4-ROW Utilization Permit App.pdf

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City of Ocala

CITY ENGINEER’S OFFICE

Transportation Engineering Division

1805 NE 30th Avenue, Building 300

OCALA, FL 34470

CONTACT: Transportation Engineering

Division Telephone (352) 351-6725

R.O.W. UTILIZATION PERMIT

APPLICATION

(Authority: City of Ocala Code of Ordinances Section 58-5 and Section 59-5)

PERMIT NUMBER: ______________________

TYPE: WORK / EVENT NEWSPAPER DISPENSER

DATE OF APPLICATION: APPLICATION FEE $50.00

NAME OF APPLICANT: COMPANY NAME:

MAILING ADDRESS:

TELE. NO.:

LOCATION OF WORK / EVENT / NEWSPAPER DISPENSER:

EMAIL:

PARCEL NUMBER: ZONING :

WORK / EVENT

BRIEF DESCRIPTION OF THE WORK / EVENT:

FIELD PERSON IN CHARGE : CELL. NO.:

PROPOSED START DATE & TIME OF WORK / EVENT:

FROM: AM PM

PROPOSED END DATE & TIME OF WORK / EVENT:

TO: AM PM

PARTIALLY TOTALLYWILL WORK / EVENT REQUIRE THE STREET TO BE CLOSED? NO YES

IF YES, IS A ‘MAINTENANCE OF TRAFFIC’ PLAN PER DOT INDEX 102-600 ATTACHED? NO YES

IF YES, PROVIDE PLANNED START DATE & TIME: PLANNED END DATE & TIME OF STREET CLOSURE:

FROM: AM PM TO: AM PM

IF WORK INVOLVES UNDERGROUND UTILITY INSTALLATION, DESCRIBE METHOD: OPEN EXCAVATION

BORE JACK PUSH DIRECTIONAL BORE

WILL THE WORK RESULT IN CITY STREET PAVEMENT DISTURBANCE? NO YES

WILL THE WORK RESULT IN SIDEWALK AND/OR DRIVEWAY DISTURBANCE? NO YES

DESCRIBE IN MORE DETAIL THE WORK / EVENT AND OTHER FACTORS OR CONDITIONS THAT ARE AN IMPORTANT PART OF THIS R.O.W.

UTILIZATION PERMIT APPLICATION:

I HEREBY CERTIFY THAT I HAVE MADE APPLICATION FOR THE PERMIT DESCRIBED ABOVE AND THAT I HAVE PROPER AUTHORITY AND

AUTHORIZATION TO APPLY FOR SUCH PERMIT.

I FURTHER AGREE TO COMPLY WITH ALL APPLICATION PROCESSING PROCEDURES AND WITH ALL CONDITIONS OF THIS PERMIT CONTAINED ON THE FIVE PAGES ATTACHED TO THIS APPLICATION, MOST PARTICULARLY THE RESTORATION REQUIREMENTS WITHIN THE PUBLIC RIGHT-

OF-WAY.

I ACKNOWLEDGE THAT ANY APPROVAL, DIRECTION OR DETERMINATION OF THE CITY ENGINEER REFERENCED IN THIS PERMIT MAY ALSO BE

MADE BY A DESIGNEE OF THE CITY ENGINEER.

SIGNATURE OF PERMIT APPLICANT DATE

RIGHT-OF-WAY UTILIZATION PERMIT PROCESSING PROCEDURES

IMPORTANT: THIS APPLICATION IS TO BE SUBMITTED A MINIMUM OF FIVE (5) FULL BUSINESS DAYS PRIOR THE EXPECTED STARTING DATE - REFER TO INFORMATION ON THE FOLLOWING PAGES FOR PROCEDURES - AND SHALL BECOME A PERMIT WITH THE CITY SIGNATURES OF

AUTHORIZATION.

