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3273 Hill Ridge Dr4 0 1 ' City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 GnC/ -3'2‘.171 7/ 7, 75; 7 7 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t4' ? • a0 // Site Address: b 7 x 10e) I e- t Applicant's Printed Name nt's Signature Permit #: Staff: Use BLUE or BLACK Ink c eU , ?nag' Permit Fee: +r Date Received 00 CALL BEFOR 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.gopnerstateonecall.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 app . val Page 1 of 3 - - •� JIM IF. RESIDENT OWNER Name: Onz Mct-na9Qr4.4.44-1 . r . Phone: 763 - yy9 -9700 Address / City 1 Zip: _ * , , d _ /O . „ , � , L/F r ! Applicant is: Owner x Contractor TYPE OF WORK Description of work: Re, —r^-P Construction Cost " 395 7 Multi- Family Building: (Yes k / No ) CONTRACTOR Company :, S(,t n r;,s ernco P e ∎ri S c Contact: eJ Pe4 o s j Address: 59 7 to /-/ be_ I.-.,e r_ City: 34, ( lA 1 State: f 1 AJ Zip: 55//0 Phone: 606/ - 761 - 9045 License #: jn5157g Lead Certificate #: NAj - 2- 71 - 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: Phone: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Porti of the information may be classified as non-public if you provide specific reasons that would permit the City t conclude that they are trade secrets. 4 0 1 ' City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 GnC/ -3'2‘.171 7/ 7, 75; 7 7 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t4' ? • a0 // Site Address: b 7 x 10e) I e- t Applicant's Printed Name nt's Signature Permit #: Staff: Use BLUE or BLACK Ink c eU , ?nag' Permit Fee: +r Date Received 00 CALL BEFOR 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.gopnerstateonecall.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 app . val Page 1 of 3 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454 -5242 PERMIT FOR WATER SERVICE CONNECTION Date: 1 +/25/73 (12/29/72) Number: 11b6 Billing Name: iw., , _ad Villa - di;- 16 Site Address: 3zu7- 9 -7 -1 i 75 17 1`.i 1:LI tU ;e Drs Owner: Billing Address Plumber: J . ' 1'1)u.1.1n> Co. Location of Connection Meter Size Connection Chg:`L�• L /':" A Meter No. Permit Fee 1u. ,, .ct 12/26/72 Meter Reading Meter Dep. Meter Sealed: Yea Add'l Chg. NO Total Chg. Inspected by Date Building is a: Remarks: Residence \\`Se ECT�O` ED \AE�ERS' Multiple x No. Unita ' Zy pO'R \NS • Commercial Industrial Industrial By' Chief Inspector Other In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. BY: siK ey}aor:,t P1;4 Go. Please notify the above office when ready for inspection and connection. 3795BAPAN TOWNSHIP Knob Road St. Paul, Minnesota 55111 Telephone 454 -5242 PERMIT FOR SEWER SERVICE CONNECTION DATE:12 /29/72 (4/25/73) NUMBER WO OWNER: 1 iv�r sGa Villa - ftlldg. to r , r Address 3 "'('"x`71 '(3 75 -'(7 iii11x1dUx Dr3v PLUMBER beIrEA.::r4t P1mub5 Cc. TYPE OF PIPE 2.y}r cc.;;t ircri DESCRIPTION OF BUILDING Industrial Residential Multiple Dwelling No. of units Location of Connectionss 6 - o,,,: a:,11 .> Connection Charge 117C.&u Li-Lt Permit Pee 1 C.t v -ct 12/6/72 Street Repairs r 4 jc Tote 1 Inspected by: Da By Chief Inspector In c onsideration of the issue and delivery hereby agree to do the proposed work in ord with the regulations of Ea with the above permit, I Eagan Township, Dakota County, Minnesota rules and By PluL,Utae CO. Please notify when ready for inspection and connection and before an of the work is covered. y Portion r�ug ia io i i:�oa ounnsercemoaeiers o�i-ro�-y3yo p.�� Use BLI�E or BLA�CK Ink r_.�� -----------i 1 For O(fice Use � E j ,� . ` Per�nit#: / �� i ��u� U� �� I Permit Fee: � ' > � I � 3830 Pilot Knob Road � Eagan MN 55122 � �ate Received- I Phcne:(669)675-5675 � � � � Staff: � Fax:(631)675-5694 � � .�Y V ��.E, � �, � . ��el�€,'� C..i�� G` �,�°'`,'�C.t'1 iCt►'�^ ---_-__...__�_�__�� 2015 6��IDENTI�►� ��llL�t�VG PERNfIT A1�PLi��4TtON C-2 d-�.�° 13G��'� Tc,,�n h.:�i s-�s' Qate:�1�4�1 ti Si4e Address:��0'7�� i i �•:��a� ��r��- 55��I u��t�: _ - _......_._�.._z_.r.s.��-_Y�.._,,,.,.