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4236 Sandstone Dr. Chicken Permit r_ For Office Use - I Permit I Cty of Eajan ' I 3830 Pilot Knob Road I I Eagan MN 55122 1 Fee: $50.00 (collected City Clerk) Phone: (651) 675.5000 j Date Received: J / j L-------- CHICKEN PERMIT APPLICATION - Et" Please Identify coop and run Information on a scaled site plan drawing that shows lot tin structures and existing conditions. Site Address Site Address for chickens: a.3{, S-AmDS'Tomc Dit EA(.AN N S-SIa,1 Name: A P+(SC, " Phone: R5-,-4-g6q(o(o$ Applicant Applicant Signature: Date: 3 Ins LA., ~ Email address: s4 3 rA j. e orvj Owner Name: AD A M R P01 Address: 4~3to Sf~NDSTaNa✓ DR: City/State/Zip: Gok6M A J 55-ta- Property and Property Owner Signature Owner (if different than applicant): Date: Information The above referenced property's Homeowners' Association rules, if any, do not prohibit the keeping o chickens on the property: (please initial) Yes No Not Applicable Number of chickens: Dimension of chicken coop: a h o~ i n Dimensions of chicken run: o? R X 1 Description of exterior t M - ' Coop/Run materials for the coop and run: Coo = Pt labA-~ c- t r • r = I, Information i Will a fence be added in addition to the coop and run? Yes No X ' ! O - ` s Description of fence, including e location, size and materials: Page 1' of 2 G:11I nning\CHICKENS I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with t e ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application fora it. 1 acknowledge that structures will be constructed in accordance with the p roved plans. x HDlk'M i x Applicant's Printed Name A licant's Signature Planning roved Denied Review Date: z z ' Staff: ! l= r , S ~t ~ ~C t Notes: ~~~•W~ C~dvf r~.ca fe Zv," li ~nec1X ?~z iKgfp C2~ufc' Revised Plans Approved: Yes / No Review Date: Staff: Animal Control Approved / Denied Inspection Date: Staff: Notes: After a permit application is approved and the chicken coop and run are constructed, an Animal Control Office will inspect the space for compliance. Once the structures are approved, your chicken permit may be granted. II L Page 2 of 2 GA minglCHICKENS ' City of Eagan Cash Receipt Receipt Date 3/19/2013 Receipt Number 187763 ADAM RAY 0401.4116 50.00 CHICKEN PERMIT Total Receipt Amount 50.00 104037 15:43:39