3261 Valley Ridge DrGity of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For ft ce use
Permit #: F7-/! i
Permit Fee: tf 3W. V5
Date Received:
Staff:
5/, 6/, -----
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L( •(.01 • ac9// Site Address: 3SS 9// 1? of C C Unit #:
LI al 1)
RESIDENT /
OWNER
Name: 0n7 Mn,L je ✓t, 4-, At_
Address / City / Zip:
Applicant is:
Phone: 763 ,/,/q -9/Do
Owner X. Contractor
TYPE OF WORK
Description of work: Rf
Construction Cost `607 /, 59/ a /
CONTRACTOR
Multi -Family Building: (Yes x / No )
Company:, SLt n (7 se, Kery no e iex, 4 c Contact:
Address: 5 7 6 1-10& t -Cl n
e.( Pew
City:. Pau
State: M N Zip: .5//O Phone: 616/ - ?bol - W 45
License #: OS/s/$ Lead Certificate #: NAT' 2a9.3-1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions os
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call 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.clopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and app . val . : an
x 3oeJ PO4-9_,CS
Applicant's Printed Name
x
A
p
nt's Signature
Page 1 of 3
RESIDENT / OWNER
Name: 3 vl. ui/ve- & b1 4J Phone:0 -1 4° .1 3 V C/
Address / City / Zip: 32- 1 vuaO g,( ?) G ail i V1n ` O 5 a I
CONTRACTOR
Name: - r it op et � // License #: S0515
Address: v 1' (fit t-4M `C k City: 6WJi,f Vi M
l/1
State: 1 r ! I" s Z p: 3 Phone: S 2- q .S5 21i7 ( 2
Contact:
• i
Email: ft 01 (CU tijr1,I/ 71 fitip(e 4,14 « CO
TYPE OF WORK
New
Replacement Repair Rebuild Modify Space _ Work in R.O.W.
_ _ _
Description of work:
PERMIT TYPE
RESIDENTIAL
X Water Heater
Water Softener
Add Plumbing Fixtures ( Main / _ Lower Level)
Lawn Irrigation
(_ RPZ / PVB)
Septic System
_
Water Turnaround
New
_
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water
Heater, Water Softener,
(includes $5.00 State
Fixtures, Septic System
(add $166.00 if a
New ($10.00 per as
or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
Surcharge)
Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
5/8" meter is required)
built) (includes County fee and $5.00 State Surcharge)
ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
burned out appliances,
CllyofEaali
x
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
-r.E VED
Use BLUE or BLACK Ink
Permit #: c w o 1
Permit Fee: 55 00
FEB 2 4 2011
�J 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 2( 2z ��t(� Address 3Z( 1 ( Vai � qC (y.
I 1 Sit
Tenant: , ( l
Date Received:
Staff:
Suite #:
CALL BEFORE YOU DIG. Call 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.gopherstateonecall.orq
1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval � of y plans'
ilarlAA An x 10-ono
Applicant's Printed Name Applicant's Signature
City of Ea all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675=5694
2011 RESIDENTIAL PLUMBI
Date: 4( f T' / Site Address:
Tenant
RESIDENT 1 OWNER
CONTRACTOR
TYPE OF WORK
Use BLUE or BLACK Ink
Permit*: /0
Permit Feer 0
Date Received:
Staff:
G P R j IT APPLICATION
•!4w
Suite ft:
Name: �ix� i P eve Phone: (n 1. — 1 )b "'1(a
Address / City / Zip:
Nance: _MILBERT COMPANY I'C.dba CULLIGAN WATER
Address: 1801 50TM ST EAST Cit INVER GROVE 1IG'TS
•
State: • MN Zip: 55.077' Phone: 65,x:.;:451;-2241
Contact BILL.MILBEftT. Email:
g_
New Replacement _ Repair Rebuild Modify Space Work In.R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater
• Lawn Irrigation (_ RPZ /PVB)
Septic System
• .'New
. Abandonment
4Water Softener
Add Plumbing Fixtures L Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (inchldes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtutes, Septic System Abandonment, Water Turnaround* (Includes $5.00 State Surcharge)
"Water Turnaround (add $166.00 If a 5/8" meter is required) •
5105.00 Septic System N (610.00 per as built) (includes County fee and 65.00 State Surcharge)
695.00 Fire Repair (replace burned out appliances, ductwork, eta) (includes 65.00 State Surcharge) 53"
�' d
TOTAL FEES $ y� '
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities.• wvrw.000herstateonecall.or2
thereby acknowledge that this ktfirmatlon Is complete and accurate: that the wort will be in conformance with the ordinance and codes kit the City of
Eagan; that I understand this Is not a permit. but only an application fora permit, and work Is not to start without a permit that the work will be in
accordance with the approved plan, in the cased work which requires a review and approval of pians.