��.c:i�ci%�s`-�`a,Co�_;3�-iJ� ,m3��3;��--7�� 3�-1''7 � > Name: Phone: t �$@S149�17� Owner ; Address!C�ty I Zip: - r � , . . ; � � Ap�icant is:.. .._�n Owrier �Coatractor ..,�.� ..... __.,.......,.,.._..,_.�......._, Description o�wo�lc: �� - - ; �yp�o��lork __....:..,.,_......�._.�..�-_�..a... - ConstructionCost: � ��1�%�.'__LJY---.._y�^.�_a_N Mulii-FamilyBuildir�gf(Yes�lNo_, `..�..� _:.; Campany:��Y�, �; �� w1 ci,-e..-t-� �S �aniact: �G� 1 �-4-�.�'�.�:��'1 ��ntTdG�Of ^ Address:� �� D 't'"��-'�-. �-.c�'tll-� City: ��` r '�`�"� 1 � State: I,�`Zip: � G l /C� Pho�e: Email: i Y1�"� � �-Z�'►+�'��'��+�=c��..�:sr � ,� ;cu:,. �` � Lic�nse#:��1-: l� � � `-r� I � �ead Certificate#:�`��!`f� " r�c�� .� � ..,�____._,..�......__.._.._w._.........__.._._�� ._,�.�._�.._._..�w____..._..__..__�...�T�..._�_.� �..,.__._._.-----.._,_,.,.._ � if the praject is exempt from lead csrtification,P�ease explain why: � ; ' � �~�v CONiPl.E'E�THIS �EA ORILYTIF CONSTRUCTINC A I�EW BUI�DlNG : Ic+the IaSY 12 rnonths.has the City of Eagan issu�ed a perrrtit for a simifar pian 6ased an a�aster plan? s Yes f�o f�yes,date and address of master plan: ` Licertsed Plumber. Phone: E�echanic�Can�fractor: Phone: � Sewer�Water Con�ractor. Ft�one: 3 Fire Suppression GontraCtar: Phone: r� �NOTE:Plans and sup�or�ing documtnn�s tha�yace subrnit are canseBereat tv be public inforra�ation.i Poi�ions of , �ie 1rrf�Ptt�ation may be classifred�s aoe��vu6lic i�you provide sp�cific reasons that w�uld perlrrit�fre City ta : � ; cvx�clvde that fhey are frade secre�s. � a..__:..._.-.:�.:.�.w.:_.:.::......_._ti,..�:.:.:._..�...:.:.._. .,_�..._..y�_. ..,.,....�.,�.....r....,..._... C14LL BEFORE YOU DIG. Call Gopher S4ate One Call at t651)4540002for protecifon against underground utility damage. Ca11481�urs before you irrter�d to dlg to reCeive loCates of underground ulilities. www aopherstateonecall.ora I hereby acknow�edge that Ihis inFormation is complete and accurate;that the work will be in co�formance with Ihe ordinances and eodes of the City of Eagan; that I under5tand Ehis is not a permit,but only an application far e permit.entl wOdC is not to start without a permit;thai ihe woric will be:n accordance vrith thQ approved�lan in ihe case off woric wlvch requires a review and app�rovsl ofi pterrs. Exterior work auth�rized by a bvihfing pertnit issued In accordeece vrdh the Hlinnesota State Buiiding CaBe musi be compleEed wititin 160 days of permle issuar�ce. �—'—" x �j�` �L-F�^"� Ci'r'1 X -��/ Applicant's Pri�ted Name A 4's ignat�are Page 1 of 3 Use BLUE or BLACK Ink r----------------� I For Office Use � ' � Permit#: / �% � /� I Clty of �� Permit Fee: �e �- � 3830 Pilot Knob Road � �� Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: I I I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION �. 3��7`7 Date: Site Address: G1C_ T �v� 7 �J�� k��7..� �� Unit#: ' Name: Phone: I R�SI�f��/ ..�� (�y��; '� Address/City/Zip: �''� � �:��i�;ac�� . �}6,�1+•>, I1�1 rv• 55/�3 - Applicant is Owner �Contractor � �� Description of work: �S�Pt,A�tfi, (� �ja2S T�j� t3f It1/aCk � � I Construction Cost: 3(�� Multi-Family Building: (Yes ✓ /No� Company:_�N►��► �iA�u,��Aii�9fr� �Oo�t.as. (.L G Contact: � � e�Ohl*�So� Address: �57�0 90��0. City: (.,�¢NyUii,�J ��2Ls CU?t'�1`14'�O�i' State:�/� Zip: 5500� Phone: 65/--?5�S—D3//Email: SJoNn►.SDr��tiwvOn�lJMti�^t� •��"" License#: N�A' Lead Certificate#: *� If the project is exempt from lead certification, please explain why: /vo (�}� PR�Sg,�„ 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: ; I�aDT�.Fl�ias ar�d',�t�Rpor�r��foc�met�t�r�t yr�u s�rb��are ca�rs��Iered to��rt��c fnfor�r��i�an. l�or�vf �ire�rrt'ort�re�iaaa r�t��e cl�s�r�ed�s r��rn p�blic�f you pror��d?e�s��c�c reasorrs�t�#aw�o��t perr��t t�:G►"f,y t� cur�cfwtle tl�a�.th$ are t�'��ale secr�s 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. wuvw.qopherstateonecall.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 authorized by a building permit issued in accordance with the Minnesota State Build' must be completed within 180 days of permit issuance. X ��.✓�i �JVH'N.S6N X ApplicanYs Printed Name Ap ' anYs Sign ture Page 1 of 3