HomeMy WebLinkAbout2018-04-10 OPH Ltr to Applicant Re Moving of Townhomes e ;�
City of Oak Park Heights
14168 Oak Park Blvd. N•Box 2007.Oak Park Heights,MN 55082•Phone(651)439-4439•Fax(651)439-0574
April 10,2018
TO: Mr.Tim Nolde, Via EMAIL ONLY: timnolde(0comcast.net
RE: House Moving—Permits and Process Update.
Dear Mr.Nolde:
The City is aware that you hope to relocate the two structures(via a house mover)located in your development
Oakgreen Commons to a site in the City of Stillwater.In order for the City to consider this proposal further we are in
need of the following:
1. Please submit a clear plan for the route and specific times for the movement of these structures through
the City.The plan must include a clear and concise map showing the routes,staging,times and
structures you would anticipate to be temporarily impacted.Closure of any City streets will require
careful coordination and communication with adjacent property owners as well.
2. Provide complete Contractor Permit application.(See attached).A demolition permit will be needed for
the remaining structures and foundations as well but will be addressed later.
3. Complete the enclosed Right of Way Permit application,the City will advise you later of its ROW escrow
requirements.
Once we have this data the City can consider necessary permits and estimate costs for which would be attributable
to this project—such as staff time,police,removal of signal poles,etc.Please note the City will not permit the use of
58th Street for this project until at least 180 days after the planned MILL AND OVERLAY which is scheduled to occur
in mid-June 2018 so the timing of this project should be staged prior to that.
Sincerely,
Eric Johnson
City Administrator
CC: Julie Hultman,Building Official
Brian DeRosier,Chief of Police
Weekly Notes
CONTRACTOR LICENSE APPLICATION
City of Oak Park Heights
14168 Oak Park Blvd. N.
P.O. Box 2007
Oak Park Heights, MN 55082
TELEPHONE: DIRECT:(651)351.1661 GENERAL:(651)439-4439—FAX:(651)439-0574
Email:jhultman@cityofoakparkheights.com
Business Name:
Address:
Telephone: ( ) Fax: (
E-mail
LICENSE REQUIREMENTS
• Fee based on trade. State license is required for residential general contracting, roofing,
plumbing and fire protection. Mechanical Contractors require MN State Surety Bond.
• Certificate of Insurance, minimum coverage, $100,000 per person, Public Liability; $250,000 per
accident, Bodily Injury; and $100,000 Property Damage. CITY OF OAK PARK HEIGHTS
MUST BE NAMED AS AN ADDITIONAL INSURED on this policy.
•Agreement to hold CITY OF OAK PARK HEIGHTS harmless for ALL claims of damage liability
that may come against the license/permit holder.
• Proof of WORKERS COMPENSATION INSURANCE if required, by law, to be carried.
• State and Federal Tax Identification numbers pursuant to MN STATE STATUTE 270.72.
•The CONTRACTOR further agrees to adhere to all OSHA STANDARDS, UNIFORM TRAFFIC
CODES and any CITY CODES AND STANDARDS that may apply to this license.
• License period: January 1 to December 31 of each year. Cancellation will occur upon failure to
provided continued proof of insurance coverage.
LICENSE CLASSIFICATIONS: Commercial General Contractor- $50
Blacktopping - $50 Heating, Ventilation & A/C - $50
Building Moving -$50 **Attach copy of MN Mechanical Bond
Concrete and Masonry - $50 Outside Sewer &Water-$50
Excavating/Grading - $50 Siding - $50
Pool Installation - $50 Signs & Billboards - $50
Irrigation System Installation - $50
COMPLETION OF THE WORKERS COMPENSATION INSURANCE ANDTAX I.D. FORMS IS
REQUIRED BEFORE A LICENSE CAN BE ISSUED. THESE FORMS ARE ATTACHED AND
MADE PART OF THIS APPLICATION.
Office Use Only: Liability Insurance Expiration:
Worker's Comp. Insurance Expiration:
Mechanical Surety Bond ID:
Mechanical Surety Bond Expiration:
LEAD ID & Expiration:
Date License Issued: No.
LICENSE APPLICANT:
Pursuant to Minnesota Statute 270.072 Tax Clearance; Issuance of Licenses, the
licensing authority is required to provide the Minnesota Commissioner of Revenue your
Minnesota business tax identification number and the social security number of each
license applicant.
