1

Permit No.320 South Oak Street - Sauk Centre, MN 56378 PID No.

DATE RCVD.

Permit FeeSurchargePlan CheckTotal Fee

Please Type or Print Legibly:

1. Site Address____________________________________________Sauk Centre, MN 56378

2. Owner(s)______________________________________Daytime Phone___________________

3. Owner's Address (if different from above)______________________________________________

4. Legal Description of Site: (Please Attach Metes & Bounds Description)Note* If unknown, please refer to property tax statement or ask Zoning Administrator

5. Type of Improvement/Addition: (Bedroom, Living Room, Garage etc.) ___________________________

6. Describe in detail work to be done

7. Approximate Start Date_______________________________

8. Please provide contractor's name and license number as required by Minnesota Statute

Name__________________________________License No.____________________ ORThis work is being done by applicant who is acting as their own general contractor and assumes completeresponsibility. I have read and signed the Licensed Contrator Disclaimer. __________(Initial Here)

9. Estimated Cost of Project (Including Materials & Labor ): $______________________

10. Type of Construction:

Lot__________Block_________Addition_________________________________________

For Office Use Only

Additional Information Required on Reverse

City of Sauk Centre

Ph: (320) 352-2203 FAX: (320) 352-0121

Building Permit ApplicationResidential Additions

On Site_____ Other______________________________________________(Explain)

11. Dimensions of Structure: Length________ Width_________

12. Height of Structure: Sidewalls_________ Roof Line_________

14. Please Provide the Following: (If Applicable)

Electrical Contractor _______________________________________PH:___________________

Plumbing Contractor _______________________________________PH:___________________

Mason & Concrete Contractor ________________________________PH:___________________

Heating & Venting Contractor ________________________________PH:___________________

Excavation Contractor_______________________________________PH:___________________

X Cross Section detailing foundation, footings, wall, roof, steps, deck (as applicable) X Floor Plan X Certificate of Survey (by licensed Land Surveyor) X Utilities Checklist (To be completed and signed at Public Utilities Office)

I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. I have identified all property boundaries, easements, flood zones and/or wetlands existing on the property on my site plan and application. The undersigned further agrees the City and its' adminstrative staff relied on the accurateness of this application, plans and specifications relative to this project and holds the city of Sauk Centre, and its employees harmless from all liability arising from the granting of this permit.

AUTHORIZED SIGNATURE OF OWNER OR BUILDER ZONING ADMINISTRATOR

This Permit Expires One Year From:_________________________ BUILDING INSPECTOR

Staff Comments:

13. Is the structure being placed near any hanging utility lines? ______________________

Required Forms & Items to Return with Application:

Your application will be deferred until all checked items above are provided.

Licensed Contrator DisclaimerOther

2

Capacity of continuous ventilation rate in CFMs: "round" duct ORTotal ventilation (intermittent + continuous) rate in CFMs: "metal" duct

CFMsLocation of fans(s), describe:

Other, describe:Energy Recovery Ventilator (ERV) Capacity in CFMs: Low: High: Location of duct or system:Balanced Ventilation Capacity in CFMs:

Describe any additional or combined heating or cooling systems if installed: (e.g. two furnaces or air source Not required per mech. codeheat pump with gas back-up furnace):Select Type

Passive

Heat Recovery Ventilator (HRV) Capacity in CFMs: Low: High:

" round" duct OR"metal "duct

Combustion Air Select a Type

Residential LoadCalculations

Heating Loss Heating Gain Cooling LoadCFMs

Location of duct or system:

Other, describe:

Efficiency AFUE orHSPF%

SEER/EER

Model Interlocked with exhaust device.Describe:

Rating or SizeInput inBTUS:

Capacity inGallons:

Output inTons:

Fuel Type Passive

Manufacturer Powered

MECHANICAL SYSTEMS Make-up Air Select aType

Appliances Heating System Domestic Water Heater Cooling System Not required per mech. code

Windows & Doors Heating or Cooling Ducts Outside Conditioned SpacesAverage U-Factor (excludes skylights and one door) U: Not applicable, all ducts located In conditioned spaceSolar Heat Gain Coefficient (SHGC): R-value

Describe other insulated areas

Building Envelope AirTightness:

Duct System Air Tightness:

Floors over unconditioned areaBay Windows or cantilevered areasCeiling, vaultedCeiling, flatWallRim Joist (2nd Floor+)Rim Joist (1st Floor)Perimeter of Slab on GradeFoundation Wall

Location (or future location) of Fan:

Other Please Describe Here

MECHANICAL VENTILATION SYSTEM

Foam

, Clo

sed

Cel

l

Foam

, Ope

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ell

Min

eral

Fib

erbo

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Rig

id, E

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Pol

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Below Entire Slab

THERMAL ENVELOPE RADON CONTROL SYSTEM

Insulation Location Tota

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of a

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of

Insu

latio

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Type: Check All That Apply Passive (No Fan)

Non

or N

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Fibe

rgla

ss, B

low

n

Active (With fan and monometor orother system monitoring device)

Fibe

rgla

ss, B

atts

New Construction Energy Code Compliance Checklist/Certificate

Mailing Address of the Dwelling or Dwelling Unit City

Per R401.3 Certificate. A building certificate shall be posted on or in the electrical distribution panel. Date Certificate Posted

Name of Residential Contractor MN License Number

Rig

id, I

socy

nura

te

3

Utilities Checklist

NOTE: This form must be presented to the Sauk Centre Public Utility Commission Office (101 Main St. S.) signed by a member of their staff and returned to the Planning & Zoning office before a building permit will be issued.

