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3317 River Bluff DrCityofEaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 / S3/6; �.� /� ` / / 23 Date: 4 • n • a0 // Site Address: x ��oe/I te.601 Applicant's Printed Name 2011 RESIDENTIAL BUILDING PERMIT APPLICATION A .pl nt's Signature Use BLUE or BLACK Ink Permit #: ClO 9)*(9 Permit Fee: Date Received: Staff: RESIDENT / OWNER TYPE OF WORK CONTRACTOR .3/3 At i RJa Pr Name: Om Address / City / Zip: Applicant is: Owner x Contractor Phone: 76.E - Hy9 - WO() IL Ad Description of work: RP ,�f7)p Construction Cost: 49y G //. $ 5 Multi - Family Building: (Yes X / No ) Company: . t ,t o ke ,h 61 o f ) 7 - Contact: Address: 59 760 14 State: M f\J Zip: 55//O Phone: 6 - 76 - 9029'5 License #: c15 /5 /g City: it Pit c1, Lead Certificate #: NAT-- 3 -0 �I Pe l lithe 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: i TE: Plans a nfor Unit #: 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. wvvvv.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 Page 1 of 3 V�l7�i L71.YV V� Y�/'��.ra��• r-----------.�_._—_— 1 For Offfce Usa � I // � ��`7� I C�t af �� ; PeRnit#:_ ' S I � � ' o� � , I PeRnit Fee: , 3830 Pilot Knob Road � I EagBn IIAN 55122 � Dake Received: � Phane:(657)675-5675 I � Fax:(651�576-5694 ' � Staff: j '�Yr,CZ.t, E �� . �I�'•l��y C..�� G' �,4��;CY1 ' _.—__..� C�vr ��_...—_--�.__-- 2015 RESIDENTIAL BUILDING PERMIT APPLICAT1t]N C-e�.�;:,r' �3(,u�'-� Tc��+ h�� s-c� . , Qar�:?�-/�'� r? Site Address: 33 i 3 ��v��t�,�r I,c,��'j�-:v'�e., 55�a��n��: ��..'�,� _ �. s ,��i 5�, 33 � 1, '3� I �' �33�� 3 3�-3 � ' ; ;�v+c.l-N ; Name: �hone: � � Residentl ; ; pW�� ; Address/City/Zip: r ; �S 3 Applicant is: Owner ,,,�,�Cvntractor � .._..�_e...�_......_. .�....�.�.. ._o_,__._.. ..,.,,.._,_..�� Y 1 � T e of Wor1c � Descri tian of work: �� C� n 4� � r yp • p � °'' � � : 4 ; Construdion Cost: � ��: �v�� Multi-Family Building:(Yes 1 No !' t.......�.,,�.,,p.,.-.��,.�,...,__ .�._...�.... . _.,..�-�.�.-_�.�.v. _.�.�.._. �-�..�.__. � � ,� ..__. . . - � �s Cornpany:Cj�.'�Y1 r��{-' 1'S-�w1 �c�-z.�t'S Contact: ,J c�(?.� �-�'_� .��iY 1 � At�dress:�-l'� lG' �R:�� l 1/1-� Cily: �'�'� �t�t 1 , Co�rtractor (' � � State: �1/t� ZEp: � C� !v Phone: Ernail: �Yi`'t'v P S-t tn r� ��'2�^�-�'��.�5� t ! i - (��T-�a :��. � License#: � �V � i S ,� �_Lead Certif+cate#: '� �3� � ° �....,,........,..�F-,....,...F�.,.�......._...e..�.....�..�.,e....�.... _,._. r.,.y..._.,,.,a�.,.,�.,..,.�,�..�..,u,....,,....s.,. i ? �f the pro�ect is exemp#fcom lead certi#icati�n,ptease expiain why: ; i : �---�-- ,,,�__� GOMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING € !n the tast 12 months,has the City of Eagan issued a permit for a similar plan based o�a master�ian? ; 5 ' Yes No If yes,date and address of master plan: ' t � Licsnsed Plumber Phone• � � s ' i : lNechanical Corrtractor. Phone: ' � � ; Sewer 8 Wate�Contractor: Phone: ` i � � Fire 5uppression Cor�tractor. Phone: a � NOTE:Plans and s�pportfng docurnents thatyou submitare considered to be public ir�format+on. Potfions of ; r the intorr�ation may be cla�ed as non public if yvv provide specff'rc reasons that wo�ld permit th�e City to � �y�� --- ----.._.�...,�..�..�. conclude that they are tr�de secrets. �.�._._. ..�...- CALL BEF�RE YOU DIG. Caa Gopher S1ate One Cali al�651)d5�E-OD02 for prolection against underground uliliy da�nage. Ca1148 haurs before you iMend to dig lo receive locabes of�dergraund utillties. wwir�.ga�herstateor�ecall.om I here6y s�[cnowledge that ihis infamation is compiete and accurate;that the work wiil be in coaformance with lhe orclinances and codes of the City of Eagan; that 1 understand this is not a permit, hvl anly an application iw a permit, and work is not to sfart without a pennit;that ihe woiis v,riEl be in accordanfle with the approved plan in the case of work whic�h requir�a review and�proval of plans. Exieriorwork authorized by a 6uilding permit issued In accordancewifh fhe Minnesota State BuUding Code must be complated within 180 ilQ�f 9f pV►lnit isal��nwo _... x �,� Q,�-�.