Permit No. Permit Fee: $ Permit Expires (D+90 days): Business Name: Applicants Name: Telephone Number: Address:

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1 City of Woodland Park Internet Service Provider (IPS) Permit for Installation of Telecommunication Infrastructure within City Owned Rights-of-Way (up to five locations per single permit) Permit No. Permit Fee: $ Date (D): Permit Expires (D+90 days): Business Name: Applicants Name: Applicants Signature 1 : Mailing Address: City/State/Zip Code: Telephone Number: Address: Permit Locations* (must be specific provide a detailed map) Street/ROW Begin End Notes By signing this permit you acknowledge that you have read and agree to the attached permit Conditions & Agreement. 1

2 2. Any disturbed areas, be they public or private property, must be returned to the original Condition upon Completion of Work. 3. Construction without inspection is subject to rejection. SPECIAL CONDITIONS IMPOSED, if any. (Explain need for special conditions imposed under Chapter of the Woodland Park Municipal Code.) Itemize conditions and number them. (This section is for City use only.) Notes: 1.) The City is not responsible for locating privately owned and maintained sanitary sewer service lines. 2.) Installation of ISP infrastructure shall be in accordance with the current edition of the Utility Notification Center of Colorado's Excavator Handbook and comply with Colorado State Law (SB ). Please visit a7a0-bd761ba57028&groupid=18 to download a copy. Special Conditions, if any, acknowledged by applicant by signing below: Applicant s signature: Date: Do Not Write Below Line For City Use Only Will the street(s) be closed? Teller County Business License Number: Bond Number: Certificate of Insurance: City Business License Number: Approved by: Date: Rejected List Reason: 2

3 City of Woodland Park Internet Service Provider (IPS) Permit for Installation of Telecommunication Infrastructure within City Owned Rights-of-Way Permit Conditions & Agreement SECTION 1 -Construction and Maintenance of the Telecommunications System 1.1. Permits and General Obligations. The Permit Holder shall be responsible for obtaining, at its own cost and expense, all permits, licenses, or other forms of approval or authorization necessary to construct, operate, maintain or repair the Telecommunications System, or any part thereof, prior to the commencement of any such activity. Construction, installation, and maintenance of the Telecommunications System shall be performed in a safe, thorough and reliable manner using materials of good and durable quality, in accordance with all applicable codes. All transmission and distribution structures, poles, other lines, and equipment installed by the Permit Holder for use in the Telecommunications System in accordance with the terms and conditions of this Permit shall be located so as to minimize the interference with the proper use of the Public Ways and the rights and reasonable convenience of property owners who own property that adjoins any such Public Way. The location within the Public Way shall be as specified in the City Engineering Specifications (e.g. Figure 5.3.2, link: ) Conditions on Street Occupancy New Grades or Lines/Relocation for Public Projects. If the grades or lines of any Public Way within the Rights-of-Way are lawfully changed at any time during the term of this Permit, or in connections with any other public project that requires any portion of the Telecommunications System in the Public Way to be relocated, then the Permit Holder shall, upon reasonable advance written notice from the City (which shall not be less than ten (10) business days) and at its own cost and expense, protect or promptly alter or relocate the Telecommunications System, or any part thereof, so as to conform with any such new grades or lines, or other public project requirements Relocation at request of Third Party. The Permit Holder shall, upon reasonable prior written request of any Person holding a permit issued by the City to move any structure, temporarily move its conductors to permit the moving of such structure; provided (i) the Permit Holder may impose a reasonable charge on any Person for the movement of its conductors, and such charge may be required to be paid in advance of the movement of its conductors; and (ii) the Permit Holder is given not less than ten (10) business days advance written notice to arrange for such temporary relocation Restoration of Public Ways. If in connection with the construction, operation, maintenance, or repair of the Telecommunications System, the Permit Holder disturbs, alters, or damages any Public Way, the Permit Holder agrees that it shall at its own cost and expense replace and restore, in accordance with the latest version of the City s Engineering Specifications, any such Public Way to the condition of the Public Way existing prior to the disturbance Safety Requirements. The Permit Holder shall, at its own cost and expense, undertake all necessary and appropriate efforts to maintain its work sites in a safe manner in order to prevent failures and accidents that may cause damage, injuries or nuisances. All work undertaken on the Telecommunications System shall be performed in compliance with applicable FCC or other federal, state 3

