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Entrance Permit Application
Permit # ENT 2015-0005
App. # 2015-0142
UID # 8976
Current Status: Work Completed/Filed
Valid: 04/17/2015 - 04/16/2016Highway Department
16589 County Road 142
Brainerd, MN 56401
Phone: (218) 824-1110 Fax (218) 824-1111
Permit # ENT 2015-0005
App. # 2015-0142
UID # 8976
Current Status: Work Completed/Filed
Valid: 04/17/2015 - 04/16/2016Highway Department
16589 County Road 142
Brainerd, MN 56401
Phone: (218) 824-1110 Fax (218) 824-1111
Terms
Entrance Terms and Conditions
I have reviewed the Cross-Section diagram in section 3.
I have read the Entrance Access Policy in section 4.
Invoice 04/17/2015
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 04/17/2015 1:57 PM Residential Entrance Deposits |
$500.00 | x 1 | $500.00 |
| Grand Total | |||
| Total | $500.00 | ||
| Payment 04/17/2015 | $500.00 | ||
| Due | $0.00 | ||
Invoice 05/06/2015
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 05/06/2015 12:21 PM 18" band |
$8.50 | x 1 | $8.50 |
| added 05/06/2015 12:21 PM 18" x 14' culvert |
$94.22 | x 2 | $188.44 |
| added 05/06/2015 12:21 PM Inspection Fee |
$25.00 | x 1 | $25.00 |
| added 05/06/2015 12:21 PM Residential Entrance Deposits |
$-500.00 | x 1 | $-500.00 |
| Grand Total | |||
| Total | $-278.06 | ||
| Payment 06/14/2016 | $-278.06 | ||
| Due | $0.00 | ||
Approvals
| Approval | Signature |
|---|---|
| Applicant | joshua r. larson - 04/17/2015 1:58 PM cd8f7dc88057cdedcf484ca4f40e8d9d 2bffaa4c83697d91ac0e04ce4204f5e8 |
| #1 Reviewed by Admin | Cindy Rader - 04/17/2015 2:20 PM 7fce85a7f38f00be11701ba5949efe68 c53ad7f6cadcc8fd60fe2d347ad75065 |
| #1 Preliminary Inspection Report | Cindy Rader - 05/04/2015 2:04 PM 8d9bab5410044a50bd7bdd449415a09d aa1464c7079e5b7d863bd875db32441a |
| #2 Preliminary Site Inspection | Lukas B. Marks - 05/06/2015 11:58 AM 0a3570fc64d82a09181013b3ac05d34b 7ae3f56870dae4a9e93e75a836379eba |
| #4 Final Inspection Report | Cindy Rader - 06/02/2016 3:46 PM c3b88ec405e6d1e265dc54cc54eab149 5aa51e33726ffdc7afd026265c4b7c36 |
| #3 Final Inspection | Cindy Rader - 06/02/2016 3:44 PM d13db83f06745633ff2beb2f61e83eeb 6b00fc63e6e5415b0f5298f43317c60f |
Application has been approved. All signatures have been obtained.
Public Notes
| Text: | 04/17/15 forwarded for site inspection. CKR 5/6/15 Need 28 feet of 18" pipe. 2 14 foot pipe and 1 18" band. 06/02/16 Final inspection completed per Lukas. Request for refund prepared. ckr 06/14/16 refund ck #6233 for $278.06 mailed to applicant. ckr |
| File(s): |