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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 ~ iQ t cK F J E c.-i~ 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 lop I ~~I l L'd 8L08999Z69 }}osoaOIN d80:£0 Z6 07 deS v 7C/ 6 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. Z-d 8L08998Z69 }JosoaoiW d80:Z0 Z6 OZ daS /c/;) 7a/ RICHFIELD RICHFI "The Twin Cities Paver of Choice" ' c,1 p (D y EAVAc" SSI'2Z 1 ~ z` ~JZ' y i I Wl- 17 A5 'IS ,/1,i0 TU ~c isl ~p 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 c C-d 9L09998Z69 40soaoiW d80:E0 Z6 OZ deS