1884 Southpointe Ter411' City
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit Fee: .
Date Received:
Staff:
2011 MECHANICAL PERMIT APPLICATION
Date: //7/020/ Site Address: J sky sau`i��ar fe T e r �, fiyt IN 55/d.
Tenant: k r S S ` k'LS
Suite #:
RESIDENT / OWNER
Name: e-LGO-hs -J• lSe."' Phone: a19575.c
Address / City / Zip:
CONTRACTOR
Name: ("�l License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
New _ Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mounted and ground mounted mechanical equipment is required btr be screened by City
Code. Please contact the Mechanical inspector for information cut permuted ng methods.
PERMIT TYPE
�% RESIDENTIAL
i� Fumace
COMMERCIAL
_ New Construction Interior Improvement
X Air Conditioner
Install Piping _ Processed
Air Exchanger
_
Gas Exterior HVAC Unit
Heat Pump
_
Under / Above ground Tank ( Install / _ Remove)
Other
**When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
or alteration to an existing unit (includes
bumed out appliances, ductwork, etc.) (includes
$5.00 State Surcharge)
$5.00 State Surcharge) $ TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
_ $ Permit Fee
- If the Permit Fee is less than
Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
= $ TOTAL FEE
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 1 understand this is not a permit, but only an application for a permit, and work i not to start without a permit; that the work will be in accordance
with t approved plan in the case of work which requires a review and approval of plans
x ! 4. Inc EZ--se/i-
Applicant's Printed Name
Applicant's ,nature
FOR OFFICE USE
Reviewed By:
Required Inspections: Under Ground ' Rough in _Air Test =Gas Service Ti
Exterior MVAC Screening Inspection
RESIDENT /OWNER
Name: P
one: � le , -
Address / City / Zip: • O IN % -
Lew OA 5 '7b
CONTRACTOR
Name: ► +11, ' A.A. , Af ; I License #: iM . _.t -P
Address: IP ► aill0 City: 11 1
`75 5
State: 6 Z' : P3 Phone: lel e -
Contact: -- -- C V Email:
TYPE OF WORK
New Replac: e t "e a
Rebuild
_
Modi p.• a: . , . 111., ,
Description of work: ) � �...,
p h
_
`
+1�,
4. � Ole. ' . i .1, A - ' Arffja
,
PERMIT TYPE
RESIDENTIAL
i Water Heater
PVB)
)
( Water Softener
O
�� . , 4 1 :
( Main / _ Lower Level)
5 Add Plumbing Fixtures
Lawn Irrigation ( RPZ /
Water Turnaround
Septic System
_
New
_
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water
Heater, Water Softener, or
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment,
(add $166.00 if a 5/8" meter is
New ($10.00 per as built) (includes
Water Heater
Water
required)
County fee
etc.) (includes
and Softener (includes
$5.00 State Surcharge)
$5.00 i State Surcharge)
TOTAL FEES $ 65f
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
Turnaround* (includes
and $5.00 State Surcharge)
$5.00 State Surcharge)
burned out appliances, ductwork,
ir City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
RECEIVED.
MAY 1 3 2011
Use BLUE or BLACK Ink
1 /4
Permit #:
mo t /
Permit Fee:
Date Received:
Staff:
( l 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
Dated()( SiaAddr s: n `
Tenant:
CIA r'
Suite #:
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454 - 0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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 -tart without a permit; that the work will be in
accordance 'th the appro d�plain in the case of work which requires a review and approval of plans. t
Applic nt's Printed Name
Applicant's i s ature
11101 C!ty of Eaaafl
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit Fee:
10-00
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: Art , j ,2c4. (1;:ihkel Afki la salFr`
RESIDENT /
OWNER
Name: euillb. ELAN Phone: 8.87S/.1j
k.
Address / City / Zip: 4 d K 64k411,1 J 102 r" / AL
Applicant is: X Owner Contractor
TYPE OF WORK
Description of work: / ?).4/7Z-___
Ire
Construction Cost: `� Multi -Family Building: (Yes S• / No )
CONTRACTOR
J �J _1686
f
,i -
Company: %t/ 4 lQ-ci-S Sri e Ai tf e. Contact: &d ff (®e! s- i' i
Address: ') 45/ ti . (A v S i
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� U�e BLUE or BLACK Ink
�-----_..�_-------i
. � For OlMce Use �
; Pw,,,it� Z�'S/Z� I
�� 0��� � Permit Fee: I J,� I
9830 Pibt Knob Road j I
Eagan MIN 661ZT � Date Reoeivad: i
Phons:(651j 695�678 � � �
Fax:(661j 675�684 � �
�._____________�__�
2013 RESIDE�TIAL BUILD�NG PERMIT APPLICATION
i�7s�� s��. 8x,�r�i; s�� St�
s- -J�/ ' cu� o,.J rd ,�'2
Date: Sibe Addro�s:/�� 9 A,�'/�4 6,9 B,i� S�ouTii�P UnR�:
� �,. , Name:GLc f1 G 7" /y1�4,J+4���'N SU: .�"�C Phone:7(r� -S'S3 - 4770
Raa� .� Gr►e��,..D 1�r�c.�'
Oy�e� , Address/Ciry I Zip: �'S�D � �G�l rv.Q Ad p
� ; �- '..: �,�,�.0 s'Sy�7
� �. Applic�nt is: Owner ,�Contredor
��,���. �escription of wortc: `T s,g,2 oF-f" � 2� �F
� � , ConsUvction Cost��x 7 85.GQ Multi-Famfly Building:(Yes � /No_�
. >t� ��1 .' company:G,�E J �'ar r�,¢�o.¢ /y17i..�:. �p ContacC ��v�� ��r�R�5
��r, Address: �o S' � 6 0� S�. �;�: /h P�s
' � - � State: /Yl�Zip: SS'// 9 Phone: �O'z �b�' �Z`/3
� � , Licorts�#: �C .�y 1I 3/ l.ead CerWicaLe#:
ff the projeGt is exempt from lead certification, ple�ase explain why: (see Page 3 for addiGcnal information)
����s t,J�2� R��-�r. Pos; J 97 S'
COMP��T'E THIS AREA ONLY IF CONSTRUC71NG A�i„IEW BUILDING
In the last 12 manfhs,has the city of�apan lesued a permn'br a sirnilar plan baasd on a ma�bBr plan�
_Yes ,.,�,No If yes,date anp�ddress of ine�ter plen:
liceneed plumber. Phone•
MecAanical ConWttor: Phone:
Sewer�Wa�er ContrA�tor. p��;
���,'��. , ,o .. ; .. �,�
� � . .�g, _ �p r,�jjr'
•��y 'G •S7+c•'�l'
'�`� ��� .`x,�;`,i',` :'I'��::'�a��aS �'�",� rY���!' �,p ;'.��F��j���'yl'.
