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.)
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° 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
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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