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Home My WebLink AboutDriveway permit 15-D-30 "EXHIBIT B" „�,��,.. :�� .� .��' � " �� °�,��_. �' � � _ � � w �.n.�� '� �� { .�� . ��._ � � �.. . ��.,�_��..... �� .�� '�` �" FOR CITY USE ONLY � 4 F � =�fh,��oj�:=�`` PERMIT# ��_� �..� .. .�,. ��..�_,p,.��w�� DATE ��„;�-�' DRIVEWAY PERMIT � ,� �� , � �� W, APPLICANT NAME: � � ��C,� �� '��.., ��""�� d •�,��,� � �;� .. �� , OWNER NAME: � ��'a'�',� �•� � ��-d PROPERTY ADDRESS: I�,��°� �� ,�� r�� "�''�,� �� TO CONSTRUCT: � New [� Replace � Widen ' TYPE OF PROPERTY: � Residentia) ❑ Commercia) ❑ Industrial I Proposed width of temporary or permanent driveway (Please provide sketch on reverse side or on separate sheet) Type of Material �� "_ ��°�" Is property located within the Shoreland District? ❑ Yes ❑ No (If yes, applicant must submit impervious surface calculation) The driveway is proposed off what roadway? �� „� �� I Is driveway shared by another property owner? ❑ Yes ,� No (If yes, signature of all parties is required) Estimated Start Date �� f � � � Estimated Completion Date ��.��p�� SKETCH REQUIREMENTS 1. A driveway sl<etch is required as part of this permit. The sketch can be drawn on page two of the permit or on a I separate sheet. The sketch does not need to be drawn to scale, however dimensions must be provided on the sketch. 2. Driveway skefch should include the 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 shall be left or deposited on the road during the construction of driveway. I 4. Road must be swept clean after worl<is completed. I i 1 , "EXHIBIT B" 5. Prior to placement of concrete or bituminous surfacing,the applicant shall notify the Engineering Department at 952-447-9830 that the work has been completed and is ready for final inspection. 3 6. No changes or alterations in entrances may be made at any time without written permission from the Engineering Department. 7. Permit expires 90 days after approval date. 8. Additional Conditions ��-�`U�L,,��.,� ,�,,�� t °;�' ��,� ��.� Li",,� 11161PORTAPVT- BEFORE STARTIIVG WORK EXCAVATOR ARID OPERAT�R'5 N�1'I�E This notice is to inform excavators and operators they rnust comply with Sections 216D.03 to 216D.q7 of MINIVESO'TA STA"fUTE� Call Gopher State One Call (800)252-1166 or 651-454-0002 Or go to www.gopherstateonecall.or� Smart Phone: http://mnticketentrv.korterraweb.com 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 further agreed that no worl<in connection with this application shall start until the application is approved and the permit issued. � � ,� ; Contractor Applicant's Signature FOR CITY USE ONLY AUTHORIZATION OF PERMIT Permit Fee$ ��,�� 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 worl<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. „��...��.�.- �,. ENGWEERING OFFICIAL�� _ Date ��""'`,�j �`�� Permit is valid if signed by City Official 1 PERMIT EXPIRATION DATE(90 days from approval date) f� . �� ,�� f � ��"� ��, �.,A � . . . . . . . .`-�-" , . . � . . , . . . . �(rr; . ,•1 �� • r . . . . _,w,..,� A �� • �� I Vr . . . . � � � �� q (;-•�"� +J . /�, . . . � �[!b�r�� ,- �,�� . . ��l� 2,,>�rj,3�� . , , . �� . �%°7� . ydY� 3°"�%�f.jC:.. . . . �` I��'. . . . rP�� . . . . . . . . . . . ��. ��. . . . . . � . . . . . � 4� . . . � . . . � �' r',;, _ , - � � �'-�y''�i• :;��u%'`J., � �'�.'��t:.�.- , �'�, ��xn'��.�? � tl . fi . . . � � . • � . . . . � . . • • � �; Bld ($ ) �"; �us if not accepted within days. � Y'- � � `� AWhorla�d ��..�,/''✓ ,/'�/7 i ,� � � SFoMlIN� 1 . Y . � �':, �%I/,.o,'... � e�� / ��ceptance of Proposal renders this fo��an INVOICE �ease pay from this invoice no Statement will be sent. w � ��snlo�ce e Iwn upwt IM imWwed Iand il iMy e�e nol paid IMir toniribuliona.wsn H wch paHies d Irom hi�conl�ector�w much ol ll+a eonlreei pric;e u may D�neee��ery lo msal IM darrunde �el p�be,or wiNihwld aman�t Irom hia conlnclor uMil IM oxpirstbn ol 120 dayo Iran �`�ol claKn�lo�mechanics iis�eipned by ps�wns who IumraMd eny 4bor or malorial(or IM i; . � ii �lo Uo�+F�bd ,, F Yeilow - File Pink - Customer � � � � �