3484 Greenwood Ct SAug 1 2012 12 36P Sela Accounting No 1661 P. 4
City of Eaean
3830 Pilot Knob Road
Eagan MN 55122
Phone; (651) 675-5675
Fax: (651) 676-5694
Use BLUE or BLACK Ink
For Office Use/y
Permit*: �,-)
Permit Fee: * 6 (,)
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: I /!1 Site Address: 3y 7$, 60 3N$2.-134Yy 6reer>;tabbci Ci-. S Untt#;
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J
RESIDENT /
OWNER
Name: 5uYYt'�/ N-c\l n��i C( CG Phone: ()S -?3l1-3$
/ J e l\\L' Ca ;-},CN r
Address / City/Zip: Lill ra- L-k.'hi (,Jt's+ Par-Lca y
g;c\' n c)“,l,r\ ,rnY1 5 5 ',73I)1-1
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: re (t
Construction Cost: 1 chi 091 , DO Multl-Family Building: (Yes X / No, )
CONTRACTOR
Com an nC,U-7 VI k Ke tVY'I t✓>� ���4 i
:
Company: &Ia., d I Contact: k.
n
Address: LU UCU t,XCr-A S► O t'' t61 V CL J City: S , LULR IIS r -k_
•
State: Min Zip: S 5'-I 1 (.0 Phone: CII cJ L— i (`J - D-
License #: __(12. VD) V 5_±(.2_ Lead certificate #: AfA r •-- a J 03 ii — 1
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes 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:
^No
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.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call Ale hours
before you Intend to dig to receive locates of underground utIlllles. www.00pherstateonecall.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 I 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 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 he completed within 180
days of permit Issuance.
rkhr�l�r
x
Applicant's Printed Name
Applicant's Signature y j
Page 1of3
TC
Jul 15 2013 2:36PM BRUCKMUELLER PLUMBING INC 6516882160
*City o[Eke!
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
page 1
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
-1(7(3
INFLOW & INFILTRATION PERMIT APPLICATION
V Plumbing 1 Sewer & Water
Site Address: s Lj / V f"'ctr wood Co(A-1-1- 5O (---1-1-1
Date: "1- / 5-- / 8
Tenant: Suite #:
tak
Name: it km As 5ee'CC. Phone: CAS 2- -02- O /7
Address/City/Zip: 3'1(/Cr' r'eef-xi)eve/ Cc L(iSOL1M,kagan5S7
Name: andt 'iceirt a + - MT PICA in b _roe. License #: 0 621 S i- 1- Fm
Address: ?9R:/JL41/'1( City: 1.4::a9a
State: Mil) Zip: 561 a3 Phone: 65 7- 6.5 61. a Ce q Co
Contact: trj-Lai6 Email: hrucktevieilerel rn!ari yc1. corn
PLUMBING (Within the building envelope)
47 -Sump Pump Repair
Other:
SEWER 8 WATER (Outside the btAlding envelope)
Repair
Other:
Description of work: AI^I'r19 �Ld r 1p PLt nip /h j ll9 1 L 2'i j Cede..
FEES
$60.00 / Each (includes $5.00 State Surcharge)
TOTAL FEE $ °O
,r
`Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit III repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting wwW.citvofeaaan.comlinflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call 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.gooherstateonecaliorg
1 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 I 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 with the approved plan in the case of work which requires a review and approval of plans.
x rt tckrv'u 4 Jer
Applicant's Printed Name
Ap cant's Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA165290
Date Issued:10/27/2020
Permit Category:ePermit
Site Address: 3484 Greenwood Ct S
Lot:2 Block: 09 Addition: Surrey Heights 1st
PID:10-73000-09-020
Use:
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.ci.eagan.mn.us
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, Mark Anderson at
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 -
Alemtsehay Assefa
3484 Greenwood Ct S
Eagan MN 55122
Home Energy Center
2415 Annapolis Lane N #170
Plymouth MN 55441
(763) 476-1990
Applicant/Permitee: Signature Issued By: Signature