Laserfiche WebLink
Obstruction Permit Application in the City Right-of-Way or City Easement September 2012 <br />PERMIT NO. <br />CITY OF LAKE ELMO <br />3880 Laverne Avenue North <br />Lake Elmo, Minnesota 55042 <br />Phone: 651.747.3900 <br />RIGHT-OF-WAY OR CITY EASEMENT <br />OBSTRUCTION PERMIT APPLICATION <br />Name and Address of Permit Applicant: Name and Address of Party Performing Work: <br />Contact: <br />Phone: <br />24-Hour Emergency Phone: <br />Email address: <br />Contact: <br />Phone: <br />24-Hour Emergency Phone: <br />Email address: <br />1.Nature of Work: <br />Type of Surface to be Disturbed:  Gravel  Bituminous  Concrete  Boulevard <br />2. Location (House No., Street, and Nearest Intersection): <br />(Attach 5 copies of scaled drawings showing accurate right-of-way information, topographic information, and planned installation.) <br />3. Method of Construction or Installation: <br />4. Work to start on or after and to be completed on or before <br />5. Will detouring of traffic be necessary?  Yes  No If so, describe routing: <br />For <br />(Applicant) <br />Signed By <br />Dated <br />The date when the work is completed must be reported to the City of Lake Elmo.