1557 Antler PtCity of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
CC
Use BLUE or BLACK Ink
Permit #:
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Permit Fee$ Sa
Date Received:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
RESIDENT/
OWNER
Name: Phone:
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Address / City / Zip: / 6^65 /1 /J'T Lef T f-5-45 0A) 5-6-7 2 2
Applicant is: Owner Contractor 4 IS-' 17
TYPE OF WORK
v'((/A/
Description of work: goec
Construction Cost: i.„2/ b 0 O Multi -Family Building: (Yes X_ / No )
CONTRACTOR
Company:mmecii}ai . � 3 n
t (1C Contact: ._,AVE R 'MCS
Address: 1.7.6---4:9. ex„0.747 Q, � `S
E City: �c 7
State: Al NJZip: 5%�3i Phone: 7 (c " Li2o SIC) 7
License #: QOf 5” 1 7_ Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
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.gopherstateonecall.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, - • 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
x ck E- t'ee)` `c �
Applicant's Printed Name
proval of p
x Q`
Applica s Si
ture
Page 1 of 3
City of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA098198
Date Issued: 03/10/2011
Permit Category: ePermit
Site Address: 1557 Antler Pt
Lot: 15 Block: 01 Addition: Deerwood Townhomes
PID: 10-20200-150-01
Use:
Description:
Sub Type: e - Fixtures
Work Type: New
Description: Main Floor
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Alex Blaylock
13972 Ember Way
Apple Valley , MN 55124
952-323-6392
Fee Summary:
PL - Permit Fee (miscellaneous) $50.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $55.00
Contractor:
Artisan Plumbing & Remodeling
13972 Ember Way
Apple Valley MN 55124
(612) 750-5892
- Applicant -
Owner:
Barbara A Kale
1557 Antler Pt
Eagan MN 55122
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
r
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 64/23/
0613 Site Address: t55 -5115c7 Unit #:
Resident/
Owner
Name: p pLJco %OwA t D/ t Als0 ` "' Phone:
Address / City / Zip:
Applicant is: Owner Contractor
Type of Work
Description of work: A00 C` g1 P 4 C fiA-c CA -'7
Construction Cost: Multi -Family Building: (Yes / No )
Contractor
qq-, (4°04 C cry r fr�`% ba r
Company: /l 14- a,rE CA -64 -- Contact: ,A-14---4-6_ 60,dz✓r `t
Address: , 17 % s'40 $t�� C.r�- City: (.)ff —7 ASR -(c
State: /ti,it-/ Zip: Phone: 26 , 6/ 20 ' 1i 6 ?
_S`3-1/62
License #: / C 6'61070 Lead Certificate #: S 66 16-6-x&--1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
g tk.,ALT- =; /77e 07?6 c"..--°
In the last 12 months,
_Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
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 Cali 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
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 autho ized b
days of per 0' s; ance
a building permit issued in accordance with the Minnesota State Buildin• .de must be completed within 180
Applican 'nted Name
x
Applicant' . ignature
Page 1 of 3
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
isPer/R3 815 -
Permit
mit Fee: /4 G . d v1 I
Date Received: lj /4 ' 1 7
Staff:
2014 RESIDENTIAL
BUILDING PERMIT APPLICATION
!J
Date: Site Address: 57 / r)kk/" Pr Unit #:
Resident/
Owner
Phone:
Contractor
Applicant is:
Owner Contractor
Description of work: 4f. 5r 'de. (-6 i nGle/^-S
Construction Cost: i 1.7000
Company: r.c�,2�n� )(
Address: a' 7 8' aS)--
State: %t)/Zip: 1571) Phone:
License #:
Multi-Famil Buildin.: (Yes / No
Contact:
City: IAA �, c
G
‘‘V 9'2-) Lead Certificate #:
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
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.gopherstateonecall.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 / ie4 / Cha
nt's Printed Na
Applicant's
Ax
Applican s Signature
Page 1 of 3