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