Will buifding require electrical heat?

Are you Installing an electric hot water heater?

Adding electric central air conditioning?

Do you require new electric service or or a change in service box location?

Date: ----------

Are there any changes to your present water service planned or a new line hook-up?

Are there any changes to your present sanitary sewer service planned or a new hookup?

If a disturbance to the street adjacent to the structure is needed for utility services, have you applied for a street opening permit from the City Hall?

Do you wish to know more about load management of electrical service?

YES

Will you be Installing a lawn sprinkler system? ___ _

Name:

Address:

NO NIA

Legal Description: _______________________________ _

General Contractor: Electrician: ---------- -------------------

Plumber: Excavator: _________________ _

REMINDERS: 1. There shall be Installed in all new buildings a remote reading water meter adjacent to the electric meter.

The owner must install a half inch (1/2) PVC conduit from the water meter location to the electric meter socketpanel on the outside of the building. Conduit shall be placed within six (6) inches alongside the conduit of theelectric meter socket panel and a minimum of two (2) feet above grade.

2. There will be NO removal of dirt in the public road right-of-way or the public easement.There are many different utility services located In the R-0-W and easements, therefore,the elevation and coverage cannot be changed.

3. Customers with new sewer & water hookups to the sanitary sewer & water mains shall pay both sewer andwater access charges (SAC & WAC). The WAC charge is $. ____ for a (1) inch service line or smallerThe SAC charge Is $. ____ for upto and including a (4) inch service line. Services over these sizes will be addressed on an individual basis. This charge Is to be paid along with the building pennit fee at City Hall.

Public Utilities Signature

Property Owner/Applicant Signature

Date

Date

4

Initial______

Initial______

Initial______

Licensed Contractor Disclaimer

I understand that the State of Minnesota requires that all residential building

contractors, remodelers and roofers obtain a state license unless they qualify for

a specific exemption from the licensing requirements. By signing this document,

I attest to the fact that I am building or improving this house myself. I hereby

claim to be exempt from the state licensing requirements because I am not in the

business of building on speculation or for resale and that the house for which I

am applying for this permit, located at _____________________________, is the

first residential structure I have built or improved in the past 24 months. I also

acknowledge that because I do not have a state license, I forfeit any mechanic’s

lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01.

Furthermore, I acknowledge that I may be hiring independent contractors to

perform certain aspects of the construction or improvement of this house and I

understand that some of these contractors may be required to be licensed by the

State of Minnesota. I understand that unlicensed residential contracting;

remodeling, and/or roofing activity is a misdemeanor under Minn. Stat. 326.92,

subd. 1, and that I would forfeit my rights to reimbursement from the Contractor’s

Recovery Fund in the event that any contractors I hire are unlicensed.

I also acknowledge that as the contractor on this project, I am solely and

personally responsible for any violations of the state building code and/or city

ordinance in connection with the work performed on this property.

________________________________________ Signature of Property Owner Date______________

To determine whether a particular contractor is required to be licensed, or to check on the licensing status of individual contractors, please call the Minnesota Department of Commerce, Enforcement Division, at 1-800-657-3602.

5

P:\P&Z\Applications\Residential Addition Application packet\Disclaimer form.doc

Erosion Control Requirements Landscaping and Grading

It is the intent of the City of Sauk Centre to satisfy the appropriate water quality requirements of the Clean Water Act and the Environmental Protection Agency’s (EPA) Storm Water Phase II of the National Pollutant Discharge Elimination System (NPDES) storm water program.

Provisions shall be made to the maximum extent practical for construction related activities to assure:

• Public streets remain clean• The water quality of our water bodies and wetlands is protected and enhanced• Discharge of sediments and pollutant runoff into storm drains is reduced or eliminated• Surrounding properties will be minimally affected by erosion and runoff

Construction activities which include: clearing, grading or excavating land shall provide for effective control of erosion, sediments and all other pollutants. The property owners or construction site operators shall be responsible for the installation and monitoring of erosion and sediment controls and best management practices (BPM’s). Such controls will be monitored through the building permit inspection process.

At minimum, the following BPM’s shall be implemented:

• Silt fencing around areas of disturbed soilSilt fencing shall be placed around the outer edge of all areas in accordance withthe details shown on the back. On typical residential lots, the placement shall bewithin 3' of the lot line. The City will determine those areas that require siltfence based on the site plan submitted, but the city reserves the right to requireadditional silt fence at any time as determined necessary. A sample of erosioncontrol requirements is on the reverse side illustrating the details for installationof silt fencing.

