HomeMy WebLinkAboutDriveway Permit #11-D-03 O � PR1p
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"��`' "EXHIBIT B"
FOR CITY USE ONLY
DRIVEWAY PERMIT PERMIT # s:• _ : �,
DATE ' //
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APPLICANT NAME: ��`� C�"S�C����ON ��
OWNER NAME: � G-1J Fi.7� C�
PROPERTY ADDRESS: �Q � �• � �
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TO CONSTRUCT: � New �Repla� ❑ Widen
TYPE OF PROPER7Y: }�Residentiai ❑ Commeraai O Industriai
Proposed width of temporary or permanent driveway (Please provide sketch on reverse side or on separate sheet)
Type of Material , 1...611���r�
Is property within the Shoreland Distrid ?❑ Yes ,,0'`Vo (If yes, applicant must submit impervious surface calculation)
The driveway is proposed off what roadvway? ��✓C l CW � R
is driveway shared by another property owner? 0 Yes ,01Vo (!f yes, signature of all parties is required)
Estimated Start Date Jlv�G
Estimated Completion Date�a� v
$KETCH RE�UIREMENTS
1. A driveway sketch is required as a part of this permit. The sketch can be drawn on page two of the permit or on a
separate sheet. The sketch does not neeci to be drawn to scafe, however dimensions must be provided on sketch.
2. Driveway sketch should inGude proposed driveway, existing driveway {dashed line), driveway dimensions, property
lines, dimensions of driveway from property lines, building locations near driveway, arro�ro indicating north, surface
features near proposed driv�way location (trees, hydraMs, utilities, etc.).
3. If on a comer lot, the sketch should indude dimensions to intersecting roadways.
CONDITIONS OF APPROVAL
1. No work under this application is to be started urrtil application is approved and the �rmit is issued.
2. Where work on traveled roadv+�ay 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 sv�eept clean after work is completed.
5. Prior to placement of concrete or bituminous surfacing, the applicarrt shall notify the Engineering Department at 952-
447-9830 that the work has been completed and is ready for final inspection.
6. No changes or alterations in er�trances may be made at any time without written aermission from the Engineering
Department.
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"'��"' "EXHIBIT B"
7. Permit expires 90 days after approval date.
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8. Additional Condifions f i� 1'
J`�eu� � ��te.�v5 � �S .
IMPORTANT: Befone startinfl work . . .
The Applicant shall call Gopher State One Call (1-800-252-1166) 48 hours prior to starting wrorlc. Applicarrt must call the
Engineering Department (952) 447-9830 for inspection 24 hours prior to 6me of inspedion.
' 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 construc�ed to conform
with the standards of the City of Prior Lake and to any speaal provisions induded in the permit. ft is agreed
that all work will be done to the satisfaction of the Engineering Department. It is further a that no work
in connection with this application shall start u�e application is approved per i ssued.
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Contractor pli M's Signature
Date: y �
FOR CIN USE ONIY
, AUTHORIZATION OF PERMIT
Permit Fee $ � � �� �
In consideration of agresmerrt to comply in all respeds with tt�e 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 grarrted for the work to be done as descxibed in the
above application and submitted d�awings, said v�o�lc to be done in accordance with this application and submitted drawings.
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ENGINEERING OF ICIAL Date ��
�j /�,�/ !� �� ���/ � -', Permit is valid if signed by City Official
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Permit Expira on Date (90 days from approvat date)
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