HomeMy WebLinkAboutExcavating & Filling Permit
CITY OF PRIOR LAKE
Permit No.
APPLICATION FOR
EXCAVATING/FILLING PERMIT
lJ,OS -J -D )
Date
.1.../
L/
/()S'
447-4230
Applicant CH I QlllTA .,. fY1 ~ Ie:.:.
Address: liP j iP 4 I af}eS/ de AIle
Property ~r: ~h 'E:t: .. mafk.
Address: '(PJ _ cJ __is/de. Av-R
Contractor: ~a -k K V ~5a.r- _ . .
Address: " 'J 1/ (7') - 6+ 6a~t- Pn (5Y La k.e
Consultant Engineer/Surveyor ~ ~ ve:J' n5 CD .
Address: liP&70 fYa.-nlLllrJ Tya.t I ~ +t- ~;~ PrlfJY lAh:e
Location of Property: / (p I lot./- La ~/& Atte Pi" I Ov La ~.
Legal Description: Lot 3lP l1.tld 6011 ~ /..ok I t1.J1td J <;;er:fu>'l IdT/AJ';hlJ II t./ f!.a..n,& ~ a
Will the excavation or filling be in a: Watercourse Wetland ' Upland ~ SW++ Vt1"ht
Purpose for the proposed excavating or filling: 10 replac.e-h~~;- reta"fljfj LU1 Lt. (~i"!5 t-'1l--kn
~ (aYpeniev t1Y1'fz:,) i-V,th muldiw yern /() '~ ~..a..i.<)
&J~T
P"o-r /Aile
~+
C5Y La. ~
Phone,q5) -'-140-54;)..;;)...
Phone 1199 -(/40 ,- '9'; ~~
Phone II tJ 47- '6 ~"2f5
Phone
11%;) . '-li.f7- -;;'15'70
"~. +,t 8:p.' I 2t12; .-
Estimated start date: ;t-cu n 1, Completion date: fY>aj .JO. ~W:::, .
What is the type of material to be removed or deposited: .-B.e.m 0>1 e .-f1 m-helT'S l2f)cJ (' c:u I Y'oad -h .pc;.,
rfpl/Ja Wrf~ bou..fdus
In what manner will the material be removed and/or deposited? ..b1J pm {tPSSJDl1l.1.. C .J%/'11 va.-kr-
What highway, street. or other public way will material for removal or depositation be hauled or carried?
What. if any, street, avenue, lane, alley. highway, right of way, thoroughfare or public ground will be obstructed? () one
IT SHALL. BE THE RESPONSIBILITY AND THE BURDEN OF THE APPUCANT TO DEMONSTRATE TO THE SATISFAC110N OF THE CITY
ENGINEER FOR THE CITY OF PRIOR LAKE THAT THE PROPOSED EXCA V A TION AND/OR ~LUNG COMPUES WITH THE OVERALL CITY
OF PRIOR LAKE STORM WATER MANAGEMENT PLAN. SAID BURDEN SHALL INCLUDE TJi~ FURNISHING OF A REPORT WITH SUPPORT-
1NG CALCULATIONS OF A REGISTERED PROFESSIONAL ENGINEER. - M-hr chRCI
Will proposed excavation or depositon affect the City of Prior Lake overall storm water management plan? Yes - No Llf
yes. show proposed effect.
SUBMISSION REQUIREMENTS:
(A) Completed application form (B) Completed legal description (C) Map or plat of the proposed filling o~ excavating showing location and amount of material
proposed to be removed of deposited. with a description of the area (D) The depth or heights to which sUFh removal or deposition is proposed throughoutlhe
area and the proposed angle of all slopes to be shown on a 2' contour map at a scale of I" = 50' or larger: 'the proposed and origirial conlOUJ'S shall be shown in-
cluding all propeny within ISO' of proposed excavation or deposition and shall be signed by an engineel! or surveyor registered in the State of M;iUIeIOla .(E)
Erosion control plan (F) Affect on existing utilities (G) Protection of site by erection of suitable fence. guard or barricade (H) Application fee (I) Bond. letter of
credit. or deposit of monies in a sum sufficient to pay the cost of restoring a site. The extra ordinary cos~ of repairing, highways. streets or other public ways
along designated routes of travel and to pay such expenses as the City may i neur by reason of doing anytl\ing required to be done (J) Public liability insurance.
Permit deposit
Signature of applicant
City Engineer
Permit is valid if signed by City Engineer.
liability. insurance provided
Date~
Date ~l/;6t;
Amount of bond
Permit fee ~ 3.5"0
Letter of credit,
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of Real Estate Value ( ) fLIed ( ) not required
Certificate of Real Estate Value No.
,19_
County Auditor
by
Deputy
STATE DEED TAX DUE HEREON: $ 726.00
Dale:
December 13
,191..L
(reserved for recording data)
FOR VALUABLE CONSIDERATION, Verlyn J. Raaen and Kay M. Raaen, husband and wife
(marital status)
hereby convey (s) and warrant (s) to Mark F. Ewert and Chiquita M. Ewert, husband and wife
, Grantees as joint
tenants real property in Scott County, Minnesota, described as follows:
Lot 36, Lakeside Park, and all that part of said plat of Lakeside Park and
Government Lots 1 and 2, Section 2, Township 114, Range 22, Scott County,
Minnesota lying northerly of said lot and running to the water's edge of Prior
Lake and between the northerly extension of the westerly and easterly lines of
said Lot 36 to said water's edge, Scott County, Minnesota.
, Grantor(s),
The Seller certifies that the seller does not know of any wells on the
described real property.
(if more space is needed, continue on bac:lc)
together with all hereditaments and appurtenances belonging thereto, subject to the following exceptions:
Affix Deed Tax Stamp Here
STATE OF MINNESOTA
COUNTY OF
Dakota
} ss.
The foregoing instrument was acknowledged before me this
by VerI n J. Raaen
r:r~.1
~ ,. . JULIE A. KRANIG
i '::0.,:7:;, NOTARY PUBLIC - MINNESOTA
!:6tf DAKOTA COUNTY
. ...... My Comm. Expires Jan. 31.2000
.
Ia
day of
Raaen
December , 19 96
husband and wife
, Grantor(s).
NOTARIAL STAMP OR SEAL (OR OTHER TITLE OR RANK)
Mark F. Ewert
I'f Q
8'
$ 5
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