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4641 Kingsbury Dr - Zoning Permits & Plans 04/03/2015 23:04 I� N0.334 #001 �'._:�' ---------_..._...____-,.. � For Offlce Use � ��� �� �U �� � Pertnit#: 4 /J� �� 1 � � � ` � I 3830 Pllot Knob Road � i Eagan MN 55122 �; �. . I Pafe Received: � L----_.�.�..�...�-..��....�.�.�d Phone:{651)67b-6686 Fax;{651)675-5694 Emall: plannin�@ci�ofoaqan.com ZONING PERMIT APPLIC,ATION ❑ Please identify improvements on a scaled site plan drawing that shows lot lines,structures and existing condltlons. ,. , '`....`.'.. Site Address: `'\ f� • • ". ....:........... .. ........ / ;,....:.. , ,.... ......: ... . Prope�fy:. � :.. .. .. �-....._ 1�1fti1`ili�ti�ri. ;. ..:.; q`�}n /" : Owner Name: �\(J!1'' �'l..�j � � � G , ,..,:..:...�.. ... . ._.�,_. .. ;-� ( � ,. \ M�J-' r C',�� 'r.:•''/ Name: �'���. 1l�.l � � �� ��+ )_ PhOn6: �����•w e.,� -=�' -i���.���'� .. � .f � _.... .... :.. ... : ._, .. , ,,...: ,. ,: Add ress: 1 �..) • y tate/ p \�C.� ��� aI L . ,r1 L�; �.,, � �, �:.;c,"�/ _:...,...:... f : �1 �� ,� Cit IS Zi C� f �1�1/"�,: ; � � '' :J 1 1:011��t.:..:. ._._,_._ ._ ....... ��.. ....� , . . - -- — . ......:.: � t t :. . . ,.. lican Signa ure: Date: �- ..,_,� •.. � ..:... a ... . .. , � �, � � _ ,.. .__: � . .__ .� _. _ . , . ; �y _t , f i Emailaddress: �I<:)�.�'1 c:;�? ����`��EI-c� ���iLr'����i�J�(�iG�'�{ ......� ,_..... . . .:,.:_.. ``.:`"� ❑Ketaining wau<a teet �„f�(;�riveway , ... .......:.::... O OthE.r � ❑Patio �SpoR Court 'Fypo of.WO�k ❑Sidewalk D 1=ence � .,,,.... . ::,.:.:. - . - Description of work: � ;,, : .. . — ,... .. . ; Planning. Setbacks,;hard��surface coyerage„s�oFgland zoning',bluff:zonelset6�d. �� ,ete .,. .,.,. ....... . .. Approv enied Oate: � � �� Staff: 9: Propert�i lines to be verifled . .. . by contractor/owner. Revlsed Plans ��W ��+y�� ' Approved: Yes I No pate: Staff: I ;::.:�. 'i':::.. ,. , :.:,:.:.... .�........ ............:..:•..:..........,...: :,,,::::: . ...... .. ... . .:..:::::::..:.. .. ::. ...:. ..:-:::...,:: : Englneer�l�g; GradEne,dra�ndge�uUllty��setnenES;weflHnds;eitision ooptrol,�mproxeiiient$:in�h��tight=afway,etc.. __ . . . _...... ........ .... .... .� . • ,:N,.:.._::..:: Approved/Denied Date: Staf� � Notes: � � Revised Plans - """"""""�`"".,� Approved: Yes/No DaEe: Staff: � r . . � C�fll'IT'1'ef1LS` :... . ,. ;- . .. .. . . : ,. :. _ . �i _. . _. . ..w.::: � .....:...�......�;. ,., ,.._. ____._ ,�. .. . — _... ,._:_.._.,,.,,r.;,�,. CALL BEFORE YOU DIG. C211 Gopher State One Call at(851)454-0002 for protection against underground utility damagc��Call a8 hou�s before you intend to dig to receive locates of underground utilifies. www.po�he�stateonecall.orp G:16uilding InapeclionslPERMITAPPLICATIONS201112011 PermltApplicatior�s 04/08/2015 23:05 N0.334 �002 - The Twin Cities Paver of Choice - , � , , . �STIMATE By: �'I�-:� # � . i .�1 tl y�� ��! � � ��8 Date; �'� — � � � v T i JII11I q��l,l��l�ili;;; � �� � � Name: � -� �'` � � � , ' , .. il�' T r� �i� Address: L � U 1..:_. _. l� �' L u ,:,� I �8� � �--�= � � y B _o �� ������ � � City: �u'��' /'� )� ,� Zip:55 �� _ •- • • • P l:l� o Phone /c���VlT��y �( �,�_ ---� No Yes No Yes 0 Phone Replace as is � ❑ Water shut off � ❑ p __ � Flares 0 F`Y New Cover �'' ❑ StumpslRoots � 0 Drainage P�oblem Y� ❑ ermit es No � 0 Desig on:�eparate capy : ,.; emove Asphalt(Extra charge if over 4") O Sprinkl r he:ads? ,::. .._.. 0 Remove Concrete(�xtra charge if over 4") , ... ,. .. O Apron removal 1 car 2 car 3 car - � ' ' '``` ,..,.... .. . ... ........_ F�--Eap Blocks � (Does not include foundatron work) Q�gmNve Gravel, Di�t or Sod ,� f� � � Cfi�Base,after compaction - . �,� , � ,. , 0 Your existing base and ours �•-'�� �-Regrade for proper drainage , ' , ��Hot Mix Asphalt compacted to�� „� . � �ddition to drive ,� �1 1°, �/'.S '' � O Concrete,see conc►�ete form ��� �� � � � � �(lYApproximate Square feet —or'���� I .I�^ � ���Yr.Warranty ( ��a� � I i p—�_Yr.Asphalt Protection Plan (see details on back) `.�� Options: (Not included unless checked and initialedj � . f� ��� � ! ( 0 Fabric Installation SF $ � �+ . � � � � � O Permaloc L jC� ( � Customer Initial � � � . � � i � Estimated CosL• � c� .� :S ' � Down ' -- � B a n � � � �� �� .. .. � � X , �/W�,' � i --� ��;�� . . ' 'i G._ t 1? fJ Customer 'proval Date • -�--�•--"'�"'7 I have read and agree with the terms and conditions on the reverse side. SIGN AND RETURN WNITE COPY Property Line? O Compd � O Subpd 7745 2nd Avenue S•Richfield, MN 55423�Pf�: 612-866-8836•Fa�c: 612-�666-8078�www.richfieldblacktop.com Licensed • Bonded • Insured �