4758 Cypress Pt - Zoning Permits & PlansPLANNING
I Setbacks, hard surface coverage, shoreland zoning, bluff zone /setbacks, etc.
Approved NDenied
Notes:
Date: I s Staff: k?
CONTACT
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:
TYPE OF
WORK
Revised Plans
Approved: Yes / No Date: Staff:
COMMENTS
❑ Sport Court
❑ Fence
- 1 K €pl C � j I� OZ. �l/�(
PROPERTY
INFORMATION
Site Address: L/ 7s
c-1 ( re s
t ,
Owner Name: cttr ; c.K 'Ili o r
CONTACT
S36
Name: R\c 'C.l2 b icc..1oP Phone: 6/ 66
Address: 7 ,_ five City /State /Zip: Ktcj- 'eja u �Z-3
Applicant Signature:
OA C‘' Date: 7.--,72t-/-/
Email address: — 70616, 02.6 r Lk173P. C() A
TYPE OF
WORK
❑ Retaining Wall <4 feet
❑ Patio
❑ Sidewalk
Description of work: l�FC
riveway ❑ Other:
❑ Sport Court
❑ Fence
- 1 K €pl C � j I� OZ. �l/�(
l r
C!tyotEapo
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5685
Fax: (651) 675 -5694
Email: planninqacitvofeagan.com
For Office Use
Permit #:
Date Received:
/05
L
ZONING PERMIT APPLICATION
❑ 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.gopherstateonecall.orq
G: \Building Inspections \PERMIT APPLICATIONS \2011\2011 Permit Applications
ZS' /Z
- The Twin Cities Paver gf Choice -
ESTIMATE By: 1.<02 5 (22
Date: ( `
(h)
(c0 I 3 z C.' 1
(w)
(f /e)
Name: F) t ' � tp ` , c
Address: t*Q s 5? In
City: < 1
*Permit Yes No
L Remove Asphalt Drive (Extra charge if over 4 ")
❑ Remove Concrete (Extra charge if over 4 ")
❑ Apron removal 2 car 3 car
I Cap Blocks y (Does not incl. foundation work)
❑ Remove Gravel, Dirt or Sod
/.C, ?' Base, after compaction
❑ Your existing base and ours
"Regrade for proper drainage
47 Hot Mix Asphalt compacted to
❑ Ad6ition to drive
❑ Concrete, see concrete form l 1 ]
/ .- G 4Approximate Square feet
Yr. Warranty , t,-
1/9 7
Down
Options:
❑ Fabric Installation
❑ Permlock LF
Customer Initial
l
f
L.6`50
Estimated Cost:
/550
Balance 3 D
X �= �-C
Customer Approval
1 2 3 4 5
L I - 1 c3" C
Licensed • Bonded • Insured
7 /.ao /aa /a
Date
I have read and agree with the terms and conditions on the
reverse side.
SIGN AND RETURN WHITE COPY
P
L
B
P
RICHFIELD
BLACKTOP
7745 2nd Avenue S.
Richfield, MN 55423
Ph: 612 -866 -8836 • Fax: 612 -866 -8078
www.richfieldblacktop.com
Replace as is
Flares
Stumps /Roots
Water shut off
New Cover
Drainage Problem
Heaving
0 Ok to use Bobcat
in yard. Customer
repsonsibie for any
yard /landscaping
repair.
Sign
Cross Street
❑ Design on separate copy
Property Line?
ti± J)
Circle One