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Staubach Global Services, lee. <br />Permit Services <br />3017 Lou Monk Drive, Suite 100 <br />Port Worth, TX 76131 -2800 <br />To be completed for Residential use: <br />By <br />City of Little Canada <br />Dayt inc Phone: 651- 766 -4029 <br />(Legal Name as shown for Perm't) Fax Number: 551 766 -4048 <br />Address: 515 Little Canada Road P., Little Canada, MN 55117 <br />To be completed for Commercial/Industrial Use: <br />Licensee: Daytime Phone: <br />(Legal name as shown on permit) Fax Number: <br />Address: <br />Corporation: State in which incorporated: <br />Is applicant a Railroad Shipper? Yes__ No If yes, BNSF Marketing Rep name and number: <br />The Following is to be completed by all applicants: <br />Type of Crossing (plank, concrete, etc.): concrete New: x Existing: Width: 8 <br />If Existing: Need Rehab? Yes No <br />Crossing ocation: 2 000' West of Country OriveCil Little County: Rarnse <br />g y y y State: MN <br />Section: 31 Township: 30 Range: 22 HighwayName/Number: <br />Temporary; Permanent: x Crossing, located at RR Milepost: DOTfl <br />If Temporary, specify time period crossing will be required: <br />What use will be made of the crossing: Public Trail Crossing <br />(Residential, Farm, Commercial) <br />User Vehicle Type: Pedestrians Bikes Total number of vehicle crossing per day: 10 -15 eat.. <br />(auto, pickup, van, if industrial, list lypc): <br />Other private crossings in vicinity: Yes,_,_ No x_ If yes, give distance /direction from the crossing: <br />What is the distance to the closest public crossing in either direction: 1200 feet West, 2000 feet East <br />Do you own or lease the land on either side of your crossing: Lease Own <br />If leased, provide owners name and telephone number: <br />If leased, please provide written authorization for legal owner with application. The City has an agreement wit i st. Paul <br />Regional Water for the use of their ROW for <br />Cit trail use. (gee Attached) <br />If this is an existing crossing, bow many families are using it now? If kno <br />n, list names and addresses on reverse. <br />If Cooperative use, please provide names and permit numbers held by others (attach) and provide proof of land ownership. <br />What are the future plans for this property? No future improvements beyond regional trail use proposed <br />Applicant understands he or she will be requested to sign a regular crossing permit, which will provide that Applicant will <br />1) assume the cost to construct the crossing, 2) furnish insurance as requested by I3NSF Railway, 3) assume the cost to remove <br />the crossing if crossing is temporary, and 4) reimburse BNSF Railway for the expense incurred to maintain this crossing. <br />Date: <br />/7A /4 LYAY <br />If you would like confirmation of your application, <br />Please print your email address: <br />Joel. hen son(dci.little- Canada.tun. us <br />HIBIT B <br />20 <br />X0 <br />APPLICATION' FOR PRIVATE CROSSING <br />1) i I [1 \71 Date: March 14, 2006 <br />APR 0 7 2008 <br />Signature; <br />Print Nam Joe Hanson <br />PhOneNu bare 651-766-4029 Fax: 651- 766 -4048 <br />