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3814 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 ) . , - OoNTRA4 tag .:: 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: :NOT . P• p ai ��� ... .. .,.,�, :.• , ! , �wt�i�!� � �rit��ra�41 .� ld�racFlA ' i t�'i� c�nsof 4� ... the' , ,IC. �( . ... :........ +/� JR4.4. /t' of P f d p ►;r ` � , �! d, D�F �/�B ; �G I �Ri ..... 1�1;� n 4 � t� � A:S coy l . ....: . � ' •. ' :. : ... .•.. .' '. . [Q�`, 4 IQV. t1t8 � }CJ . 'r o e ude tEtiata`h are c Ie •::: . - . � ... '... �: .tom .aec�+ets: : ... .. ..;. ,. ..,. ....... ... � ... .. . � City of Eagan ZO 3JCd 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. t� ,{� x :I.�A�iq l�3U/LR /S x Applicant's Printed Name Applicant's Signature Page 1 of 3 1NICW d0I831X3 I3S L9Z9T98Zt9 SZ :OI ZIOZ /6Z /S0 3€ a $ Yr g ' mr e 1 v4 r� 1.e 1 f , r rib a ° I i 4` Aa xt rt + �i J7 y k a i '` v L$• Y ; f�a Fa k k " r * w ..;, r ,� 4 s 73 4 ,:, r a t e ' °ti, , . � �, . ,„.., ,, 4V tt o f pilefs a !mg,' _ drs is " -. r F yr. # L66 :1 b ar '4 umber: . ' Gertz R P Mint) Lau k4 2 -27 -. 4 718 % , 100.00 pd r , ,, , waft tit* Of Eagan Connect 6n -Mare: 4 2$ _ 0 9 > - } . i Account IDeposit: . .1 4 F ' _ ; " k, + Pernit Fee: 1 -PO Pd , _' By Q� 41 Surdtrge: - SQ .* .�-- Misc. merges: / Total: '' :r' kns .) . Date Pahl: PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA111029 Date Issued:06/10/2013 Permit Category:ePermit Site Address: 3814 Willow Way Lot:66 Block: 01 Addition: Briar Hill 4th PID:10-14993-01-660 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. Renae Frienwald 2200 Hwy 13 W Burnsville, MN 55337 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Curtiss L Moen 3814 Willow Way Eagan MN 55122 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature Logo BLUE or SLACK Ink I For Offift Um PwWv. oI*D r.. Pena 3530 Pnoc wwe Raad l a, lzooehad: 3 + l Koons. 65, 546 1, 1 , Fax: (WI) 67"M I Sao ~ 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Dale: / o - i - 3 Site Addneas• 380 8, s V /o :3 B1x 3 3/y tLo W Lj#4 > r : cfo A C 7/-V A til a 6 L M x v , x e _ php~; 763 • -r 3 - 4 y 70 Andrew/ City / ZJp: ?so a t~ e- *"7 •v Q Av A~ .1 o om a ss-yx7 Apprroant - o mew Cpntrecbor .~IPe.t yMpr c DasaVbonofwork: 7'£o42 OA= 2E- p4oF r Consouction Coat 13,'7a'[% cJO IWWd-FamUy BulkfM (Yes. /No -1 . . ''~<:=1 • company: 43E ; •rc.Q.o.e /yler.,~ ; . G' 2P ContBCtZvi d Q~ t:~ ~ 5 . Address LV S APe. 5, c;q Stalle: , Zip: I A-VI 9 Phone: &'z - ?6 i ~ &A V Z . um" 5; J9 C A cf!/ 2 / Lead Cerlifleale ff the projw is O*mpt from lead ca on. please explain why: (see Page 3 fora WWOI al itt =Wticn) i~~a/ms ~l:>x~•R.~/Lr Pos: J4ti S' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has ttr Clgr of Eagan lfisoad a permit for a sknilar plan based on a masber phn? ,".,_Yes -40 If yes, daps and address of rmgaW plan: Lk*naed PlumAor: _ Phont►: MMwAanioal Cenftcf r phi. saws & wa/ar Contractor Phone: t: c m =You DIG_ Can GOphersha 0" 016 +f (00)044 -0002 for prowcoon 4-VWM wxWgmLxW t~ apt • Ca148 Noss Now, amasiammla before to dm" of tdfl5as. F hereby ad=wWp &pa that this is aonrpl~ end male: that t11® work v4I be in confan rwm va the ardbvji s and codes of tlra Qpr of MtMtMA. FAW this is not 8 permit, Dut anN in app0eS0an 6or a pemtiL and work is not to start withaa a mvidt dw ft wwk vie b$ r oo Qrww.a per► ar vw a~ oswerk w~oN iov~ure. • ~w era .pp.ow of pku~s• walc depot;- umm hya bW Mbrs PW" Ewuad In alooordanoe whli tht+ wnas$W $tW Cods =W be ooaploled woda 1a0 rotit lastteaaa, - D~,..A ~~tzrtrs • ~a rnnted Manse AoplloartCs Slgna6~re P4010(3 Z0/Z0 3!DVd iNIdW 1X3 13E1 L9Z9198ZT9 ZT:60 6T0Z/T6/0T 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 b0/TO 39Vd 1NICW 1X3 I3a L9Z9Z98ZZ9 OZ:tT bTOZ/8I/ZO