• Stabilized construction entrancesUsing soil to bridge the curb line or cross the street is PROHIBITED. Plywoodor wood planking may be used or curb cuts or driveway aprons may becompleted for entrance.

• Temporary rock construction entrancesTemporary rock entrances shall be placed at all access points to a constructionsite. The installation of more than one access point shall be reviewed andapproved by the City. The rock entrances shall be a minimum of 12 feet in widthand 20 feet long and shall be placed in accordance with the details shown on theback.

I have read, understand and agree to the above requirements.

Signed: Date:

6

7

8

9

House 1600 sq. ft

Garage 800 sq. ft.

East Property Line 115’

South Property Line 220’

40’

24’ 26’ 34’

North

West Property Line 115’

North Property Line 220’

John & Jane Brown Site Plan

2400 total sq. ft. of building

Lot 1 Block 3 Smith Addition

Scale 1” = 20’

10’ wide utility easement

Example Site Plan

Center Line of Jasper Street

Proposed Addition 24’x24’

10

A Site Plan is required with all applications for new construction and/or additions. The Site Plan should include at minimum:

* Legal description of the property and site address* Lot dimensions* North Point and Graphic Scale* All adjacent streets, easements and alleys* Footprint of ALL structures with ALL setbacks and dimensions noted

An example site plan on the reverse side demonstrates the minimum detail expected.

Additionally, the Building Official requires TWO sets of Construction Plans drawn to scale. An approved set of plans will be returned to you; the second set will be filed with the City. The following items must be included on all construction plans (as applicable):

* Cross section detailing foundation, footings, wall, roof, steps, deck (as applicable)* Floor plan of basement and each floor above* Foundation drainage* Names and addresses of: General Contractor, Plumber, Mechanical, Electrician

The following standards apply for R-1 zoning district:

Site Requirements: Minimum Lot Area - 10,500 (sgl family) 15,000 (two family) Minimum Lot Width - 75' Maximum Lot Coverage - 50% Structure Requirements:

Maximum Height - 2 & 1/2 Stories Setback Requirements: Minimum Building Width - 24' Front Setback - 30' Minimum Building Area - 576 sq. ft. Rear Setback - 25' Side Setback - 5' Maximum Area of Garage - See City Code Section 156.022. Corner lots at street intersections shall maintain front yard setbacks on each street side

Please contact the Planning/Zoning Office with questions at (320) 352-2203.

Residential AdditionsBuilding Permit Request Requirements

11

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SEC. 11 T 126 N R 34 W I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota.

Date _ October 24th, 2016 _______ License No. 51816

DATE: 10/24/2016 • DRAWN BY: MTR • CHECKED: BMN • JOB NO. 9206

REQUESTED BY:

�Nyberg�_.] SURVEYING

509 22ND AVE. EAST, SUITE 101

ALEXANDRIA, MINNESOTA 56308

PH. (320) 762-4111 * FAX (320) 762-4112 www.nybergsurveying.com

12

THE 811 PROCESS FOR HOMEOWNERS

For projects that include planting a tree, installing a mailbox or building a deck, among others.

Notify your local one-call center by calling 811 or making an online request 2-3 days before work begins. Click here for information about your local one-call center and online service availability. The one-call center will transmit information to affected utility operators.

3

4

Wait 2-3 days (varies by state; please click here for state law information) for affected utility operators to respond to your request. On average, between 7-8 utility operators are notified for each request.

NOTIFY

WAIT

CONFIRM

Respect the marks. The marks provided by the affected utility operators are your guide for the duration of your project. If you are unable to maintain the marks during your project, or the project will continue past your request’s expiration date (varies by state), please call 811 to ask for a re-mark.

RESPECT

5Dig carefully. If you can’t avoid digging near the marks (within 18-24 inches on all sides, depending on state law), consider moving your project to another part of your yard. If you must dig near the marks or use machinery of any kind, please click here to read “The 811 Process for Contractors.”

12

2-3

DIG CAREFULLY

Confirm that all affected utility operators have responded to your request by comparing the marks to the list of utilities the one-call center notified. State laws vary on the process for confirmation; please check with your local one-call center for more information.

CALL BEFORE YOU DIG

13

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ate

dist

ribu

tion

net

wor

ks,

do

not

get

mar

ked

by f

acili

ty o

pera

tors

. W

hen

apr

oper

ty o

wne

r or

ten

ant

has

any

type

of

priv

ate

unde

rgro

und

faci

lity,

the

y ar

e re

spon

sibl

e to

loca

te

thos

e fa

cilit

ies

or h

ire

som

eone

to

loca

te t

hem

.

Cust

omer

-ow

ned

lines

usu

ally

incl

ude

any

that

se

rve

outb

uild

ings

, ho

t tu

bs,

secu

rity

ligh

ting

, po

ols,

and

nat

ural

gas

gri

lls.

The

free

loca

ting

ser

vice

ava

ilabl

e th

roug

h G

ophe

r St

ate

One

Cal

l (G

SOC)

app

lies

ON

LY t

o pu

blic

fac

ility

ope

rato

rs.

