700 Hay Lake Rd N - Zoning Permits & Plans3830 Pilot Knob Road
Eagan MN 85122
Phone: (681) 6754685
Fax: (661) 6754694
Email: planrilritaftitvoleattan.com
For Office Use
Permit ft: 7-57/
Date Received:
L.
ZONING PERMIT APPLICATION
o Please Identify Improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
PROPERTY site Address:
INFORMATIOR
Owner Name:
CONTAC
Name:
Address:
Applicant Signature:
Email address
t1/41cLy P -D
L9hL I_7_
Ameteps
one:
eke
Cfty/State/Zip:
Date:
0 Retaining Wall <4 feet
TYPE OF 0 Petit)
WORK 0 Sidewalk
Description of work:
zunveway
0 Sport Court
0 Fence
0 Other:
PLANNING
Setbacks, hard surface •-•riverage, shmeland zoning zone/ - . --0 i /
4 a
/
i pp v Denied
RIM
Date of Approval: i 41 /Mgr • Start '1101,411r q II ii Vr,"'
Property lines to be verified
by contractor/owner.
Revised Plans
Approved:
Yes / No Date of Approval: . Staff: .
... -
ENGINEERING
Grading, drainage, tiny easements, wetlands, erosion control, improvements in the Right -of -Way, etc.
Approved / Denied
Notes:
•
Date of Approval: Staff:
-
t
Revised Plans
Approved:
Yes / No Dote of Approval: Staff:
COMMENTS 1-
4
' '
............
Call .'
CALL BEFORE
YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
48 hours before you intend
dig to
ve locate.; of underground utilities. wvAr.00cherstateoneca .orq
GABufiding InspectionsAPERMIT APPLICATIONS1201112011 Permit Applications
RICHFI FLED
BLACKTOP
Date:
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The Twin Cities Paver of Choice —
Pruecrly !Inas to b
by ountractcriowrier.
Name: COLI
Address: 70 W. -"KAY
City: EA -4)111‘i 2 n: 55 2-3
U Phone
L13-11‘le (05-7 Hog' 0
epit if needed
Sc--Kemove Asphalt (Extra charge if over 4)
U Remove Concrete (Extra charge if over 4")
O Apron removal 1 car 2 car 3 car__
O _cap Blocks include foundation work)
UVRemove Grave Dirt or Sod
�1' 'Base, after compaction
crlour existing base and ours
''Regrade for proper drainage
IEK:311 Hot Mix Asphalt compacted to • AS -11
111-4ddition to drive 296
LI Concrete, see concrete form
111-4pproximate Square feet 0 fda
tiect:/ig— Yr Warranty
tc---Y7:Asphalt Protection Plan (see details of hack)
g Options: (Not included unless checked and initialed)
Cl Fabric Installation SF
0c52,
Estimated Cost
Down
-7o
3 '71-0 9
Balance
_32g
customer Appro
f-20-15,
Date
I have read and agree with the terms and conditions on the revere side,
SIGN AND RETURN WHITE COPY
L U
B
P
ACCREDITED
BUSINESS
No Yes
Replace as is U
Flares AD v U..„, i:a---
Stumps/Roots RV CI
No Yes
Water shut off tie; CI
New Cover 5/'' U
Drainage Problem CI
1:1 Design on separate copy U Sprinkler heads? Property Line?
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7745 2nd Avenue S • Richfield, MN' '3.0423 . Ph: 612-866-8836 . Fax: 612-866-8078 wwwrichfieldblacktop.com
Licensed . Bonded • Insured
Property lines to be verified
by contractor/owner.