Excavation Permit Utility Installation Permit No. 2021-EP225, UID # 4740
App. Status: Work Completed
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:
2218 200th Street East
PO Box 189
Clearwater MN 55320
Additional email address to notify: frank.felser@telcomconstruction.com

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:
2218 200th Street East
PO Box 189
Clearwater MN 55320

PROJECT

Nature of Work:
Main Installation
Surface to be disturbed:
Boulevard
Work to start on or after: 08/02/2021
To be completed on or before: 02/02/2022
Applicant Project No.: N.886554

INSTALLATION / CONSTRUCTION

Provide a detailed work description:
Access for Splicing at Existing MH 8505.5R-8505 at 10503 89th Avenue N. Lane will narrow, see traffic control plan.
Access for Splicing in Existing HH 10655 at 10520 89TH AVE N. Work truck with 360 degree light will be parked more than 2 feet from the curb on the boulevard 
Begin placing at Existing HH 10655, Bore 1.25'' ID and Bore 200' East 
along 89th Ave N turn 100' North to customer property. Work truck with 360 degree light will be parked more than 2 feet from the curb on the boulevard
Attach detailed plan sheet:
Size and kind of pipe:
1.25'' ID
Depth from surface: 36"- 48"
Length of utility construction: 300
Method of installation:
Directional Bore
Development: Existing

LOCATION

Location/Address: 10520 89TH AVE N, Maple Grove, MN
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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.

  • Absolutely no removal of bituminous or concrete is allowed without prior approval from the City of Maple Grove.

  • Core drilling is not allowed in street, sidewalk, or trail without prior approval from City of Maple Grove. The City of Maple Grove does not allow core drilling to take place in ped ramps.

  • Vehicles, equipment, and materials are not allowed on sidewalks, trails, or ped ramps at any time unless the contractor performing work has exhausted all other alternatives, including, but not limited to lane closures, boulevard parking, etc. If it has been determined that all alternatives have been exhausted, permission must be obtained from City representative before proceeding to use sidewalks, trails, or ped ramps.

  • 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.

  • 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.
  • Restoration Requirements in areas where core drills were approved:

    1. Bituminous: Core drills in bituminous paths are replaced at width of path (example: 8 foot wide path is replaced 8'x8' per core).
    2. Concrete: Core drills in sidewalks require a minimum of two panels to be replaced per core to assure base has been properly reestablished.
  • 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 concrete is allowed during winter months.

Invoice #4220 (07/26/2021)

Charge Cost Quantity Total
Non-Taxable
added 07/26/2021 4:08 PM

Excavation permit fee per occurance

$160.00 x 1 $160.00
added 07/26/2021 4:08 PM

In addition to excavation permit fee (per lineal foot)

$0.40 x 300 $120.00
Grand Total
Total $280.00
Payment 07/26/2021$280.00
Due$0.00
Action: Print  

SPECIAL PROVISIONS

It is assumed that the proposed work and/or staging along 89th Avenue will not impact travel lanes and/or shoulders. If the travel lanes and/or shoulders along 89th Avenue will be impacted, a traffic control plan will need to be submitted and approved

Approvals

ApprovalSignatureOptions
ApplicantCindy L. Albright - 07/28/2021 4:36 PM
02fdab9f4e8678bd12de01769b742888
58a5af05f382d0ebf32be0cd1666e00f
 
#1 Right of Way Technician ApprovalKelly Matzke - 08/03/2021 3:03 PM
55df94c5992f3a7f3be0e9fe07e25123
fc7f764b195127ca5f471a590121c1ec
 
#2 Traffic Operations Engineer ApprovalJohn Hagen - 08/03/2021 3:06 PM
c45cdb9298437cd88e526245302a42b6
9a07aa8c3a124cdfd8594ad706dbe185
 
Application has been approved. All signatures have been obtained.
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