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3866 Mersey Way - Zoning Permits & Plans40.• City of Eke 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5685 Fax: (651) 675.5694 Email: planninu6►.ciitvofeaaan.com L For Office Use Permit t: Ito 4 41 Date Received: J 2�1J7° ZONING PERMIT APPLICATION p Please identify improvements on a scaled site plan drawing that shows lot lines, structures and existing conditions. .. .. Site Address: 3 a° 6 ��/ 14Q,e-JeI pRopEgry INFO (1&I �q Owner Name: \ Aft Y \ c G-r4Q;‘)-- CONTACT Name: i L�T \ 'e` Gt CC -/ 4'(h : 6 I2` 6 W1P Address: —7.7 5 /I " `- - 5 City/State2p: 5—$ 3 Applicant Signature: Date: 7 L-.)--c ^Z V Email address: 'S �, rJ" e d lell t a " Co4- Ill TYPE'OF ' Wow ❑ Retaining Wall <4 feet ti.Driveway ❑ Other. ❑ Patio 0 Sport Court 0 Sidewalk A ` ❑ nce Description of work: , t (3 (/(&_.,_ PLgl . Setbacks, hard surface coverage, shoreland zoning, bluff zone/setbac lcs, etc. Appirc v.d vied Date of Approval: Staff (2 Notes: Property by i lines to be verified 'May ' wie.)-1� it s 2 cn � y 22 contractor/owner. i I Revised Plans Approved: Yes 1 No Date of Approval: Staff. • ENGINEERING I Grading, Vie, utility easements, wetlands, :erasion control, improvements in the Right -of -Way, etc: Approved / Denied Notes: Date of Approval: Staff: Revised Plans Approved: lies / No Date of Approval: Staff: COliil'E9: CALL BEFORE YOU DIG. CaII Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call - 48 hours before you intend to dig to receive locates of underground utilities. www.aoohe,stateonecall.ora G:1Building Inspections1PERMITAPPLICATIONS1201112011 Permit Applications RICHFIELD - The Twin Cities Paver of choice Cty l �l lfcrr� ESTIMATE By: 4,1K #b_1- e21 Y- u/° (j y # l k2'. BLACI(TOP Date: Name: Address: ( LOa City: C05 4 /9 Mq I Zip: 55,, ClPhone &Si V 7(9 gl 3 3 ❑ Phone 17.-Permit if needed -Remove Asphalt (Extra charge if over 4") D Remove Concrete (Extra charge if over 4") ❑ Apron removal 1 car 2 car 3 car map Blocks 2— (Does not include foundation work) nnf ve Gravel, Dirt or Sod � Base, after compaction ❑ Your existing base and ours p_-Re rade for proper drainage - Elevation change may be rpded. (See reverse) i-- Hot Mix Asphalt compacted to ©—Addition to drive L' V ❑ Concrete, see concrete form i -Approximate Square feet -Backfill: Homeowner m S� Yr. Warranty (see details on back) p. 5" Yr. Asphalt Protection Plan (see details on back) Options: (Not included in esitmated cost) ❑ Fabric Installation SF $ Permaloc LF Customer Initial Estimated Cost: Down Balance X Customer Approval Date I have read and agree with the terms and conditions on the reverse side. r' r 211 tz2 70 SIGN AND RETURN WHITE COPY I ❑ P ❑ L ❑ B ❑ P ❑ RICHFIELD BLACKTOP rrr, Angies list SUPER SERVICE AWARD Replace as is Flares Stumps/Roots No Yes ❑ �r 0 BBB. ACCREDITED BUSINESS No Yes Water shut off 0- ❑ New Cover EL ❑ Drainage Problem . Y ❑ ❑ Design on separate copy ❑ Sprinkler heads? Property Line? 1,7 /_ s011A; li 111 PUIM —i M�xw1 1?1S1.-Fo4' wc`/ ivN Property lines to be verified by contractor/owner. 7745 2nd Avenue S • Richfield, MN 55423 • Ph: 612-866-8836 • Fax: 612-866-8078 • www.richfieldblacktop.com Licensed • Bonded • Insured