HomeMy WebLinkAboutDriveway Permit
APPLICATION: DRIVEWAY CONSTRUCTION
TO THE CITY OF PRIOR LAKE, MN
PERMIT
NUMBER
The undersigned herewith makes application for a Concrete or Bituminous
Construction Permit
DATE
0'1-& -{)6
Cj ~ / 1- Or
(for office use only)
TYPE OF PROPERTY: ~ Residential DO Commercial 01] Industrial
ADDRESS OR LOCATION /&/[I? +1at.'{C0 At/.e. SE fr;;r I.v./( f
LEGAL DESCRIPTION OF ABUTTING PROPERTY
BLOCK ADDITION OWNER
/41 /V 5537:2.
APPROVED BY:
DRIVE APPROACH
TO CONSTRUCT
ih4-B
New'( Replace'1( Widen 0
'wide (TEMPORARY, PERMANENT) Drive app.
aSpAtl/f-
FEE COLLECTED
~.../ I-()L{
!h4l>
Type of Material
Date
By
When widening or constructing new driveway approaches a $10.00 fee is required at time of application and a sketch of property
showing present and proposed driveways in relation to property line.
(Sketch on reverse side of application or provide a separate plan)
As provided in Ordinance Numbers 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
agreed that no work in connection with this application will be started until the plication is approved d the permit issued.
Contractor
c,-t
Applicant's
?)//~
, 20 tJ r
Date
REQUIREMENTS
1. No work under this application is to be started until application is approved and the permit is issued.
2. Where work on travelled 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 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 placment of concrete or bituminous surfacing, the applicant shall notify the Engineering Deparment 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 permission from the Engineering Department or
inspector.
IMPORT 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 of inspection.
CITY OF PRIOR LAKE, 16200 EAGLE CREEK A VENUE S.E, PRIOR LAKE, MN 55372 (952) 447-9830
G:IPERMITSIDrivewaysIDRIVEW A Y.DOC
Jj~l(e T_P '10'/ 6" ).3 () $/
Concrete
Patio, Steps
Sidewalks
, J
"-'. ), '2. \)q ~.-?
..,Jr , C 7
~'1")'
,'"
('!'1'
''f.''J
Nli/ iJe marked /;
,j ,'11Pt ;:;,' / '3 ~
" 1'''
4;i"
5742
,{'1
t '~');"
'\
South Suburban Asphalt
NEW WORK - OVERLAYS - SEAL COATING
20455 Huntington Way
Prior Lake, MN.55372
(952) 447-8698
PARKING LOTS
1-< 't ,? jJ I "f) ,rit) I) (;,,). /"?-~1 \ 1I'v-L y(.oo;ft-' ~~
; ...--..------- ..
~~~:P f !.~ :~.i.m'~.;:r. /itj.-K 61 .,. &.; ~ ~ '
') il
ct.-'\...Q..,.. ";-f),)' 1.)_......". 'LA ) ,) ..;' t ~ 1
' ,- .,', 1....'....-.....0,:. .~, i t2.e...."-<-::A , \/~.-<,..... ....-.......t. '-r
\.~ '-"f';L~ ,;J li.a_~,.s>-. ,\ /J ,iA;'*,,, j;/'7A'~ &./-,:2.
)'1'" It ,.) " I ( \\ \ P'1 I...e.-t' ,4~;;t . .Li J i'1 .2 r ")'.24..J
;' ;. ,-"..,,~ ~ t..f!.i" .,,-~,.., It ..' ~l-;/ <'" '/ ..
,'. . ) ~J ....' n ,. .,;A.,-/... '''r~'.~ j~i1l. /j,;,
1./1 ';,../ \ ;-,,;::.rr ,,;t....->, .4;..( 1,,"1 ~ '" ....,
V' "I" ' ..~.
'II" .;;.;;,j /' il
},(~.. YI /(.0 I ~.A.. 1),.'-f.,~..,A Je/;? Pi
:~.. '1-~ ,~Wa /,," i}-~ . ; Bid ($ <, 7 J/-j/i,!!
N~lt~-~ p1~-:nay::~:~;~;~lnt:ccePted within q i) days,
A__ OJ /J-f.- .J
......UN ( I J;') (oJ " "......~ ..,..,v-,,-_.. n..
