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Driveway Permit #11-D-01
' . o �� ;" M �. �� � !°"""'°`" � "EXHIBIT B" � FOR CITY U5E ONLY DRIVEWAY PERMlT PERnniT # /— �_ L � � � DATE �3 . Q �`c ; e� � �l� �1��� � APPUCANT NAME. 1 ` �� OWNER NAME: � \ PROPERTY ADDRESS: (�� C'L. YI � c� G� TO CONSTRUCT: Ij�New- �f-Replace ,D.Y�C+tlea-- TYPE OF PF20PERTY: �.RasidenUal O Commereial ❑ Industrial i Proposed width of t�+mporary or permanent driveway �� / (Please provide sketch on reverse side or on separate sheet) Type of Materla! 1`7'"� � �� � �' Is property within the Shoreland Distrlct ? O Yes � NO (If yes, applicant must submit impenrious surface calculation) .1p� (�� /�,' The driveway Is proposed off what rpadway? ����' ` i`-(J �'�/ Is driveway shared by anotherproperty owner2 ❑ Yes qYto (If yes, signature Af all parties is.required) '-" � Estimated 5tait Date ,� � ,! l ;� , . . , . , , . � ,., � ;./,,, , ,,',�� �i' . ' Estimated Completion �Date �Q -` ,.._.... .......... .. . . , -- � $KETCH REQUIREMENT8 � 1. A driveway sketch is requlrod as a part of this permit. The sketch can be drawn on page two of the permit or on a separate sheet. The skatch doea not nead to be drawn to scale, however dimensions must be provided on sketch. 2. ' Driveway sketch should inGude 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 loca�on (trees, hydrants, utilities, etc.). 3. If on a corner lot, the sketch should (nclude dimensions to intersecting raadways. CONDITIONS OF APPROVAL 1. No work under thi9 apptfcatfon (s to be started until application is approVed and the permit is issued. 2. Where wo�1C 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 materfaF soch 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 afte� work is completed. „_ _._ _ _�_— ---... _. ___.___. _. . . ,.. , r 5: ' `Prior ar bl#uminous surfacing, the applicant.shall, potify3;th� Engineecing Department at 952- 447-9830 that the work.has been completed and is ready for'final inspection. . 6. No changes or alterationa in entrances may be made at any time without written oermission from the Engineering DepartmeRt. a� �� " � � �"�`� "EXHIBIT B" 7. Permit expires 90 days after approval date. • i , � � w 8. Additional Conditions � `� : ,.Z.�c.L � - � �; ��-' � - � �� ` y � . v � ��L/ c'„a/ �•� d�+�� 1�ti. ;�t,J � IMP TANT: or ' tartin 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 to any special provisions included in the permit. It is agreed that all work will be done to the satisfaction of the Engineering Department. It is f her agreed that no work in connection with this app ' tion haN start until the application is appro I-ert it issued. _ ������ ��� ��� � Contractor ApplicanYs Signature Date: � �` �� FOR CITY USE ONLY AUTHORIZATION OF PERMIT Permit Fee $ �� . Q 6 In consideration of agreement to comply in all respects with the regulations of the Ciry 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) P� :� C,�x��t IP` Q .��.� ,Q.� # g_ , � Licensed,�,Bonded • Insured.� �� .. � � �� «�.:.. '��� .,rn:��,; TIM �'��� � �. =��� a � ' ES ATE;�r�,/D �� 6�as���„�'� � . . . � ,_ � � ??•l3°#� �C'+J9�Q7"7. 'W�',�. ��'ti �� ++*xt., .,+��+� »iwel}� c:Ut,+rv,.ti+J tad� k�u�:tu �i1tf �{,�lJ }�f;n1C1 , � "� i � �����j ��i � �� f� �` ..;• ��,���� t=' 4 S '�i"i 1 � � � � . _ -{,Clr£'7 .,�ttt Pr? �,l!1?�' } . ft e �ls. 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J� (M�;ilti ,��'" �VkH l,JiT�7Y �Y1+t�..t �t1!}�3V}4'1lP rr , (�'rQ� d'T` � . ,: ;,:: ,�� t, 4 ��ti1:':�iy�tr 2 ;ir'� ��1�r.: Q��f ^:1�'� -�� � C''q�� I • `�' '. 'i7L'V � ��� _ / v����� Estimated Cost: J J 7�#:�7,�3VUFF��s� <�, ��t.�"`� , �,., , t � ;! , , ..,., ` •�ic�;? fillG MC?A� 6�p�'; , 1`�lNl�� 1"�UC13C� �iYtA Y„iTJ��t4i! � /L0� �: �/ , .. 35% Down �t.�ca �s , �c(:d i "` It?N'i'IW RQ ,��iFi�i 1"�t�`xFi i' -�� � -+r , a .. ,u ��. �:: < + �.�� 1��, �.: ,.: , is )�.; '��a,s�7 �•. - ,�+ T ACf OSi' ..11i'L1U r.'•�: �,tt �yi"�i „r�, �i, � :.�:..; •a...;�! ,. Bal C@� �` � „ �ru . � ��a�► �Hr �o Ho�r�_����{:?� � . . ;:, , -�.i�c'. ') i`Jti : txc��.°�I Y8'f3 y'r"afi� �i�Vit�dv 'r1a�:s �i +i�JY X e j ; , �,,� � .. � _.. � , .:t.l�l� � i. ���1 n � �; ;a., t�',t;� � . . . ' _ Cust eiAPproVal�I�T.UUY �VA� Cyhl.Datetaa 1' i��v7 . ��::,i�, , .�:� .�it �;,, ;:.: � I have read and agree with the�terms and conditions on the ' ' r �' '� `""'';� �''' �" � „ :' � , � , `; " rl t. �1 _1�!t,!���f41 ��a";�T1� �nf.,�]!1�'Jtt1 �. .- .. �� .. . reverse side. , : . SIGN AND RETURN WHITE COPY ,�� �. �; rivr ;;rr��,�� a;it �nr; zlout bn:_;� � � i�� , ,. �>;� � �.,; :: . , u� ' . . � . ... .. ... . . . � � . 'c7Vb�`l� fS�fl �''� UAbf�,j:` �t .,. .;'Tt _ ..