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SEWER & WATER PERMIT OFFICE USE ONLY
Q OF EAGAN MITER # . PEFIMIT DATE 02
3830 Pilot Knob Rd CHIP ,� # t ? 51i 5
Eagan, MN 551 22 -1897
METEI SIZE B.P.I CEIPT# C 01.7372
DATE FEB 18, 1992 ISSUE DATE t# I': RECEIPT DATE 02/19/92'
PRV ___ B0OSTER >PUMP
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4078 401) 4084 4016 4080 VI E - DAN RI)
SITE ADDRESS 4145 41 414c 1 0): : : . 41, 4151 4.15rt E'IAf q' PERMIT REQUESTED
LOT 8 BLOCK 2 SEC/Stja HIFFLEY - S
SEWER _X_ WATER —,TAPS
APPLICANT:
ADDRESS: COMM /IND ..X_ RESIDENTIAL
CITY, STATE F; ZIP X NEW .___ EXISTING
PHONE:
Lawn Sprirrkler Meters are to be Installed
PLUMBER VALLEY :. F 1 . :: s Domestic Meters • on Water Line.
ADDRESS: 610, E ' -. *J L NOT be giv -n for T?eciuct Meters.
CITY, STATE J :. e ZIP . 55352
492 -2 L21, ,
PHONE: �,.'. .. �.. -
t AGREE < • 0 WITH CITY OF
OWNER: THE ;'RI0TTL ,00,:INC EAGAN ORDINANC S
ADDRE 4 5201 E RIVER R1
CITY, STATE F'$I E Y Mit ZIP 5 5471
F) st _ r SIGNATURE WHEN METER ISSUED
t �� ,ere . ' rir . ?" c f b R P ROCESSING. CALL 454 - 82'211 FOR IN SPECTIONS . ;FOR S�,
SEWER PERIINTS, COtflAC‘TEft401141EEIIING DEPT.
06/17/2014 15:05 Les Jones Roofing,Inc. �AX�528817009 P.0091020
Use BL.U�or BLACK Ink
( For OHlce U9e ^ ^� �
. ' j Permlt#: ������ I
C"�"� o^ ��5�`�^ I permit Fee: l0 �� �
3830 Pilot Knab Road � �
Eagan MN 66122 j Dete Recelved: j
Phone:(651)6755675 1 I
Fax:(661)6rG.6ss4 , � 5��� �
I I
�____.___�_.__-----.,
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: � �? Slte Address:y/ys-y/'Y�-�//y9-N/r/- y/S3-�//s'� �u.2,�q�t.t, [ozia.7tinTt�:
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;:;�:�:;���'�,';�+;� %;;";� Llcense#:_ �2�/a� L.ead Certlflcate#: �U�4T `e`O � 7�-/
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If the proJect Is exempt from lead certification, please explaln why:(see Page 3 for additional information)
COMPLETE THfS AREA ONLY IF CONSTRUCTING A NEW BU(LDING
in the laet 12 montha�ha9 the Clty of Eagan Iseued a permlt tor a elmllar plan based on a msster plan?
� Yes _No If yes,date and eddress of inest�r plan:
Llcensed Plumber: Phone:
Mechanlcal Contractor: Phone:
Sewer 8 Water Contractor: Phone:
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CA�L BEFORE YOU DlG. Cell Oophor 9tafo One Cell e1(661)46M0002 for proteCUon agelnst underground utliity damape. C8U 48 houre
before you Intend to dlg to receive locat8e M underpround uUlltlee, www.aonhersteteonecau.oro '
i hereby acknowled8e lhat thle Informalton Is comptete and accurate;that the work wtll be In conforrnancs with the orcllnencee end codea of the CUy ot
Eegen; that 1 underetand thle le not a permtt,but only an appllcaGon for a permit, and work le not to atan wlthout a permit; chal Ihe work wlll be In
accordence with the approved plen In the caae oF work which requlree a revlew and approvel of plane.
Exterlor work authorized by e building permit 199uad in accordance with the Mlnnesota 8tate Bu(Iding Code must be completed withln 180
days of permit lesuance.
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Appllcant's Printed Name Applicant's Slgnaiure
Pege 1 of 3
0211912014 12:34 Les Jones Roofing,Inc. �A�}A528817009 P.0091020
Use BLUE or BLACK Ink
� ForOHlceUeeYy__�____i
1 7�'�7�i
� Clt� Of ���1�I1 , Pe�,���: .
R��,�9°,!��' ► �7 i
� Partnit Fee: �
3830 Pilot Knob Road FEB 1 9 2014 � Date Rec�1�d: � I
Eegan MN 65122 � I
Phone:(661)876-66y6 I Statt: 1
Fax:(661)676-569e1 . � �
�----------------�
2014 RESIDENTIAL BUILDING PERMIT APPLICA710N ��
Hp'78, 4080, H08Z,ti1t�8�I. �1D8b. SI08$ ,c3�A�V�� �� a'p
Date: �I� � Slte Address: `�ISi / D �o� "T"` Unit#;
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�� ��"`����<,�'t""((`1� ��� Appilcant Is: Owner X Contractor
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�:;�� � -�-� } Construction Cost: �S�I 7�I GI. /S Mui�-Family 8ullding:(Yes x �No� �
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G:�''"i�.QI��C�t�t r�f£^4,� Address_��/ �1/. SQ� .�°!� � City: .
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;`�� _ �,��`�t'';�y�:��,;':�"'' Llcen6e#: /05'"�D Lead Certlilcate#.�t/�7'� �f o.� 7�7 -/
If the project is exempt from lead cettificat(on,piease explain why: (see Page 3 for additionel informatfon)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A EW BU G
(n the Ia$t 12 montha,has the Clty of Eagan lesued a pertnit for a simllat'plan based on a master plan?
� ^Yes uNo If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Coniractor: Phone:
Sewer&Water Contractor: phone:
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CALL BEFOR�YOD UIG. Cell Gopher State Ona Ca11 at(e61)a64•0002 for proledlon agalnst underground ullNly demege. Ce�ll 48 houre
before you Mtend to dlg to recelve Iocates ct unde�gro�d utllidas.
I hereby aCknowledge thel thls Intormetlon Is complete and sccutete;thflt the WoAc VNII be In COnfom19nC8 With lhe ordlnences and codes of the Clty of
Eagen;that I underaland Ihls le not a permlt,but only an eppllceNon for a permit, and work le not to slart wllhoul e pertrdt;thet lha work wI11 bo In
accordence with the epproved plan In the caee olwork whlch requirea e rewew and approvel of plane.
Exterlor work uuthoAxed by a building permit issued In accordence wlth the Minneeota State Bullding Code mu6t be completad within 180
days of permit 19eupnCe.
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Appllcant's printed Name Applicant's Stenature
Page 1 of 3