Fillable Blasting Permit Website Final

Fill Online, Printable, Fillable, Blank Blasting Permit Website Final Form

Use Fill to complete blank online CITY OF BANGOR (ME) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Blasting Permit Website Final

On average this form takes 13 minutes to complete

The Blasting Permit Website Final form is 4 pages long and contains:

  • 0 signatures
  • 12 check-boxes
  • 47 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Bangor

BROWSE CITY OF BANGOR (ME) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
(hereinafter "BLASTER") is hereby granted permission to conduct blasting activity, in accordance with the Laws and
Ordinances of the City of Bangor for a period of Days commencing .
BLASTER agrees to abide by the requirements of the Laws and Ordinances of the City of Bangor, and the terms
and conditions of this permit.
BLASTER agrees to obtain and maintain general liability insurance in an amount to be approved by the City
Engineer and shall provide the City of Bangor with proof thereof.
BLASTER shall notify the City of Bangor in writing as soon as practicable of any claim, demand or action arising
out of the blasting activity and to cooperate with the City of Bangor in the investigation and defense thereof.
BLASTER shall defend, indemnify, save and hold harmless the City of Bangor from and against any and all claims,
demands, suits, judgments, costs, and expenses asserted by any person or persons, or loss or damage to property
resulting from the blasting activity under this permit or as a result of anything done or omitted by BLASTER.
BLASTER expressly agrees that it will defend, indemnify, save and hold harmless the City of Bangor from any and
all claims made or asserted by the blasting activity under this permit. For this purpose, BLASTER expressly waives any
and all immunity it may have under the Maine Worker's Compensation act in regard to such claims made or asserted by
BLASTER's agents, servants or employees. The indemnification provided under this permit shall extend to and include
any and all costs incurred by the City of Bangor to answer, investigate, defend and settle all such claims, including but not
limited to, the City of Bangor's cost for attorney fees, expert and other witness fees, the cost of investigators and payment
in full of any judgments rendered in favor of BLASTER's agents, servants or employees against the City of Bangor in
regard to claims made or asserted by such agents, servants or employees.
General Blasting
Routine Blasting
Certificate of Liability
Pre-Blast Survey
Permit #
Map/Lot
Engineering Department, 73 Harlow Street, Bangor, ME 04401
Phone: 207-992-4248 Fax: 207-992-4194
BLASTING PERMIT
Sheet 1 of 4
Submitted with Permit:
Expiration:
BLASTING PERMIT
.
BLASTER shall notify all parties required by any applicable local, state, and federal ordinance, law or regulation of
blasting activity.
Sheet 2 of 4
Location of Blasting Activity:
Purpose of Blasting:
Blaster Name:
Blaster Address:
Blaster
City, State, Zip
Other Conditions: All work to be done in accordance with 38 M.R.S.A. §490-z(14), Bangor City Code, Chapter 76, ,
and all other applicable federal, state, and local regulations. All property owners within 2500' to receive 24 hours
notification of blast.
BLASTER by its signature hereby acknowledges and accepts the terms and conditions of this permit.
Witness
John M. Theriault, PE, PTOE
City Engineer
Date Signed:
Signature
Print Name & Title
Company Name
Date Signed:
$25.00 (Not to Exceed One Week)
$50.00 (Not to Exceed One Month)
$100.00 (Not to Exceed One Year)
Date Paid:
Check #
Eng Receipt#
Phone:
Email:
For Office Use:
Sheet 3 of 4
BLASTING PERMIT
Performance Standards
(Please Read & Sign Each Paragraph)
The applicant must ensure that the blasting is conducted in accordance with regulations issued pursuant to M.R.S. A. Title 25,
Section 2441 and conform, at a minimum, to MDEP, Article 8-A, Performance Standards for Quarries dated July 4, 1996, 38 M.
R.S.A. §490-A(14).
The blasting plan submitted that work will be conducted in a manner which will cause no damage to surrounding properties.
The owner or operator shall use sufficient stemming, matting, or natural protective cover to prevent fly-rock from leaving
property owned or under control of the owner or operator or from entering protected natural resources or natural buffer
strips. Crushed rock or other suitable material may be used for stemming only if no other suitable material is available.
Blasting shall only be performed by fully qualified blasters experienced in blasting procedures and knowledgeable in all
applicable blasting regulations, and blasters shall submit any and all information requested by the City Engineer to satisfy
this requirement.