-d
n , ./1
c.B.:l '. I V
,:,,\ -;1. JI. 0 (j '0
DRIVEW A YS
\ "
,\"
,"~ i ilt
.,.,iI; t \...
; ",
I, _
C,
..tJ..
l.l) ,
-:7 ('""' . , (
j\ -i. ,.., /U...~ ,
--:?' l
Proposal Submitted 10: ~"'..c. I ~
, '7 .....,.... -to
I t I (;', /_ j,L\S CA
,) d '~)' :{
r ..~ f/_i
r-r
, ~.
. ,
- _.-
Street:
f.\ iJ
j
(...., ::.
!(~.J
I
/'JI!,',i
City, State, Zip
Property to Blacktop
,,~.....ri /Q'
r 'r.t...v. fU...., '-r
'" ( ~ , Ulrectlons C.. .... . ;')
Scope of work to be done:
J? ~'''7S: :' 7
B{ ~3'-1 H(1_ ~
~51i~ ~~~71/1.;l1,7r;l
;11'-(
, {,
Y..1 i k: (o(-,._
i ,^ A' jl
,- ,. i,/ J. ..
';', '"1 ".-1 "'j
" i
j:' ~-t 0
/)
A ' A...<JY
~J-""
~ ~ , ,.V ~
,.V' ("I)
</," " n
.J( ;"
" it j Q
v :2,/),.&
"! ,,'
b
A CEPT ANCE OF PROPOSAL. The above prices, specifications and
condittons are sallsfactory and ar8 hereby accepted, You are authorized to do the
work a. .pecilllld Payment will be made as ot~e .~a ~. PI. _I dIM on
=1.liOll.-Unle..~ ,..,' J,/ /'-/
X:. / /) ul "'.
Oat. 0' Ace anee ! i I (,
, ,,{ tAl. ,I / ""'0-//1
Cuslome. S'9. r. ~ iJ-t2 fiI (""
PATHWAYS
Date
.... f-t i-'-'....'. U '-I
I
Phone W
Phone-i' f.z - ::."2L . t.f'-15 .?H
? ,
!~1'(~,,'i'1
- .n
lr ,\
....-
;0
..:-.~-t.; ~: +~~.;,} ~
st.
. ....-; - ."-' t. . . ..'--- .
I . ' ....,...
. · . !(-n-:-Ot\, \. .
'I.JI1~)I: : : ~ ~'-;
. I 'D'\"I ~;.' ,":, A'\~' . -r ~
,w. ~'J ~~,.\,..
. I
I i U
,:...-:..~~;? ~ 7t _ (
'f::. 4 J2. . r ''." ! .
i) /)i) ..,~'--",J'
Acceptance of Proposal renders this form an INVOICE
Please pay from this invoice no Statement will be sent
NOTICE OF IEN: Normally med ahe. JO days, with legal co.t. added.
P.rson. 01 ca"'pa",e. lur",'h'''Q I.bo, 0' ma'."." lor 'he ...ptov......., of ,.., property may enl",c;.a . lie" upon ,he improved land d they .r. not p,ald lhett contributlOnl, _ d _ p,atlial
have no con'.aclual '.'ahOnsh,p w,th the OW"., l.I."".sotllaw perm~llhe ow".r 10 Wlfhhold 'rom hil con"ICI",. SO """'" oIlhe conlr8Cl pnc;.a.. m.V be ....,......, 10 ....l.he_
01 an o'''e' h." CII,"'a",.. pav d"BCtly luch he"s and dedo.oc:1lhe COIllhe<eolondlhe eonlrac' pric.. or __ '_I'rom hie conl'tICtGf....~!he ..pirltion 01 120....,..._
,n. COmpl.llon 0' !ucn Impro....menls unless Ihe contfeetOf' rum..",.. to the owner ..rven of cta",,_ 101 ~ic. lien aigned by petsona wt\o fulN8t'ted any ..bot 01 material lor the
Improvem.", ,nd who provldeClI the awne' wi'" lamefy nOlee
COmplelton Oafe .
Nolte. 0..1., Int,,", 10 File lie" .
O..e L_ F_
Q,sl~ ~"
Ci) V ~J ~ r w~ft~SUb,~ah(A~W' ~eit-- Cuslomer