Revision Date: October 2022

City of Ocala

CITY ENGINEER’S OFFICE

Transportation Engineering Division

1805 NE 30th Avenue, Building 300

OCALA, FL 34470

CONTACT: Transportation Engineering

Division Telephone (352) 351-6725

R.O.W. UTILIZATION PERMIT

APPLICATION

(Authority: City of Ocala Code of Ordinances Section 58-5 and Section 59-5)

RIGHT-OF-WAY UTILIZATION PERMIT PROCESSING PROCEDURES

IMPORTANT: THIS APPLICATION IS TO BE SUBMITTED A MINIMUM OF FIVE (5) FULL BUSINESS DAYS PRIOR THE EXPECTED STARTING DATE - REFER TO INFORMATION ON THE FOLLOWING PAGES FOR PROCEDURES - AND SHALL BECOME A PERMIT WITH THE CITY SIGNATURES OF

AUTHORIZATION.

1. APPLICATION TO BE FILLED OUT BY APPLICANT AND SUBMITTED TO ENGINEERING DEPARTMENT FIVE (5) WORKING DAYS PRIOR TO

EXPECTED STARTING DATE.

2. FEE TO BE PAID BY CHECK MADE PAYABLE TO THE CITY OF OCALA AND SUBMITTED ALONG WITH APPLICATION.

3. REVIEW AND APPROVAL OF APPLICATION TO BE MADE BY INSPECTION DIVISION AND TRAFFIC DIVISION.

4. APPROVAL TO BE SIGNED BY THE CHIEF ENGINEERING INSPECTOR AND TRAFFIC ENGINEER OR THEIR DESIGNEE.

5. FINAL PERMIT WILL BE ISSUED BY THE ENGINEERING DEPARTMENT WITHIN FIVE (5) WORKING DAYS.

TO BE COMPLETED BY CITY OFFICIALS ONLY

RECEIVED BY: DATE: CHECK NO.

COMMENTS: _____________________________________________________________________________________________

PERMISSION FOR THE ABOVE DESCRIBED WORK / EVENT / NEWSPAPER DISPENSER IS HEREBY GRANTED SUBJECT TO THE ATTACHED

GENERAL REQUIREMENTS AND THE FOLLOWING SPECIFIC ADDITIONAL REQUIREMENTS:

APPROVED BY __________________________________ APPROVED BY __________________________________

(CHIEF ENGINEERING INSPECTOR) (TRAFFIC ENGINEER)

WORK COMPLETED ON __________________________ PAVING REPAIRS BY ____________________________

INSPECTOR’S SIGNATURE ________________________________________ DATE_________________________

City of Ocala

CITY ENGINEER’S OFFICE

Transportation Engineering Division

1805 NE 30th Avenue, Building 300

OCALA, FL 34470

CONTACT: Transportation Engineering

Division Telephone (352) 351-6725

R.O.W. UTILIZATION PERMIT

APPLICATION

(Authority: City of Ocala Code of Ordinances Section 58-5 and Section 59-5)

GENERAL REQUIREMENTS CONCERNING PERMITS FOR UTILIZATION OF PUBLIC RIGHT-OF-WAY

(PART OF “APPLICATION FOR PERMIT”)

CONDITIONS: PERMITTEE AGREES THAT:

1. ALL WORK AUTHORIZED UNDER THIS PERMIT SHALL BE DONE IN ACCORDANCE WITH THIS APPROVED APPLICATION, THE PROVISIONS OF

THE CITY ORDINANCES, AND OTHER APPLICABLE REGULATIONS.

2. PUBLIC SAFETY SHALL BE MAINTAINED DURING CONSTRUCTION IN ACCORDANCE WITH THE PROVISIONS OF THE ‘MANUAL ON UNIFORM

TRAFFIC CONTROL DEVICES (MUTCD)’.

