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
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