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Mn Highway Deptarm 1721 Or MINNESOTA HIGHWAY DEPARTMENT Truk �- % % District Hwy No Route - PermitC- APPLICATION FOR ACCESS DRIVEWAY OR ENTRANCE PERMIT Sect; an i' �'�'> No. (Applicant to be furnished with proper standard plato) Name of Applicant City of Fridley Address__ 6131 University Ave. N.E. Tel 560-3450 PRINT OR TYPE APPLICATION Name of Property Owner Maurice Filister Address 1312 E. 21st St., Mpls. 55404 Tel.332-6311 Location: T.H. Cty- in Anoka County 1/3 Miles N -5T -W ( of 694 Interstate) • (Circle Ono) (Specific road, Landmark, or road intersection) Legal Description of Property See sketch Purpose of Driveway ❑ Residence ❑ Commercial (specify type) Entrance from County #1 to service road Is a Building to What be Constructed M No ❑ Yes Kind check Will the Building be ❑ Temporary or ❑ Permanent proper Is the Property in ❑ Platted or ❑ Unplatted Are,. squares Distance from center of highway to front of building, or front of pump island is feet. Is land 'higher? lower?level? with highway. , Show feet & inches Show feet L iochos Number of Present Driveways to Property one Date Proposed Driveway Will be Needed at once Give Exact Location of Proposed , Driveway to Property 30 north of present entrance (to replace present one) Give Exact Location of Present Driveway to Property See—akctI _ Sketch Property, Present and Proposed Driveways and Relation to Trunk Highway ON REVERSE SIDE OF ALL COPIES OF APPLICATION. 1, We, the undersigned, herewith make application for permission to construct the access driveway at the above location, said driveway to be constructed toconform with the standards of the Minnesota Highwoy Department and to any special provisions included in the permit. It is agreed that all work will be done to the satisfaction of the Minnesota Highway Department. It is further agreed that no work in connection with lois application will bo started until the application is approved and the permit issued. / Cit Tica°nt'sFl�Zle�,'City Engineer �; d Date. ....,i i'7L.r Signature FILL OUT, SIGN AND SUDMIT FOUR COPIES TO MINNESOTA HIGHWAY DEPARTMENT APPLICANT DO NOT WRITE EELOW THIS LINE This Entrance is approved subject to the following conditions: le Geometries and width as si3Own on attached plot plan. 2. Existing entrance must be removed not withstanding the fact that future geometric c'ianges ;ay possibl;,i be considered. 3. Divider island Aust be 41 in width -arid reduced in len-th to ljlo • V .111. c' IV Mp"11Canf .. ... .. •....-. .. .. �_ .. _.. ... _ ❑ Buff to Control Office [I/ `'• _. • ��/ ._��/ .= Pink to Dist. Maint. Offiul L�� c�`L ( i / � ❑ Green to Municipality or Sec. Crew Date'-- d ✓ Dist. Maint. Engin.er 1 VE v f so' �-%GAN '. 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