4 and local regulations. The Telecommunications System shall not endanger or interfere with the safety of Persons or property in the Public Way or adjacent areas Trimming of Trees and Shrubbery. The Permit Holder shall have the authority to trim trees or other natural growth overhanging any of its Telecommunications System in the Public Way so as to prevent contact with the Permit Holder's wires, conductors, cables, or other equipment. All such trimming shall be done at the Permit Holder's sole cost and expense. The Permit Holder shall be responsible for any damage caused by such trimming Aerial and Underground Construction. If all of the transmission and distribution facilities of all of the respective public or municipal utilities in any area of the Public Way are underground, the Permit Holder shall place its Telecommunications Systems' transmission and distribution facilities underground; provided that such underground locations are actually capable of accommodating the Permit Holder's cable and other equipment without technical degradation of the Telecommunications System's signal quality. In any area(s) of the Public Way where the transmission or distribution facilities of the respective public or municipal utilities are aerial, the Permit Holder shall have the discretion to construct, operate, and maintain all of its transmission and distribution facilities, or any part thereof, on the same pole with consent of the owner of the pole. Nothing in this Section shall be construed to require the Permit Holder to construct, operate, or maintain underground any groundmounted appurtenances such as customer taps, line extenders, system passive devices, amplifiers, power supplies, pedestals, or other related equipment. 1.3 Safety Requirements. Permit Holder shall at all times employ ordinary and reasonable care and shall install and maintain in use nothing less than commonly accepted methods and devices for preventing failures and accidents which are likely to cause damage, injuries or nuisances to the public. 1.4 Performance Bond. No later than the Effective Date of this Permit, Permit Holder shall establish and provide to City, on behalf of City as security for the faithful performance by Permit Holder of all provisions of this Agreement, a bond in the amount of Five Thousand Dollars ($5,000.00). The bond deposited pursuant to this section and its accrued interest shall become the property of City in the event this permit is lawfully terminated or revoked for cause by reason of the default or material breach of Permit Holder, and Permit Holder has exhausted all of its remedies relating thereto. Permit Holder, however, shall be entitled to the return of the bond deposited in accordance with this section, or any portion thereof remaining upon normal expiration of this Permit, or upon termination other than for breach of a material provision hereof. 1.5 Street Cuts. The following requirements must be met for all street cuts and excavation within the Public Way: Any work within the Public Way that requires excavation, cutting or modification to a paved surface must be done in accordance with the City Engineering Specifications Any Contractor in employment of the Permit Holder must have proof of insurance and an active insurance bond provided by the insurer in the amount of $5, on file with the City or put up a cash deposit of $5, prior to Street Cut Permit being issued. Contractors must also have an active business license with the City Asphalt cut maintenance fee of $ per 60 square feet minimum is to be collected upon completion. 4