3. WHEN EXCAVATION FOR UNDERGROUND UTILITY WORK IS INCLUDED THE SCOPE OF THIS PERMIT, UTILITY COMPANIES MUST BE NOTIFIED FOR FIELD MARKING OF THEIR UTILITIES AND CONSULTED FOR INFORMATION AS TO THEIR EXISTING FACILITIES AND APPURTENANCES PURSUANT TO THE PROVISION OF FLORIDA STATUTES, CHAPTER 553.851. TELEPHONE NUMBERS TO REPORT ANY

DAMAGE AND FOR COORDINATION PURPOSES ARE:

Utility Company Contacts

• FLORIDA SUNSHINE ‘CALL-BEFORE-YOU-DIG’: 811

• CITY OF OCALA WATER & SEWER DEPARTMENT: 352.351.6775

• CITY OF OCALA UTILITY SERVICES – ELECTRIC: 352.351.6620

• CITY OF OCALA PUBLIC WORKS DEPARTMENT – TRAFFIC (SEE 4): 352.351.6733

• EMBARQ: 352.857.2766

• TECO / PEOPLES GAS: 352.622.0112

• COX COMMUNICATIONS: 352.873.5629

• AT&T: 352.237.2383

• MCI WORLDCOM: 352.258.8711

4. FOR ANY WORK TO BE DONE IN THE RIGHT OF WAY WHICH REQUIRES UNDERGROUND LOCATES AND IS WITHIN 500 FEET OF A SIGNALIZED INTERSECTION, THE APPLICANT MUST CALL THE CITY OF OCALA TRAFFIC OPERATIONS DIVISION FOR TRAFFIC SIGNAL

LOCATES (352-351-6733).

5. NEWSPAPER DISPENSER: REFER TO CHAPTER 59 OF CITY CODE OF ORDINANCES FOR COMPLETE DETAILS. TYPICAL LOCATION CRITERIA FOR PUBLIC RIGHT-OF-WAY IS PROVIDED IN SHEET 1 ATTACHED. A PLAN SHOWING THE LOCATION OF DISPENSER IS REQUIRED. INCLUDE

PARCEL NUMBER ON PLAN.

6. TEMPORARY FIRE HYDRANT WATER METER: TO REQUEST AND OTHERWISE COORDINATE THE INSTALLATION OF A TEMPORARY FIRE HYDRANT WATER METER CONTACT OCALA UTILITY SERVICES AT 629-8411, AT LEAST 24 HOURS PRIOR TO THE DATE THE WATER

SERVICE IS NEEDED.

7. CITY INSPECTIONS:

A. ALL MATERIALS, EQUIPMENT AND WORK SHALL BE SUBJECT TO INSPECTION BY THE CITY OF OCALA AT ANY TIME.

B. THE PERMITTEE MUST CALL THE CITY INSPECTOR (@ 629.8419) AT LEAST ONE WORKING DAY BEFORE ANY PORTION OF CONSTRUCTION COVERED BY THIS PERMIT BEGINS. IF THIS PROCEDURE IS NOT FOLLOWED, THIS PERMIT WILL BECOME INVALID.

C. THE PERMITTEE MUST INFORM THE CITY INSPECTOR (@ 629.8419) AT LEAST ONE WORKING DAY IN ADVANCE OF ANY ACTIVITY ON A DIRECTIONAL BORE WITHIN CITY RIGHT-OF-WAY. DIRECTIONAL BORE TO BE PERFORMED PER SECTION 475.4.12 OF CITY OF OCALA STANDARD SPECIFICATIONS FOR CONSTRUCTION OF STREETS, STORMWATER, TRAFFIC, WATER AND SEWER INFRASTRUCTURE, OCTOBER 2018.

8. PRIVATE DRIVEWAYS, PUBLIC UTILITIES, AND OTHER SUCH IMPROVEMENTS PERMITTED HEREWITH WHICH ARE NOT AVAILABLE FOR IMMEDIATE USE BY THE GENERAL PUBLIC ARE CONSIDERED AS REMAINING IN PRIVATE OWNERSHIP AND ACCOMMODATED WITHIN THE PUBLIC RIGHT-OF-WAY OR OTHER PUBLIC AREAS. THE OWNERS OF SUCH FACILITIES, OR THEIR SUCCESSORS OR ASSIGNS, SHALL BE

RESPONSIBLE FOR MAINTAINING SUCH FACILITIES IN GOOD AND SAFE REPAIR.