The

diag

ram

bel

ow

show

s a

vari

ety

of u

tilit

ies,

som

e ow

ned

by t

he

utili

ty a

nd s

ome

by t

he h

omeo

wne

r.

THO

SE U

TILI

TIES

MA

RKED

BY

DO

TTED

LIN

ES A

RE

TYPI

CALL

Y O

WN

ED B

Y TH

E PR

OPE

RTY

OW

NER

. Pr

ivat

e lo

cati

ng s

ervi

ces

will

mar

k th

ese

for

a fe

e. T

hose

line

s w

ill N

OT

be m

arke

d by

co

ntac

ting

GSO

C.

DON’T

FORG

ET!

Afte

r ca

lling

GSO

C, w

ait

48

hour

s (e

xclu

ding

wee

kend

s an

d ho

liday

s) b

efor

e yo

u be

gin

your

exc

avat

ion!

Re

mem

ber

to c

heck

for

fa

cilit

y op

erat

or r

espo

nses

.

If y

ou a

re

inst

allin

g pr

ivat

e fa

cilit

ies

cons

ider

doi

ng t

he f

ollo

win

g:

•Pr

epar

e m

aps

of a

ny n

ew u

nder

grou

ndfa

cilit

ies.

•Bu

ry t

race

r w

ire

wit

h th

e ne

w f

acili

ties

.•

Use

abo

ve g

roun

d m

arke

rs o

r si

gns

to in

dica

teth

e bu

ried

fac

iliti

es.

•Vi

sit

ww

w.g

ophe

rsta

teon

ecal

l.or

g/ho

w-

gsoc

-wor

ks/p

riva

te-f

acili

ty-i

ntro

for

mor

ein

form

atio

n ab

out

prot

ecti

ng p

riva

te f

acili

ties

.

If p

riva

te f

acili

ties

are

su

spec

ted,

the

exc

avat

or s

houl

d:

•Ph

ysic

ally

insp

ect

the

jobs

ite.

•As

k th

e pr

oper

ty o

wne

r.•

See

wha

t eq

uipm

ent

or p

ower

may

ser

veou

t bu

ildin

gs.

•Co

ntac

t th

e or

igin

al in

stal

ler

of t

hefa

cilit

ies

for

any

map

s of

the

line

s.•

Exca

vate

wit

h ca

utio

n an

d be

aw

are

of a

ny w

arni

ng s

igns

of

unde

rgro

und

faci

litie

s.•

Visi

t w

ww

.gop

hers

tate

onec

all.

org/

cont

ract

-loc

ator

s-di

rect

ory

for

info

rmat

ion

on p

riva

te lo

cati

ngco

mpa

nies

.

The

cont

act

info

rmat

ion

for

a nu

mbe

r of

loca

ting

com

pani

es

who

will

loca

te p

riva

tely

ow

ned

unde

rgro

und

faci

litie

s on

you

r pr

oper

ty c

an b

e fo

und

in t

he in

dust

ry

dire

ctor

y at

ww

w.g

ophe

rsta

teon

ecal

l.org

/pr

ivat

e-fa

cilit

y-lo

cato

rs.

!

HO

MEO

WN

ERS:

Tel

l you

r ex

cava

tor

abou

t an

y pr

ivat

e un

derg

roun

d lin

es y

ou k

now

of.

Not e

very

thin

g get

s ma

rked

whe

n you

call

Did Y

ou Kn

ow?

RESP

ECT T

HE M

ARKS

!O

nce

the

utili

ties

hav

e be

en lo

cate

d, y

ou’l

l se

e a

vari

ety

of p

aint

mar

king

s or

flag

s on

th

e gr

ound

. Re

spec

t th

e m

arks

! N

ever

use

m

echa

nize

d di

ggin

g to

ols

whe

n yo

u ar

e di

ggin

g w

ithi

n 24

inch

es o

f th

e m

arki

ngs.

Onl

y us

e ha

nd t

ools

.

Are

a of

Pro

pose

d Ex

cava

tion

Tem

pora

ry S

urve

y M

arki

ngs

Elec

tric

Gas

, O

il, S

team

, Pr

opan

e

Com

mun

icat

ion,

CAT

V, F

iber

Wat

er

Recl

aim

ed W

ater

, Ir

riga

tion

Sew

er

WH

ITE

PIN

K

RED

YELL

OW

ORA

NG

E

BLU

E

PURP

LE

GRE

EN

GAS

24”

Han

d D

ig24

”H

and

Dig

24”

24”

LOC

ATI

ON

TOLE

RA

NC

E ZO

NE

Han

d D

igH

and

Dig

SMA

LL P

IPE

OR

CA

BLE

tole

ranc

e zon

e

15

ww

w.g

ophe

rsta

teon

ecal

l.or

gV2

017

1.Te

leph

one

Num

ber

2.N

ame

and

Com

pany

Nam

e –

Prov

ide

GSO

C w

ith

your

nam

e.D

O N

OT

SUBM

IT A

TIC

KET

UN

DER

SO

MEO

NE

ELSE

’S N

AME.

