3296 Sibley Memorial Hwy - Chicken Permit ------------------,
For Office Use I
�1, n O� L�non Permit#:City / `'� [ ✓Ac
I I .
3830 Pilot Knob Road I
Eagan MN 55122 I Fee:$50.00 (collected by City Clerk)
Phone:(651)675-5000 1 ( ( �- 11�
I Date .31 1
L-------- 1--j------j
CHICKEN PERMIT APPLICATION
Eg Please identify coop and run information on a scaled site plan drawing that shows lot lines,
structures and existing conditions.
Site Address Site Address +�`C`1 14&dt - r
for chickens: 0f G ( 3 Eanan m 12-�5 la
Name: ff(A) 4QC0 Q Phone: (r5 t D71 `1 L 0 !
Applicant Applicant
Signature: ` ( Date: Q
Email /
address: a o d— all t ry t��I
Owner Name: Q
Address: 3 �1\ h City/State/Zip: �w (r n m N 5�
Property and Property Owner Signature
Owner (if different than applicant): ' z f Date: -Z) .ZQ
Information
ti.
The above referenced property's Homeowners'Association rules, if any,do not prohibit the keeping of chickens
on the property:(please initial)
Yes No Not Applicable
Number of chickens:
Dimension of chicken coop: H X
Dimensions of chicken run: ( X 1 X W
Description of exterior
COOP/Run materials for the coop and run:
Information
Will a fence be added in addition to the coop and run? Yes No
Description of fence, including
location,size and materials:
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G:\Planning\CHICKENS
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the
ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit. I
acknowledge that structures will be constructed in accordance with the approved plans.
x w t Q x dzut�--
Applicant's Printed Name Applicant's Signature
Planning
�Pproved Denied Review Date: .,3 � ✓ l./ Staff
Properly lines to be verified
by contractor/owner.
Revised Plans
Approved: Yes/No Review Date: Staff:
Animal Control
Approved/Denied Inspection Date: Staff:
Notes:
After a permit application is approved and the chicken coop and run are constructed, an Animal Control Officer will inspect
the space for compliance. Once the structures are approved, your chicken permit may be granted.
Page 2 of 2
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