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Grading Permit
"EXHIBIT A" � ��sar��,� � . .�`,`'`���"°���� �"� �%/� G�l�,� �� �,� ._. �� ������� � R CITY USE ONLY �°���;��,o��" PERMET# �`�' (� 4- ~�. s DATE � . EXCAVATING &GRADING PERMIT �„ ����w ��;�,� � � ��..��, � ��°��,� Applicant: �1ti� F`vC���z�.�C•u�i�5�2��° �e��'�rr�cs ���t�� Phone: _�I� �����I�'"C�G� Project/Development Name if Applicable: �:1��1fa�.l.►� S Q��,-2 ��,�,► �,��. Address: �'`�.�'� G.�R��'� G�{����5 ��(Z��t�. � ,� �i� Cc��'r� re ���%rr�1 .S� PropertyOwner: �A'��K,SGOZ��v"7` ��%S�/��"�1 ('�P 1..�---Phone: l��v� - � �a`,�`���u"' Address: W��C"�,i2 S'�"(�{"�T �' ��4rv°•uca- Y'�a..i �S 3�' 1 ' Contractor: �Vf��Z' ��c c.�Y ,o,r � Phone: "2l���� 5�5���.�� I Address: � '��� {�c�c�,*�Sy t�t:✓�-niiA l�v� �U� �ri pt.,���..! S�'��,� Consultant Engineer/Surveyor: '�f�r(�C-�-G�✓)G:, r ���� �"�1� Phone: ���� ���• �,c.���', Address: � zi (,��y�t7-� �07 [���\rf� �`�al�'- :�� �'»�°r� rY�a� "�',���1 � Emergency Contact(24 HRj: �1�G� ��N '�-- Phone: f�I�.-��cy- 1�� Location ofthe Property: �q � � ��i� r�2��g��f7.� `�" �,. ,�tr�! � I Legal pescription: ��`� � ��t,�'eV ���� �,��-� q.����.-,� I i i Wfll the excavation or filling be in a:N� Watercourse Wetland Upland � Purpose for the propased excavating or filling: ���N�► c=a,�- �'�er,�cN�, La£. Estimated start date: .�'�ra�e'., 2�, Z��5 � Completion date: �°"ut�.� �, 2c,�5 � What is the type of material to be removed or deposited? __�,-�ti,s-r,N�� ��►� � What is the quantity of material to�e removed or deposited? �'�d �-t • What is the total area disturbed for excavation or filling? �`"� ��r In what manner will the material be removed and/or deposited? l,o��-o r�-rJ� ��c.��, �,�� What highway,street or other public-way will material for removal or deposition be hauled or carried? �,�4,�'ccc�«. What, if any,street,avenue, lane,alley,highway, right-of-way,thoroughfare or public ground will be obstructed? -- Nc�a��. .w. � i�SHALL BE THE RESPONSIBILITY AND THE BURDEN OF THE APPUCANT TO DEMONST�RATE TO THE SATISFACTION OF TNE � 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 P�AN. SAID BURDEN SHALL INCLUDE TME FURNISHING OF � A REPORT WITH SUP'PORTING CALCULATIONS OF A REGISTERED PROFESSIONAL ENGINEER. T � Wil) proposed excavatian or deposition affect the City of Prior Lake overall storm water management plan?Yes_ No,� � If yes,explain proposed effect i 1 i p � "EXHIBIT A" 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 fihe proposed angle of all slopes to be shown on a 2' contour map at a scale of 1"=50' ar larger. The proposed and original contours shail be shown including all property within 200' of proposed excavation or deposition and shall be signed by an engineer or surveyor registered in the Sfiate af Minnesota D. Erosion control plan E. Effect on existing utilities F. Application fee G. Arnount of Letter of Credit,csr deposit of monies in a sum sufficient to pay the cost of restaring 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 CONDITION5 OF APPROVAL: A. Applicant must call the Engineering Departrnent for erosion contro) inspection at (952) 447-9830 prior to earth moving activities. B. Maximum 4:1 siopes are allowed in "maintained" areas except approved by City Engineer. Maximum 3;1 slopes are allowed adjacent natural resources. C, Slopes greater than or equal to 3:1 shall have approved erosion control eest Management