4296 Sunrise Rd - Zoning Permits & PlansC!tyofEaaau
400o
3830 Pilot Knob Road
Eagan MN 56122
Phone: (651) 675-6686
Fax: (651) 675-5694
Email: planninaecitvofeaaan.com
For Office Use x�
Permit it: /tkc i
Date Received: (4PM
ZONING PERMIT APPLICATION
- p Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
PROPERTY
INFORIIMOR
Site Address:
Owner Name:
419 (i 5
c
e)s
ACT
Name:
Address:
Applicant Signature:
Email address: S
Gic6ci `Phone:
5 City/State/ZIP: :55-6/
5C r
Date: 7 — I
aCd-i/P1
TYPEOF.
WORK
0 Retaining Wall <4 feet
❑ Patio
0 Sidewalk
Lf.Driveway
0 Sport Court
0 Fence \ '�
Description of work: I
0 Other:
Setbacks. 4hr }Serfalle coverages;shoreland Toning, bluffzone/setbaoks, etc.
Approved / De ed
Date of Approval:
lines to be verified
contractor/owner.
Staff:
CS
IV IMca
W eAt•
iN i/o t
i,.
Property
by
Revised Plans
Approved: Yea 1 No Date of Approval:
Staff:
•
ENGINEERING
Grading, drainege, utilityeasements, wetlands, erosion control, improvements in the Fight -of -Way, etc:
Approved / Denied
Notes:
Date of Approval:
Staff:
a
Jj
Revised Plans
Approved: Yes I No Date of Approval:
Staff:
_
COMMENTS
d til'
d
a e Call
•
CALL BEFORE YOU DIG. Cali Dopher State One Call at (651) 464-0002 for protection against undergroun u ity am g .
48 hours before you intend to dig to receive locates of underground utilities. www.aoaherstateonecall.orq
G:\Building Inspections1PERMIT APPLICATIONS\201112011 Permit Applications
RICHFIFLD
CONCRETE
*- The Twin Cities
Paver of Choice -'
ESTIMATE By: %'1%4v 's #6S1- )L1'Y0l/
Date:
e?0.9) /6(?-1
Name: C 1 SSc( ///706e7
Address: V?6 24 1
City: ) Q3 c? sI I Zip: 55
# (19 — 67a_ 7$)(
Txt #
Premium Concrete Service
❑ Apron U Patio b S iveway
U Sidewalk ❑ Steps U Garage Floor
❑ Stoop ❑ Curb 0 Footings
❑ Sub Cut 0 Color
0/Kermit (if needed)
(Remove Asphalt (Extra charge if over 4")
Pd'iemove Concrete (Extra charge if over 4")
W-Remove Gravel, Dirt or Sod
CD -Addition to driveway l
®-Regrade for proper drainage - Devotion change maybe needed. (See revers
®-Cravel as needed (up to 4 inches)
T inches Titan Concrete Mix
• 5000 PSI • Class A Rods
• Intregeral Sealer • Zinc Coated Steel Fibers
• Formulated for MN winters
d -Finish: Broom / Smooth / Exposed
I Saw Cut / and joints / (8 feet or less)
C-Sackfill Hom r
lrass Repairs. omeown
2) YR Warranty (see reverse)
Estimated Cost:
Deposit
Balance
X
2
Customer Apptoval
I262)
ate
I have read and agree with the terms and conditions on the reverse
side SIGN AND RETURN WHITE COPY
P
L
F
P
❑
❑
RICHFIFL D
CONCRETE
All of our crews are certified by the
American Concrete Institue.
No Yes
Replace as is I ❑
Flares 0 Pa,
Stumps/Roots ❑ iY
No Yes
Water shut off ❑
New Cover l:11- 0
Drainage Problem qv ❑
❑ Design on
gip.\I\
`� `t�
3
separate copy 0 Garage Door 7'
/ 6
0
Sprinkler
heads?
be verlfl
K /1
* A
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69.2cAlkf I�MDI/�{
f
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Qkft
6 Feflo
V
Property
by co
Ines to
tractor/owner.
5(-6-,-(rt
22' MAX wic}FN"
- ce ux.,
ttn PAlt►
Risk of Concrete in Minnesota
0 Ok to use Bobcat in yard.
Customer responsible for any
yard/landscaping repair.
Initial
Peeling, cracking
excluded from
(See reverse)
Intial /► . .
and popouts are
warranty.
/ �/
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.
7745 2nd Avenue S • Richfield, MN 55423 • Ph: 612-866-8073 • Fax: 612-866-8078 • www.richfieldconcrete.com
Licensed • Bonded • Insured
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