Small Wireless Facility Permit Small Wireless Facility Permit UID # 3448
App. Status: Returned for Changes
City of Maple Grove
Engineering Department
12800 Arbor Lakes Parkway
Maple Grove, MN 55369

Kelly Matzke (612-968-3615)
 

APPLICANT

Applicant:
Name:
Kelly Matzke
Company:
City of Maple Grove
Company Phone:Local Phone:
(612599 - 1234
(599123 - 1234
Email Address:
wematzke22@blakeschool.org
Mailing Address:
10622 Lancaster Lane N.
Maple Grove MN 55369
Additional email address to notify: kmatzke@maplegrovemn.gov

CONTRACTOR

Contractor:
Name:
Kelly Matzke
Company:
City of Maple Grove
Company Phone:Local Phone:
(612599 - 1234
(599123 - 1234
Email Address:
wematzke22@blakeschool.org
Mailing Address:
10622 Lancaster Lane N.
Maple Grove MN 55369
Additional email address to notify: kmatzke@maplegrovemn.gov

PROJECT

Work to start on or after: 01/01/2020
To be completed on or before: 01/30/2020
Applicant Project No.: Testing
Project Description:
Testing
Number of Locations: 9
Type of Installation:
Collocation

REQUIRED DOCUMENTS

Small Cell Supplemental Agreement Upload:
Construction Plans Upload:
Radio Frequency Study:
Structural Analysis Upload:
Design Route For Backhaul Upload:
Traffic Control Plan Upload:

LOCATION

Site Plan(s):
Calculated Fee: 900.00 

Terms

Activation and Preconstruction Meeting Required
  • Contact Kelly Matzke at 612-968-3615 at least 48 hours prior to construction to activate permit and schedule preconstruction meeting. Failure to contact Mr. Matzke prior to construction and schedule preconstruction meeting shall be considered a violation of the permit and grounds for dismissing contractor from the job site.

Limits of Permit
  • This Permit covers all work related to the installation(s) of Small Wireless Facilities listed on the permit only. Each site shall be limited to a maximum distance of 50 feet from the facility. Work beyond this limit is subject to additional permits and approvals by the City.

Multiple Locations
  • May include proposed collocation sites up to 15 Small Wireless Facilities provided the sites are located within a two-mile radius, consist of substantially similar equipment, and are to be placed on similar types of supports.

General
  • Article IV. Public Right-of-Way Management Ordinance will be enforced for work being done in the right-of-way.

  • All excavations taking place in the right-of-way must conform to Minnesota Statute Chapter 216D. Excavation Notice System.

  • All rules and regulations for locates must conform to the most current Gopher State One Handbook.

  • All properties affected by excavation and construction must be notified in writing prior to beginning work.

  • Permittee is responsible for notifying abutting property owners and the City 48 hours in advance of any work that may disrupt the use and access to the abutting property.

  • The permit issued does not in any way imply an easement on private property or grant a right to encroach on private property.

  • The Permit issued does not in any way imply an easement on private property or grant a right to encroach on private property.

  • A City of Maple Grove approved Small Cell Utility Permit shall be on site at all times and available upon request by any City official.

  • Safety vests must be worn by all people occupying the right-of-way.

  • Applicant shall maintain safe conditions for pedestrians at all times during installation.

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

  • New ground structures must be placed near existing structures at a minimum of at least five feet away from hydrants.

  • Vehicles, equipment, and materials are not allowed on any sidewalk or trail unless prior approval has been granted by a City of Maple Grove official.

  • Notify Kelly Matzke at 612-968-3615 of any changes or revisions made to right-of-way permits that have already been approved by the City of Maple Grove.

  • Street crossings must be installed perpendicular to the road to avoid future potholing in street.

  • Plowing and pneuma gophering are not acceptable forms of excavation allowed in the City of Maple Grove.

  • Core drilling in street or trail requires approval prior to doing work.

  • All open trenches and holes must be backfilled before leaving work site at the end of the day.

  • All flags from locates must be removed and picked up immediately once excavation has been completed.

  • Street and boulevards must be kept clean and presentable throughout construction as deemed by the City of Maple Grove.

