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Road Excavation Permit Application | 1 ROAD EXCAVATION PERMIT APPLICATION Date: _______________ Contractor/Agency Name ____________________________________________________________ Road Location _______________________________________________________________________ Contractor Registration Number _______________________________________________________ Purpose of Work ____________________________________________________________________ Permit Type: Emergency Excavation ☐ Project Under 50 Feet ☐ Project 50 Feet and Over ☐ Type of Installation: ☐Water ☐Sewer ☐Electric ☐Telephone ☐Other _________________________ This authority executed in the original and four copies this ______ Day of ____________________ by the Department of Public Works acting for, and on the behalf of the U.S. Virgin Islands hereinafter called the territory witnesseth that the territory does by these present, grant to: Applicant Name _____________________________________________________________________________ Mailing Address _____________________________________________________________________________ Telephone _____________________ Email Address: ________________________________________________ Road Excavation Permit Application | 2 ROAD EXCAVATION PERMIT APPLICATION A permit to erect, construct, operate, maintain, and repair a ________________________________________ Within the right-of-way of the hereinafter said highway(s) for the purpose of transporting _____________________________________________________________________________________________ As shown on the attached drawing(s) and further described as follows: Location: ☐ St. Croix ☐ St. John ☐ St. Thomas ☐ Water Island Project #______________________________________ ☐Transverse Installation ☐Parallel Installation Highway/Road Name _________________________________________________________________________ Limits: from ______________________________________ To ________________________________________ Total length of installation: _____________________________________________________________________ The installation will be made in the following manner: _____________________________________________ (Boring, pushing, overhead crossing, and other description) Size of line ______________________________ Size of casing ______________________________________ PIPELINES (IF APPLICABLE) Size Alloy/Material Wall Thickness Contents Test Pressure Working Pressure Max Operating Pressure Depth of Installation Road Excavation Permit Application | 3 ROAD EXCAVATION PERMIT APPLICATION ELECTRIC POWER LINES (IF APPLICABLE) Voltage Conductor Size Type of Structure Maximum Span Depth of Installation COMMUNICATION LINES (IF APPLICABLE) Wires/Pairs Gauge Cable Type Fiberoptic Size Depth of Installation OTHER TYPE OF INSTALLATION (IF APPLICABLE) Size Material Purpose Further Description Road Excavation Permit Requirements | 1 ROAD EXCAVATION PERMIT REQUIREMENTS Underground Utilities Project No: ______________________ 1. Three copies of design drawings on 18”x24” or 24”x36” and one electronic copy. 2. Submission of designs or drawings should include: a. Island Map indicating site location b. Location drawings indicating surrounding roadways and site plan c. Site plan to include the following: i. Topo(s) and grade(s) ii. Roadway widths on site plans and names iii. Existing and proposed drainage patterns and drainage facilities within boundaries iv. Indication of drainage patterns and facilities on public roadway(s) v. Cross section and profiles of grades at excavation site to include public right of way vi. Location(s) of existing and proposed underground facilities vii. All engineering drawings, designs, and specifications, etc. viii. Contact person and telephone number on application 3. All Traffic Control Plans must be submitted to DPW and approved at least one week prior to the start of construction. The traffic control plan shall be developed in compliance with the Manual on Uniform Traffic Control Devices and shall contain diagrams of work zones for two-way traffic, work zones at intersections and work zones on divided highways. All traffic control shall conform with sections 156 and 635 of FP-14. 4. Existing traffic may be interrupted only with the written approval of the department. Should such interruption create excessive traffic delays in the opinion of the department’s representative, work shall be suspended, and the travel way restored to its normal width until traffic volumes subside. 5. The Contractor/Applicant will be responsible for submitting a letter to Virgin Islands Police Department, Traffic Bureau for monitoring and enforcement of highway devices. Road Excavation Permit Requirements | 2 ROAD EXCAVATION PERMIT REQUIREMENTS 6. Prior to the start of construction all utilities, including the DPW Traffic Signal Division, shall be contacted and requested to mark all their underground installations. Please be informed that any damage to signal loop detectors shall require the removal and replacement of the entire loop and the subsequent resurfacing of the entire loop detector area. 7. A professional construction inspector must be assigned to each project. Their name and qualifications must be submitted to DPW for approval prior to the start of construction. 