4095 Camberwell Dr N - Zoning Permit
For Office Use
City of Eajan ; Permit
1 I
I
3830 Pilot Knob Road
Date :
Eagan MN 55122 L--- Received-- l
Phone: (661) 676-5685
Fax: (651) 675-5694
Email plannina@cityofeaaan.com
ZONING PERMIT APPLICATION
p Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
Property Site Address: t~ii l itttllic r~~ zt ( "u" N y0'" aA VtfIU
Information
..C. iJ t:c
Owner Name:
Name: S t:ciC. Phone: (5l 3 ~L ._.5 Y -
Address: 4 tj"y QG4m6erwett o l', I\.. City/State0p: r Av y7L
Contact
Applicant Signature: DI AZI 6j/ Date: 41-11- 3
Email address: "(-o( c - J v Ale (0;
❑ Retaining Wall <4 feet ❑ Driveway ❑ Other:
❑ Patio ❑ Sport Court
Type of Work p Sidewalk 0 Fence
Description of work: I;nl< J,
::1 'y Setbacks, hard surface coverage, shoreland zoning, bluff zo a/setb etc.
Planning
Approved nled Date: Staff.
Notes:
Property ones to be verified l*WJQA eq a3 s>oeu~ ~t~r~d
by contraotor/owner.
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.oogherstateonecall.orct
G:Suilding InspectionsWERMIT APPLICATIONS12011\2011 Permit Applications
Hudson Page # Township
Hudson Grid # Range
525 E. Yllaume Ave. / South St. Paul, Minnestoa 55075 Corner Lot El Section/Quarter-
I
(651) 451-2221 - Fax (651) 451-6939
Varrte V ` C /+r Date {i 1ZP 20
i
• 1 f
Spouse _ i Job No.
Wdress Salesperson f~
l
:ity County 2 State • Zip ~ '1 P. O.
Employer Home Phone( ) Picture No.
Job Site Address Work Phone ( ) Terns: 10% Down
SO% Start
Work Phone (Spouse) ( )
Balance To Installer on
Completion
E-mail: Call Phone:
Customer Initials
QUANTITY DESCRIPTION.
•
i
17e- 141 71
7> Pike
Down Payrnent: Check # Amt. f Date " < f/ r
DP PS BC O ALL ❑
7onSrl CHARGE of 1s/s% per month (18% Annually) will be applied due balances. MATERIAL AND INSTALLATION
The purchaser shall be responsible for any and all collection and legal costs
incurred by Midwest Fence in the event of this bill becoming past due. TAX ter...
Midwest' Fence reserves the right to lien the improved property if payment THIS ESTIMATE VALID FOR SO
DAYS FROM ABOVE MATE
in full as agreed to in this contract is not received. TOTA
Owner responsible for establishing correct Property and fence linen. Arty Permits required shall be the sale responsibiliI of the owner. Owner responsible for removal of
obstructions of every nature which will interfere with the installation of the fence. This contract assumes normal ground conditions. Should rocky or excessive hard digging be
encountered, owner agrees to pay additional costa of such work. Midwest Fence 6 Mfg. Co. shall furnish only the material and labor specified in this contract. Any changes made
from the above specifications will be billed at Midwest's current retail prices.
Tans order will become Minding only upon Midwee Fence Manager's approval. f
Custortm a eirc V r r~ ee
f, v
Form 2 - Rev. 2-05 Manager al serson's Signature Date
Ciopytight* 2005 www.midwestfence.com