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do/DOT 1P-I/'E) E/•11), ,.a•we Call -1 6204 Tank 10
<br />%MINN I'SOl'A0IPA nVAINTOF"ANSPORTATION r sf &lion Rwy.
<br />APPLICATION FOR ACCESS DRIVE 13EIlMIT if District 9 Permit 02-E37
<br />o IM• No, No.
<br />Pdnl of IVTII apill 11 At Is"'. Slyn In INtt Pl n.hle d. Sobndl 3 C.I.Io IO local Qfice Of m1oftesula (),,PJItIo... I of Tumricotation.
<br />r~'TACIT TO ALL 3 COPIES, A SKETCH OF THE PROPERTY, PRESENT AND PROPOSED DRIVEWAYS AND RELATION TO TRUNK HIGHWAY,
<br />ICII SKETCIRS SHALL BE DRAWN TO !;CALE WIIEN HEOIIIIIIiD DY THE ENGINECR.
<br />►I
<br />_S_kYCrrvc _ ObvLrto�N_EKT. <<In7FltryP—
<br />I w nbuu ul p, upUud Iu nrway.
<br />l.clal UesnPbun of In up Us I
<br />Le)r $/ /il'nr>eS;k Sd11 Jr ( L;!
<br />Purpose of Residence 11tLn
<br />Unvcway t.U111114g [,.11 ($pccdy TI'IseI MOV$
<br />class
<br />f3433 Cselrr_2 DaJv_21 M0.S.� Mr✓ SS¢j2 �86-7/LI
<br />(SPecdw sued, landmdl, or road interseclionl
<br />y Iddrt N-S I:
<br />NC, f—�0y2 rAaMSc Lc, 0tv,
<br />Proposed Is o Pudding to I] No
<br />IJ Publi I Le Cunstmcted [R Yet (Type)
<br />Will Ihr 01raloo,my al P,dlHhly Cam, Pialituo,
<br />Building br Pomanent list ❑ Unplaned Ara
<br />Landis 'Show lest L mclns U Level
<br />hinn�era 2,Y t lowers _ witbnihway .
<br />Give Exact Location of Proposed X'19sr EVGQ O-e P2[•PCSeU
<br />Dlivcw.W to Pmpcl ly ���,�Kl liN.65r✓CL.i�
<br />Give Esacl Location of Present
<br />utiveway to Proper ly {✓Gt,7- AF06J2 aF_g,r/fr /n/E
<br />Distanct hose center Uf bulllway to (ronl
<br />_ of hminmg, or Irons of pump island is /O r
<br />No. of Prelenl Duvtwayt Date DtivewaY is nettled
<br />Ocerc Swag lwmeSrer WIrN Mwr
<br />0
<br />I still, pat• uuih•, fill .unl is, epplu must. 1., Peudnsnu, b, rn,mm. I no, ruxo,hvnney al Ill., Am,m Ise abut., last] it' tawny to be comllucted to Cal
<br />w,Ih Ill. or,.UoW,1 nl Ile Mmot. Danar noun at TmmpW Im-.o .,,if to snv mecul p,roo,,ont mpmled in Ina na,ndl. 11 i1 aylae0 inn all wort will be de
<br />,for ub11.14nn of Ihr Muuwmlm Dana, lmrdt sit T,J n%o,,Ia la W, 11 ,1 halo•, aq.,e.l 11,11 no wo11 so is w,lh Ihi1 apnlitil on will be 1lplad until The
<br />,al.nn ,v .ttnuo.ul ,ton fill- penun ,ot.r,t II n e, Waspy uddw I".0 it's u,n aonm n clod ....... ..I upon rrplaetrdrm so ealtotsion of the honk highway to Its
<br />net Ill Ill a ulot.clmv a mimmn 1. it husta, -W.W."d Ib.n llnl pr,mul,f nWll wnpn nJ in, np oval of Idol env, vilpaa or borauah auehmlllel MYint
<br />yahv rhlon Uvel tale Ilenl at highway. It I: ❑miser Tin Ormond nNl IbiT pmmll II Itctrc0 adprct In appllonl'{ comnlNnce with the Jul ea and laeu11110n1 a
<br />^, Moumtola Envbnnmertlal pualil, Council and any other affected gavunmenol agencies.
<br />1 DO NOT WRITE BELOW
<br />ACCESS DRIVEWAY OR ENTRANCE PERMIT
<br />NOT VALID UNLESS
<br />SIGNED AND NUMBERED Certified or Cashier's Check, or Money Order No. _Io'L�IO No Deposit
<br />For
<br />Difllict
<br />U. Only
<br />o
<br />A Ileposil of S SOLI -D payable to The Commissioner of Transportation, in the loon of a Certified or Cashier's Check or
<br />Money Older shall accompany the application.
<br />Th., Depavt Made uY' _Lr eAAf r
<br />Ocuos,1 vnll be rtlu:unl In apill,cam upeo completmn of Item 5 (,eve,m Tine.)
<br />Spenal Pof,wons.
<br />M( t-'AIT,WC DE CoAI$)rCvETE'.b/ %}AN11 IZ161iT Tb�a
<br />ANC CCN57L'UG7t� /n1 /}Cjog ��NLC Arli74 H6 DFId�IL A"C.µt:D.
<br />A rtijtDlAAI CfiZvc"5.0VEft WILL NoT BE �'Por,A�, RRIN�
<br />CIE A(PLieliltei - WILL PI=RPI: rU,4i-r itFF s��fACE r�
<br />RAY (r�rti r 4,fo.
<br />rt,� WITFf AM/AIInIVM�In
<br />a�L y)lsll%caEn ,�r&As WILL Dt Cosy Gic�y
<br />mNso[c. �acssr�� Aa.iD ,�A�Y �, Oil
<br />r�a%
<br />o(`31r�« �I2r r unf I s 2�'a`�1tt8Lf sr[r�.
<br />MIIL eA cJ/ mril Al r?),#4l0 VlFirlk
<br />All Work to be completed o_27,0 Stale to furnish ie`jmfyL x culvert and__apl
<br />Alter Prison if approved: 11r1.
<br />❑WniretoApplicani MINNESOTA DEPARTMENT OF TRANSP TION
<br />n PinA to D,1l, Alum r. Office ip
<br />Green to Municipolias• nr See• Crew �� 8 r
<br />Dale for Aulhadled
<br />
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