2070 Quartz Lane - Zoning permit41101'CilyatEaRan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5685
Fax: (651) 675-5694
Email: planninq(aicityofeagan.com
For Office Use
Permit #: a/
Date Received:
L
2012 ZONING PERMIT APPLICATION
Identify improvements on a site plan that shows lot lines, structures and existing conditions.
p Please submit a set of scaled drawings with the application.
Site Address: v Qj f42.
Name:
Address:
2° 4 4) Ove...-"tL
Applicant Signature: ) �-- `i� f �_rw..` Phone:
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Email address:
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Ly144-GL
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City/State/Zip: -C-4_) vim/ `J 5 / 22
Date:
❑ Retaining Wall <4 feet
O Patio
O Sidewalk
Description of work: r
O Driveway
❑ Sport Court
'Fence
/AZ -L.
0 Other:
Approved:
Notes:
Date of Approval:
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Revised Plans
Approved:
Yes / No
Date of Approval:
Staff:
Approved:
Notes:
/ No Date of Approval: /.140//.2._ Staff:%Iayy,
Revised Plans
Approved: Yes / No Date of Approval:
Staff:
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.gopherstateonecall.org
G:\Building Inspections\PERMIT APPLICATIONS\2011\2011 Permit Applications
Apr 09 2012 12:46PM HP LASERJET FAX
Date:
City of Eapp
3830 Pilot Knob Road
Eagan MN 55122
Phone: (851) 675-5675
Fax: (651) 675-5694
EC ,, E
APR 092012
p.2
Use BLUE or BLACK ink
For Otece Use
Permit #:
Persil Fee:
Date Received:
Staff.
2012 RESIDENTIAL BUI DING PERMIT APPLICATION
Site Address: 2044Qq..K..rz_)
, Name: -T cGfelf tr to i d a
RESIQENT/ 20 - -QQ.)441-3-2 (;•-/pWNER -� Address !City / Zip:
Applicant is Owner Contractor
TYPE OF WORK Description of work: ?E P (ACJ 6)(1 S 1 r -PP -1 t -L FIC? Af
Unit #:
Phone:
CONTRACTOR
:. Construction Cost: 3 51) C) S Multi -Family Building: (Yes / No
Company: Ly„ J ,z. & -rs Contact JLir, d �1,►�t s.. (es
I.
Address: 7' Dia" ' r'iL AUc city: .4 r t-
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State: '"IN Zip: S.S. i 8 Phone: 6s 01‘k
License #: Lead Certificate #:
• 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 1L 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 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 Cal at (161) 454-0002 for protection against underground utlity damage. Cat 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 wit 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 penrat; that the work will be in
accordance with the approved plan in the csse of work which requires a review and approval of piers.
rcr crz authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
x j40e .r " SCINNelaeir
Applicant's Printed Name
Apr 09 2012 12:46PM HP LASERJET FAX
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2070 Quartz Lane