3472 Greenwood Ct SRESIDENT /
OWNER
Name: ir- t ■ 'tc , s - 1 - 1,:ir\ t,l ( 66C) C. Phone: C)5
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Address / City /Zfp: � t.. ? ' (..d (,JeS+ 7 r Kt. ' . V �� �" 1� r. w
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Applicant is: Owner X( Contractor
TYPE OF WORK
Description dwelt Ce..'C () C""
p
Construction Cost v' Oct s Up Multi- Family Building: (Yes X_/ No )
•
CONTRACTOR
Company: 6 (4a_ t -'b - 1 o �i'll t. c-11 N Contact: <c;,r t i~
Address: t_1 [CO tE XC'r-A St Or g \ V d City: 51; . LCA 1 S Pa r - k_
State: VYlY\ Zip: 5 5LI 1 Lo Phone: Cl 6 1 5 -- dd L
License #: C tit OD \ 0 50 Lead Certificate #: AM T- 5 03 -/ - 1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes No if
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
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,
Aug. 1. 2012 12:35PM Sela Accounting
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 676 -5694
Applicant's Printed Name
City of Eaau
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
No 1661 P. 3
Use BLUE or BLACK Ink
For Office Use
I /
Permit #: / (J -66 5e)
Permit Fee: 6- /,) • J�J
Date Received:
Staff:
J
Date: / I /I Z Site Address: 3470, 34 - 7Z, 3t17t/ Greenwood C-k S Unit #:
CALL BEFORE YOU DIG. CaII Gopher State One Call at (661) 454 -0002 for protection against underground utility damage. Cell 48 hours
before you Intend to dig to receive locates of underground utilities. ywv.gopherstateonecall-orq
I hereby acknowledge That thls Information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Cl[y of
Eagan; that 1 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 will) the approved plan In the case of workwhich requires a review and approval of plans.
e xterior 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 a r \Y1
(1_9-JAT-SL._
Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA170854
Date Issued:07/20/2021
Permit Category:ePermit
Site Address: 3472 Greenwood Ct S
Lot:5 Block: 07 Addition: Surrey Heights 1st
PID:10-73000-07-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Eugene B & Elaina J Simkhovich
860 Great Oaks Trl
Eagn MN 55123
(612) 308-5056
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA173435
Date Issued:11/12/2021
Permit Category:ePermit
Site Address: 3472 Greenwood Ct S
Lot:5 Block: 07 Addition: Surrey Heights 1st
PID:10-73000-07-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Angelina Jefferson
3472 Greenwood Ct S
Eagan MN 55122
Mcquillan Brothers Plumbing & Heating Co
1711 East Highway 36
St. Paul MN 55109
(651) 292-0124
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA173436
Date Issued:11/12/2021
Permit Category:ePermit
Site Address: 3472 Greenwood Ct S
Lot:5 Block: 07 Addition: Surrey Heights 1st
PID:10-73000-07-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Angelina Jefferson
3472 Greenwood Ct S
Eagan MN 55122
Mcquillan Brothers Plumbing & Heating Co
1711 East Highway 36
St. Paul MN 55109
(651) 292-0124
Applicant/Permitee: Signature Issued By: Signature