HomeMy WebLinkAbout2007-05-02 MNDOT Drainage PermitorsrrRi DIMON
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0 t3epasit Required in tlga Amount of
DEPOSIT TYPE
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_DATE WORK COMPLETED ' • e rate when the work is Cary • t feted maw be r. r °r 1 to the loral NA T Rau , R . miartoiT S rpetvis r.)
Mr O Tii,3o795 -02 (REVISED 6-2,006) 553 i v
MINNESOTA DEPARTMENT OF TRANSPORTATION
RP.
PO NO COMPLETE rots SECTION F R OFFICE USE 01
ATTACH A SKETCH POSE WORK AND RELATION TO TRUN `I SUCH SKETCH SHALL BE DRAWN TO
SCALE WHEN REQUIRED BY THE `N IN . PRINT OR ME APPLICATION. IGNIN SPACE PROVIDED. SUBMIT TO LOCAL
CE OF THE MINNESOTA DEPARTMENT OF TRANSPORTATION.
APPLICANT
APPLICATION FOR DRAINAGE PERMIT'
Manley Commercial Inc.
PROPERTY OWNER
Manley Commercial Inc. ; (651) 289-020
PARTY PERFORMING WORK
Manley ommercial c.
..5.. �._.Ya • w•�Yaa mot-" •LY.. y _- v•� _. .
LOCATION ATI OF PROPOSED DRAINAGE WORK
Highway 36 Oaf p rkr h igh _ Washington
T P3 op DRAINAGE. r i Tie Owlet Open Ditch AREA TO BE DRAINED
.} 'a to Installatioli 1, the M ...
LEGAL DESCRIP1101 PROPERTY
P ' MtT NOT VAUD Ui LES
BBC SIGNATURE AND MB EL.
y
TELUXHONE
TELEPHONE
TELEPHONE
(651) 9 421
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gmcznym
la MAY 0 7 20D7
(651) 289 -
. ., %,• • Acres
Lot 2 Block 1 WalVart Addiffon • May 15,200 • } , .. • l , 2607
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,. �•.1� \'#4 #4r.. +v 5 44 5 MAY#. � ., ..4 ... _ _ ..
1, We, the undersigned, herewit h accept the teams and conditions of the
permit requirements of the Commissioner of Transportation and agree to
fully comply therewith to the satisfaction of the Minnesota Department of
Transportation. It is agreed that no work in connection with this
application will bo started until the application is approved and the prat
issued. It is finther understood that this permit is issued subject to the
approval of local city, village or borough authorities having joint
supervision over said std or highway and subject to applic iiL
compliance with the rules and regulations of the Minnesota Environmental
Quality Board and any other affected govenunental agencies.
Furthermore, except. for negligent acts of the State, its agents and
employees, the . applicant or his agents or contractor shall assure all
liability for, and save the State, Rs agents and employees, harmless from,
(0)
WORK TO START ON OR AMER WORK TO ME COED ON OR AFTER
Doted
By
Si
DO NOT NVIIITE BELOW THIS LINE
AUTHORIZATION OF PERMIT
it is expressly understood that this merit is conditioned upon replacement or restoration of the trunk highway to its original condition or to a satisfactory condition.
In cortsideration of the appiicanf s agreement to comply in all respects with the regulations of the Commissioner of Trir's pa ttatiOn covering such operations,
permission is hereby granted for the work to be performed as describdd in the above application, said work to be performed in accordance with special provisions as
hereby stated:
SEE ATTACHED SPECIAL PROVISION'S
ADDRESS (Wm, City, State, Zip)
Page 1 of
•
'strict
C.S.
copy -5 Miles East
CASING SIZE AND TYPE
NA
�aR �.tr_ aL71
Permit �f
2640 Eagan Woods Drive Suite 220, Eagan , MN 55121
,•`a vy, , \ . A•. • • •••• . . , F
ADDRESS (Sired, City, Stake, Zip)
2640 Eagan Woods Drive Suite 220, Eagan , MN 55121
ADDIS (SU City, Stale, p)
2640 Eagan Woods Drive Suite 220, Eagan , MN 55121
• `t
any and all claims for dates, actions or causes of action arising out of the
work to be done herein and the continuing tie, constructing,
reconstructing, rn i tainin and using of said drainage facility under
application and permit for con traction.
+ tt? rOl
t •- Print orTypc
7 _7- tAl
4./ - En _4'
(SPECIFY ROAD INTERSECTION OR LANDMARK)
�.. of orrel Ave •
• PIPE SIZE AID' "PE
15 inch RCP
•
SEE RISE SIDE FOR GENERAL
INFORMATION AND REQ I N i `
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