HomeMy WebLinkAbout2006-Henn Co driveway permit HC`,��3C(�G�)
HENNEPIN COUNTY
. Transportation Department
1600 Prairie Drive—Medina, MN 55340-5421
Permit No. �g�g
DRIVEWAY OR STREET ENTRANCE PERMIT AND SPECIAL PROVISIONS
Field Inspected By: Dave Zetterstrom Date: 07-05-06
Location: #19 1760 Shadvwood Speed Zone: N/A ADT:
Nearest Cross Street:
(If Rural)
Sight Distance: Actual - Left Right
Minimum: Minimum - Left Right
Curb to be removed to: � Construction Joint � Sawed Joint
Recommended
Drainage: � Surface ❑ Culvert Culvert Length _ Culvert diameter _ _
1. CONSTRUCTION SPECIFICATIONS (Within Right of Way)
BASE SURFACE CURB SIDEWALK SHOULDER BLVD/DITCH
Type CL5 Equiv Type 2341 BIT Type Type Type Topsoil X
Depth 4" Min Depth 2" Min Design Depth Depth Depth 3"
+ Seed or Sod
2. TRAFFIC CONTROL REQUIREMENTS Plate#2
3. SPECIAL PROVISIONS
One 12' minimum width private driveway relocation permitted as requested. Approach profile to be similar to Diagram 'B' below
without culvert. Remaining boulevard to be restored with seed or sod.
DO NOT PLACE CONCRETE ON COUNTY RIGHT-OF-WAY WITHOUT WRITTEN
PERMISSION. IF YOU HAVE ANY QUESTIONS, CALL (612) 596-0355
IDiagram A ! Diagram B ��
R� IMPORTANT: TYPE"a"CONSTRUCT ROUNDED BERM TO C�L IMPORTANT: CONS7RlJCl'SWALE TO DIVERT WATER FROM R�
PREVENT WATER FROM RUNNING DOWN SHOULDER.
OR1 VE. I
'b•.
2"Gutter 6"Swale
9rivewaY
�,a�QYiveWeY .. _.:...: _ v . , ._.- . •se: ��.�e. .� _..... a.w..'...: :•!.�... `.::::.,••;.�
�"� Ezisting Roadway t•�\�
Shoulder Shoulder '
Place culvert in existing ditch
Final Inspection Date: APPROVED/D�D:
❑ Satisfactory HENNEPIN COUNTY
Driveway was found to be: ❑ Unsatisfactory Transpo ati Dept. +
Inspected By: BY� �
Date: �7—� 3 —O C
HC53�"29(9/b0 j
ENTRANCE HENNEPIN COUNTY PERMIT NUMBER
PERMIT FEES Transportation Department L��¢9
PRIVATE/ • ft Planning Division
RESIDENTIAL $50.� �,bL�`d�'`�`�`
TEMPORARY $�oo.o0 1600 Prairie Drive
COMMERCIAU Medina, Minnesota 55340
STREET $200.00
APPLICATION FOR DRIVEWAY OR STREET ENTRANCE PERMIT
(READ: "General Requirements"on Attached Page)
NAME OF APPLICANT , P ,, TELEPHONE PAGER FAX
��., � �F ���� �� �s��-y�Z/—�'�y �- �-
MAIL ADDRESS ' � � ��� CITY a STATE ZIP CODE
�G�� � ( ��� c,�.�.. ��. �� �s.��2
NAM PROPERTY OWNER STREET ADDRESS CITY STATE ZIP COOE
�,L��V�M � ` �� ���� / �4'Z'\ `r I 1✓ '�`V �I� �� 1F,
J
CONTRACTOR PERFORMING WORK(IF KNOWN) STREET ADDRES CITY STATE ZIP CODE
�
1. �'j-�' ' ,�'
2 APPLICATION IS HEREBY MADE FOR PERMISSION TO CONSTRUCT AND THEREAFTER MAINTAIN I�•DRIVEWAY(S) ❑ PUBLIC STREETS
3. BUILDING TO BE CONSTRUCTED: � NO �YES � RESIDENCE � COMMERCIAL
.;C �-- SPECIFYTYPE
q. DRIVEWAY OR STREET WILL BE: ❑ TEMPORARY � PERMANENT DATE PROPOSED +���I � '.
ENTRANCE WILL BE NEEDED I
5, IS THE PROPERTY: �-�LATTED ❑ UNPLATTED NUMBER OF PRESENT DRIVEWAYS i
OR OTHER ENTRANCES TO PROPERTY I
CIT R PER IT NUMBER
g. BUILDING PERMIT ACQUIRED: ❑ NO �YES ��" �,1 u ��/� C1
�, TYPE OF PROPOSED ENTRANCE SURFACE: �BITUMINOUS � CONCRETE � ROCK �OTHER
LOCATION—STREET ADDRESS �1COUNTY ROAD CITY
8. j !��-� � � '' ' c,a:+;!:ac� I�t H'l�:'� 1 j � �c� +'1 �
LOCATION—RURAL ROAD OR STREET
9' ON RURAL ROAD MILES � � � � OF
DATE P ED NAME �„ , APPLICANT' IGNATURE
/ � �/I
7'' � ""(�'� <:1 �i...� i C� 4 ( 5� v �i'rJ-i-�i'J AC..�C.�7
TO HELP THE INSPECTOR, PLACE A STAKE WITH A CLOTH ATTACHED, IN THE CENTER OF THE PROPOSED ENTRANCE
AND HIGHER THAN ANY SURROUNDING VEGETATION.
APPLICANT'S DIAGRAM (IF PLAT,SITE PLAN, OR CONSTRUCTION PLAN IS NOT SUBMITTED)
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,�� , `� — ' Complete this form and send all copies to: Hennepin County
�,�`' t Transportation Department,Planning Division, 1600 Prairie
E"'" � �� �?��J'� Drive,Medina,Minnesota 55340. Phone: (612)596-0355,
N'` FAX: (763)478-4000. After approval,one copy will be
{ iG'wE��s'� retumed to applicant.