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962 Stanwix Rd - Zoning PermitPLANNING Setbacks, hard surface coverage, shoreland zoning, bluff zone /setbacks, etc. Approved enied Notes: rn�( (-44%4.-4 -1- Date: 7- /7-,42 Staff: �t2,C h "ri yyLvQ- 3 W io�C'In. f r.% OLD ` l 1 tom. e.w.) >, a' o (dom e:, v _ ° P'- » -Q - (051 - 615 ' 5b Lfio Revised Plans Approved: Yes / No Date: Staff: ENGINEERING 1 Grading, drainage, utility easements, wetlands, erosion control, improvements in the Right -of - Way, etc. Approved / Denied Notes: Date: Staff: a-, f=> Revised Plans Approved: Yes / No Date: Staff: COMMENTS 5 , City /State /Zip: :GA C i e t o3 PROPERTY INFORMATION Site Address: / ",74 571-C1 11 ( A/ i `)* 1 Owner Name: � ( ire VA CONTACT Name: 'C_ lk [1. t C} //K( Phone: c ( a (oC- — a-, f=> Address: 7 q5 / ) ,2 5 , City /State /Zip: :GA C i e t o3 % � Applicant Signat -4 ► = Date: l ( 3 `� Email address: lCJf Q? 7CL ilgc_( p, c TYPE OF WORK ❑ Retaining Wall <4 feet ❑ Patio ❑ Sidewalk Description of work: ;Driveway ❑ Sport Court ❑ Fence ❑ Other: A lb° City of kali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5685 Fax: (651) 675 -5694 Email: planningAcitvofeagan.com .1U 212 Date Received: ZONING PERMIT APPLICATION o Please identify improvements on a scaled site plan drawing that shows lot lines, structures and existing conditions. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454 -0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.org G: \Building Inspections \PERMIT APPLICATIONS \2011 \2011 Permit Applications ESTIMATE By: Date: Name: Down Balanc X (h) (c) /7-■ (w) (f /e) 4 9 t & 44- Address: City: 6 - ,4 •a•�� _iaol‘rnit Yes / No IX Remove Asphalt Drive (Extra charge if over 4 ") ❑ Remove Concrete (Extra charge if over 4 ") ❑ Apron removal 2 car 3 car ❑ Cap Blocks (Does not incl. foundation work) ❑ Remove Gravel, Dirt or Sod y ' Base, after compaction %Your existing base and awes - - Regrade for proper drainage t Hot Mix Asphalt compacted to /'L ❑ Addition to drive -❑/ Concrete, see concrete form elm App oximate Square feet Yr. Warranty Options: ❑ Fabric Installation ❑ Permiock LF Customer Initial y. K. do /ah yen/ f TiJt tto ...! 5.@/y /.1.„•Gti gob— Estimated Cost" "J "f-)1.— 4 3, 1 (,ts" S2,34q Customer • prove Date I have read and agree with the terms and conditions on the reverse side. SIGN AND RETURN WHITE COPY 1 2 3 Licensed • Bonded • Insured he Twin Cities Paver of Choice — # 5Y 7i 7 Pk P L B P 7 - / 3 / i _ RICHFIELD BLACKTOP 7745 2nd Avenue S. G� ( Z Si-L'\'( Richfield, MN 55423 / Ph: 612- 866 -8836 • Fax: 612- 866 -8078 www.richfieldblacktop.com No Yes Replace as is ❑ LA FlaresAC GeKAY ❑ ❑ Stumps /Roots fl Water shut off ❑ itt New Cover A Drainage Problem 6 Heaving -d ❑ ❑ Ok to use Bobcat in yard. Customer repsonsible for any yard /landscaping repair. Sign Cross Street ❑ Design on separate copy ,t1_8,8 f) Circle One