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le QSe of <br /> way <br /> <br />)ilding be <br /> <br />ire Exact Location ot Proposed <br /> <br /> Exac'~ L(~tion o! Present <br /> <br />riveway to Property <br /> <br />[] T...po,a,y o, i P,o~.,,y [] ~t,e~ o, J' Oi,,an~. ,,om ~'n,e, o' .,~hw.y ,o <br />_[~.Pe,mane~, d isin _E~. ynplattedAre, l °' build'ng'°'ir°n' °' Pump island Js ./.~'"? <br /> Show fee~ & ,nches .~ Level J No. of Present D~iv~ays j Da~ ~'veway is needed <br /> <br />Ii' the undersigned, herewith make application for perrt~ission tO construct the access driveway et the above location. *..aid driveway tO be construcled to conform <br />the r~gul}t;ons ol the M,nneso~a D~part~en~ of 7ran~or~11~on end ~o ~ny spec~} provisions included in ~e per~ I~ is ~g~eed ~hat all ~or~ ~;~ be don~ <br /> <br />ltion is approved end the permit issued. Il il expressly understood thel this permit il condition~ upon replacement or resloretion of the trunk highway IO <br /> <br />rvitiOn OVer ~id street Or highway. And subject to the applicant's compliance with the rules end ~eguletiOns Of the Minnesota Environmenlel Ouelity C~ncil. <br /> <br /> DO NOT WRITE ~ELOW THIS LINE Signa~re of Applicant <br /> <br />~CCESS DRIVEWAY OR ENTRANCE PERMIT <br /> <br />IOT VALID UNLESS I NED <br /> AND <br /> NUMBERED <br /> Cashier's Check No. w- Or certified Check No. <br /> <br />No Deposit Required <br /> <br /> A deposit of $~, payable to the Commissioner of Transportation, in the form of a Certified or Cashier's <br />Check, shall accompany the application. <br /> <br />riot <br /> <br /> This Deposit Made by~ <br /> <br />Deposit will be returned to applicant upon completion of item 5 {rever~e ,]de.) <br /> <br />Special Pro,visions: <br /> <br /> All work to be completed_.~State to furnlsh~ x~culvert and , , aprons. <br /> ~s'.o A~' 0.'" ...... <br />White to Applicant MINNESOTA DEPARTMENT OF TR RT I <br /> <br /> Date ~;.;, ;.: ~.;c:c.: <br /> <br /> <br />