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3811 Windcrest Ct SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN # PERMIT DATE 09 / 10 / 91 3830 Pilot Knob Rd. Eagan, MN 55122 -1897 CHIP # PERMIT # 19967 METER SIZE B.P. RECEIPT # C 14309 DATE SEP 9 , 1991 ISSUE DATE B.P. RECEIPT DATE 09/10/91 _ PRV BOOSTER PUMP SITE ADDRESS 3811, WINDCREST CT PERMIT REQUESTED LOT 26 BLOCK 1 SEC /SUB WINDCREST 2ND X SEWER X WATER TAPS APPLICANT: ADDRESS: COMM /IND RESIDENTIAL CITY, STATE ZIP X NEW EXISTING PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: VALLEY PLUMBING CO INC Ahead of Do estic Meters o n ater Line. ADDRESS: 610 CREEK LN Credit WI ., %�' . •- Meters. CITY, STATE JORDAN MN ZIP 55352 ® ®� // PHONE: 492 -2121 /�i�L. I AGR -E TO C • MPLY ITH IIP TY OF OWNER: PRIME BUILDERS INC EAGAN ORDINANCES ADDRESS: 3409 KILMER LN CITY, STATE PLYMOUTH MN ZIP- 55441 PHONE;„ 550 -1346 j C SIGNATURE WHEN METER ISSUED It ! l � 1 x' O R ' /O E % PLEA E AL T ORKING DAYS FOR PROC SSIN A L 454.5220 FOR INSPECTIONS. FOR STORM SEWER PERMILS, CONTACT ENGINEERING DEBT. izo Use U- or BLACK Ink r For Office Use t f Z t'crml ?i ~ City of Eap ~~3> 1 Permit Fee 4 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675.5675 Fax: (651) 675-5694 1 Staff: 7 1 t 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: i J Site Address: 6 o D:l _01 ) LO) iU,,a eKe St- (ZA&2y!~' Unit Name: 1 tip C Y'4 b* T,zW .3 t ~ S-'1LnJ3&)E'hone: (~>S 1 4es-Z -al 0 Resident{ Owner Address j City = Zip: Q °')C n2~ fi 41 CAJSAoa S- SE 34 Applicant is: Omer 4, Contractor Type of Work Description of work:-140 Construction Cost: AN Multi-Family Building: (Yes r No _ ) Company: A b A- `rVy rho u Contact: 1.X u r; R~ N-~ .o Contractor Address: Q 2-0 CfU Y ru 711tA i city: 9 G Ao4. State: j N~ Zip: f2 ~ Z~ Phone: Z ° Z. ) License 1r [ 6 9 Lead Certificate q%c l I 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 information. 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 Call at (651) 454-0002 for protection against underground util,41 damage. Call 48 hours belwe you ,nlend to dig to receive locates of underground ufrlthes 1 hereby ncka owiedge that this inforrnat on is complete and accurate that the work will be in conformance with the ordinances and codes of the City of I-agar: tf.al I undwsland this is not a pemtil, bA only an application for a permit, and work is not to start without a pormrl. tnat the work wO he 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 / 1 1% 144 ( c i 1► ~ ~n.3 x Applicant's Prihted Name ~T Applicant's ignature