Practices installed ' immediately after finished grading. I D. Minimum grade for drainage swales shall be 2%or greater. ' E. Removal or depositing of material greater than 400 cubic yards requires a conditional use permit, unless it is part I of a preliminary plat application. F. Applicant is responsible for obtaining and meeting the cpnditians 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, MPCA. G. Applicant is responsible for all damages to other property or facilities as a result of work covered by this permit. H. Applicant must call the Engineering Department for final grading inspection at(952)447-9830 prior to release of grading security. I. Additionai Conditions: � THE UNDERSIGNED HEREIN CERTIFYTHATTHEY HAVE READ SECTION 706 OF THE CITY CODE AND ACCEPTTHE TERMS AND CONDITIONS TO THE ISSUANCE OF THIS PERMIT AND AGREE TO FULLY COMPLY THEREWITH TO THE SATISFACTION OF THE CITY OF PRIOR LA E ENGINEERING DEPARTMENT OR ITS DESI6NATED AGENT. �� Applicant: W�s� �Si�/�tJ , Date � Property Owner: r pate � , f "EXHIBIT A" INIPOR`fAIVT- �EFORE ST�4R`fIN 1�! Ri6 EXC�4V�4TOR AiV PERAT' R°S N l`ICE This notice is to inform excavators and operators they must comply with Sections 216d.03 to 216D.07 of MIRJIVESOTA STATUTES Call Gopher State One Cal) (S00)252-1166 or 651-454-0002 Or go to www.�opherstateonecall.org Smar� Phone: http://mnticketentrv.korterraweb.com FOR CITY USE ONLY AUTHORIZATION OF PERMIT Financial Guarantee Amount$ 2 t��� Financial Guarantee Type �� S �- (Letter of Credit, Bond or Cash) Permit Fee$ Z �-� Liability Insurance provided? ❑ Yes J�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 worl<to be done in accordance with this application and submitted drawings. ENGINEERING OFFICIAL � �\ Date � / �- �1' I I S Permit is valid if signed by City Official PERMIT EXPIRATION DATE(90 days from approva) date) 01� S _Planning Dept. Initials����� LEGAL DESCRIPTION OF PROPERTY LOT 7. GREEN HEIGHTS 1 ST ADDITION AND i.�li.�.p`. l�7��i `;�°1�'�,�,�t�r,r`6': iwPJf'.f� I.�E''�r�1!�7F'�'?�F: .ri�� r'r�1� �u�r,i. ._�4�r�r�f'� � " � � 'J'1f'��° ''1�t_;f�,`r i ���"� - ;..+'+L�7'v�'fir'�Awa .��C`.€'Jf� l',�:?::.'`.+PFi� xr0'+�/)11f3�itld ti:s�U.�ts'7�'f:� �Gt d�!E' tC"L�:?t:l��r r'�1 �R�'i"C'7� r,?f. 'Sr �.,�, c�'t'�'� �.. �r r,.. R�. ,.. �. 4 r i � ��,:i ��i�r;r3:d lysr,� ::����t�r,t�, .;,r f1+r� f,,�,i%�Nr,^:� r;+�•� res:� ,rr�; . . . .- i'ir.¢���7��1t�c,r r1.� r,, pu,����r rxq P�t,.�: .;en.rdf��rt�+lirr,� r�t <<lrti7 �'.r',�� .?'�'�, s9(7 tw.�,� ;"J.5'C`a�.r;y' tfr�ii t/;°c' r"7L���1 �C2�.�ff;r��l�+ c�, :1��` ?r��a��,��# !���:?c_-e+ r;� � r�c.r+d�;�r.�� r.V �(�pe..{�r�rr t:,r.�a�i�d� r: w��s<'r�: tc1 !itr• :s.#:�ar�» r�P t'r;nr l,�kr;� r;,fi� tl��,�n rt�.rl�';KiEs?ii�s, 5f11�n'�,�,'�t ^'e?s;_Y,'hru v.;S tr7���iWti: . _ . ��.rr��o�w,+,.,.,!y� <:�t .��� r*tu,? ��J?t7r,�t ci-rr��.r :�! ..u��' t'•�f .�t�; Ltr.:r�"� ?t''c�.r�h x�+ ��y,r��w �f3 m�hut�•� ,�� � .,�-��;d: . , ; J.r r�._E t' �' � .�, � c>f �"Jt`. . ,�''P' f*7r,"�; ,"«;��� �'� Ca'^��t�:� ?7)t,'��:,.33�..�� �r;<�f e'1.1c?�n ¢'P�'�':! �ir�':.�'f;�r'y^,'rn� !P �s; �_�; �.�;i' ;.a" �f ': F fJi i-,r1h ,¢r (?� �t J 7 sc �,�r�;l5� :1:.: si'..� tee�� !c, scFr`C�cjr�iP. � . , , . � t,..,�7 .^,!?��,�5rc; ." r" �rn.��tlr7,� r.( i7r tn>�r+�,'r; r�'�:f'.�i�Crrr�,��!'.�. u.7tJ �'r?��!'o,.7t��"r�7ac�nr�s �,1✓� ;r�� �xr „{f ,,t:277 a�?,';'�' ��.;��tr�;..1y ;t. 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