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4592 Cantebury Cir4 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Mechanical Contractor: Sewer & Water Contractor: Applicant's Printed Name 2012 RESIDENTIAL BUILDING PERMIT APPLICATION NTRACT Site Address: `O 9 Y27? �p � o� �S 447 frayeillonc Applicant is: Owner Contractor Lead Certificate #: Nlf Contact: Mat* 4'nPeh City: ArHirr Ye Staff: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) &'f Ik tin 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: Phone: Phone: Applicant's Signature Use BLUE or BLACK Ink r � For Office Use f Permit #: / 0 '2,5 Permit Fee: )(6. Date Received: NOTE: Plans and supporting documents "that you submit are considered to be public information =P ortions th e information may be classified as non public rf you provide specific re' - • • - conclu" de't iat trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Cali 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.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 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 State Building Code must be completed within 180 days of permit issuance. Page 1 of 3 CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road ,P. O, Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 ogres to comply with the City of Eagan Surcharge: Ordinances. Misc. Chorges: Total: B Date Paid: Date of nsp.: / �G� Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road �. O: Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: _ Site Address: Plumber: 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: B Misc. Charges: Dote of Insp.: Total: _ Insp.• Dote Paid: Use BLUE or BLACK Ink i------------------ i For Office Use Permit O f Wan 6Y I I Permit Fee: 1 3830 Pilot Knob Road I i i gate Received: I Eagan MN 55122 Phone: (651) 675.5675 j Fax: (651) 675-5694 i Staff: 1 L_---------- 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: ►J Phone: 7 4 6 ~J -4 Zy~ Resident! QVyngf Address /City /Zip: 'y Applicant is: Owner Contractor Type of Work Description of work: Construction Cost. Multi-Family Building: (Yes / No k Company: 5 / i ~ ntact: dl-OL/ _ Contractor Address: , ® 7 City: ~5 State: Zip: 6 Phone: C.e f License Ae6sgzae 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 & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public-intro oration. 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 Cali at (651) 4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.ora 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 of plans. Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180 d1~a f f permit issuance. x l~ ka,~ E0 x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA173274 Date Issued:11/05/2021 Permit Category:ePermit Site Address: 4592 Cantebury Cir Lot:14 Block: 02 Addition: Ches Mar East 1st PID:10-17150-02-140 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Dana Outen 4592 Cantebury Cir Eagan MN 55123 (651) 655-6138 1st Team Exteriors P O Box 9237 St. Paul MN 55109 (651) 308-6860 Applicant/Permitee: Signature Issued By: Signature