1362 Camelback Dr - Zoning Permits & Plans � per- Office-----------------
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PERMIT ZONING APPLICATION
Please identify improvements can a soiled site plan drawing that shows lot tines, structures
and existing corrdi o a.
Site Address:
Owner Name
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Address: City/statelzip: -c
Contact
Applicant Signature,
Email address.address. y
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0 Retaining Yell<4 feet riveway 0 Other.
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0 Patio 0 Sport Court t
jype.oAWork f e oiic e
Description of work: �� � � � � �7APProvsd�� Yee : l Data: Staff:
oww tility t may,etc-
Approved ni Date Staff:
Revised Plans
Approved. Vas I No Date, stuff; 3
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9A II BEFORE YOU DIG. Cali Gopher State One Call at(661)454-0002 for prote0on against underground utility da a .-call
48 hours before you intend to dig to receive legates of underground utilities. 2rh6r tate pall-oaf
: ulldinq InspectionsTERMIT A,PPLICATIO 1 W01 Penn#Applications
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Date: c
Name: P
City: Zip:; b P
Q Phone
No Yes No Yes
Replace as is J -Water slut c Q
Flares ever
SturnpstR ts Ira Drain ' e Problem Q,
Pete U Demon on separate copy
0""Remove Asphalt charge ff over 41 L] Sprinkler heads
• Remove Conmete(Extra charge it over 4")'
• Apron removal t car 2 ter 3 ccr
Ll Cap Blocks____ not include a work)
0-1Gnove Gravel,Dirt
"Base,after compaction
Your existing base and curs k
Regrade for proper drainage
x�blot Mix Asphalt compacted to ,.
Aditl€ to drive
Concrete,see concrete tomes
ro ims e Square t > - ' v
Yr, Wan-anty
Yr.Asphalt Protection Flan(see details on back)
Options:(Not included unless chocked and initiated) �
Q Fabric installation l~ l
errs*c IF
Customer lr lfial t #91
Estimated Cost
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Down
Balance
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I have rat and agree with tl tennis and condi ons on the reverse side. �
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SIGN ANA RETURN 'WHITE 00PY Property Lt
C) Compd Ll Subpd
7745 2nd Avenue S•Richfield,MN 554 Ph:61U866-8836 4 Fax:612-86W78•www.richffeidblacktop.com
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