3483 Greenwood Ct SAug, 1, 2012 12:36PM Sela Accounting
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (661) 676-5694
Address: _ .; �� erlvJp CA- . S
No.1661 P, 9
Use BLUE or BLACK Ink
For Office Use
Permitil:
Permit Fee: c-7-774,
,
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
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1 Z Site
Unit #:
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RESIDENT /
OWNER
Name: c‘ 11, •tet S rclii. �'iA ` (7)C. Phone: r•15t,q3I-11-3 j
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Address/City/Zip: (Q/j 3'3' Li' 1C.1rK l LA -)&S+- MN\'r-- 1—(\!-:At'_ r -
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i -der. PickvA�_ ,mi-) , 5 ;SIV
Applicant Is: Owner Contractor
TYPE OF WORK
Description of work: re 'coo
Construction Cost: Ids 0C) S . 00 Multi -Family l3uilddiing: (Yes X / No _)
CONTRACTOR
Company: �� c- CL-' IRO �l rt (4 d. Reit ibar-111 Contact: Kc —t 11
Address:1-1100 t .xC�-1 St o t'' �� v (I- City: St LL 1-'. 3 nil t—k
State: On Y\ Zip: 5 5'4 1 (.o Phone: CI 6)--q 1 5 -- -7 c)- C
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License#: a I2 DO 1 0 5 0 Lead Certificate #: AIA T— 5 ()3 l/ — I
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) 4540002 for protection against underground utility damage. Cali 48 hours
before you Intend to dig to receive locates of underground utilities, www_gopherstaleonecall.orq
( hereby acknowledge that this information Is complete and accurate; that the work will be in conformance with the ordinances end codes of the City of
Eagan; that 1 understand this is not a permit, but only an appllcallon (or a permit, and work is not lo start without a permit; that the work will be in
accordance with the approved plan In the case of work whloh requires a review and approval of plans.
Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
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Applicant's Printed Name
Applicant's Signature /
)-91G�--1]r�-lam
Pagel of 3
City of aaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
1 05(p-]
to ��
o
2013 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: Site Address: 7.3 G r c e /"',9 J Cot -1r -I 5
Tenant:
Suite #:
Name: M
5'0 _lIL L (r. Phone: 7C 1 J 7 C Sa
�
Address / City / Zip: 00 i\ -1 --Cc,, l /c T// /�'") cf ! / - ?-0
Name: _7,111 . r(.-)
License #: /
Address: Cc? / SO 41' "�fL e. %` J , City: /V qctAd
kr (7
State: /i 'P") Zip: 5-5IQ j Phone: 6.4? g- 5 5 J // o
Contact: JJ "g / � i S Email: a ("' F-0 £ 71't':C �' 4,-A, , t' e,""
New Replacement Additional Alteration Demolitionli
-
Description of work: _ ' 1 c c"� r +� .` vet 4/.,
til
SO : o
RESIDENTIAL
2S Furnace
Air Conditioner
Air Exchanger
Heat Pump ,
Other Lc4L .1
c
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under / Above ground Tank (_ Install / Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) _
TOTAL FEE
COMMERCIAL FEES:
$70.00 Underground tank installation/removal
$55.00 Minimum
*If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x 1%
= $ Permit Fee
= $ 5.00 Surcharge*
= $ TOTAL FEE
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.gopherstateonecall.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.
x VC T r -o e/)
Applicant's Printed Name
x
Applicant's Signature
41011' City
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
L
J
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 9/// ZOIfJ Site Address: 31/10 U0 6'fa2i-4)00/ Ct.slc4✓l,'14V 5$722
Tenant:
•
a t tlOWrt@r
Name: r,�i%2fct..vt , 2/"L '�—Y Phone: Zig %Se9 9 7
Address / City / Zip: 34/83 6,yeo,i,cwool Cl $ &z y A/ ✓!:572-/x'
^:
�?ICI'I:rac
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
,.;
New /Replacement Repair Rebuild Modify Space Work in R.O.W.
_ _
Description of work:
Perin•
i
RESID TIAL
Water Heater
Water Softener
Lawn Irrigation ( RPZ / PVB)
Add Plumbing Fixtures ( Main / Lower Level)
_
Septic System
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,
$60.00 Lawn Irrigation
$60.00 Add Plumbing
*Water Turnaround
$115.00 Septic System
Water Softener, or Water Heater and Softener
(includes State Surcharge)
Turnaround* (includes State Surcharge)
TOTAL FEES $
(includes State Surcharge)
Fixtures, Septic System Abandonment, Water
(add $280.00 if a 3/4" meter is required)
New (includes County fee and State Surcharge)
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gopherstateonecall.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.
x
Applica 's Printed Name
x�.r/
Applicant' nature