3.M

ailin

g Ad

dres

s

4.E-

mai

l Add

ress

5.Al

tern

ate

(Fie

ld)

Cont

act

Nam

e an

d Ph

one

Num

ber

– Pl

ease

prov

ide

the

cellu

lar

tele

phon

e nu

mbe

r of

the

per

son

to b

eco

ntac

ted

duri

ng t

he e

xcav

atio

n pr

ojec

t.

6.Ty

pe o

f W

ork

– Th

e sp

ecifi

c re

ason

for

the

wor

k as

com

pare

d to

the

wor

k m

etho

d. F

or e

xam

ple,

“in

stal

lati

onof

a s

anit

ary

sew

er la

tera

l” is

muc

h m

ore

help

ful t

han

“dig

ging

a s

ewer

line

.”

7.W

ork

Bein

g D

one

For

– Yo

ur n

ame,

the

cus

tom

er’s

nam

e, o

rth

e ge

nera

l con

trac

tor’

s na

me

is s

uffic

ient

.

8.D

urat

ion

– An

est

imat

e of

how

long

you

pla

n on

bei

ng a

t th

ejo

b si

te.

A lo

cate

tic

ket

is v

alid

for

14

cale

ndar

day

s. If

the

dura

tion

of

the

wor

k w

ill e

xten

d be

yond

14

cale

ndar

day

s,yo

u m

ust

requ

est

an u

pdat

e on

the

tic

ket

at le

ast

48 h

ours

,ex

clud

ing

wee

kend

s an

d ho

liday

s, p

rior

to

the

expi

rati

on o

fth

e 14

day

per

iod

(unl

ess

arra

ngem

ents

are

mad

e w

ith

the

affe

cted

ope

rato

rs t

o pe

riod

ical

ly r

emar

k).

If t

he p

roje

ctw

ill e

xcee

d 6

mon

ths,

a n

ew t

icke

t m

ust

be s

ough

t pr

ior

toth

e ex

pira

tion

of

the

6 m

onth

per

iod.

9.Ex

plos

ives

– G

SOC

mus

t as

k w

heth

er e

xplo

sive

s w

ill b

e us

edin

an

effo

rt t

o as

sist

gas

and

pip

elin

e fa

cilit

y op

erat

ors.

10.

Tunn

elin

g &

Bor

ing

– Yo

u m

ust

advi

se if

you

will

use

any

mea

ns o

f tu

nnel

ing

hori

zont

ally

wit

hout

dis

turb

ing

the

grou

nd a

bove

, al

so k

now

n as

tre

nchl

ess

cons

truc

tion

.

11.

Righ

t of

Way

(RO

W)

– G

SOC

defin

es t

he R

OW

as

the

area

on,

bel

ow,

or a

bove

a p

ublic

roa

dway

, hi

ghw

ay,

stre

et,

cart

way

, bi

cycl

e la

ne,

and

publ

ic s

idew

alk

inw

hich

the

gov

ernm

ent

unit

has

an

inte

rest

, in

clud

ing

othe

r de

dica

ted

righ

ts-o

f-w

ay f

or t

rave

l pur

pose

s an

dut

ility

eas

emen

ts o

f go

vern

men

t un

its.

Mak

e su

re y

ouar

e fa

mili

ar w

ith

the

ROW

in t

he a

rea

you

are

wor

king

.Pl

ease

not

e th

at t

he R

OW

is n

ot t

he s

ame

as a

n ea

sem

ent.

12.

Area

Mar

ked

– H

as t

he a

rea

been

mar

ked

wit

h w

hite

pai

ntor

flag

s, u

nles

s fo

und

to b

e im

prac

tica

l?

13.

Stre

et A

ddre

ss o

f W

ork

Site

– B

e ca

refu

l to

accu

rate

lyde

scri

be t

he f

ollo

win

g.

•Co

unty

nam

e

•Ci

ty/T

owns

hip

nam

e

•St

reet

add

ress

of

the

wor

k si

te

You

mus

t us

e th

e ph

ysic

al a

ddre

ss o

f th

e ex

cava

tion

sit

e,

not

your

mai

ling

add

ress

. “B

lank

et t

icke

ts”

are

not

an

acce

ptab

le p

ract

ice.

If y

ou a

re a

sub

cont

ract

or a

nd y

ou

are

exca

vati

ng,

prot

ect

your

self

and

you

r co

mpa

ny b

y pr

oces

sing

a t

icke

t. T

he g

ener

al c

ontr

acto

rs’

tick

et d

oes

not

appl

y to

any

one

exce

pt f

or t

he g

ener

al c

ontr

acto

r.

GSO

C re

com

men

ds a

hom

eow

ner

not

to o

btai

n a

tick

et f

or

an e

xcav

ator

doi

ng w

ork

on t

heir

beh

alf.

The

Exc

avat

or

shou

ld o

btai

n it

s ow

n ti

cket

.

14.

Nea

rest

Inte

rsec

ting

Str

eet

– Th

e ne

ares

t in

ters

ecti

ng s

tree

tto

the

exc

avat

ion

site

. Pr

ovid

e th

e cl

oses

t in

ters

ecti

ngst

reet

, ev

en if

it is

not

a m

ajor

cro

ssin

g.

