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4677 Kingsbury Dr - Zoning Permits & Plans 05/21/2015 22:12 N0.396 �001 ----------------� � For OTiice Use i C�� O��ap a� j Permit#: /��� ` � � � v ( I 3830 Pilot K�Ob R061d 1 � Eagan MN 66122 1 Da1e Recalvetl: , , ,„_,_ L______�___�^����.� Phone:(657)875-5685 Fax:(661)676�694 Email:planninnl�citvofoas�an.�om ZONING PERMIT APPLICATION ❑ Please identify irnprovements on a scaled slte pian drawing that shows lot lines,structures and existing conditions. / �. , :;.,.r.•'`P�'b��.l'���`•�',�� Site Address: �Itl�� �/1. ,'7�1, � ��G _ , ., ..,... �I�fo.rrtiatlon;::'`"' L , . • ,.;;..�,,,:,�,.,�.. .,.:..,.. . . ; ,°. ' Owner Name: �Cl�_ y lr1, '� ,,.,,,, , - —„ .... . .�.�.�._ ___.. , w..._..,..�.._. - �:,..,.....,....,..,,, a , �'•� t i i � .,..✓ ;(,r"�:y � Name: T�.�t... �l 1. �.� �1 �.. `��f �.. ,�.,`�� Phona: �i/�:��� ��-:��•-��,: I , . , .�., 1 1 �� � / i , �"`'.,_ L.��� � / ' . . ,,.. ... .• ....... .....::..:.�.,,. �.,,. ...;,,:..,. , ...... ••• ' .,.,.�,;: ��;,,';:':;,',`:•,,; ':•:,.;•'� Address. f ,� �'L CitylState/Zip: j'�.tiC.,.�l� ...,,7� l � G� � � . 4 , � : i'�-t.� ,__�,'1 t� .._ . ;..� ..;1C011�c1Ct�� ;�� ��, _ ,..�. . 7 ...� "�:,,,. ,���� _ ' �/ , ,,, , � , ApplicantSignatu2: � �� Date:�� , �� Email address: ��p,, ✓t•-t G;,,� ��..��[.�t���l�': ��i.C..�"" �1���.`���('..��'�'.� � ....... .. . .. �..�..,: .. .,.. ._._ _ ..... �n uow�.�w.�� � . ❑Retaining Wall<4 feet �Driveway p Other: ,,.,..;:::r:,. ':';:::::�� �'�;' ❑Patio �Sport Court ._'— , ,.,:.:•:.:�. � ��. . ��TYpe.of�.VYo�k.• ❑Sidewa�k � ❑Fe � . ...:.:....:...:.�.,,. .. ......;. ,.. .. , ..,,.:.:::.:;., . . ;,,;:�.:...... . . .:..:�.: ' �•� • • bescription nf wprk; �.. � t .. ............ ....,, ._...,. _ _'. _. ".....,..,.,..u�,�.... , , . ,. '� ,..:•.. .. .. .•,,,. ....:.,. �:::•,,, .. ......,....:•.:..... ,p , . :. .,,,'.• •:.Se .. ..�:;....,,...�,,,,�..:. .::...:....:.:. ., ., . .:..,:�.:::..:.��;;;.,�;;; ....:::.....:.. ,..: .�. .. ..,.,, .,,,,,;,;;,;,, .� ,...I�nninq�::,:;, �mac��ha,rd�urfi�ce;;ccvera�e;�sN�or.e;fand�����it�g,.plu`ff.zone�seibsolts;�gtc��:�.�;;�:� ... ".� c _ � enied oate: �.���� staff: � '��. � � � �� � � , . .,,,._. . ,.... Notes: ' �� �.��� i�t�.��- �f� ��L�����+•� �%4�. �`�� ���;���, . � �' l�� � s �'s .. Revised Plans ��� � il Approved: Yes I No Date: Staff: _ — '_' , ' , . .. .,.:::.:•. ... .;; .•,. ::•::•:;:::�:.......:.:. . . ....,, .�., , . .,..,. •::::.��::.:..:. ,•-::•:::...:,.. .,:i::,:::::. ::r::,s� ��:r:;+:;�;;:�:•.,;.;.:;�:...... .,, �...,,M..,.....—�. • �:::::�.�� ............. . :.�....:.. .........;,., '.��.�:..... ....., ...,.. . :.: . ......... . ••.:.::.:,:,. ;•.;:.,.,;:.•. ..:......... . . • �: En,g��ee.