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4689 Ridge Cliffe Dr m 4/9 :i; gr . 41T .. ). l un fit mP O ' iomnson Homes , 4689 Ridge Cliff e1 'r T,2 153 .3 . Ceke 2� 7, , Lenz P,57 art r Hp : - :enaction : 270.00 net .br: Ai�rmrnt Deposit• No.. ts Permit Fare: 1(1 _ no . pri '. 4Mw1 M the City eF $ Swe�shamps; _ af; p ri - ''t Mist : - Charges: 60.00 ad eter: to /9 �r v2bC' Total. Rote Paid; pate of insp.: lrnp.;. .: srry .. owt o sAN sawn .SISIYlt Pangs $795 !lam WMD Reed PERMIT NO: MN $5122 DATE: Zonhj: No. of units: . • °c__ 7 szeti ckinokr: ( r l e i TI ?' r- 4 c n : c. Address: site ,Atddtess: L ( ( 1 if €e 'T' T. %- i .,- f`A. ?, a c ' , f: T Plumber: E is 1 r 1 wee to goo yr with the City sf isles Connection Charge: OMdiwwsa. Account Deposit: Permit Fee: 1 ' , ":' Surcharge: Y , ) �? BY Misc. Charges: Date o(1r . : ;� " / I. O Total: Insp.: Date Paid: _ �l� U� . ��� 1 , l �" l � , �(��� ;Use�Lt9E or BLACK!nk � ForOfficeUBe------- — I ; j Permif#; r���L.� / � I ���� ������� -f� 7 � -Z,` S' I i � � Permif�Fee: - ��irJ� { li 3830 Pibt Knob Road Eagan MN 55122 � Date Receivsd: � ' Phone:(65t)675-5675 � 1 i Fax;{651)675-5694 i staff: � �---- ----------+' 2014 RESIDENTIAL BUILDlNG PERMIT APPLfiCAT�ON oat�: �°'l.2`j`� s�t�Ad�,�s: �b�?> `Tb� I., �2, ��,.� �✓ii�,p,� un�t�: � tvame: t�C?�1?Y�E-�' Gs�-�� �t;.�r�h�c�. �P�: Resident/ _ � QWfl�t � Address i Ci#y/Zip: �����°' �,.ti '+ APPlicant is Owner z/l. Contractor � °��Y � �- -' �� TYpe�f V1/ork ' Description of v�rk: � r1� � � �°� , � , Cans#ructian Cost: 1��G�B Multi-Family'Buildin9:{Yes�/No ) �� / ��- �{ ,' Company:/VCJYZr1�5� �c��J�t�v9��?�t��5 '� Cor�tact c!r� i�����y Address:L��Lj�'l ��°�'l�J�/'�7��2- Lr�N�t /� City:l�s ��' ��(�J.s�. COC!#T8C#OI' � . . State:�Zip: ��� Phone:����'�'EmaiL��►r,��$?`?t3r'LV�S'?���d�`�d�#�.�c�r� - License#:�� �.�� � 7 3 ���_�r� t ead certiflcate#:rV�-7-�.r-=�/�1 t�3 �-1 If the project is exempt€�om lead certifi+cation, please explain why: (see Rage 3 for additionat informatian) COMPLETE THiS AREA ONLY tF CONSTRUCTING A NEW BUtLDtNG � In t#�e last Z2 mont i , tt�City cf Eagan iss�d a permit for a simitar plan based ort a master plan? .,,_Yes _Na It yes,date and ad�drL� f master plan: Ucensed Plumber: Phone: Mechanica!Contractor. Sewer 8 Water Gont r: Phane: 1VATE: and sup�ir�rting d+o�ument�fhat ycrr�s�ubmtt are.c�nnsftlered#a�e pvb�rc infcir�#�an 1���r�s t�� - rnf�r�#ra�cm may b��lass��d as non pc►b�c`Ff yo�u provtde spec�G rea�crrrs tfr�#wa�rld�e�nti�`�.C�}r t+� ? �ons�ude th�t�►e "a+?�frade secr+�ts; GAi.L BEFORE Y�U DIG. Gal!Gapher State One CalF at(651}454-0002 for protection againsf undergrour�utility damage. CaU 48 hours before you irttend to dig to receive toc�fe.s of underground u#Nities. www.aophe�stateanecalt.org 1 hereby acknowAedge that this is�formation is compiete and accurate;that#he work will be in confortnance with the ordinara:es and cndes of the Gity of Eagan; #hat I undetstand this is not a permit, buk anly an app4icatron for a peRnii,and wrork is not to start without a�m�it;'that the wodc wilt be in accordance with Urte appraved ptan in the case of wAOrk which r�quires a r�eview and approvat of ptans. Extedor work author�zed by a bullding permR issued in accordance with the Minnesota Sf�t,a ilding Gode m�t be compiebed within 180 days of psrmit issuanca. X �K .��../.�' � . .. .. � �"l� i'-l X '" ApplicanYs Printed Name � ant's Sigrtature ` Page i af 3