The maximum allowable air-blast at any building not owned or controlled by the developer may not exceed 129 decibels
peak when measured by an instrument having a flat response (+ or -3 decibels) over the range of 5 to 200 hertz.
The blaster shall comply with all local, state, and federal ordinances, laws, and regulation and conditions of the Blasting
Permit. Said notice shall specify the nature of the violation or failure to comply and steps taken by the blaster to correct said
violation or failure to comply.
If necessary to prevent damage, the City Engineer may specify lower maximum allowable air-blast levels than those in the
previous paragraph of this section for the use in the vicinity of a specific blasting operations.
If necessary to prevent damage, the City Engineer may specify lower maximum allowable air-blast levels than those in the
previous paragraph of this section for the use in the vicinity of a specific blasting operation.
Notification list of residences and abutters requesting notification of blasting 24 hours before blasting.
Pre-blast surveys shall be conducted in accordance with MDEP regulations outlined in the above-referenced Article 8-A,
dated July 4, 1996 and a copy provided to the City Engineer.
Pre-blast surveys must be offered to abutters and residences within 2640 foot radius for gravel pits and quarries and 500 foot
radius of general blasting.
Blasting activity shall only be conducted during daylight hours; provided, however, that it shall commence no earlier than
7:00 a.m. nor continue later than 7:00 p.m. on any given day, except that detonation of blasting explosives shall be
conducted only during daylight hours; provided, however, that it shall be no earlier than 8:00 a.m. nor later than 6:00 p.m..
Routine production blasting is not allowed on Sundays.
Blasting may not occur more frequently than four times per day.
Under no circumstances shall the City permit routine production blasting within one hundred fifty (150) feet of an adjoining
property line.
The maximum peak particle velocity at inhabitable structures not owned or controlled by the operator may not exceed the
levels established by MDEP Article 8-A, Performance Standards for Quarries, effective July 4, 1996, 38 M.R.S.A. §490-Z.14.K.
(Blasting), including Table 1 and the graph published by the U.S. Department of Interior in "Bureau of Mines Report of
Investigations 8507," Appendix B, Figure B-1. Either of the above referenced guidelines must be used to evaluate ground
vibration effects for the blasts for which a pre-blast survey is required and/or when blasting is to be monitored by seismic
instrumentation.
The maximum allowable ground vibration may be reduced by the City Engineer beyond the limits otherwise provided by this
section, if determined necessary to provide damage protection.
A record of each blast must be compiled in accordance with the specifications in the above mentioned Article 8-A, dated July
4, 196. In addition, pre-blast, blast, and post blast linear-peak sound levels in decibels should be included for each air-blast.
The records for each blast, including all monitoring records, shall be filed with the City no more than ten (10) days
after each blast.
Routine production blasting schedule shall be prepared by the blaster and copies of the schedule shall be
distributed to the City, public utilities, and to all abutters and residences within a 500 foot radius within 24 hours
notice for proposed general blasting and 1000 radius with a 24 hour notice for proposed routine production
blasting. And shall contain, at a minimum:
1.) Name, address, and telephone number of operator.
2.) Identification of the specific areas in which blasting will take place.
3.) Dates and times when explosives are to be detonated.
4.) Methods to be sued to control access to the blasting area.
5.) Type and patterns of audible warning and all-clear signals to be sued before and after blasting.
Upon violation of any provision of this ordinance the City Engineer shall have the right to revoke the Blasting Permit
without notice.
Any person adjudged to have violated any provision of this ordinance shall be punished by a fine not exceeding One
Thousand Dollars ($1,000) for each offense.
Sheet 4 of 4
(Please Read & Sign Each Paragraph)
Performance Standards
BLASTING PERMIT
Submission Checklist
Blasting Plan/Blasting Schedule
Notification List within 500' Radius
Initials at Each Paragraph on Pages 3 & 4
Signature on Pages 2 & 4
Check for Blasting Permit
Blaster Point of Contact Information
Contact Name:
Contact Cell:
Signature
Date Signed:
Print Form
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Blasting Permit Website Final

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 11 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document