1658 River Bluff CtGity �f Eaffau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1-{ ' S r7 • a0 // Site Address: / C.
x 130e-1 PP,4 - e -Ca
Applicants Printed Name
n Signature
Staff
Use BLUE or BLACK Ink
Fir Office to
Permit #: 9
Permit Fee: / oz)
Date Received: 1 -1-a/-#
if
CALL BEFO 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
1 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-
Page 1 of 3
RESIDENT !
OWNER
Name: pine n 1`` e,ttai,e~„i- (1. Phone: 763 yy9 -91nn
V
Address / City / Zip: _ • . . .I, Ali . y ♦ 4 1 �
!
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: R -r o
Construction Cost 4 ow i 2 n , Multi- Family Building: (Yes ?C / No )
CONTRACTOR
Company: SUnr•;,5e-- ke.r,n,)d e4 Sc Contact: d P
c y y -)
Address: ai 7 ( 11p& j n c_ City: 1/454-, f a i n
State: {"l Jv Zip: 551/0 Phone: 66/ - 7601 - 9.245
License #: 06/5/S Lead Certificate #: JA 1 - aa9 . "3 -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 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.
Gity �f Eaffau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1-{ ' S r7 • a0 // Site Address: / C.
x 130e-1 PP,4 - e -Ca
Applicants Printed Name
n Signature
Staff
Use BLUE or BLACK Ink
Fir Office to
Permit #: 9
Permit Fee: / oz)
Date Received: 1 -1-a/-#
if
CALL BEFO 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
1 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-
Page 1 of 3
Aug 18 1511:03a Sunrise Remodelers 651-762-9395 p.16
Us�BLUE or BLACK ink
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i ForOfilce Use �
1
° � Permii#_ ����� 1
A1�6� O� L���9� ! Pemiit Fea:�, ��. S�` 1
I
3830 PiEot Knob Road � �
Eagan RAN 55422 � Oate Received: ►
Pho�e:(fe5'�)675-5575 , ! I
Fax:(651)675-5694 3 �a�' j
•'�I�GL�` � �� f! , ����•�i�'� �:1�'j 6' ��4=-�c.n Ci:vr j-----------------'
2o�s RES1�]E�'�iA BIj�L�111dG P�RM�T APPLIC�►TI��1
C-�dy_,r t3il.� � .7"'c 4.�n h.:�t s-c sf
Date:?�-��'i � Site Address: 1�D-J� �'.V,��( �1�,ti��� tu�.l� S�l 31 Unit#: -� _--
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' 3Vaane: Phone:
R2SI1��0141 �
Owne` =. Address i city l Zip:
' � Appiicar�f is: Ov�aner �Coniractor
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T�p2�f 9Norlc : �escriptian of work �j� � n�
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� ConstruGtion Cost � ��- �'1 C��'• Multi-Family Bu�ding:{Yes ✓ I No_, �.
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; � Company:��'�Yt ��: 1-{'_ i'�`�-�crvl �.c�.t-e �S Gontad: ��C'..1 �-ti-t�:'� �:�-�
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� Address:��'��G' 'i�Tl:�� �-c1 v'1-� City: �i. �a
� Cc�ntra�tor (' � '.
` State:,,'��1.'Zip: � �i JtJ Phor�e: Email: i Yl'�'� �', �-�-"..t3�r:�������n�c�i�e,-s�
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` ' License#: E.. � �`� � � Lead Certificate#: �� _
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1 - 2� � �"�--
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� if the project is exempt Yom lead certification, piease explain why:
��_�Y'�� �OMPLET� THIS AREA ONLY BF CONS�RUC'T�NG A NEW BUI�.OING
;. I�the last 42 mon�s,has ihe Citv of Eaga�t issued a pertni4 fior a sim[lar plan based on a master pian?
Yes No if yes,daie and address of master plan: �
- Licensed Plumbee: Phone:
;
s ilflechanicaf Coe�tractor. �hone:
a
; SeuYer��I/ater Contractor: Phone:
; �ire Suppression Contractor. Phorie:
C...y_.-......<.....�....�.-:....._,�,.��....�-F.�:.�..,....r..._......�,:..,.>..-x�.u��.,...._,,,,'_.___._._...�....,:-,.:......._.....�..,,sx..�.<„e..-....,.....t�:n.-.., .�.e.�„e-_>..:_. .....--.+�.-....�. . . . �a.,...+:.:
: a'�OTE:Plans ano9 suppor�ing�documee��.s ihaf you submit are considered to be parbfic inforrnafron. Por�ions of ;
�ie infarrrxlation mey be c/a3sified'as no��ublic if yo��mvide spec�frc reasons t�at would permit th� City to ,
` _._.�u:sconcle�de that#hey are�rade secs�fs.
C14Li..�EFORE YOU DIG. Call Gopher State Oee Cell at�651)454-0002 for prokecfion against underground utflity damage. CaA 48 hours
be#ore you iritend io dig to►2ceive loestes of underground utNities. �rrwu��.Qoahersiateonecall.ora
i hereby acknov�edge that this iniortnation is camplete and accurate;that the wror}c wAl be in r,rorifortnanae with ihe ordinances and codes of lhe City of
Eagan; �hat I understand this is not a permit,but oNy an apppcation for a permlt, arxi work is not to start wik�eut a pertni�thai ihe work wi11 6e in
aocortiance wilh the approved plan in the case of wark which neqaires a review and approva!af plans.
ExEe�lorworl:authorized by a buiidMg pemrit iss�ed in accordance wlth the Nfinnesota State Building Code musR be oompleted wi4hin 960
days of perm�t issuance. � ---- ..
�
x ,�` ��--�-�L'f'� C+r1 X
�4ppiicanYs Printed Name A an s Ignature .
Page 9 of 3
Use BLUE or BLACK Ink
r----------------�
I For Office Use �
' �� / I
Permit#:�� r I
Cl6y Ol ����� I Permit Fee: �.--�-��� I
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (657)675-5675 I I
Fax: (651)675-5694 � Staff: I
I �
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: � [��� � �J ����Unit#:
` Name: Phone:
I�eSitle��' � �� �
('�yy�� Address/City/Zip:�tD�� ��VI.�RaI�.I.f^P CT ��k'�nA-r�. '7'�'IN• 55���
' Applicant is: Owner Contractor
T�� Q���� Description of work: �EPt.�UE � ��
to
Construction Cost: `� 3 Multi-Family Building: (Yes�/No�
Company: On► b6' �,r� L(.G Contact: S7�L[�' ����
,
Address: ,3, 7B0 qD f`` �Lt' City: �it�oa.+ �i�-z�..s
�0�1"�=t+�C'�OJ'
State:�N Zip: SSOD Phone:�OS/-a`/5- d3�1 Email: SJoH*�so..i��o����^jGo�l-a►' ,�
�
License#: JV IR Lead Certificate#: Iv�9-
If the project is exempt from lead certification, please explain why:
No (,t,�o ('��ss�•�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:
l�t?T�'.F�a»s arrd sc��ca�►��r�g dncurner��s t�rat you;�tr�t;��t are ca�slde,r.ea1#o be p��bl�c�n�rr;►�at�ort Pa��vr�'r�f '
r����i�rt�a��a�r�aay b�c�s����d�s�t�n-p�bti��'�'yc��►pro�rld���e�i�c reasar�s ti��#wfltrld�err��t�e G�'y ti�
cr�c�d�fhat the �r.��d+�,;s�crest�, :
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. vwvw.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 Building Code must be completed within 180
days of permit issuance.
x S?Z31/� �OI�rS� x
ApplicanYs Printed Name Applic 's i nature
Page 1 of 3