3239 Random Rd - Zoning Permit & Plans 08/21/2013 19:57 N0.434 #001
For For Office Usa
City of I Permit W
I I
3830 Pilot Knob Road
Eagan MN 56122 I Date Received:
L-------------
Phone: (651) 6765686
Fax: (651) 6765684
Email: olannino0citvofeaclan.com
ZONING PERMIT APPLICATION
❑ Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
. Site Address: i~. l C M1 f r
' 1
Owner Name: r' a. -z ~.y
Name; Phone:
(i City/State/Zip: 1 t Cr ~l\ c ` ~j
Address:
:
Applicant Signature: Dater
Email address:
ldtG\
ce'D
0 Retaining Wall <4 feet riveway ❑ Other:
13 Patio ❑ Sport Court
Type Qf WOrk p Sidewalk 1 ❑ Fen
Description of work:
Pll~..nin Se>',~acks Il~td sti►fOpp: aavere e, shoreland:zanfn ~►luff elsefbacks, etc
g ,
Approved / pled Date: _ Staff:
Notes: - b~ (Jltit 0~ ~o? 11 >~O vv . 277
4i4 - Dt -W ZJ &51-6 75' -~i5 b
Rev sed Plans
6L- k-kki
Approved: Yes / No Date: staff:
71
^M .
Engitlelering; Grading drs inage, uelity+ easements, va~atlar~ds erosiz~n control Irxlprovernents rn the Right of .Aria etc. .
Approved / Denied Date: Staff:
Notes:
Revised Plans
Approved: Yes / No Date: Staff:
COMM~Ms
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454.0002 for protection against underground utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.noi3herstateonecall.org 4
GABuilding InspecUonsTERMIT APPLICATION&P-D1 W011 Permit AppllcaUons,
Property Imes to be verUled
by contractodowner.
08/21/2013 19:57 N0. 434 #002 11 a~r
? yam` - i ne 1W111 LfffleS rdVVf UI 141JUlUC - l 7 T,
899. pgj~E BBB.
nEiBEL QY 1~ Y y /r DYED
ESTIMATE By: 79YC U ■/~71p)J
Date: •
Name: to ~ P •
Z5
~ 7745 2nd Avenue S.
Address: .3 7 ~✓~'"t L Richfield, MN 55423
c B Ph: 612-866-8836 - Fax. 612-866-8078
City: 14 -a p www,nchfeldblacktop.com
(h) No Yes ❑ Ok to use Bobcat
(c) Replace as is ❑ in yard. Customer
Flares ❑ 41 repsonsible for any
(w) Stumps/Roots ❑ yardnandscaping repair. i
Permit 'yer"_ / No Water shut off ~rl U
remove Asphalt Drive (Extra charge if over 4") ~rN New Cover IV u Sign
Remove Concrete (Extra charge if over 4") 1 o Drainage Problem W U
*i . ll~ Apron removal 2 car,)C 3 car ❑ Design on separate copy
❑ Cap Blocks (Does not incl. foundation work)
❑ Remove Gravel, Dirt or Sod
Base, after compaction
❑ Your existing base and ours
JX Regrade for pr°oper drainage
th Hot Mix Asphalt compacted to
❑ Addition to drive
O Concrete, see concrete form ~y
Approximate Square feet `
Yr. Warranty
Yr Asphalt Protection Plan (see details on back)
Optlons:
❑ Fabric Installation SF $
❑ Permlock L F _ C7 ~
1
Customer Initial
darwy 3
Estimated Cost: o~ / _
Down G
satance T_ p•. i tt R' ?--.251 j
Property lines to be verified
_C YAAM-s,,&_A zn by contractor/owner.
Customer Approval Date l ` .-y=( j~~---
I have read and agree with the terms and conditions on the reverse side."
SIGN AND RETURN WHITE COPY Property Line?
1 2 3 4 5
Circle One
;Licensed - Bonded - Insured