1294 Crestridge LaneAug 18 11 01:46p Gates General Contractors
40 11 ' Cityofaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
CONTRACTOR `:
7634387710 p.4
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Applicants Printed Name Applicant's Signature
Use BLUE or BLACK Ink �C
For Office Use / (�
Permit #: ! O
Permit Fee: '3/0%76'
Date Received:
Staff:
// 2011 RESIDENTIAL BUILDING PERMI APPLICATION
m �
6((gi 7 r •>-Li 36 E563�
Date: Site Address: j ( 1 ` Unit #•
Name: 1 P7C0---- 4 /1 •
RESIDENT /
OWNER l Address / City / Zip:
Applicant is: Owner fr6cntractor
TYPE OF WORK Description of work: - te-Ar
Construction Cost: 7 v - v Multi- Family Building: (Yes " / No )
_. _ ,...•_ _.... _.� .. ■_ . .
Company: � iP'f�S� C9 �-*� �rti9 dis 7�' 411- Contact: / ` ./c
:' c ' ._ . •
Address V'1deN! ifi i L,a/ Sl � aO - &S) City: r- C v)'"4
5
State: el Zip: - (7 Phone: / 4!�
License #: 79 Lead Certificate #: /
If the project is exempt from lead certification. please explain why: (see Page 3 for additional information)
Phone:
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:
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. CaII 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.aooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the o . finances and codes of the City of
Eagan; nderstand this is not a permit. but only an application for a permit, and wo not to start without permit; that the work will be in
a 9 anh the approved plan i e case of work which requires a review and ap • •o al • "plans.
Page 1 of 3
EAGAN TOWNSHIP - y
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: April 11, 1972 Number: 611
Billing Name: lira Hori Homes Site Address : & 1294 Cru:3trid; a & 3635
Luwu:Ax
Owner: • =,,ma Billing Addreas3 Ko1at d
Plumber: Thaapson Plumbing Co.
Location of Connection Meter Size Connection Chg.
Meter No. Permit Fee '10,CO ixi 4/11/72
Meter Reading_ Meter Dep. .50 16 4/11/72
5 meters dL 00.UU us.
Meter Sealed: Yea Add'l Chg.3 Pd 4/11/72
NO Total Chg.
Inspected by
Data 7 - 1 "' 7
Building is a: Remarks:
Residence
•
Multiple Hat. tn
Commercial I(u . _ f L L METE S.
Industrial By:
Other Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
ThCnp.,on 1le:,bing Co.
Please notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP 4/ gi
-
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454.5242
PEREI=T FOR SEWER SERVICE CONNECTION
DATE: 4ti 11 11'1972
NUMBER 1 '
OWNER: I�:r i:o.iaon 110i40.1 1291, Cr jrrid;� :c 3635 c :)637 uer
Address
PWMBERTn ;,ri Plwnbin` !;n. TYPE OF PIPE
•
DESCRIPTION OF BUIIDING
Industrial Commercial Residential Multiple Dwelling No. of units
Location of Connections: Connection Charge
Permit Fee 16.•..:J r.,, b/11/r7
0
p-4/11/7=:
Street Repairs
Total
Inspected by:
Date J :7L ∎ 2 -
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota•County, Minnesota
By
•
�w�:oim Co.
df Pleashe notify when ready for inspection and connection and before any portion
te wor ie cove