HOME RULE BOROUGH OF EDINBORO

APPLICATION FOR MAINTENANCE AND ACCEPTANCE

NOTICE TO APPLICANT: Please complete the entire form as this document is designed to assist Council in determining whether said improvements have been installed and constructed pursuant to the specifications and requirements contained in the CODE of the Home Rule Borough of Edinboro.  Requirements and procedures for said acceptances are contained in Article XII of the Subdivision and Land Development Ordinance # 474 of the Borough of Edinboro, entitled Acceptance of Public Improvements.

A.  Owner/Applicant                                       B.  Representative/Builder

Name _____________________________                                 Name ______________________________

Address ___________________________                                 Address ____________________________

City ______________________________                                  City ______________________________

State _______________ Zip ___________                                 State _______________ Zip ___________

Phone _____________________________                                                Phone _____________________________

Fax _______________________________                                 Fax _______________________________

C. Project Information

Subdivision Name/Description:  __________________________________________________________

Location:  ____________________________________________________________________________

D.  Performance Bond Information

Estimate of Final Wearing Course:  ________________________________________________________

                                                                         (Estimate must include provision for pavement base repair)

E.  Maintenance Bond Information

Actual Costs of Improvements:  ___________________________________________________________

                                                                (Applicant must provide a cost summary of said improvements)

Maintenance Bond Amount:  _____________________________________________________________

                                (Maintenance Bond shall be fifteen percent (15%) of actual cost of said improvements)

                                (Period of maintenance of said improvements is 18 months from date of acceptance)

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F.  Project As-Build Information

Prior to final acceptance the Applicant must submit plans containing as-built locations of all improvements including, but not limited to, the following:

·         Roads with corresponding edge of pavement;

·         Roadway profiles with vertical geometry;

·         Rights-of-way and recorded easements;

·         Permanent Monument locations;

·         Storm sewers, catch basins, manholes, headwalls and endwalls;

·         Stormwater management ponds, spillways and outlet structures;

·         Wetlands and conservation lands;

·         Public Utilities;

·         Light Poles;

·         Guide rails and

·         All other appurtenances within the public rights-of-way.

The Applicant must supply the Borough with a minimum of four (4) copies of the as-built plans showing the said improvements.  The Applicant shall shade or color that portion of said roadway in yellow and storm sewers in green on each of the four (4) copies and shall clearly designate the number of linear feet of roadway and storm sewer to be accepted by the Borough.

G.  Municipal Road Data Processing Report Information

Provide the following information for the roadways to be accepted by the Borough.

H.  Certification

Signature _____________________________________________________________________________

Title _________________________________________________________________________________

Representing __________________________________________________________________________

Date __________________________________________________________________________________

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The Home Rule Borough of Edinboro shall complete the following information

I.  Final Inspection

Date of Final Inspection _____________________________________________________________

Notes or Deficiencies:

Final Inspection and Remediation of noted deficiencies.

Inspection completed by ________________________________________________________________________

J.      Recommendation of Acceptance

The above information has been reviewed along with the submitted as-built information.  Performance and Maintenance Bonds have been received for said improvements.  Acceptance of said improvements is hereby recommended.

WWTP Superintendent, Robert Kennerknecht _________________________ Date________

Water Department Superintendent,  Butch Shafer______________________ Date________

Public Works Superintendent, Tom Schruers __________________________ Date ________

Representative, Lake Engineering __________________________________    Date ________