1648 River Bluff Ct4 11b°. CityofEaWafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
/6LQ q 7 l l 116 4(
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Li • a t ) • (2011 Site Address:
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
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
x 100) e t_so -» x �'
Applicant's Printed Name
A •1 cant's Signature
Use BLUE or BLACK Ink
For Office Usa
Permit #: $c 7/ (Q
Permit Fee: ' 395.06
Date Rec2ived: `7' — (2/ 1I
Staff:
Page 1 of 3
`-� 4.11111. ft.
RESIDENT /
OWNER
Name: 0ryJ ey) n Nea „ a tille.�a 1 c Phone:
_26,1:
V ,J
Address / City / Zip: _ _ * . , 4 . ,` . • hi A a/
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: Re -
Construction Cost c.$ &7,s. 0c, Multi- Family Building: (Yes X / No )
CONTRACTOR
Company:, S(,t n 6s e, kll.m,or ell S Vi1 Contact: ( Pe r 0 .,- )
Address: 59 7 (o I kbc 1--c ,n City: .5-1-. F c t I
State: M 1\j Zip: £j //O Phone: 66/ — 7601 — 9 45
.7
License #: a0 ($15/ Lead Certificate #: j - aa9 7)3- O
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 in orr ati on. Porti o
the information may be classified as non-public if you provide specific reasons that would permit the City t o
conclude that they are trade secrets
4 11b°. CityofEaWafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
/6LQ q 7 l l 116 4(
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Li • a t ) • (2011 Site Address:
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
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
x 100) e t_so -» x �'
Applicant's Printed Name
A •1 cant's Signature
Use BLUE or BLACK Ink
For Office Usa
Permit #: $c 7/ (Q
Permit Fee: ' 395.06
Date Rec2ived: `7' — (2/ 1I
Staff:
Page 1 of 3
Aug 18 1511:01a Sunrise Remodelers 651-762-9395 p.14
Use BLUE o�BLAC�C Ink
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-----------�
1 Eor Office Use �
1 !-�
G�° � PermB�#: /�v� ���-- j
t� of �a���. � Pe.�n�Fee: ���5-�� I
3830 Pilot Knob Road � i
Eagart MN 65722 � Oate Receiv�d: �
Phone:(659)67fi-5675 ,. 1 �
Fax(65�E)B75•5694 � Slaff: �
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Da4e:�'1�'�_'r_�_ Site Address: E��cJ P'1►w�°t ���,'��t• ���l� ��l�I linif#:
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:�ve c t u c`��;�..r l.����'��lv�-1 � � I ln���--'r..�C��-i� t�� I�:�.{'�r
: Name: Phone:
' 9ZesideaEt/
��p��P ; Address/City/Zip:
�
� = Applicantis: O�vner �Cflntractor
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' T e of�'orit � aescri tian of work: ��: � ��
� �p p ' �J
; Co�strudi�n Cost: � ��4 �C�� � Muiti-Family Building:(Yes�/No_j �
� � Company:�L;.� v';S-� ��e vv1 cc�_1-e:S Contact: �t;i..1 �•�� ���1
� n
� h-�t �
� �011'�P�C$�T , Acldress:��� lL' 't"IC.`�'�-. �.ct �-� City: �'�'• .�a
' State: '�,�Zip: �C 1 !U Phone: E�nail: i Y!�i'z% � S..e 1�r=���r���:c�-e.1�;s r
.
�C.c:�•
.
: .
" �tcense#� C � (� ��I e � � ea��ert+Ficate#: i�//�-'T 2� �l �3
.
� � �. - i /
-- .,
: �f the project is exempt irorn i0ad certificatien,piease explain 1+uhy:
�4AflPLETE THiS AI�EA�NLY�F CONS1't4UC't1�4; �,NEIR/BUILDING �
: !n 4l�e lasf#z rr�onElis,has the City of Eagan issued a permit fior a sirnilar plan based on a master plan?
- Yes Mo IF yes,date and address of master plan: '
�
� �icensed Plumber, Pi�one:
R
; �flechanical ConQractor. Phone:
;
` Sewer�Water Contracior. � �ho�+e:
' �ire S�uppressio�ContracYor: Phone:
� P�lJTE:Pfan�arrn►siipporfi�rtg dociirneii$s�Pia#yoei�su,br�+if are considere�eo~be public imfa�rmmateon. Partiorrs o���
.
�e iRfo�rna�or�may be c�assifreaf as non-pubrc if yo�peevide speci�c rr�aesons thaf woWd permit the CitJ�to ,
:
� cor�c/u�e fh3g$hey�re trade sec�ets.
CALL BEFO4E YOU DiG. Call Gopher SPate One CaEi at(fiS1)454-0002 f�proiectian against undergrourst�l�7ity damage. Call 48 hours
befote you intend to dig to receive locates of underground utilities. www.aonherstateonec�ll_oro
1 hereby acknowdedge that this inForr�atian is complele and accutate;ihat the vrork wzll be in conFormance wi�h the otdirrances and codes of the City of
Eagan; thaf[understand this is nofi a peRnii, but only an applicaiion for a peRnit, and wo�:is not to starl wil�out a permit; that ihe v�+ork wilf be in
accordancewiEh the approved plan in fhe case o�work which requires a review and approvaf of plans.
Exter�orwork authorized by a building perm�t issuerf ia accordancewltle the Minnesata State Bullding Coda mus4 be compleEed wiYh9n 180
days af permit Essuance. __,_.,.,.
� ��>�,� �'.�..-�-�.q�s' G V"� � �
Appficant's Printed Name A a 's ignature .
Page 1 of 3
Use BLUE or BLACK Ink
r----------------"'�
I For Office Use �
I �
,
C�� O� n� �� j Permit#: j
Y � � � �
� Permit Fee: y�,l�S-�� �
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone:(651)675-5675 I �
Fax: (651)675-5694 I Staff: I
I �
-----------------�
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: r7 1Lt �'`�`� � `� ��'� Unit#:
Name: Phone:
Re�iden�l / .-�
_ Owr�er
Address/City/Zip:�(� �� ��Vl.�R3l u.f^P CT ��.,s�. 7YI�. S5/2-T
Applicant is: Owner Contractor
.�,��Q Q,����,� Description of work: �GPt.�C.E � ��
to
Construction Cost: `� 3 0 Multi-Family Building: (Yes�/No�
Company: O�J 66 �/+d LLL Contact: .�7�GE3 V�S��
` Address: ,3 7B0 90� �'L� City: �it�o� �if-t.�s
�.r'Q411�t'a+��t '
State:�/U Zip: .5500 Phone:�DS/-ay5- d3/I EmaiL SJoH*�soy.i��q,�oN1l�'�16�N-a++r ,�
License#: JV 1R Lead Certificate#: Iv��4- ,
If the project is exempt from lead certification, please explain why:
No l,t.�-o PFGss�.�rT
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�DT�' Pl�ns art���tp�part�g docc��ner��tf�at y�ru�ub�it�r�c��r�s3tl�red to;b�p�a#�c��rr�at�or�. Porttrr»s c�' '
t�re�r�f�i�rr�a�in may be cla�.���'�etl�s�n�atii�tic l�',y�ou pro►�e s���if��rea�tsns.�fi�t wo�t�t per��t i�C�at',y t�
c�n�lude t��t�l� . are tr°aal�,,secre�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. www.aopherstateonecall.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 180
days of permit issuance.
x 'JlTZ3V�' �d/�nTS o-+J x
Applicant's Printed Name Applic 's `i nature
Page 1 of 3