  • Inclement weather shall be reason for delay of the project start or suspension of the project as determined by the City of Maple Grove.

  • Any work in the City right-of-way that impacts pedestrian facilities must be restored to conform to current ADA requirements.

  • The permit does not give the permittee the right to cut, remove, or destroy shrubbery within the right-of-way or utility easement.

Traffic Control
  • All permit applications requiring traffic control shall conform to the most recent version of the Minnesota Manual on Uniform Traffic Control Devices, including the Temporary Traffic Control Zone Layouts Field Manual, and be approved by the Transportation Operations Engineer.

  • The City of Maple Grove only allows traffic control to occur during off peak hours, which is between 9:00am-3:00pm Monday thru Friday.

  • All traffic control devices must be removed from the job site promptly upon completeion of work.

  • Traffic control on weekends requires prior approval from Transportation Operations Engineer John Hagen. John can be reached via email at jhagen@maplegrovemn.gov or by phone at 763-494-6364.

Restoration
  • Restoration must conform to Section 28-105. Restoration of Right-of-Way.

  • Restoration Requirements on Soft Surfaces:

  • Turf: Hydroseeding is required unless otherwise directed by Right-of-Way Technician.
    Soil: Six inches of topsoil is required on all boulevards that are damaged.
    Sprinklers: Restore to prior condition with like materials and equipment.
    Pet Fences: Check for continuity after repair.
    Landscaping: Restore to original with like materials.

  • Removal/Restoration Requirements on Hard Surfaces:

  • Bituminous: Shall be removed and restored in a timely matter to its original or better condition.
    Concrete: Shall be removed and restored in a timely matter to its original or better condition.
    Driveways: Notify Right-of-Way Technician of any damage and address with homeowner.

  • All disturbed areas during excavation must be restored to their original condition within 30 days.

  • Damage on boulevards due to vehicles and equipment must be restored and treated the same way that excavation damage is restored.

  • Work completed in winter months must notify City with plans for restoration to take place in the spring.

  • Permanent restoration plans must be submitted to Kelly Matzke at kmatzke@maplegrovemn.gov for temporary restoration during the winter months.

  • Once restoration has been completed, contact Kelly Matzke at (612) 968-3615 or change status on permit software so an inspection can be completed in a timely manner. Failure to notify the City will result in all permits with the City of Maple Grove being put on hold until notification takes place.

Additional Information
  • All contractors, including subcontractors, must be registered with the City of Maple Grove to do work in the right-of-way. Contractors doing work in the right-of-way that are not registered with the City will be considered in violation, and will be dismissed from the work site until registration is completed.

  • Absolutely no removal of bituminous or cement is allowed during winter working months without approval.

  • Absolutely no removal of bituminous or cement is allowed during winter working months without prior written approval.

  • This permit is subject to the provisions of all applicable local, county, state, and federal rules and regulations, including, but not limited to, Maple Grove City Code.

  • This permit is subject to the provisions of all applicable local, state, and federal rules and regulations, including, but not limited to, Maple Grove City Code.

  • Any violation of the conditions of this Permit and/or any applicable local, county, state, or federal rules and regulations may result in revocation of this permit, assessment of costs and denial of future permits.

  • Any violation of the conditions of this Permit and/or any applicable local, state, or federal rules and regulations may result in revocation of this permit, assessment of costs and denial of future permits.

  • Small Cell Utility Permit required from the City of Maple Grove and Hennepin County for installations taking place in County right-of-way in the City of Maple Grove city limits.

  • Poles supplied to replace existing city owned poles become the property of the city.

Acknowledgement
  • By submitting this application, I (applicant/company) hereby acknowledge that I must adhere to all provisions of City of Maple Grove Code and all applicable ordinances, including statute 237.162 and 237.163 in addition to the terms and conditions which are attached to this document. The applicant shall also comply with the regulations o all other governmental agencies for the protection of the public.

Invoice #3027 (01/16/2020)

Charge Cost Quantity Total
Non-Taxable
added 01/27/2020 8:34 AM

$1.00 x 900 $900.00
Grand Total
Total $900.00
Due$900.00
This Application has not been submitted, so you may not pay for this Invoice.
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