Excavation Permit Utility Installation Permit No. 2022-EP054, UID # 5199
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:
Shawn Sandberg
Company:
Embarq Minnesota Inc dba CenturyLink
Company Phone:Local Phone:
(612431 - 3506
(612431 - 3506
Email Address:
shawn.sandberg@lumen.com
Mailing Address:
425 Monroe Street
Anoka MN 55303
Additional email address to notify: becky.richter@lumen.com

CONTRACTOR

Contractor:
Name:
Mike Gillette
Company:
Telcom Construction
Company Phone:Local Phone:
(612968 - 4959
(612968 - 4959
Email Address:
office@telcomconstruction.com
Mailing Address:
2218 - 200th St E
Clearwater MN 55320

PROJECT

Nature of Work:
Service Installation
Surface to be disturbed:
Boulevard
Work to start on or after: 04/11/2022
To be completed on or before: 09/28/2022
Applicant Project No.: N.939162

INSTALLATION / CONSTRUCTION

Provide a detailed work description:
directional bore 213ft of 1.25in conduit with fiber, hand dig 2ft of 1.25in conduit with fiber
Attach detailed plan sheet:
Size and kind of pipe:
1.25 inch HDPE conduit
Depth from surface: 36"- 48"
Length of utility construction: 215
Method of installation:
Directional Bore
Hand Dig
Development: New

LOCATION

Location/Address: 11700 80th Ave 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

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 #4681 (04/05/2022)

Charge Cost Quantity Total
Non-Taxable
added 04/05/2022 8:33 AM

Excavation permit fee per occurance

$160.00 x 1 $160.00
Grand Total
Total $160.00
Payment 04/05/2022$160.00
Due$0.00

Invoice #5363 (12/15/2022)

Charge Cost Quantity Total
Non-Taxable
added 12/15/2022 11:16 AM

In addition to excavation permit fee (per lineal foot)

$0.40 x 115 $46.00
Grand Total
Total $46.00
Payment 12/19/2022$46.00
Due$0.00

SPECIAL PROVISIONS

It is assumed that the proposed work will not impact pedestrian traffic along the existing sidewalks/trails. If the proposed work will impact pedestrian traffic, a traffic control plan will need to be submitted and approved.

Approvals

ApprovalSignature
ApplicantRebecca Richter - 05/05/2022 7:34 AM
35c7b939a5518fa1fe84ac405028b2a9
d6c0cdf292acef71d0821cc2e28d11a1
#1 Right of Way Technician ApprovalKelly Matzke - 05/05/2022 10:25 AM
5f75154a57d2a9b84ec5885725e35a7a
aad8d94882aa349720c1d1a86d483463
#2 Traffic Operations Engineer ApprovalJohn Hagen - 05/05/2022 4:01 PM
4f8f9d0a66f660363dff53618c188ecc
faffc51939bec47e4f14c51a253491c1
Application has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

    Internal Notes

    Text:
    File(s):
      Powered by