Under the Minnesota Government Data Practices Act and the Federal Privacy Act of
1974, we are required to advise you of the following regarding the use of this
information:
1. This information may be used to deny the issuance, renewal or transfer of your license in the
event you owe the Minnesota Department of Revenue delinquent taxes, penalties or
interest;
2. Upon receiving this information, the licensing authority will supply it only to the Minnesota
Department of Revenue. However, under the Federal Exchange of Information
Agreement the Department of Revenue may supply this information to the Internal
Revenue Service.
3. Failure to supply this information may jeopardize or delay the processing of your licensing
issuance or renewal application.
Please provide the following information and return along with your application to the
agency issuing the license. Do not return to the Department of Revenue.
Licensing Authority: City of Oak Park Heights
License Period: Annual: January 1 through December 31
Personal Information: (Complete only if applicable)
Applicant's Name:
Applicant's Address:
City State Zip Code
Social Security No.:
Business Information: (Complete only if applicable)
Business Name:
Business Address:
City State Zip Code
Minnesota Tax Identification No.:
Federal Tax Identification No.:
If a Minnesota Tax Identification number is not required, please explain:
Date: Signature:
Title:
PROOF OF WORKERS' COMPENSATION INSURANCE COVERAGE
Minnesota Statue, Section 176.182, requires every state and local licensing agency to
withhold the issuance or renewal of a license or permit to operate a business in
Minnesota until the applicant presents acceptable evidence of compliance with the
workers' compensation insurance coverage requirement of Chapter 176. The
information required is: the name of the insurance company, the policy number, and
dates of coverage or the permit to self-insure. This information will be collected by the
licensing agency and retained within their files.
This information is required by law. Licenses and permits to operate a business may not
be issued or renewed if it is not provided and/or is falsely reported. Furthermore, failure
to provide or falsely reporting this information may result in a $2,000 penalty assessed
against the applicant by the Commissioner of the Department of Labor and Industry.
Provide the information specified above, in the spaces provided, or certify the precise
reason your business is excluded from compliance with the insurance coverage
requirement for workers' compensation.
Insurance Company(not the Insurance Agent):
Policy Number
Dates of Coverage:
- OR -
I am not required to have Workers' Compensation Insurance because: (check one)
( ) I have no employees covered by law;
( ) I am self-insured (include permit to self-insure); or
( ) Other(specify)
I have read and understand my rights and obligations with regards to business licenses,
permits and Workers' Compensation coverage and hereby certify by my signature below
that to the best of my knowledge, the information provided is true and correct.
Date:
Signature
Printed Name of Signature
Title/Position of Person Signing
g
INDEMNIFICATION AGREEMENT
To: City of Oak Park Heights
14168 Oak Park Boulevard, N.
P.O. Box 2007
Oak Park Heights, MN 55082
NOTE: The following must be signed by an Officer of the Corporation or by the Owner
and notarized.
In consideration for the granting of this license, the license applicant agrees to hold the
City harmless from all damages and claims of damage which may arise by reason of any
negligence on the part of the Contractor or the Contractor's agents or employees
engaged in the performance of this Contract/Permit, and will indemnify the City for the
amount of all claims, liens, expenses and claims for liens of work, tool, machinery,
materials or insurance premiums and for the amount of all loss by reason of the failure of
the Contractor to fully perform its obligation under this Contract/Permit, including but not
limited to attorney fees and costs incurred relative to such claims and losses.
By:
Date Corporate Officer or Individual Proprietorship Owner
Subscribed and sworn to before me
this day of ,
, Notary Public.
County.
My commission expires: .
Updated:01-01-2018
City of Oak Park Heights
RIGHT-OF-WAY PERMIT FORM
CITY PERMIT NO . : 20 - PERMIT FEE : minimum $150 . 00
COMPANY PERMIT NO . : DATE :
APPLICANT INFORMATION:
DEVELOPMENT/ ADDITION / LOCATION DESCRIPTION OR. SITE ADDRESS:
OWNER (Applicant) :
UTILITY COMPANY: CONTACT PERSON:
TELEPHONE NO: ADDRESS:
CITY: STATE: ZIP CODE:
CONTRACTOR INFORMATION:
CONTRACTOR PERFORMING WORK:
CONTRACT NAME: CONTRACT NUMBER: PHONE:
CONTRACTOR PERFORMING WORK MUST ATTACH CURRENT CERTIFCATE OF INSUARCE NAMING THE CITY AS
AN ADDITIONALLY INSURED AND IN AN AMOUNT NOT LESS THAN $1,000,000. WITHOUT SUCH PROOF OF
INSURANCE NO PERMIT WILL BE ISSUED.
