3297 Valley Ridge DrCityofEaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694 la I 3 q q 7
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2011 RESIDENTIAL BUILDING PERMIT APPLICATION
��- 3 30(
Date: 4' ?o • a0 // Site Address:
CALL BEFO YO 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.gopnerstateonecalLorq
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 t 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 . v : a
t �
x ��oPi f P,1P.l_SvYi
Applicant's Printed Name
A . 7 cant's Signature
Use BLUE or BLACK Ink
ForAi
Permit #: 9^ V f c
Permit Fee: 9S O()
Date Received: i 2/ 4 /
Staff:
Page 1 of 3
vnrt if;
RESIDENT !
OWNER
Name: (ryle n 1"le,ria je , o,41 „ - 1 A c. Phone: 763 - yy9 -Woe)
(/ ,J
Address / City / Zip: . . Aft d 1.. . 4 Al . ' / r
!
Applicant is: Owner )( Contractor
TYPE OF WORK
Description of work: (j , -- roa -P
Construction Cost 23 (p/ Multi-Family Building: / y g: (Ye�s ?C / No )
CONTRACTOR
Company:,, S(,t n (',,5� PGn.yv� v t 5 A r✓ Contact 9 n eJ J"e�fi
Address: 5976 Hobe, 1,Can r_ City: 3-1-. PPx ;4
State: M N Zip: 55//0 Phone: 66/ - 76) -- 9o? 4 5
License #: j (1575/g Lead Certificate #: NA I " ,2Q9 33 —o
if the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In 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 specific reasons that would permit the City to
conclude that they are trade secrets.
CityofEaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694 la I 3 q q 7
-� c
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
��- 3 30(
Date: 4' ?o • a0 // Site Address:
CALL BEFO YO 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.gopnerstateonecalLorq
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 t 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 . v : a
t �
x ��oPi f P,1P.l_SvYi
Applicant's Printed Name
A . 7 cant's Signature
Use BLUE or BLACK Ink
ForAi
Permit #: 9^ V f c
Permit Fee: 9S O()
Date Received: i 2/ 4 /
Staff:
Page 1 of 3
Aug 181511:OOa Sunrise Remodelers 651-762-9395 p.12
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Us�BL�E ar BLACK i�k
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i For Offlce t35e (
. � Permit�: /�c�- `�� 7 I
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1 Pe�rnit Fee: o
3830 Pilot Knob Road � �
E2gan MT!55122 � Date Received• ;
Phone:(659)875-5675 - � ���, I
F�x:(651)fi75-5694 � �
�-etr►flr�.E` I ', (�, -���=.�G�'' c-,�-/ c �-e"�c.n c��.,� -----------------�
2015 �ESIDEh�'�'O14� ��!lLDIi1IG PERI'1AlT APPLi�I�TION
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Date: �1'���'I � Stte Address: � '1� "r��l 3 Unit#.�..-�.F..�.��w_�__
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� Pfame: Phane:
f Residen�}
��� �. Address/City l Zip:
� � Applicant is; Owner �Coniractor .... . -- - t,�y,�.Y_r��.,T
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: Descdp6on ofiworic ��� � ��
; Type of�1York .
� � ConsVucF�on Cost• � ��- ���•cJ Mulu-Family Builciing:(Yes��!No____) ._.:...-
4:,...�,m. ..:.-.__.....�.._....� Company;�L'�Yt +�; S-e ��vY1 �c�^l-� �''S 6 Contact:���: '�� ��-�:�' �c�'�
; Address: 'r'„� -i��G' '1""1t:t�''�_ �--.c� t,�-� City: �fi � �-R•�a � .
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' State: 1�11U`Zip: � �I !U Phone: Ernail: i Y1•�'t: S...t ti��:����'��v+�cr-z�;�5,.
