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3300 Valley Ridge Dr4,11/1''City atkall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: 9 -, ` c_s 9'4.4 94,1( f-� 06 2011 RESIDENTIAL BUILDING PERMIT APPLICATION TthoJ =7.764.75 mato a Use BLUE or BLACK Ink For Me #Jsep n Permit #: 1 Q Permit Fee: $395. 00 Date Received: I- I I Staff: Date: L/ • k.C. • 070// Site Address: . vrAJ (may r ; tide D( Unit #: RESIDENT / OWNER Name: oma Address / City / Zip: tyk Phone: 763 `1"/9 -Woo Applicant is: Owner )‹. Contractor TYPE OF WORK CONTRACTOR Description of work: ( ,- roo-P Construction Cost k ,= y/, 5 b Multi -Family Building: (Yes X / No ) Company:` S/,t n r; s•e e4od eJe f SC Contact: of Pe e.r cry-) Address: 597 6 /fob.- j n City: .54; P0,4 f State: M N Zip: 551/0 Phone: 66/ - 7601 - 9079'5 License #: aoc1$/5/g Lead Certificate #: AT- ,2Q9 3 —0 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 spec reasons that would permit the City to conclude that they are trade secrets- CALL ecrets 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.gopnerstateonecall.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 appfgval x 30e,1 PO4-9,(S(7/1 x Applicant's Printed Name Apptliccant's Signature Page 1 of 3 City of Eaaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Staff: � ` Fax:�)(651) 67/5-56946 C .'G�'V/1e11'I,. e•— j cK ? -I/1 ireT-eelCrt -ci+Vl' 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: - /2– t 5 Site Address: 3-.P, (LP R; cat 55l1 Unit #• �tni✓I. . . L4!, Name: Phone: r Use BLUE or BLACK Ink For Office Use Permit*: / ,JcP—1 ZS Permit Fee: Date Received: d Resident! Owner Address / City / Zip: Appticant is: Owner -'L Contractor ,. Type of Work Description of work: � ; (1 n G` J Construction Cost: ; 000 �G Multi -Family Building: (Yes / No Contractor Company: Cj L . Y1 k ; ve R. -e 0" Cc .:1-e rS Contact: .S 0eA PR- "4-e.1,110.1 Address: 6 C1 1 to ll: Vi -'e Let V i - City: St' 1 ritc.ti i • State: j ill zip: I3 6 i 1 U Phone: Email: i Yl S.e t-‘ r = wit e:Jo cci-e iie (s , License #: (4 05 15I `6 Lead Certificate*: NAT- - ; C 3 3 If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY W 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: t Mechanical Contractor: Phone: Sewer 8 Water Contractor: • Phone: Fire Suppression Contractor Phone: NOTE. Plans and supporting documertts t/tat you submit are considered to ,be public information. Portions of the information maybe 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. Cali 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 utc1ities. wowr.000herstateonecali_orq I hereby acknowledge lhat 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 roust be completed within 180 days of permit issuance, x � � Fe 44 -r i c r1 Applicant's Printed Name 's Signature Pagel of 3 Date: City of Eau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: l Li/0 Permit Fee: /051 -� Date Received: Staff: 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address:T t ��� Sci`�W/ia f 0 Name: Phone: Address/City/Zip ALLy RID 6,13 - Eheo3-/J %%N. 55$.23 Applicant is: Owner . Contractor Description of work: R6N A(..-- Gum,.6- �D Construction Cost: -A 3 co pa Multi -Family Building: (Yes x / No ) Contact: S'i'9I43- JDMV_Se.) Company: trJVku.tl erii-QA-tia- 1, LLG Address: 35-72o go('" /fur City: 6144.44.)e".) S State.71%/U Zip: 5506 9 Phone: 6,57-G2(6%03 /t Email: SJONn+sc,* 4-Ayart44u`s, 6644aliovsti. License #: k Lead Certificate #: N/'k If the project is exempt from lead certification, please explain why: No (AAA -Pctstipr 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: NOTE: Plans and supporting documents that you submit are considered to be pr bl the information may be classified as non-pub/ie it' you provide specific reasons th. conclude that the are trade secrets. is information. �t would permit the Ci 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.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 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 5-113Vs- JOIkru e,) Applicant's Printed Name x Applic is Signature Page 1 of 3 Use BLUE or BLACK Ink For Office Use Date: City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Permit #: Permit Fee: Date Received: Staff: L 20"16'RESIDENTIAL PLUMBING PERMIT APPLICATION Tenant: _ Site Address: 3 306 (/%/[P7 Pr, 6 Mit 5-5721 Suite #: Resident/Owner Contractor Type of Work 1 .Name: 1'l.: Vl V t en l Address / City / Zip: 136o &I t Phone: (a/Z' 5 157/ frig, 6512.1 Name: CHAMPION PLUMBING, LLC License#: PC000308 Address: 3670 DODD RD. #100 state: MN zip: 55123 City: EAGAN Phone: 651-365-1340 Contact: JILL, COLE Email: permits@championplumbing.net New Replacement Repair Rebuild Modify Space _Work in R.O.W. Description of work: Permit Type RESIDENTIAL X Water Heater Lawn Irrigation (_ RPZ / PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( , Main / Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge) *Water Turnaround (add $280.00 if a 3/4" meter is required) $115.00 Septic System New (includes County fee and State Surcharge) TOTAL FEES $ lf� O. 00 CALL BEFORE YOU DIG. Call Gopher State One CaII 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 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; thatthe work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Signatu TROY M. GOOD Applicant's Printed Name FOR OFFICE USE Required Inspections: Under Ground Rough -In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: Reviewed By: Date: