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C,ori°t . P3tan
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Zet Oat PERMIT NO.•
- .i Z i No. of Units: 3 / . I :nit - .1 e x
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12/11/79,17025 140.00 pct
lessee to esaipir 'risk the Ckp of connection (force: 42 r 5.0" I'd
OnIi Uear . Account Deposit: ,
Permit feat 10.00 „d
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Surcharge. .50 pd
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3830 Piiot Knob Road ! ►
Eagan MN 55122 � Date Received: �
Phane:{651)675-5675 � }
Fax:{651)675-5694 � Staff: I
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2014 RESIDENTIAL BUILDING PERMiT APPtiGATION
�t�� �..�- '"I,�"�� Site Address� L-1�5d�'-"t�/�g 3 r��5G lil��1���� u„�t:#,
� Name: ����'1✓��-t' t'—�'��. �r::„�hs�r L: .�fi��
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OWCt�c Address/Ci#y/2ip:��r�}'"�' /��,�,� �
APPlicant is: Owmer � Contractor
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Type o�Work Descriptian of work: � G�l� � � ��'�'
, � ;
Construction Cost: ��'c��p Mufti-Famiiy Buiiding: (Yes � !No�
Company:tVf?YZt��°.5� C� c�v7%s�r�C,��17�'S '� C no tact t/r� /�G�7���%
CCirit1'3�f�1' Address:Q�(j�2 Z✓$Y1�✓/ �js� Lr!�}n°Z �d City:j�r'�'�- ��l'ti'"�
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State: Z : �� � PhonB: Email:t �rn�d9 Jd'L�GS`7���d yl�i��u t�v —
Lfcense#:�� I.�� Ll 7� �n v_c:�t--• ,
�eaa Certificate#:M,a-t�,..r>/i 1 r�3 -°1
If the project is exempt from lead certi€ication, please explain why: (see Page 3 for additional information}
COMPLETE THiS AREA t3NLY IF CONSTRUCTING A NEW BUtLDING
!n the fast 12 mant , t1�City of Eagan issusd a permit#or a similar pian based urt a master pla�? '
Yes �No If yes,date and addr f master plan:
Licensed Plurnber: Phone:
Mechan'rcal Contractor: ,
Sewer�Water Cont r: Phone.
1114FE. s=ar�d.�uppartin,g dc�cumertt,s fl�a#you st�btnit are consid'er�d#t�L�e publ`r�in�,r��a�n: Pz�r�ort�of '
��fot�natia+�rnay�e�/ass�ed as nan�pt�blic if yau provide�pec�c n�asotrs#hat wc�crfd�e�mlt#�e C�,y?ta
' " '� � : � ' �� � c�n�Iude#ha#the`� ar�e�eade secref� '� � � � � `
CALL BEFORE YOU DIG. Calt Gopher 3tate One Call at(6S1}q54-0002 for proiection against underground uGlity damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.QOOherstateor�ecail.ora
I hereby acknowiedge that this iMormat�on is complete and accurate;thai the v�rork wili be in c�nfamanc�e writh the ordinar�and codes of the Giry o#
Eagan,fha#1 understand this is not a permit,buf only an application for a peanit,and wr�rk is not to start without a penni#; that the wo�lc will be in
accordance wikh the appmved ptan in the case of v+rork which requires a review and approwat of plans.
E�cter�or v�ork autharized by a buildl�permit iss�d in accordance with the Minn�ota State ilding Gafe mt�!1�complet,ed within 180
daya af parmit issuance.
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ApplicanYs Rrinted Name a+tt's Signatare
Page 1 of 3
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� For Qf#tce U�se-------- i
� � i Permif#: �,J� �
C�t� af���a� �o ; u� � �
� Permik Fee. �
3830 Ritot Knob Road ';
Eagan MN 55122 � Date Rec:eiv$d: �
Phone:(651)675-56Z5 i i
Fax:{651)675-5694 I Staff: I
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �°'��`!� L-��� �'�f---���� r r��.rG ���j��/'•\
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Site Addn�s• tlnit#•
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� tVame: tJC?fT-1�i�Lf' ��� tr�t�.�ll�it..:.. � Ptrona �
ResrdenU ;
�'?Wil�t' Address l Ci#y 1 Zip:�7�✓�°' ��
APPficant is: Owner �l�, Gontractor
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Type vf Wc�rk
Description af work: ��'� ,�?�� � �� -'R'��
Construction Cost: ��'f l�P � Mufti-�amity 8uiiding:(Yes�/No�
Company:LVCJYZtJ�5� C�c'�v'1�y'v9��?�t�/'S '� Contact� r r-vt /�G�t1a�'
Address:�t'��� Z'�'�c��'��� L.�j��t /�d City:���'�2- ��I�I.A'�.
C�ntra�tc�r �
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State:�Zip; ��,, Phone: ' Emai1:t�►rn��9t3Yt,�5'T��c�Yl`l'�i/���r�v —
�YJ v_C:t7 r�a
I.icenss#:13� I.�`� � 73 I.�d Cgrt+�cate#:1V�.t-',...�=»Jla 3 �-1
!f the pro}ect is exempt from lead certifcafion, please expfain why: (see Page 3 for additionat information)
CflMPLETE THlS AREA ONtY tF CONSTRUCTING A NEW BUILDING
!n the last 12 mon# , t#�Glty of Eagan issued a pertnit for a simifar plan based cn a mas#er ptan7 '
_Yes _No 7f yes, date and addr f master ptan:
Ucensed Plumber: Phone:
AAecl�anical Contractor:
Sewer�Water Gont r: Phone:
1�ft7T�'. s'a�al!sr�p�orting documents tltat,�au submit are consFdered tt��e pubtic in�'�rm�ti�rn. Por#iarrs bf
rnfor�atioR�rta�r�e�la�s�if"�ed as non=pt�bli�;jf yo�provide�p�i�"fc reast�ns#h��rt�rld�ermit##�te C�y tc�
c��clude#lrat�re ar�e d�rde�rets
CALL BEFORE Y�U DiG. Cail t;opher Sfate One Call at(6,51)454-0002 forpratection agair�st underground uUlit�r damage. Cait 48 hours
befiofe you intend to dig to receive toqte.s of underground utitities. v�u;r.aanherstateonecaiLorg
1 hereby acknowledge thet this iMo►mation is c�mpfete and accurate;that the Hrork wiit be im m�famance wiih U�e ordinances arid codes of the Gity of
Eagan;fhat i understar�d this is nof a permi#,buf only an application for a permit,and vvark is not to start without a pertn►t;'that ihe uvork wiil be in -
acxordance wath�e aPproved ptan in the case oi vwrtc which requfres a feview and aPRravat ofplans.
Exteriw wark autharized by a buiiding permit issued in accordance with the Minnesota Sta#e iiding Code must be ccmpieted within 180
days of p�rmit issuance.
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APplicanYs Printed Name arlt's Sigrtature ;
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA153175
Date Issued:11/28/2018
Permit Category:ePermit
Site Address: 4659 Ridge Cliffe Dr
Lot:2 Block: 06 Addition: Johnny Cake Ridge 2nd
PID:10-39801-06-020
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 -
Ryan D Politz
4659 Ridge Cliffe Dr
Eagan MN 55122
(612) 363-7892
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature