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
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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
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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
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3830 Pilot Kr�ob Roa� � Date Reoeived: 1
Eagan I�tN 55122 1
Phoae:(651}675-567b ' j 5taff: �
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2015 RESIDE�II�IAL BUILDING PERMIT APPLICATION
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� If the project is exempt irom lead certi#ication,please explain why: ;
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� COMPLETE THIS AREA ONLY I� CONSTRUCTING A NEW BUILDING ��
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: [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' �;
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� Phone•
` Mechanical Contractor:
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� Sewer 8�Water Contractor. Phone: :
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� Flre S�ppression Contra�tor. _____ �O°e' -- �
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'��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. - -_.._-.
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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.
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Applicant's PriMed Name s ignature
Page 1 of 3
Use BLUE or BLACK Ink
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I For Office Use �
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C�+ 0� �1� �� j Permit#: f _ j
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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
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�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