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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 r-------------.__.._� 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#: -� _-- ;_�.,�r_�_.-..�._,,___�. ���ic.�i"�y`c�s:�(v 5�a;-I l0 5�'�jMl(0 5��._f�,vX����� ���.�._�_ ' 3Vaane: Phone: R2SI1��0141 � Owne` =. Address i city l Zip: ' � Appiicar�f is: Ov�aner �Coniractor :�,_.:.-.:..,..,.��n..:: ....�..V..,�„�.._.....-;.,,r_ ��.�,-_......__ _ ,,.w.-.�...�.. .�..._.�..___,.,�._�e,.t��,..,.-._�_.�..,.Y�_.�__.___..�...�_A._.._r....,Y.�,.�.-�...,�..,..�,�_..z_ T�p2�f 9Norlc : �escriptian of work �j� � n� . CJ � ConstruGtion Cost � ��- �'1 C��'• Multi-Family Bu�ding:{Yes ✓ I No_, �. :.:�_._.:,.....,.-..:._,�....._:..-__.:.�,,..._r�..�..,�..,�.,�_.�.:. ....,_ ' . .___.._.,_....�._...,,� .�..,�.�._�__.�._...�._.._.__._,�__.,..�_.�..:,•.__ ..�,.�..�.-�.. ,__�__...__._._... . ; � Company:��'�Yt ��: 1-{'_ i'�`�-�crvl �.c�.t-e �S Gontad: ��C'..1 �-ti-t�:'� �:�-� � � � ��' � � � � 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� • � 'L c:-►- . , . . , . : � � - - ` ' License#: E.. � �`� � � Lead Certificate#: �� _ : 1 - 2� � �"�-- . : � -- � 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