HomeMy WebLinkAboutRight of Way Permit
10/28/99 THU 10:12 FAX 6124474263
CITY OF PRIOR LAKE
141002
~t>Dd Z80d - 0.0 1
-Z~fItt.- ~,~- u..
PERMIT
TO VVORK WITHIN CITY PROPERTYIRIGHT.OF.WAYIEASEMENTS
AND
APPLICATION FOR INSTALLATION OF UTILITIES
1. Location /5-- J.. .j - 7
.) 1
2. N~ture of Work LvlJ..O
L-VJ: L,t:J ->
A 4./( ................
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PIL,w ;..V~1 ~A'L74i
3. Indicate below items to be affected and include a sketch or plan of work to be done.
)(/ _ Curb & Gutter
TraiVSidewalk
PondlWetlands
Traffic Control Devices/Signs
. Drainage
StructurelBuildings
Street Surface
Trees:
(Publically owned_
or Privately owned->
Utilities
Other
4. Method of Installation or Construction
5. . Work to start on or after: /<../ /h);/ 'l ~ and shall be completed by: I Y IJ<.<.. ,~ l' unless an extension
~antedro: by:
DATE STAFF/DATE
6. Will detouriJ:lg of traffic be necessary? M./ If necessary to detour traffic, describe suggested
route:
7. Provide witlt1his application a copy of the contractors Public Liability Insurance.
DETOURS:
The Director of Public Works shall be notified in'writin& at least 72 hours in advance of
any detour being established, changed or discontinued.
NAME OF APPLICANT fX....;rT. 1-141 ~.
PLEASE PRINT
ADDRESS. 7 J:<.o Co tit.) .5(, &..L~.t
STREET CITY
PHONE blJ. Y''t!l-7..:v<..
FAX
/'1/'1./
STATE
s-s- ?/S-
ZIP
NAME OF PARTY OR OjtGANIZATION PERFORMING WORK P~c.,j.f)/1 ~. Ida.>
CONTACT PERSON: ~CTI Jk..~~ EMERGENCY (24 HR.) PHONE #: "/Y.f'-700L
ADDRESS _ .5..,'>1(. A:- A6~~A.': DAY PHONE '1q Y (6)' 7
STREET CITY STATE ZIP
The undersigned herewith accepts the terms and conditions of thispennit by the City of Prior Lake as herein
containe.d Zee to fu~: comply therewith to the satisfaction of the City of Prior Lake.
Signed:./':; "'7 ~~ Title: r:;...../ll"'c>(' Date: IV fi';o.../ '77
EXHIBrrCDOC Page 1 of 4
16200 Eagle Creek Ave. S.E., Prior Lake, Minnesota 55372-1714 I Ph. (612) 447-4230 I Fax (612) 447-4245
AN EQUAL OPPORTIJNITY EMPLOYER
10/28/99 THU 10:12 FAX 6124474263
CITY OF PRIOR LAKE
. EXHIBIT"C"
FOR CITY USE ONl.Y
AurnORIZATION OF PERMIT
FINANCIAL SECURITY:
AMOUNT:.
TYPE:
(Cash, bond, LOC etc.)
Fee: $
Receipt No.
Petmit No.
LIABILIlY INSURANCE PROVIDED:
In consideration of agreement to comply in aU respects with the regulations of the City of Prior Lake covering such
operations, and pursuant to authorization duly given by said City of Prior Lake; pcnnissioD is hereby granted for the
work to be done as de:-.cribed in the above application, said work to be done in acCordance with special provisions as
hereby staled:
APPROVED BY: DEPT. OF PUBLIC WORKS
By: 1w'~cj)~-tt '~/9/99
~ /DATE I
. . ALL LEGAL REQUDffiMENTS SHOWN ON PAGE ONE (I) AND ON ALL "SPECIAL PROVISIONS" SHALL
BE COMPLIED WITII. TIlE DATE WHEN WORK IS COMPLElED MUST BE REPORTED TO TIlE CIlY
OF PRIOR LAKE Cny ENGINEER.
EJQIIIIII'C.DOC
Page 2 of 4
141 003
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10/28/99 THU 10:12 FAX 6124474263
CITY OF PRIOR LAKE
@004
EXHIBIT "e"
CITY OF PRIOR LAKE
REGULATIONS PERTAINING TO THE INSTALLATION OR
REPAIR OF UNDERGROUND UTILITIES IN CITY STREETS
OR IN CITY RIGHT-OF-WA YIEASEMENTS
The following regulations and conditions constitute a part of the application made by any installer or contractor for
the installation of utilities in any City street right-of-way or City utility easement and the applicant, in making his
application to do such work, shall agree to abide by these regulations and conditions:
1. The individual obtaining the permit shall, before commencing such work, notify the City Engineer when
the work at each location is to commence; and, when requested by the Engineer, shall submit plans and
specifications.
2. Upon CQ,mpletion of the project the individual shall promptly notify the City Engineerinl: Department for
final insp@ml.
