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1846 Cliff Lake Ct     ôìô     ÿþ þý ÿþþ  ýüûüúûû     ùþþ û÷øëê óôþ  î  ààåó   ÿþô  ü ûúù   ô ÷ á ì    ô Úü  þ     þù í ñü í îü   ãþ  ý þ ÿ  þù  ýßÞ  þ óóåó î úï íþ úíüîä á ãÿ çêåêóåå óù  ü îþ çêê  òýýñ ô öð ùùþ þþ  þ ö ÿ  á  üù úíüîä êáåóâôþ ô ã þùãáóÿþ þãáóà ßâÞåóââ î úþì  îþîþä  þîþùùþþþ îþî  íþ þþ íùúìîþþùùþ   þ  ã þ þü þôúÿþ þï þ ê ùùþë í   þü ü ú  þü Oct 07 2014 0824AM HP Fax page 7 Use BLUE or BLACK fnk � For Office Use r I C�t O j Permit# I� ��� � Ly f�a�a� ; � ; � Perm�t Fee� � ` I 3830 Pllot Knob Road Ea an MN 55122 � 9 Date Received: � PhonQ:(651)675-5675 � Fex:(651) 675-5694 Staff: I I _�������^�������J 2014 RESIDENTI14L BUILDING PERMIT APP�ICATION '• .P s' ^ �+ . �� Date: �"��� a Site Address; �� ��' i �� f��'l 1,�Yv � � ��� � — unn ai' Name: ��.��='��", ��/=. ,�r'�:� �`;, L,, �„- Phone: ResidenU Owner Address I City I Zip:_' �h?yr�v- Applicant is: Owner �f Contraclor Type of Wcrk Description of work � ��• ��...- �� � • �' •�"�a. / 1 •�; Construction Cost: �7 �Z��Y . � Mulii-Family Building: (Yes G°�No� . r �; o � Company• ��. . ,.' f =:���✓�+ r ``'�1'� , , Contact: �r'.��`9'`�-,t.''�.-�--�--.. ������/ Contractor Address:���':.� '1.7;��l3��•.=e'; Fr��'" �'����>�:i�' � City: ��''��%��`c.-�.��� � State!°`�`�°�'� Zip: �°`5�`�,� Phone: � ���' '?,��� ���Email.���c,c;',_.��r.��*er'���^'si�C�'.��:��•�.�r•+. ---,— � �, License fiE: ,a�%~1��'� �'�,.� Lead Certificate#: .��''���"°�w%°"?.�� " � If the project is exempt from lead certificatlon, 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 Eegan Issued a permit for a aimila�plan based on a master plan? _Yes _No If yes: da4e and address of master plan: Licensed Plumber: Phone: Meehanlcal Contractor: Phone: � Sewer&Water Contractor: Phone: NOTE:Plans and supporting documents that you subm/t a�e considered to be pu6llc Information. Port�ons of the Informatlon may be c/assffied as non public if you provlde specitic raasar►s that wouid permit fhe Clty to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at 651)454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive iocates of underground utilities. www. o herstateonecall or I hereby acknowledge that this information is complete and accuraie;that the wo�c 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 perrtiit, and woric is not to slart 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. Exterlor ��hortzed by a bullding permlt issued in accordance wlth ihe Minnesota State Bullding Code must e completed wlihln 180 da pe�m�t+7ssuance. -�•---�:,�,:....: �, X_ ��a���rF�-"�--- �""'`� j '.�..„�. .x .--"°�.i�-7.�,,.-_. ��-•.,'`� ---•.__„ Appllcant's Printed Neme ApplicanYs Slgneture j Page t ot 3 Use BLUE or BLACK Ink r-------------------� I For Office Use � • � Permit#: �� L 1�� I Clt� 0� ����Il � � ����� � Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Fax: (651)675-5694 I Staff: i I � 2015 RESIDEMlTIAL BUILDING PERMIT APPLICATIO� �.��� �. � L /, �/ C� � M Date: rL ��l�S SiteAddress: ��� �lf �� '-'""^G �o� � Unit#: ��, �.� ° � Name: H� Vil YY __ _,. ��n��.�,.��,m ��.v✓�.�w.��ew,..�..�.�.., �,W,�.....�,.�Phone:�,..- ��.�.,..�..�A�,.._.��.,�..�d_� S � f�tes3�l��#1 � ���gr � Address/City/Zip: ��' � � � � � Applicant is� Owner Contractor ��� w,��. �,.,k. �,.��.v.�...,�� �..,,�.���.�.�_�.n.�.�,.�w.�.v�..,�,..,,,,�ti.,,..�.......��...�,.�. � ��<.��.,�...�.,�,��..�,.,e� .�..� .,�,..�.,� � � � Description of work: ��✓� ��� Ty�pB d�'l�lori� � � � � Construction Cost: Multi-Family Building: (Yes /No� � £�_.,� � ��. � Com�an �.,�.�.��.�n��a��„_,a�G�d 1 �hc. Contaci: L��.I ��t �� �-�-, �.�_��.�„_..�� � � P Y•� , � ` Address: JS�'b �'L.��?tM'� �/� � Sui�e u.�1/ City: + � � � � COhI"�f'�CtO�' � � � State:�Zip: �Sy�� Phone: '7�3-SS� .�D'�� Email: ��_���.I�r�n,cy����"1-� $ , � �G �o� ��.� � ( License# Lead Certificate# ��..P,..��,� �.�.�.�..,w,..,�_�..��.,,.,...w�Fa___.�,�._�.�.� ,..���.... ..M.e.�_ ...,,.n,�,�.�...,... �..., .,..d,,,.. �._��.�.,�.M�.� w..�,.�,.�,.�....��.,w,._.�.�.._,._..�.._..�._.�.w..�.�.,_..��.�w..�..._.,.... � If the project is exempt from lead certification, please explain why: � � �,e..� .,.�..ti.�.�..��_...� . �.a._..__�,.�.a. _...w.�..� r�.��w�...�_.�...M...�.,.�..�.a. �.M...�.,.�k..�..�.�...�...�..,�..._..�.�..�,�.,.,�..a..,..._.�.�,.� COMPLETE THIS AREA ONLY I� 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 )f yes, date and address of master plan: � i ; ; Licensed Plumber: Phone: � Mechanical Contractor: Phone: � � Sewer&Water Contractor: Phone: �� Fire Suppression Contractor. Phone ,� �°�11��3T�':Pl��s a�d��vr�i��o[�r.t��:r�ts t���yow�s�br��a�e co��i�ed to�p�b��r���#�. f�o�o�s af � � ` r��i�a�`�r������r�e Gl�ass��d a:s r�on p�bl��i�y��pro�it��s�e��r�+��s fi�a,���t psr�i�th�C��y t�a � ���.� c�n�.��le�at t�e��-�trad��ect°e�s. � CALL BEFORE YOU DIG. Calf 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.qopherstateonecaA.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 noi 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 S t Building Code must be completed within 180 days of permit issuance. �_ X �(.!�f�Y(�(' ���.� X Applicant's Printed Name Appli s Sign ture Page 1 of 3