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HomeMy WebLinkAbout2025-04-02 ROW Permit & Utility Connection Packet Julie Hultman Subject: FW: 25-05 Well #3 - ROW Application From:Jim Warzonek<jim@hobs-excavating.com> Sent: Wednesday,April 2, 2025 11:50 AM To:Andrew Kegley<akegley@cityofoakparkheights.com>;Julie Hultman<jhultman@cityofoakparkheights.com> Cc:Jacob Rife <JRife@cityofoakparkheights.com>; 'Lee Mann' <Lee.Mann@stantec.com>;Jaryd Marks <JMarks@cityofoakparkheights.com>; nolanj@americanliberty.biz Subject: RE: 25-05 Well #3 - ROW Application Andrew— Excellent! Thank you. We will contact the appropriate people for the required inspections. Regards...Jim... Jim Warzonek H Q E35' ILLC�.Y/tvM® Cell: 763-276-0624 Fax: 763-241-8624 Off: 763-241-3908 From:Andrew Kegley<akegley@cityofoakparkheights.com> Sent: Wednesday, April 2, 2025 11:45 AM To:Julie Hultman<jhultman@cityofoakparkheights.com> Cc: jim@hobs-excavating.com;Jacob Rife<JRife@cityofoakparkheights.com>; Lee Mann<Lee.Mann@stantec.com>; Jaryd Marks<JMarks@cityofoakparkheights.com>; nolanj@americanliberty.biz Subject: Re: 25-05 Well #3 - ROW Application We do have the documents ready and typically use the packet as "The Permit". Stantec will be doing inspections on this project and they have their own forms, but we will also complete our forms for our records. The packet-AKA the utility connection permit is attached.You are good to go! Andrew Kegley I Public Works Director City of Oak Park Heights 14168 Oak Park Blvd N I Oak Park Heights,Mn 55082 1 , I (..../..-). ) ________,,, City of Oak Park Heights RIGHT-OF-WAY PERMIT FORM ( CITY PERMIT NO. : 20 - ' PERMIT FEE: minimum, $200.00 COMPANY PERMIT NO. : DATE: V/i/75 APPLICANT M1FORYATION: DEVELOPMENT/ ADDITION / LOCATION DESCRIPTION OR. SITE ADDRESS: Wa 1 5 ( /�8os t�f�l-r41oai v-e I(' ©P// 7Ive/ OWNER (Applicant) : / j IOf 0 .P ?,� /4-7`� /, Jlss-Uf��-/7! p--- 4UTILITY COMPANY: /Dd(4j5'rr////ec6r/ (fr CONTACT PERSON: J I K4 (1 / 2 - ` -/ Z 'L*Z� TELEPHONE NO: '74? 'Z Y[` "Pe? ADDRESS:� / L jS G(jif?i(C( �� //�V�s�" CITY: �[�Ti(J LrA./ STATE;i1 A ip CODE: /0 �---" `/d CONTRACTOR INFORMATION: CONTRACTOR (/,(J PERFOO�RMING WORK: Z C) Pj- )C -F�(J 4 6 CONTRACT NAME: Dew) ,4Ck7T1 QH CONTRACT NUMBER: PHOtv"E: t r i'/L 'EY9,- . 59' CONTRACTOR PERFORMING WORK MUST ATTACH CURRENT CERTIECATE OF INSUPRCE 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 : OVEW PRIVATE UTILITY EREPLACE/REPAIR nn L�ICo !ERCIAL DRIVEWAY APRON (WIDTH?) feet ORESIDENTIAL DRIVEWAY APRON (WIDTH?) feet CONNECTION TO CITY SYSTEM (REQUIRES PP.PAYtMNT OF ACCESS FEES): LATEREAIN OSTORM SEWER ESANITARY SEWER Ine1HER— C t+'`( VJtk1 3 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): OSTREET 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) ( i IR.O.W. ACCESS (requires approved plan on use, control, mitigation and restoration. Must have full marking of new utilities) EXPLANATION OF WORK / ADDITIONAL COMF2NTS: f 74.1,<3 ,4a-i9 e,..7.