CA„LL B�FORE YOU DIC3. C�II Gppher Sbq One Cal)at(B61)46L-0002 for protedion ageiytigt unde(ground udlily damage. CaU d$hpuls
befnna yau it�end to dlg to rec�lve locete4 af undarground utqftles. y�!,9pphersr�teonecad.o�
1 heroby ackrwwledge that this informadon is ramplate and axurate:Ihar the work will be in coriformance wdth d�e adineuioes end oodas af Ihe City of
EaBan; that I undelStend itqs is rlot�permk.but on}y an eppiication fnr 8 OermR.and work fa noC to stert without a oam+lt;that the�wnc win wo in
s�wd.nw w:u,eno oPWvwd pen m tno osee dwv(k vMnldl roqW�S d rEVioW anC 8ptlfGV8101 p{0►Ie.
F.xOerior worlc authprized by d buildin8 pertnit(saued in�dance wF!!�tfle Mlnnesota StaEa Bulldi Cqda mu�st bs Completed within 180
days of penni�ieouance.
X I��..�A �a212 �S
ApPlicanP's Printsd Nams x
_ App11canCe Signatun
vega��s
Z0/Z0 �9vd 1NIvW 1X3 I�g L9Z9Z98ZZ9 bS�80 bt9�/TZ/99
Use BLUE or BLACK Ink
� ������������� i
� For ORice Uae. � �
I
• ; pe�►n�: � � 1 i
C�t of�a � � � �
� � '"��;' �'i� !�"°*'°.� ; Pertnit Fee: �
3830 Pilot Knob Road
Eagan MN 55122 /' � Dabe Received: i
Phone:(651)675�,675 �
1
Fax:(651)675-5694 � �' j
V���������������_J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
�-�� l� >�78, �Pd,sz, gy, ��, S3� o�.�:� TL2<
Date: Site Address:���e►,,px, Fy,q�,y�,r Sc,� SovrflP Unit#:
� Name:��o A C T /y1�4 n.3�4�E/'tit E�T .T•}C Phone:7l03 -s'9 3 - �7�o
Res�e�i#/. , . �
��� . : , Adaress�city r zip: �so � �e.�4 7—,�,2 Av ,c� '� �2 1'9 �oi�E.•' f/r}�L.L�£�
• /r�•�s s',T"y',t 7
� Applicant is: Owner �Contractor
' :''�� •..�. Description of work: /1�K o ci E � (2 ���F�� ��d r s�S�o
TYPe;��YoMc
Consbvction Cost�•�� �� — Multi-Family Building:(Yes � /No_�
' Company: �£ I £��r f2�o R Iy1�t'i..��. �� Contact ��v�� Q�'R-R�5
��;4 -. .: '. : Aadress: �i/os t� bv� S�. c;ty; �PL S.
Coa�ai:�cr��`�.
_. - • State: /Y�� Zp: S'$�y/ 9 Phone: !o�,'� - �6�� �Z�/3
� . License#: �C .�y�/3/ Lead Certificate#: �
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I�.iLDloS t��2� �vlL� POS; ! S� 7 �
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 mo�,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 ptan:
Licensed Plumber• Phone•
Mechanical CoMractor: Phone:
Sewer�Water Contractor: Phons:
!��j 1�I0!/S���R��.M...' .��`Fr. r+7`�..�}t' `: '✓.'. .'.�.� , a,; .. t�. � +�. �, ,c. •,�-,y:fS
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�5� Yj�?��W+�O�y'#'W,J :.y�J{d"•.'.•.. i.w'^'.y'.�� td� st
.d
CA�I.BEFORE YOU DIG. Call Gopher Stabe One Cal!at(6S1)454-0002 for prote�ction agair�st underground otility damage. CaII 48 hours
before you ir�tend to dig to nec:eive locates of underground utili6es. wuvw.ao�heistateonecall.or4
I hereby adcnowledge that tlus informaUon is oomplete and accurate;that the woric will be in confortnanc�e with tl�e ordinances and codes of U�e City of
Eagan; that I understand this is not a permit,but only an application for a pertnit.and woric is not to start without a pertnit;that the w�k wiu be in
acoondance wkh the aPP��1 Wan in the caSe 01 Wpltc vyhlUl fgyUifCS 8 fCViBNV 8fld 8�f'OV81 Of�113(18.
Ezbena'work suthoraed by a building permit issued in accordance with ttw Minne.sota S�ts Buildi Code must be completed within 180
��Pe�lt Issuance.
x ��Avi� ��22rs x
Applicant"s Prirrted Name APplicant's Signature
Page 1 of 3