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HomeMy WebLinkAboutWork within County Right-of-Way(fillable) COUNTY OF HAWAI‘I Rev DEPARTMENT OF PUBLIC WORKS – ENGINEERING DIVISION PERMIT TO WORK WITHIN THE COUNTY RIGHT-OF-WAY IN CONSIDERATION OF GRANTING THIS PERMIT, THE PERMITTEE UNDERSTANDS AND AGREES TO: _____ the County, its officers, representatives, employees, and agents AGENCY USE ONLY PERMIT NO: FEE: County of Hawai‘i is an Equal Opportunity Provider and Employer DPW Form 33(2) CONSTRUCTION PERMIT CONDITIONS OF APPROVAL 48 48 5 County of Hawai‘i is an Equal Opportunity Provider and Employer Rev. 4/09/15 County of Hawaii DEPARTMENT OF PUBLIC WORKS – ENGINEERING DIVISION Permit to Work within the County Right-of-Way INSTRUCTIONS TO THE APPLICANT 1.The Applicant shall provide three (3) sets of plans to the Department of Public Works. The plans shall include the dimensions of work relative to the road and property lines, type of asphalt or concrete pavement, swales (or other drainage devices) and any other relevant information. 2.All work shall be in accordance with Chapter 22 – County Streets, of the Hawaii County Code, and as shown on the approved plans. 3.As required, all work shall be performed by a licensed contractor. The contractor may sign the permit application on behalf of the permittee/owner. 4. required, the Applicant shall provide a copy of DCAB’s “Document Review” confirmation letter with the application. A copy of DCAB’s form and associated fee schedule can be found at http://health.hawaii.gov/dcab/files/2013/01/HRS-103-50-Transmittal-Form-Dec-2012.pdf. 5.If not already on file with the Department of Public Works, the contractor shall provide a certificate of insurance specifically naming as an additionally insured, the County, its officers, representatives, employees, and agents as required by Hawaii County Code. 6.The issued permit will become null and void if the authorized work is not completed within one (1) year of the issuance date. 7.If you are closing a road, at least two (2) weeks before the scheduled closure, complete an application form and drop it off at the Police Department’s Traffic Services. (Application Forms are available from Traffic Services 961-2227 or 961-2226). Attach a map of the area to the application. The Police Department will route the application through all applicable County agencies for approval. County of Hawai‘i is an Equal Opportunity Provider and Employer :~· SAW CUT BOTH SIDES & APPLY TACK C04T 1S' MIN. Q' MIN. MIN. I= TRENCH WIDTH MIN. ..::!::It,-.-BACKFIU MATERIAL SHAU. BE IN CONFORMANCE WITH STD. SPECS. f'OR PUBLIC WORKS CONSTRUCTION, Oi\TEO SEPT. 1986. R/W COUN'IY RIGHT-or-WAYI SHOULDER RO>DNAY SURFACE SHOULDER L_ PRIVATE UTIUIY SHAU. BE LOCATED AS CLOSE TO RIGHT-Qf'-WA\' BOUNOAAY AS POSSIBLE. PRIVATE UTIUIY SHAU. BE BURIED ur Mitt WHERE IT CROSSES PRIVATE DRIVEWAYS AND COUNIY RCW>WA'YS. S£E ROAD PAVEMENT ANO SHOULDER RESTORATION DETAILS. lYPICAL ROADWAY SECTION NOT TO SCALE ROAD/DRIVEWAY ·RESTORATION DETAIL NOT TO SCALE NOTES: 1. WHERE EXISTING RESIDENTIAL DRIVEWAY IS CON~4• THICK Cl.ASS •If CONCRETE REINFORCED WITH 6x6-10/IO WWI.I ON 4 BASE COURSE SHAl.l BE USED IN LIEU Of' THE ABOYE SECTIOf.I. 2. WHERE N4 DCISTINC DRIVEWAY IS UNPAVED, THE DRIVEWAY SHALL BE RESTORED 10 A CONDITION EQUAL TO OR BETTER THAN THE EXISTING DRIVEWAY. J. CONTRACTOR SHALL NOTIFY THE OWNER Of' JHE DRIVEWAY 48 HOURS BEFORE THE COMMENCEMENT Of' N4Y WORK. 4. AREAS WITH PAVEMENT I GEOTEXTll.£ f'ABRIC SHALL BE RESTORED AS DIRECTED BY THE DEPAl'lTl.IENT Of' PUBLIC WORKS. _.J I 111" MIN. r' MIN. SHOULDER RESTORATION DETAIL NOT TO SCALE •NOTE: f'OR PAVED OR OTHER IMPROYED SHOUL.D£R_...!URf'ACE SHALL BE RESTORED TD A CONDITION EQUAL TD OR Bt.11 t.R THAN THE EXISTINC SHQULOERS, AS DIRECTED BY THE DEPARTMENT Of' PUBLIC WORKS. County of Hawaii is an Equal Opportunity Provider and Employer , 2 Min.** 1­w w !=!= (/) 0 w CD a:: ::> (..) -.t- Q) 0 z E_ ::I 0 E+:i ·­c:x Q) 0 "O :::E ·­en -~ ~-- "O • E §en ::I E -o~ · ­Q) ..0c ..0 ,_ ·­,_ ::I:::E ::I 0 - o I 0 '-c I") 0 0 LL. c E :::i­.s~ x c 0 Q) :::E :12 en -Q) ~ a:: ... . ,. .. .·: . •• •• 11 , . . ..-. ·. ·. .. .... .. . . .. .:-> Ol Property Line NOTES: 1. For non-curbed areas, driveway apron shall conform with standard detail 0-33, 0-34 or 0 -35 depending on the existing drainage conditions fronting the property. 