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APR-16-96 TUE 0:49 RIVER VALLEY CHRISIHN CH 6127791�J32 <br />roam urJ•1 Im" i <br />WASHINGTON COUNTY HIGHWAY DEPARTMENT <br />11860 Myeron Road N. <br />Stillwater, Minnesota 65082 <br />43WSB <br />APPLICATION FOR <br />STREET OR DRIVEWAY ACCESS PERMIT <br />P.0 <br />OFFICE <br />,USE <br />ONLY <br />Permit No. qa-- <br />County Road <br />Municipality <br />Permit Fee 4 aIEH <br />Attach to ALL copies a sketch of the property, present and proposed access and rotation to the county highway, <br />See Instruction on reverse side, <br />Addroee <br />.y uvmer - - <br />Cv.- ar ,,,.r,rCNno.eP A� �1c.R(cn Address y6C W.til� rros r<oAp T.I. <br />SUAN rAtilei CHf<!GO i{aL{NOIS 60613E �i9 IQa2Fq. <br />Legal Description of Properh (sbbrevWs if n%wmryl I HL• 1-. 787. 00 F IK-7 of +h e. N • O;Q 7.1't ft ct of th ti - E <br />» o{ tl) E <br />N56RC,2. -'A4N AI W tansttr,rerw C <br />o4Y. <br />end Street eF Address <br />Putpow of 0 Street XDrfvwmy 0 Feld Entrance Is a Building to ❑ No <br />Access❑ Comms'mjel (epeaify typal C H Q - be Constructee? Yee (hpe> <br />.WW.Na.:......._,.,..OTemponryor•-- ••-ProperN'"'r•:"r" btiliiri�Sii•,...... <br />t"-�n iomcen hYtforoQntBuaaingbe 19Permanent Is In •Vnpsttedarea of building.b��di}e.c....-- <br />APPRo <br />ft of present Dab <br />Estimated <br />drWeweye to WOPsrN O N E" Needed completion data - <br />Give arrest loaatlon of proposed - S. W, CitU ADCCa.N �- 0 <br />driveway to property �9ut)S CAyr C�Riw{!z o I�RoPF&tt! �bCsiF �T HcR4. 36AM0go irT <br />Give errut location of present <br />drhtiwaytoprop" ca21A1k.<4"t, PRoPF:QT't LPSf.T�0 j <br />h aFvty. ,a, + O.,.Kn. 17 <br />I, We, the underslitmd, herewith make application for permission to Construct the access at the above location, said secasa to be eormtrueted to conform with <br />the reguladom of Washington County and to arty rpedlsl provisions Included In the permit It Is agreed that tit wwk will be done ro the wdegctlon of <br />Washington County. It le funher tgreed that no Work In Connection with this applic adan wal be abned until the application is approved and the permit Issued. tt Is exproos y understood that thb Pennirls condhfoned upon replscamant or restoration of the highway to its orlglnal or to a satisfactory condition. It Is further <br />uperstood that this Permit Is tested subject to the approval of local city, village or township suthcr lss having joint aupmisi �or htg�w�� <br />This permit M non•trenvhnsblo. ){IYeR L�Yy t SS N Cr1i U1['C Ica <br />Date Wgmturo of Appaunt <br />DO NOT WRITE BELOW Tits LIVE <br />ACCESS ORIVEWAY PERMIT AUTHORIZATION <br />"rmamv Requirement <br />Aeap pli oT s`"• n ;'ilaiya`Fila 'ffta`Tie"awivi olfiA a ington Carnty, in tha form of a Certified Check or Cashiers Check shaftaaompany <br />tits applleedon and will be returned upon final construction acceptance by the County. Nb Interest shall be earned or paid on this deposit. <br />Cashier's Check or Certified Check No. <br />If The work is not completed by the date given on this application, the cost of oomplating unfinished construction by County forces may be <br />deducted from the deposit In the event that construction has not started by this data, this permit becomes nail and vokt and the deposit shail be <br />refunded, <br />SPECIAL PROVISIONS: <br />Permission is hereby granted for the construction of the driveway no described In this application, isard`driyoway rc beconstruatod In accordance <br />! with the regulations of Washington County and subject to tintabove requirements and spec e( ptpvfaJon t, t -� ; ! i <br />1 work to be completed by <br />Culvert site x --- Culvert and - apron. <br />Copies: ❑ Applicant Approve <br />Ccunry Engineer <br />Cl Municipality <br />Anrhadr �nnAhR9 WavhMOr.^,n rnunN HinhlVAv nenomm�nr <br />