Excavation Permit Utility Installation Permit No. 2022-EP028, UID # 5098
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 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 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: 02/17/2022
To be completed on or before: 08/17/2022
Applicant Project No.: N.966545

INSTALLATION / CONSTRUCTION

Provide a detailed work description:
Access for splicing in HH-1014-9006 at the intersection of Dunkirk Lane and Wearer Lake Rd. Work truck with 360 degree light will be parked more than 2 feet from the curb on the boulevard. Pedestrian traffic will be detoured to the east side of Dunkirk Lane N.
Access for splicing in HH-9016 at 15051 Weaver Lake Rd N. Work truck with 360 degree light will be parked more than 2 feet from the curb on the boulevard. A temporary pedestrain walkway will be maintained.
Access for splicing in HH-9019-HH90 at the intersection of Weaver Lake Rd N and West Fish Lake Rd.  Work truck with 360 degree light will be parked more than 2 feet from the curb on the boulevard. Work will not effect pedistrian traffic.
Access for splicing in PED-1132 along East Fish Lake Rd just south of 81st Ave. The shoulder of the road will be coned off for the truck with 360 degree light to be parked.
Access for splicing in HH-9025-9025 at 13792 Reimer Rd. Work truck with 360 degree light will be parked more than 2 feet from the curb on the boulevard.
Start Excavation in HH-1374-9018 bore east across East Fish Lake Rd then south along East Fish Lake Rd, place new HH and continue bore onto customer property. A temporary pedestrian walkway will be maintained at HH 1374-9018. Work truck with 360 degree light will be parked more than 2 feet from the curb on the boulevard at new HH.
Attach detailed plan sheet:
Size and kind of pipe:
HDPE 1.25"
Depth from surface: 36"- 48"
Length of utility construction: 239
Method of installation:
Directional Bore
Other
If other is selected, please provide additional information:
access for splicing
Development: Existing

LOCATION

Location/Address: 7000 East Fish Lake Rd, Maple Grove
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TRAFFIC CONTROL

Will traffic control be necessary? Yes

TRAFFIC CONTROL PLAN

Attach Traffic Control Plan:

Terms

DEFINITIONS
  • Public right-of-way. "Public right-of-way" means the area on, below, or above a public roadway, highway, street, cartway, bicycle lane, and public sidewalk in which the local government unit has an interest, including other dedicated rights-of-way for travel purposes and utility easements of local government units. A public right-of-way does not include the airwaves above a public right-of-way with regard to cellular or other nonwire telecommunications or broadcast service.

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
  • (1) Article IV. Public Right-of-Way Management Ordinance will be enforced for work being done in the right-of-way. (2) All excavations taking place in right-of-way must conform to Minnesota Statute Chapter 216D. Excavation Notice System. (3) All rules and regulations for locates must conform to the most current Gopher State One Handbook. (4) 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. (5) All properties affected by excavation and construction must be notified in writing prior to beginning work. (6) The permit issued does not in any way imply an easement on private property or grant a right to encroach on private property. (7) A City of Maple Grove Excavation Permit shall be on site at all times and available upon request by any city official. (8) Safety vests must be worn by all people occupying the right-of-way.

CONSTRUCTION
  • (1) All underground utilities must be placed a minimum of 36" and 48" maximum below finished top of curb elevation. (2) Any placement of utilities, including but not limited to cabinets, boxes, and pedestals must conform to city code. (3) Absolutely no removal of bituminous or concrete is allowed without prior approval from the City of Maple Grove. (4) 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. (5) 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. (6) Any changes or revisions to the Excavation Permit after approval must be resubmitted and approved before proceeding with work in the right-of-way. (7) Street crossings must be installed perpendicular to the road to avoid future potholing in street. (8) Plowing and pneuma gophering are not acceptable forms of excavation allowed in the City of Maple Grove. (9) All open trenches and holes must be backfilled before leaving work site at the end of the day. (10) All flags from locates must be removed and picked up immediately once excavation has been completed. (11) 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
  • (1) 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. (2) 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. (3) All traffic control devices must be removed from the job site promptly upon completion of work. (4) 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
  • (1) Restoration must conform to Section 28-105. Restoration of Right-of-Way. (2) Restoration Requirements on Soft Surfaces. (a) Turf: Hydroseeding is required unless otherwise directed by Right-of-Way Technician. (b) Soil: Six inches of topsoil is required on all boulevards that are damaged. (c) Sprinklers: Restore to prior condition with like materials and equipment. (d) Pet Fences: Check for continuity after repair. (e) Landscaping: Restore to original with like materials. 3) Removal/Restoration Requirements on Hard Surfaces. (a) Bituminous: Shall be removed and restored in a timely matter to its original or better condition. (b) Concrete: Shall be removed and restored in a timely matter to its original or better condition. (c) Driveways: Notify Right-of-Way Technician of any damage and address with homeowner. (4) Restoration Requirements in areas where core drills were approved. (a) Bituminous: Core drills in bituminous paths are replaced at width of path (example: 8 foot wide path is replaced 8'x8' per core). (b) Concrete: Core drills in sidewalks require a minimum of two panels to be replaced per core to assure base has been properly reestablished. (5) All disturbed areas during excavation must be restored to their original condition within 30 days. (6) Damage on boulevards due to vehicles and equipment must be restored and treated the same way that excavation damage is restored. (7) Work completed in winter months must notify City with plans for restoration to take place in the spring.

ADDITIONAL INFORMATION
  • (1) 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. (2) Absolutely no removal of bituminous or concrete is allowed during winter months.

MISCELLANEOUS
  • 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 of all other governmental agencies for the protection of the public.

Invoice #4580 (02/10/2022)

Charge Cost Quantity Total
Non-Taxable
added 02/10/2022 3:12 PM

Excavation permit fee per occurance

$160.00 x 1 $160.00
added 02/10/2022 3:12 PM

In addition to excavation permit fee (per lineal foot)

$0.40 x 139 $55.60
Grand Total
Total $215.60
Payment 02/10/2022$215.60
Due$0.00

SPECIAL PROVISIONS

It is assumed that the proposed work will not impact travel lanes. If the proposed work will impact travel lanes, a revised traffic control plan will need to be submitted and approved.

Approvals

ApprovalSignature
ApplicantCindy L. Albright - 02/10/2022 3:12 PM
6a1d056e214bfcaaa91fa348902dcb7d
06aaae7e3d2eb34dde4097fd85894154
#1 Right of Way Technician ApprovalKelly Matzke - 02/23/2022 3:31 PM
33f288a3d66445607ff8c34f7c26f5f1
22c33a83da0fe1ccea4d33a4e161cd06
#2 Traffic Operations Engineer ApprovalJohn Hagen - 02/23/2022 3:31 PM
9213d9919713b12c8a23667505371d16
2cebd1c92f98ddb33076c440b9c55846
Application has been approved. All signatures have been obtained.

Public Notes

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    Internal Notes

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