4064 Blackhawk Rd - Zoning Permits & Plans
For Office Use
City of Eapn 1 Permit
3830 Pilot Knob Road
1 Dale Received: 1
Eagan MN 55122 L -
Phone: (651) 675-5685
Fax: (651) 675-5694
Email: planning(ftityofeaclan.com
ZONING PERMIT APPLICATION RECEIVED SEP 1112012
p Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
PROPERTY Site Address: "r 0 Lk V w
INFORMATION
Owner Name: rJ 0, ~ C) L ~
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Name: T, V P EF--~ 6L'NCwrv P Phone: (c(2 ' tc _ vo 3
Address: ~T -7 2-r"0 Or -F S. City/State/Zip: Kt C- kpi F-~ M 0, SSf~
CONTACT n
Applicant Signature: Vq II Date: q 2_
Email address: t o~nn r i Lt b (a -
O Retaining Wall <4 feet Driveway ❑ Other:
TYPE OF O Patio O Sport Court
WORK O Sidewalk O Fence
Description of work:
PLANNING Setbacks, hard surface coverage, shoreland zoning, bluff zo setbacks, etc.
Approved enied Date: J`~r Staff:
Revised Plans by contractor/owner.
Approved: Yes f No Date: Staff:
ENGINEERING Grading, drainage, utility easements, wetlands, erosion control, improvements in the Right-of-Way, etc.
Approved 1 Denied Date: Staff:
Notes:
Revised Plans
Approved: Yes 1 No Date: Staff:
COMMENTS
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call
4B hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
G:1Building Inspections\PERMIT APPLICATIONS\2011\2011 Pe it Applications
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The Twin Cities Paver of Choice - BBB
ESTIMATE By:~~ S~ 3 G 7 r~ - RICHFIELD
Date: I
(h) P 7745 2nd Avenue S.
Richfield, MN 55423
(c) Z~ L Ph: 612-866-8836 • Fax: 612-866-8078
B www.richfieldblacktop.com
(w) P
(fle) No Yes
` Replace as is ❑ ~ ❑ Ok to use Bobcat
Name: 0 Flares ❑ ❑ in yard. Customer
Address: Stumps/Roots ❑ L] repsonsible for any
Water shut off ❑ ❑ yard/landscaping
City: New Cover U ❑ repair.
Permit Yes / No Drainage Problem CI ❑ Sign
10 Remove Asphalt Drive (Extra charge if over 47) Heaving ❑ ❑
❑ Remove Concrete (Extra charge if over 4") C ss Street
Apron remova~ 2 cap--' 3 car Design on separate copy
-Cap Blocks (Does not incl. foundation work)
❑ Remove Gravel, Dirt or Sod
)EY Base, after compaction
❑ Your existing base and ours lc~
❑ Regrade for proper drainage Y 0 0 0 r
Hot Mix Asphalt compacted to r vA LA10"
❑ Addition to drive ~CX~ S n 2 ev
U Concrete, see concrete for L
Approximate Square feet Yr. Warranty
Options:
❑ Fabric Installation
❑ Permlock LF
Customer Initial
J
Estimated Cost. J `
Down
Balance 5
X
' Cus om roval oat
I have read and agree with the terms and conditions on the
reverse side.
SIGN AND RETURN WHITE COPY Property Line?
1 2 3 4 5 I 1~ Circle One
Licensed • Bonded • Insured ~J~~~ILL~111
Property lines to be verified
r by contractor/owner.
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RICHFIELD RICHFI
"The Twin Cities Paver of Choice" '
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Property ones to be verified
by contractor/owner.
7745 2nd Ave 5 • Richfield, MN 55423
Office: 612-866-8836 • Fax: 612-866-8078. www.richfieldblacktop.com • www.richfieldconcrete.com
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