Excavation Permit Utility Installation Permit No. 2016-139, UID # 211
App. Status: Closed
Valid: 09/02/2016 - 11/01/2016
City of Maple Grove
Engineering Department
12800 Arbor Lakes Parkway
Maple Grove, MN 55369

Kelly Matzke (612-968-3615)
 

APPLICANT

Applicant:
Name:
Cindy Lou Albright
Company:
Telcom Construction
Company Phone:Local Phone:
(320286 - 8369
(286286 - 8369
Email Address:
cindy.albright@telcomconstruction.com
Mailing Address:
PO Box 189
Clearwater MN 55320

PROJECT

Nature of Work:
Service Installation
Surface to be disturbed:
Boulevard
Work to start on or after: 09/02/2016
To be completed on or before: 11/01/2016
Applicant Project No.: 16188504

INSTALLATION / CONSTRUCTION

Attach detailed plan sheet:
Size and kind of pipe:
3 pr 22 gauge copper cable
Depth from surface: 36"- 48"
Length of utility construction: 125
Method of installation:
Directional Bore
Other
If other is selected, please provide additional information:
Plow
Machine excavation: Yes
Development: New

LOCATION

Location/Address: 11882 84th Ave N, Maple Grove
Mark the installation/construction
location on the map:
Mark the location of the installation
How to use:
1. Use only one option (dot, line, or polygon)
2. Made a mistake? Click on feature and press delete key.
Will traffic detouring be necessary? No

Terms

Requirements
  • Contact the Right-of-Way Technician by phone (612-968-3615) 24 hours prior to starting work, and upon completion so a final inspection can be completed in a timely manner.

  • You must adhere to [url=https://www.revisor.mn.gov/statutes/?id=216D]Minnesota Statutes 2015 CHAPTER 216D. EXCAVATION NOTICE SYSTEM[/url]

  • Notify all affected properties in writing prior to beginning work.

  • All cabinets, boxes, pedestals, etc. at corners must meet the City of Maple Grove's City Code, Sec. 360818 traffic visibility at corner lots.

  • All large trucks or large equipment are not allowed on any boulevard sidewalk or bituminous trails unless prior approval has been granted by the Right-of-Technician.

  • All signing for equipment in street must conform to the current MnDOT Manual on Uniform Traffic Control Devices.

  • Pneuma gophering is not allowed by the City of Maple Grove in this area.

  • All underground utilities must be placed a minimum of 36" and 48" maximum below finished top of curb elevation.

  • No hand holes or pot-holing in bituminous trails unless approved by the Right-of-Way Technician.

  • All disturbed areas must be returned to their original conditions within 30 days.

  • Lawn / Blvd areas must be restored per 28-105 of the Maple Grove Code of Ordinances.

  • Must adhere to MnDOT's Standard Specifications for Construction, Section 2575 and Maple Grove's specification for grading, landscaping and traffic control.

  • Notify Right-of Way Technician when work under this permit is completed, not at year's end.

  • Flag or mark utility location as required by state statue prior to calling in locates.

  • No work shall begin this year if it cannot be properly restored this year (unless emergency).

  • Street crossings to be installed perpendicular to street whenever possible.

Invoice #159 (08/30/2016)

Charge Cost Quantity Total
Non-Taxable
added 08/30/2016 11:08 AM

Excavation permit fee per occurance

$130.00 x 1 $130.00
added 08/30/2016 11:08 AM

In addition to excavation permit fee (per lineal foot)

$0.20 x 125 $25.00
Grand Total
Total $155.00
Payment 08/30/2016$155.00
Due$0.00

Approvals

ApprovalSignature
Applicantcindy L. Albright - 08/30/2016 11:09 AM
9bf98b0c6bbb3778192d9f2bfe435b96
fec271add52fbbf4a9f1f6bfd4c15ca1
#1 Approved ByKelly Matzke - 09/02/2016 8:18 AM
8b6cebd75156982757d159c01cf4130b
5ca721674d7a5caff79e1231beea775c
Application has been approved. All signatures have been obtained.

Public Notes

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File(s):

    Internal Notes

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