HomeMy WebLinkAboutDriveway Permit #10-D-03 � � Plf(1�+��.,,
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"''.vM��;'� "EXHIBIT B
FOR CITY USE ONLY
DRIVEWAY PERMIT PERMIT # d -
DATE S - a — 1
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APPLICANT NAME: �� � ����tt � C'� � `Gl LI` '' � '
OWNER NAME: I �� � � j �' ' � �� �'� ��� � '-��+'�*
PROPERTY ADDRESS: �� a�: .` ( . � � � �..� � � ; ; ; �V� ' r ' _ -, `: =
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TO CONSTRUCT: ❑ New �Replace ❑ Widen
TYPE OF PROPERTY: � Residential ❑ Commercial ❑ Industrial
Proposed width of temporary or permanent driveway (`�= �` (Please provide sketch on reverse side or on separate sheet)
Type of Material �� _�� "��, � ) �'i �.� � �-
Is property within the Shoreland District ?❑ Yes ,�No (If yes, applicant must submit impervious surface calculation)
The driveway is proposed off what roadway? f`��. �_� �'� �� `
Is driveway shared by another property owner? ❑ Yes .'E�� No (If yes, signature of all parties is required)
Estimated Start Date ' I L' i L`
Estimated Completion Date � -( S G C�
SKETCH REQUIREMENTS
1. A driveway sketch is required as a part of this permit. The sketch can be drawn on page two of the permit or on a
separate sheet. The sketch does not need to be drawn to scale, however dimensions must be provided on sketch.
2. Driveway sketch should include proposed driveway, existing driveway (dashed line), driveway dimensions, property
lines, dimensions of driveway from property lines, building locations near driveway, arrow indicating north, surface
features near proposed driveway location (trees, hydrants, utilities, etc.).
3. If on a corner lot, the sketch should include dimensions to intersecting roadways.
CONDITIONS OF APPROVAL
1. No work under this application is to be started until application 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. Prior to placement of concrete or bituminous surfacing, the applicant shall notify the Engineering Department at 952-
447-9830 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.
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'`'��"�-��''` "EXHIBIT B
7. Permit expires 90 days after approval date.
8. Additional Conditions �ka✓.-L�` /l eiPlL+LCQI7�P.Y�L (//7 /V ,
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IMPORTANT: Before startinq work . . .
The Applicant shall call Gopher State One Call (1-800-252-1166) 48 hours prior to starting work. Applicant must call the
Engineering Department (952) 447-9830 for inspection 24 hours prior to time of inspection.
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 tn any special provisions inc!�ded in the permit. It is ag�eed
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 shall start untii the application is approved and the permit issued.
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Contractor � Applicant's Signature
Date: �-f — �>L l� r;� �", � ;� ,
FOR CITY USE ONLY
AUTHORIZATION OF PERMIT
Permit Fee $ 3a � � �
In consideration of agreement to comply in all respects with the regulations of the City of Prior Lake covering such operations, and
pursuant to authorization duly given by said City of Prior Lake, permission is hereby granted for the work to be done as described in the
above application and submitted drawings, said work to be done in accordance with this application and submitted drawings.
ENGINEERING OFFICIAL �, �, Date � �� ��
Permit is valid if signed by City Official
Permit Expiration Date (90 days from approval date) ^� '� -�C�
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�TIMATE By�/�'� ���J������ � �
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Date: �� S p�l. "�'�_
Customer Phone: (h) �� —� 7''� /�I�v`7 ��"��� �
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Hudson ��� �SC�
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Name: Cross Street q' 1" �' r/�/ ���'�� �I�
Address: ��S,� S� 5� Locate � a� �-�� 5��Y3�lal
City: �r��� ��'/` e �7`��7`� Base 1�,`��`� `t J-� _.r� C�i
�`� Pave ✓ 10- l�
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� Remove Asphalt Drive �
(Extra charge if over 3" or multiple layers) �� .���
�D��
O Remove Concrete Drive ►,,.` c�
(Extra charge if over 4", rebar or �mesh) ���^ ^ J�
� Remove Gravel,.Dirt or Sod� ��
,� Regrade for proper drainage
�I � Class-5 base
�l our existing base and ours � � — — — — -
� `� �`7 /ton additional if over � ton � . ' P��� � � � �
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bas� allowance ,,,�b�-�' �,�a
� ���Hot Mix Asphalt '� �` --?�'� I
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❑ Overlay existing ���� � y
❑ Apron removal �
`� Addition to driv� " � _�
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�, Edging (circle): brick ermalock �,NL/Jc�C � kr � '1 _ �t�
�1 � inside / outside �b�� �
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❑ Sealcoating , ��� � ,�C�
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� Permii � �� � ., .�ti!�,� 1 � ,
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Remarks�� ��� � � 3 / . "�
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Estimated Cost: � � � � �� � I . � �
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35 /o Down � \ � � I � � .
Balance � �
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CustomerApproval Date V�G���2 TO PUT G11� � �6/z /,`, ��.���
I have read and agree with the terms and conditions on the �-rje, -- Cc7 rU i,V�{�e w/ C�Lt.��;�F�'-�
reverse side. ���� 5 �
SIGN AND RETURN COPY �� �aR Cic��t1`
'(�I �T� M O V � .
SURVEY PREAqRED FOR:
DOU G CAR LSO N Val ley El1y!►18�e11n� CO. � Inc .
i5090 AOUILLA AVE. SUfTE 120. C, 16670 FRANKLIN TRAIL
PRIOR IAKE, MN, gg372 FRANKLIN TRAIL OFFICE CONOOMINlUM
- PRIOR LAKE, MINNESOTA 55372
TEI.EPNONE (612) 447-25T0
447 - 324!
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HOUSE rn I N���E 27•33 HOUS�
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. EL. 939�.99 �10.2 �`� I 22.87 m � I�2 EL. 942.21
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' 150 TH �TREET
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� DESCxzPrzor�l: •
Lr�t 15, Block 1., S'iUP.I1S FIR�T P,DDITIOTI., Scott Count�,�. ?ti.rvzesota also showi.� the
location of the pro*�osed house as staked this 17th da�J of 'larch, 1937. �
r1rn�s :
� B.M. EL. 934.80 Top rim af sanitary rri�nhole Ce.nterline
of 150th Street @ Lr�t 15.
� 3O , 6O 939.0 denotes existin�; grade elevatiori I hereby certity fhot this surv�y
��-`- -��----------� 940 .1 denofes �roposed finished �rade elevation was Pr'epo�ed by rne o� under my
d�rect supervision and that I am
SCALE IN �ET -� denotes proposed direc�tion of surl=ace a duly Licensed Land Surveyor
dr�inape under the laws of the StoM ot
o OMOt�s iron monument set. Minnes . - ;
• ��r1ptls kon mpwment }p�nd. set �arage slab @ elevation 940.20 /�� . .
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set top of block @ elevation 940.53 — ��-�:=..'t��Y %, �.
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__� . Oa te �' r� ,n, � Ucenp N0: 10183
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-• ; FILE NO. 5 _� 141 p,G 2 5