4.2. ERMUSR 05-10-2011Elk River:
Municipal U
UTILITIES COMMISSION MEETING
TO: FROM:
Elk River Municipal Utilities Commission David Berg -Water Superintendent
John Dietz, Chair
AI Nadeau, Vice Chair
Da 1 Thom son, Trustee
MEETING DATE: AGENDA ITEM NUMBER:
May 10~", 2011 4.2
SUBJECT:
Well Sealia Cost Share Pr am Contract
The Cost Share Program contract is now complete and ready for community members who
are interested in sealing their abandoned wells. Infom~ation will be available on our
website shortly. When an application is approved the applicant will then sign the contract
and start and finish the sealing project within (90) days. After the certification of well
sealing is filed with Sherbume/WrightCountiw,the applicant will submit the project
invoice and certification to F..RM[J and be rennbursed our portion of the agreed upon
funding. We have included in the meeting notes the contract and application.
PID No.
Abandoned Well Sealing Cost Share Agreement
Contract No.
Well Depth
Well Diameter
THIS AGREEMENT is between Elk River Municipal Utilities, 13069 Orono Parkway
NW, Elk River, Minnesota, 55330, ("ERMU") and
("GRANTEE"): (Name of GRANTEE)
The parties agree as follows:
1. GRANTEE warrants that s/he is the lawful and sole owners of the property
located at ("Property") and that
the well to be sealed is located on the Property.
2. GRANTEE agrees that the well located on the Property will be sealed on or about
. GRANTEE shall submit proof of filing of the well
sealing report and an invoice from the well sealing contractor.
3. GRANTEE shall allow on-site inspection of the well by ERMU or by the
Minnesota Department of Health staff ("MDH"). Inspection by ERMU does not
constitute approval or a guarantee as to workmanship.
4. GRANTEE shall be solely responsible for contracting directly with a licensed
well-sealing contractor and for paying the contractor.
5. ERMU will reimburse GRANTEE the lesser of the following: a) fifty percent
(50%o) of the actual cost of the well sealing; or b) $400. The cost to ERMU shall
not exceed a total of four hundred dollars ($400.00). The cost of any work
performed by the GRANTEE'S contractor in excess of this Grant will be the sole
responsibility of the GRANTEE.
6. ERMU will reimburse GRANTEE after completion of the work and after
GRANTEE'S contractor files a sealed well report and a copy of the well record
with ERMU and the MDH upon completion of the well sealing. Payment will be
made within (30) working days after GRANTEE provides proof of the filing of
the sealed well report to ERMU and an invoice from the GRANTEE'S contractor
documenting the costs of the well sealing.
7. Neither GRANTEE nor Grantee's contractor shall be considered to be either a
temporary or permanent employee of ERMU. It is mutually understood that the
GRANTEE and the GRANTEE' S contractor act hereunder as independent
contractor's and acquire no tenure rights or any rights or benefits by way of
Workers' Compensation, unemployment compensation, medical and hospital
caze, vacation and sick leave, severance pay, PERA, or any other rights or
benefits offered to ERMU employees.
8. In accordance with ERMU policies against discrimination, no persons shall be
excluded from full employment rights or participation in the benefits of any
program, service or activity on the grounds of race, color, creed, religion, age,
sex, disability, marital status, sexual preference, public assistance status, ex-
offender status, or national origin; and no person who is protected by applicable
Federal or State laws, rules, or regulations against discrimination shall be
otherwise subjected to discrimination.
9. All well sealing shall be done in accordance with Minnesota Statues governing
well sealing the rules of the Commissioner of Health related to sealing of unused
wells and all other applicable statutes, rules and ordinances related to the sealing
of abandoned wells.
10. The MDH will resolve any disputes as to the best method of sealing the well.
11. The GRANTEE agrees to defend, indemnify, and hold harmless ERMU and its
employees from any liability, claims, causes of actions, judgments, damages,
losses, costs, or expenses, including reasonable attorneys' fees, resulting directly
or indirectly employed by them, and/or and one for whose act or omissions they
maybe liable in the performance or the services required by this Agreement, and
against all loss by reason of the failure of said GRANTEE to perform fully, in any
respect, all obligations under this Agreement.
12. If GRANTEE should sell or offer to sell the Property within 12 months of
ERMU's payment to GRANTEE under Section 6 of this Agreement, any amount
paid to GRANTEE shall be returned to ERMU within 30 days. Failure to return
the grant amount to ERMU shall result in the amount owed to ERMU being
charged to the water account for the Property.
for ERMU
Grantee
GP:2970057 vl
Elk River ,~,,
Municipal Utilities
Well Sealing Cost Share Program Application
Fill Out Application & turn into Elk River Municipal Utilities Office (ERMU)
Include two licensed well sealing contractor bids with your application
• Once approved for the Cost Share Program, ERMU will contact you to approve the start of the project
• Complete project within (go) days of approval
• Submit a copy of the sealed well report available from contractor; and also submit the invoice from
your contractor indicating the work performed, with final cost of the project
• Once all is submitted you will receive ERMU's portion of the reimbursement within 3o days of project
completion and submittal of documents
Contact Name:
Address:
Zip Code:
Telephone:,
Cell: Email:
Property/ParcellD#:
WELL SITE ADDRESS:
What was/is the well used for?
Depth: (ft.) Diameter: (in.) Water Table Depth:
Please Check Any That Apply:
Is there a septic system? YesNo Are you currently using City water? Yes _No
Are other wells nearby?_Yes_No Is the well grouted?_Yes_No
Basement offset?_YesNo Are there any fuel tanks?_Yes_No
Submit Application to:
Elk River Municipal Utilities
13069 Orono Parkway NW, P.O. Box 430, Elk River, MN 55330
Office Use: llate Application Approved & Contacted Applicant
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