HomeMy WebLinkAboutDriveway Permit # 16-D-16 "EXHIBIT B"
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Arra toi' ;, PERMIT# /l: t— 14
DRIVEWAY PERMIT DATE .7 16,
APPLICANT NAME: C •e yy s 4s,
OWNER NAME: ifee.4.--`7 J4-84
PROPERTY ADDRESS: /5-6- % ,�; ' /' 2 e ' A J L'`-) L C/
TO CONSTRUCT: ❑ New GI' Replace ❑ Widen
TYPE OF PROPERTY: P. Residential ❑ Commercial ❑ Industrial
Proposed width of temporary or permanent driveway (Please provide sketch on reverse side or on
separate sheet)
Type of Material L'.-Gf e---,'€'014.—,'
Is property located within the Shoreland District? ❑ Yeso (If yes,applicant must submit impervious surface
calculation) ))��,��,, ,A
The driveway is proposed off what roadway? , �' /�-� G�< v`_.
Is driveway shared by another property owner? ❑ Yes ,L No (If yes,signature of all parties is required)
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Estimated Start Date
`- lC� &-n-/?&K- '%73� eG AIA-e.
Estimated Completion Date .7
N) 666 7/
SKETCH REQUIREMENTS
1. A driveway sketch is required as 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 the
sketch.
2. Driveway sketch 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.
4. Road must be swept clean after work is completed.
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"EXHIBIT B"
5. Prior to placement of concrete or bituminous surfacing,the applicant shall notify the Engineering Departmentt,t
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.
7. Permit expires 90 days after approval date.
8. Additional Conditions
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.gopherstateonecall.org
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 work in connection with this application shall start until the a• ' ation is approved and the permit
issued. (07,7A124/4„
]
Contractor Applicant's Signature
FOR CITY USE ONLY
AUTHORIZATION OF PERMIT
Permit Fee $ 6/ . tOO
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 4 mitted drawings.
ENGINEERING OFFICIAL 1� i Date
Permit is var. signed • C y ' ial
PERMIT EXPIRATION DATE(90 days from approval date) 40 `Z7
riRi. City of Prior Lake RECEIPT
0 4P h` 4646 Dakota Street SE
'E Prior Lake MN 55372
4.,j 611 952-447-9840
Received Of: Receipt: 6073
Jason Franek Date: 07/06/16
Customer: Jason Franek
3673 Kanabec Ave
New Prague MN
R556071
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Driveway Permit 16-D-16/15596 Skyline Ave N
•�'� `�L�
J��� s 60.00
Receipt Total 60.00
TENDERED: Cash 60.00
Total:60.00