3. The public is to be protected by the individua~ at all times, from the conunencement of the work until the
completion and acceptance by the City. The installer or contractor shall so conduct his operations as to
cause the minimum inconvenience to the public. The installer or contractor shall furnish, erect, and
maintain, in accordance with the legally accepted standards, all necessary warning and traffic control signs,
barricades, traffic cones, and flashing lights to direct and control the movement of traffic through the
project in all directions and at all times.
The . foregoing provisions shall not in any way relieve the installer or contractor of any of his legal
. responsibilities or liabilities for the safety of the public.
4. All opellings in bituminous surfaces shall be cut in a straight line with sides smooth and vertical. No
ragged l:dges will be pennitted. Cutting shall be done with a concrete saw,. cutting wheel, jack hammer,
spades or similar approved tools.
Backfill material shall be suitable for highway embanlanent construction. No peat, frozen lumps, broken
asphalt, sod, roots, or other undesirable material shall be pennitted as backfllJ. Rocks larger than six inches
(6") in d.iameter shall not be used in backfilling of trenches.
The backfill material shall be placed in layers not to exceed one foot (1') and mechanically compacted to
not less than 95 percent of modified Proctor density.
The upper six inches (6") of the backfill shall meet Minnesota Highway Department Specifications for
Class 5 material and shall be compacted to not less than 95 percent of modified Proctor density.
As soon as possible after backfill operations .are completed, the cut bituminous edges of the trench shall be
painted with an asphalt emulsion such as SS-l. Immediately thereafter, the patching material shall be
placed and mechanically compacted to not less than 95 percent of modified Proctor density. The asphaltic
material used in patching shall be of the same type as removed from the roadway; except, that in no case,
will a plant mixed asphalt of less quality than Minnesota Highway Department Specifications 2331 be
used. TIli~ fmisbedsurface of the patch shall confonn to the surface of the undisturbed roadway.
No pemlllnent asphalt patches shall be on any base whose temperature is 32 degrees Fahrenheit or less.
Cold wea:ther patching shall be of temporary nature, using cold mixed asphalt, well graded crushed rock or
similar approved materials. Temporary patches shall be true to line and grade. Temporary patches shall be
replaced by permanent patches when weather conditions penn it and notification shall be required as stated
. -,
mI...
EXHlBITC.DOC
Page 3 of 4
10/28/99 THU 10:13 FAX 6124474263
CITY OF PRIOR LAKE
EXlDBIT "C"
5. Other areas Inay be required to be compacted at the direction of the City EDgineer. .
6. Such permittee to be responsible for maintenance and repair of all trenches for a period of one (1) year and
if settlement occurs or excavation caves in, the sameshallbe promptly indicated by adequate waniiog signs
and shall be: restored to proper condition in accordance with specifications above provided as soon as
conditions pt~it. -
7. All culverts and ditches sba1l be replaced in their original position and condition existing prior to
construction and no change shall be made in dnUnage without approval oftbc City Engineer.
8. Permittee shall save the City harmle.ss tiom all third party claims for injury or damage which may occur
between the time the work commences and the time it is finally accepted by the City.
9. Th~ permittee may be required to jack or bore under certain streets, as determined by the City Engineer.
10. . Theapplicallt shall fuinish evidence of public liability insw'ance of not less than SIOO,OOOI300,ooo and .
property danaage of not less thau. $25,000 issued by au. insul'ance compau.y authorized to do business in the
State ofMiimesota on which the City is named as an additional insured party. .
11. Except for the negligent ads of the City, its agents and its employees, the permittee shall assume all
liability for, and save the City. its agents and its employees, harmless and defend same at its sole cost and
expense frODl any and all claims for damages, actions or causes of action arising out of the work to be done
herein and dle continuing uses by the permittee, includiogbut not limited to the.placing, CODSbucting, and
reconstroctiIhg. maintaining. protecting and use of said facility under this application and permit for .
construction.
12. Existing Facilities - The utility facility and installations shall not interfercWdh any existing utilitY facility
on the City's right-of-way or easements. It is the n:sponsibility of the applicant to call for necessary
locations. of existing utilities. (Gopher One) .
13. Private Property - The wode permit or pCnnit for construction as issued does not in any way imply that the
appropriate t:asement exists to allow the applicant to work on private property.
14. CUtting Trees - The permission herein &J3Dted does not confer upon the permittee the right to cut, remove
or destroy trt~ or shrubbery within the legal limits of the right-of-way, easements that are not specifically
identified Oil. the plan attached to this permit or relieve pennitte.e from obtaining any coDSCDt otherwise
required from the owner of the property adjacent thereto.
15. Clean-Up - Street:. trailways and affected right-of-way shall be scraped clean at the end of each wode day
and swept (;~..an after coi1struction is completed and left in a neat and presentable c:onditi~ .
16. Replacement of Sod - Wherever top-soil and -sod are disturbed, they shidJ be replaced in kind and
maintained satisfactorily until the turf is established.