x
' Applicant's Printed Name '
x
Applicant's,Signature
Aug 18 1510:56a Sunrise Remodelers 651-762-9395 p.7
,
Use BLUE or SLACK Ink
r�...___._�_��_������
I For OfEics Use �
C I
. � Pertn3t#: /��`��� �
Vlt� �f ����il I Permit Fee: ,�7��`�� j
1 �
3830 Pilot Kr�ob Roa� � Date Reoeived: 1
Eagan I�tN 55122 1
Phoae:(651}675-567b ' j 5taff: �
Pax:�b51)675-5694 � --------�
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2015 RESIDE�II�IAL BUILDING PERMIT APPLICATION
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` ' Name: Phone: �
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; Residentl � �
' Owner � �d�sslCitylZip: ^
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4 � Applicant is: Owner �CoMractor ��� _ �
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�4� N'i Descriptian ofwork: ��� � ��
Type of Work � o�
' F Constn�cGon Cost: � #� O��• Mulii-Family Building:(Yes��No„_�� ���
��.�.,.,..._.�._,.�......._.w_ � ,� Y S �w� �:c�.� �S Contact: �� �-�"�''� �:..1 ;
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� : Address' �. ��i v� c�cy: S-f- , ��.�1 � �
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.` � Staie: �il��Zip: C �I l U Phone: Email: i P1 Yt% Q S.-e►�,r;�e��t vv�x�,�c.-s,`-
� � License#:������-----Lead Certificate#�,�,��--��� ��'-� '
-�,,._.r_ -_ ....rr�.-e,.m 4
� If the project is exempt irom lead certi#ication,please explain why: ;
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� COMPLETE THIS AREA ONLY I� CONSTRUCTING A NEW BUILDING ��
, �
: [n tt�e�ast 12 rnor�ths,has t�e City of Eagan issued a permit for a sim�lar pian based on a master plan?
� .
� Yas tVo tf yes,date and address of masfer ptan:
�
� Licensed Plumber:
Phane' �;
f
7
� Phone•
` Mechanical Contractor:
f
� Sewer 8�Water Contractor. Phone: :
, �
� Flre S�ppression Contra�tor. _____ �O°e' -- �
a,�._..a.._,..,.�..�Pa..—_ ___._....._,.._ ":
'��NOTE:1'larrs and supparting docrrments that you submit are cunsidered to 6e pu6lic irrformafion. P�r'�ons of ;
� the information may be c/ass�ed as non�ublic if yot�provide spec�c reasons that would pem+it fhe Cfty to
� condude that the are trade secrets. - -_.._-.