15.

Mar

king

Inst

ruct

ions

– Id

enti

fies

the

spec

ific

port

ion

of t

he e

xcav

atio

n si

te t

hat

need

s to

be

mar

ked.

Her

ear

e so

me

exam

ples

of

how

to

effe

ctiv

ely

use

mar

king

inst

ruct

ions

.

•W

ork

keep

ing

wit

hin

(###

) (f

eet,

met

ers,

yar

ds,

mil

es)

of (

pre-

mar

king

: fl

ag,

pain

t, l

ath,

etc

.).

•W

ork

area

is

loca

ted

(des

crib

e pr

oper

ty o

rien

tati

on—

fron

t, b

ack,

sid

e(s)

, in

side

/ ou

tsid

e fe

nce,

etc

.).

Plea

se n

ote:

(do

g on

site

, ga

tes

lock

ed,

guar

d/re

stri

cted

acc

ess,

haz

ards

, et

c.).

•A

ddit

iona

l in

form

atio

n: (

TRSQ

, M

ap p

age

and

grid

,G

PS c

oord

inat

e, l

andm

arks

, et

c.).

Avo

id d

efau

lt t

o“m

ark

enti

re l

ot”

unle

ss t

he n

atur

e of

the

wor

kre

quir

es t

his

desi

gnat

ion.

Plea

se n

ote:

Thi

s do

es n

ot r

elie

ve t

he e

xcav

ator

fro

mus

ing

whi

te m

arki

ngs

to d

efine

the

exc

avat

ion

site

.

16.

Dri

ving

Dir

ecti

ons

(if

need

ed)

– D

escr

ibe

clea

rly

how

to

get

to t

he w

ork

site

fro

m a

kno

wn

inte

rsec

tion

.

•Fr

om (

Cros

s Ro

ad)

trav

el (

N-S

-E-W

) fo

r (#

##)

(fee

t,m

eter

s, y

ards

, m

iles

) on

(D

ig S

tree

t) t

o th

e (l

ocat

ion,

Flag

, La

th,

etc.

) on

the

(N

-S-E

-W)

side

of

the

road

.

•Fr

om (

Dig

Str

eet)

tra

vel

(N-S

-E-W

) fo

r (#

##)

(fee

t,m

eter

s, y

ards

, m

iles

) on

(dr

ivew

ay,

serv

ice/

grav

el/

farm

roa

d) i

nto

the

prop

erty

to

(pre

-mar

king

).

17.

GPS

Coo

rdin

ates

– P

rovi

de t

he G

PS p

oint

s of

the

exc

avat

ion

site

. Pl

ease

iden

tify

if t

he G

PS c

oord

inat

es,

if a

vaila

ble,

repr

esen

t th

e ce

nter

or

four

cor

ners

of

loca

tion

.

18.

Tow

nshi

p, R

ange

, Se

ctio

n an

d Q

uart

er S

ecti

on –

Pro

vide

the

TRSQ

num

bers

of

the

exca

vati

on s

ite

if a

vaila

ble.

Thi

sin

form

atio

n ca

n be

fou

nd o

n G

SOC’

s IT

IC w

ebsi

te:

ww

w.

gsoc

subm

it.o

rg o

r on

mos

t pr

oper

ty t

ax s

tate

men

ts f

rom

your

cou

nty.

To

prov

ide

TRSQ

info

rmat

ion,

indi

cate

the

tow

nshi

p, r

ange

, an

d se

ctio

n by

the

ir n

umer

ic d

esig

nati

ons

and

quar

ter

sect

ions

by

thei

r di

rect

iona

l qua

lifier

(N

E, N

W,

SE,

and

SW).

Exam

ple

TRSQ

: To

wns

hip:

108

N R

ange

: 28

W S

ecti

on:

12-N

E

Belo

w a

re b

rief

exp

lana

tion

s of

the

info

rmat

ion

that

you

will

be

requ

ired

to

prov

ide

whe

n pr

oces

sing

a lo

cate

tic

ket.

Al

l ide

ntifi

ed in

form

atio

n is

als

o m

ade

avai

labl

e to

fac

ility

ope

rato

rs,

exca

vato

rs,

and

gove

rnm

ent

agen

cies

. Th

is is

not

privateinform

ationandnoexpectationofconfi

dentiallyorprivacyshallb

eassumed.

LOCA

TE R

EQU

EST

GU

IDE

16

Don

’t a

ssum

e yo

u kn

ow w

hat’

s be

low

. Pr

otec

t yo

urse

lf a

nd t

hose

aro

und

you.

U

se G

SOC

thi

s ti

me

and

ever

y ti

me.

