Permit for Installation of UtilitiesCITY OF HOPKINS
Permit No Job M-201, 1982
Name of Party or Organizatio performing work MINNESOTA GAS COMPANY
Address 733 Marquette venue Telephone No
1 Nature of Work I stallation of gas semn main
Type of Surface to be Disturbed
(Check type) (Gravel) (Bituminous) (Concrete) (Boulevard)
2. Location As Shwa an 6 �t. 42
Street, Avenue and House number
(Additional information attached when necessary) 2"f, n E' �g 537% 3. Size and kmd of pipe, conduit or cable
Depth from Surface 2.5 feet
Dimensions of Excavation 18" x 51 78 ti:
4. Method of Installation or Construction (including method of compaction and excavation)
In accordance with procedures as described in Mtnnegasco Distribution Department Operations Manual,
Section 500, "Excavating; Backfilling and surfacing '1, the`most recent edition on f`i e with the jiermttttng authority
Machine Excavation Yes X No
5 Work to start within Sumer. 1982 days and completed with OPon 14#
6. Will detouring of traffic be necessary No If so, describe rerouting
(Apple ant)
Mere 11, 1982(
The date when work is completed must be reported to the person designated by municipality
APPLICATION FOR PERMIT FOR INSTALLATION OF UTILITIES
OR FOR PLACING UNDERGROUND CONSTRUCTION
For
Signed By
Dated
DATE
Minnesota Gas Company
.e,AUTIIQRIZATION OFTERMIT
Upon payment of permit fee in the ariioltn't of fderation of theagreementto m all
respects with the Street or Alley excavation ordinances and 'regulations-apfhcable- covering suchoperations, permission is here-
by granted for the work to be done as described in the above application; said`kork to be done in accordance with special pre-
cautions required, as hereby stated (1) gat all backfilling be done as the main is placed and
fiat all surfaces be restored as n 'as 1 (2) that care- be taken to not dasnage
At c0 or txce mob). that 4-ha City P.n?inaear is inotrnntaa to ohaarva tha work aai ly
and that the permit can be revoked if the work is not proceeding's set for by M .Ellaysky
which the City Engineer stated to the Council. (4) that the company cooperate with the City
and the ne#.ghbors to install the main in a safe and timely manner.
It is expressly understood that this permit is conditioned upon replacement or restoration of the road surface to its proper
condition m accordance with the appropriate rules and regulations It is further understood that this permit is subject to re-
vocation within ten (10) days of receipt of copy of application by the County Engineer when the permit is for work on a
County Road.
APPROVED
days thereafter.
All requirements shown on reverse side to be comphed with
White copy to apphcant, yellow to Municipality Engineer, blue to Mumcipahty Street Superintendent.
Form 16 R3/78
RULES PERTAINING TO STREET AND ALLEY EXCAVATIONS
2. Roadside shall be cleaned up after work is completed.
SAFETY
1. Excavations shall be properly protected and identified by barricades and flags in the daytime, aed_flares, red lanterns)
or flashing signals night, to protect persons and traffic at all times.
2. Barricades,to be erected in a manner which will provide suitable visibility in all directions.
3. Excavations must be cribbed when necessary, depending upon type of soil, in order to prevent cave -ins.
4. No-guys or stays to be attached to trees on Right of Way.
5. Underground construction must be so constructed as not to harm or unnecessarily destroy the root growth of sightly
or ornamental trees.
ROADWAY
1. Installation of pipe under concrete or high type of bituminous pavements to be done by jacking or boring unless other-
wise authorized by Engineer. When an installation is made by jacking or boring a pipe three Inches or larger in diame-
ter, a casing of larger dimension moat be used to encase the service pipe,
2. All back filling must be placed in 6-inch layers and thoroughly tamped, and material must be flush and even with the
road surface when finally in place, unless Engineer authorizes alternate method of construction.
3. Finished surface, base, and sub -base of road after excavation and back -fill, shall be at least equal in stability to
finished surface, base, and sub -base prior to excavation.
4. Concrete pavement to be replaced according to specifications which will be provided by the Engineer.
5. If settlement,occurs or excavation. caves in within one year from completion, date so that replaced materials settle
(bituminous mat or concrete base), same shall be restored to its original condition by the holder of this permit.
6. No pole anchors, anchors, braces, or other construction to be put on roadway shoulder except by special authorization.
7. No driving onto highway from ditch or driving on shoulders except when authorized by the Engineer, and if damage oc-
curs, permit holder will make proper repairs.
8. No machine excavation shall be permitted except when noted in application for permit.
9. Excavations greater than four feet in width at top of trench will not be generally permitted and may be made only when
expressly provided for on the permit.
10. Streets may not be closed to traffic unless expressly authorized by the permit.
LIMITATIONS
1. No lugs shall be used on equipment traversing road which will damage the road surface.
3. No work shall be done which will create a nuisance.
4. Within 24 hours, (Saturdays, Sundays and legal holidays excluded) the permit holder shall notify,the municipality
issuing the permit and, when applicable, the County Engineer, that such work has been completed and is ready for
final inspection.
5. Within ten days after receipt of a copy of the permit application the County Engineer shall notify the applicant of any
objection the County may have to the application.