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3296 Valley Ridge DrG ity Use BLUE or BLACK Ink For (at a #J Js se Q f - Permit #: 1 0 "7 Oq Permit Fee: $3 3830 Pilot Knob Road 9' 00 Eagan MN 55122 � Date Received: +y-ZI -1I Phone: (651) 675 -5675 Iry OW 01gt-� f 01qt-ha/it it A • p nt's Signature Fax: (651) 675 - 5681 `` 4 f / Q0 f Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: i-j • Sn • a0 // Site Address: ( may ` �� ty• LHLL 6Cr'VKt VU Ulta. 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.gopnerstateonecaluorq 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 X 50e,1 r - { -P-Cs(m ._ Applicant's Printed Name Page 1 of 3 - 1 4 unit Fr RESIDENT / OWNER Name: Omo n H4 �a er✓u41 -1- r Phone: 7 3 - yy9 - 9/n« Address f City / Zip: * • e t • . it , , 11 i `/ ` Applicant is: Owner X Contractor TYPE OF WORK Description of work: Re, -roo -P Construction Cost k , =, . '3y /, ,5b Multi- Family Building: (Yes X / No CONTRACTOR Company: ctt n r, se...- PC.e.yvt�nd edema 3 S Contact: e P �i:� Address: 59 7 (o 140b.e- �ci n c- City: i-( P0 `'t l State: M N Zip: 55//0 Phone: / - 76,;1 - 9a y'5 License #: c`.S j�,S/ g Lead Certificate #: pi Q I - ,2a9 , ? -t If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) I n 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 spec reasons that would permit the City to conclude that they are trade secrets G ity Use BLUE or BLACK Ink For (at a #J Js se Q f - Permit #: 1 0 "7 Oq Permit Fee: $3 3830 Pilot Knob Road 9' 00 Eagan MN 55122 � Date Received: +y-ZI -1I Phone: (651) 675 -5675 Iry OW 01gt-� f 01qt-ha/it it A • p nt's Signature Fax: (651) 675 - 5681 `` 4 f / Q0 f Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: i-j • Sn • a0 // Site Address: ( may ` �� ty• LHLL 6Cr'VKt VU Ulta. 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.gopnerstateonecaluorq 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 X 50e,1 r - { -P-Cs(m ._ Applicant's Printed Name Page 1 of 3 Use BLUE or SLACK lnk r__��__ ��.�_�.�_; l Fcr Offlce lfse � �j 1 �.' � � Pertnit#:,��c��l �S � c �1t �i, i � .SZ� i ib� �� lJ�� I Permi�Fee: � I 3830 Pilot Knob Road � I Eagan MN 55722 � Date Rece'rved: 1 P�one:(651)675-5675 � ' j Staff: _- � �ax_(6599 675-569+6 � --E'�iMC�t�� `, �, �f��.�:��' L;�-J a° �e.�t�c.n c::�y' �----------------� 2015 RESID�NTIAL �ll,llL.Di�Vt; PERIVI6�ls►PPLICA'TION c-�� a -�� ,�� s�s� � �� - _ _ . - Da2e: ' ' S�te Ad�dress: -- - •� - — - _ _r.�.:>=-:,,�_�:.-�....-,�<.t-x.-,r.,.�.�.-.�.ra.i�,. G A�-..�......�`� 'oZ oZ�l�O r/3��'1 �y 3`3.C�C�` :��nL +� �� ' �� 3 •. Name: J �i j Phone: R@5lcien�l - ��,�r � Address 1 City/Zip: n , � ? '; Appiicar�f is: Ov,mer �Cont�acto� .�,..�.zu. ..-._n.�- ; .:�......_:..,.._.._:.__..::�,:.. �,,.w„_,�....R..... . . .. . � � n c � ° Descriptio�of work: �� '�ype of 9�/urk J ` � Cons�ruction Cost: � ��C��G _ Mul'U-Family Building:(Yes�1 No_� , T��.....