HomeMy Public PortalAbout1995-045FERN,4ITJ REQUIRED
5T. 'HWY..
MINNEGASCO MAIN JOB
R, R
CO. RD.
CITY
PIPE REQRD 851 FT 2 TR Cl 8
MAP 2742107405
MAP 922
MEDINA
ION
TOTAL PIPE 851
1IORK NEEDED Y
ONE CALL
WILL LIE 3 FT. 4/- 6 ' BELOW EX 1ST. GRADE
QUAD
SECT
TWP. /RANGE
COUNTY
DESIGNER DOUG G VOLD DATE
NW
12
118 / 23
HENNEP IN
321-535 09/27/95
PHONE C
DESIGN APPROVED /L/11- C, g�%//3
RELEASE FOR CONST.
/
SIC NBC°
PAGE 1 OF 1 A2354 1995
MEDINA (513)
1499 11608001
MAJOR MINOR
1 3763 11 1
SUFFIX PROJECT
91 11 A2354I
LOC. WORK ORDER
1 020 Pi
SIZE TYPE
SCALE 1' = 200
NOTE:
BORE ALL PAVED STREETS AND DRIVEWAYS
Mi ni mum depth raqui rements f or pneumogoppher crosi Mi ni gs
of state highways and county roads is 60'. mu m
depth requirement for pneumagopher crossings of el ty
streets and township roods is 48. Minimum depth for
parallel inatal l ati ons on state hi ghwoya and county
roads i s 36'. Mi ni mum depth for par al I el i nstol I at ons
on city streets and township roads is 30'.
EXIST 2" TR CAP: 155' EEBL AND 56' SSBL
OF #3800. 1 4' E AND 7' N OF MANHOLE.
INSTALL 2' TR COUPLING.
TO
CO
•.; RD
176
C� yo 0, 1.4- `\
s
EXIST 2" TR CL6 MAIN
(A-894-93) 30' N C/L
So
\ e MN
INE RR
INSTALL 2' TR CL6
MAIN AT 26' N C/L
5' Y`
S
INSTALL 2' TR CAP AT 1 0' EEBL OF #550
C/L OF CLYDESDALE TRAIL (60' ROW)
C TAer
15'ND
Winnegasco
A Division of Arkla, Inc.
T vC # 1908
A2354-95
City of MEDINA
Permit no. � -
Name of party or organization performing work
Address P.O. Box 1165, Mpls., MN 55440-1165
MINNEGASCO, INC.
APPLICATION FOR PERMIT TO
INSTALL UTILITIES OR TO PLACE
UNDERGROUND CONSTRUCTION
1. Nature of work XIN gas main installation
Type of surface to be disturbed AS REQUIRED
(Check type) ❑ Gravel
Telephone
Richard J. Pilon, PE 321-5426
❑ gas service installation ❑ other
❑ Bituminous
0 Concrete ❑ Boulevard
2. Location SEE ATTACHED DRAWINGS — ClEYDESDALE TR
Street, avenue and house number
(Additional information attached when necessary) T
3. Size and kind of pipe, conduit or cable $51 2 TR, CL 6
Depth from surface 0 2.5 feet ± XFN 3 feet ±
Dimensions of excavation AS REQUIRED
4. Method of installation or construction (including method of compaction and excavation)
In accordance with procedures described in Minnegasco Operations Manual. Procedures,
Section 500, "Installation'; the most recent edition on file with the permitting authority.
Machine excavation: Yes X No
5. Work to start within 30 days and be completed within 30 days thereafter.
6. Will detouring of traffic be necessary? TO
If so, describe routing.
For MINNEGASCO, �: C.
licant)
Signed
Date
The date when work is completed must be reported to the person designated by municipality.
AUTHORIZATION OF PERMIT
Upon payment of permit fee in the amount of $ and in consideration of the agreement to comply in all
respects with the street or alley excavation ordinances and regulations applicable covering such operations, permission
is hereby granted for the work to be done as described in the above application, said work to be done in accordance with
special precautions required, as hereby stated:
It is expressly understood that this permit is conditioned upon replacement or restoration of the road surface to its
proper condition in accordance with the appropriate rules and regulations. It is further understood that this permit is
subject to revocation 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
DATE
All requirements shown on reverse side to be complied with.
White copy —applicant. Yellow —Municipality Engineer. Blue —Municipality Street Superintendent. Form 16 R7/88
"
R U L E S P E R T A I N I N G T O S T R E E T A N D A L L E Y E X C A V A T I O N S
S A F E T Y
1 . E x c a v a t i o n s s h a l l b e p r o p e r l y p r o t e c t e d a n d i d e n t i f i e d b y b a r r i c a d e s a n d f l a g s i n t h e d a y t i m e , a n d f l a r e s , r e d
l a n t e r n s o r f l a s h i n g s i g n a l s a t n i g h t .
2 . B a r r i c a d e s s h a l l b e e r e c t e d s o t h e y p r o v i d e s u i t a b l e v i s i b i l i t y i n a l l d i r e c t i o n s .
