Loading...
HomeMy WebLinkAboutWindsong Cir ROW Permit � . , f� ��� ', , � _ I ) ►� �G �; JUN : : i'(]06 XHIBIT "C" �Bv ... �- � PERMIT TO WORK WITHIN CITY PROPERTY/RIGHT-OF-WAY/EASEMENTS AND APPLICATION FOR INSTALLATION OF UTILITIES 1. Location LJ t I.t.�Sfl Al C� G 1'R C LE. 2. Nature of Work �-��M�NT OF NEW PNvNE CA�LE DI�E TD RD�AD RE-CO�lS7'R ION 3. Tndicate below items to be affscred and ir.clude a sketch cr pian of work to be done. Curb & Gutter Street Surface TraillSidewalk Trees: Pond/Wetlands (Publically owned Traffic Control Devices/Signs or Privately owned _, Drainage Utilities StructureBuildings Other �$ L V D. " 4. Method of Installation or Construction SMtZLL CR�LE '�UDLJ ' 5. Work to start on or after: �`�•�� and shall be completed by: � �Ry 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 writin� at least 72 hours in advance of any detour being established, changed or discontinued. NAME OF APPLICANT = N� E G�R T�L ��.� ��. PHONE Q S Z-' `!'�'�'3 SE'� PLEASE PRINT FAX 9 52 - 22.l0 - 3 7 5 E3 ADDRESS �`�� ��R1�.0� St. S�E. Pt�AR.. 1Al2�.. MN 5537Z -AZ9�► STREET CITY STATE ZIP NAME OF PARTY OR ORGANIZATION PERFORMING WORK CONTACT PERSON: �N BARLRGE EMERGENCY (24 HR.) PHONE #: � � Z' °� �°� " S Pf a l ADDRESS DAY PHONE q 52 - 22 Lo - 7 E� f�4- STREET CITY STATE ZIP _ Th dersigned herewith accepts the terms and conditions of this permit by the City of Prior Lake as herein cont 'ne agree fully co ply therewith to the satisfaction of the City of Prior Lake. Signed: itle: �� �� � EER--� Date: �' �' " � � 79 � � r 08 � � , , . - ., - , � . . . . ..... . . .. . . . . � .._ ._ ....'��t .. .'-�, , . . . . . . . � . . . . ! . . '�I3�IIJ1�[fl.t.LI� ��IV'I �IOI?Id 30 JI.LI� �H.L O.L d�.L2iOd�2I �Q .LSf1W a�.L3'IdWO� SI SRIOM J�I�HM �.LNa 9I-i.L 'H.LIM a3I'IdWO� 9H '1'7dHS �,SI�IOISIAO�Id'I`dl��dS„'7'l�d I�10 dt�td (I) �I�10 �J�d I�IO NMOHS S.LI�I�IN32IIna32i'1dJ3'I'I'I1� �idai . _ _L .:�ca . ; . _ � S�I�IOM �I'Igfld 10 '.Ld�Q �1�fl Q�AO?Iddd . ' :pa�e;s �Sqa�ay se suois�no�d le��ads ya�n� aauep�o��� ui auop aq oa ��on� p►es `uoi�c�i�ddu anoq� ay� u� paqi�asap se auop aq o� x�onn aya lo� pa�ue�� �Cqa�ay si uoissrwaad :axe� aoud �o �i� pies �Cq uani� �t�np uor�ez�ioqan� o> >u�ns�nd pue 'suo�araado y�ns �uuano� a��� �o�ld3o ,C��� ay3,�o suoc���n�ai aya y��,►1 s��adsa� ��e ui ,C�dwo� o> >aawaa��e,}o uo��elapisuo� ui �� �y� rnJ f.�,�� �Q�41A021d S��I1�21f1S1�1I 1�,LI'IISdI'I ��_ p_ � •oH �euu�� ._�, •a� �dia�a21 _,.,1 $ ;aa3 . . (•� �O'I `P uoq `qs��) �Hd�i.L �111f lOYVd ��.LRIf1��S 'IdI�PIdPII3 .LIY�I2I�d :10 I�IOI.Lt�'ZI�IOH.LfId 1l'II10 �Sfl A.LI� ?l03 f , «�» ,LI�IIHX� ,�. . . ; t �e fi � : NE � � s �; � :� - � � � �F ;:.�� '.. ..... ..�..... . ... _.... . . ... . . .. ;� 1NTM 8T �Z ... .,. . . . . . . ........ .... .. .. � C ��� :�` ,� � 3 �� � � � ^I <� W Z � �te � a �� �� �� ��" ;��a:� �:, � - .Q � a: � x �� : a �� ::� .. � �. . �� , {; ' ' �� . � ; ; ; SO8 � � , I.00.A'�'101�1 N ���� � .. ; - b , r ;;��. . ,,; _ .:.:� - , .., . .;; _ .w ,;; : �, . . ;, ,.h.� ..s�.� , .. . w '.,.. . a� ',; r o w � q� q � �.. � ����.�. � . zz ... ., . . .., - . . . ...� � � .. . � .;,'��.: r :. t r .O � ��.� .���� � � 4 R ���: ��� : ' �� �� � II -'-'-' a . . 'r :` � F S � �� �, , �� M.OE � �� {� � ! � {� �� , _ -- Q � n+eT � ; N � ` O IQIOLLS . i � � .j s �� ; f3 3 � s ,� � 'y � .. r: , i � ♦ W 3 3 r ' ; , " �. ,.. � r ^ �' q } , '� o ` � I � . Y�. - '.,,. 1 �I � � L , �� � � k ' � y ; t �. L . .. i .. '..:� ' �:: � � . �� ;:. � x �. . .._ .. . ..;� � �' �. . �... ._ ..e,. iR; . .. . . ..._._.._. � � .. . .�:�.;�- ...�. _- �. -.�-:�� . ��:.,,,'.;.�• _ _-� _1 � µ � � � � . R'p0 .�� N=` � & w . � Uf�l4 #?EtfQR UtK� ` � E � � W � �r N iY �U � � � � < � � t Y A$ A iHe tUME'[11E� �� & sT � aiae� ofu s ' t � 19LIit�f.�IR + ao� o ° i• � * CR �. � � � 41'�L� ; ` . r e �., ar � � � ... �a t�? 2 t � ' ' , Is�'SI 4110 N � 4130 � M � � (U d- l� o C'� � �� n � � M � > � 4�2� a, °` I� S -;8St � j` 9�SI NE �/INDSC]NG CIR � o u� �/V N � r �1J 8 � A No N �n � � �.9r � I.--� 0� lf� d � �I¢ . . \ �Q�� � o � �, �y � � � � IM 2 "°°� � � ` o � �o F , � � �c� Sj �'I� . � � .I � � ,� o .�- � # � � lo � 09�, � � N � � ('� C.� � �' ' �r d � . � o � : f � � � ��� • � �� > � � W Q Q , , , � � �� � , � � �� � _ � � � , � � Q �� , , ��. � � —,.�� p' 0� �/�d ����� �1�d3 uI " M � Q � �� � �� - 0 � � q �I � _' �-, 3 � a � � � � ~ d Z �3 3 0 . z � - � � � 4 M c�r �il� � �