HomeMy WebLinkAboutDriveway Permit
SEP-18-2006 09:04
CITY CF PR I ffi LAKE MA I NT
P.02/02
DRIVEWAY PERMIT APPLICATION
PERMIT #
~ -~O{.
q q OC:)
,
DATE:
wide (TEMPORARY, PERMANENT) Drive approach
~y:
Dale:
fj -/~ -fJt
DRIVE APPROACH
TO CONSTRUCT: 0 New .~ Replace JjJIr"-.
Fee:
(Please provide sketdl 011 reverse llde or on I separate IMet)
Type of Material.-N\ N DOT d.~4 \ PfiJh1tt-
I (). (;()
- ,
REQUIREMENTS
1 . No work under this application is to be started until application is approved and the permit is issued.
2. Where wort< on traveled roadway is necessary, traffic must be protected and flags. signs, safety cones and proper
barricades must be placed in accordance with safety pmcedures,
3. No foreign material such as dirt, gravel, or bituminous material shall be left or deposited on the road during the
construction of driveway.
4. Road must be swept clean after work is completed.
5. Prior to placement of concrete or bituminous surfacing, the applicant shah notify the Engineering Department that the
work has been completed and is ready for final inspection.
6. No changes or alterations in entrances may be made at any time without written permissiQ-" from the Engineering
Department or inspector.
IMPORTANT: Before starting work . . .
The Applicant 5h8l1 calt Gopher State One Call (1-800-252-1166) 48 hours prior to starting work. Applicant must call the
Engineering Department (952) 44 7-9830 for inspection 24 hours prior to time of inspection.
When widening or constructing new driveway approaches a $10.00 fee is required at the lime of application and a sketch of tile
property depicting present and proposed driveways in relation to the property ~ne.
(Sketch on reverse side of application or provide 8 separate plan)
As provide in Ordinan<:e Numbe~ 1107.205 & 1107.206> I, We the undersigned, herewith make application
for permission to construct the driveway at the above location. said driveway to be constructed to conform
with the standards of the City of Prior Lake and to any special provisions included in the permit. It is agreed
that all work will be done to the satisfaction of the Engineering Department. It is further aoreed that no work
in connection with this application will be sIarted until the application is approved and the permit issued.
S~~. tJIlL1ilrli'\ 'JVx/. ~ ~
Contracto"TJ AppUcant's Signature _.
Date: l.] /1 ~I 0 &
{ f
TOTAL P. 02