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2109 Kings Rd - Zoning Permits & PlansCity 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5685 Fax: (651) 675-5694 Email: planninot citvofeaaan,com L For Office Use Permit #: /v g eC 7 Date Received: 5- 6 - 0702 t ZONING PERMIT APPLICATION p Please identify improvements on a scaled site plan drawing that shows lot lines, structures and existing conditions. PROPERTY INFORMATION Site Address: Owner Name: CONTACT Name: G 5 �►L� � e.� /2(c e: `•�'`2` Address: —2-7 5 City/State/zip: 5'V Applicant Signature: Email address: -5 oc,e. N / `-" t a Date: -("1/11 TYPE OF WORK' ❑ Retaining Wall <4 feet L9.Driveway ❑ Patio ❑ Sport Court ❑ Sidewalk ❑ Fence Description of work: i - [c (_. `e_ ❑ Other: PLANNING . Setbacks,,):etaface;coverage, ;shoreland zoning, bluff zone/setacks, etc. = • • rove • / Denied Notes:VV;vi;Way Date of Approval: 5- 6 - Q2ba21 Staff: e c,1 i i J ok a S Svbm;-ika . t1o.x w;13.+h o.,4 )oe*,n c+. Revised Plans Approved: Yes 1 No Date of Approval: Staff:• ENGINEERING Grading, drainage, utilityeasements, wetlands, erosion control, improvements in the Right-of-Way,etc. Approved / Denied Notes: Date of Approval: Staff: — Property lines to be verified by contractor/owner. . Revised Plans Approved: pp, �I ?es / No Date of Approval: Staff: COMMENTS ti tecti ainst unde round utility damage. CaII CALL BEneFORE YOU DIG. Call Gopher state OCall at (651) 454-0002 for pro on ag rg 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.oro, G:1Building Inspections\PERMIT APPLICATIONS1201112011 Permit Applications Date: RICHFIELD BLACKTOP - The Twin Cities Paver of Choice - ESTIMATE By: aie 9 Y % f -a E(- go? Name: Lj S�j L3 r6%wt ) (9 layj RP 7n4 Zip: 55 g Address: City: ❑ Phone (9 51 L 07 -' L b ❑ Text 10.5 `7 -7 "" 14 c3 Ea -Permit if needed CO --Remove Asphalt (Extra charge if over 4") ❑ Remove Concrete (Extra charge if over 4") ❑ Apron removal 1 car 2 car 3 car gL-Cap Blocks 2 (Does not include foundation work) rld-Remo! Gravel, Dirt or Sod gase, after compaction CI--Re9rade for proper drainage - may b ded. (See reverse) a- S Hot Mix Asphalt compacted to a< -) GI ---Addition to drive 7 S / or 3 75' ❑ Concrete, see concrete form -Approximate Scit. feetc�lcy i 4 -Backfill:�lomeow SYr. Warranty (see details on back) Yr. Asphalt Protection Plan (see details on back) Options: (Not included in esitmated cost) ❑ Fabric Installation SF $ ❑ Permaloc LF $ Customer Initial Estimated Cost: � .!. I /q� re 4-„i 3 5Y0 Down APL `q o Balance 15C \h7 ? d x BAio-u)-0\) 5 - Customer Approval Date I have read and agree with the terms and conditions on the reverse side. SIGN AND RETURN WHITE COPY BBB. ACCREDITED BUSINESS No Replace as is Flares Stumps/Roots Yes No Yes ❑ Water shut off g'L-, ❑ New Cover ❑ L Drainage Problem -' ❑ 0 Design on separate copy 0 Sprinkler heads? Property Line? 70 y >< lGy 78' Property Tines to be verified by contra I:tor/owner. cu21 n (ire �` „co kI 7745 2nd Avenue S • Richfield, MN 55423 • Ph: 612-866-8836 • Fax: 612-866-8078 • www.richfieldblacktop.com Licensed • Bonded • Insured