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Excavation Permit Utility Installation Permit No. 2021-EP005, UID # 4257
App. Status: Work CompletedCity of Maple Grove
Engineering Department
12800 Arbor Lakes Parkway
Maple Grove, MN 55369

Kelly Matzke (612-968-3615)
 

APPLICANT

Applicant:
Name:
Jody Cox
Company:
CenterPoint Energy
Company Phone:Local Phone:
(612) 321 - 5532
(612) 321 - 5532
Email Address:
jodell.cox@centerpointenergy.com
Mailing Address:
700 W Linden Ave
Minneapolis MN 55440

CONTRACTOR

Contractor:
Name:
Jody Cox
Company:
CenterPoint Energy
Company Phone:Local Phone:
(612) 321 - 5532
(612) 321 - 5532
Email Address:
jodell.cox@centerpointenergy.com
Mailing Address:
700 W Linden Ave
Minneapolis MN 55440

PROJECT

Nature of Work:
Service Installation
Surface to be disturbed:
Boulevard
Work to start on or after: 01/18/2021
To be completed on or before: 07/31/2021
Applicant Project No.: 96564289

INSTALLATION / CONSTRUCTION

Provide a detailed work description: 
INSTALL A NEW GAS SERVICE 
MGC# 21-36
Attach detailed plan sheet:
Size and kind of pipe: 
1 1/4 " PLASTIC 
DESIGNER TJ DEHNE 612-321-5426
Depth from surface: 36"- 48"
Length of utility construction: 145
Method of installation:
Directional Bore
Development: New

LOCATION

Location/Address: 18655 73RD AVE N
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TRAFFIC CONTROL

Will traffic control be necessary? No

Invoice #3739 (01/06/2021)

Charge Cost Quantity Total
Non-Taxable
added 01/06/2021 1:26 PM

Excavation permit fee per occurance

 $160.00 x 1 $160.00
added 01/06/2021 1:26 PM

In addition to excavation permit fee (per lineal foot)

 $0.20 x 145 $29.00
Grand Total
Total $189.00
Payment 01/06/2021$189.00
Due$0.00

Approvals

ApprovalSignature
ApplicantJody Cox - 01/06/2021 1:26 PM
5f5337eea3fddd715a7e41830c04c05a
2d1d52564fec4aa7b615eec02655c495
#1 Right of Way Technician ApprovalKelly Matzke - 01/11/2021 2:45 PM
de971f3d67724c88dee055021dca367f
f077858b20637796b6da7c2d71f4f989
Application has been approved. All signatures have been obtained.

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