HomeMy WebLinkAboutDriveway Permit
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TO THE CITY OF PRIOR LAKE, MN
APPLICATiON: DRIVEWAY CONSTRUCTION
PERMIT
NlJMBER
The undersigned herewith makes application for a Concrete or Bituminous
Construction Permit
00 -O~
DATE
fill Joo
(for off ce lIse only)
1
TYPE OF PROPERTY:
l'J1~esidential L1 Commercial 0 Industrial
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ADDRESS OR LOCATION
LEGAL DESCRIPTION OF ABUTTING PROPERTY
BLOCK ADDITION
OWNER
DRIVE APPROACH
TO CONSTRUCT
AP/jc~
New rr Replace IJ Widen [J
_ ' wide (TEMPORARY, PERMANENT) Drive app,
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Type of Material
#:;~ 1CTED
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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 applicatiun 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 Ule
driveway at the above location, said driveway to be constructed to conform with the standards of the City of Prior Lake and ,,) allY 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 apP,lication is approv~d, and the permit issued.
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Contractor /-' Applicant's Signature
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Date r .' (,; 20 (~:\( ')
REQUIREMENTS
1.
2,
3.
1,
5,
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6,
No work under this application is to be started until application is approved and the permit is issued,
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,
No foreign material such a~; dirt, gravel, or bituminous material shall be left or deposited on the road during the construction of.iriveway.
Road must be swept clean aiter work is completed,
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,
No changes or alterations in entrances may be made at any time without written permission from the Engineering Departmci it or
insp'ector.
IMPORT,\ NT: Before starting work, , , ;]
The Applicant shall call the Gopher State Number (1-800-252-11 (6) 48 hours prior to starting work. .
Applicantmllst call Engineering Department (952) 447-9830) for inspection 24 hours prior to time of inspection,
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CITY OF PRIOR LAK1:
Impervious Surface Calculation"
(To be Submitted wilh BUildini Pennil Applic:lIlon)
For All Properties Located in the Shoreland Di3tnCt (SD).
. The Maximum Imper,tious Surface Coverage Permitted in 30 PI:rcc:nt.
Property Address /<1~~o MLLlJ -T/t.h<- - ~I.o/? ~ [kc.1<-.:5/ Tl/cf..JlcD:s
------
LOI Area ;2C{ O? 0 _ Sq. Feel x 30% = ..............-7!- Z ''=-L
.......*.***~...............*........*...........~............~....**....
LENGTH
WlDTH
SQ. fEET
HOUSE
)(.
;;
x
A IT ACHED GARAGE
,..
x
=>
DETACHED BLDGS
(GiUilgelShc:d)
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TOTAL PRINCIPLE STRUCTURE...................... -.:.?~ 1() ~=-
x
x
--~-_._--
TOTAL DETACHED BUILDINCS.......................
DRlVEWA YIP A VED AREAS
--------
(DrivewaY-Pllved or nOI)
(Sidewalkl?arking Areas)
x
X
X
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9(pi
P A TIOSIPORCHESIDECKS
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TOT AL PAVED AREAS.................._...._............... _ I
(Open Dc~1u 'I." min. opening between
bONds. wil1l 3 jl<<Vious surface belo...,
are nct consider~ 10 bt im~"'rv;otlS)
x
x.
:;;
x
...
TOT i\L D I CKS.............._. ....... ........................._.....
OTHER
I S-' C:)
)(
X
:::
TOTAL OTlIER....................................................... _
~P-/(P _J ~2Z. <<1 ~o
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Date .//040
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TOTAL IMPERVIOUS SURFACE
dfND~VER. P .
Prepared By ~~_
Company ~/MI
Phone # '?>.:2 .-C;~ 7 - ~60
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