4759 Cypress Pt - Zoning Permits & Plans p Fa1II
For Office Use/f41,11' Cityo1 I Permit ` 7i 0
3830 Pilot Knob Road ` I #
Eagan MN 55122 i Date Received:
Phone:(651)675-5685
Fax:(651)675-5694 1
Email: tlannincAcitvpfeaoan.com
ZONING PERMIT APPLICATION -
p Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
Property Site Address: _• 1 c L ,)_<„ 5 1
Information ^)
i Owner Name: i
_. Hama: .,:,,&Q`,.t' � 1 >TtC1 4 Phone r� i ` j(4:- ?` g3
? Address: �' ) City/State/Zip. Lg.t4 ‘,)
Contact r\
Applicant Signature: ,. Date: e (S __.-17.
-- y�4)4I 1 c.d ,^�
i Email address '� `�' i't 4 C X� ` J
O Retaining Wall<4 feet veway 0 Other:
0 Patio C Sport Court
Type of Work i 0 Sidewalk ■ Fe• -
I Description of work: 1t'.--t.,
t)eiyi
Planning Setbacks,hard surface coverage, shoreland zoning bluff zone/setbacks,etc.
roved 'Denied Date: (1 1%;L.: l 1 Staff Ci#„ ...,C(.1,, ,,,-4„.,..1.‹............
Notes:
Revised Plans
Approved: Yes 1 No Date: Staff:
Engineering Grading,drainage,utility easements,wetlands,erosion control,improvements in theilf=Way,etc,
Approved/ Denied Date: Staff.
, :1:
Notes:
Revised Plans
Approved: Yes i No Date: Staff:
•
Comments _ l
CALL BEFORE YOU DIG. Call Gopher State One Call a:(651)454-0002 for protection against underground utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecalLorq
G-\Building Inspections\PERMIT APPLICATIONSl201112011 Permit Applications
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FiUCHFIELD - The Twin Cities Paver of Choice - RICHHELL.
BLACKTOP BLAC3CTOP
ESTIMATE By: ...a,,,Kill --6 -- / V. ,-- V
Date: ;17 o r
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Name: c' i PL3 ie list ;
twilit, "MUM I
Address: 7 , f r , ili4—t— L a ss
BEI
City: G ' Zip: 55 ACCREDITED
ss
P ID
Phone c ,
No Yes No Yes
Li Phone Replace as is ❑ Cts Water shut off ler
L i
u Flares I " O New Cover i , L
Stumps/Roots Cts U Drainage Problem Egy U
‹mit if needed U Design on separate copy ,11 prinkler heads? Property Line?
remove Asphalt(Extra charge if over 4")
U Remove Concrete(Extra charge if over 4') I
❑ Apron removal 1 car 2 car 3 car
D Cap Blocks _ (Does not include foundation work)
O Reiove Gravel, Dirt or Sod
44- Y-6"Base, after compaction
L1 Your existing base and ours -
gi"°Rerade for proper drainage , ,�
Hot Mix Asphalt compacted to { ‘
❑ Addition to drive l f ,w, C,,, ,
L1 Concrete,see concrete form Cl t` /` A
approximate Square feet � i ,-K. ,-- ,
V2--5" Yr.Warranty ---
j Yr.Asphalt Protection Plan (see details on back) + 1c
Options:(Not included unless checked and initialed) '''''#"9*<41) 6
O Fabric Installation SF j
1 41/112
Li Permaloc LF $ ,p,14111/
Customer Initial
eii
Estimated Cost:
Down '17 c�, , , ,
�
4
Balance
X .,‘,2,k- 4 id-----
7 ..1--, ise,:rt---
Customer Appr ai D e
I have read and agree with the terms and conditions on the reverse side.
SIGN AND RETURN WHITE COPY
f
7745 2nd Avenue S.Richfield, MN 55423•Ph;612-866-8836.Fax: 612-866-8078,`www.richfieldblacktop.com
Licensed • Bonded • insured