Loading...
4538 Mallard Tr S SEWER & WATER PERMIT OFFICE USE ONLY CITY Oh EAGAM piETER'# PERMIT DATE 07 Pl 551 �d. CHIP #E ; WA6 PER # 1 511 Eagart;=MN 55122 - 1897 METER SIZE B.P. RECEIPT # ., C * 723 ISSUE DATE B.P. RECEIPT DATE 0710619D PRV BOOSTER P. z SITE ADORES$ 4534 South a11ard Trail .PERiETREQUE _ LoT ocK E uS ,T pmas Lake Woods SEWER WATER . _. _ TAPS APPUGANT: Thomas L e Devel ogme t , . Ltd, ROSS: 6645 Rt Road TS E r • t i . . c fIND X RESIDENTIAL CCI'Y,STATE P'r3..r Lake, MR �. - ZIP 55372 PHONE: 4 :, X NEW . easTING PLUMBER: 4z n P1 umbi g & ' Heating 14745 South Robert . Trail _ 'ADDRESS: I AGREE T Y wITt+criroP CItY STATE Ro s emd t , , ,MST z#P 55068 AN it 423 - 1144 PHONE: .., W.f f . 11; OWNER: Thomas Lake Development, Ltd.' ADDRESS: 6648 Rustic Road S siENATHHE WHEN44ETERISIEIV= CIrY, STATE Prior 'Lake : MN zip 55372 P .I NE: . 1( ' # � '+ � • 5 1G STOORM SEWER PE� MITE,,`," # m DEPT. s ANOixLUMBER WILL ,BE ttolwitrt WHEN m P . r D (4..# r----_-__-_.___ v• - I For Office Use I I Permit#:! Z11 City of Ea~a~ - I Permit Fee: 3830 Pilot Knob Road l 1 Eagan MN 55122 Date Received: -9 1 Phone: (651) 675-5675 1 Fax: (651) 675-5694 j Staff: I 1 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Ad/dress: l Unit Name: '7 3 At 3 q, rr, IWPhone: Resident/ Owner Address / City / Zip: r1iL Applicant is: Owner Contractor Type of Work Description of work: roo Construction Cost: Multi-Family Building: (Yes No ) Zvi J Company: / 11 ~Contact: ~a ~~d ? ~~a1 Contractor Address: v~ 4` ity: Lc~j~Lf State: Zip: 3 Phone: al / 6 3 oe License SC 6 J 6 3'~;- 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: i Sewer & Water Contractor:___ Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of M 1 the information may be classified as non-public if you provide specific reasons that would permit the City to I conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to di to receive locates of underground utilities. ~ 9 wvsN.gopherstateonecall.org 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. x nce. l~ d C k60 x~ Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA146967 Date Issued:11/28/2017 Permit Category:ePermit Site Address: 4538 Mallard Tr S Lot:17 Block: 03 Addition: Thomas Lake Woods PID:10-76100-03-170 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Karen R Roth Tste 4538 Mallard Tr S Eagan MN 55122 (651) 338-7174 Bn Builders Inc PO Box 202 Rosemount MN 55068 (612) 644-8274 Applicant/Permitee: Signature Issued By: Signature