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. )
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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
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