Loading...
1630 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