7-09 PennDOT Highway Occupancy Permit No. 06123055.pdf

Name and Address of Permittee:

Whitpain Township P.O. Box 800 960 Wentz Road Blue Bell, PA 19422

County: Montgomery

County Contact No.: (610) 275-1409

Issuing District Office: 6-0

District Contact No.: (610) 205-6790

Municipalities: Whitpain Township

Issue Date: 9/26/2025

Expiration Date: 9/26/2026

Application No.: 379658

Account No.:

Permit Fee: $ 0.00

Immediately upon completion of the work Permittee shall notify the permit office where application was made. Subject to all the conditions, agreements, restrictions, and regulations prescribed by the Pennsylvania Department of Transportation, (see in particular 67 Pa. Code, Chapter 212, 441 and 459 and State Highway Law, 36 P.S. Section 670 - 411, 420 and 421 ) and subject to the plans, special conditions, or restrictions herein set forth or attached hereto. This permit shall be located at the work site and shall be available for inspection by any police officer or Department representative.

Location and Description of Work Permit No.: 06123055

1 of 1 State Route #: 2016 Segment(s): From 0010 To 0010 Offset(s): From 0000 To 0900

141: Connect Surface Drainage to Department Drainage Facilities 171: Perform Roadway Improvement 611: Install Sub-surface Water Facility

Permit Conditions Permit No.: 06123055

1 of 14 DRAINAGE INSTALLED BY THIS PERMIT IS THE RESPONSIBILITY OF THE PERMITTEE TO

CONTINUALLY MAINTAIN OR REPLACE. [RECORD]

2 of 14 THIS PERMIT WILL NOT BE CLOSED OUT UNTIL THE PERMITTEE HAS SUPPLIED THE

DEPARTMENT WITH AN APPROVED AND RECORDED SET OF RIGHT-OF-WAY (ROW)

DEDICATION PLANS. FURTHER, THE FORMAL ROW DEDICATION PLANS MUST BE

SUBMITTED WITHIN SIXTY (60) DAYS OF HOP ISSUANCE. THE DEPARTMENT WILL NOT

ACCEPT REQUESTS FOR PERMIT CLOSE OUT NOR RELEASE OF ESCROW UNTIL THE

FORMAL ROW PLANS ARE PROVIDED TO THE DISTRICT PERMITS MANAGER (ANTHONY

ANTONELLI) AND FORMALLY APPROVED BY THE DISTRICT ROW ADMINISTRATOR

(VERNESA BRODIE). BE AWARE THAT THE LETTER OF CREDIT WILL NOT BE REDUCED

TO 20% NOR WILL THE TWO (2) YEAR WARRANTY PERIOD BEGIN UNTIL THE ROW PLANS

ARE APPROVED BY THE DISTRICT, SENT TO HARRISBURG FOR THE SECRETARY'S

SIGNATURE, AND ULTIMATELY RECORDED IN THE COUNTY COURTHOUSE. THE

PERMITTEE IS RESPONSIBLE FOR THE PREPARATION OF THESE PLANS IN ACCORDANCE

WITH PUBLICATION 14M (DM-3), MARCH 2015 EDITION, CHANGE NO. 1, DATED APRIL 30,

2016, CHAPTER 3 RIGHT-OF-WAY. THE PERMITTEE IS ALSO RESPONSIBLE FOR THE

RECORDING OF THESE PLANS.

3 of 14 THIS PERMITTEE MUST SUBMIT THE PENNDOT CONVEYANCE OF RIGHT-OF-WAY FORM, M-950D1 (DEED FEE SIMPLE) PRIOR TO THE START OF CONSTRUCTION. THE FORM MUST

BE COMPLETED BY THE APPLICANT AND ACCOMPANIED BY AND 8 1/2" X 11 DRAWING

OF THE AREA BEING CONVEYED. THE ORIGINAL DEE FEE SIMPLE FORMS MUST BE

SIGNED BY DISTRICT PERMITS MANAGER (ANTHONY ANTONELLI), RECORDED AND

THEN RETURNED TO THE DEPARTMENT. PLEASE CONTACT ANHONTY ANTONELLI AT

610-205-6795 OR MARY ELLEN CULHANE AT 610-205-6825.

4 of 14 NOTIFY THE TRAFFIC MANAGEMENT CENTER AT 610-205-6500 PRIOR TO SETTING UP ANY

LANE CLOSURES OR RESTRICTIONS, AND WHEN THE CLOSURE/RESTRICTION IS

REMOVED.