: y- --—�_,�...�..e...�..�..�...,,.._.�.....�.�.�,.----.,_...�...�....�,.y- _. �
;.�.�...,.:�,:�n_.�,,.,.._..,�.�..�,.-- ----��,�...x...Y.--- - _-_.� ---------.�Q�
CALL BEfORE YOU DIG. Calt Gophar State On�Ca1i at(651)454-0002 for protection againsl u�erground uU7ity damage. Ca1148 hours
before you intend to dig io reaeive lacates of underground ufiliEies. www goPherstateonecall.ora
I h�eby admom9edge ihal 1h�information is camplete and acaurate;that the work wi1�be in coMamfance wilh�he ordinances and codes of Ihe City ai
Eagan;that I understand Ihis is not a permit, but only an application for a pertnR,and wo�c is not to staR wit�out a perm�;thal the work wiil be in
accordance wifh the approved pla�in Ihe�ase oiwork which requites e revlewand apprava�of plans.
Exterior work authorized by a buifdiog permit Issued In accordance with the Ninnesota State Bullding Code must be compleLed witi�in 980
days of pe�rnit Pssuance.
X ��� �.i2_—�-1��''� G t"� g �
Applicant's PriMed Name s ignature
Page 1 of 3
Use BLUE or BLACK Ink
� r-----------------+
I For Office Use �
� / I
C�+ 0� �1� �� j Permit#: f _ j
i � /,a� ,,. �
6 1J I Permit Fee: ! td�-�� I
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 1 I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
R - '� �:. .2 �" . � � �'..s��;.�
Date: Site Address: �� ` �� l-��Unit#:
^3
=' �� Name: Phone:
��S[�E:[l�/ u,�� '/ n
;C���1�T'.: . ' Address/City/Zip: �o��� Y�I,��H IC��Er� .�ft, �6rtr�, `'�1N. .�$��3
_� Applicant is: Owner Contractor
v Description of work: ��P��,.� �6��
Ty.pe of W�rk
w
Construction Cost: '� 3 Multi-Family Building: (Yes�/No�
� \
Company: c�an��/,�,R,...,��_ LLG Contact: S'�i'L� V�H���
` Address: 35780 �j��` ,�t� City: �,��..� �u.s
�c�n�tr�`actor
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�r :�. State: �N Zip: 5�� Phone: �Sl-a`lS-D3/� Email: SJoF}�vSaN t(.,q�u�ku,�y(�r�R,lkd�.
` License#: r1� �' Lead Certificate#: N��
If the project is exempt from lead certification, please explain why:
No (,��, �a.f,��u-r
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
Nt)T�,Plan�at�d�t����►r�rrrg d�a�r�m��#s th��,yau�ub►������� ��t�ia��r���o be p��11��nf�rmatrr�n ���'t�+r+�n���:
t�����'orm�tivrt�ay�e�la�st��d as rran��t��b��`��,����rr,����I+�s��cr�`����,a�i�r�s t����►rc��rld�er�����Crty#�
�.. :
� a
� can�lr��e that�?��' �re tr�c���secr.ets: ; ����,. :
CALL BEFORE YOU DIG. Call 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.qopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance. ^
x S�76V� ��I�NSo,� x
Applicant's Printed Name Applic t's Signature
Page 1 of 3
Plzc4sg2_ Cg11 L{-24 ..
City of Eagan r c .
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#; I g g 1o&
Permit Fee: / v
Date Received:
Staff:
2017 MECHANICAL PERMIT APPLICATION
❑ Pleasesubmittwo (2) sets of plans with all commercial applications. ]
Date: ` �"'�1 Site Address124)!
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State: Zip: 1 Phone:. -5-1-7S ��
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New X Replacement Additional Alteration Demolition
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Description of work: _619 -it �.�\ \'�'+��
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Gas Exterior HVAC Unit
Pump
Under/Above Tank (_,.,, Install / Remove)
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Other
_ ground _
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge = $ TOTAL FEE
COMMERCIAL FEES contract Value x .01
$60.00 Permit Fee Minimum
$75.00 Underground tank Installation/removal, includes State Surcharge = $ Permit Fee
= $ Surcharge
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge = $ TOTAL FEE
I hereby acknowledge that this information Is complete end accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this Is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
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