5 CALL BEFORE YOU DIG. All utilities must be located prior to cutting the street with at least 48 hours notice in advance of excavation. Call 811 for the Utility Notification Center of Colorado All work must be completed by the date(s) on the Street Cut Permit. If an extension is required, the City must be notified prior to the expiration of the permit so that emergency services can be notified TRAFFIC CONTROL PLANS are required for all Street Cut permits and shall be provided to the City Inspector at least 24 hours in advance. The Traffic Control Plans should include a drawing of the street where the work zone will be located, along with the nearest cross street noted as well. Street names, North arrows, type of traffic control devices, distances between, and location of excavation on the street should also be noted. A minimum of one lane must remain open at all times, unless an alternate reasonable route, approved in advance by the appropriate City Official is available for traffic. A certified Flagger may be required to facilitate traffic flow safely through a construction zone. The contractor should adhere to the Manual on Uniform Traffic Control Devices (MUTCD) for all traffic control plans. Please visit to download a copy of the manual. Any equipment or other obstructions left on the road surface after sunset must be barricaded with lighted barricades. Police and Fire Departments will be notified for emergency routing Backfill compaction testing is required. City right-of-way (ROW) backfill shall be compacted per current City of Woodland Park Engineering Specifications. Compaction test results shall be submitted to the City within 30 days of cutting, or prior to patching Flow fill is acceptable as long as it is designed within the range of 30 to 90 psi maximum strength at 28 days, however, the roadway must be open for traffic at the end of the day. If flow has not set up by the end of the day, steel plates will be required over the trench to allow traffic to pass. (Compaction testing is not required if flow fill is used the full depth of the trench.) All roadways shall be patched within 7 working days of cutting, unless prohibited by cold or inclement weather. All patches shall comply with the City Engineering Specifications prior to patching. The contractor shall monitor daily the condition of the cut area and immediately repair all potholes and bumps in the temporary gravel surface. If weather does not allow asphalt placement within 7 working days, cold mix shall be placed in the surface cut for the interim until hot mix can be placed Asphalt shall be saw-cut for a clean straight edge prior to new asphalt placement. Asphalt placement shall comply with the City Engineering Specifications and the thickness shall be matched to existing conditions plus one inch Open Hole Limits all trenches shall conform to appropriate federal, state and local safety regulations. Every effort shall be made to guard the safety of the general public. OSHA regulations for trench safety are mandatory and shall be adhered to at all times. Open trenches are not to remain open overnight without prior approval from the City Construction Inspector Reminder: Once all the construction work is completed it is the responsibility of 5

6 the Permit Holder of the Street Cut Permit to remove the utility marking flags used to mark their service/utility lines Construction without inspection by the City is subject to rejection. SECTION 2 -Insurance and Indemnity 2.1 Insurance. Throughout the term of this Permit, the Permit Holder shall, at its own cost and expense, maintain Comprehensive General Liability Insurance and provide the City certificates of insurance designating the City and its Officers, Trustees, Boards, Commissions, Councils, Elected Officials, Agents and Employees as additional insured and demonstrating that the Permit Holder has obtained the insurance required in this Section. Such policy or policies shall be in the minimum amount of One Million Dollars ($1,000,000.00) for bodily injury or death to any one person, and Three Million Dollars ($3,000,000.00) for bodily injury or death of any two or more persons resulting from one occurrence, and Three Million Dollars ($3,000,000.00) for property damage resulting from any one accident. Such policy or policies shall be non-cancelable except upon thirty (30) days prior written notice to the City. The Permit Holder shall provide workers' compensation coverage in accordance with applicable law. The Permit Holder shall indemnify and hold harmless the City from any workers compensation claims to which the Permit Holder may become subject during the term of this Permit. 2.2 Indemnification. The Permit Holder shall indemnify, defend and hold harmless the City, its Officers, Employees, and Agents from and against any liability or claims resulting from property damage or bodily injury (including accidental death), loss, liability, cost or expense that arise out of the Permit Holder's construction, operation, maintenance or removal of the Telecommunications System, or any other act done under this Permit, by or for Permit Holder, its Agents or Employees, or by reason of any negligent act or omission of Permit Holder, including, but not limited to, reasonable attorneys' fees and costs. Such indemnification shall include, but is not limited to, indemnification of City for any damages, claims, additional costs or expenses assessed against, or payable by, City arising out of, or resulting directly or indirectly from, Permit Holder s failure to remove, adjust or relocate any of its facilities in the Public Way in a timely manner in accordance with any relocation required by City, and any claims arising out of the lawful actions of City in granting this Permit (to the extent such actions are consistent with this Permit and applicable law) and any damages arising out of any failure of Permit Holder to secure consents from the owners, authorized distributors or licensees/licensors or programs to be delivered by the Telecommunications system, whether or not any act or omission complained of is authorized, allowed or prohibited by this Permit. Provided, however, that the City shall give the Permit Holder written notice of its obligation to indemnify and defend the City within ten (10) business days of receipt of a claim or action pursuant to this Section. If the City determines that it is necessary for it to employ separate counsel, the costs for such separate counsel shall be the responsibility of the City. 6