1649 River Bluff Ctki City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
4 4 (7, ziq
Date: 4 ap // Site Address:
cant's Signature
Use BLUE or BLACK Ink
trice Use
Permit #: -1 0 i I xi
Permit Fee: '39?. 75
Date Received: ( 1 - 2141
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
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
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 1 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 ��oGI P f3o»
Applicant's Printed Name n .
Page 1 of 3
RESIDENT J
OWNER
Name: • •• - , ,, V _ , , - ,,. _A „a Phone: 76,3 - `/y9 - 9 /on
Address / City / Zip: , � . 1 • . .. Ali . ►f A/ __
Applicant is: Owner x Contractor
TYPE OF WORK
Description of work: Re, -a0-
Construction Cost `� 5 23. 77 Multi- Family Building: (Yes X / No )
CONTRACTOR
Company :, Sl t n r<<Se, (e.p.n otJ e lM d7 C.. Contact: el PQ. -)
f .i
Address: 64 7 6 IIobe. L j i e_ City: SF. P0 to I
State: t'9 N Zip: 55//O Phone: 616/ - 76„1 - 9a 45
License #: ( 1515/g Lead Certificate #: NAT aa9. 3 -a
lithe project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
_Yes No If
COMPLETE TI-HS 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 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.
ki City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
4 4 (7, ziq
Date: 4 ap // Site Address:
cant's Signature
Use BLUE or BLACK Ink
trice Use
Permit #: -1 0 i I xi
Permit Fee: '39?. 75
Date Received: ( 1 - 2141
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
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
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 1 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 ��oGI P f3o»
Applicant's Printed Name n .
Page 1 of 3
Aug 18 1511:02a Sunrise Remodelers 651-762-9395 p.15
Use BL�JE or BLACK{o�k
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� Permit#:� � f
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1 Pem�il Fee: �
383Q P11ot Knob Road � E
Eagan Mla�5122 � Datie Reoe9ved; �
Phone:(651)676-567� _ � �
� StafF �
Fax:(S51)6TS�iS94 �
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2015 RESID�t16T�A►9� BllILDIN�a PER�AAIT'APPLICA'�'1��'V
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DaYe:�-��'i � Site Add�ess: ��D � ��V� Y' �1�r���t l�e�4l� 'r�'�13{Unit#:
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: Name:
� �hor�:
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OWne� �: Add�ess/City/Zip: �
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: :
' Applicant is: Owner �Contractur
r T'yp�O€1�fOPk ' �escription ofwork: ��; c�i n c�
i �J
� � Construction�ost: � 9�: �C��� flfluiti-Family Building:�Yes,�/No_)
: ;
:
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3 Company:�`1�'�1r� �r;��-� ��e vv1 c�c�-z._4-��S Contact: �c;<'..� �•�� ���'1 `
` Address:"��� �C 't�iL' Y�� �-ci �1�'� City: �'�`' �.�•'� � '
- ��r�tra�� .
, (' ��
State:��/�: Zip: �C1 !U Phone: Email: i 1r1-1"� � S..e ri,r:����r�v+ccr-e:.�;s,
` � �L�r►.
? Lfcec�se#: C v �f� ! � Lead Cert�cate#: /��_1 ��� �����.
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; 1�the project is exempt from iead cert�fication,please explain why:
�O�iIPI.�TE �'HI�fAREA 0�1LY�F CONS7'RU�TIl�G A N�4fl/BUILDING
; 9n fFi�iast�2 mortt6s�has 4he City of Eagan issued a permit for a similar plan based o�a master plan?
Yes I�o If yes,dale a�al address of masfer pian: '
= Lic�nsed�iumber. P(none:
; Mechanical Confractor: Phone:
; Sewe{�Water Contractor. Phoeee: -
> "
* Fire Suppression Gontracf�or. Phone:
;_._......:__:,.»_..._.,R.r..,.�,.�._..r__.::r...�..�.-e�..._.��..�,.�:..��-._.M�,,,�.,..,._.:....�...,�..�..._�-_x:�..,.x,-�:_,:�....�.�,...-------„-�._„�.��._._,�.�,.��-�....�.�:
' �P+�TE:PEaras anai suppor#it�g dectarrae��s ifia2 ya�at st�bmet ar�consfdered#o be pubrc irrfarmatiori. Fo�tioc�s of ;
�= �lae frrforrara�ion rna�be ciassrfie�as non pubrc if you�rovide speclfic r�easmns t�aat wbufd permiE the Cety do
I
.
ear�clude ghat�Fre ar�trade secrefs.
CAlL�EFORE YOU DlG. CaEI Gopher State One Call at(651)454-0002 for protedion agai�st undeEground utildy damage. Call 48 hours
be(ore you intend W dig to reoeive toqtes of underground ulilities. www aoohersta[eoneoall.ora
I hereby ec�cnowledge ihat this informalion is oompleie and accura6e:that U�e work will be tn cor+forrnance wilh Ihe ordinanaes ar�d c�odes af the Ciry of
Eagan;ihat 1 unaierstand ihis is not a perrnit, buf only an appGcaGon for a permit, and worh Is noi to start without a permi� thaf ihe work wiH be in
accordance w9#h i3�e approved plan in d�e case of work which tequires a review and aoprovaE of plans.
Exterlor wor�c authorized by a building peRnit tssued In accoTclance with the Minnesota&tate Buiitiing Code ms�st 6e completed wi4hin 180
day�of permit issuanes ,__,.,
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Y.
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Applicar�t's Prir�t�af Mame 's Igoature ,
Page 9 of 3
Use BLUE or BLACK Ink
� r-----------------�
I For Office Use �
' � Permit#:���/ t% i
Clty of ����� � C. �� ;
� PeRnit Fee: r�
3830 Pilot Knob Road � � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: I
I �
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:� � ` 5 ��' .� � � ���i 7 Unit#:
Name: Phone:
� �F��S�i�BFt� �� /'�
(�y�� Address/City/Zip:��� � `"/ ��Vl.�alt�,f"P C'�' ���J. 7YIN• S5/-2�
'! Applicant is: Owner Contractor
�. �� Q��Q�,� Description ofwork: ��Pl.+9C� � ��
�
to
Construction Cost: '$ .3 Multi-Family Building: (Yes�/No�
Company: Da 66 �M L(.G Contact: �7�K3 ��SD�
,
�������, � '�� Address: ,3. 780 9D� � City: ��Fivruo..r �i�'t,Ls
State:�'1N Zip: 5So0 Phone:�OS/'a`/5- d3/J Email: SJoH*�soy.i�('�4rwoN�'��jC� ,�
�
License#: JV IA Lead Certificate#: N��
If the project is exempt from lead certification, please explain why:
No (,t.tio ��ts�.r�
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:
J1f�'?lf:t��a�rs ar�d str�t�a�rg al����ents t�at yoc�,s�-it ar�can���feretl to be,;pu6li�:��ft�r��a►a �?orttfl�s.a�' '
tt�e J�rfor�a�it�n�ra�ty b�cl�s�i�ed�;�Eron��bli��f yot�,prot�eil��pec���rea�r�r�s�hat wauPd°�err�tt�r�C�'�r�
'c�����le t����i �ar.e tr�c�le.,��crets. '
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 5� �a�s� X
Applicant's Printed Name Applic 's nature
Page 1 of 3