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Home My WebLink AboutDriveway Permit #13-D-22 (2) � � r�s � � �. '"''�"'"`` "EXHIBIT B" FOR CITY USE ONLY DRIVEWAY PERMIT PERMiT # 3 - -„�„�,� DATE /U :3 � APPLICANT NAME: � � � �� i ` V �` � C- �`� � \ � OWNER NAME � �. r �� 9 PROPERTY i4DDRESS: / �� S � (�` � � W�� - � t (� S C1'� TO CONSTRUCT: ❑ New '�Replace ❑ Widen TYPE OF PROPERTY: �sidential ❑ Commercial ❑ Industriai Proposed width of tem orary or perm n nt driveway (Please provide sketch on reverse side or on separate sheet) Type of Material " `� �� Is property within the Shoreland District ?❑ Yes �Alo (If yes, applicant must submit impervious surface calculation) The driveway is proposed off what roadway? ,'�- � J� Q� �� Is driveway shared by another property owner? ❑ Yes �Jo (If yes, signature of all parties is required) Estimated Start Date / � r � Estimated Completion Date r 1 ' �� 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 shail 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 surtacing, 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. �.� �ar�� w � '��`¢ "EXHIBIT B" 7. Permit expires 90 days after approval date. 8. Additional Conditions �✓ Z ��,/ �(1�/ ^ �f �• �-- ,�l'�-..tL IMPORTANT: Befor startin 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 De e. t�i her agreed that no work in connection with this plication shall start untii the application ' approv e ermit issued. t�, <�C�� 1��/� 7'd`� - Contractor ^ �� I� Sig�e C� / Date: l � FOR CITY USE ONLY AUTHORIZATION OF PERMIT Permit Fee $ �Q . a U 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 drawin , 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 (9 days from approval date) �� _ . r��v ■ rr�� v�a�vv ■ a� • v■ v■ v��v�vv �°F �. ._ EDRED •.� . BBB_ pUSINE55 �^ �� 0.CCNfOREO BUSMESS • ESTIMATE B �� / �(9�/- � �� Jq � � � Date: f � � `� 6 � I � �� • Name: -� 1�' c9 P �� L 7745 2nd Avenue S. Address: Richfield, MN 55423 / B Ph: 612-866-8836 • Fax: 612-866-8078 City: �/�� C��_ -I I��/� ��'3 7� P www.richfieldblacktop.com � No Yes ❑ Ok to use Bobcat �� (�� ._ � � '"'' �� C� Replace as is � ❑ in yard. Customer Flares ❑ �' repsonsible for any W � Stumps/Roots lr� ❑ yard/landscaping repair. Permit �/ No 1Nater shut off � ❑ �emove Asphalt Drive (Extra charge if over 4") New Cover � � Sign 0 Remove Concrete (Extra charge if over 4") Draina e Problem ❑ ❑ Apron removal 2 car 3 car ❑ Design o separate copy ❑ Cap Blocks (Does not incl. foundation work) _. ❑ R�nove Gravel, Dirt or Sod �' `� Base, after compaction ❑ Your existing base and ours � jn�' �Re rade for proper drainage � �C �"'! [ZY � Hot Mix Asphalt compacted to_ �. � �� ❑ Addition to drive aq, ❑ Concrete, see concrete form � � �Approximate Square feet 3 7 �D � S Yr. Warranty ��, � C��' Yr. As halt Protection Plan see details on back S� � � p � ) � nI � 0 tions: ��, `` � p� ❑ Fabric Installation SF $ � r 1 ❑ Permlock LF b $ fi )� �� ' � � - Customer Initial �.. ��_ � G � �� . � Estimated Cost: � Down � � � � . Balance � � � X � '�� CustomerApprov I Date � I have read and agree with the terms and conditions on the reverse side. �� SIGN AND RETURN WHITE COPY . Property Line? � ��, i 1 2( 13 J 4 5 v Circle One Licensed • Bonded • Insured