Excavation Permit Utility Installation Permit No. 2020-EP109, UID # 3866
App. Status: Approved
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
(320286 - 8369
Email Address:
cindy.albright@telcomconstruction.com
Mailing Address:
PO Box 189
Clearwater MN 55320

CONTRACTOR

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

PROJECT

Nature of Work:
Main Installation
Surface to be disturbed:
Boulevard
Work to start on or after: 05/14/2020
To be completed on or before: 11/13/2020
Applicant Project No.: N.735757

INSTALLATION / CONSTRUCTION

Provide a detailed work description:
Access only for splicing at existing HH3-HH3 at 12000 Elm Creek Blvd N.
Access only for splicing at existing HH1 at 11852 Elm Creek Blvd N.
Access only for splicing at existing HH11700ECB at 11670 Elm Creek Blvd N.
Access only for splicing at existing HH188-HH7 at the intersection of Zachary Lane and Elm Creek Blvd.
Access only for splicing at existing HH7710R at the intersection of Revere Lane and Elm Creek Blvd..
Access only for splicing at existing HH1191-HH9 at 7865 Jefferson Hwy N.
Access only for splicing at existing MH8514-8514 at 7865 Jefferson Hwy N..
For all splice points we will be using Utility work ahead signs and our trucks have 360 degree strobes and cones
At MH 8513-8513 bore 26’ to customer property.
Attach detailed plan sheet:
Size and kind of pipe:
1.25" ID
Depth from surface: 36"- 48"
Length of utility construction: 26
Method of installation:
Directional Bore
Other
If other is selected, please provide additional information:
bore and access for splicing
Development: Existing

LOCATION

Location/Address: 12000 Elm Creek Blvd N
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.

TRAFFIC CONTROL

Will traffic control be necessary? Yes

TRAFFIC CONTROL PLAN

Attach Traffic Control Plan:

Terms

ACTIVATION REQUIRED
  • Contact Kelly Matzke at (612) 968-3615 at least 24 hours prior to construction to activate permit. Failure to contact Mr. Matzke to activate permit prior to work being started shall be considered a violation of the permit and grounds for dismissing contractor from the job site.

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 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.

  • Excavations taking place in the Maple Grove city limits in the Hennepin County right-of-way requires permits from the City of Maple Grove and Hennepin County.

  • Flagging or painting of route required by City of Maple Grove prior to calling in Gopher State One Call ticket.

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

  • 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 Excavation 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.

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

  • Any placement of utilities, including but not limited to cabinets, boxes, and pedestals must conform to City Code.

  • 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.

  • Any changes or revisions to the Excavation Permit after approval must be resubmitted and approved before proceeding with work in the right-of-way.

  • 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.

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

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 Transporation Operations Engineer.

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

  • All traffic control devices must be removed from the job site promptly upon completion 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 763-494-6364.

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

  • Restoration Requirements on Soft Surfaces:

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

    1. Bituminous: Shall be removed and restored in a timely matter to its original or better condition.
    2. Concrete: Shall be removed and restored in a timely matter to its original or better condition.
    3. 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.

  • 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.

Invoice #3387 (05/07/2020)

Charge Cost Quantity Total
Non-Taxable
added 05/07/2020 12:37 PM

Excavation permit fee per occurance

$160.00 x 1 $160.00
added 05/07/2020 12:37 PM

In addition to excavation permit fee (per lineal foot)

$0.40 x 26 $10.40
Grand Total
Total $170.40
Payment 05/07/2020$170.40
Due$0.00

Approvals

ApprovalSignature
ApplicantCindy L. Albright - 05/07/2020 12:38 PM
49271d6f724eac11b575bd71f41dd6ea
89c5b82ecaea77283e1cd14c797ef1cd
#1 Right of Way Technician ApprovalKelly Matzke - 05/20/2020 10:44 AM
ba7b94e3e1b395cc07093a15323889c9
bca686cfd6c774cc5f6cb3a784e36df7
#2 Traffic Operations Engineer ApprovalJohn Hagen - 05/21/2020 2:04 PM
5e38546acca3bd3ac6c2f691cc8714c6
e9c77a4b2b58b3986dff2db5c6a66b4c
Application has been approved. All signatures have been obtained.

Public Notes

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    Internal Notes

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