2. No driveway approach shall interfere with Municipal facilities or other street structures. 3. Culverts, swales and other drainage improvements. No driveway approach shall i nterfere with the proper runoff of surface waters into, or passage of waters through existing drai nage culverts, swales, ditches, watercourses, defiles, or depressions. When in the construction of a driveway approach, the proper runoff of surface waters and other waters require the construction of a drainage structure other than a swale, such drainage structure shall be designed by an engineer and subject to the approval of the director. · 4 . Distances shall conform to Section 22-4.9 of the Hawaii County Code . 5. Ref. Sec. 22.2 Intersection Sight Distance NO OBJECT WITH A HEIGHT BETWEEN THREE FEET (3-FEET) AND EIGHT FEET (8-FEET) ABOVE THE NEAREST SURFACE OF THE COUNTY STREET SHALL BE ALLOWED IN THE SHADED AREA . ~ a.. I--.-----'i----~,- PRIVATE DRIVEWAY 1 I I 1s· . / / / / ,. // / //' ... / / / / / ; . / ..· /// . ; '._ / / / / Min . / / / SEE/N011:." 1/ / /---+--J / / . / / / .. / / ----11­ / / / ,/ .·'' / / / / / ,./ // / ; / / / / // / , .'/ _/ /' .-" ,.. ~ ,./ / ,. / /' , / Edge of Pavement 30' See Note 41---..:::..:::.----1-.w-­ lS c.,..., ..,~,..c:.:c.\ 36' Maximum 2' Min .** (Residential) NON -CURBED STREET ** No minimum if frontage is less than 20 feet. STANDARD . DRIVEWAY LAYOUT R-38COUNTY OF HAWAII DETAILS REVISED SCALE: NOT TO SCALE FEBRUARY 2003 A<.;Uf(LJ~ ~J::.K I lrll,,1-\. It: Ut" LIJ-\tjlLI I T IN~Ut(J-\Nl,,t: ~ 09/11.10·6 THE POLICIES OF INSURANCE LISTED BELOW HAVI! BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TliE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTliER DOCUMENT WITH RESPECT TO WHICH TlilS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUIS.IECT TO All THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CV.IMS. TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY A X X ·COMMERCIAL GENERAL LIABILllY CGLS 4. ·j Cl.AIMS MADE [Kl OCCUR 1---+-~ A ----------- GEN'l AGGREGATE LIMIT APPLIES PER: il POLICY n ~~8i .n LOC AUTOMOBILE LIABILITY-X ANYAUTO- ALL OWNED AUTOS - SCHEDULED AUTOS -X HIRED AUTOS X NON-OWNED AUTOS - GARAGE LIABILITY ~ANY AUTO EXCESS/UMBRELL.A LIABILITY =:J OCCUR D Cl.AIMS MADE I DEDUCTIBLE I RETENTION s WORKERS COMPENSATION AND B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes. describe under SPECIAL PROVISIONS below OTHER ~ .. ' CBA S3.6· FWC ·713· 06/01/06 06/01/06 12/01/05 EACH OCCURRENCE S 1, 000 1 000 06/01/07 PREMiSesfi;........~"r::na.1 s100,ooo MEO EXP (~one person) S 5 , 0 0 0 PERSONAL&ADVINJURY S 1,000, 000 GENERAL AGGREGATE s2,000,000 PRODUCTS ·COMP/OP AGG $ 2 1 0 0 0 1 0 0 0 COMBINED S1NGLE LIMIT s06/01/07 (Ea accident) BOOIL Y INJURY s1,000,000(Per person) BOOIL Y INJURY s 1, 000, 000(Per accident) PROPERTY DAMAGE s1,ooo,ooo(Per accident) AUTO ONLY· EA ACCIDENT s OTHER THAN EAACC s AUTO ONLY: AGG s EACH OCCURRENCE s AGGREGATE s s s s· x hoRY"'L1Mlf's I IUER" 12/01/06 E.L EACH ACCIDENT sS00,000 E.L. DISEASE· EA EMPLOYEE ssoo,ooo E.L DISEASE· POLICY LIMIT ssoo,ooo DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The County of Hawaii, its officers, representatives, employees and agents are named as additional insured in accordance with the General Liability policy provisions, cov~ring any claim or liability for damages,. injur.ies or death resulting from any of .the uses permitted hereunder ~:::=~::;::::::~:... -· .......... .. . .-· ...­·-.. • • , ••-.... _ .. _ •• t. : • : ~-~ .-:-~-~:· :··-:·--t~·: t .PRODUCER INSURED - COVERAGES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURER A:. 41 INSURERB: INSURERC: INSURERO: 7· --_-.·~:· ••.·~ _,_-, INSURERE: CERTIFICATE HOLDER CANCELLATION County of Hawaii Dept. of Public Works Engineering Division 101 Pauahi st Ste 7 Hilo HI 96720 :,"". -;·= • ·-,C,OUD;tL. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION -: • :~ )•: ... : ": •: •: ··: •-:·· DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN 00 0 0 ·.,·~: .: ~·-· • ': " ' • NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ~~~~It~~!~~:~:~~ :::::::TION OR ~UTY OF ANY ~ND UPON THE ~SUR~rrs AGENTS OR ~.: • > :_;>>!·°!~: .;.:1-,..-UTH=---0-0~=----~---~~------T....A-~......,=-.---------------------1 ··-. --....-. ....... ... ... ~ • -. • ec . .a • - • ACORD 25 (2001/08) ©ACORD CORPORATION 1988