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<br /> .b' " .;`' HENNEPIN COUNTY PUBI.IC WURKS Perm�t No. 33t7
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<br /> '°'- � 320�Yashington Avenue So�th
<br /> }"-<� Hopk�ns,M�nnesota 55343
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<br /> �' ` APPLICATiON FQR DRIVEWAY OR STREET ENTRANCE PERMIT
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<br /> . (Read"Generai Requirements"reverse side)
<br /> r " Nartxotapptiunt f�rt5�vrn �tAt s F��_=•r� ��r,� ty$A� Phone�3Q-6279
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<br /> , � �►dd�-e:s '�14 t31cU11nt 1�a11 , �Sinnea�olis, Yii �„^?
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<br /> Name of Property Owner hAD�i<<�r Address ����
<br /> .�:.+�'-�1. Controctor P�rforming work il.S.i. Phone -.'•r)-S7�:
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<br /> �.',?',2.Appliption is hereby made for permission to co�struct and thereafter maintain: 1 Dri��way(s) Pubiic Streetls)
<br /> �,�'�":3, eu��d�n9 to be ooMc.�,ceed: o Yes e No � Residence � Commercial ISpeci fy Type) `�' S �4�r.��n
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<br /> 2�JVe.;��er_..2�.1��9 ._._.�.,.
<br /> .dfiVewdy^t7A`strle[wFM be:.,p.:'ferr!{�orgry,.d`f'ermanent Date proP�entrarKe wf1/be needed• . .
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<br /> irq 5 (s the proG..�rty: � Ptatted � Unplaued Number of present driveways or ent•ences to proper.y: +
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<br /> �-�\ 6. Bui�ngPertnitacquired: QYes � No City CCI'.d{ti0^31 USC P•�1�11t, �11'Or,O PermitNo. LiiR6
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<br /> '�4;.7.'Type of proposed envance surface.,a Bituminous � Concrete d Rcek � Other
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<br /> C 8, �t•,� 34f,tt Fth AvPn��e tk�rth ��Rd. f j Grnno. 4;1n�esota
<br /> �.,� � � (Adtlrys) Co.Roaei (City)
<br /> `°��^ ��`- approx 400' i Orci:ard ?aad
<br /> .tocat(on i�nxa�: Mi�es of
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<br /> p,' 'tiCt. 23 I�39 � �.:-�,t��.:�.��'-�.�
<br /> ��p�� ' • Applicant's Signature � � ,
<br /> �=�t t?ar�a�er;/Land � air.ht of t�1v
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<br /> �,7o help:dtie inspector, P�ace a stake with a dotfi attached in the cen'er of the propaaed envance,higher than sny surrounding
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<br /> ��: A�PUCANTS DIAGRAM•(lf pbt or construction pian is not submitted)
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<br /> �, .nY1 } (CompNt•n�hfo.m.ne.endapeopbato:HAnr��pi,County }
<br /> a�, N19hwW Dirisiort TnHk OMw.320 WpNnpton Av�rKw
<br /> iss+��` South, Hopklna, Mlnrnsou 66343. of+onr 936-J38t.
<br /> ��': Aksr spp�w�l.o�e copy wAI be ntumed to�pplicuK.)
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