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3263 Valley Ridge DrGity of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Tic1udd� *3- 6/,43, 6.5 - - - -- 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: �( •,.n • aQ // Site Address: x Z�o�r PP.-( Applicant's Printed Name x A nt's Signature Use BLUE or BLACK Ink For Office us ee Permit #: �! i Permit Fee: tf 3W. V5 (_f 3/_1) Date Received: Staff: CALL B EFORE 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.clopherstateonecall.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 1 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 . vat . • an Page 1 of 3 RESIDENT / OWNER Name: 0ry o y l ra No n Cre,✓t,tf -/ .. Phone: 76,3 - HH9 -9Woo �J Address / City / Zip: _ J , • d . p • ,� , , V I 4ls. - 1 Applicant is: Owner x Contractor TYPE OF WORK Description of work: Rf - Construction Cost '6(9/„59/ / Multi- Family Building: (Yes x 1 No ) CONTRACTOR r Company:, SLt ft r, ke 4 0 d ple.. c/i1 Contact: e.( f"ekie -,Cr-i-) Address: ,S 7 6 ii-� /. ob ..r i n .S¢ t_ City: P Gt State: M N Zip: 55//0 Phone: 616/ - 76,;1 - W q5 License #: (151,5/g Lead Certificate #. NA 1 - 2Q9. 3-0 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. Portion 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. Gity of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Tic1udd� *3- 6/,43, 6.5 - - - -- 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: �( •,.n • aQ // Site Address: x Z�o�r PP.-( Applicant's Printed Name x A nt's Signature Use BLUE or BLACK Ink For Office us ee Permit #: �! i Permit Fee: tf 3W. V5 (_f 3/_1) Date Received: Staff: CALL B EFORE 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.clopherstateonecall.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 1 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 . vat . • an Page 1 of 3 Aug 18 1510:56a Sunrise Remodelers 651-762-9395 p.7 , Use BLUE or SLACK Ink r�...___._�_��_������ I For OfEics Use � C I . � Pertn3t#: /��`��� � Vlt� �f ����il I Permit Fee: ,�7��`�� j 1 � 3830 Pilot Kr�ob Roa� � Date Reoeived: 1 Eagan I�tN 55122 1 Phoae:(651}675-567b ' j 5taff: � Pax:�b51)675-5694 � --------� �-eYYIG[,i� � `. � . -�lec.r:�y t;�-f c� �'�e���c n -�.��Y' --------- 2015 RESIDE�II�IAL BUILDING PERMIT APPLICATION ��rl-cti,r� �3l,��'�- T"c�;.� t-►.:�i �-c r �e;$-),Q�I S SiteAddress• _ _ ' � ��� SJI� Unii#� .��.a,.= ,;�v�c.�u c s : �a 5'7� ��5"G, 3.�.C� (, 3� � :�; ��S � ` ' Name: Phone: � � ; Residentl � � ' Owner � �d�sslCitylZip: ^ ; � i 4 � Applicant is: Owner �CoMractor ��� _ � ,....,�_.��...�.,._...�.... ,�,..�.,� t �4� N'i Descriptian ofwork: ��� � �� Type of Work � o� ' F Constn�cGon Cost: � #� O��• Mulii-Family Building:(Yes��No„_�� ��� ��.�.,.,..._.�._,.�......._.w_ � ,� Y S �w� �:c�.� �S Contact: �� �-�"�''� �:..1 ; f Comparry:�j,��.Yl +r� -e � � � y 4 ' � = ; , ��� �G' 'NL� � : Address' �. ��i v� c�cy: S-f- , ��.�1 � � ` Co�tractor , � �� .` � Staie: �il��Zip: C �I l U Phone: Email: i P1 Yt% Q S.-e►�,r;�e��t vv�x�,�c.-s,`- � � License#:������-----Lead Certificate#�,�,��--��� ��'-� ' -�,,._.r_ -_ ....rr�.-e,.m 4 � If the project is exempt irom lead certi#ication,please explain why: ; k � § �..,a.�a..v..