3812 Willow WayREsIDENT��, •.
Q1�.YNS `�:: " °
Name: c/o AS S° C. / +rro ,J 1 S.- 6144— 10-,J 6 % Phone: 7 3 - 3' z 7
Address / City / Zip: 7 °A R £_ mss L.rs E 2 5 d MARL 4 aaot✓e S3 / /
Applicant is: Owner X Contractor
TYPE WQRK
a
Description of work: Y id- a 4 /Zcr
Construction Cost: /%I, ff� Multi- Family Building; (Yes k' / No
)
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Company: (14/ 4.-7-414,.!2. /�'!IE},, -: , Le',2P? Contact: bi {i.,RiZr 5
Address: 9°4-- f3. !p o . f'. City: / 1,4 r
State: /'` Zip: -S-.1-1-// f Phone: ( 0/4- F ‘;/ - i . W3
License #: 4 C X"/ I -3 ! Lead Certificate If:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes No If
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 plan?
yes, date and address of master plan:
Llceneed Plumber: _ Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone;
Phone:
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� City of Eagan
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3830 Pilot Knob Road
Eagan MN 55122
Phone: (661) 675 -5675
Fax: (661) 675 -5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee; a L �
5 - 21�/2-
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /Y - X A 7 /A SiteAddreea: 3do7, 3FS °, 3811 , 55 t•-•-3/1-"Li Li**, :
Unit d
(kj
CALL BEFORE YOU DIG. Call Gopher State One Call at 1651) 454.0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. w Nw.000herstateonecol.orq
1 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 tate Build' de must be completed within 180
days of permit Issuance.
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Applicant's Printed Name Applicant's Signature
Page 1 of 3
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d f Road • i t `'i I RMITNo.. 6 13
ago, 5121 4425/ ' R4 No. of Virtitsr.
Owner: 0 B2dls !
Si ess: . 812 W + .4 W 4 i S ' 1 _ _t.,_ ! r .Yg. ..e
Plum ber, Germ Ryan P!.�ing "" ,
2- 27 -84- 41.71 " 1 ! 100.0
t .gr« to compin frf E�, on di 2
A noneee; i , Delo*w
ermtr Fee: 7 n n c q
Dote o insp.: 4 r y i Teac h
Insp.: - Paid: j
City of Eagan
PERMIT
4111' C!ty
of
Eaaan
Permit Category:
Permit Type:
Permit Number:
Date Issued:
Permit Type:
Permit Number:
Date Issued:
Mechanical
EA106677
09/05/2012
ePermit
Site Address: 3812 Willow Way
Lot: 65 Block: 01 Addition: Briar Hill 4th
PID: 10-14993-01-650
Use:
Description:
Sub Type:
Work Type:
Description:
e - Furnace & Air Conditioner
New
Furnace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445-2840
Fee Summary:
Valuation: 4,386.00
ME - Permit Fee (Replacements)
Surcharge -Fixed
$55.00
$5.00
0801.4088
9001.2195
Total:
$60.00
Contractor:
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
- Applicant -
Owner:
JULITTA A GYAMFI
3812 Willow Way
Eagan MN 55122
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
Logo BLUE or SLACK Ink
I For Offift Um
PwWv.
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Pena
3530 Pnoc wwe Raad l a, lzooehad: 3 +
l
Koons. 65, 546 1, 1 ,
Fax: (WI) 67"M I Sao ~
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Dale: / o - i - 3 Site Addneas• 380 8, s V /o :3 B1x 3 3/y tLo W Lj#4
> r : cfo A C 7/-V A til a 6 L M x v , x e _ php~; 763 • -r 3 - 4 y 70
Andrew/ City / ZJp: ?so a t~ e- *"7 •v Q Av A~ .1 o
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Apprroant - o mew Cpntrecbor
.~IPe.t yMpr c DasaVbonofwork: 7'£o42 OA= 2E- p4oF
r Consouction Coat 13,'7a'[% cJO IWWd-FamUy BulkfM (Yes. /No -1
. . ''~<:=1 • company: 43E ; •rc.Q.o.e /yler.,~ ; . G' 2P ContBCtZvi d Q~ t:~ ~ 5 .