Whe

ther

you

are

a p

rofe

ssio

nal e

xcav

ator

or

hom

eow

ner,

in a

ccor

danc

e w

ith

Min

neso

ta S

tate

law

, yo

u m

ust

cont

act

Gop

her

Stat

e O

ne C

all (

GSO

C) b

efor

e st

arti

ng a

ny e

xcav

atio

n pr

ojec

t if

you

are

usi

ng a

ny m

achi

ne-p

ower

ed

equi

pmen

t of

any

kin

d, o

r ex

plos

ives

. Yo

u m

ay b

e si

mpl

y in

stal

ling

a ne

w m

ail b

ox o

r pl

anti

ng a

tre

e, w

hate

ver

the

proj

ect

may

be,

con

tact

ing

GSO

C be

fore

sta

rtin

g yo

ur p

roje

ct m

ay a

llow

you

to

avoi

d co

stly

dam

ages

to

unde

rgro

und

faci

litie

s.

THE P

roce

ss FO

R Saf

e Ex

cava

tion

Exca

vato

r Res

pons

ibili

ties

PLA

N F

OR

YOU

R EX

CAVA

TIO

NYo

u ar

e re

quir

ed t

o us

e w

hite

mar

king

s to

defi

ne t

he e

ntir

e ar

ea w

here

exc

avat

ion

will

occ

ur,

unle

ss it

can

be

show

n it

is

not

pra

ctic

al.

Incl

ude

a sa

fety

buf

fer

whe

n m

arki

ng t

he

area

.

NO

TIFY

GSO

CAl

l Min

neso

ta e

xcav

ator

s, in

clud

ing

hom

eow

ners

an

d fa

rmer

s, a

re r

espo

nsib

le f

or n

otif

ying

GSO

C of

th

eir

prop

osed

exc

avat

ions

so

faci

lity

oper

ator

s w

ith

unde

rgro

und

faci

litie

s ne

ar t

he e

xcav

atio

n si

te c

an b

e in

form

ed o

f pe

ndin

g ex

cava

tion

.

Use

thi

s ti

cket

typ

e to

req

uest

th

e fa

cili

ty o

pera

tor

to p

hysi

call

y m

eet

at t

he e

xcav

atio

n si

te.

A m

eet

shou

ld o

nly

be r

eque

sted

w

hen

it is

dif

ficul

t to

pre

cise

ly

defin

e th

e lo

cati

on o

f th

e ex

cava

tion

sit

e in

a r

outi

ne

loca

te r

eque

st.

The

use

of w

hite

m

arki

ngs

to c

lear

ly id

enti

fy t

he

exca

vati

on a

rea

can

gene

rally

be

used

to

avoi

d th

e ti

me

and

cost

of

a m

eet.

As

defi

ned

by M

inne

sota

Sta

tute

Ch

apte

r 21

6D.0

1 su

bdiv

isio

n 3,

em

erge

ncy

loca

tes

are

used

for

“a

cond

itio

n th

at p

oses

a c

lear

and

im

med

iate

dan

ger

to l

ife

or h

ealt

h,

or a

sig

nifi

cant

los

s of

pro

pert

y.”

GSO

C re

min

ds y

ou t

o fir

st c

all 9

11

whe

neve

r th

ere

is a

rel

ease

of

flam

mab

le,

toxi

c or

cor

rosi

ve g

as o

r liq

uid,

or

a da

nger

ous

situ

atio

n is

cr

eate

d. N

ext,

con

tact

the

fac

ility

op

erat

or in

volv

ed in

the

em

erge

ncy,

th

en c

onta

ct G

SOC.

Use

thi

s fo

r st

anda

rd e

xcav

atio

n pr

ojec

ts.

Loca

te r

eque

sts

are

the

mos

t co

mm

on t

ype

of r

eque

st p

roce

ssed

at

GSO

C. T

his

type

of

tick

et m

ust

be r

eque

sted

by

the

exca

vato

r at

leas

t 48

hou

rs (

excl

udin

g w

eeke

nds

and

holid

ays)

and

up

to

14 c

alen

dar

days

fro

m t

he p

lann

ed

star

t of

exc

avat

ion.

The

tic

ket

is

valid

for

14

cale

ndar

day

s fr

om t

he

star

t da

te a

nd t

ime

stat

ed o

n th

e ti

cket

, un

less

the

loca

te m

arki

ngs

beco

me

obsc

ured

or

oblit

erat

ed.

LOC

ATE

RE

QU

EST

EM

ER

GE

NC

YM

EE

T

Tick

et T

ypes A

rea

of P

ropo

sed

Exca

vati

on

Tem

pora

ry S

urve

y M

arki

ngs

Elec

tric

Gas

, O

il, S

team

, Pr

opan

e

Com

mun

icat

ion,

CAT

V, F

iber

Wat

er

Recl

aim

ed W

ater

, Ir

riga

tion

Sew

er

WH

ITE

PIN

K

RED

YELL

OW

ORA

NG

E

BLU

E

PURP

LE

GRE

EN

24”

24”24

”24

”

20”

LOC

ATI

ON

TOLE

RA

NC

E ZO

NE

Han

d D

igH

and

Dig

LAR

GE

PIP

E O

R M

ULT

IPLE

DU

CTS

Han

d D

igH

and

Dig

TELEPHONE

20”

GAS

24”

