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Driveway Permit
DRIVEWAY PERMIT APPLICATION _a0 Y JUL 1 5 2008 PERMIT ft , 8 - ►dr DATE: 7 -16 D1 By • /( FOR OFFICE USE ONLY) 0 Industrial TYPE OF PROPERTY: l� Residential D Commercial APPLICANT NAME: !!! Xlji0k/ a, OWNER NAME: — /V 9e f PROPERTY ADDRESS: W5 2 644 �G O cur Aide L ? 7� _ 4 v Approved 8y. DRIVE APPROACH TO CONSTRUCT: XNew ib Replace O Widen Dom a 2'/ �)('j 4' /� 7-' We (TEMPORARY, P RN�N T Drive approach `7 . I 'UC 1� Type of Material l yON / E Fos: 0,0a --W i • /9 , > *Is dafir. i�`umy s /;a1 /:v f 49 r? � REQUIREMENTS 1. No work under this application Is to be started until applicator) is approved and the permit is issued. 2. Where work on traveled 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. Prix to placement of concrete or bituminous surfacing, the applicant shah no* the Ergkreering Department 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 oemnisston from the Engineering Department or Inspector. IMPORTANT: Before stamina work . The Applicant shall call Gopher State One Call (1800-2521166) 46 holes prior to starting work. Applicant must call the Engineering Department (9621 for inapectkm 24 lours prior to time of Inspection. When widening or constructing new driveway approaches a $10.00 fee is required at the time of application and a sketch of the properly depicting present and proposed driveways in relation to the property line. (Sketch on reverse side of application or provide a separate plan) As provide in Ordinance Numbers 1107205 & 1107.206> 1, We the undersigned, herewith make application for permission to construct the driveway at the above location, said driveway b be constructed to conform with the standards of the City of Prior Lake and to any sp,,pclal provisions included in the permit. It is agreed that al work will be dons to the satisfaction of the Engineering Department. It le further agreed that no work in connection with this application will be started until the application is pproved and the issued. P s) /r te � fi� G �G�� co�racxor Applicant's Signature Q28O J /? i✓� elf � Date: v/ score 0700 s . ASPHALT & CONCRETE BUY KNOX, INC. Office Use E ii u'' Contact Person 7.5 l° Cross tree e'" :p /1 r)(1 r1 At'4 A • , I __ Street " �^ f Site Address Drainage robe. ❑ ❑ 4 7 / / . ? C /�tn0 51- �1 9e .K"I Electric Wires ❑ VA City Home Phone _ 1 l — r '- Gas Line DI jl .-.:) ,"1e/(�� ' /.!V<' /i ` . "7. ' 4 " / 2 7 L�1)S ❑ ❑ Zip Work Phone Grade Change e-- r� 2 -.,2 2 `") ? / Heaving ❑p Di Date Sold Cell Phone [ Overhead Wires ❑ 0 0 O ' Salesperson, l � j Pnone Wires E3 Q Lead # Source Map Co-op s rs t� �'r" Roof Overhang ❑ 1 ;-6 DS 5 / - q I I Saw cut at street c] PERMIT: Y D GOPHER: YD N D Spnnkler System❑ ❑ 5 Tree Limbs ❑kI </ 1) Applied: � '$��o Approval: # El 171 Prop.Dist. Tree Roots Existing Tree Stumps ❑ 0 (A/ AP GR SW SP PT BD WI_ FT Water Shut-off ❑ C : A -5" B-3 1 /2" C-2 1 /2" D- O/L ----___ New BASE: 1 Parital Repair Sideview EXCAVATE ... , t ! ,... : SCHEDULER: PG S/P • • 121 . * A. S.A. P. or AFTER BASE r , .) e y,� "' �a ��1 /0 07 EBB /- i . i. , f E STEP ... REMOVA , , • ' r• . . . . 14 EXTRA TRUCKS SPECIAL INSTRUCTIONS: IN/OUT - • fY ,�� �/ SAW CUT • ' p : ( 17 -� ,'; — .. . . • CUSTOM ' �! G��Ci� r� /t WORK CLAY _ • A D / BARRIE' .' — jz ' REPLACE WITH . . . I-;-- -:-- -: 34 ' .--74 . • A/C .... �, • PATCH ���� L_ E © ... . i t ' • O • c. SEALER • ..' , • WHEEL ; `- BARRO ' CUSTOMER TO ADJUST SUR- CUSTOM i ROUNDING HEIGHTS TO MATCH WORK - ! ' FINISHED EDGES AS DISPEL) Regarding this installation is everything you wanted in writing? Customer has received Instruction booklet. Customer agrees to pay required permit fees ,V YES D r I, /NQ If not, Please put it in writing, sign and attach. "WE BUILD THEM STRONGER SO THEY LAST LONGER" Initial 1 '