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Home My WebLink AboutGrading Permit 15-G-23 "EXHIBIT A" � �j� s�,�- � : , ��"� /�..�� 'L�K�-�� .b. L�, M. � � Y,,.,,_p. . � � �" "Y� ��v..u"&;�� ` E� '�� "P�� FOR CITY�E ONLY �, ,+ `��,f,�;��,� PERM'IT# -�� DATE (o -/g-/.s EXCAVATING & GRADING PERMIT Applicant: �l.�,�(�r��+�� Phone: __��'""��,��. Project/Development Name ifApplicable: , Address: I�, Property Owner: �'�� , �G"v" Phone: �J,�`"�`�(,�"'�"'�r�"� Address: `fi f` � f►��"}(' Contractor: �1"�Y'"�"7��✓'� �_�'��"�'�%� � ,��-,�,��'�o�. Phone: ��r�"��-�S"��✓ Address: �j�� L.� f"T�� l��`(.�' ,��1�`� Consultant Engineer/Surveyor: f�`r� [�i��c+t,��,�`�"'vc��y Phone: �Jr�"7,�c�'� � Address: �L�C?l� �C7�'�'�' �`i��Y'� �� t",�-r�. 1�1��-'�tdk C�� . �'J,�� Emergency Contact(24 HR): Phone: Location of the Property: �, �...rd�',�� Legal Description: Will the excavation orfilling be in a: Watercourse Wetland Upland Purpose for the proposed e�avating or fiiling: `� �sr w�a.s c ' Estimated start date: �/f�/%,� ompletion date: t`,,�'"" What is the type of material to be removed or deposited? ��r�' What is the quantity of material to be removed or deposited? �� w,/��; `"" '�� r/�' S What is the total area disturbed for excavation or filling? i� • �f In what manner will the material be removed and/or deposited? -X��--E?,��" ;S�.� �`c� �a'` What highway,street or other public-way will material for removal or deposition be hauled or carried? 1-�t�,� �',.� What, if any,street, avenue, lane, alley, highway, right-of-way,thoroughfare or public ground will be obstr cu ed? . � IT SHALL BE TNE RESPONSLBILITY AND TNE 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 FILLIN6 COMPLIES WITH THE OVERALL CITY OF PRIOR LAKE STORM WATER MANAGEMENT PLAN. SAID BURDEN SHALL INCLUDE THE FURNISHING OF 1 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� I If yes,explain proposed effect I � � i � < � 1 "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 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 shali be 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 contro)plan E. Effect 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: A. Applicant must cal) the Engineering Department for erosion control inspection at (952) 447-9830 prior to earth moving activities. B. Maximum 4:1 slopes 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 Best Management Practices installed ' immediately after finished grading. 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 of a preliminary plat application. F. Applicant is responsible for obtaining and meeting the conditions outlined by other permitting agencies induding ' 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. Additional 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 LAKE ENGINEERIN6 DEPARTMENT OR ITS DESIGNATED AGENT. .µ'" � � �5 Applicant: Date -=� l�. Property Owner: �--#' Date ��/�//5� �me "EXHIBIT A" . IMPORTANT- BEFORE STARTING WORK EXCAVATOR AND OPERATOR'S NOTICE This notice is to inform excavators and operators they must comply with Sections 216D.03 to 216D.07 of MINNESOTA STATUTES Call Gopher State One Call (800) 252-1166 or 651-454-0002 Or go to www.�opherstateonecall.org Smart Phone: http://mnticketentrv.korterraweb.com FOR CITY USE ONLY AUTHORIZATION OF PERMIT , Financial Guarantee Amount$ Financial Guarantee Type (Letter of Credit, Bond or Cash) Permit Fee$ �C��•D 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. ENGINEERINGOFFICIAL Date ��^�� Permit is valid if signed by City Official PERMIT EXPIRATION DATE(90 days from approval date) r �CO '�S Planning Dept. Initials ¢ a;�.� ��r,��;-..X �ity of Prior �ake RECEIPT � 4646 Dakota Street SE ��;� � � �' � Prior Lake MN 55372 ;�: '�� '�"' 952-447-9840 � ,; , ,��f��i.�cti"�' ,- Received Of: Receipt: 2823 Horizon Landscape& Design, Inc. �ate: 09/11/15 Customer: Horizon Landscape& Design, Inc. 14350 Ebony Lane Saint Pau) MN 55124 �eceipt Item ' Receipt Description Gl Number Total Grading Permit 15-G-23/4633 Lords St NE Zoning&Subdivision Fees 200.00 Receipt Total 200.00 TENDERED: Checks 3159 200.0� Total:200.00