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: