1657 River Bluff Ct4
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694 / / 1
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: y •fin • c20// Site Address:
x 10e,! PO4
Applicant's Printed Name
x
A
nt's Signature
Use BLUE or BLACK Ink
For t3 ffice Use
Permit #: g `
Permit Fee: '3c2 q •'75
Date Receii ed: ti-a/
Staff:
RESIDENT /
OWNER
TYPE OF WORK
CONTRACTOR
16.G/ f, ■A
Name: OrYJoy)rA rmagt°r✓tr.J')4 Q
Address / City /Zip:
Applicant is: Owner x Contractor
Phone: 76.3 yy9 -WOO
Description of work: Re , ,
Construction Cost -r DI, 5023
Multi- Family Building: (Yes aC / No )
Company :,, CI - , St - 1 Z (' 4)n")fJ J (3 SC
J
Address: 7 6 IIp& `_ � -
Contact:
city: 34-, Po (
State: M /i Zip: .ar5 //O Phone: 676/ - 76 - 9a
License #: 05/5/g Lead Certificate # : N A T - -
Pe J c ,-)
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
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.
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454 -0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. nrww. gopherstateonecaII.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 . vaI
Unit #:
Page 1 of 3
Aug 18 1511:04a Sunrise Remodelers 651-762-9395 p.17
Use BLUE or BLACK lnic
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I For Offlce Lise �
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C�t� o��a �� � Perm Fee: ���'�� �
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3830 Pllot Knob Road �
Eagan Af3N 55122 � Date Received: �
Phone:(fb7)575-5675 ,. � �
Fax:�651�675-5694 � Staff: �
1
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Resider��
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�.�pe O'F 11VQ�'(K Description of work:_ �j+ CJ� n�\ �
� � Cons6vction Cost: � 1 !� ���'•C�
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_- Multi-Family Building:{Yes ✓ !Na_) ?
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� ; Shate: 1?/1J Zip: � �� �V Phone: Email: i Y1 yZ.% �. S�-i Yr r� ��V��v+cc1-��;s,
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� If th�project is exempt from lead certification, please expfain why:
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; GON3PLETE'd"FlI��►6�EA�MILY�F CONS'i"RiJCT[�G�4 NE91�/BUIL�ING
_ !n 4he last 42 months,has the City of Eagar�iss�ed a perm'rt fror a similar�lan based on a master plan?
' Yes No If yes,date and address of master plan: �
� License�Plumber. Pfione-
: Mechanicai Contractor: Phone;
; Sewer&Water�ontractor. � Phone:
; Fire S�ppression Co�tractar. p�aRQ;
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; I�OTE:PiaraS ardd sttppanis�g cfoct�me�nts�daag you sue�rrrit are consldereaP i�be pubiic informafton. Por#ions e�� Y '
- the ir�fa�t»atlo!r�ay be classi�re�as nan pubiic if�rou provfde specFfic reas�ns that wbulaP�enrrit the City tm- �
' __......��..._---�N,�p��nclude thaf tfreyare�de secre#s:, n�... ....:,.�.....:�4.�_�.,_�._�..y.�...�..._s_.�.r_.�..._.�
CALL BEFORE YOU DIG. Calf GapherS4ate Oae CaIE at(651�R54-0002 for proteciion against�mderground utilitydamage. Cafl46 houfs
befere you intend io dig to receive lacates of u�erground utiUfies. www.aooherstateonecail.ora
I he�e4y acknawledge tbat this information is complete and ac�rate;that the work w�11 t1e in contom�ance wiU�the ordinances and oodes o4 the Ciry of
Eagan; tnat 1 understand this is not a permit, bu#only an applicalion for a permit, and+nrork ts not to start without a permit;that ihe work vm71 6e in
accoMance wiiE�Ihe approved pfan in the case of work which requires a review and approval of plaris.
ExEerlorwotk authooized by a building perrni!issued in accardance witB the ARin�esota State 8uilding Cade must be completecf wi4hin 980
days of pennit issuance. _,_
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Applicas�t's Prmbed�Uame a 's ignatuee _
Page 1 of 3
Use BLUE or BLACK Ink
r_______________s.�
I For Office Use �
• � Permit#: ��� �� I
C��� �� '""�"� � I Permit Fee: !��' �� j
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I �
Fax: (651)675-5694 � Staff: I
I �
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: { ��� �'�� ���� ��� `���U�nit#:
� ���� Name: � Phone:
Ftes,ic�ert�J �
(���r Address/City/Zip: �L/�J� ��Vl.�alt,�f^P Cl� L�/�C�. 7'j'IN• 55���
' Applicant is: Owner Contractor
' Description of work: �FPL+�CE � ��
Typ� b��ar#
w
' Construction Cost: '$ .3 Multi-Family Building: (Yes�,/No�
Company: On� 66 d�4 L(.L Contact: �'TI�G[�3 ��5��
Address: ,35780 qD k �LtT City: (..�it�o� �i1'c.s-s
CC�tl'�1'+�.C'C01'
' State:�N Zip: 5500 Phone:�..5/-a`�5- d3/I Email: SJoFFNsQ..i�Ci4�woN��'�'1 C�'� ,�
�---
' License#: /V 1R Lead Certificate#: N��l- '
If the project is exempt from lead certification, please explain why:
No (,t,�.o P�Lss�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:
; �Q7`�':P�ax�s a�d�u#��art�ng�a�c���ents t�iat yau su�r���are c�nsid�retl tos�be pr�btr,'c tr�fc�r�at�rrn, F�:���s;of ::
t�ei��r�rr���or�m��r be cl�s�si��ed����on�itib�lc�',�o�p�ov�e spe�i�'fc r�asor�s��t t��d�erm��e Ci�,�t�
'ctrr�c�i��fe that t�e ar�t,rade;�cr,e#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.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 J1773iR'' �0/�-,�rS a-�J x
Applicant's Printed Name Applic 's nature
Page 1 of 3