3265 Valley Ridge DrGity of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For ft ce use
Permit #: F7-/! i
Permit Fee: tf 3W. V5
Date Received:
Staff:
5/, 6/, -----
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L( •(.01 • ac9// Site Address: 3SS 9// 1? of C C Unit #:
LI al 1)
RESIDENT /
OWNER
Name: 0n7 Mn,L je ✓t, 4-, At_
Address / City / Zip:
Applicant is:
Phone: 763 ,/,/q -9/Do
Owner X. Contractor
TYPE OF WORK
Description of work: Rf
Construction Cost `607 /, 59/ a /
CONTRACTOR
Multi -Family Building: (Yes x / No )
Company:, SLt n (7 se, Kery no e iex, 4 c Contact:
Address: 5 7 6 1-10& t -Cl n
e.( Pew
City:. Pau
State: M N Zip: .5//O Phone: 616/ - ?bol - W 45
License #: OS/s/$ Lead Certificate #: NAT' 2a9.3-1
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 os
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.
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.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 . val . : an
x 3oeJ PO4-9_,CS
Applicant's Printed Name
x
A
p
nt's Signature
Page 1 of 3
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use +
Permit #: 1 t pl 1 `
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
1-'043 Site Address: 3
Tenant:
Suite #:
Name:
Address / City / Zip:
Name: MILBERT COMPANY INC dba CULLIGAN WATER License #:
063031 -WC
Address: 1801 50TM STREET EAST City: INVER GROVE HGTS
State: MN Zip: 55077 Phone: 651-451-2241
Contact: BILL MILBERT Email:
New Replacement Repair _ Rebuild Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
Septic System
New
Abandonment
_ �h/ater Softener
(( Add Plumbing Fixtures ( Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (Includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Tumaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) ms
TOTAL FEES $s)(QL9,W
CALL BEFORE YOU DIG. Cali 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.gopherstateonecalLorq
I hereby acknowledge that this informatio`►;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
I/
Lo//,, / ,r
Applicant's Printed Name
x
App
c:' is Sig ature
Aug 18 15 10:56a Sunrise Remodelers
4*''' City of EaQau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
•-en/a,,`I`. .- 1ec.kC! t; -j c'�e���an-co,.r
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
C -e rlc ir- i3`t4 4 - r » t-►.: ��)i--�c����r
Date: -1 5 Site Address: igri.S VL'c I e g -:y- - 551a I Unit #:
-7I G, 3a.Co I 3 (� 3 FSS
Name: Phone:
651-762-9395 p.7
Use BLUE or BLACK Ink
For Office Use
Permit*
Permit Fee: ✓ 0 3.
Date Received:
Staff:
Resident!
Owner ? Address 1 City !Zip:
Applicant is: Owner 1.Contractor
Description of work: � cj
Type of Work o�
Construction Cost: di n:000 • Multi -Family Building: (Yes / / No
Company: j �� v1 +r ' S -e R -e . t' cct. (- e r S Contact: •St:; 'L �. �'. 10.1
Address:
Let. vi city: St , Pt. r✓1
Contractor �!
Email: i �1 Yt-% e S. e �>r ; WV. a vvi oci-e-Vers,
Stale:/A Zip: 63J i / v Phone:
License #: Q j Lead Certificate #: N - -p 9 33
If the project is exempt from lead certification, please explain why:
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:
Phone:
Sewer & Water Contractor.
Fire Suppression 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 specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.gocherstateonecall.orq
I hereby admowiedge that this information is complete and accurate; that the work will be in confamfance 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 BuildingCode must be completed within 180
days of permit issuance.
Applicant's Printed Name
8 Signature
Page 1 of 3
City of Eaall
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 #: f g/ // 7
!
Permit Fee: /05 -D5
Date Received:
Staff:
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ('l U (k.S 2,-)± 7, Cf 6 I , Unit #:
Name: Phone:
Address / City / Zip: � � ALL t y RID -Oil 6rnrI ` 11N . 55 (123
Applicant is:
Owner X Contractor
Description of work:flf 'L 4(t C- 6'
Construction Cost: 3 (o Oa tip Multi -Family Building: (Yes X- / No )
Company:
VA-1.t..ei 6 aii-cam A51944
Address: 35%80 qD" A-ur
%LG Contact: S' Jb/t'Nsv
City: 0.4/viva)
State7'ii/t/ Zip: 55069 Phone: (,5/-a4/c-03 /I Email: SJOF}/vlow e QQMr ku,67 GsitilotAX$4. C A
License #: IN) 1 is -
Lead Certificate #: N�1`�
If the project is exempt from lead certification, please explain why:
No L -eR-i6tArri
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:
Mechanical Contractor:
Phone:
Phone:
Sewer & Water Contractor: Phone:
Phone:
Fire Suppression Contractor:
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—tuv JO) -(mo,,.
Applicant's Printed Name
x
Applic
is Signature
Page 1 of 3