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<br />APPLICATION POR DRIVEWAY OR STREET ENTRANCE PERMIT <br />(Read "General Requirements" reverse side) <br />. . <br /> <br />P ermi t No. 6.1;¿" . <br />Permit Fe#~ ~ <br />/ <br /> <br />f RAMSRY COUNTY DEPARTMENT OF PUBLIC WORKS <br />; 33'17' North Rice Street <br />Shoreview, Minnesota 55126 <br />484-9104 <br /> <br />Name of applicant k .l5LLL:~ <br />. <br /> <br />Address J 30 I CI1l./ I 1":;;1:: <br /> <br />Co )./t;.-r!? uc..., If} ~ I <br />, <br /> <br />Phone C 1.:2- t.¡. '3/.-- ~~ s-c, <br /> <br />;l(d <br /> <br />J-/u 04{'Á <br />. city) <br /> <br />LV/t:;. <br />(state) <br /> <br />ð7~//J ~ <br />zip c de) <br /> <br />Name of property owner"."'76'p !3(/4"o{' 1';;;"1-..1 <br /> <br />Address CrÝ 8 --/V/~ D+Lc;: <br /> <br />1. Contractor performing· work j""ç2/ /~ /"'.-/"J ¥~7 . <br /> <br />.' Phone #?L:- t3~(r¿; <br /> <br />2. Application is made to construct and thereafter maintain: <br />Jill Driveway(s): 0 Residence or 0 Commercial OPublic Street(s) <br /> <br />3. Driveway or street will be: QResurfaced OReconstructed (widened) t;EJN ew Construction <br /> <br />4. Driveway or street will be: Dre!!JRorary ~ ~ermanent <br />Date proposed for construction ~"~ 9t!1-- . <br /> <br />5. BuDding permit acquired: DYes tE/No City ß¿;~ I./¡'~t ,~ <br /> <br />6. Number of driveways or entrances to property: Existing 6 <br /> <br />Proposed ..3 <br /> <br />7. Type of proposed entrance surface: QØ3ituminous DConcrete <br /> <br />'s. Width of proposed entrance(s): <br /> <br />, ::z ~ !.. () <br /> <br />9. Location c-¡- ~ ß - t?..4-¿ c;: <br />. (addreSS} <br /> <br />.4.HNt'¿O <br /> <br />(city) <br /> <br />10. Location, if no address <br /> <br />feet of <br />(N, S, E. or W) <br /> <br />(road or .street) <br /> <br />Place a stake in the center of the proposed en·trance, higher than any surrounding vegetation. <br /> <br />1, We, the undersigned, herewith accept the terms and co'nditions of the regulations of the Ramsey <br />County Engineer and agree to tully comply therewith to the satisfaction of the Ramsey County <br />Departm'ent of Public Works. <br /> <br />Dated . / <t::/. . .z..~ý I.~~ (' <br /> <br />Applicant's <br />Signature <br /> <br />~ ,þL- <br /> <br />REVIEWED BY <br /> <br />DATE <br /> <br />CULVERT SIZE: <br />APRON: <br />COMMENTS: A...L flY\.. <br />~~.Á/ <br /> <br />" x <br /> <br />Design <br />Maintenance <br />Environm ental <br /> <br />~ { 10 ~ q I <br />Jt) ~, <br />, <br />It is expressly understood that this permit is conditioned upon replacement or restoration of the <br />'County roadway to its original or to a satisfactory condition. It is further understood that this <br />permit is issued sUbject to the approval of local city, village or township authorities. <br /> <br />CAPPROVED/D'EmED: <br />RAMSEY COUNTY DEPARTMENT OF PUBLIC WORKS <br /> <br />BY])~['~ D.te~ <br /> <br />~~b-- <br />J.<.' J <br /> <br />WBJ/ptd- 10/89 <br />FORM DRIVEWAY PERMIT <br />