�. ,._._...._...,......, ... Company:��;.Y1 M�;.1-£'_ �-�s� cx�:1-2 t'S`ConEact:'�C::�.� �-�'�.� �:.'1 . ? � �y- Address:�� "' �1L' V�'L �-ct i/1-� Ciry: S�"'� �t.c.ti � �ntrac�o� , � ' State: i1��Zi ��i I U Phone: Ernail:s Y1�� ' S`.e��r-�v r��v►,�:c►-z l�:s, ,�. P� �c�-+- Lead Certi#icate#• �- �� .._....,.._w.__..._....Y,,1,.,._ License#:�� ,..�,� - -�--��.._...�.,�_...,�. ` If the proJect is exempt from i�arl certificatio�, p�ease explain why: '�-.^��x��.�F'��C01111iPd.ETE THlS AREA ONL1(!� CONSTRUCTlP1G A NEW BUILt3ll�1G ; 1n the last iZ months,has the Ciiy oT Eagaea issued a pe�mit for a similar plan based�n a Enaster plan? ' Yes No If yes,date and address ofi master plan: > ' Licensed Pl�mber. Phone: > . ' k�echarticaf CoMractor: _ Phane: : t ` Seuier 8 Wa�er Contractvr: F+hone: � ; Pire Suppression Contractor. �hOi1.,r _ e: .._.„ ..x.-..�...,,_,_._..._,,.��.,.,,-..,-..-_..._._.��>.�-_....�..�.-.....��,.-�..._......�..�.,....�._��..r_.._�..._ ..,_ ... � r-��dOTE:P/ans end supporting a�osumerrts f�at,irou submi�are considereal to,be Fub/ic inf�rmation. �o�iflns ot ; �Pre ie�forrnation ma,�be classified as non•pzr�ilic if yora proyirle specific r�asons thaP woufd permit#h� City to ; ', : �or�clude fha��heyare trade seciets<__...._,... ..�_,._:.m.:,_�..__.�..:.._.F.k...�...�..__,._..,_...�_„_. , � :._..:,..._...:_.:_,,:-.:._.....:.._._._......._�.:.:_:.:....................._._..�._..:._.._�.r._..:�_..-.:,..._..._..:,_..:a..,.._,_._.__ � C.�LL BEFORE YaU DIG. Calf Gopher State One Call at(651)454-0002 tor protection agai�t�mdergcound uUllty damage. Ca0 48 hours befiore you i�tend to dig to receivz locates of underg�ound uG1ities. w�w�aooherslateonecaU.om I heeeby acknovvle�dge ihat lhis infflrmatior�is complete and accurate:that the work v�n'd be irE confamance with ihe ordinances and codes ot ihe City of Eagan;that I undersWnd ihis is not a permit, but only an applicatian for 9 permit, and umrk fs not io start vuithoat a permit; that f!'�e�nroric wi��Ise�� accardance wfth 1he approved plan in the case of work which requires a review and appro�al ofi plans. ' Exterior woric authorized by a buitding parsnit Issued tn accoMancewith the Mirmesota State B�eilding Code rreust be complete��nrithin 180 days of gennit issuance, ---"" � �� QL'-�-��i''� C3 r'� � � ApplicanYs Prirrted�lame A 's Signa�ture . Page 9 of 3 Use BLUE or BLACK Ink r----------------� I For Office Use � ' �� i C�� j Permit#: � � � I permit Fee: d �� '-� � 3830 Pilot Knob Road � I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: I � I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Sr� ' Sc� <-� � � � �� Unit#: : Name: Phone: Re�i:d�► � '/ `7YJN, .�5 �3 ()y�� Address/City/Zip�� Y�L��H ��&e's -� L�A�6nl�►�. � Applicant is: Owner Contractor ' Descriptionofwork: �L�Pu4[r ��4R.46��8� Ty�� Q�=w�� w Construction Cost: � 3 Multi-Family Building: (Yes�/No� � � ; /� ' ' Company: ( 4n�t�n�V„��.r.