HomeMy WebLinkAbout2014 Driveway Permit 4-D-20 d
"EXHIBIT B"
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FOR CITY USE ONLY
' 4-A :st!a,`.- PERMIT# /'/—D„C
DRIVEWAY PERMIT DATE 9 //-//
APPLICANT NAME: �1- 1kJGJ-1-i oc..-t-(0 tv
OWNER NAME: —?:11 Ctioo..4J4 kGI".%N� 1 1
PROPERTY ADDRESS: Z81 S ‘ itvVe_ tem bc ? coC L Prici"
TO CONSTRUCT: ❑ New „Replace El Widen
TYPE OF PROPERTY:Kesidential El Commercial ❑ Industrial
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Proposed width of temporary or permanent driveway d, (Please provide sketch on reverse side or on
separate sheet)
Type of Material 6"."0.4-iere 71-e
Is property located within the Shoreland District? ❑ Yes,fNo (If yes, applicant must submit impervious surface
calculation)
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The driveway is proposed off what roadway? ✓t v ,t'PL% P
Is driveway shared by another property owner? ❑ Yes .. No (If yes,signature of all parties is required)
Estimated Start DateTP//'///4/
Estimated Completion Date poi,/
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 an 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 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://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. I '/urther agreed
that no work in connection with this application shall start until the applicati.% i - •r• -, and the permit
issued. Z
Contractor Applic. is Signature
FOR CITY USE ONLY
AUTHORIZATION OF PERMIT
Permit Fee $, OD
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, permissic n 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 'th t is:,pplic., on an submitted drawings.
ENGINEERING OFFIC = Date
Per -,4111s valid if signed by City Official
PERMIT EXPIRATION DATE(90 days from approval date) P—