9. OPEN CUTS ACROSS PAVEMENT WITHIN CITY RIGHT-OF-WAY ARE DISCOURAGED. BEFORE A PAVEMENT CAN BE APPROVED FOR AN OPEN CUT THE PAVEMENT MUST BE 5 YEARS OR OLDER, THIS APPROVAL CAN ONLY BE GIVEN BY THE CITY ENGINEER. THE APPROVED METHODS FOR CONSTRUCTING UTILITIES ACROSS PAVEMENTS THAT CANNOT BE OPEN CUT ARE ‘BORING AND JACKING’, ‘DIRECTIONAL

BORING’ OR ‘PUSHING’ BENEATH THE PAVEMENT.

10. AFTER A PERMIT HAS BEEN OBTAINED TO WORK WITHIN THE CITY RIGHT-OF-WAY, ALL CONSTRUCTION PERTAINING TO THE PERMIT SHALL BE DONE BY A FLORIDA CERTIFIED CONTRACTOR WHO SHALL BE RESPONSIBLE FOR THE CONSTRUCTION OF THE UTILITY AND

MAINTENANCE AND REPAIR THEREOF FOR A WARRANTY PERIOD OF 1 YEAR.

11. WHERE BRICK OR OTHER USABLE MATERIAL ARE REMOVED WITHIN THE STREET PAVEMENT STRUCTURE FOR THE INSTALLATION OF A UTILITY, SAID MATERIAL WILL BE DELIVERED TO THE CITY PUBLIC WORKS STORAGE YARD AND THE TRENCH CUT RESTORED WITH BELOW INDICATED BASE COURSE MATERIAL AND ASPHALT CONCRETE SURFACE COURSE, AS DESCRIBED HEREIN.

http:475.4.12

City of Ocala

Transportation Engineering Division

1805 NE 30th Avenue, Building 300

OCALA, FL 34470

CONTACT: Transportation Engineering

Division Telephone (352) 351-6725

R.O.W. UTILIZATION PERMIT

APPLICATION

(Authority: City of Ocala Code of Ordinances Section 58-5 and Section 59-5)

12. TRENCH BACKFILL AND COMPACTION: TRENCH BACKFILL SHALL BE CONSTRUCTED WITH SUITABLE MATERIAL PLACED IN 12 INCH LIFTS.

WETTING OR DRYING WILL BE REQUIRED TO OBTAIN PROPER MOISTURE CONTENT AND TAMPED WITH MECHANICAL TAMPER TO OBTAIN REQUIRED COMPACTION. ALL BACKFILL SHALL BE COMPACTED TO A DENSITY OF AT LEAST ONE HUNDRED (100%) OF THE MAXIMUM DENSITY AS DETERMINED BY AASHTO T99 (STANDARD PROCTOR). DENSITY TESTS SHALL BE REQUIRED AT LEAST EACH 12 INCHE OF COMPACTED FILL. DENSITY TESTS SHALL BE REQUIRED NOT MORE THAN 500’ APART. (SECTION 120 AND 125-8 OF FDOT STANDARD SPECIFICATIONS FOR ROAD AND BRIDGE CONSTRUCTION, 2018 EDITION AND CITY OF OCALA CODE OF ORDINANCES, SECTION 83-378).

13. BASE COURSE MATERIAL TO BE USED IN ALL OPEN CUTS SHALL BE EQUAL TO OR BETTER THAN THE EXISTING BASE BOTH IN QUALITY AND THICKNESS. THE DECISION AS TO THE TYPE AND AMOUNT OF BASE MATERIAL IN EACH INDIVIDUAL CUT WILL BE DETERMINED BY THE CITY ENGINEER. WHERE LIMEROCK IS USED AS A BASE MATERIAL, IT SHALL BE THOROUGHLY COMPACTED IN 6 INCH LAYERS WITH A MINIMUM TOTAL THICKNESS OF 12 INCHES, TO RECEIVE THE SURFACE COURSE. THE LIMEROCK MATERIAL SHALL BE OF QUALITY ACCEPTABLE TO THE CITY OF OCALA AND THE BASE SHALL BE MAINTAINED IN A CONDITION ACCEPTABLE TO THE CITY ENGINEER UNTIL SURFACE COURSE IS APPLIED TO ENSURE A GOOD RIDING SURFACE. ONE LIMEROCK DENSITY TEST OF AT LEAST 98% COMPACTION

WILL BE REQUIRED PRIOR TO SURFACING. LIMEROCK SHALL BE PRIMED PRIOR TO PAVING.

