1628 River Bluff CtCity otEagau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675-5694 & / - 54/r 36
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L( man • ap// Site Address:
GALL BEFORE YO 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.gopherstateonecali.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 n
x ,oeJ PPA -e.cso
Applicant's Printed Name ..�..«�
Signature
Par- 3( Use
Permit #: ! F iS
Permit Fee: H' 39 g 75
Date Received: y - l ! J
Staff:
Use BLUE Or LACK Ink
Page 1 of 3
. .... ,. .. 11 . �. VIII(if:
RESIDENT t
OWNER
Name: Ornp j'`ir•nnayr:ryt ( 41 r. Phone: 76 - 'Ng - 9 /nn
Address / City/Zip: i , , d t. ` _ / . 4/. F91111 • V
_
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: Re.,- -P
Construction Cost i /, 5x23. 99 MuIli- Family Building: (Yes X / No )
CONTRACTOR
Company :, co n r,s� ke PJ(X3 di �. Contact: 5 L( Pue - sc
Address: ,5 7 6 Iiobe. /n r_ City: 34.. Pa u'
State: M N Zip: £5//Q Phone: 65/ - 7601 - 9a 95
License #: o /5/ g Lead Certificate #: NA axi .33-0
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. Portions o
the information may be classified as non-public if you provide spec reasons that would permit the City to
conclude that they are trade secrets.
City otEagau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675-5694 & / - 54/r 36
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L( man • ap// Site Address:
GALL BEFORE YO 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.gopherstateonecali.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 n
x ,oeJ PPA -e.cso
Applicant's Printed Name ..�..«�
Signature
Par- 3( Use
Permit #: ! F iS
Permit Fee: H' 39 g 75
Date Received: y - l ! J
Staff:
Use BLUE Or LACK Ink
Page 1 of 3
Aug 18 1511:01a Sunrise Remodelers 651-762-9395 p.13
Use BLUE or BLACK Ink
r----�'-----__—_�_i
I For OFflce Use �
1 �
�' � Permit#: /���(� � I
�b� O����LLli � _�� �- ,�t`} I
I Permit Fee: �
3830 Pt1ot Knob Road � j
Eagan MN 55122 � Date Recewed: �
Phone:{657�G75-5673 , � �
Fax:(651)675-6694 � Sta�F: I
'�Y r I�.i ' �� � , �(���i�� C:!"` G' �4�1.7C,n G.�:rY� !----------------''
2015 RESI�EIVTIAL BUILDING PERMIT APP�ICATION
�-e d�Y' G��-� Tb��r► H►��i s-rr s('
�ate:�-��-E � Site Address: �tfUp��P ���V�Y 171L�t�t' ���1� rjGl 31 Unitti:
;,�,_,.. . .._-�,.-:a,x...��
; ,�v�c,t�c� �: �tp�S, ��03� I Cv"3�. , 3�� , I(0 3 G� €
3 Name: � Phone: �
t �
� Resident! - s
i Qy�n� � Address 1 City 1 Zip:
; s Apptica�t is: Owner �Conlractor t
�._,.�.,.,..:._._,�..,._�.. , �,x.��.�w.,. — --.w--�- -
� ' Des cripEion of wQrk: ��: C� /�� ''
� Type of Work � �
� a Construction Cost: � 1�: �C�Q•Q Multi-Family$�.olding:(Yes�/Na�
�_�.r..��.....�....,._.._�._...,_.;,----�_.,..,.�.�_...._,_.� ._._....u.�..__,,,..-..�... ..,,w...�. - - ...._.:...._
>: :
, e ` e
t � Company:�j�:'�Y1 ir ��-� ��vv� cx�_4-e�S Contact: .]t.',C'_.� ��--4-e.� ���1
} ; Add :����G' 'I��C:�E... �ci 111-�'_ Ciry: ��'• �t.�t � �
's Corttrd¢tor �ss �
�, � a
� � State: !L`Zip: � c/ /v Phone: Email: ��1�Yt� P'. �-�1�r-�'y r�v+ucl-el�e�.s�
s ,C.c r►-
! ; L�ce�se#: L � (y �I� � � Lead Gertificate#: �7'3 �'�_3�'� `
�..�.�..p...._,.�.�....,�..._�--�- - -- -----�- �� "
{ � �
� !f the project is exernpt from lead certificatio�,�lease expiain w�y: �
k � ��
:
�
�....---. ,.�, � - . . ;
= COMPLETE THIS AREA ONLY IF CONSTRUCTING A NE1N BUILDING
; In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
�
4
c Yes No If yes,date and address of master plan: '
; lice�ssd Plumber: P�one:
t
5 Mechanica�Contractor: Phone•
1.
a
iSewer�Water Co�hactor. Phone:
i
� Fi�e Suppression Contractor. Phone: ?