--- rr ...i_ . __...... ...... i I tp 7/ZS PROPOSED START DATE: PROPOSED END DATE: C/1 5u/z s 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. ) V#R Name O t N ?, Title 7ty 1 Signature Et1/ 'Z+—`' Date: tI/ 1 7. Phone #: 7-6 3 Z ! ",.a Zpi PERMIT EXPIRATION DATE: • k\,,. ttiro+lC i S Carte( SECURITY ESCROW AMOUNT REQUIRED: $ BAS PROOF Iow INSURANCE BEEN SUPPLIED? \fe5. TYPE OF SECURITY: EIASB/CSECK Lamm APPRO SIGNATURE: TITLE: DATE: -------_— Dfr\i 1 - z- Zs RIG T-OF-WAY FEES do 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(%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. Project: Water and Sewer Connection Inspection r Intermediate r Final From: Jaryd Marks, City of Oak Park Heights To: Date: Wednesday, March 19 2025 Re: Well #3-Hobs Excavating Project No: Number Item Inspection 1 Sanitary Sewer Connection 2 Water Main Connection 3 Hydrostatic Pressure Test 4 Flush and water sample Signed By: Date: City of Oak Park Heights 14168 Oak Park Blvd N.•Box 2007.Oak Park Heights,MN 55082•Phone(651)439-4439•Fax 439-0574 Public Works Utility Inspection Form Sewer Service Connection Testing 24 Hour Notification Required: Contractors are required to contact the Public Works Department for a water and sewer inspection appointments 24 hours prior to the time of the inspections Sewer Service Connection Inspection: Sewer service connections will be inpsected by Public Works prior to covering of the connection. . The sewer service lines needs to be completed and exposed in a safe trench. (Oak Park Heights employees cannot endanger their lives by entering an un-safe trench. Trenches need to comply with Minnesota OSHA and Federal OSHA trenching safety rules.) The inspection will check that the materials used are those shown on the approved plans, that the pipes have been installed correctly, check that the sewer pipe is a minimum of 12 inches below the water pipe if in same trench,check the bedding material for proper pipe support and that it is free on boulders or large rocks, check slope of pipe, depth of the pipe and and other building/plumbing code requirements. The following tests/inspections may also be required: Sewer Pressure Testing. Sewer lines in excess of 100 feet, or which has a potable water line crossing (water line below sewer or less than 18 inches above sewer)or systems which have manholes will be pressure tested with compressed air of 5 psi for 15 minutes. Air pressure shall remain constant over the test period. If you have any questions please contactAndy Kegley, Public Works Director at 651.439.4439. Sewer Service Connection Testing Date/Time: Location: Contractor: Contact: Sewer Line Material and Size: Does the pipe have proper slope: Depth of pipe from finished grade: How is the Line connected to Main: Location of sewer pipe relative to water pipe: Is bedding material supporting pipes and free for boulders?: How is pipe terminated: Pictures taken: Sketch buildings and sewer lines. Public Works Observer Name and Date: Notes: 2 City of Oak Park Heights 14168 Oak Park Blvd N.•Box 2007.Oak Park Heights,MN 55082•Phone(651)439-4439•Fax 439-0574 Public Works Utility Inspection Form Water Service Connection Testing 24 Hour Notification Required: Contractors are required to contact the Public Works Department for a water and sewer inspection appointments 24 hours prior to the time of the inspections. Water Service Connection Inspection: Water service connections will be inspected by Public Works prior to covering of the connection. The inpsection will check that the materials used are those shown on the approved plans,that the pipes have been installed correctly, check that the water pipe is a minimum of 12 inches above the sewer pipe if in same trench, check the bedding material for proper pipe support and theat it is free on boulders or large rocks, check