Address LV S APe. 5,
c;q
Stalle: , Zip: I A-VI 9 Phone: &'z - ?6 i ~ &A V Z
. um" 5; J9 C A cf!/ 2 / Lead Cerlifleale
ff the projw is O*mpt from lead ca on. please explain why: (see Page 3 fora WWOI al itt =Wticn)
i~~a/ms ~l:>x~•R.~/Lr Pos: J4ti S'
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has ttr Clgr of Eagan lfisoad a permit for a sknilar plan based on a masber phn?
,".,_Yes -40 If yes, daps and address of rmgaW plan:
Lk*naed PlumAor: _ Phont►:
MMwAanioal Cenftcf r phi.
saws & wa/ar Contractor Phone:
t: c m =You DIG_ Can GOphersha 0" 016 +f (00)044 -0002 for prowcoon 4-VWM wxWgmLxW t~ apt • Ca148 Noss Now, amasiammla before to dm" of tdfl5as.
F hereby ad=wWp &pa that this is aonrpl~ end male: that t11® work v4I be in confan rwm va the ardbvji s and codes of tlra Qpr of MtMtMA.
FAW this is not 8 permit, Dut anN in app0eS0an 6or a pemtiL and work is not to start withaa a mvidt dw ft wwk vie b$ r
oo
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Use BLUE or BLACK Ink
I I
Per office Use--- -
I
j Permit V
of Etan I Permit Fee:
3830 Pilot Knob Road
Eagan MN 86722 pate Recelvad: 2-TI 3/,
i
Phone: (651) 676675 i Staff: I
Fax: (651) 675.6694
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date; 3 y She Address: 3 8io, 3 8~ z, 3 y ~1 LGo(,►) is AV Unit
Name: e a AbZ.AtZ'4 r__ C. Phone: 763 -.5 FI-- 9'77x
ReiIderw o Go~p,s 1~ /n.J
owner Address i City /Zip: ~S D E Gr4Yu1Z Qv, A), A r
Sryl 7
Applicant is: Owner Contractor
a• P L %4'L f^ f b•"J 6 b '01re' 0 i4 9 *0 G
O 'Work Description of work: R £w.e ~ E £
TYPO'
Construction Cost: , e~dg.. S"oo (IU Multi-Family Building: (Yes No
Company: £ 1 Lrrr r ~.Pr o 2 IY~rd~ . Cv .2P. Contact N ✓ r 0 O19uaA' S
/dam LJ GatA Y77, City: PL 5
Address
ContI~Ct01
state: /VJ'~ zip: SS-09 Phone: lp/ Z - 9 to - Co 2 e1.3
License r~ Z Y/ / 3 > Lead Certificate It
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
t%'Lh4-S_ ~u/L7' PoS:' 157
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:
sd tjl~Rlyir~gl~tt(, i* 1Y ~
1W.M., Phis and
the~,lor►neaoii.;~iy • ct ro • r~",ylaitr .gala ~ , • ~ . .
CALL BEFORE YOU DIG. Can Gopher State One Call at (651) 454-0M for protection against underground utility damage. Cell 48 hours
before you intend to dig to receive locates of underground utilities, vmw.ooaherstateonecall.org
1 hereby acknowledge that this iMOrmstion is oomplele and accurate; that the work will be in conformance with the ordinances and codes of the City of
accor : dance that I t with the the appr appr tide is not me but only an appliootion for a pem+R, snd work is not to start without a permit; that the work will be in
ccor plan In the e case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued In accordance with tfte Minnesota State Building Code must be complet>Ad within 180
days of permit issuance.
X- t'4 4 2.2~ 5 x
Applicants Printed Name Applicants Signature
Page 1 of 3
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