��NQTE:Plans and supporting documents that you snbmff are considered to be pub►ic inforrnatior�. Por�fons of j
' the information may be classified as non•public if you pruvide speci�ic reasons t/iat waLld pemtit the City#o '
,
;
� conclude that the�r are trade secrefs.M��.��.�- _ ---__-�����:
CALL BEFORE YOU DIG. Catl Gophar State One Call at(651)454-0002ior protedion against under�ound util9ty damage. Cail 48 hours
befire you irrtend to dig to receive locates of underground utilities. www,aonherstafeonecall.oro
I hereby acknowledge that ttvs ir�#ormation is camplete and accurate;that the vuark w�'ll be in confortnance with the ord9nances and codes of the£ity of
Eagan: that I understand fhis is not a permit, buE Only an appfication for a permit, and work is nol to ste�t witfiout a permit; Ihat the wodc wiA be in
accordance with t3�e approved plan in the case of woric which requires a review and approval of plans,
ExteNor woric authorizsd by a bufl�ing permif issued in accordancewith the M9nnesota Staie Bu�diflg Code must be complelgd within 180
daysofpem�itissuanoe. � _..._.
X ,�,l ��L.--�-E�i1r.� c r^� -.�.�
Appiicant's Pr[nted Name A � 's igRature .
,•' Page 1�f 3
Use BLUE or BLACK Ink
r--___---
--------�,4�����
I For Office Use
I
' � Permit#: � � � �S
Clty of ����� ,J
� /a�. �� ��
� Permit Fee:
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
/ f �� �- /�=�(�
Date: Site Address: �/)�:((.0 E- �����'v��� �� �� Unit#:
Name: Phone:
I���iCler��' /�
(�y��;� , Address/City/Zip: ��o�t� }��Vl,��lt�,f^P Cl� �A�c'�,9�r�. 7'YJN• S5i�3
Applicant is: Owner Contractor
Description of work: �6Pt.�GE 1�3�2�cy3 ��
T�I'p@ c}�Ws�?rk
w
' Construction Cost: `� 3 0 Multi-Family Building: (Yes�/No�
Company: 0�1 �r+d GC.L Contact: STIy'L(�' ��5��
.
Cc�ntr�ctar Address: 3578o yo f`-" A�.� c�ty: c�.�uo� �.1�u.s
State:�N Zip: .S.SOD Phone:�O..S/-a`/5- d3�J Email: SJol+Nso��('�4�vo�11��lCs�th�+' ,�
License#: fV IA Lead Certificate#: N�9- �
If the project is exempt from lead certification, please explain why:
No l,t.ao �F�ss"rr
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:
11�flT�':P�a»s a�ads�p�c�rl�n�alr�ci�ts�ts��#yot,r�ub�are ca�asld�t�etl to:be pt�b1��`f�fr�r�a��a�a 1?i�,r���s of
' �he ir��rrna�#r�rr rn��!b�e cias��#'ied a�s��:p�#l����'yc��prrr�l�e s�e���"ic reas�t���rat ti�a�fd j�e�r��t��C�fy t� '
concfe►de`�i�at t�� �re�ad�se�r�;�. '
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Ca1148 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 authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 780
days of permit issuance.
x -J�??I31/� �J d 1�t1 o�+J x
ApplicanYs Printed Name Applic 's nature
Page 1 of 3
For Office Use _
; ` Permit#:
Permit Fee:
Date Rived:
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinoinspectionsCcitvofeaagan.corn L
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: "'"12)-A 41.-2i% site Address: ` tV U'( " CU 'jeaccuct,M 5S 2A
Tenant: kAte,Aoi U„ - Suite#:
Resident/Owner
Name: �-k V ( 4„.„, Phone: , et.• Vit
Address!City I Zip: NNN 2& ZWA-C CA,G-QTAin.j A) S5 42-1
Name: 't- License#:
Contractor Address: City:
State: Zip: Phone:
Contact: Email:
Type of Work New —Replacement Repair Rebuild —Modify Space !Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater •
_Lawn Irrigation( RPZ 1 PVB) Water Softener
Permit Type Add Plumbing Fixtures( Main/_Lower Level)
_Septic System
New _Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures,Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(851)454.0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.gopherstafeonecall.org
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeauan.com/subscribe.
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.
X 00..\‘‘. t . -- x‘1"--;41-
Applicant's
1--4 'Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-ln Air Test Gas Test Final
liater Related items: Meter Size T Radio Read Manometer Staff,