3818 Willow WayCityofEa�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use ����
Permit #: 40. to Co
Permit Fee:
Date Received:
Staff:
45- z9z
199
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 0141-Y i9 i.2 She Address: 3VG, 311 / 8, 3 8:t e , 3 S'2 Z cJ «c w ! j
,..
•; RESIDENT r.
("INNER -•, .
Name: c% A s 504-1 -'7-1 .J P �.4.J 4 r 44L. "0 4, 7 --;Phone: 7 4, 3 - 141 3
74- 7
Address / city /zip: 7 02.1. z. ..c% 5/444/ Jea /41315,41:. a.2o r .S3//
.
Applicant is: Owner X Contractor
T ` 1.'•`.. I
T'fpE:;.:..:
QF 11N( .
Description of work: 7+/o a. QX•2c uF 0 w L`c. i ..s 4, R.010 f.-- 0.a L y
Construction Cost 7, 4/ULA. Da Multi -Family Building; (Yes S / Na
)
C ON7' 7'OIR'',
•
Company: !fie/ Z'x 7.-42iGI. 2 /447$07-. deaP,, Contact: &w>r (t3� r'‘- r41
Address: yo s— /3. 10o rbc S`r, City: /SPG S ,.
State: M A Zip: SZ—V/ 9 Phone: 6 IA -• 8 4I , 6 2.4/ 3
License #: a -- .7 4/1/ 3 / Lead Certificate #:
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:
Licensed Plumber: - Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
NOTE: R 044" $if,!p 1a
.heanfVit,800:::F Cd:tion,001lc:ff,-.00vde:'• ,cdc ��if��Gh �o0lea
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.
CALL BEFORE YOU DIG, Call Gopher State One Call at (651) 454.0002 far protedion agaInst underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecal ,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 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 won( 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 8uiidir3p»Cpde must be completed within 160
days of permit issuance.
x $vip aup-ai.;
Applicant's Printed Name
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Applicant's Signature
Page 1 of 3
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City otBaQen
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Nfiia
Permit* T/(2 99q
1
Permit Fee:
Date Received:
Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION a
Date: ^ � -.d S Site Address: :38/x, / ' A 0 ac, 2, cat tto C.J 4 Y
Tenant:
Suite #:
RESIDENT 1 OWNER
Name: 4114,Ci 4-7, .-) F..:.4 + a//%L fr 1 L-`' T Phone: l l0 3 - Yid" -
Address 1 City / Zip: '7° A R E . f%JN L.91.4 1 kb /01A)
Applicant is:
Owner X Contractor
S5'3//
TYPE OF WORK
Description of work: /'a AIX-- 4. £, c" -t 1' 70'
Construction Cost: g, 600 Multi -Family Budding: (Yes k / No )
CONTRACTOR
Name: es/ El2..oi2
License # Y, //
Address; S/03 • ip COIL 5!- ---
State: /20A) Zip: S—C-`// 7
Contact Person: ) 4 V £ !t -/s
City: 1'7 PLS
Phone: b/Z- $!o/-- G 2V 3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 — Minnesota Rules 7672
• Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculations Submitted
Energy Code
Category
of submission type)
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:
Mechanical Contractor: Phone:
Sewer & Water Contractor Phone:
Phone:
NOPE: PlartA;'and suppc tlf0,dOGuig pts that you submit are considered tci:be .public inforn atlon. Portions of
the mforrnadon may G(gss�ff/ed as non-public if you provide specific reasons that Would permit the City to
I: a cr s..
'conc.lcida`that t, hey ar trade se et
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 01 ans.