for electrical bonding, and that adequate chlorine tablets have been added for disinfection. The following tests/inspections may also be required: Disinfection: Pipes of 2 inches or larger will be disinfected in accordance with American Water Works Association Specification No. C651. Following disinfection the pipes will be flushed and tested for the presence of coliform bacteria using a Minnesota Department of Health certified testing laboratory. Gate valves added to the system will have the city side of the valve disinfected with a solution of 200 ppm chlorine prior to installation on the system. Pressure Testing: For water services with copper lines less than 2 inches in diameter,the water will be turned on and the system pressurized to inspect for leaks. Lines of 2 inches in diameter or larger will be subjected to a hydostatic pressure test of 150 pounds per square inch for a period of 2 hours. A drop in pressure of 3 psi during any 30-minute period shall be cause for failure of the project. Conductivity Testing: Conductivity testing for iron pipes will be made after pressure testing with pipe full of water at normal operating pressure. Test will include 350 Amps at 30 Volts for 4 minutes. Current will be measured continuously on an ammeter and shall remain steady without interuption of excessive flucuation. After 4 minutes at 350 amps the currently shall be raised fo 400 amps for one minute without interuption or excessive flucuation. Water Service Connection Form Date/Time: Location: Contractor: Contact: Water Line Material and Size: How is the Line connected to Main: Location of sewer pipe relative to water pipe: Is bedding material supporting pipes and free of boulders?: Electrical bonding straps between pipe sections: How is pipe terminated: Were Pictures taken: Public Works Observer Name and Date: Notes: 2 City of Oak Park Heights 14168 Oak Park Blvd N.•Box 2007•Oak Park Heights.MN 55082•Phone(651)439-4439•Fax 439-0574 Public Works Utility Inspection Form Hydrostatic Pressure Testing 24 Hour Notification Required: Contractors are required to contact the Public Works Department for a water and sewer inspection appointments 24 hours prior to the time of the inspections. Pressure Testing: For water services with copper lines less than 2 inches in diameter, the water will be turned on and the system pressurized to inspect for leaks. Lines of 2 inches in diameter or larger will be subjected to a hydostatic pressure test of 150 pounds per square inch for a period of 2 hours. A drop in pressure of 1 psi during any 30-minute period shall be cause for failure of the project. Please contact Public works director Andy Kegley at 651.439.4439 with questions. TREE CITY U.S.A. Hydrostatic Pressure Testing Form Date/Time: Location: Contractor: Contact: Water Line Material and Size: Hydrostatic Pressure Test: Time Pressure Initial Pressure Reading 30 Minute Pressure Reading 60 Minute Pressure Reading 90 Minute Pressure Reading 120 Minute Pressure Reading Pressure Reading: Was any leakage observed at any fitting: Public Works Observer Name and Date: Notes: 2 TREE CITY U.S.A. CHAIN OF CUSTODY INSTRUMENTAL RESEARCH, INC. it-"��, 7800 MAIN STREET NE, FRIDLEY, MN 55432.2520 763-571-3698 Client: PWS#1820020 Sampler(s)Signature: " Analysis City of Oak Park Heights ! RequestedLI3 1.S ili tS n. ' -LI' i+ j = 0 d V Z 0 c Z a Q- "a , re L. E E41 a Date Time Type