�„ �riq-RA-t� 9�,_ LLG Contact: S'7SI�f3 Vt�/�� ' Address: �5-180 �jo�` � City: �,v�� s �c��tra+�tn� State: '/�N Zip: ,5`5�,� Phone: �S/-�ys-03/� Email: SJoNn+Sc�et�ivMr�k�sy(rAR�,t�. License#: r1� �" Lead Certificate#: N�� If the project is exempt from lead certification, please explain why: N� �� -P��.�-r 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: N�T�:Af��rs ar�d�u�#�or��n�do�t�r��rr#�i�;�t,�ou;st��imi#are cor�.�de�er!':to b�e pr��c 1r�fc�r►��t?�;:l�or�,s c�3': t�e:int'armafiic�r�may�e ct��fi�d as nvn-�wbl��'yc�u�rowi�le spe�r'��rea�on�t��t wcir�ltl�r�ti�tl�e C�iy td c�r�c,��d�that the �re�ra�e sec�ts. ' 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. Exteriorwork 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"7�1l� �J01"1'NSo,� x — ApplicanYs Printed Name Applic t's Signature Page 1 of 3 RECEIVED Use BLUE or BLACK Ink JUL 1 0 2017 For Office Use •t (� / 'i /O'/ " F City of Eapii Permit#: j /� 3830 Pilot Knob Road v Permit Fee: (l/0 -0 0 Eagan MN 55122 (00 Phone:(651)675-5675 Date Received: Fax:(651)675-5694 Staff: 2017 MECHANICAL PERMIT APPLICATION ❑ Please ub it two(2)sets of plans with allQcommercc''al pplicationnss. Date: Site Address: 3 y"-t ( (/ at /�-tceQJ r Tenant: Suite#: 0 Name: q "'4 e Q le Phone: .� f'' it Reslderttl4-finrner' ..3.--q Address/City/Zip: Cp A. lC" T t5A'YI 4/.".)- baa, G Narr�etdndard Heating 8.Air Conditioning License#: ` 130 Plymouth Avenue North Contract Address: Y City: r � innea�• a!' 6 824-2656 State: �+ Phone: Contact: Email: . New X Replacem t Addition I Alteration Demolition Type of Wit' ,) Description of work: (\P' icr Lei Q, (— z floiA40--jo !t at 4 "tn iunted a c�anica t d tt l !S tienetf t it ) �. .,''"��'1tCip'�I� � '� � S�'!�u11 � iJi�� i" �> i�d �. 1+-t ' ^s e� a Code.Please confaci the Ile ha►lI I(d1� 1,'�,etc r� at„�.L� ° " ± � `j*thuds ,., d,, RESIDENTIAL COMMERCIAL _Furnace —New Construction —Interior Improvement 4.;:-'‘',4 " Air Conditioner Install Piping Processed �@l'l1'1i 'type — _Air Exchanger Gas Exterior HVAC Unit —Heat Pump Under/Above ground Tank ( Install/ Remove) Other . — 1 RESIDENTIAL FEES 1 f $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge 1 $100.00 Residential New, includes State Surcharge =$ `C.70- TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee _$ Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be in conformance wi the • .--t_, ces and codes of the City of Eagan;that I understand this is not a permit,but only an pplication for a permit,and work i of t, art without aper -t;tha ,e work will be in accordance with the pproved plan in the case of work which requires a review and approval of plans. I // x 5 (,-17t-V / A x • Applicants Printed Name Applicants Sign ure FOR OFF10E USE , � ��„�� ' ,� rlmd,uv . ,� ra �'� Required lnspectit ns�„1R .'„ � � RevteW$ Date Underground -"� .00tgh'j . ' irJest 'peeService Test ;th ffoor t-tegt Final _ tivAQ Screening '