TYPE OF WORK :
TY
IN EW PRIVATE UTILITY
❑REPLACE/REPAIR
❑COMMERCIAL DRIVEWAY APRON (WIDTH? ) feet
❑RESIDENTIAL DRIVEWAY APRON (WIDTH? ) feet
CONNECTION TO CITY SYSTEM (REQUIRES PREPAYMENT OF ACCESS FEES) :
❑WATERMAIN STORM SEWER ❑SANITARY SEWER
OTHER
WHAT THE WORK WILL INVOLVE (REQUIRES SECURITY TO PROTECT INFRASTRUCTURE / COMPLETE
RESTORATION . Complex plans may incur additional costs for mitigation plan review and
inspections . Must include erosion control, protective measures, and restoration plans -
all new utilities must be fully located for future GSOC requirements) :
STREET OPEN CUT (requires approved plan with access, traffic control, and inspected
full width restoration - security required)
▪PATHWAY CUT (requires approved plan with full width restoration and security for
restoration)
❑EXCAVATION IN BOULEVARD or CITY OWNED PROPERTY (requires approved plan and security for
restoration)
❑R.O.W. ACCESS (requires approved plan on use, control, mitigation and restoration.
Must have full marking of new utilities)
EXPLANATION OF WORK / ADDITIONAL COMMENTS:
PROPOSED START DATE:
PROPOSED END DATE:
Applicant agrees to abide by and follow all applicable
ordinances, laws, rules, and regulations of all regulatory
bodies, including but not limited to city, county, state or
federal regulatory agencies. Applicant acknowledges that
placement of its utilities in any Right-of-way is subject to the
rights and rules of the City Of Oak Park Heights. Damage, loss or
destruction of applicant's facilities and/or its resulting
business interruption will not be restored, compensated or
reimbursed by the City in the event the City needs to remove,
relocate or terminate such facilities while accessing its utility
services in the area for any reason. Private utility locates are
required by the owner and/or applicant for the utility in the
Right-of-way and in perpetuity.
The Applicant shall provide, at its sole expense, full "as-built"
drawings for all infrastructure installed in the City Right-of-
way. All "as-built" drawings shall be completed by a licensed
Minnesota Engineer or Surveyor. "As-builts" shall be provided in
paper and digital form acceptable to the City of Oak Park Heights
including GPS coordinates in the Washington County Coordinate
system. The City additionally reserves the right to remove
and/or deactivate any and all installed infrastructure placed in
its Right-of-way should these "as-builts" not be provided or
should these prove inaccurate.
The Applicant accepts in perpetuity the responsibility to perform
at its expense all necessary locates (Gopher State One Calls)
that may arise or be requested in the future by the City or other
parties. The Applicant does release and hold harmless the City
from any and all responsibility for utility / service locates.
APPLICANT SIGNATURE - by your signature you accept and agree to
all conditions as stated above. Must be signed by owner,
president or CEO of firm installing utilities.
Name
Title
Signature
Date:
Phone #:
TO BE COMPLETED BY CITY
PERMIT EXPIRATION DATE:
SECURITY ESCROW AMOUNT REQUIRED: $
HAS PROOF IOF INSURANCE BEEN SUPPLIED?
TYPE OF FINANCIAL SECURITY: _CASH/CHECK EIANNUAL
APPROVAL SIGNATURE: TITLE: DATE:
RIGHT-OF-WAY FEES & CHARGES
Base Permit Fee $150+ Escrow Deposit
Includes initial review, plan and restoration review, permit issuance and tracking, one final
inspection.
Additional Hourly Fee $60 per hour
Based on regular hour rate, does not include overtime or minimum hours for non-standard work
hours.
Engineer!Legal Services Actual Cost+ 10%
Developer is required to pay for all City-out of pocket expenses; e.g. contract work as required by
the City for review, testing, additional mapping, digitizing, survey work, recording, etc.
Re-inspections(1/2 hr min) $60 per hour.
Escrow Deposit Requirements:
Tracer wire installations in grass ROW shall have a $1,000 deposit, minimum, in case engineer
needs to be brought in to survey and perform a trace. Separate escrow amounts will be required
for street or trail impacts or other excavations based on proposed project, materials and areas to
be disrupted. Fees for trenching, excavation, and additional infrastructure impacts will be
estimated prior to permit issue and be adjusted for additional work on an hourly basis.