�.. . -- ......,.�� � � COMPLETE THIS AREA ONLY I� CONSTRUCTING A NEW BUILDING �� , � : [n tt�e�ast 12 rnor�ths,has t�e City of Eagan issued a permit for a sim�lar pian based on a master plan? � . � Yas tVo tf yes,date and address of masfer ptan: � � Licensed Plumber: Phane' �; f 7 � Phone• ` Mechanical Contractor: f � Sewer 8�Water Contractor. Phone: : , � � Flre S�ppression Contra�tor. _____ �O°e' -- � a,�._..a.._,..,.�..�Pa..—_ ___._....._,.._ ": '��NOTE:1'larrs and supparting docrrments that you submit are cunsidered to 6e pu6lic irrformafion. P�r'�ons of ; � the information may be c/ass�ed as non�ublic if yot�provide spec�c reasons that would pem+it fhe Cfty to � condude that the are trade secrets. - -_.._-. : y- --—�_,�...�..e...�..�..�...,,.._.�.....�.�.�,.----.,_...�...�....�,.y- _. � ;.�.�...,.:�,:�n_.�,,.,.._..,�.�..�,.-- ----��,�...x...Y.--- - _-_.� ---------.�Q� CALL BEfORE YOU DIG. Calt Gophar State On�Ca1i at(651)454-0002 for protection againsl u�erground uU7ity damage. Ca1148 hours before you intend to dig io reaeive lacates of underground ufiliEies. www goPherstateonecall.ora I h�eby admom9edge ihal 1h�information is camplete and acaurate;that the work wi1�be in coMamfance wilh�he ordinances and codes of Ihe City ai Eagan;that I understand Ihis is not a permit, but only an application for a pertnR,and wo�c is not to staR wit�out a perm�;thal the work wiil be in accordance wifh the approved pla�in Ihe�ase oiwork which requites e revlewand apprava�of plans. Exterior work authorized by a buifdiog permit Issued In accordance with the Ninnesota State Bullding Code must be compleLed witi�in 980 days of pe�rnit Pssuance. X ��� �.i2_—�-1��''� G t"� g � Applicant's PriMed Name s ignature Page 1 of 3 Use BLUE or BLACK Ink � r-----------------+ I For Office Use � � / I C�+ 0� �1� �� j Permit#: f _ j i � /,a� ,,. � 6 1J I Permit Fee: ! td�-�� I 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 1 I Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING PERMIT APPLICATION R - '� �:. .2 �" . � � �'..s��;.� Date: Site Address: �� ` �� l-��Unit#: ^3 =' �� Name: Phone: ��S[�E:[l�/ u,�� '/ n ;C���1�T'.: . ' Address/City/Zip: �o��� Y�I,��H IC��Er� .�ft, �6rtr�, `'�1N. .�$��3 _� Applicant is: Owner Contractor v Description of work: ��P��,.� �6�� Ty.pe of W�rk w Construction Cost: '� 3 Multi-Family Building: (Yes�/No� � \ Company: c�an��/,�,R,...,��_ LLG Contact: S'�i'L� V�H��� ` Address: 35780 �j��` ,�t� City: �,��..� �u.s �c�n�tr�`actor ?,4' . q� �r :�. State: �N Zip: 5�� Phone: �Sl-a`lS-D3/� Email: SJoF}�vSaN t(.,q�u�ku,�y(�r�R,lkd�. ` License#: r1� �' Lead Certificate#: N�� If the project is exempt from lead certification, please explain why: No (,��, �a.f,��u-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: Nt)T�,Plan�at�d�t����►r�rrrg d�a�r�m��#s th��,yau�ub►������� ��t�ia��r���o be p��11��nf�rmatrr�n ���'t�+r+�n���: t�����'orm�tivrt�ay�e�la�st��d as rran��t��b��`��,����rr,����I+�s��cr�`����,a�i�r�s t����►rc��rld�er�����Crty#� �.. : � a � can�lr��e that�?��' �re tr�c���secr.ets: ; ����,. : 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 S�76V� ��I�NSo,� x Applicant's Printed Name Applic t's Signature Page 1 of 3