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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 C.Z— x 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