14. THE PERIOD OF TIME BETWEEN THE RESTORATION OF THE BASE MATERIAL AND THE APPLICATION OF THE FINISHED SURFACE COURSE SHALL NOT EXCEED SEVEN (7) CALENDAR DAYS EXCEPT BY WRITTEN AUTHORIZATION BY THE CITY ENGINEER’S OFFICE.

15. SURFACE COURSE SHALL BE A TYPE EQUAL TO OR BETTER THAN EXISTING, TO BE DETERMINED BY THE CITY ENGINEER, FOR EACH LOCATION. WHERE THE SURFACE COURSE IS OF ASPHALTIC CONCRETE IT SHALL BE FDOT SP 9.5 WITH A MINIMUM OF 1,500 LBS.

MARSHALL STABILITY AND WITH A MINIMUM COMPACTED THICKNESS OF 1 ½ INCHES FOR RESIDENTIAL STREETS.

16. BEFORE SURFACE COURSE IS APPLIED TO THE AREA IT SHALL BE SAW CUT AND SQUARED TO FORM A RECTANGULAR SHAPE, THE SIDES OF WHICH SHALL BE A MINIMUM OF 2 FEET FROM THE FARTHEST EXTENSION OF THE CUT ON ALL SIDES, OR AS DIRECTED BY THE CITY

ENGINEER.

17. IN AREAS WHERE PAVEMENT CUTS ARE CLOSE OR IN A ROW, THE ENTIRE AREA, INCLUDING THAT BETWEEN PATCHES, SHALL BE SAW- CUT AND RESURFACED IN A CONTINUOUS STRIP, THE WIDTH OF WHICH, IF IN QUESTION, SHALL BE DETERMINED BY THE CITY ENGINEER.

18. WHERE A UTILITY IS INSTALLED IN AN UNPAVED STREET, SAID STREET WILL BE STABILIZED FROM DITCH LINE TO DITCH LINE AND

RESTORED TO CONDITION EQUAL TO OR BETTER THAN ORIGINAL UNDISTURBED CONDITION.

19. ALL UNDERGROUND UTILITY CROSSING INSTALLATION SHALL BE LAID AT A MINIMUM DEPTH OF 36 INCHES BELOW THE PAVEMENT.

EXCEPTIONS MAY BE MADE, IN SPECIAL CASES, IF APPROVED IN WRITING BY THE CITY ENGINEER.

20. WHERE A UTILITY IS INSTALLED IN AN UNPAVED PORTION OF THE CITY RIGHT-OF-WAY, THE UNPAVED DISTRUBED AREA SHALL BE RESTORED IN A MANNER ACCEPTABLE TO THE CITY, INCLUDING RESTORATION OF GRASSED AREA WITH BAHIA SOD, DRIVEWAYS AND

SIDEWALKS RESTORED IN KIND, AS WELL AS DRAINS, RETAINING WALLS, CURBS, ETC.

21. ALL STREET EXCAVATION SHALL BE DONE IN KEEPING WITH STANDARDS, POLICIES AND PROCEDURES OF THE CITY OF OCALA, SUBJECT

TO THE INTREPRETATION OF THE CITY ENGINEER.

22. IF A SEWER LATERAL, WATERLINE OR ANY RELATED WATER-FACILITY, OR OTHER PRIVATE UTILITY IS BROKEN OR DAMAGED DURING

CONSTRUCTION, IMMEDIATE NOTIFICATION OF THE APPROPRIATE AGENCY IS REQUIRED.