N Sample Location f°- a` 1- c=i 2 D a X 3 D X 4 5 6 7 8 9 10111 f 11 1 12 13 14 15 16 17 18 19 20 1 22 M Chlorine Avg.Weekly 23 i Relinquished by: (signature)Date: Time: Ii i y Dispatched by: (signature) Date: Time: Received for Laboratory: !Date: Time: -- Method of Shipment `C'S City of Oak Park Heights RIGHT—OF—WAY PERMIT FORM CITY PERMIT NO. : 20 - PERMIT FEE: minimum $200.00 COMPANY PERMIT NO. : LO( ai)-ic, DATE: APPLICANT INFORMATION: DEVELOPMENT/ ADDITION / LOCATION DESCRIPTION OR. SITE ADDRESS:. (-Vat � //s�g(o�s 1Z- skit)(21,*- e a/ o P/i �771u' OWNER (Applicant) : y7_ / f / 1 �{ 1'/ /Z .fjl' - / i > II SS �6 z—UTILITY COMPANY: / D �L/ W I/��J �"� CONTACT PERSON: �//� ���� \� TELEPHONE NO: W'3' -Z VI 3,9U, J ADDRESS: / 7 5j G(Gate% 5� /{1 t4-) // �1' � CITY: /VC�, 'FP Lr�-/ STATE:rV[e1JyIP CODE: C �l el,Laer !`v CONTRACTOR INFORMATION: CONTRACTOR PERFORMINGDom) IIWO//RK: L `' 33 -AiJ I�(//�� CONTRACT NAME: i3 e/ i/ )/1-� DIA.CONTRACT NUMBER: PHONE: (.0 �' (C�/ e 3 5 ) CONTRACTOR PERFORMING WORK MUST ATTACH CURRENT CERTIFCATE OF INSUARCE NAMING THE CITY AS AN ADDITIONALLY ENSURED AND IN AN AMOUNT NOT LESS THAN $1,000,000. WITHOUT SUCH PROOF OF INSURANCE NO PERMIT WILL BE ISSUED. TYPE OF WORK : n EINEW PRIVATE UTILITY [lI EPLACE/REPAIR ��'�E]COMMERCIAL DRIVEWAY APRON (WIDTH?) feet []RESIDENTIAL DRIVEWAY APRON (WIDTH?) feet CONNECTION TO CITY SYSTr 1 (REQUIRES PREPAYMENT OF ACCESS FEES): EkATERMAIN ❑STORfi SEWER SANITARY SEWER �THER- C I+`( VJct\ 3 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): DSTREET OPEN CUT (requires approved plan with access, traffic control, and inspected full width restoration - security required) I (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) DR.O.W. ACCESS (requires approved plan on use, control, mitigation and restoration. Must have full marking of new utilities) EXPLANATION OF WORK / ADDITIONAL COMMENTS: C'`fGa r f .LJ NOTES: 1.) ALL WATER MAIN SHALL HAVE 7.5 FOOT MINIMUM COVER. 2.) ALL 8" PVC SANITARY SEWER SHALL BE SCHEDULE SDR 35 UNLESS OTHERWISE NOTED. 3.) ALL 4" PVC SANITARY SEWER SERVICE SHALL BE SCHEDULE 40. 4.) SANITARY SEWER RISERS FROM PVC MAINS SHALL BE 4" PVC, SCHEDULE 40. 5.) FIELD VERIFY SERVICE LOCATIONS. 6.) RESTORE BITUMINOUS DRIVEWAYS W/12" AGGREGATE BACKFILL, 8" CL. 5 AGGREGATE BASE & 3" TYPE 41A BIT. WEAR 7.) RESTORE MAINTAINED AREAS AND DITCH BOTTOM W/4" TOPSOIL & SOD ALL OTHER AREAS WITH 4" TOP SOIL, FERTILIZER AND MULCH 8.) PATCH MEMORIAL AVENUE AND 58TH STREET W/12" AGGREGATE BACKFILL, 12" CL. 5 AGGREGATE BASE, 3" TYPE 31 BIT. BASE, OVERLAY STREET W/1- 1/2" TYPE 41 BIT. WEAR. REPAIR SHOULDERS WITH CL. 2 AGGREGATE SHOULDERING. 9.) TRANSPLANT TREES IN CONFLICT WITH CONSTRUCTION. 10.) REMOVE AND REINSTALL SPRINKLER SYSTEM IN CONFLICT WITH CONSTRUCTION. OI Z� J 1 m I, cl:fI W �I 12"X6" TEE J 5'-6" DIP 6" GV & BOX HYD ® EL. 940.77 c/) 12" 1/32 BEND ILL y I i 1 1 1 1 1 _,-LLA I i 1 ? ., iJ: y=.'.� J _ _ r i �l_f ! ;4-1 — I- �I , � r r l ✓ o i l � -------------- 1'I I11 i I 111'�j !III 1� I 'N>jrl Ir!j (I - NOTE: REMOVE AND REINSTALL O CULVERTS AS NECESSARY TO PERFORM JACKING AND WATER MAIN CONSTRUCTION I� SEE SHEET 10 _ l; CD I f, Z W Y ; I� f— U) JACK 215' 12" DIP IN 24" STEEL CARRIER PIPE CONNECT TO EXISTING 12" DIP STUB 12" 1/32 BEND 12" GV & BOX 65-12" DIP TH STREET NORTH _3$5 1 al® Q O U) Ld U) Z Z Z w — 12 w wp 0 (n n z z L:z w� O �¢ LI W I-- = w co U 'n Y ry z Q Of CLw Y