5) days prior to construction. Traffic will not be stopped longer than five (5) minutes.
INDOT DISTRICT OFFICES
Crawfmdsville District
PO. Box 667
Crawfordsville, IN 47933
(765) 362-3700
Fort Wayne DIStllct
5333 Hatfie]d Road
Fort Wayne, IN 46808
(219) 484-9541
Greenfield DIstrict
P.O. Box 667
Greenfield, IN 46140
(317) 462-7751
LaPmtc District
PO. Box 429
LaPorte. IN 46350
(219) 362-6125
Seymour District
185 Agrico Lane
Seymour, IN 47274
(8] 2) 524-3700
Vi ncelllles District
2526 N. 6th Street
Vincennes, IN 47591
(812) 882 -8330
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Page 1 of 4
Conn, Angelina V
To:
Chris Wiseman [cwiseman@cripe.biz]
Tuesday, November 20, 2007 7:57 AM
Conn, Angelina V; Brewer, Scott I; Littlejohn, David W; Hollibaugh, Mike P; Duncan, Gary R; Greg
Hayes
Jim Shinayer; Dahm, Bill; JERRY DAHM; Wells Terry; Frank Hindes; mefloetker@lawnpride.com;
Grierson, Cheri; Sara Farny; Sherri Wilson; bill@johnsonbros-sign.com
RE: Team Meeting at my Office Monday 11/19 at 1 :30 pm : Mikes Car Wash: November 20 Plan
Commission department reports
Attachments: PermiUNDOT ROW ApprovaL 11 ~19-07.pdf
Cc:
From:
Sent:
Subject:
Angie, Scott and Greg
Here is the Approved Encroachment Permit from INDOT in regards to the planting located within the R/W for your files.
Thanks
Chris
-m-Original Messagem--
From: Chris Wiseman
Sent: Man, November 19, 2007 1:18 PM
To: 'Aconn@carmel.in.gov'; 'SBrewer@carmel.in.goY'; 'dlittlejohn@carmel.in.goy'; I MHollibaugh@carmel.in.gov';
'gduncan@carmel.in.gov'; 'Greg Hayes'
Cc: 'Jihl Shinayer'; 'Dahm, Bill'; 'JERRY DAHM'; 'Wells Terry'; Frank Hindes; 'mefloetker@lawnpride.com'; 'Grierson,
Cheri'; Sara Farny; Sherri Wilson; bill@johnsonbros-sign.com
Subject: RE: Team Meeting at my Office Monday 11/19 at 1:30 pm : Mikes Car Wash: November 20 Plan
Commission department reports
Greg and Scott,
Here are the revised Site Plan and Utility Plan illustrating the relocation of the regulated drain and the revised storm
sewer system. Cripe is diligently working on the detailed engineering plans based on this final layout and are
planning on submit those early next week to all the TAC members. Any comments received thus far shall also be
addressed at that time.
Miles,
Please forward a PDF of the revised Landscape Plan illustrating the planting that shall be located within the
regulated drainage easements, which is the area to the north of the building and then the island to the west of the
site between the entrance and exit to the site.
See everyone tomorrow night.
Thanks
Chris
Chris Wiseman, PE
Project Manager
Cripe Architects + Engineers
7172 Graham Road
Indianapolis, Indiana 46250
1112012007