4668 Ridge Cliffe DrEagan,
Zoning'
Owner:
Address:
EAGAN
of Knob " Road
N 55122
Orrin
Site,Address: 466
Plumber '*
Meter; No.:
Size:
WATER SERVICE PERMIT _
PERMIT NO • 3179
DATE.
No of Units: ti3` G i
dp e Dr L4" C'
Connection Chorge 7
poit:
Account De "
'
Permit Fee lei=.00 .1.1dSurcharge•.. P
d
Misc. Charges: 601.04 ''1)d Tnet r :!
Total
Date Paid:
Insp •
dr
Reader No'-
1 'agree to comply with the City of Eagan
CITY' ,OF EAGAN
3795 Pilot Knob Road
Eagan, MN 55122
Zoning: No. of Units -
Owner
Address
Site Address
Plumber:
I agree to comply with the City of Eagan Connection Ckarg
Ordinances. Account Deposit:
Permit Fee•
SEWER SERVICE PERMIT
PERMIT NO •
DATE
By
Date of insp
Insp.:
Surcharge.
Misc. Charges:
Total.
Date Paid
Z -41 -7 -At
f
t
/‘if
0 3 \Ai i
'4-... .._ 1 ....--
...: ,...-,
7 •••••---- ----"..
) ;.....
i 1/40121V10 eViOrr").9q: `?"4" nti401, ,,d„? 5 if-1.--,--7-,7A->2...c
e -----
.-....,4_,I,
JL-
L� -
s
tr-V
; e
5ei9eizm:uv)
-erD
gq,e75
_
:1-c- dK5.1,,, •
t) \
--17y
1 z
- -
I
1kt
,
,e54-1 I/01 il‘ to- 1, -0 -4 -en
)44441,:ie
/
57-4,12-i /Cr 6•C-
1 1,;-' 13
•--
....,
Lew-I/L(6(0G t-tcpby
City of Eatali
3830, Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
12-T73J
Permit Fee: )v
r I
Date Received:
Staff:
2014 RESIDENTIAL BUILDING /PERMIT APPLICATION
Date: Site Address: Ili 1 — "/ j 7P A 4c- I/ unit #:
Resident/
Owner
Name: L1) ,42, ' /`l L !; 14-'4 her liertsPhone:
Address / City / Zip: t771' /�
Applicant is: Owner ✓L Contractor
Description of work: f e c'i f
Construction Cost: f 6, d OP Multi -Family Building: (Yes .X. / No )
Company: A%r-ui t", 5 %~ G o h r r/s+6,122 S' ContacC tr' i G flay
Address:6 6 2 Z•41/7 X-/- 4,)144- 4-4-3ITZ Al,City: y k 6:ft0
State: /2 -1/1, -Zip: 5`' " 3 ` 1 Phone: v �' D Email , J r nrei) f7, )jP W65 OO 4e,
License # ' I a l 7 3 Lead Certificate #: N =, r--;/ / / / a 3 —1
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
the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and add
Licensed Plumber:
Mechanical Contractor:
f master plan:
Phone:
ng docu
is .that you submit are con.
on :public if you provide s
onclude that they are trade
'derecf to be public infor,
�cfic parsons that wouli
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.gooherstateonecall.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 l 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 wilt be in
accordance with the approved ptan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building penult issuedin accordance with the Minnesota State : 'tding Code must be
days of permit issuance.
x ieH
Applicant's Printed Name