�ing;��� �,�Crading;,,idrelnage;:;ui�hty,;e�s�r�har�e;•�uetfands,�erosPon oQn.trol;;t�iproyeitient's�Ili,th�.RigMt�iofi�'Way,;:etc.,, . ,�::, :... .�:.. . ..� .. .;:.::::, .. � . ,......... , ,.. :�. ...., .„ r iM4�YM1 ' Approved/Denied Date: Staff: — . _........ ....._ .. ' Notes: , Revlsed Plans `" Approved: Yes/No Date: Staff: ..,..,.„ .._.,, .„..,",...,..._,�_.,,... �' ,._. . , ,,. ... ; •, .omrnants::'::: :�.. ......� ::�..,; ... . . � �.. . � , . ... ., . .,.... :. :: . : .. . ...... :.:..�...:,� ' � .;:•,::��� � , ���:•����.., , ..•::�::,.. ,,..,..,• �,,,.,,..�. ... .. :::,:.... ;.. .�....:...:.::.. .�.. ,..._,..... � ,.. ,. ...�:.:.�.. � , ::; ;,�::,;:.:�, :.�:,:,• :..::::�,;,,, ,;,;,,,,; .�,�.,,,n....__� � ! CALL BEFORE YOU DIG. Call Gopher State One Call at(651)dS4-0002 for protection against underground utility damage, Call 4S h�lll'R bP.ff11'P.VAII 111�P.nl�tn�1in tn�arai�ro In�afpe nf��n�lomm��nr�nfili4ioc unanu nnnherolofn�nrnnll NMM G:\Building In;,pociions�PERMIT AI'I'UCATIONu12�111209 9 Pertnit Appllcaliun� 05/21/2015 22:12 N0.396 #062 ������ . ��� _ Tho Tu�in �'itioe D�ver nf r`hniro _ .._ . .. ... _. .. ..,. . . ... _. _..-•-- � : • � • � � • � ESTIMATE By: .c�r K #(�5,�-� l y- �1�9 f . Date: .,� "` ��� I U , .Z�. � Name: Q � P 0 `� � __J �i 5 a ✓1 T / 1s' '!` Address: �' /� L ---�--�u B p Q;�,' BB�w City: G'd Zip:55�a? P U - . . C�Phone _, S,I"�3 �—� Z � �� � w No Yes No Yes ❑Phone _ Replace a5 is ❑ � Water ShU1 on � � p Flares tJ ' New Cover l4'' J Stumps/Roots Cl � Drainage Probiem I�i/�C.1 UYPe�mit �No � — 0 Design on separate copy �emove Asphalt(Extra charge if over 4") u Sprinkler heads? O Remove Concrete(Extra cha�ge if over 4") ❑ Apron removal 1 car 2 car 3 car_ C4�ap Blocks�(Does not include foundation work} �_ `� �� O Re�move Gravel, Di�t o�Sod �-���Base,after compaction s ' U Your e�usting base and ours t�,rRe rade for proper drainage S �'�Hot Mix Asphalt compacted to�%, `�j O Addition to drive o Concrete,see concrete form q� 5�1� CB�Approximate Square fee �� � � �� O—.,�Yr.warrany �..�/'�p �•..�Yr.Asphalt Protection Plan(see details on back) � Options: (Not included unless checked and initialed) „ I � , �,y � LI Fabric Inslatlation SF $ � ❑ Permaloc LF $ Was�-}����'w��� � . Customer Initi�l � � �O ��.5 ! � �'�o►} �.�k1� � EsGmated Cost: .�.,�.._„ 0 � � g 3 8� Down _....�.� .1., . Balance � l� '����.'�� X �� 5' z�..1� % Custo Date {�� � I hav read and agree with the terms and cnnditions�n the reverse side. P�f��l 11�IR nPT111��1��1����r�.nmi �rn�n►h��inn7 �� V�VI\f'U\V IW I VIV\tfll/l�.vV/' 1 1 �vpv11� rnlV• , ' �... ... ... ... I � V Compd _�, , .,.,,_ U Subpd 7745 2nd Avenue S�Richfield,MN 55423•Ph:612-866-8836�Fax:612-866-8078•www.richfieldblacktop.com Licensed • Bonded-• Insured