x t 4 ✓. '
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
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rmit Fee
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Site Address: 3 811 'Ni 11ow. wary L64 t Briar Pill v t+2i
Plumber. ' t - to 42746 . ' 100 .00 '
t ewe to comply with the City, of Balm 1 Connection C Q" " pd
Ordinances. i i Account Deposit: 15.00 Pd
Permit dee: 10.00 pd
By 4 Surchargi: .50 pd
Misc. Charges:
Date 'o�r'!e'� ' ® Total:
Insp.. Z c^ Date Paid:
*City of Eatail
3830 Pilot Knob Road
Eagan MN 56122
Phone: (651) 675-5675
Fax: (651) 675.6694
Use BLUE or BLACK Ink
For Mee Use
j Permit a: •
�Jd
Permit Fee:
Date Received:
I Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Data; //- 7- /3 Site Address: -3S 1 to , 8.1S, 3816, 31'11. L/LLe(,.) t 'Unitttl:
Resident/
Owner
Name: e/A 46 /ij4, 4 6 £ /+t
Address / City / Zip: :so JJ e 4 .-/-u Q Av. A . A
Applicant is: _ Owner Contractor
Phone: 743 - •S-91- 9 7
6ot.6£4,:) 1/444.1 y MA)
Ss' yx 7
Type•ei Vlork,
Description of work: R f i•-o.d t: 8- R £ Pt, 4 -c -i. d F -0t cs a )17 E rrr /.
Construction Cost: L 5/ do • t!U Multi -Family Building: (Yes / No .�
Cath dc(iar
Company: a 81 4->< r ra R iy%r , 2° 12/'" Contact NW/ r II 13.,0_32.,s
Address: L��.r CO 100/1` l".
City: /y1 PL
State: 11,w1 Zip: 55.-V/ /r Phone: IP, L - /o / - Co 2 X13
License #: 2 4!/ / / Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
gas' Poste J97Y"
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:
NOTE: PIa s ondsaptim.ThootOmenk;.,
•intcmteuoni►1 ; vyioru sp
rondordi �'�'241 M S �. ... ,.'M •'S .. z ~A, '•1 rs .:
CAU., BEFORE YOU DIG, Call Gopher State One Call at (691)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities, www.gppharstateonecali.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 aceontance with the Minnesota State Solidi Code must be completed within 180
days of permit issuance.
X. i�4v't Jidda -2/ f
Applicant's Printed Name
TO/T0 39G'd
Applicant's Signature
Paget of 3
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11111/11/16.
Ci1yofEaao
3830 Phot Knob Road
Eagan MN 55122
Phone: (651) 6754675
Faro (661) 6754684
Data: / O -1
Use BLUE or BLACK Ink
w
. For O16m 1168
Penna# I 19413
PennitFes: 53,15
Date Received: rof 3r/i3 •
staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
i3. siteAddreeo: 3Ssi 38A°,13�:i:i; (A)/M-41W l'34"r Unit #:
Name: 4/o R t~ % /0 p di} r4 G . Ir[ L N i X")
Address 1 City !Zip: 8sD cc A Av
Appy ix Owner Z. Contractor
Phone: 741 -- 977o
'` 14 6014 (/SKL 4d
,W4 SSV.t7
.1
Description of work: -7-£.4k a l2 E -Roo F
Construction Cost /3 ) Multi -Family Building: (Yes k' ! No
Company: 61 E 1 j). re 0147")7. 612.14 Contac 11114V/ d tl•A R.. r 5
Address: OS- W k 11 city: /hPL $ .
sem: Zip: 5r9I9
Phone: to // 6 A 93
Licenee* Age .*4')// head Certificate it:
If the project is exempt from lead certification, please explain why; (see Page 3 for additional infom ation) A.
‘_los L Ear.. -11011.7 Poe-' J 97
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 beeed on a meatier plan?
_Yes _.No If yes, date and address of master pian:
licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
NOTE!:
Phone:
Phone:
n,
you ndmdig tore -a locates of underground www.ttoolAl ooll-oweYOU DIGCM GNwrSfCell at (es).for p against underground uugMeow. Cala8 hours
2
1 hereby ac khsvitdge that this intimatiOn is complete and
Eagan that 1 underaaerd this is not a permit, but ;that the wont veal be in o Is not
t with the ordinances and cotes of the of
.owrdent with the sep+ou.a hien 1n ms ogee otwe k weigh permit. andpploval ("�C to start v►ifyfott a Oelrillt that the w�Ofrc tN� In
s.
&meg' work
days of pmtauthericed by a building permit Issued In accordance wr+ldt the Minnesota Stage Buil Code Wat=t be
completed within 180
••
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Appiloant7 PHntoc Nr ne
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Applkante Signaiuro
Page 1 of 3
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