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3030 Sibley Memorial Hwy - Zoning Permits & Plans
07/15/2015 13:33 N0.452 #001 �----------------� � For OHice Uso � Cit af�a a� ; Pem�it#: , � ^ � � � � � 883D Pilot Knob Road � � Eagan MN 55122 I Date Rece�ved: ____ � L���. ______ _.. ..A Phone:1681)676-6685 Fax:(651)675-5694 Email:�lannina@citvofees�en.com ZONING PERMIT APPLICATION ❑ Please identify improvements on a scaled site plan drawing that shows lot lines,structures and existing conditions. . ..� ,, ` � Site Addreas; i .;..,.:.�..:.;:.::�;::::•r�::+..,.,�,:•, ;.r��,�•����•���„���d�,,;,���„���,,,���r�.�.�'G �. ::�..::..:..:..:�.;,,, .........:..:rar.....,,,.,;..;;.,;,,;,. . ....:..................�,� �, . ... .�:;•.:�.� rn:. . . � ', :;,:,.:�,••i:.FR'M ..�.i.: ;p,�,:: „ _... ��-- :::�.���������'�;;`: i ;:;;;;:.::::'�:�;::::"���:?: Owner Name: �, I . .. „nl��n��.,. :•,.:. ' ��.3�� . ���. ''� � r Phone: Ci 1�=� r lv `�i'��/'G� ;;;;;;�' Name: '��C�� l�` I� ���( (� C. � ,;,,.,.,�; .:�...::.�..:..:....:..:....::.:. '•, . � °'�- *. .. ................... ...... ,,,,,,,,,,,,;,, ,, , , , � , ,,,..�:: ,. . , ..::.�,. dd ry tate� p ,... .,. .. ..... ...:.... A ress: L L� �L ��`� � Ci /S Zi ,C�i� .� � �;) �j � , � U �' , ' „�,.,�.,�.; , ...� ..:;.,:,.:';:con�ac��:::::,,::_;; �� ... .. ... . ... ..:..... . ..:......::... ........ . �,.,,,: .. �,:,•;:;•.:.,.;..;,.;••... , PP� 9 a x:�,. �ti/ J � A I cant Si n ture: . Dete:��� �� � ;'�:� :;�� � !.. _t � � ( �'�;CC;I�� _..... ...... Emailaddress: � G� ��c.. �+Cl�,; k� ��l`�� �� ._. `"''''�"".`""`'""�"'`' ❑ Retaining Wall<4 feet ? riveway :::;: ;.;,�;:;,;.. .�, �Other, . ..,,, . ..:...... ......: .:. ..., .:`:�'::'c;'ii'',:;,'r;''r:�li,�,:..:�,:,��,�;;;;,;, ':.....:....:...�•:...:.:•.:•.:,:,..;.,..•.;:.; .• .,...,...,.... .,... .... oLIR ..........................: .:...........:..... ❑ Patio O Sport ' ..............:..... ,: .. 8.a���! ..,,.,. :.';:��...,,,:'...;;'•...�,..,:..'!i: •°• ❑Sidewalk ❑Fe�ce �•�.; ., �.... ...:::.:.:•..: .. . ::?::?:;��::::,::.:.•.::::::;.•::.::::.:::::r•r'°�;' Description of work: , . .. .......:. .• , ,. ��:,, ::..;,;,.,.:,• ,,:,..:�.:..:...::.....:;. . ,,...�.,..:.,. ,.,.;. ..:::��.:.�.:,;...... , ;;;..,:::,., .�::.::.::::•:::::::.:.. ...............................:::::::::.. .,.:��:::....:.:.... .. ,�..:;;:.;::.:::::�:-.:;�::;�::;::.... ,.::....:. .. .. ....... ... ..........:::::::.;;�: ......:.:::::�:;;:,.�::::::•.�;.':��;:;:„•,: �. .. ..;; rtace�Eou�et,a !�.���F'�I�t�d:�onm �°;#�lurf�:mt�af:a�'tbar�c��;::e�C�;:::.;';.;:�::;::'.::;�.��:;:':;;:;,:i��>i;.:,i��';;,';;::,.:,;'::>�:::';.,� #?ler�rtln ::�.� ,;�.::,:8etba�[cs:h�r�;.;�u. ..............�...� ..::�w:::..: .. ,,.;..;....::.::,:,. ..., .,....�....: � ,,.�.,� ..9., Ap .,l benied Date: 7�,����� Staff: _ �/'►�k~ ��C ._��.l,� �--�.—.--__ Notes: . . r�pi���.�s :� ... �.��� � p.��.�t, i,�. �. sd�.��, . � . Property 19nes to be verifie Revised Plans rac ar own�r. Approved: Yes!No Date: _.,,,___ .Staff; � . ... ..........:.....:.:.:.: ...:.:.:.:::... • .:..::........:..:• .,....... ... •-- � ... ........... ................ :.....�.:::......:�.