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3366 North Shore Drive - 08-117-23-41-0017/18 & 42-0003
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Application for installation utilities
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Last modified
8/22/2023 5:47:04 PM
Creation date
11/15/2017 12:00:50 PM
Metadata
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Template:
x Address Old
House Number
3366
Street Name
North Shore
Street Type
Drive
Address
3366 North Shore Dr
Document Type
Misc
PIN
0811723410018
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HC 5137(1/95) HENNEPIN COUNTY <br /> DEPARTMENT OF PUBLIC WORKS ����� <br /> 320 Washington Avenue South <br /> Hopkins, Minnesota 55343 <br /> (612) 930-2550 <br /> UTILITY PERMIT& SPECIAL PROVISIONS <br /> SPECIAL PROVISIONS <br /> 1. RESTORATION <br /> BASE SURFACE SHOULDER BOULEVARD- Ditch <br /> Type Type Type Topsoil <br /> Depth Depth Depth Sod <br /> Prime Joint Width Seed <br /> Tack Cu re <br /> 2.TRAFFIC DIRECTION <br /> AS PER ATTACHED PLATE NO. <br /> 3. REMARKS t•;,:�LS P1.AC�:J Iir 1J9=i WITItUt11 I'�i:P1IT. <br /> NO WORK PERMITTED WITHIN ROADWAY SURFACE DURING WINTER (NOVEMBER 15th thru APRIL 15th), <br /> UNLESS "SPECIAL PERMISSION" IS OBTAINED. NO WORK WILL BE PERMITTED ON SATURDAYS, SUNDAYS <br /> OR HOLIDAYS, UNLESS "SPECIAL PERMISSION" IS OBTAINED FROM THIS OFFICE. <br /> IT IS EXPRESSLY UNDERSTOOD THAT THIS PERMIT IS CONDITIONED UPON REPLACEMENT OR <br /> RESTORATION OF THE ROADWAY TO ITS ORIGINAL OR BETTER CONDITION. <br /> ALL LEGAL REQUIREMENTS SHOWN ON REVERSE SIDE AND ON ATTACHED "SPECIAL PROVISIONS" TO BE <br /> COMPLIED WITH. THE DATE WHEN WORK IS COMPLETED MUST BE REPORTED TO HENNEPIN COUNTY <br /> DEPARTMENT OF PUBLIC WORKS PERMIT SECTION. TELEPHONE: 930-2550 <br /> LIMITATIONS <br /> If the County shall make any improvement or change on all or any part of its right of way upon, over, under or along a <br /> county road, and such change or improvement requires the moving or changing of public utility facilities in such right of <br /> way, then, in that event, the applicant herein shall, after notice in writing by the County, alter, change, vacate or remove <br /> from the county road that part o# its facilities necessary to conform to the improvement at its own cost and without any <br /> cost to the County. <br /> APPROVED: HENNEPIN COUNTY DEPARTMENT OF PUBLIC WORKS. <br /> BY - . <br /> Date ' <br /> -----------------------------------------------------------------------------------------------------------� <br /> NOTICE OF COMPLETION OF THE WORK <br /> HENNEPIN COUNTY DEPARTMENT OF PUBLIC WORKS DATE <br /> OPERATIONS DIVISION-PERMIT SECTION <br /> 320 WASHINGTON AVENUE SOUTH <br /> HOPKINS, MINNESOTA 55343 <br /> Be advised that all work including restoration authorized under Permit No. <br /> issued to for work in <br /> the Municipality of on County Road # at <br /> was completed on and is ready for inspection <br /> By (Print Name) (Signature) <br /> (THIS FORM MUST BE COMPLETED AND RETURNED WITHIN 24 HOURS OF COMPLET/ON OF TH�' WORIC� <br />
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