8. The construction inspectors on each project shall submit a written report of daily activities to DPW no later than noon the following day. 9. A representative from DPW will be assigned as a coordinator of the project. The construction inspectors retained by the utility company are expected to communicate and coordinate the work with DPW’s representative daily. 10. A professional testing and quality control company must be retained to perform required tests and compile a complete record of testing to be submitted to DPW on a weekly basis. 11. The Utility Company must submit specifications on concrete manholes and backfill material for DPW’s approval. Where manholes, vaults, pull boxes, and any related utility boxes are installed in areas subject to traffic, including sidewalk sweeper vehicles, they shall be H-20 traffic rated and display the utility company name on the covers and lids. 12. Trenching should be done in the middle of the travel lane to the greatest extent possible. The trench must be planted within 6 inches of the saw cut edges of the asphalt pavement. 13. Due caution shall be exercised to ensure proper compaction around manholes and other structures within the traveled way. Road Excavation Permit Requirements | 3 ROAD EXCAVATION PERMIT REQUIREMENTS 14. Trench patching shall be done by an approved paving contractor. No paving shall be done until approved density tests have been performed in respective layers along the trench. No trench sections shall be left unpaved for more than two weeks, and in very sensitive areas, patching may be required immediately following backfill and approved density tests. 15. Patching of trenches shall be to the full depth of the pavement and shall be full width in accordance with the attached details. 16. At the conclusion of the project, all trenches running parallel with the roadway will be overlaid with a 1” surface course for a full lane width. Prior to paving the surface course, all trench patches shall be shimmed to grade. 17. All pavement markings which are defaced shall be restored in kind with an approved thermoplastic product. 18. The applicant shall submit a performance bond in the amount of $___________ to insure satisfactory conformance with the conditions of the permit. Upon completion of the roadway excavation, it shall be inspected by a representative of the department. The performance bond shall be released one year following satisfactory completion of the permitted road excavation as determined by the final inspection. 19. Excavation (a) For trenching (placing of conduits); excavation, backfill and compaction shall follow the requirements of Section 603 of Standard Specification FP-14. (b) For other excavation and embankment; the work shall conform with Section 203 of FP-14. 20. Pavement shall be cut with a saw to obtain a square edge and straight lines. When the entire roadway is to be overlaid, pavement cuts using a cutting wheel may be permitted. In no case shall the finished pavement cut be made with a spade or other air operated tool. 21. Replacement of aggregate base courses shall meet the requirements of Section 301, 302, 303 or 304 whichever replaces the existing base course material. Road Excavation Permit Requirements | 4 ROAD EXCAVATION PERMIT REQUIREMENTS a. Hot Asphaltic Concrete Pavement replacement shall meet the requirements of Section 401, 402, 403, 405, 410 or 411, whichever is applicable to the roadway. b. Portland Cement Concrete Pavement shall meet the requirements of Section 501 of FP-14. All work must conform to standard specifications for construction of roads on federal highway projects, FP-14, U.S. Department of Transportation, and Federal Highway Administration. *Good condition is defined as less than 10 percent of the total road surface of the road or segment is affected with a particular or a number of distresses. Distresses may be present, but in low severity and not causing a problem. DEPARTMENT USE ONLY Road Permit No. ___________________________ Date Issued: ______________________________ Permit Fees: _______________________________ Permit Approved: Yes ☐ No ☐ Lane Restoration Type: Full Lane ☐ Partial Lane ☐ Remarks: ____________________________________________________________________________ Reviewing Engineer: _________________________________ Date: ___________________________ ___________________________________________________ Date: ___________________________ Commissioner Road Excavation Permit Requirements | 1 Road Excavation Permit Requirements | 2 Road Excavation Permit Requirements | 3