City of Maple Grove

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Excavation Permit Utility Installation Permit No. 2021-EP142, UID # 4628
App. Status: ApprovedCity of Maple Grove
Engineering Department
12800 Arbor Lakes Parkway
Maple Grove, MN 55369

Kelly Matzke (612-968-3615)
 

APPLICANT

Applicant:
Name:
Crystal Dopp
Company:
Comcast
Company Phone:Local Phone:
(651) 583 - 1103
(651) 583 - 1103
Email Address:
crystal_dopp@comcast.com
Mailing Address:
4255 Lexington Ave N Ste. 100
Arden Hills MN 55126
Additional email address to notify: npilarski@usi-universal.com

CONTRACTOR

Contractor:
Name:
Nick Sarantos
Company:
Universal Services, Inc
Company Phone:Local Phone:
(651) 775 - 1713
(651) 775 - 1713
Email Address:
npilarski@usi-universal.com
Mailing Address:
12151 120th St S
Hastings MN 55033

PROJECT

Nature of Work:
Main Installation
Surface to be disturbed:
Boulevard
Work to start on or after: 06/15/2021
To be completed on or before: 05/31/2022
Applicant Project No.: JB0000603276-NW IN - 20910

INSTALLATION / CONSTRUCTION

Provide a detailed work description: 
Hand Trench for Placement of (1) 1.5" Coax in Conduit
Attach detailed plan sheet:
Size and kind of pipe: 
(1) 1.5" Coax in Conduit
Depth from surface: 36"- 48"
Length of utility construction: 109
Method of installation:
Open Trench
Other
If other is selected, please provide additional information: 
Hand Trench
Development: New

LOCATION

Location/Address: 9152 Upland Ln N Maple Grove, MN
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TRAFFIC CONTROL

Will traffic control be necessary? No

Invoice #4109 (06/01/2021)

Charge Cost Quantity Total
Non-Taxable
added 06/01/2021 7:25 AM

Excavation permit fee per occurance

 $160.00 x 1 $160.00
added 06/01/2021 7:25 AM

In addition to excavation permit fee (per lineal foot)

 $0.20 x 109 $21.80
Grand Total
Total $181.80
Payment 06/02/2021$181.80
Due$0.00

Approvals

ApprovalSignature
ApplicantScott T. Sandkamp - 06/01/2021 7:25 AM
8834e2dd565ac928edce6817861c8402
05a71402b1dbd0690ca0f5ac33cd3ff4
#1 Right of Way Technician ApprovalKelly Matzke - 06/02/2021 11:03 AM
47ae772c07b4d30f4ddba51c133afa57
bea4b90107fc2b30ddb5bbb379876e2c
Application has been approved. All signatures have been obtained.

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