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Home My WebLink About2014 Driveway Permit 14-D-17 "EXHIBIT B" PRr °4" te, FOR CITY USE ONLY 4tANt . PERMIT# /1-1-D--)7 DRIVEWAY PERMI DATE APPLICANT NAME: \ ` \ C-An, `vr� AQ OWNER NAME: 0CZ GINo(�� PROPERTY ADDRESS: q17 I Ulm it l nsf TO CONSTRUCT: ❑ New EgReplace ❑ Widen TYPE OF PROPERTY: Residential ❑ Commercial ❑ Industrial Proposed width of temporary or permanent driveway 2 (Please provide sketch on reverse side or on separate sheet) , cam Type of Material C-0 Is property located within the Shoreland District? ❑ Yes g No (If yes,applicant must submit impervious surface calculation) The driveway is proposed off what roadway? kU1 I n C bird / / Is driveway shared by another property owner?) 1711 Yes No (If yes,signature of all parties is required) Estimated Start Date ? 1 �� l 64 Estimated Completion Date I v — l / 1 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. "EXHIBIT B". 5. Prior to placement of concrete or bituminous surfacing,the applicant 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 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 a,lly�. •rk will be done to the satisfaction of the Engineering Department. It is further agreed that i o work i it 'on with this application shall start until the application is approved and the permit issued. ,..40 //101, Contractor Applicant's Signature FOR CITY USE ONLY AUTHORIZATION OF PERMIT Permit Fee $ 3D 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 15 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 appli ation and submitted drawings. ENGINEERING OFFICIAL 4 Date Permit is valid if signed by City Official PERMIT EXPIRATION DATE(90 days from approval date) 1/ -2 Z-1 y RICHFIELD _ The Twin Cities Paver of Choice - RICHFIELD CONCRETE CONC ' ETE / ESTIMATE By: 0°��/ # Cc C f' , AilIw ❑ rtgie 1�Ftp tv Date: /zi/t� P 1a �,�}_yes- G � L ❑ ,,, �� Name: F ❑ °I� 1r r 61,, Address: 4‘,eI W. M ,, ' gaz Zip: 55 7'1- p ❑ BI3B® i /�L �+ rh AC, DITED Pr (T k C BUS NESS City: «lI 5' / S LI (h) No Yes2( ❑ Ok to use Bobcat 676-, c Replace as is O/ CSI" in yard. Customer (c) Flares C� ❑ repsonsible for any Stumps/Roots ❑ yard/landscaping repair. (w) Water shut off ❑ Garage Door t' �Ga� ,�-. d r , C.7,-^ New Cover l ❑ Drainage Problem LI � Sign Premium Concreteservices sign on separate copy ❑ Apron ❑ Patio riveway D ❑ Sprinkler heads? ❑ Sidewalk ❑ Steps LI Garage Floor ❑ Stoop ❑Curb ❑ Other Permit es''i, No aemove Asphalt(Extra charge if over 4") .w M ° ❑ Remove Concrete (Extra charge if over 4" " °i° ❑ Remove Gravel, Dirt or Sod � — LI A 'tion to driveway l Ba work as needed up to 4" �e rade for proper drainage 28-'-'0 ' Rebar 4'on center I �, 6 SUPER EXTERIOR CONCRETE MIX 51 s PSI a --C.2-°c' 'cro Fiber PPFinish ---( S � roo mooth/Exposed/Stamped ❑ Color 1:15aw Cut/Hand Tool joints/Zip Strip(8 feet or less) ure Agent Sealer 3 CI Backfill. omeowner Contractor ,c 4- LI Grass Repair omeow Contractor CI Warranty c .- '` t � ..' .WMA .. .._. - /fL Q s' S ito2 J `wyy Estimated Cost: a� C7 Deposit - C' / d Balance X Customer Approval ate I have read and agree with the terms and co itions on the reverse sid Property Line? SIGN AND RETURN WHITE COPY LiCompd ❑ Subpd _ 7745 2nd Avenue S •Richfield, MN 55423• Ph: 612-866-8073• Fax: 612-866-8078•www.dchfieldconcrete.com Licensed • Bonded • Insured