HomeMy WebLinkAboutDriveway Permit
DRIVEWAY PERMIT APPLICATION
PERMIT # us--,/J- 09
DATE: g/qJ/O s-
APPLICANT NAME:
OWNER NAME:
...k AJC-
PROPERTY ADDRESS:
DRIVE APPROACH
TO CONSTRUCT: D New ~epIace 0 Widen
Approved By.
tVt+D
Date. <1-30 Dr
wide (TEMPORARY, PERMANENT) Drive approach
Type of Material
!bfJk-r
.
Fee: Ie oj)
REQUIREMENTS
1 . No work under this apptication is to be started untU application is approved and the permit is issued.
2. Where work on traveled roadway is necessary, traffic must be protected and flags, signs. safety cones and proper
barricades must be placed in accordance with safety procedures.
3. No foreign material such as dirt, gravel. or bituminous material shan 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 shan notify the Engineering Department that the
work has been completed and is ready for fmal inspection.
6. No changes or alterations in entrances may be made at any time without written oermission from the Engineering
Department or inspector.
IMPORTANT: Before startina work. . .
The Applicant shall call Gopher State One Call (1-800-252-1166) 48 hours prior to starting work. Applicant must caD the
Engineeri De rtment (952) 447-9830 for Inspection 24 houfS prior to time of ins .
When IMdening or constructing new driveway approaches a $10.00 fee Is required at the time of application and a sketch of the
property depicting present and proposed driveways in relation to the property line.
(Sketch on reverse side of application or provide a separate plan)
As provide in Ordinance NumberS 1107.205 & 1107.206> I, We the undersigned. her9'Mth make application
for permission to construct the driveway at the above location, said driveway to be constructed to confonn
with the standards of the City of Prior Lake and to any special provisionS included in the permit. It is agreed
that aU work will be done to the satisfaction of the Engineering Department. It is further agreed that no work
In _,...,..in this opplIcatIon wiD be _ _!he 8J>llIcatioo is approwld ~~
IfsphJtL-r ~att7~ ~Vllj!A>>y.:t;-Jt-
, 'contractor / f/ APP~'S Sign re
Date: .,1; t'J 5
( I
1;!~~PHAL ~ & CONC!!I.E BUY KN .. X I
Cable 0 ~ Cross Street tx:4.\\( (\'tc {( ~
'Drainage Probl. 'Q;J CJ +~, ~
Electric Wires tJ ~
GasUne ~D
Grade Change 0 1m
Heaving ~ 0
CNemead Wires 0 ~
Phone Wires 0 ~
Roof CNerhang 0 ~
Saw cut at street D.CI
Sprinkler SystemO t!l
Tree Umbs 0 IW % '
TreeRools D~ Prop. Dist. ~
Tree Stu"1ll ~ LJ r;:;:: .
Water Shut-off 0 0!) G OW SW SP PT SO FT
/(fc; Oy yr Partial OIL WL Sideview
f/(' EXC~V ATE
)LJ BASE
\ V\~ EIB
~~
E.<O
STEP
REMOVAl
EXTRA
TRUCKS
~\~ INIOUT
,. '
",/
SAW
CUT
CUSTOM '.
\\Q~~ ClAvf
X BARRI R
JZf REPLACE
WITH
\ [\01 Ale
...........-....-....
, "tD-.o C>--......-..
@e...n--....
C SEAl
WHEEL
X BARROW
'I.... CUSTOM
WORK (
11
r.;]
.~
I
Ii
\ i
\ ,.J
cf
Date Applied:
----
3
dO
j)- 1
~... .~,.
\.,.-~
'\, . .
,/
, "-.l
" .\~ .
I \ .;<-
, \~
/'
..~ .,
. c: .
f'
, 1- ' -:!'
lJ 4,
. 6 "(~)'
. J' ,
. rl .
.U,.
1---.
. '.\
D1"t~~c')
<;:;;., , ,f'J"'\J\\L \)\;')
U , -7l:.. y '6\1-1
~'fu::S .
-.
Map Co-op
0)< b ItfNG--
GOPHER: y[] N-fJ
f\J\f\ rvt( fi(~2'p )t.vst,
Approval: # Pt: ~,U/I
~ER
-----.
SPECIAL INSTRUCTIONS:
r { 'Xt.t (~ .
iCcTI / "
I
,_I
II:
~
:i'
~
. .
,V
'" ..... ~
'.,:.J
'. \.J' \/)$.~
-:r :..>
.<<"\ .
. \.
.: .
CUSTOMER TO ADJUST SUR-
ROUNDING HEIGHTS TO MATCH
FINISHED EDGES AS DESIRED
Regarding this installation is everything you wanted in writing? Customer has received Instrucion booklet. Customer agrees to pay any required pennit fees.
It not, Please put it in writing, sign and attach. '.
. DO IT RIGHT...TBE FIRST TIME...BUY KNOX
.,;:;,!;'f3 0 NO
Initi<tr--