23. CONSTRUCTION AND MAINTENANCE OF SUCH UTILITY SHALL NOT INTERFERE WITH THE RIGHTS OF A PRIOR OCCUPANT.

24. ALL PROJECTS AND WORK ON CITY STREETS SHALL HAVE AN APPROVED TRAFFIC CONTROL (MOT) PLAN. ALL WORK SHALL BE EXECUTED UNDER THE ESTABLISHED ‘MOT’ PLAN, AND THE LATEST FDOT DESIGN STANDARD INDEX NO. 102-600 THAT CONTAINS INFORMATION SPECIFIC TO THE STATE GUIDELINES ON TRAFFIC CONTROL IN WORK ZONES, FOR CONSTRUCTION AND MAINTENANCE

OPERATION, AND UTILITY WORK.

25. IT IS EXPRESSLY STIPULATED THAT THIS PERMIT IS A LICENSE FOR PERMISSIVE USE ONLY AND THAT PLACING OF FACILITIES UPON PUBLIC PROPERTY PURSUANT TO THIS PERMIT SHALL NOT OPERATE TO CREATE OR VEST ANY PROPERTY RIGHTS IN SAID HOLDER.

26. THE ATTACHED SKETCH COVERING DETAILS OF THIS INSTALLATION SHALL BE MADE A PART OF THIS PERMIT. ADDITIONAL SKETCHES

SHALL BE FURNISHED WHERE ATTACHED SKETCH IS NOT APPLICABLE.

27. IT IS UNDERSTOOD AND AGREED THAT THE RIGHTS AND PRIVILEGES HEREIN SET OUT ARE GRANTED ONLY TO THE EXTENT OF THE CITY’S RIGHT, TITLE AND INTEREST IN THE LAND TO BE ENTERED UPON AND USED BY THE HOLDER, AND THE HOLDER WILL, AT ALL TIMES, ASSUME ALL RISK OF AND INDEMNIFY, DEFEND, AND SAVE HARMLESS THE CITY OF OCALA AND THE ENGINEERING DEPARTMENT FROM AND AGAINST ANY AND ALL LOSS, DAMAGE, COST OR EXPENSE ARISING IN ANY MANNER ON ACCOUNT OF THE EXERCISE OR

ATTEMPTED EXERCISES BY SAID HOLDER OF THE AFORESAID RIGHTS AND PRIVILEGES.

28. WITH REFERENCE TO STREET CLOSINGS, THIS PERMIT WILL BE REQUIRED FOR THE TEMPORARY CLOSING OF PUBLIC STREETS, ETC.

Transportation Engineering Division

1805 NE 30th Avenue, Building 300

OCALA, FL 34470

CONTACT: Transportation Engineering

Division Telephone (352) 351-6725

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DIRECTIONAL DRILL BORE LOG

NOTE: All bores must be constructed in compliance with the requirements of City of Ocala Standard Specifications for Water & Sewer Construction, Volume III, Section 475

PROJECT NAME:

DATE OF BORE: TIME BEGIN: TIME COMPLETE:

BORE CONTRACTOR:

FOREMAN’S NAME: FORMAN’S CELL PHONE NUMBER:

DIRECTIONAL BORE UNIT (MODEL & MANUF.):

TYPE OF FACILITY (WATER, GAS, SEWER, ETC):

LOCATION OF BORE:

CARRIER PIPE TOTAL LENGTH (FT):

REAMER SIZE (IN):

CASING TOTAL LENGTH (IF APPLICABLE):

SIZE OF PIPE (IN): TYPE OF PIPE (HDPE, PVC, ETC): DR RATING:

TYPE OF JOINT (WELD, COUPLING, ETC):

PROBLEMS ENCOUNTERED:

BORE INFORMATION LOG

RECORD BORE DEPTH AT A MINIMUM OF 10 FOOT INTERVALS ALONG ENTIRE BORE PATH, REFERENCING DISTANCES FROM EDGE OF PAVEMENT, FACE OF CURB, ETC.

RECORD THE BEGINNING AND ENDING DEPTHS.

LOCATION: DEPTH (FT):

LOCATION: DEPTH:

LOCATION: DEPTH:

LOCATION: DEPTH:

LOCATION: DEPTH:

LOCATION: DEPTH:

LOCATION: DEPTH:

LOCATION: DEPTH:

LOCATION: DEPTH: