kdot water main permit I-135/schilling 1/5/1982
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White - Maint. Dept.
Yellow, - Petitioner
Pink -District '
Green - Area
Blue - City or Sub..,.Area
KANSAS DEPARTMENT OF TRANSPORTATION
Maintenance Department
Permit No.
Route
HIGHWAY PERMIT AGREEMENT
USE OF HIGHWAY RIGHT OF WAY
Co.
THIS AGREEMENT, made and entered into this 5th
Jan. 82 .
day of . 19_. by and between the Secretary of Transportation
City of Salina
(Name)
hereinafter referred to as the "Owner." and
of the State of Kansas, hereinafter referred to as the "Secretary,"and
P.O. BO~ 746
Street" No.)
N/A .
(Name - if not applicable, cnter N/A) (Street & No.) (City)
as the Agent. Lessee or Contractor of the Owner. hereinafter referred to as the "Agent." The Owner and Agent are hereinafter referred to col-
lectively as the "Petitioner ," where both are applicable, otherwise Petitioner shall refer to the Owner.
WHEREAS. the Secretary has jurisdiction and control of aU highway right~f-waYI within the State Highway System of Kansas,
Salina. KS
(City)
and.
WHEREAS, the Secretary believes it is in the interest of the Citizen 'I of the State of Kansas to permit certain work or projectl to
be performed upon State Highway rights~f-way, and
WHEREAS, the Owner and/or Agent requests permission and authority from the Secretary to perform certain work, described
as follows:
Repair of a 24" C.I.P. water main located within the R/W of 1-135.
(See attached location drawing)
involving State High~a;-;t~ht~f':~;i;:~pon-~l~~g State -ffig~:;';R~;~I -135 in Sec 2 Twp. 155 Range 3W
C;"linp '~UnlY~ mU.. south from 1-135 & Schilling Road ,and
(Direction) (City or JW1ction)
WHEREAS, the Secretary has delegated full and complete authority to the District Engineen of the Kansas Department of Trans-
portation to execute Highway Permit Agreements. hereinafter referred to as Permits. for and on the Secretary's behalf.
NOW THEREFORE, in consideration of the permission granted hereunder by the Secretary to utilize State Highway rights~f-
way in the manner described above, the Petitioner agrees to the following terms and conditions:
1.0 PLANS: Petitioner shall furnish five (5) sets of comprehensive plans or sketches, 8%" x 11" or larger. of the proposed work.
1.1 Plans for utility installations must include a description of the size. type, and method of installation for the proposed
faciUties to be located within highway rights-of-way. and adequate sketches to indicate the location of the proposed installation with
respect to the traveled way of the highway. the rightJ~f-way lines and, where applicable, the control of access lines.
.1.2 Plans for entrances must include a plan layout sketch or drawing for the proposed installation, and a description of the
location of the entrance, surfacing material, and provisions for drainage structures.
2.0 MATERIAL AND METHODS: All requests to perform work tn. upon or along State Highway rights-of-way must be ap-
proved by the District Engineer.
2.1 The Petitioner shall furnish all material, do aU work and pay all costs for the work described on this permit.
2.2 All utility installations shall comply with the conditions and requirements of the "Utility Acc::ommodation PoUcy for
the Kansas Department of Transportation ", current edition.
2.3 All entrance installations shall comply with the conditions and requirements of the "Driveway Control Standard Plans
and Regulations". current edition. as established by the Kansas Department of Transportation. Proposals for commercial entrances must
be reviewed by the Urban Highway. Department.
2A Drainage structure requirements shall be determined by the Petitioner, but said requirements are subject to review and
approval by the District Engineer.
2.5 Commercial Entrances shall be surfaced with material of the same general type and thickness as the adjacent highway
roadway surfacing.
2.6 All materials and construction methods used on work within the limits of the right~f-way shall be equal to or better
than that required by the Standard Specifications for State Road and Bridge Construction, current edition.
3.0 OBSTRUCTION OF TRAFFIC: Petitioner agrees that highway traffic will be free of interference unless specifically pro-
. vided for as a part of this Permit. Traffic protection shall be in accordance with the Manual on Uniform Traffic Control Devices, current
edition.
4.0 RIGHT-OF-WAY: Petitioner agrees to restore said right~f-way to the condition existing Prior to approval of the work
described on this Permit.
4.1 Any sod, shrubs or trees destroyed by this work shall be replaced as directed by the District Engineer.
4.2 The right-of-way shall be kept free from parking, advertising signs or any other commercial activity.
5.0 MAINTENANCE: All utility installations shall be maintained or caused to be maintained by the.Owner.
Rev. I-SO
D.O.T. Form No. 304
8.0 BOND (check either 8.1. 8.2 or 8.3):
8.1 0 A check. or other suitable bond. in the amount of dollan .
'~de payable to the Kaa.su Department of Transportation. ahaD be 4epodted with this Permit to cuuantee satilfactory performance of
the conditlODl of the Permit before the Permit wW be IUDted.
6.2 D A standing bond has been med with the Fiscal Management Department by
in the amount of dollan $ KDOT Reference No. (Bonding Co.)
6.3 QI No Bond Required.
6.4 Petitioner agrees, that if a check or bond is med pursuant to paragraph 6.1 or 6.2, said check or bond will be forfeited
or called if Petitioner fails or refuses to perform the work required under this Permit to the satisfaction of the District Engineer.
6.5 The District Engineer agrees that upon satisfactory compliance with all conditions of this Permit, said check or bond
will be released.
7JJ "INITIATION AND COMPLETION OF WORK: Petitioner agrees to notify the District Engineer or his duly authorized repre-
sentative before work is initiated and again when the work II completed.
7.1 An approwd signed copy of th1s Permit shan be on the premises before and dwing the period any work is performed.
7.2 AD work, including right-of-way restoration, shall be completed within_calendar days of APPROVAL DATE,
otherwise this Permit is nuD and void. The District Engineer or his duly authorized representative may grant an extention of time provided
the request is submitted in wrltins and states the reasons for delay in completins the work.
8.0 LIABILITY: The Petitioner, his successor, or usigDJ, shBn assume all risk and llabiUty for accidents and damages that may
occur to persoDJ or property on account of this work, and shan indemnify and hold the Secretary harmless from any and all costs, UabWties,
expeDJes, suits, judgements, or damases to persons or proPerty or claims of any nature whatsoever arising out of or in connection with
this Permit, or the operation and performance thereunder by the Petitioner, his agents, employees, or sub-contracton. In this regard it is
further understood and agreed that the Petitioner shall obtain insurance coverage as may be required by the Secretary 9r the District Engi-
neer. (check either 8.1 or 8.2).
8.1 [J The Petitioner shall cany Uability iDJurance to protect the public from injuries by reason of the carryins on of the work
.to which this permit applies and to protect the Secretary from all liability on account of injuries to workmen, as provided by law. and to
protect the Secretary frC?m all liabilities to any person for damages sustained by reason of the carrying on of this work to which this Permit
applies.
8.2 Cl No liability insurance required.
8.3 The Petitioner agrees. that if Dability Insurance is required pursuant to paragraph 8.1, to me with the Secretary prior to
the cranting of this Permit, "Certificates of Insurance" or other evidence to show that he carries Workmen's Compensation Insurance, Em-
ployer's Uabllity Insurance, Standard Form Comprehensive Public UabWty and Property Damage Imurance. and Comprehensive Auto-
mobile Owned, Nonowned and Hired Insurance as recognized by the Commissioner of Insurance of the State of Kansas. The Standard Form
Comprehensive PubUc Uability and Property Damage Insurance shall carry the fonowing coverages: minimum Coverage A "BodDy Injury"
each person $250,000; each accident $500.000; Coverage B "Property Damage". each accldent $250,000; pollcy aggregate $500,000. The
CompreheDJive Automobile Owned, Nonowned and Hired Insurance shaD carry the following coverages: minimum Coverage A '.Bodily
Injury" each person $250,000; each accident $500,000; Coverage 8 uProperty Damage" $250,000.
8A "Certificates of Insurance" shaD include a clause requiring the insuror to notify the Secretary ten (10) days in advance
. of any cancellation or change in insurance contracts. _ _ __ __ ~_ .._ ___ __
8.5 Insurance as herein required shaD be maintained in force. until final release of the Petitioner by the District Engineer
from all obllptloDJ under the terms of this Permit. Said insurance contract shan cover claims for such length of time as said claims are per-
mitted by law.
9.0 HIGHWAY IMPROVEMENTS: In the event the Secretary deems it necessary or proper to make any alternation or improve-
ment along or upon the highway right-of-way which is the subject of this Permit, the Petitioner agrees to hold the Seaetary harmless for
any and aU damage or injury to said Petitioner's coDJtruction, whether finished or unf"mished, as weD as damage or injury to Petitioner"
equipment, materials, employees, agents or contractees, and the Petitioner further agrees, that within a reasonable time after written notice
from the Secretary and without cost or expeDJe to the Secretary. that he will alter, change the location of, or move his coDJtruction or
work.
9.1 Petitioner agrees that the work approved on this permit will be conducted in such a manner as not to lnterfere with
cODJtruction or other work being performed by the Kansas Department of Transportation or it"s contracton in the vicinity of the Peti-
tioner's work or project.
This Permit is hereby accepted and its pro\'istODJ agreed to by the parties hereto.
Circle One: Agent - Lessee - Contractor
City of Salina. KS /
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1/5/82
Date
Date
Tltl.
Assistant City Engineer
Title
Recommended
Dat.
by:
Circle one: Area Engr. - Area Supt.
Permit approved this
day of
19_
SECRETARY OF TRANSPORTATION
OF THE STATE OF KANSAS
By:
District Enslneer
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