�,,�' c,,.� -�_.--� x AppiicanYs Prinded�lame A s ignature ,` Qage i ot 3 Use BLUE or BLACK Ink � r----------------� I For Office Use � C' � Permit#: /��//�� j �� O� `�� I Permit Fee: / �J� � j I 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:� ��.�� G� �� Unit#: , Name: Phone: ReS�+C1+�� / -� (}yy�g� ;�; �: Address/City/Zip: ��! � �iVLR13�u,FF� .�R • �6•�ii �1'1�✓� SS/�3 Applicant is: Owner �Contractor � �` � ` Description ofwork: �C'P��4c� �'�r+-R.ia.t,-rf �oOlt,� T�p+R 4��►�rk ' w Construction Cost: � .3 Multi-Family Building: (Yes�/No� Company:(_�}-i1,YVo�J Vil-U��w, ��Crri° d�Dizs�,L[,C, Contact: �7Fi1�'��0�✓�'"� ��, Address: 357RD 91�� AI.E�. City: (_.�9'NNd�✓�i??�LS : State:�Zip: SSUO Phone: �oS/-�y5- 03�/ Email: SJohtAtSav�CA+✓�N✓ki��/��qd�"� ns,c�„ License#: /J�� Lead Certificate#: N�f} If the project is exempt from lead certification, please explain why: ,No Le� Pafs�.vr' 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: �OT�';Pta�is.�r�d;sr��por�g t��ur��e�,s f��,�uu��br�i�are;c��d��ed to bE�trf�c�nai��.:Ptrrfio�s.�rf : �e i�fvrr»�f1c�n�a,�y��cla�st�'ietl�rs��n pubt��if y�u}�ra��l�s�ecifrc r�p�s tt�a#t�c��l�l per��f�e C��°�. ' �or��ud�.t�a#fh are tw��(e�e�r�: 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 S�'�VE" �uN�NSc�N x Applicant's Printed Name Appli ant's Signatu e Page 1 of 3 09/13/2017 WED 12: 54 PAX 1001/001 vs I- (v15-S ce9°,q Use BLUE or BLACK Ink For Office Use Cit of Hanan Permit*: , �sa � 3830 Pilot Knob Road Permit Fee: 6 6 - C / Eagan MN 66122 Date Received: 9"13�/7 Phone:(651)676-6678 .a 'i 3 717 Staff: — 2017 MECHANICAL PERMIT APPLICATION 0 Please submit two(2)sets of plans with all commercial applications. Date; 9-11)-1/ Site Address: 5 3 7 i‹)',/121 &1 -c Tenant: Suite 8: 'i�:','�':'��':`;;;}iii';7,'sY,1 i,•;J; ;.'•'•, ; . ;: ' a;; ; . Name: * ' a I lb - Phone: LOS I. 33. 0000 • .r: Address/City/Zip: 3 I)c • Name:Aft*D(d a/OJ.t COr►r!{bt' - mtan. License 0: r:,c�;'»`� . ;,;, ;,,�;,',',1,�,• y 'i l`5• Address: � t.Q !1 D •I-�tJi/t,� Blvd.I/�. N, cit �� r � !� State: YON Zip: `'I i S' Phone: LDS( - '"7°10 0 Cs C) " '•, ,,.'',; ''r',J;•/ ,;' ':,. ; Contact ..( Li,< b r1 Email: A • • A •. A 41!) /4 el .GOl1.i • �'''' ' /%! i r'' �"0,1q°;' New � Replacement _Additional _Alteration Demolition (I r . x• ''1:1',:,',h''f ti, ;',4'ype'pN,, ig' Description of work: R.4pl&C.l'.. A A C. k Fel(/lc C -. � '.J � :�I'a.'!:. l',%l. '• " ' � ' ' ' �i•11Jr ',,'„r .lr } ,tl `I A^' "• '.i. •,�.,.�,.. ,,, .:r.., �> ,�.,,. � , ,I,eP�+td', �i��t, �4.�idl" '..�;�,��a�, ,, ! t 7 , Y �. d � y$,, ; "m d i ;;,,P„ ':,,'.,,,:';4; ,1',:•i ;;• ;#44,A/.18 e�:4�1�fi�t80nth"e;1lAbCl1011.'0" 10,4.0dCCo�';� 0.10,dtt' 4.0.0.WF, ,!!d• !� �" fA hili►;• °;� y.�;;; 1''" '' °' `' `,, 1 s ,,,,'i•, RESIDENTIAL COMMERCIAL •Furnace New Construction _Interior Improvement Conditioner Install Piping _Processed i• *.,rlarirktryygie, "''t' Air Exchanger Gas Exterior HVAC Unit ,,':, i Heat Pump _Under/Above ground Tank t.Install/_Remove) Other RESIDENTIAL FEES $60.00 MMus Add or alteration to an existing unit,Includes State Surcharge $100.00 Residential New,includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES $60.00 Permit Fee Minimum Contract Value$ x.01 $76.00 Underground tank Installation/removal,Includes State Surcharge _$ Permit Fee Surcharge=Contract Value x$0.0005 $ Surcharge If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for en email update on the City's website at www.cllvofsaaan.comisubscrlbo. 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. A-X 1I e 4e)in tY\1 x GP, Av 1," — Applicant's Printed Name ApplIcant"s Signature FORQFFlCE Oat , , „ Required'lhspeatlon:r: , ' •,• ' ' ;:: , , ' ',' • • ' RevIewed'Bya. : D'ata:,'__-_ U'nde'rground ;.. Reu P',lhi _,AlifTeat. Se s:ServlceTeat '111,50orHead r;,;,,Flnei' „ . kIY�AG ae�niir' • � � -Yr Cctddt CArd .