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Home My WebLink AboutExcavating & Filling Permit #10-G-10 �� P1tl(�� h �. � �`'` "EXHIBIT A" FOR CITY USE ONLY EXCAVATING AND GRADING PERMIT PERMIT # _— G—lo� DATE -y-�c7 /� T -�/� Appiicant: �E�' f'" �� 1 CJ Phone # � � �� ProjecUDevelopment Name if Applicable: Address: � � ��? � ' � z-�/ T �: Property Owner: v��"�r V� �'f`r 1 � Phone # T�` /'�V �U Address: ��4�m� � S �Ir�v�L � Contractor: � � 1� � � � �C�✓V Phone # Cu�vZ-:J�oa '.�777 Address: ��5�� Consultant Engineer/Surveyor: U � � � Phone # 7 �" �"'v� � �C7 �--- Address: �v 7� '��/l� �'✓� � Emergency Contact (24 hr): ��(:� � �v �-�`7 T� Phone # Y' 7/�, d�5.� Location of Property: ��J� Z � ! Legal Description: L13 � �•�Z ' <. - Will the excavation or filling be in a: Watercourse Wetland Upland �' - 111•� G9- i.c, Purpose for the proposed ex ava 'ng ar fiiling: �C:(.r�� , Estimated start date: C�' Completion date: vl � What is the type of mate al to e removed or deposited? ''� What is the quantity of material to be removed or deposited? ��. What is the total area disturbed for excavation or filling? �[� In what manner will the material be removed and/or deposited? -- G� O c� What highway, street or other public-way will material for removal or deposition be hauled or carried? ' � Wh if any, stCeet, avenue, lane, al y highway, right-o -way thoroughfare or public ground will be obstructed? T.�Q A u� �'' -Q Abc�fl — i � D l'� IT SHALL BE THE RESPONSIBiLtTY AND THE BURDEN OF THE APPLICANT TO DEMONSTRATE TO THE SATISFACTION OF THE CITY ENGINEER FOR THE CITY OF PRIOR LAKE THAT THE PROPOSED EXCAVATION AND/OR FILLING COMPLIES WITH THE OVERALL CITY OF PRIOR LAKE STORM WATER MANAGEMENT PLAN. SAID BURDEN SHALL INCLUDE THE FURNISHING OF A REPORT WITH SUPPORTING CALCULATIONS OF A REGISTERED PROFESSIONAL ENGINEER. Will proposed excavation or deposition affect the City of Prior Lake overall storm water management plan? Yes No� If yes, explain proposed effect SUBMISSION REDUIREMENTS: (A) Completed application form (B) Map or plat of the proposed filling or excavating showing location and amount of material proposed to be removed or deposited, with a description of the area (C) The depth or heights to which such removal or deposition is proposed throughout the area and the proposed angle of all slopes to be shown on a 2' contour map at a scale of 1"=50' or larger. The proposed and original contours shall be G:Wdmin\PW Design Manuxl�2007 PWDM UPDATEIEXHIBTI' A APPLICATION FOR EXCAV & CILLING.da: 1 O'� g ��' t: � t`� "�"�'`'' "EXHIBIT A" shown including all property within 200' of proposed excavation or deposition and shali be signed by an engineer or surveyor registered in the State of Minnesota (D) Erosion control plan (E) Affect on existing utilities (F} Application fee (G) Amount of Letter 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 ways along designated routes of travel and to pay such expenses as the City may incur by reason of doing anything required to be done (H) Public liability insurance CONDITIONS OF APPROVAL: (1) Applicant must call the Engineering Department for erosion control inspection at (952)447-9830 prior to earth moving activities. (2) Maximum 4:1 slopes are allowed in °maintained" areas except approved by City Engineer. Maximum 3:1 slopes are allowed adjacent natural resources. (3) Slopes greater than or equal to 3:1 shall have approved erosion control Best Management Practices installed immediately after finished grading. (4) Minimum grade for drainage swales shall be 2% or greater. (5) Removal or depositing of material greater than 400 cubic yards requires a conditional use perrnit, unless it is part of a preliminary plat application. (6) Applicant is responsible for obtaining and meeting the conditions outlined by other permitting agencies including but not limited to the following: DNR, Corps of Engineer, Prior Lake/Spring Lake Watershed District, Scott County, MN/DOT, M PCA. (7) Applicant is responsible for all damages to other properry or facilities as a result of work covered by this permit. (8) Applicant must call the Engineering Department for final grading inspection at (952)447-9830 prior to release of grading security. (9) Additional Conditions: THE UNDERSIGNED HEREIN CERTIFY THAT THEY HAVE READ SECTION 706 OF THE CITY CODE AND ACCEPT THE TERMS AND