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4049 Blackhawk Rd - Zoning Permit I For Office Use I City of Eap Permit#: 3830 Pilot Knob Road I / Eagan MN 55122 I Date Received7 - - - - - - - - - - - - - - - - - - Phone: (651) 675-5685 Fax: (651) 675-5694 Email: planning(a7cityofeagan.com A4&G", ZONING PERMIT APPLICATION Please identify improvements on a scaled site plan drawing that shows lot lines, structures and existing conditions. Property Site Address: a L ~_"{a }F Information Owner Name: Name: t < t ~ ~ o Y ,j-~,,,.~,.~ Phone: Address: 1:3 1 City/State/Zip: M` Contact r - a IV, Date:t ' Applicant Signature. ) -Z4 _ na Email address: t 11, 1"2,;- / ❑ Retaining Wall <4 feet ❑ Driveway % ❑ 1Other: Type of Work ; ❑ Patio 11 Sport Court U Y tL~/ cq v e X t S {or f r5 ❑ Sidewalk ON Fence t`Y~c c~a~ Description of work: -r~s_s~.~ _ L('d 5~, _ tt (z Planrtiing Setbacks, hard surface coverage, shoreland zoning, bluff zone/setback etc. Approved Denied Date: Staff: Notes: Property lines to be verified by contmctodmner. Revised Plans Approved: Yes / No Date: Staff: Engineering' Grading, drainage, utility easements, wetlands, erosion control, improvements in the Right-of-Way, etc`. Approved / Denied Date: Staff: Notes: Revised Plans Approved: Yes ! No Date: Staff: Comments CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org G:\Building lnspections\PERMIT APPLICATIONS\201 1 \2011 Permit Applications 1 8 r rumw i ra - vl~ 4L 31),o { ,9 "-Z 7 z ~ m I kA