1284 Carlson Lake Lane - Zoning Permits & PlansZONING PERMIT APPLICATION
p Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
CONTACT
Applicant Signature:
Email address: rt r /mil e • 4 C[("Pi
0 Retaining WaII <4 feet Td.Driveway
0 Patio ` 0 Sport Cawt
0 Sidewalk 0 Fence
Description of work:
0 Other.
PLANNING
I Setbacks, Mari surface coverage, shoreland zoning, bluff zone/setbacks, etc. {
pprovCe.LD1n(ed
Property
Date of Approval: '"r % 20/ a Staff e S
lines to be verified
by conitraater/owner, v lecore..) OS iS Siveeleve 11
Revised Plans
Approved: Yes / No Date of Approval: Staff, ,
ENGINEERING
Grading, drainage, utility easements, wetlands, erosion control, improvements in the Right -of -Way, eta�s�2
Approved / Denied
Notes:
Date of Approval: Staff;
v4Fi„
Revised Plans
Approved: Yes / No Data of Approval: Staff
,.
COMMENTS I'
�
,,
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 4540002 for protection against underground utility damage: Call.,.
48 hours before you Intend
to dig to receive locatesofunderground utilities. uwuw.aopheretateonecall.ora
uain: i'
aor
Name.
Address.
City r / I t i7 Zip 55
❑ Phone-
Perrnit if needed
emoveAsphalt (Extra charge if over 41
rpo ncreta rar c#rarget_
U Apron removal 1 car___ 2 car 3 car___.
❑ Cap Blocks ___ (Does not include foundation work)
Y ri ;. I:] Rers Gravel, Dirt or Sod
Base, after compaction
0 Your existing base and ours
gi. Re9rade for proper drainage - Swain may ia,.()
'i Hot Mix Asphalt compacted to_-
U Addition to drive
U Concrete, see concrete form
1-Approximate Square feet .
i) 'BackfillU Homeowner
Yr, Warranty (see details on back)
tar, j Yr. Asphalt Protection Plan (see details on back) •
Options: (Not included in esitmated cost)
a Fabric Installation SF $ 4
: 'U. Permaloo:`'*F. ' $
Customer Initial
Estimated Cost:
Down
Balances
have read and agree with the terms and conditions on the r•everse side.
Date
PER SERVICE
AWARD
RICHFIEL
ACCREDITED
BUSINESS
�No No Y :
Replace as is 0 ater shut off LI-
Flares LI t;Y New Cover ° 1.4" ■
Stumps/Roots p, Drainage Problem tom'
Design on separate copy LI Sprinktetheads?'-':Properly Line
cope 44 iS
oparty lines to be ve fled`
tiU contractor/owner.
{ 77Q5 2nd,Avenue S • Richfield, MN 55423' Ph 612 866-8836 Fax B�2 66-$QTI _• w�uw rich�ieldb ackkto�
censed • Bond d •. nsnred� ..