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: License�:���,_�'�.,��� ad Cert�cate#: ---- :
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:' tf the project is exempt from Bead certiiication, please exptain why:
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' COIIAPLE'�E THIS e�R�A�NLY IF CONS�'RliC'1'�NG J�NEV9! BIJILDING
� tn#he last'[2 mon�s,has the City flf Eagan issaed a pertnit for a sim�lar plan based on a masfer plan?
t
Yes iV a if yes,daie and address of master�fan:
�� E.ic�nsed Plurnber. Phone-
' �lechanicai Cor�tractor: ____ Phone: -
' Setve��t�k►ater Contractor: Phane: '
� FiEe Suppression Contractor. .� _ ._ P�O��;, ,rr _. __ - _
; ��fidf�TE:Plar�s anaf supporfietg docuinents thaf you�suhmif are cc�siderecd�o tre pub%ic information.�r�ions of
f)
�e i�f�arrrnation may be c/assi�re�a�nan pr�blic if y�ra provide sp�ci�c reasons that wo�rlt�permit fhe C�to _
t �oncluc/e tha�they are iraaie secrets. .
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�C�4��BEEORE YOU Dlt's. Cali Gopher State One Call at�551)454-0002 ior protection against underground utii'sty damage. CaN 48 howrs
bef�ore you icrtend to�9 fo r€ce�ve lo�aies oi underground utifilies. wvuw aooherstaleonecall.ora
1 hereby acknowiedge that this iniutmaaon is complele and accurate:that ihe work wiU be in cflnformance w�hh ihe ordinances and oades ofthe City of
Eagan;tfi�ai E understand this is noE a permil, but only an application for a p�em�flt, and work is nW to start without a permit;ihat ihe woEk►vill be in
accordance with ihe approved plan m the aase of wor�:Which req�ares a review and approval of plar.s.
Exterier work authorizer!6y a bullding peRnit Issoed in accordance w�th Yhe Niinnesofe State Bullding Code rnust be comp[efed rv�thin 980
days of pertnit isavanee. --"
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Ap�iic2ini's Printed Name A 's ignature .
Page 1 oi 3
Use BLUE or BLACK Ink
r----------------"'�
I For Office Use �
. � � // � �
Clt� of �a�a� � Permit#: �
, t-� �
iPermit Fee: �C1 �•� c�� i
3830 Pilot Knob Road
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I �
Fax: (651)675-5694 I Staff: I
I �
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
�j � (
Date: Site Address• v��G� c�C� �c�c ��lU��# ���
' Name: Phone:
R�S!{��1� -'��C - � 6+q�i,, N. .�$ �
(�y���;�� Address/City/Zip:�' /�L��H �D Er�
' Applicant is: Owner Contractor
Description of work: � P A a� ���
�'ype Of 11���k �
w
Construction Cost: '� 3 Multi-Family Building: (Yes,�/No�
Company:���/��,.,, �rfl-R,A-t� �_ LLG Contact: S'�6b� Jt�/�+1�N
C�►n�ra�kor aaaress: ���8o qo�` ,� c�ty: �.,r�� �-u.s
state: 1�u z�p:yi Sv,� Phone: �S/-aNs-o3�� Email: $JoN�vS�e c�iv�.�-�-i�ku.w,G�u,�A�.
' License#: �1� (� Lead Certificate#: N��
If the project is exempt from lead certification, please explain why:
N� �s� ���►�;�.-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�:P�ar�s anal��r�ao�g tl�curr�ents�h�t you su�b��a�e ccr�r�idered�o b�pitbl�c i�a�or���t��.-Ftr�tierr�4�f=:`
t��e inf�rmaa�i�r�tr���e cla���fie�f��rr�n��ti�i�if,�ac�prorr��;��eci�ic rea�9�;tt��#�+cr�#a�perr�i�t�r�Ciijr t+�
c�nc�utle ti�at t�e are t�ad�secret�»
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.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; 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'7'�'1!� �a HNSa� x
Applicant's Printed Name Applic Ys Signature
Page 1 of 3