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Home My WebLink AboutExcavating & Filling Permit #12-G-02 r � 4 � PRI�� F t� � . "�+�'} "EXHIBIT A" FOR CITY USE ONLY EXCAVATING AND GRADING PERMIT PERMIT # (2 —-02 DATE t� -� 3 y f; I Applicant: ��ffl� r / �'"�!S Phone # �Z"�f'�f� ' S�f /� ProjecUDevelopment Name if Applicable: Address: �33� F/e05% �a/N?; PIQ/D�Q L.AI�CE� M/lf s�� C property Owner: J � l�{N rl Tz-! �'j Phone # Address: Contractor: �� N �� -s Phone # Address: Consultant Engineer/Surveyor: �bu SwAN Phone # g�"'�, S�� Address: /�•S�qb f�A�kt-�1►� ?'R�/t.. ST�' 2�t�s� �i¢�e�2 Gi�il'E !l��t1 5'SS?� Emergency Contact (24 hr): �LA/N� ��` Phone # ��/ "��'1 Location of Property: ✓ �� 7 �! ��lN� �� /�� 1�� /n dV ss � 7 � Legal Description: Will the excavation or filling be in a: Watercourse Wetland Upland Purpos�for t,he proposed excavating or filling: Q�SfdRE '.�' w�T� w.�5 ff �!T Estimated start date: �''� "" �� Completion date: k "�'"'' ��"" �� ' What is the type of material to be re or deposited? ACs6�IQE'G'i�T� ��TAiN�NC wi4c1 �St.o�KS What is the quantity of material to e rem or deposited? � What is the total area disturbed for excavatio or filling? In what manner will the material be removed and/or deposited? AGK � a� ` �� T� ST�+MP aLLG What highway, street or other public-way will material for removal or deposition be hauled or carried? N�F� � Wh , if any, street, avenue, lane, all,e,Y , highway, right-of-way, t orou�9 hfare or public ground will be obstructed? No+�E iL],� /N' lNCs A C*G/'C CG.�!'y"'E �/�-�- �E I'�-�! L.�}�-.6A �AT L-Acc) �v �riG� .-- IT SHALL BE THE RESPONSIBILITY 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 REQUIREMENTS: (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 C:\AdminU'W Design Manua1121107 PWDM UPDATE\BJCHII3IT A APPLICATION FOR EXCAV dt PILUNG.doc 1 . * �� PBr�y� .k. t� �br ��! "EXHIBIT A" shown including all property within 200' of proposed excavation or deposition and shall be signed by an engineer or surveyor registered in the State of Minnesota (D) Erosion control plan (E) Affect on existing utilities � : Ap}�li�tion.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'�ity may incur by reason of doing anything required to be done j �. (H) Public liability insurance ' ' CONDITIONS OF APPROVAL: � �. . (1) Applicant must call the Engineering'C3epartment for�erosion�control inspectiQn:�f.($92��4Z-983Q,prior fo;eaxt� moving activities. (2) Maximum 4:1 slopes are allowed in "maintained" areas except approved b�r,City Maximwm 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 cOndifional �use permit; 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 �011..owing: DNR, Corps of Engineer, Prior Lake/Spring Lake Watershed District, Scott County, MN/DOT, � MPCA: � • . . . ." ti �`'.;q', <: s :... (7) Applicant is responsible fior,all �amages to o�her �operty or f�,c►lities,a� a reSult of w.ork covered by this permit. (8) Applicant must call the Engineering Department for final grading insp�ction at`(J52)44�-9830 prior #o'release Qf grading security. � PI e�.S� � c�� C' �'�r�'ti • F' PO rC r- C. �IN �- ��3 Z (9j AdditioY�al Conditions: � � r ,••�a._ c, ci� THE UNDERSIGNED HEREIN CERTIFY THAT THEY HAVE READ SECTION 706 OF THE CITY CODE AND ACCEPT THE TERMS AND CONDITIONS TO THE ISSUANCE OF THIS PERMIT AND AGREE TO FULLY COMPLY THEREWITH TO THE SATISFACTION OF TH CITY F PRI R LAKE ENGINEERING DEPARTMENT OR ITS DESIGNATED AGENT. Applicant: ` . , . - , . • , . Date � 23 �P Property Owner: ' � ` Date ,:'.: . ` FOR CITY USE ONLY F� -- '' � � � - � � ` " � AUTHOR��ATION OF PERMIT '' • ,•` :';, /ooCrQ,� �o�rL.T Financial Guarantee Amount $ Financial Guarantee Type�"�^� �`"'� (Letter of Credit ond, r. Cash) Pe�mit Fee $ /��CS �'e'G. . . . : �.. � , . Liability Insurance provided? � Yes� No (Insurance Certificate must name the Ciry of Prior Lake as an'additiorral�insured p�rty) 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 � 2 ''� � Z Permit is valid if signed by City Official _ Permit Expiration Date l� 1'Z Planning Dept. 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