- .
The undersigned ben:by declares he/she has read and will comply with all the PERTINENT REGULATIONS as
stated above and re1ewJilt City Ordinances.
~- /lC
DATE: .;~ ~v _"77
~ "
/-- -' /
SI~p~~~
EXHDlITC.DOC
Page 4 of4
~005
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NU It.: tjUILUINlo UIMtS'l::>IVN:l ::>MVYVI'f f\t\t r VI'{ NVI'<ILV''4I/\L I\NU Vt.~ II\,..I\L LV\..I\ IIVI'II
or STRUCTURES ONLY. SEE ARCIIITECTUAL PLANS tOR BUILDING AND
tOUNOA TlON DIMENSIONS.
NOTE: NO SPECltlC SOILS INVESTlGA TION HAS BEEN COMPLETED ON TIllS LOT OY THE
SURVEYOR. THE SUITABILITY Of SOILS TO SUPPORT THE SPECltlC HOUSE
PROPOSED IS NOT TIlE RESPONSIBILITY or TilE SURVEYOR.
NOTE: THIS CERTltlCA TE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN
THOSE SHOWN ON THE RECORDED PLA T.
NOTE: CONTRACTOR MUST VERity DRIVEWAY DESIGN.
APPROVED
ENGfNEERfNG DEPT
Signed ~;~ -Oa:e fo/ufn
~
J::
/ APPROVED pi ~
l,ANN\NG DE. LO
P L/'!I A ^ ~o-2-t)-Cf15
~ ~ n..tA~ fn
, V - "'....--
S\gned -
PROPOSED HOUSE ELEVATiON
LOWEST FLOOR ELEVA TION: _:i:l1~
TOP OF BLOCI< ELEVATION: cr 50, 7
GARAGE SLAt! E.Ll VA nON: -2.-:; 0, 3-
TOB @ LOOKOUT ELEVA TIOhl:
BENCH MARK -'
TOP Of PIPE ""
ELEV.~94.9.18
( (1\18. ')) 0
. 10
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9018.10,,>
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r -' -' - EXISTING 9.38_0 CONTOUR
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~3.67 I I
- - ~II - -t - - -
DRAINAGE'" UTILITy I \
_ _ EASEMENT PER PLAT \,.
--- "-
S8\6'44'3:"E - -lmOlJ3~:'--:F
941.8 942.3 (J1\ /5 or-
to
943.65 ----T---__{j!J~,I) 941.9 I.-
18.19 I :;; 2400 17:-cih-
i g~22.0~ <o~ "
o I ;! PROPOSED g
0: HOUSE",..; I 0
:g 948.0 -_ ___ "I I~
::< '" '" - 34.00' 948. \ In
"! 'GARAGE ~. I
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18 10000", u, {.n5'~
--~ __.:..Ol'-i\':' '" 20.ac 9'!..8.:._~ 0,0" 17.9~ .__ .
o 948t.8 ph~~; --'-'----1 ~ -"~6~C~r~~~
o DRIVEWAY sr."v. V 0 ELEV.~9~O.32
.n - - - _ _ _ <1l '5 ~ ;(
N 0 - - - - - - --.J lfl &'>
--l)48.25 ~ S47.9 0 9 - .1~ ttJ?~ ri
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sa .OO'OO"E ~o
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947.5 917. _ 94 .~ -. - - ~rJ.
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WILDS PARKWAY '--JClJRO CUT
~~lA10VL t0l.-Y ~~I"~r'(,/t<.C wifl.J Cv~ c.v-r.
THIS IS A TRUE AND CORRECT I~EPRES[NT A TION OF A
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X 000.00
{ 000.00 }
DENOTES EXISTING ELEVATION
DENOTES prlOPOSED ELEVA liON
DENOTES DRAINAGE I.NO UTILITY EASEMENT
DENOTES DRAINAGE FLOVl DIRECTION
DENOTES MONUMENT
DENOTES OFFSET IIU[l
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942.04
NOTE: [lEARINGS SHOWN ARE BASED ON AN ASSUMED DA TUfA
WE HEREBY CERTIFY TO BRANDL ANDERSON THAT
SURVEY OF THE BOUNDARIES OF:
LOT 1, BLOCK 1, THE WILDS 4TH ADDITION
SCOTT COUNTY. MINNESOTA ___
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCI iROACHMENTS. EXCEPT~S <"1-IOWN. AS SURV["yE~_ BY-tylE OR
UNDER MY DIRECT SUPERVISION THIS 27 ~AY OF AUGUST, 1999. SIGI ED: PI~NEER ENJIt~! P.A.
SCALE: 1 INCH = 40 FEET /,. . ,,~
. B (: . ......"\.-1..
18311 9915'1.00 _._m__._"""- . Z~H-~-C. ",:orson, L.~~~~o_-' 9niiJ
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PRECISION BUILDERS
Carver, Minnesota (612) 448-7002
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