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