3 . E x c a v a t i o n s m u s t b e c r i b b e d w h e n n e c e s s a r y , d e p e n d i n g u p o n t y p e o f s o i l , i n o r d e r t o p r e v e n t c a v e - i n s .
4 . N o g u y s o r s t a y s s h o u l d b e a t t a c h e d t o t r e e s o n r i g h t - o f - w a y .
5 . U n d e r g r o u n d c o n s t r u c t i o n m u s t b e c o n s t r u c t e d s o i t w i l l n o t h a r m o r u n n e c e s s a r i l y d e s t r o y t h e r o o t g r o w t h o f
t r e e s .
R O A D W A Y
1 . I n s t a l l a t i o n o f p i p e u n d e r c o n c r e t e o r h i g h t y p e b i t u m i n o u s p a v e m e n t s s h a l l b e d o n e b y j a c k i n g o r b o r i n g u n l e s s
o t h e r w i s e a u t h o r i z e d b y e n g i n e e r .
2 . A l l b a c k f i l l i n g m u s t b e p l a c e d i n 6 - i n c h l a y e r s a n d t h o r o u g h l y t a m p e d ; m a t e r i a l m u s t b e f l u s h a n d e v e n w i t h t h e
r o a d s u r f a c e w h e n f i n a l l y i n p l a c e , u n l e s s e n g i n e e r a u t h o r i z e s a l t e r n a t e m e t h o d o f c o n s t r u c t i o n .
3 . F i n i s h e d s u r f a c e , b a s e , a n d s u b - b a s e o f r o a d a f t e r e x c a v a t i o n a n d b a c k f i l l s h a l l b e a t l e a s t e q u a l i n s t a b i l i t y t o
f i n i s h e d s u r f a c e , b a s e , a n d s u b - b a s e p r i o r t o e x c a v a t i o n .
4 . C o n c r e t e p a v e m e n t s h a l l b e r e p l a c e d a c c o r d i n g t o s p e c i f i c a t i o n s p r o v i d e d b y t h e e n g i n e e r .
5 . I f s e t t l e m e n t o r e x c a v a t i o n c a v e s i n w i t h i n o n e y e a r o f c o m p l e t i o n d a t e s o m a t e r i a l s s e t t l e ( b i t u m i n o u s m a t o r
c o n c r e t e b a s e ) , i t s h a l l b e r e s t o r e d t o i t s o r i g i n a l c o n d i t i o n b y t h e h o l d e r o f t h i s p e r m i t .
6 . N o p o l e a n c h o r s , a n c h o r s , b r a c e s , o r o t h e r c o n s t r u c t i o n s h a l l b e p u t o n r o a d w a y s h o u l d e r e x c e p t b y s p e c i a l
a u t h o r i z a t i o n .
7 . T h e r e w i l l b e n o d r i v i n g o n t o h i g h w a y f r o m d i t c h o r d r i v i n g o n s h o u l d e r s e x c e p t w h e n a u t h o r i z e d b y t h e e n g i n e e r ;
i f d a m a g e o c c u r s , p e r m i t h o l d e r w i l l m a k e p r o p e r r e p a i r s .
8 . N o m a c h i n e e x c a v a t i o n s h a l l b e p e r m i t t e d e x c e p t w h e n n o t e d i n a p p l i c a t i o n f o r p e r m i t .
9 . E x c a v a t i o n s g r e a t e r t h a n f o u r f e e t i n w i d t h a t t o p o f t r e n c h w i l l n o t g e n e r a l l y b e p e r m i t t e d a n d m a y b e m a d e o n l y
w h e n e x p r e s s l y p r o v i d e d f o r o n t h e p e r m i t .
1 0 . S t r e e t m a y n o t b e c l o s e d t o t r a f f i c u n l e s s e x p r e s s l y a u t h o r i z e d b y t h e p e r m i t .
L I M I T A T I O N S
1 . N o l u g s w h i c h w i l l d a m a g e t h e r o a d s u r f a c e s h a l l b e u s e d o n e q u i p m e n t t r a v e r s i n g r o a d .
2 . R o a d s i d e s h a l l b e c l e a n e d u p a f t e r w o r k i s c o m p l e t e d .
3 . T h e p e r m i t h o l d e r s h a l l n o t i f y t h e m u n i c i p a l i t y i s s u i n g t h e p e r m i t a n d , w h e n a p p l i c a b l e , t h e c o u n t y e n g i n e e r
w i t h i n 2 4 h o u r s , ( S a t u r d a y s , S u n d a y s a n d l e g a l h o l i d a y s e x c l u d e d ) t h a t t h e w o r k h a s b e e n c o m p l e t e d a n d i s r e a d y
f o r f i n a l i n s p e c t i o n .
4 . T h e c o u n t y e n g i n e e r s h a l l n o t i f y t h e a p p l i c a n t o f a n y o b j e c t i o n t h e c o u n t y m a y h a v e t o t h e a p p l i c a t i o n w i t h i n 1 0
d a y s o f r e c e i v i n g t h e p e r m i t a p p l i c a t i o n .