HomeMy WebLinkAboutExcavating & Filling Permit
I
CITY OF PRIOR LAKE
APPLICATION FOR
EXCAVATING/FILLING PERMIT
(:)'1 -6 -07
Date .6
/ 23 I O'{
,
Applicant
447-4230
Clhtlr-/.-es Du.st-'rL{r!
3/8 ~ - :Bu t-t-e r I-'\I.-lt e j'rc l>of rJ0
S C\. \Ik ~
CfS;J. - 11'17-
Phone" S- 3,) 'J-
Address:
Property Owner:
Phone"
Address:
Contractor:
O'(\.'OV~
\ '\ I
/'
OvJ~..Q..v
Phone"
Address:
Consultant Engineer/Surveyor
Address:
Location of Property:
Legal Description:
Will the excavation or filling be in a: Watercourse
Purpose for the proposed excavating or filling:
h~jl w~'-be'f
Phone
,
v
Wetland
DV'~V.e",- t-
(
Uplanri
-.e r(:l ~ I I t::> V\
t/
~Vt-1.
v
Estimated start date: b - ~ 3- CJ-.t;o f Completion date:
What is the type of material to be removed or deposited: 12,' P Y'~ po )
/0.- 3/- ~;J-{)6 L/
dt'r t. 50 d
~
In what manner will the material be removed and/or deposited? h"", A. a.., d. 4 fA) ^..Q -e /
~llv CUt d i,..;h-e-..p I har.,/)~ ~
,. ~ -t:l-"f'r /.( u--f
What highway, street, or other public way will material for removal or depositation be hauled or carried? - C! I'rr l-e
What, if any, street, avenue, lane, alley, highway, right of way, thoroughfare or public ground will be obstructed? It 0 i1 L
IT SHALL, BE THE RESPONsmILITY AND THE BURDEN OF THE APPUCANT TO DEMONSTRATE TO THE sAnsFAcnoN OF THE CITY
ENGINEER FOR THE CITY OF PRIOR LAKE THAT THE PROPOSED EXCA V AnON AND/OR F1LUNG COMPUES WITH THE OVERALL CITY
OF PRIOR LAKE STORM WATER MANAGEMENT PLAN. SAID BURDEN SHALL INCLUDE THE FURNISHING OF A REPORT WITH SUPPORT-
ING CALCULATIONS OF A REGISTERED PROFESSIONAL ENGINEER.
Will proposed excavation or depositon affect the City of Prior Lake overall storm water management plan? Yes
No ../ If
yes, show proposed effect.
SUBMISSION REQUIREMENTS:
(A) Completed application form (B) Completed legal description (C) Map or plat of the '" ut'u.ol:d filling or excavating showing location and amount of material
~."<"Jed to be. ...., .ed of deposited. with a description of the area (D) The depth or heights to which such ...... AI or deposition is < '< h,.J throupoutlhe
area and the r'-r ,.ol:d angle of all slopes to be shown on a 2' contour map aU scale of I" =50' or larger: The <'"< .."ed and origirial contoUR shall be shown in-
cluding all". u,,-"y within ISO' of r" .r.~ excavation or deposition and shall be signed by an engineer or surveyor registered in the State ofM.MeIOCa (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, lettei of
credit. or deposit of monies in a sum sufficient to pay the cost of restoring a site. The extra ordinary costs of repairing. highways. streets or other public way.
along designated routes of travel and to pay such expenses as the City may incur by reason of doing anything required to be done (1) Public liability insurance.
Amount of bond
Letter of credit, or deP2sit of money liability insurance provided
,~ignature of applicant *th-:;r-- /~~~ { Date ,(,-;):1 -:J.~~ f
City Engineer ~/ K Date "I c "] / 6 'f
/~
Permit is valid if signed by City Engineer.
Permit fee
Permit deposit
..
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~/~(,
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.'~AL
'0 SITE INSPECTION
COMMENTS:
r;/'lvtr
IJ!- k
DATE TillE
SCHEDULED //"'1701
6,; !f-g/i1 (/ f- (,( r
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
(..)(iX'VRAD/FIL~
o c!oMr-LAII~ I
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
r<) Y
r 1(' (('
j'k/ /1-1,' J.,
I~ORK SATISFACTORY, PROCEED
'/0 clmRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpector~_ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
^ -^"' (
{~ . / I
V' (. 75 ;X / 51 X . 5 ~
~~
Ii)
S~3/1-7-
~
---- I
f
.t
. Ii if 7 ~ 1- --
! f, . Tf:
/ j3
?
J). 50 \,'
cl~' ~ 1
Co-S l /
~
.J- / ?)'c/
-t:- r:P"-.
/I \I t'.f '^
Ll..l I VGlllri#;
\ e v.e. \ k.t \)'
'<11"
::::s- h' ~ tl-lOo.f.' tD-"
x/.'''\ ~~/lh~ q ~\\'f wl.l
)(\." \,"- \ f ~ (' ~~~c...
'. " .. I" ~ ""C..
, . \.-/" iI'
. '''. \ /,,' ....f.
'- \ \ '~/~
t\ "~",,\,':)\. - '/~J> ( ../.../.~../'"
" r .... " .-' ,f .,' ,r/
I! ,,~x(/:;> r ~ / ~:7-'-r /
i ...'~, '-.. X \,// // -.
\ I ~~, \ --- ,/ .r/
\ f \ . '-', " '-.
\>. Ii ~ ',_, ~~,
~""'Co j'1 ~ I' . '-'"
~c'- >,-~ I.,' ~ '" ",'~ 1'"1""
h ~~.'"
r " ~ "
i[ ~."" ___.__...-'._.._..__...._....__'._.....
,,,\ - 'I . ....."..... ~ ~ I ..------,-.--
1'\
,
I
f
f
i
I
!
-I
(
i
f 0 IA J ~ r o...v<'l c! ero t.J.. r
49""" C\ 0 ")- \ t (1
I,
.1\ 'p-(,
wl 5
. \{..f q oLf.
p, f. J .t: 0 d. i y- -ttiIA J
'Co. \ > t' ,. v- ~ J.. b~
\ I OW $0
o o'^- !. -r
.Jl... ~
to 10 I
<=t 0 tf-'. 5
-~
'...
-,
.....""................
. . "---" ~--...--
,.' ..
.. \
\
,
\
,
"
\\.,.
",
'.
..,
t9\
r
-
~
~.
'f.= ~
--tr-~
~-&'lfv ~
h 0
'f
a <'
, '>
'-J'~
-r
~,>Sx
, tS
0/
o .>{
6'~ ~
~ .s.
" -f-' ::;,
J~ ...:>,
--- ,:1. ~
'.J' /'
/'
~ I ( ,'6('. .ft f.(
tsi-:., o..~\"" '!.~ 1\,0-,"'"\. Y -\-
II
hr
,.,
ttl
n!
It'
I
I
/. . \ .(
',~, O~f{o:r;--...~r{.y b' IS ~ } {(
.~', ~PfroX';""'''-l-:f'"\7" D-k" ~++\\ II
~ '
I
f
!
I
!