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4156 Countryview Dr - Zoning Permits & Plans � � ForOffice Use—^---��--I �{ n � � I C� �� O�iJ�o�J.t � Perm;t#: �� I b � � 3830 Pilo�Knob Roa�d � I Eagan MN 5b122 I Dafe ReCe�ved: � Phone:'(661)675-6685 �-----=— � t ---------� Fax:(651)675�6694 '�� i� .�.....s . �.�J Email: Isn�in cit ofea an.com ; ��1�j � � �'��t IJ � � �� ZONING PERMIT APPLICATION p Please identify improvements on a scaled site plan drawing that shows lot lines, structures and existing conditions, ��.;.:�.:.:.::..::::...:. � , .:.....:..:...::.....: .. ' S . , .1�;P'R•bPE,�''.,�'Y...' Site Add�ess: �1� �� l.�I^ y�L.uJ � '�'INFCfRMATION � � �• r Owner Name: I(��,�' � �. CU!��!'"G��:� Name: �'1�'fi �J �C I G�� Phone: 5�" L-��y� �� ! �11 � � � '1''�'�'y:';;:�.ti:'�;,':..��::..,:,,:,� Address: ��17 �� City/Sta#elZip: (��!'�E.tJ ::G'ONTA�CT:�;',;;: � /- '�,,.; � , .,. �'.•,•.�,°,..,.,'s'",..,.,'•....'• ' ' IicaniSi nature: e�3✓/� l�/� � '<' :�:�,�� MP� 9 Date: ,. � . :i�,,.�;. ,. .. .,, '�� . '�. Email address: �j e.�, s �' ` � ' �Retaining Wall<4 feet �'Driveway ❑plher. � . ;� ❑Pa' tio . ❑S o . TYP'E� � rt court , .dF P '� �� ....,: .. . , ., '�`W,OI�C;,�'"°'s..•: ❑Sidewalk ❑Fence � ,.,. ,.,, „ ,. ••. ., .,: .. ,,. ' . '•:��.'-. .: ��.�. Descriptionofwork r•; • ,.P�:. ,.�, L��'NNI` N� G: A, ��. ':SGtb' .. . •,.. ,.�.:,.,,.;;,, ; �: :..::,.•,.....,..,,�,. . ..,...., ,� ::, . , � ::,..�..::�:��. ;;,.�.,,. ...:::: ,... ackS�•ti'��d.'sui��'ee cove�a"ti'•;:,; ..... . ..::.::.:..:•.:: .,,�.:;.:. .... ,;,..-•..:..;,.., g�....sh reland;•zon►�� .b,luffzor,ae��` ''6�" :;e:.� , ,..: ...,.... ,.,,,,..,,.,...,,... ., c;' .. ::..„. :..,...,.. gs .. ........ •::.,.. :....., :;.,.....;., .;,�. . . �;�.:,........ .....� ... . . . :.., . , ::�:•:,..• :�` t •,.�.'':`.. ...... A prove enied Date: 2 �� g�{� � Revised Plans � • Approved: � Yes/No Date: Staff: :...... ...............:........ . ,. . .. .... ...........: ..�... ,.•,.,..r_;;,;.,r , ..,... . .. ,... �t.s.......... :.:... . .... ..... . .. ... .. ... ..: ....:.� , . .. .... .. ;�:,<,.:. ....... ,;�EN,G�NEERI,N , �,'��,G,r,atling;;�rainage,•ut11' ':;Ea'se'r�eh'ts,�;werlands`''•e'r'osion'coiitr.'o1'�"im�r.ove''"` ,.... .. ........ . .. .....�Y , . .,. r��nts,�in;'t�ie;'i�i�fit�o�';NVay;'e4c:•�,;•�;. P , Approved/Denletl Date: Staff: Notes: Revised Plans i Approved' Yes/No Date: Staff: .., , ..::. �: . .. .. ..:�•; ;•. :••,�.:;..,.... ;, . . . :COMMENTS;: � '. . ,.. ; . ,., . , . , . . .. CA�L BEFORE YOU DIG. Call Gophor State One Gall at(661)454.0002 for protection against underground utillty damage. Call 46 hours before you intend to dig to recaive locates of underground utilities. www.aoeherstateonecall.om G:�Building InspectlonslPERMiTAPPLICATI0NS1201112017 Permi[Appiicetions i I ; � ProPosa� � �� (,�� °° ,� A.C.'r. t-��ti 547 West County Road E � '��'' Shoreview MN 55126 Asphalt�r Concrete Techn,ologies � Pj�one 651-484-1696. fag 6 1-48 - .Asphalt� Specialties Co. • S 4 8063 www.asphaltmz�,COm � Servin8 the Twin Ciaies Metro.