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<br />Mn{DGT TP.30795-02 {1l-79) <br /> <br />MINNESOTA DEPARTMENT OF TRANSPORTATION <br />APPLICATION FOR DRAINAGE PERMIT <br /> <br />Control <br />Section <br /> <br />6285 <br /> <br />Trunk <br />Hwy. 1-694 <br /> <br />Prepared in quadruplicate. Forward all copies to <br />proper District/Area Maintenance Office <br /> <br />Milepost or Roadway Station <br />Permit <br />D. t N 9-0akda1e No. 82-D28 <br />803 - 5 T H A V E N Ui~. N<W Tel. No. 633 - 1 533 <br /> <br />Applicant C I TV OF NEW BR I GHTON <br />Property Owner SAM E <br /> <br />Address <br /> <br />Address <br /> <br />Tel. No. <br /> <br />Party Performing Work <br /> <br />SAME <br /> <br />Address <br /> <br />Tel. No. <br /> <br />Location of proposed drainage work <br /> <br />T.H. T -694 <br /> <br />in RAMSEY <br /> <br />(Circle one) (Specific road, landmark, or road intersection) <br />County ~ Miles)N{S(,*W of I - 3 5 W <br /> <br />Legal Description of property <br /> <br />Type of --L Tile Outlet Area to be Pipe Size Casing Size <br />Drainage ~ Open Ditch Drained ~ Acres and Type * and Type * <br />- Parallel Installation *SEE ATTACHED PLANS AS SOON AS POSSIBLE - NO <br /> <br />Proposed Work to Begin on nFr.FMRFR 10, 19R2 Proposed Work to be Completed on LATER THAN MAY 15.1983 <br /> <br />I, We, the undersigned, herewith accept the terms and conditions .of the permit requirements of the Commissioner of Transportation and <br />agree to fully comply therewith to the satisfaction of the Minnesot~ Department of Transportation. <br /> <br />Furthermore, except for the negligent acts of the State, its agents and employees, the applicant or his agents or contractor shall assume all, <br />liability for, and save the State, its agents and employees, harmless from, any and all claims for damages, actions or causes of action arising <br />out of the work to be done herein and the continuing usage, constructing, reconstructing, maintaining and using of said drainage facility <br />under this application and Permit for construction. <br /> <br />Dated DE C EM B E R 9, 1 982 Applicant's Signature <br />Se R S'd f P . R' , J m sF. Win k e s, D ire c to r <br />e everse I e or ermlt equlrements C munitv Devel bpment Department <br />DO NOT WRITE BELOW THIS LINE (F r Istnct UslOnly) <br />AUTHORIZATION PERMIT <br />(Permit not valid unless bearing signature and number) <br /> <br /> <br />In consideration of his/their agreement to comply in all respects with the permit requirements of the Commissioner of Transportation <br />covering such operations, permission is hereby granted, for the work to be done as described in this application, said work to be done in <br />accordance with special provisions required as hereby stated: <br /> <br />1. The disturbed landscaping and/or vegetation will be replaced by materials equaling <br />or exceeding that which presently exist. , ~~ <br />2. That the City shall retain an easement for the maintenance of the pipe in1etJf~EJ1g'MT1eN~ <br />3. That the fence shall be reconstructed as shown on the attached plans. <br />4. That the arsenal force main shall be identified and the appropriate arsenal <br />approval received. <br /> <br />White copy to Applicant <br />Blue to Foreman <br />Yellow to Area Maintenance Engineer <br />Pink to Utilities Engineer in Central Office <br /> <br />The date when work is completed must be reported to Area Maintenance Engineer <br /> <br />Dated <br /> <br />/z- I()-~V <br /> <br />Authorized <br /> <br />w'7, <br /> <br /> <br />No Deposit Required <br /> <br />Deposit in Amount of $ 10,000 <br />Required and Attached Hereto <br /> <br />Date Work <br />Completed <br /> <br />Time Savings Certificate <br />~No. <br /> <br />53074 <br /> <br />or Certified Check No. <br /> <br />Bond <br /> <br />This Deposit Made By <br /> <br />~!tv of New BrigJ;:lton <br />Name <br /> <br />803-5lli Avenue N.W. 55112 <br />Address <br />