861 Ivy LaneDate;
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
00°iDL000,2-
Date
ate Received: -3 —16-1'2-
Staff:
16-(2
Staff:
L
I ( 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
t Site Address:
Tenant:
RESIDENT / OWNER
CONTRACTOR
TYPE OF WORK
PERMIT TYPE
Name:
Suite #:
V ► `Q + Phone Q ) 1. r `'l,
Address / City / Zip:
06�
Name /\[ V CAI I I i, e #: � . 1LED Q
Address: 4 Lt6 City: 4-kfliNYN)
State: l) i Zip: ba,0 Phone: -C61 (6-3
New Replacement
Description of work:
Email:
Repair
Rebuild Modify Space
Work in R.O.W.
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $ (Qt
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities.
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 fans
x i Lily) (�
Applicant's Printed ame
FOR OFFICE USE
x
App(
Reviewed By:
Date:
Required Inspections: _Under Ground _Rough -In Air Test _Gas Test _Final
All'
City of Eagan
3630 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
JUN 17 2015
Use BLUE or BLACK Ink
For Office Use
Permit #: c i 1 I t2 )c)v-D
Permit Fee; (� < 5
Date Received:10 ` 1 _ 16
Stasi: 43
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
ta.)otob -a,.) b /%)in G.
Date: -- " C. /4' '/S' Site Address: S',171 ?✓ Y L^ Unit #: _
Resident/
Owner
Name: %' A C T /49.u46, t MLN .r Phone;
l
Address / City / Zip: g, U hL: C4'7"1-1 IL., ,u a A #14 eic. c c J.: VA L4. /OA S'S 9.2.7
Applicant is: Owner Contractor
Type of Work
Description of work: 7-X442. t) F d, les - g0 aA-A AG L D.lL Y
_
Construction Cost: /. 9 f.S- 012' Multi -Family Building: (Yes / No !)
Contractor
Company: ilL i i •1 Lt2'o f in4/ Kit... Co/2R Contact: »i./ QL R Jrl I S
Address: LI v S' t.J 6 "-t S -r. City: In P t• S
State: mi Zip: -55-41/ 9 Phone: L /X • 4'6'' - 42 V 3 Email: —I" •P.4." CJ /3 t i'‹ "1 ,. Cit ``�
License #: tl e :(y 1/ .3 / Lead Certificate #:
If the project is exempt
(Is.l,: r Po $.7.•
from lead certification, please explain why:
i 9— - Ai 0, - his 'i- ....a 3, G� Pr.1.+s"rZ.b S.. --A A-44 -_$
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master pian?
11 yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents, that you submit .are considered to be..publlc, information, • Portions of
the Information May be classified as non-public if you provide speciflc reasons that woald perm/t the City to
conclude'that they are trade.secrets. ' .
CALL BEFORE YOU DIG. Call 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.aao erstateonecall.orq
1 hereby acknowledge that mitis 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 (or 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 Bu ig Code must he completed within 180
days of permit issuance.
Applicant's Printed Name
EI/60 3Jdd
x
Applicant's Signature
Page 1 of 3
1N0/161 lX3 I3B L969I98ZI9 E9:61 5Z06/9Z/90
TICity of Eakau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit /37751
Permit Fee /0 - -
Date Received
Staff
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 ".1-C"'1‘ Site Address: 6 k t V't LAtsi C.-- Unit /0:
I Name' P1 -41* -1 1----- J-1(:) riivi 4 Ni Phone,
Address / City / Zip. '1:84 t 1%., H t.,,A-.1 I ' EA -44,1 53713
,
1
! Applicant is: Owner Contractor
Resident/
Owner
Description of work:
M-C-Vt
fa-rirt..-0—, (—
Type of Work ,
I Construction Cost: 1) .52-"'' Multi -Family Building: (Yes / No )
1 eotrottii-‘4./z.t-kAvt-
Company: I ',i --41-1c.,..1 Contact: gtre4rvi."--( LAIr2-Sor\I 1
Address: 5-1(-1 ir4Ovs-si rrt.,444.- f.,..i-- 1.:ir4' City:
Contractor i
State: Zip: 5531 Phone:165''171-*7°4Email: 440Ert Q- /44-4.-574-ei- Tbo.4.•-i •
License II: 66-7c4h'47.5 Lead Certificate #, I 5-7--851 - 1
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression 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 if you provide specific reasons that would permit the City to
conclude that they 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 wvvw,qopherstateonecall,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 t 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 Stat: B 'Iding Code ust be completed within 180
days of permit issuance.
5r-,asc>e.. 4 . LA-as(04
x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA143249
Date Issued: 06/08/2017
Permit Category: ePermit
Site Address: 861 Ivy Lane
Lot: 6 Block: 01 Addition: The Woodlands North 3rd
PID: 10-75892-01-060
Use:
Description:
Sub Type: Reroof
Work Type: Replace
Description: Does not include skylight(s)
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Allstar Construction Commercial Llc
5145 Industrial Street, Suite 103
Maple Plain MN 55359
(763) 479-8700
- Applicant -
Owner:
Dianne M Hoffman
861 Ivy Lane
Eagan MN 55123--242
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
City of Eagan
PERMIT
41' City of Eaan
Permit Type: Plumbing
Permit Number: EA145301
Date Issued: 09/01/2017
Permit Category: ePermit
Site Address: 861 Ivy Lane
Lot: 6 Block: 01 Addition: The Woodlands North 3rd
PID: 10-75892-01-060
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:
PL - Permit Fee (WS &/or WH) $59.00
Surcharge -Fixed $1.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
- Applicant -
Owner:
Dianne M Hoffman
861 Ivy Lane
Eagan MN 55123--242
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature