3302 River Bluff Dr40 111. Cit of Eagan
3830 Pilot Knob R oad
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
ncl t? ( ®qI 04 0 /
x i die ! PPS { . of
Applicant's Printed Name
cant's Signature
Use BLUE or BACK Ink
F ar Office
Permit #: / na
Permit Fee:
Date Received: 94-1/
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: •9t> • a0 // Site Address:
CALL BE FORE 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.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 val . • n _
Page 1 of 3
_ 11 %JIM
RESIDENT /
OWNER
Name: r„ , , , V _ , . -,/. _i iii Phone: 763 - H`/9 - /nn
Address / City / Zip: _ # : • , � . l D • it ,,■ . hi A 4 / -
1
_
Applicant is: Owner x Contractor
TYPE OF WORK
Description of work: Re.- (7) -P
Construction Cost ' &, 5,23 99 Multi- Family Building: (Yes X / No )
CONTRACTOR
Company: CO ,<5t. ke.hn ,Dd o.`<,(3) V/'!G Contact: ( + r
c yy)
Address: E 7 6 /lobe. L City: . P0,4 I
State: MN Zip: 55//0 Phone: 66/ - 76� -
License #: /5/ g Lead Certificate #: )lVA I - .2)9 .33
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
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:
_Yes
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 information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that thly are trade secrets.
40 111. Cit of Eagan
3830 Pilot Knob R oad
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
ncl t? ( ®qI 04 0 /
x i die ! PPS { . of
Applicant's Printed Name
cant's Signature
Use BLUE or BACK Ink
F ar Office
Permit #: / na
Permit Fee:
Date Received: 94-1/
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: •9t> • a0 // Site Address:
CALL BE FORE 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.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 val . • n _
Page 1 of 3
Aug 18 1510:55a Sunrise Remodelers 651-762-9395 p.4
Use BLUE or BLACK Ink
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I for Offlce Uss
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� I Pertnif Fee: C.`� C..-' V
3830 Pflot Knob Road � �
1
Eagan NiN 55122 � DaEe Reoeived:
Phone:(651)675-5675 � �
I
Fax:�651)675-5894 i StafF: I
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2015 RESI�ENTIAL BUILDING PERMIT APPLICATiON
C-e c#.,�r i3�u�'� Tc�:,� h��� s-t s
Date:����'� S Site Add�ess: ���� ����i'C�;� �„)�����',v'� ��/�(Unit#:
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, Plame: Phone:
� ResidentJ
� Owner Address 1 City!Zip:
Applicant is: Owner �Contracior
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� Type of Work 4 DEsc►�ptiorl of WOrk: ��i � f1 c� �
�
o� �
C Y Canstruction Cost: � 1�i (7 UQ� IUiulti-Family Build9ng: (Yes�/No_�
j . . ..,
� Company:�tA.Y1 r� S-2 �-e.w1 cx�..1-e�S Contact: �G�.1 �."�-F-�f��c�'1 �
{� y� ,_
� Address:� -l'� �G � 1�'�. �...�1 1/1'� City: s"t� �.�,t �
� Corrtractor
4 ���_�6� � 9'.�'�� ,
4 a Slate: �111 Zip: � �l l U Phone. Email:�� � S..e y�r:���r r►vi ocl�. ys,
� � �^, i �'/'1 i:�- F] �L�r►-,
s Licenss#: _C l�' �1 � �Lsad Certificate#:,��" �02 -133'"' �
If the project is exempt from lead certification, please expEain why:
�
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDlNG �
In!he last 1T months, has the City of Eagan issued a permit fur a similar plao based on a master p�an? �
�
Yes lVo if yes,date and address oi master plan: �
�
h
Licensed Plumber: Phone• �
I
� Mechanical Contractor. Phone:
� Sewer&Water Contr�tor: Phone•
Fine Suppression Corrtractor. Phone� �
IIfOTE:P/ans and supporting documents that you submit are consider+e�d to be pu6lic irtfornratiflrr. Portions of
� the info�mation may 6e c/ass"rtred as non-publi�ii you provide specific reasons that wovid permif the Clty to �
9 _ conc/ude that lhey are Made secrets.
CALL BEFORE YOU �IG. Call 6ophe►5tate One Call at(651)454-00021or prolection aga'u►st underground utitity damage. CaH 48 hours
before you intend to dig to receive locates of underground utilities. www.goaherstateonecall.ora
i hereby acknowledge that ihis intormation is complete and aocvrate;thai the work wiH be in corrfo�mance with tlie ordioances and codes af the City of
Eagan; that I understand ihis ls not a pennit, 6ut oNy an applica[ian for a permit, and work is nof to stari without a perrnit;that the wrork will be in
accordance wilh the app�oved plan in the case oi work which requires a review and approval of plans.
Exteriorwork authorized by a building perm9t issued in accordance with the Mim�esota Stabe Building Code must be completed within 180
days of permit issuance.
.-�C,� �i-�-�-' c�►-� __� __._.
x x
A��OlicanYs Printed Name A a 's ignature
;� Page 1 af 3
Use BLUE or BLACK Ink
r-----------------"�
� For Office Use �
C' � Permit#: ��//O j
ity of �a�a� I Permit Fee: /V � ��--� �
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (657)675-5675 I I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SiteAddress:� � �v� � � ��� � ���� �J�L�� "� ��Uni#:
� ��
���
� ��� Name: Phone:
�a
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� Address/Cit /Zi ���L,� �iV�R.t3l,id,FF .�I� • �36+er1 �YIn!• -55/23
?QW.Ci�t' • =' Y P� �
� : Applicant is: Owner �Contractor
� �� ', ' Description of work: �GPt_.�4�cx. ��n-R.�.Frd �oOR.�
r�p� of r�t�rk ;
w
' Construction Cost: � .3 Multi-Family Building: (Yes.,�/No�
, ���,�
���= Company:�Ipr1 Vi1-w�w, �'�,�9�rr� �izs�,L[,c� Contact: �'7L�Y������'"�
��
� ` Address:357�0 9n� �1,E'. City: C..�ivN�'y✓�i12LS
�'�11�1`dC�C��'�,. 'r
State: InJ Zip: SSUO Phone: (aS/-�y5- b3�/ Email: SJoNNtSau�C�F,✓�vON✓�1-w��Q4�''Q 2S.�va,
' License#: 1V�� Lead Certificate#: N�I�
If the project is exempt from lead certification, please explain why:
JVo (,e� �it f t
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:
NC7T�'..:Ptan��r�c�:�up�i�r�;�r���o��r�er�f�tha�y�?t��`�bt�it are c�r���d�red tab�,�ublic�rafcarrrr��t�ra: Port�c��r�af .`
t�e inforrr��t�nn tn�,��ie�la�����1��r�+�n:per�ili+c�f yc�u;"prc��r�a1e spe�rfic reascin�s that wQutd perrr��t��ae�ity tc� °;'
� � �`� v �
��r��t��'e:that fh�',are�r��Ie,s�c,re#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 �.�[c VE- �I�NSON x
ApplicanYs Printed Name Appli ant's Signatu e
Page 1 of 3