�4rea since 1979 � . Licensed•Bonded• Insured Name: ' � �5��-- � C Email: Date: C2 Y ( s'�� Street:_ � D u 6i`I ri! V j,{)c� � � —" City,Zip: . �, J- Ce l l P hone: �S Z��I S�i�� Home Phone: �stimator: Date Sold: E�ccavation � Base ❑ OK TO USE BOBCAT OR TRUCK IN YARD-CUSTOMER IS �Asphalt sqft RESPONSIBLE FORANYYARD DAMAGEAND RES70RATtON ❑ Mill p Yes ❑ No s C�'Stake and string perimeter ❑Repiace as is � � � O Locate sprinkier heads ❑Drawing on separate shaet �� ❑ Replace water shut off cover in dtiveway Cost: $_� , . D Sawcut O Tree stumps/Tree roots � � � � � � ' ' ' ' ,�-Excavate and haul�way existing asphalt ' ' ' • � • • • • • � • • . O Excavate and haul away existing concrete • • . . . . . ❑ Excavate apron,as'phalt/concrete, Replace with � � C�Rep�ir major block idamage, if necessary additional charge . . . � � ' ' ' ^ , initjal • . . , . . . . , . . �Instail recycled crush rock ase as needed, for a finished . . . . . . . , . . , , , . �ickness of 4-6 inches, including existing base. et grade and compact for proper drainage . D Instal)yard sign � . . . I. . . . ` . . _ . , . � Asphalt - � • _ . � � . . . . . . 0 TouCh up driveway if needed prior to asphalt installation ' ' • • • • • • • • • • . �ave MN Dof APPROVED� r''j r,� �asphalt hot mix at • . . �. . , . . . . , , �inches compacted to �_inches. Hand tarnp edges. � � ❑ Customer to backfill ior O A.C.T. $ ; �-� ' ' ' � � � � • • � j&3�Nar�anty for /G _years,against settlement, edge breakoff �• • • • • • . � . . . and break up(instruct/ons on reverse side). , . . . , ; Concrete� . . . . . . . . . . . . . ❑Apron O Sidewalk , , , I. _ , . . . . _ . ❑ Steps ❑ Patio 0 Driveway ❑Stoop ❑ Curb ❑Other ' ' ' I' " ' ' ' ' ' ' ' ' � ❑ Garage Floor p Jackhammer/Bobcat ❑ Doo�H�ight • • - • • • • • • • • . . . ❑ Concrete sqft � O Review footings, additional footing not included in price ❑ Install rebar 3 ft on center Cost: ' • • • • • • • • • • • � $ Intitial �4500 psi concrete with fiber mesh, Color additional . . . I. . . . . . . . , � Finish: ❑ Broom O Smooth O Stamp , �'�` 7 Hand Tool joints�Sawcut O Other � � � � � � ' ' ' ' ' ' ' �Appty curing sealer ' (,�� U • � • • • • • � • • - - • � • • � Customer to backfiU or❑A.C.T.$ ��;"\ . . . . , , _ , , , , , . � Warranty for_years (insttucfions on teverse s� e) COMMITTED TO EXCELLENCE Ve Propose hereby to fi�misq materials 8nd labor, omptete with abeva spec�ficatian,for d,e aum of Price$ �LUS ANY REQUIRED PERNIIT FEES ��,�7gpOSit$ � . � ��- 'lance upon complet�on $ �ignature All materfals Is gueranteatl to be as speciFed.All work is to be eornp)eted in a work- ' manship-like menner BCCo�ding to slandard preuiees.Any elteretion or devlaU0111fOm ' i19�8tU�e � above specificadon irnolving ex�ra costs wi11 be executed only upon wrihen orders I have read and agree with the teryns and Gonditions pn ths reverse side. and will pecome an extra cherge over and above estlmate.All agreements contingent upon strlKes,aecidents or delays beyond our cflntrol.A.C.7 Asph2lt Specialties is �oupons can not becombin�d&must be presented et fime of estlmate fully covered by Wortcmans�Compensation and Generai�iabiiity InSu�ence