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Right of Way Permit #107304
Permit Information Page 1 of 1 Send Email Confirmation roue Fight-o'-,,vay Penn Permit Application Overview Map I Billing Report I Data Export I System Setup I Logout Logged In: Susan Zick Disposition: Approving Application Permit: 107304 - Right-of-way Company Contact Name Denis Koloshuk Phone 952-380-6616 Fax E-mail denis_koloshuk©hotmail.com (also used for system login) Street Address 1 14540 Carriage Lane NE Street Address 2 City Prior Lake State MN Zip 55372 Notes to registrant: A. Formats P Send Email Do Not Send Email http://priorlake.mn.roway.net/municipal/permit_process.php 7/6/2016 612) atiNNEsisst- PERMIT PERMIT TO WORK WITHIN CITY PROPERTY RIGHT-OF-WAY/EASEMENTS AND APPLICATION FOR INSTALLATION OF UTILITIES 1. Location J�'(C O C f'(r 1 c�c L 2. Nature of Work (' \O 3. Indicate below items to be affected and include a sketch or plan of work to be done. Curb&Gutter Street Trail/Sidewalk Trees: Pond/Wetlands (Publically owned Traffic Control Devices/Signs Or Privately owned ) Drainage Utilities Structure/Buildings Other 4. Method of Installation or Construction CAA.-\-- 5. Work to start on or after: �,t r.,� Gam, /(, and shall be completed by: \)-,,r-e- ,SG, lE unless an extension granted to: by: DATE STAFF/DATE 6. Will detouring of traffic be necessary? � If necessary to detour traffic, describe suggested route: 7. Provide with this application a copy of the contractors Public Liability Insurance. DETOURS: The Director of Public Works shall be notified in writing at least 72 hours in advance of any detour being established,changed or discontinued. NAME OF APPLICANT ;n, PHONE coCic2- 5, b 6! 6 PLEASE PRINT ADDRESS � ''i 3 C�.rr4 lit. . a" w (c°„ fLX\-)' S33•?2. STREET CITY STATE ZIP NAME OF PARTY OR ORGANIZATION PERFORMING WORK 1 .S 6of CONTACT PERSON: t3e_t^` EMERGENCY(24 HR.)PHONE#: 1S2 33-C) CC/C ADDRESS: 14-/C t1.6 c-,,.r r e c. f G-€ 44' DAY PHONE STREET CITY✓ STATE ZIP The undersigned herewith accepts the terms and conditions of this permit by the City of Prior Lake as herein contained and agree to fully comply therewith to the tisfaction of the City of Prior Lake. Signed: < Title: Q[✓,t rl tr Date: OC,_5'O, / 6 a D 0 , , raj RECEIPT Date O ` 0 ' IL Received of -an. 1, ;I Shu., _., The sum of $ pec., sern Check # .-3."--31 Building Permit # Address 1--r5H &lir i & L b ,_, L.----L5-c- (-1 Receipt Clerk Signature The City of Prior Lake 4646 Dakota Street S.E. Prior Lake, Minnesota 55372 952.447.9800 o� P�o�, 1E _ KoLos}vke�r-nu-tL , c -, u 4646 Dakota Street SE Pit- i{/e9/PA Pow/4-y /2-;/s---4 Prior Lake,MN 55372 `-NNssol` June 24, 2016 Denis Koloshuk 14540 Carriage Ln. Prior Lake, MN 55372 RE: 14540 CARRIAGE LANE NE Dear Mr. Koloshuk: The driveway permit that you obtained from the city was for a driveway replacement only, not to include the curb cut. You performed work in the city Right-of-Way, which requires a$25.00 yearly registration and $250.00 Right-of-Way permit fee. The options you have are to: 1) re-pour the portion of curb and gutter at your expense or 2) pay for a Right- of-Way permit and pay a double fee for not getting the correct permits for the work you completed. Please submit the online Right-of-Way permit no later than July 11, 2016 and submit a payment of$525.00 for the Right-of-Way permit and yearly registration fees. To fill out the permit; search on the internet Priorlakeroway and that will take you to the website needed to fill out the yearly registration and Right-of- Way permit. You would then need to submit a check with your forms or bring in cash to pay for the permit and registration. If you have any further questions, call me at (952) 447-9837. pd Sincerely, (0/301 , , 0,7,--_,4, 4 "5. 5-. .00 K Nate Briese Engineering Tech III cal 1).L-- It- CITY OF PRIOR LAKE (PO Cc: Larry Poppler-City Engineer/Director of Inspections Dale Stefanisko-Code Enforcement Officer File Phone 952.447.9800 II www.cityofpriorlake.com City of Prior Lake RECEIPT =,, 4646 Dakota Street SE ft.., ‘'' '‘, Prior Lake MN 55372 i'a i 952-447-9840 Receipt: 6028 Received Of: Date: 07/01/16 Denis Koloshuk Customer: Denis Koloshuk 14540 Carriage LN NE Prior Lake MN 55372 Reqipt Item' '� , ' Rceig Description et ' ,G tilts efo �7 . Right of Way Permit 14540 Carriage LN NE Z s 500.00 Right of Way Permit Registration 14540 Carriage LN NE Right of Way Registration 25.00 Receipt Total 525.00 TENDERED: Checks 257 525.00 Total:525.00