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
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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
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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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umber: . ' Gertz R P Mint) Lau k4
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r , ,, , waft tit* Of Eagan Connect 6n -Mare: 4 2$ _ 0 9 > - } .
i Account IDeposit: . .1 4 F ' _ ;
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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
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Pena
3530 Pnoc wwe Raad l a, lzooehad: 3 +
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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
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.~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,
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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
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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
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Applicant is: Owner Contractor
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O 'Work Description of work: R £w.e ~ E £
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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.
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Applicants Printed Name Applicants Signature
Page 1 of 3
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