� ,.... ... • �. . :�;-�:�:��,;;;..,;:..... :•:•::•::�::: .....:..:::::.::.::.:::::::::::<:;:;.::� .......... . . .......... .......................................... ......... .. . . .., . .. ....... ..:.:..,:.:..,......,.:.:::,:::•.:..,.:�r;c;�i'.`:;i:.i:�'ii�i��:ir?::•;+r`!:ii:;�.:r;:�:::iJ;�':;;;.�::t;:e::,,.,,..,,:.�„,:;• :;�r� � `.erin ::::-:;:;G .i�' ''draina �.vEill. '::es§���ts�°Wetian�ds';s'r:��Ivn`�ari�of;;i. rotr�n��r.rds:�n;���.F�ig�f�o,f:�l.Ja.Y.;::�etc:;;...; . • � ,,.,......,.$;.� g,.�..:,;,.,.!�!...1fl9�. ,,,, 9 � ..�!'.... !:... ..�;.;;!�A. ... .........:�.�'.� �..�..;..::: :�...�:.�.� . ...1.�.;L....�r�.r.�: VprV�nroY.r�� � Approved I Do�ied' Date: � 5taff: Notee: � Ravised Plans •• � Approved; Yes I No Date: Staff: „ _ :;.......... ........ . :.. ... .. . .... .. � ........................::..... ,.,..,.... .,.....,,...,... .. , . :.. ..........:.:. . .. ... ......., ,,.,; ,...,,, „. ,.... . ..:.�.�Ci�mme:nfis:°:�;:..: ,.�... ..,.:,,.�.:.,.. ,.... , ,,�....:�;r-.,�:�::.�.�:.: ... ,,,,.,. „ .... ....:.... .:....�..........:..;;:;,:.:;.: ,.�. ,,: CALL BEFORE YOU DIG. Call Gopher State One Call at(6S1)454-0002 for protection against underground utility damage. Call 48 hours before you intond fo dig to receive locates of unde�ground utilities. www.�oph�rstateonecall.ors� ' G;1Building InspectlonslPERM1T APPLICA710NS\201112411 Permit Applications 07/15/2015 13:33 N0.452 #002 ! — The Twin +Cf�ies Paver of Choice — - '', , � . a " ' : ' ESTIMATE By: �'� .c�.��� # �¢ ���� �� ���� q� �1 �� � �_ 1 �� � � � ��.. ,� ������� Date: � � �' "� °' 1�`�; / �1 , �:'i�i � � Name: (��1�! ►^/ ,�_��!I�l��,r� 4?s� P O � ;;::.„ ;�� ,,::::: ,/ :�.�� ,::;;. � ;� ;,�•;:. �� Address: � � � �'",�. '�l��r! l l��f � '���� 8��� /, t r 4! '��I �S 0 '� . . City: �4'�'G r� � .� Zip:55� P U ❑ Phone � ,r�+�'� � .�) 7 Z �� ....._ ... No Yes No Yes ' ❑ Phone ,._. Replace as is u � Water shut off �^ C1 I u �_ �lares � ❑ New Cover �J^"^ �O �, SfumpslRoats O Drainage Probl�m � � �ermit �+e� No � ❑ Design on separate copy I� ��'t'emove Asphalt(Extra charge if over�") ' ❑ Sprinkler heads? ! l:l Remove Concrete(Extra charge if ov r 4�) �I la�cpron remov 1 car,_ 2 car �3 car I C�ap Blocks�(Does not include foundation work) . ���,��',� ��,�.�1��4���,��,,,��� ❑ Re��nove Gravel,Dirt cr Sod �� r8^� �jBase,afl�er compaction . � �l ❑ Your existing base and ours �.� �j ; �i r� �� r��'Regrade for proper drainage y'� f� � Z ' �°�_Hot Mix Asphalt compac�ed to�_ y�� P'��y��r`,J� , � i u Addition to drive ,,'' CJ Concrete, see concreEe form .. �"Appr ximate Square feef t�J � - t��Yr.Warranly , '� "' � K, � l� . �.•,�Yc Asphalt Protection Plan (see details on backJ 1 ��.'� . Options: (Not induded unless checked and initialed) " 0 Fabric Installation SF „ $ , � !�,� f , - � �-� • �''� l,� O Permaloc LF ,_., $ � . � �',� Customer Initial �� �+��"e� � `� � { Estimated Cost: • -� � _ `I _ . ,_.,,....,,, . , �� w ... Down , ,� �S ' � , Balance T_,,,�„ 7 _ "�'�— x �s� ' � , _.�C�_P'�-;1G�d�"�%� �' GusEomer ApproVel a � �� �� r� '"~, I have read and agree wilh the terms and conditions on the reverse side. p • �`� �'�C�`��� '�� � SICN AND RETURN WHITE COPY •• Property Line? . ❑ Cvrr►pd ❑Subpd . 7745 2nd Avenue S � Richtield, MN 55423•Ph:612-866-8836� Fax: 612-866-8078•www.richfieldblacktap.coi�n � � Licensed � Bonded • lnsured �