CONDITIONS TO THE I�UAI��E OF THIS PERMIT AND AGREE TO FULLY COMPLY THEREWITH TO THE SATISF CTIONf T E ITY OF P OR LA � NGINEERING DEPARTMENT OR ITS DESIGNATED AGENT. /� C Applicant: Date Propert �Ov . Date � FOR CITY US O � AUTHORIZATION OF PERMIT Financia! Guarantee Amount $ �- Financial �uarantee Type — (Letter of Credit, Bond, or Cash) Permit Fee $ /tl�•�v Liability Insurance provided? � Yes� No (Insurance Certificate must name the City of Prior Lake as an additional insured party) 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 f - � !D Permit is valid if signed by City Official Permit Expiration Date �� "�l Planning Dept. Initials n►�h�- G:Wdmin�PW Design Manua1�2007 PWDM UPDA7'E\EXHIBIT A APPLICAT[ON FOR EXCAV & FiLLING.doc 2 Main File No. 1025 Defautt Pa e#11 , Subject Photo Page Borrower/Client Pro e Address Ci Coun State MN Zi Code Client ;,�` Subject Front Sales Price ="s Gross Living Area ` i � 1 � ; ' Total Rooms Total Bedrooms � f Total Bathrooms Location View Sim. Res. ;�., �� Site Quality Average Age Subject Front Side From Street i�� -= _ _ � - - -_ , -_ Subject Street � . �' � Form PICPIX.SR —"INi�TOTAL" appraisal soitware by a la motle, inc. —1-800-ALAMODE Main File No.1025 Default Pa e#12 ' Subject Interior Photo Page Borrower/Client Pro e Address Ci Coun State MN Zi Code Client Subject Step Area Sales Price 5 Gross Living Area � Total Rooms Total Betlrooms t ' Total Bathrooms _. � Location View Sim. Res. Site . Quality Average Age Form LPICPIX.DSS_LTIR —"WinTOTAL" appraisal softuuare by a la mode, inc. —1-800-ALAMODE � BUILDING I?ERMIT SURVEY f'R�f'ARED FOR: VALL�Y SUF�VEYIN�G C�.� P.A. �EF'F' WH:�1'E 1�670 FRANKL4N TRAII. SE� � � . � SUITE 23Q� � 1539� BR�EZ'Y PO�NT ROAD ' � PRI�F2 Lr�KE, MN 55372 � P�RIOR LAKE, MN. 55372 � ' . � . (952� 447-257b . glt.5 � . e/% . ` .. M! . I Ts 6� NpU . ' o s � � 1, '` OR' � F k'q y � i0 � S9 p, � ' . � � �� °��` -.� N 60 ° 2 6 `46" E � � • � � � � 56. 43 plat � � � � . ., � �\ � : � • � � --' �J . . ...... , S . � `' \ 921.5 T22�24 92 z 07 . ` . . lV , N � ° t O � � � . o � • W �' s ' M � jn �' Z " � � • _ . �-- --�--- +' � Q � o a . � . . M �.8. o . W � fv a Q 93 x'� 93 . 4 932.0 � �+.. � 3 a w / . � • � � } Deck �. • _�� • ' • . ' • r. i+- ►- . ' � tr.j L�. � � � ` { N � ti ' ' • ,- _ �'".' H OU S E c ., , •.,.. � � 8 �� : , �� °_ , 1- ` • Fz�. 17. 6 ' } , � . w � - - $ .--r . Z ' p Q � . � � . . ,.. -- ' � � a �` ituminous Q � . � • , � 7uck under � Propo§.0d _ Arfveway g.�% � . 925.02 •� � Garage � Gar6ge`•4 N p ---�- p • ' ' Kj . 935A slab ei. ,,,. .�,. . � M � • I'O 5' .� x 935.9 928.2! ,'' 22 �'�.� o+ d' � 9 . �-r �..._ _ ,,.�..__._ S 0d� . ....�. _._ .... ... 1'� I .�� . . � a � � . ... .._�,i � � -�'� p � . � � I ^ ' „� wo u - � ��►�, M� , N � i0 �Fence � � � , ' �.,�, �i . __..._ l �,.� ...... _._. � � TC EL . 925.02 W ` � _ 929.3 925.74 w ��.� - t31.60 meas.. � 1�3t.63 ipiar 560� 05` t0" W--- --' . � . Fence corner i� � . 0,3 East � I.0 Nor1h � � ' •. . I � - . . � , . � � , ,I . . , , . . ' I I N N I • t ' ' � �� ' I ' . . . . � w � i ' i : . 4 • I � ' . . . I� �I . . , � li �, ' • 932.8 ' 935.4 � , • . , � . � Nouse . � , , � LEGAL D�SCRIPTION: ' � ao, 5 � . ' Lot 18, �Icck 4, GATEIMAY SHOR�S, S�ott Count�� Min�esaka. Also showing the locat�on af the . � . all vis.ible improvement� and encroachment� this 18th day December, 20�'3. � � NO'TES: Benchmork Elevation 926.:49 T.N:H. at the N�� property corner � . • ,935 ��notes existing grada elpvatton � • X � ( 928.0 ) Qenotes propos�d� gr�ade elavat�fon ' ,-�--� penotes propos�d dir�ction of finished surfac� drainage � 'I'he exlating garage �lab �t el�vation is J2$.21 ` T ��-�, MATGH PROPOSED GARAGE SLAQ 70 EXISTING EL . 928.21 �� V�`��C�.1 � Y,-�: � .:�a�.:: . .. . , . .�}.:. . . .. . . � � l �-- �3�o r � 7 7� ' *+'�CONTRACTflR Tf� VERIFY HOUSE DIMENSIpNS FRIOR TO �ONS'tRUC"iION*+'* � { hereby ceKtify that thts b,utiding� pecrntt aurvay wa�. pr�ared 20 0 � 10 , 20 � . by m� or Wnder my ,direct sup�nriat4n tind that 1 am a duly �� L[cens�d Land Surveyor under the Iews ofi the S�at,e of �i(nneaota. Scale in � �'eet • . . � c� ~ . • DENOTES IRON �MONUMENT FOUND inneaota Lic �e .'10183 or Mlnne�ota Lie�nse No.4�309� , Q DENOT�S IR4N MONUMENT SET �AND �MARKED �?cted this �� of �.�Y'�t'�'a! , 200� � BY,MINNESpTA L�CEN�E Na�10163 � . - . FILE NO. 1Q016 . BOOK 2�44 PA�GE 68