HomeMy WebLinkAboutDriveway Permit
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CITY OF PRIOR LAKE
APPLlCA liON: DRIVEWAY CONSTRUCTION
TO THE CITY OF PRIOR LAKE, MN
PERMIT
NUMBER 65 - ;;: D 1-
The underelgned herewith makes application for a Concrete or Bituminous
Construction Permit
DATE
'1-~ ~
('or of Roe VI. only)
TYPE OF PROPERlY: ~esidentlar 0 Commercial 0 Industrjal
ADDRESSORlOCATJON SS36- ~(}('//? -/V
"
LEGAL DESCRIPTION OF ABUTTING PROPERTY
BLOCK ADOrnON
5r_ S.t.. ~-/!h~r-La~ -;y'
6>37~
OWNER
APPROVED BY:
DRIVE APPROACH sia/J7-t. 7-0
TO CONSTRUCT New 0 Replace ~ WIden ~ '::<jee Y
'J...../,?l . /= . "
~ w.5"i?-et" - ~ 7?~ ' wide (TEMPORARY, PERMANENT) Drive app.
Type of Material Wncr-~/-e
~a'"
8y
When widening or constructing new driveway approaches a $10.00 fee is required at time Df application and a sketch of property
showing present and proposed driveways In relatIon to property line.
(Sketch on reverse side Df application or prOlllde a separate plan)
A5 provided in Ordinance Nl.lII1bers 1107.205 & 1107.206.1, We the undersigned. herawllh make application for permission to consltucllhe
driveway at the above locallon. said driveway to be constructed 10 conform with the standards of the City of Prior Lake and 10 any special
provisions included In the p'"mll. II fa agreed that all work will be dOne to the .aUsfacllon of the Engineering Department. It Ie rurther
agreed that no work In connecllon with this appllCBtlon will be atarf.ed untillhe appllcatlon Is approved and the p&rmllleaued. ,
~4#~~r",,/t'&y~~~~
Dale ~/-~~ . 20 t::f S
REQUIREMENTS
1. No work under this appRcalion is to be started unlil application is approved end the permit is Issued.
2. Where work on travelled roadway Is necessary, traffic must be protected and flags, signs, safety cones and proper bamcades must be
placed in accordance with safety procedures.
3. No foreign mat~rlal SUCh as dirt, gravel, or blluminous material shell be left or deposited on the road during the construcllon of drfveway.
4. Road must be swept clean after work is completed.
5. Prior to placmentl)f concrete or bilumlnous surfacing, the applicant shall notify the Engineering Deparm"nt that the work has been
completed and Is ready for tlnal Inspection.
6. No changes or alterations In entrances may be made al any time without written permission from the Engineering Department or
Inspector.
IMl'ORT ANT: Before starting work. . .
The Applicant shall call the Gopher State Number (1-800-252-1166) 48 hours prior to starting work.
Applicant must call Engineering Department (952) 447-9830) for inspection 24 hours prior to time ofinspection.
='. y~; err Street Jr a tJ k'1 iN
Dralnege PmbI. 0121 +
Elecbic Wires 0 ~
GasUne o~
Grade Change 0 iii
Heaving 0 I(l
<Nerhead Wires 0 tl
Phone Wires Of]
Roof <Nerhang 0 LtJ
Saw cut at street 0 lO
Sprinkler syste~
Tree Umbs 0 iii t 5 /
Tree Roots 0 t:l
Tree Stumps 0 []
Water Shut-off 0 ~
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STEP
REMOVAl
EXTRA
TRUCKS
INIOUT
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SAW
CUT
CUSTOM
ClAY
BARRIER
Prop.Dist.
Office Use
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10 ;f-
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Approval: # I 0
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Existing
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SPECIAL INSTRUCTIONS:
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CUSTOMER TO ADJUST SUR-
ROUNDING HEIGHTS TO MATCH
FINISHED EDGES AS DESIRED
Regarding this installation is everything you wanted in writing? ~ We have received your installation booklet. '::1 Customer agrees to pay any required permit fees. YES
Initial -; /.;J
DO IT RIGBT...TBE FIBST TIME...BUY KNOX
0 REPLACE
WITH
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ACC.PAT
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@ SEAL
WHEEL
BARROW
CUSTOM . ~~.ro'
WORK - (,w)
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. $.5',.g r..
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