Han

d D

ig24

”H

and

Dig

24”

24”

LOC

ATI

ON

TOLE

RA

NC

E ZO

NE

Han

d D

igH

and

Dig

SMA

LL P

IPE

OR

CA

BLE

ALW

AYS

USE

TH

E CO

RREC

T W

ORK

TYP

E O

N Y

OU

R TI

CKET

CHEC

K FO

R A

CCU

RACY

O

F TH

E IN

FORM

ATIO

N O

N Y

OU

R TI

CKET

ALW

AYS

CHEC

K TH

E ST

ATU

S O

F YO

UR

TICK

ET

BEFO

RE Y

OU

EXC

AVAT

E

HA

ND

DIG

WIT

HIN

TH

E TO

LERA

NCE

ZO

NE

-Kn

ow th

e Ba

sics

!

Whe

n a

call

is p

lace

d to

a o

ne c

all c

ente

r, t

here

is le

ss t

han

a 1%

ch

ance

for

the

und

ergr

ound

exc

avat

ion

to r

esul

t in

dam

age.

-Th

e Co

mm

on G

roun

d A

llia

nce’

s (C

GA

) an

nual

DIR

T re

port

pro

vide

s a

sum

mar

y an

dan

alys

is o

f th

e ev

ents

sub

mit

ted

into

CG

A’s

Dam

age

Info

rmat

ion

Repo

rtin

gTo

ol (

DIR

T) f

or t

he y

ear

2014

.

2014

Anal

ysis

& R

ecom

men

datio

nsVo

lum

e 11

To d

ownl

oad

the

repo

rt or

to a

cces

s ad

ditio

nal

anal

ysis

, vis

it w

ww

.cga

-dirt

.com

.

This

repo

rt m

ay b

e re

fere

nced

as

the

DIR

T An

nual

Rep

ort f

or 2

014.

© 2

007,

200

8,20

09,2

010,

201

1, 2

012,

201

3 al

l rig

hts

rese

rved

.

Begi

nnin

g on

line

usin

g IT

IC,

over

the

pho

ne b

y ca

lling

GSO

C, o

r fr

om a

mob

ile d

evic

e us

ing

ITIC

Mob

ile,

you

can

file

a lo

cate

req

uest

.

Rem

embe

r to

wai

t 48

hou

rs

(exc

ludi

ng h

olid

ays

and

wee

kend

s) a

fter

sub

mit

ting

th

e lo

cate

req

uest

. Ch

eck

faci

lity

oper

ator

res

pons

e us

ing

posi

tive

re

spon

se o

n IT

IC a

nd i

nspe

ct t

he w

ork

site

fo

r m

arks

. Co

ntac

t th

e fa

cilit

y op

erat

or if

yo

u ha

ve q

uest

ions

reg

ardi

ng t

heir

mar

ks.

To p

ract

ice

safe

ex

cava

tion

, al

way

s ha

nd

dig

wit

hin

the

tole

ranc

e zo

ne (

see

next

pag

e).

The

unde

rgro

und

faci

lity

oper

ator

s th

at

requ

este

d no

tific

atio

n in

the

exc

avat

ion

area

di

spat

ch lo

cato

rs t

o th

e de

scri

bed

exca

vati

on s

ite.

Loca

tors

use

spe

cial

ized

equ

ipm

ent

to

dete

rmin

e th

e un

derg

roun

d ut

iliti

es in

the

ex

cava

tion

are

a. T

hey

loca

te a

nd m

ark

the

hori

zont

al lo

cati

on o

f un

derg

roun

d fa

cilit

ies

wit

hin

the

exca

vati

on s

ite

wit

h di

ffer

ent

colo

red

flags

and

pai

nt t

hat

corr

espo

nd t

o th

e sp

ecifi

c un

derg

roun

d fa

cilit

y.

GSO

C th

en

cont

acts

eac

h un

derg

roun

d fa

cilit

y op

erat

or in

th

e ex

cava

tion

ar

ea id

enti

fied

in t

he lo

cate

re

ques

t.

GSO

C pr

oces

ses

the

prov

ided

in

form

atio

n, a

nd t

he a

rea

gets

map

ped

out

usin

g sp

ecia

lized

sof

twar

e th

at d

etec

ts p

ossi

ble

confl

icts

wit

h un

derg

roun

d ut

iliti

es.

Spec

ific

info

rmat

ion

abou

t th

e w

ork

site

and

th

e su

rrou

ndin

g ar

ea,

as w

ell a

s m

arki

ng

inst

ruct

ions

for

the

wor

k si

te m

ust

be

prov

ided

. O

ther

info

rmat

ion

can

also

be

incl

uded

.

File

Loc

ate

Requ

est

Call

GSO

C...

Gre

ater

MN

Are

a:

(80

0)2

52

-11

66

Twin

Cit

ies

Met

ro:

(65

1)4

54

-00

02

Or

go o

nli

ne

at

ww

w.g

ophe

rst

ateo

neca

ll.o

rg

DPI

nser

t Jan

2016

.indd

2-

32/

10/1

6 3

:32

PM

17