4671 Kingsbury Dr - Zoning Permit & Plans ------------------
� For Office Use �
��4 Ul L� �� I Permit#: �. �`t°`� j
� � REC��V I I
3830 Pilot Knob Road ED
Eagan MN 55122 � Date Received: �
Phone:(651)675-5685 AUG 19 ,n14 ------------------
Fax:(651)675-5694
Email:pianninq@citvofeaqan.com
ZONING PERMIT APPLICATION
❑ Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
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�\��� ❑ Retaining Wall<4 feet ❑ Driveway ❑Other:
���� .• ❑ Patio ❑Sport Court
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��\�� ��, ❑Sidewalk �ence
��� �E � ' Description of work: � �n r V�(;� ,CG
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Approved.f�Denied Date: ��.L:� / �-( Staff: ��-vv�,� ,�'��
Notes: property Anes to be verifled
by contractodowner.
Revised Plans
Approved: Yes/No Date: Staff:
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Approved/Denied Date: Staff:
Notes:
Revised Plans
Approved: Yes/No Date: Staff:
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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.popherstateonecall.orq
G:\Building Inspections\PERMIT APPLICATIONS
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ESTIMATE / ORDER Gopher State (1) Call ID $k464 Ticket ,#
Nearest InTersecting STreet��``^���'� 1�"'
Hudson Page $� Township
Hudson Grid $� Range
525 E.Villaume Ave./South St. Paul, Minnesota 55075 Corner Lot � Section/Quarter
(651)451-2222-Fax(651)451-6939
Name ���`'� w �L��' � Date � 3 20!L
Spouse Job No.
Address `��� � �-I l�Gsbv�"� �� Salesperson�'�Cv� ��� �
City __ ��G"'p�'� CounTy StaTe v.l�,e� Zip �5�22 f�Lld- �a� � r `'c� �ZT Z
Employer Home Phone� ) Picture No.
Job Site Address Work Phone� ) Terms: 10% Down
5 ,o tart Up
Work Phone (Spouse)� � Balance To Instalier on
E-mail: Cell Phone:
�1�Z — ZZD r �jl�,�-� Completion
Customer Initials
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Proper#y lines to be veriiied �
QUANTITV DESCR IPTION ;
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Down Payment: Check # Amt. Date D-r�` ��� ' ?j S �°
Credit Card# Expiration Date w upb_ ZSD �O
DP� PS� BC� ALL�
A SERVICE CHARGE of 1�/z% per month (18% Annually) will be applied
on all past 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. THIS ESTIMATE VALID FOR 30 TAX �N���
Midwest Fence reserves ihe right to lien the improved property if payment DAYS PROM ABOVE DATE
in full as agreed to in this contract is not received. TOTAL o�
Ownee responsible for establishing correct property and fence lines.Any Permits required shall be the sole responsibility of the owner.Owner responsible for removal of
obstructions of every nature which will interfere with the i�stallation of the fence.This contrad assumes normol ground conditions.Should rocky or excessive hard digging be
encountered,owner agrees to pay additional tos9s of such work.Midwest Fence 8 Mfg.Co.shall furnish only the material and labor specified in this contract.Any changes made
from the above specifica4io�s will be billed at Midwest's current retail prices.
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For Office Use �
Cityof Ea �a Permit# I LIC2�� "'/
3830 Pilot Knob Road
Eagan MN 55122 Date Received: qi SI t 7
Phone: (651)675-5685 `
Fax: (651)675-5694 '�
Email:planninqAcityofeagan.com
2017 ZONING PERMIT APPLICATION
p Please identify improvements on a scaled site plan drawing that shows lot lines, structures and
existing conditions.
Property Site Address: �( /Pt_ S,,I/y' __ (-.
Information ,
Owner Name: AJ bi. ./7 e�
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' .. Name: 5'4...01---F— 5MS GovLCjrvzft®v1 LLC Phone: (osl-- 75S-^65/Y._..?
Address: City/State/Zip:
Contact
F Applicant Signature: Date: q-- ...- /9
Email address: 5A4cGovL571,-44--111:crt0 L' i-. / C(''A - -
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17Retaining Wall<4 feet ❑ Driveway ❑ Other:
❑ Patio 12 Sport Court
l Type of Work ❑ Sidewalk 0 Fence
Description of work: �-I'e^.I v,i^ .l 1..)c,IL w t-}\.\ --bre-,i h
Planning Setbacks, hard surface coverage, shoreland zoning, bluff zone/setbacks,etc.
prove / Denied Date: c� Staff: a ��
Notes: / /
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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 I 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.qopherstateonecall.orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
G:\Building Inspections\PERMIT APPLICATIONS
Certific .te for:
Centex Homes , - 4
,_, . c. .. . Alltilt 467/ Ki126haley ' il---•
- DELMAR H.- SCHWANZ • •
• LAND SURVEYOR .
Rayittsratl under Laws of The Stalt'of Minnesota • .
•
- 2978- 145TH STREET W.-8OX M ROSEMOUNT,MINNESOTA 65068 . PHONE 612 423-1768
• - - • SURVEYOR'S CERTIFICATE -
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et1 : Itut31:ot 9, 1979 -
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MINNESOTA REGISTRATION NO.8625 �+'
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