616 Hackmore Dr - Zoning Permit
4+ .
For Office Use i
Ea n City of l all Permit it V
I
3830 Pilot Knob Road I 7 I
Eagan MN 55122 L Date Received_
Phone: (651) 675-5665
Fax; (651) 675-5694
Email: PlanningCopcityofeagan, corn
ZONING PERMIT APPLICATION
❑ Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
Y
Site Address:
Pro~ia
~ _ Itrfor~lrlatidrl / I /
Vw Owner Name' l!
y . _ P0
t , Name: 1 I~~ Phone:
Address: / City/State/Zip: ~kc~ N 1 4G
LIE-
\?rr1 r~~iC>!rlte~+Yt - - _
Applicant Signature: Date:
z Email address:
',vl ❑ Retaining Wall <4 feet b4Qriveway
❑ Other:
+ ❑ Patio ❑ Sport Court
'TY~Q ctt SNark
❑ Sidewalk ❑ Fence
t
Description of work.
" ~Plsnriirl~' Setbacks,haryl4t~"A41'a~hbrlandzonlctty b(wft`zonefsetba~ kS;i tiP
r w,
Approved / enled Date: Staff:
Notes: m to be verftd
by Contractor/otlr m
Revised Plans
Approved: Yes / No Date: Staff:
Engfneeirtng Gradih ~.dra
r~gr `ut~llty easemen3s, wetlatlids, era"st6m,GOntrai Utrpro ~r~ nt 0111 e RIgItt ~T={rVa , atc„
ip 11.
.
Approved / Denied Date: Staff: _
Notes:
Revised Plans
Approved: Yes / No Date: Staff:
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cell
48 hours before you intend to dig to receive locates of underground utilities, www.gopherstateonecall.orti
G:\Building Inspections\PERMITAPPLICATIONS\2011\2011 Permit Applications
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- The Twin Cities Paver of Choice
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BY :",v~~~
RICHFIELD
Date: z BLACKTOP
Name: ~<'ec)'
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G 7745 2nd Avenue S.
Address: GVQ t-lACk Vo6~e. ~ L Richfield, MN 55423
B Ph: 612-866-8836 - Fax: 612-866-8078
City: i AAJ Z. P www.richfeldblacktop.com
(h) No Yes ❑ Ok to use Bobcat
(C) rr' 3 n `f r-~ L Replace as is ❑ 0% in yard. Customer
Flares U .9 repsonsible for any
(w) Stumps/Roots J~4 U yard/landscaping repair.
Permit o Yes' No Water shut off ~w U
ji,eRemove Asphalt Drive (Extra charge if over 4") New Cover = ❑ Sign
U Remove Concrete (Extra charge if over 4") Drainage Problem ❑ i
U Apron removal 2 car 3 car ❑ Design on separate copy
. Cap Blocks ` 2-(Does not incl. foundation work)
Remove Gravel, Dirt or Sod
c'- Base, after compaction
U Your existing base and ours f
5, Regrade for proper drainage
Hot Mix Asphalt compacted to~
❑ Addition to drive
&-,Concrete, see concrete form
Ii,-t Approximate Square feet
W ~ Yr. Warranty
Yc~ Yr. Asphalt Protection Plan (see details on back)
Options:
U Fabric Installation SF $
U Permlock LF
Customer Initial
Estimated Cost:
Down C 4;
Balance
3 10/
xor
Customer Approval Dale
I have read and agree with the terms and conditions on the. reverse side.
SIGN AND RETURN WHITE COPY Property Line? y
1 2 3 4 5
Circle One
Licensed • Bonded • Insured
Z00t1 ZZT'Oil 0:' Z CTOZ/ZZ/90
City of Eatail
, o,,
3830 Pitot hob Road �:
Eagan M . 1 it___ t R€ceiv ___ ____.__._._
•Phare;(651)675-6685
Fax:($51)9754694
Entail:alatiftinstit4cityolaneanq om
ZONING PERMIT APPLICATION
oPieria dentisImprovementsi scaled site plan dra ring iti t h line, hires
and existing cndi .
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8 n•
TO$,
OwnName. • i
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�city/state/4,ip: � "�" '` ut Address , �''..moi� ,,-Z:2- ((K-
41101_4, w
Appticart S[g tt r :
b
::!;.:•:!:, ,
Q t# irarg £ r 4 •rit < t mother_
CI Sport
� � 0 Sidewalk 0Fence
i
D imofwork: .d.. '_a. .� �w�., .a: .�:.. .
a pprov.• Denis i of. • pp vain ®' ► 1``
, • Note :
Revised Diene
Approved: Yee 1 No Data of•Appvalt
aerr »a ��W e' '' . ger I � � �i ''� � A �i
Approved F Denied Date of Atsp'tnval: ft ....
Notes:
I
Revised Plans I
pprov ad: es i�io i is pf Ap it r t: .e
•
• r ,
s co ENTS r ds�. f •-.--,.,:,':.-.-':-.-(••:,,w.:`:'-:•:,;,,,-,,'F ,_\ 1
X31
nor
CALLBEFORE YOU DIG. CallGopher State One{r i at .+ - for7t �<tIE)E again uncle n ti. damage. till .
48 hours before you intend to dig to receive locates sf underground tttiti so• • � �r "_ . f
€#Ittir In pe i rsRMfl APPC.i aTIONS'01,1201
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i ni'cHr°i" >.rt, — The Twin Cities Paver of Choice - RI .;:>it.it-A::ia.
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ll
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No Yes E No Yes
J Phone — Repiaoe as is 0 a Water shut off i 3
j Flares `:1 •U New :t CI
Stumps/Roots J :,l j Drainage Probiem TJ '..i
--`-i Remove grad`Extra charge if ether 4"I n
J Spri�dsr h •l Separate copy ,
_I Remove Comete extra charge tf over 41 a
.,r L.y}'`-n rem v 1 _, '___.._ 2 3 ar. AJ çdc/
l e 4 ��.�.
,..t cap�Es Does not 4tiude foundatkon week)
..1 Rein vs Gravel,Dirt or Sod
J __._.,Base,after compaction
.Ynyar existing base and ours
J Rearm*for t drainage " 9„,,.C1r -
. kid tim to dnve _ _ _ ..._._.
JT ..o;';czetE. see ccncre'te b ti: r
i hs?`'.?ximate Square feet._.. 4 'C..1- t,.........
,,:: Y r Warranty
• .:;.�_Yr.Aspnat!Prcte:;tion Wan isee duels on back)
option.; Not tnciucleo jrDess checked and initialed)
117
J Fabric tnstailation SF $.. 111
Penoc LF S
r
C;istcxier initial I j
.''".:•:.ma:Gd Ccs.
//).'.'n,,
.,L. i t,^.1 . _ ,
:::,,,-;:fin ...__............. ` �,�.�G» ««..«a.........m. ,,.w......... ..�'!1
i 1.3:e rea::310 agree with me;errrvs and tic on the reverse We. r
SIGN AND RETURN ViNTTE COPY
Q Compri_ Ci S ._
774,.2rlo Avenue S•€it`d,MN 55423•Ph:612-868-8836•Fax.612-866-8078.wwx.riefleldbiacklop.con
Licensed • Bonded • insured •