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Highway Occupancy Permit Permit No.: 06123055

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Permit Conditions Permit No.: 06123055

5 of 14 DEPARTMENT MUST BE NOTIFIED IN WRITING TWO WEEKS IN ADVANCE OF PRE-

CONSTRUCTION MEETING, FOR COORDINATION CONTACT GUS FIOCCA ASSISTANT

DISTRICT PERMITS MANAGER AT 610-205-6796 OR GFIOCCA@PA.GOV. - 7000 GEERDES

BOULEVARD KING OF PRUSSIA, PA 19406-1525

6 of 14 CONTACT COUNTY PERMIT INSPECTOR AT LEAST 3 WORK DAYS PRIOR TO START OF

WORK AT 610-275-1409.

7 of 14 A CERTIFICATE OF INSURANCE SHALL BE SUBMITTED TO THE DEPT. BY THE PERMITTEE

OR ITS CONTRACTOR 30 DAYS PRIOR TO START OF WORK.

8 of 14 AN INSPECTOR, WHEN AVAILABLE, WILL BE ASSIGNED ON MORE THAN A SPOT

INSPECTION BASIS. PERMITTEE WILL BE CHARGED ALL INSPECTION COSTS INCURRED

BY THE DEPARTMENT.

9 of 14 2A COARSE AGGREGATE BACKFILL MATERIAL IS REQUIRED UNDER 67 PA CODE, SECTION 459.8 (G)(2) AND SECTION 703.2 OF PUBLICATION 408.

10 of 14 NO LANES MAY BE RESTRICTED BETWEEN THE HOURS OF 6:00 AM TO 9:00 AM OR

BETWEEN THE HOURS OF 3:00 PM TO 6:00 PM.

11 of 14 PERMITTEE IS RESPONSIBLE FOR ENSURING THAT MUD, SILT AND OTHER DEBRIS IS

REMOVED FROM VEHICLES AND TIRES (BY POWER WASH, ETC.) BEFORE ENTERING

ONTO THE HIGHWAY.

12 of 14 Contractor must notify the PennDOT District 6 Press Office no less than five days prior to any lane restrictions and no less than two weeks prior to any full closures planned on state-owned highways. A Road Restriction Form to notify the Press Office is available at www.bit.ly/d6rrform or on the District 6 home page (https://www.pa.gov/agencies/penndot/regional-offices/district-6). For questions, or to provide additional information, please email ra-pdd6press@pa.gov

13 of 14 PRIOR TO CONSTRUCTION A FOLLOW-UP SUBMISSION FOR A TRAFFIC SIGNAL PERMIT

MUST BE MADE AND SIGNED SIGNAL PERMIT ISSUED IN THE TSP - TRAFFIC SIGNAL

PERMIT SECTION OF EPS. THE FOLLOWING ITEMS MUST BE PROVIDED WITH THE EPS

TRAFFIC SIGNAL PERMIT SUBMISSION: A. SCALED 22"x34" PDF OF SIGNAL PERMIT PLAN

DIGITALLY OR ELECTRONICALLY SIGNED BY THE MUNICIPALITY; B. PDF OF SYSTEM

PERMIT PLAN (IF APPLICABLE) DIGITALLY OR ELECTRONICALLY SIGNED BY THE

MUNICIPALITY; C. ELECTRONIC CAD FILES; D. ELECTRONIC SYNCHRO .SYN FILES; E.

ONE COMBINED PDF OF THE FOLLOWING: I. COVER LETTER WITH HOP NAME, EPS

NUMBER, AND PROPOSED WORK; II. SIGNED AND EXECUTED TE-160 FORM; III. TRAFFIC

SIGNAL DESIGN STUDY (IF APPLICABLE); IV. PEDESTRIAN STUDY (IF APPLICABLE); V.

COST ESTIMATE (IF APPLICABLE); VI. TURNING TEMPLATES (IF APPLICABLE); VII.

CLEARANCE CALCULATIONS (IF APPLICABLE; VIII. ADA RAMP PLANS (IF APPLICABLE);

IX. ANY OTHER TRAFFIC SIGNAL DESIGN DOCUMENT; X. RESPONSE LETTERS.

14 of 14 THE PERMITTEE IS RESPONSIBLE TO HIRE OR RETAIN THE DESIGN CONSULTANT FOR

SIGNAL FIELD INSPECTIONS, POLE SPOTS, TIMING ADJUSTMENTS, TSAMS UPDATES, AND

AS-BUILT PLANS WITH CAD FILE AS NEEDED.

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Acknowledgement of Completion

Permit work has been completed:

Date:

By:

Michael B. Carroll

Secretary of Transportation

Din Abazi, P.E.

District Executive

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