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4428 Cinnamon Ridge Tr îý ðí ÿþþýüüû úýýþþ û ý ïðä ôêò ßïïïð ÿþ ÿþýüûú öàøäøþüûú øüûú öàø÷öàêú ô øúîþ äþäïáïãþú û Ü ÿóþ øù ôúøìôòòôøóþøôø ýøôç å øööú åøåø ô þ úçä åøå ú åø ç ä øýôæø øøóþøýû öå ôûòôç ùèáíèççï ÷ú ÿþøò ø þ èáíèççð þ á ç öðô ùó úú ö øí íòãí × û ððòì Úáïïðä ôêüø ÷ÿç ñ÷ðð ëéßßß òøýû öò ò ìø ò úú ò òåøô øø øôúûöò úú ýÿ åñ ÿ þ äûå ãø ç úú à þûÿ þø CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Ki b Road P. 0. Sox 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: _ No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.• Permit Fee: 1 ogre. to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: 3 Total: By =� ` y�� `—� Dote Paid: Date of Insp.: t-- a fi Insp.: 4.0- � 4 CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Kgob Road P. O..Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.• Total: Insp.: Dote Paid: Use BLUE or BLACK Ink ~ I For Office Use n t------- I i 11~ I 4~s*~ Permit#: 5 I 1 City of Ea a I I Permit Fee: 17~ ~ 3830 Pilot Knob Road I I Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: -31311 Address Unit Name: a d.l Phone: ~G Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor ° Type of Work Description of work: r IN ~c rc1'~~~ Construction Cost: ` 2-13 Multi-Family Building: (Yes / No ) - - Company: G- N er e-"'!v £ itv I ontact: yet' r! Contractor Address:, City: M,011 S' State: W ~ Zip: Phone: .2 License 02 6 2- 2-1Lead Certificate /1V-7- 37 )'p - 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 of the information may be classified as non-public ff you provide specific reasons that would permit the City 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. Call 48 hours before you intend to dig to receive locates of underground utilities. www.goaherstateonecall.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 Mfr tC%ar S" a`k f x Applicant's Printed Name Applicant's Signature Page 1 of 3