HomeMy WebLinkAboutDriveway Permit 16-D-17 *Single Family, Multi Family, Commercial , Industrial , Agricultural
FOR CI SE ONLY
DRIVEWAY PERMIT PERMIT ��Q "D�
i ruin, "Exhibit B" � 1
17
DATE '�. O .
�, Email completed form to NBriese@CityofPriorLake.corn CHECKAE # 7��
4 P.u m` Mail$30.00 check payable to Cityof Prior Lake to Nate Briese
— 4646 Dakota St,Prior Lake MN 55372 RECEIPT#
APPLICANT NAME: r,,1,p--t A rvw c re }-o 01- II4.sQ'"/'7 - n�C .
1.,3 1(hAvAlliec-A,ve
OWNER NAME: / �fC.GU/� ^ f /}P
�ref �� a1 ��
PROPERTY ADDRESS: l4 S r f5- l y OA, s A-,-F ,�i i 9,- /c l<
PHONE NUMBER: G/1, ssY�— X37 5/ I I EMAIL ADDRESS:
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PROPERTY CLASSIFICATION Single Fa y HOm DRIVEWAY MATERIAL: ' • - . . �
Proposed width of temporary or permanent driveway NO
(Please provide sketch on reverse side or on separate sheet)
oti.'
Is property located within the Shoreland District? Yes Al()
If yes,applicant must submit impervious surface calculation
The driveway is proposed off what roadway?
Is driveway shared by another property owner? (If yes,signature of all parties is required)
Yes //d
Estimated Start Date: Estimated Completion Date:
1.7., ---2j:7t--‘'21—1
SKETCH RECUIREMENTS
1. A driveway sketch isrequired as part of
does not need's permit. The sketch can be drawn on to be drawn to scale, however dimensions or
on a
s must be provided d onthe
separate sheet. Thee s
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. Nwork under this application
ro idwa is be started until necessary,traffic pmust be protected and flags,signs,safety cones and
cation is approved and the permit is issued.
2. Where work on traveled Y
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. shall notify the Engineering Department at
5. Prior to placement of concrete or bituminous surfacing,the applicant
952-447-9830 that the work has been completed and is ready for final inspection.
6. Permit expires 90 days after approval date.
7. Additional Conditions
nitro DRIVEWAY PERMIT
1,u "Exhibit B"
444- 9?
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)2524166 or 651-454-0002
Or go to www.gopherstateonecall.org
Smart Phone: http://mnticketentry.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 application is approved and the permit
issued.
/s/ /s/
Contractor's Signature Applicant's Signature
//iM ;(: ,
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 work to be done as described in the above application and submitted drawings,said
work to be done in accordanc- ith this application ans submitted drawings.
ENGINEERING OFFICI� ��/`/G�� i Date er,
Pees 's vali.' /`,,'f- b , •f •
/c U /A
PERMIT EX' RATION DATE(90 days from approval date)
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/r
` IoCity of Prior Lake
if 0 4,, 4646 Dakota Street SE RECEIPT
t .
Prior Lake MN 55372 110
952-447-9840
011,
Received Of: Receipt: 6111
Franek Inc. Date: 07/08/16
3673 Kanabec Ave Customer: Franek Inc.
New Prague MN 56071-5607
1 %.,;, ` JRec it f er e" ' £' A A4'*'1-t'
,, R c 3 eitri10 * ,.
Driveway Permit 16-D-17/16845 Lyons Ave
Zoning&Subdivision Fees 30.00
Receipt Total 30.00
TENDERED: Checks 7722 30.00
Total:30.00