3813 Heather Dr„EAGAN WATER SER W.
fit” Rana ..awl: ;. _... t PERMIT.TNO •
regain, MN 55122 DATE. G �.
Zonjnqf• No. of Units.
Owner:
Address:'
Site Address:
Plumber:
Meter No.:, ' Connection Charge.
Size: Account Deposit:
Reader No.: Permit Fee: �+
1 agree to ricapply with the City of Eagan Surcharge:
Ord Misc. Charges:
Total: x;
By Date Paid: ox
k .
Date of Insp.. 3,`r, insp •
CITY _de EACtAN
37 Pile` Mob
Eagan., 55122
Zoning; " TV
Owner ., ,.--on _u iders
o. of Units:
Address:
Site „Address:
Plumber:
3[24/33
1u t 4. -lex
`
I agree to comply with the
Ordlnanees.
By
I Date o
Insp.:
.zenz an
�� 22 100.'30 pd.
wren Connection Charge;
Account Deposit:
Permit Fee: la 00»d
Surcharge:
Misc. Charges:
Total:
.., Date Paid:
*City of kap
3630 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651)675.5694
Use BLUE or BLACK Ink
For Office Use
;y
Permit #: � '1 S
sv
Permit Fee: I D ( .
Date Received: ' ( 3
Staff;
7
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: - /3 Site Address: 3/07 3 V" 3 F/3, 3 F/-$ /y44 rio- 63%,
Unite:
Name: % /9550 e►4- Mot-,> otZZAFe1 Phone: 7 L3 - 19 5� - 3 7A '%
Address/City/Zip: '70A2 S. Sr► L.r-►<c Qb triApct'. I ✓E J s:s 3i/
Applicant is: Owner iC Contractor
Description of work: 7-c411-- o r R £- A F D t,5 E GG- i'a 2 creAS oN £ y
Construction Costs 24 -7,6, cro Multi -Family Building: (Yes io / No i)
Company: ti,f f c )e 4.a. 2 ri4 4-7 .e P_
Contact: 'A A ✓ 4 4.sl214-/S
Address: `/U 43 6° 11S; City; 41,1. S
State: ' A5 ZIp: SSH/ 5 Phone: L / Z - ar 6 / - G 2v
License #: 4 C AV/13/
Lead Certificate #:
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
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
`Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Phone:
Sewer & Water Contractor: phone:
. �t°o41� - ,CA'ylh�lq/lt' �1!,p',p+�n
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conclude Mit-they are, trade sec
tae : ......... ......> ..,.........�... :..., .......,,.,::: ,.> ....,.;, ;:
CALL BEFORE Yt1U DIG. Call Gopher State One Call at (651) 454.0002 for protection against underground utility damage. Coil 48 hours
before you intend to dl® to receive locates 01 underground utilfties. www_aoenerstateonecali,ora
I 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 I understand this is not a permit, but oniy 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 Building must be completed within 180
days of permit issuance.
Applicant's Printed Name
Mechanical Contractor;
E0/T0 39 d 1NICN 1X3 IBS
x
Applicants Signature
Page 1of3
L9Z9T98ZT9 ET:ZT ETOZ/80/b0
c!yof
3830 Pilot KnOb Road
Eagan MN 85122
Phonic (151) 0764675
Fax (681) 8754894
Use BLUE or BLACK ink
. For Mx Uta (ePaint
Permit Peci
Cate Reef red:
Wt.
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
SitoAaatoa3: 3805, 32';/, 3g/3/ i67.4". /aL4rN DR. unit 0:
Name; 4 A e r /r1AAi4 m L phone; 743 -sf3 9/)0
Address /City !Zip: �� t`. t W-1-0.. Q /9V ' .Z 19 G'st,�►E.a Vi1'LLIJ,_
Aro .T't7
Applicant is: _ Owner 2C_ Contractor
Deoc iptlon of work: -r>r.ga oP (2,t- P-ao
ConstructionCost /3 'CO, co Multi -Family Building: (Yes x / No
Company. rE ! EJ=-cm,o.e "trArr. e,02.14 contact • Avid ZS,*
Addreaw dos W 603. S7.. City: A/Pt. S .
smut bp: Sr4/19 Phone: /°'z - 4A4/3
Uaense 0 & yl/ 3 / toad Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
131.6 W aL-1st,,4r Pos - /F
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In tins bat 12 months. has the City of Eagan hound a permit for a a4nitar plan based on a taaatar plan?
Yes No Wyss, date and address of master plan:
Licensed Plumber. Phone:
Mechanical Contractor: Phone:
&war & Water Contractor: Phone:
MOIN,::�"]�M•�•-.�,.. .e k u,.Z. �:yvr'�G.'J�..• yt�ry�rY f.� _ — to .. !arl�s�
the ��"1'11��eya.i .4f4 1;,'-_k [. ,-,..i,,rl,.--4, ,:_`':",,L .� vti� • . "s-un.t, y :f_,- w , _ ` v,-. .:
, ,i ti .c tis
CALL YOU
before youEFI� reran CalllocaGot o One Call at 051) 454.0002 fir protectionderma. Cal 48 hOwa
underground utleties, wwr,goonerststaonscaa.e et
I hereby that
adtAowie* lhat this informationacomplete and accurate; that the work WI be in conformance with the ordinances and codas ofthe Qy al
, bind thio i6 nota Mut but 0111/an apgQeatlen for a pan* and work to abut without a vomit tot the nett 411 II
ttnoro ore pan in tna Oats W Wait wYON Iopto r. a roaow and approval l et
permitatefier
days of si.m a Pent) Issued In accordance waft the �1kY1eoc $i0m Coda mini: bt comistad within 180
Appbaants Prettied Nam
t'0/80 39 d
Applicant's Signature
7 g X
Papstora
1NI'W lX3 I3a L9Z9T98ZT9 SETT 8TOZ/LZ/TT
*City of bin
3830 Pilot Knob Road
Eagan MN 66122
Phone: (851) 676-6675
Fax: (661) 675-8894
Use BLUE or BLACK Ink
For office Uso
Permit al:
Permit Fee: a--13
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 - L `/ " 14/ Site Address: 3$° 9 3 ? I , 9 r 3, 3 "5` N ATA/L'Q 62. Unit #:
Resident/
Owner
Name: k i MAW 4 6 At Ew; .s. k; C..
Phone: 743 - a 93.-- 9 7 7 a
Address / City / Zip: 8S0 Q E C Orr U & 4v, A L W "' 14pas Y JA)
Ss VI 7
Applicant is: Owner 2fContractor
TYPO of W°rk,
Description of work: I?% o v E. a- RLP rte f- �• ' s.J 6 d 1' a S� "a' AI 47-4 l"
Construction Cost / 4 Y Uri, UO Multi -Family Building: (Yes / No _)
Cont ctor
Company: £ 1 e c. r / o 2 /niH wT - Co aP Contact DA ✓ r p 43„/LAI S
Address: h/os w 6001 �-
State: / "` Zip: 5-5-4/1 Phone:
City; nrn PL
?,i - ('-Ca2V3
License #: L x / 1 > Lead Certificate #; _
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
l�pe,l,(DS_ I1ure.r
Posr is7i
COMPLETE THIS AREA ONLY W CONSTRUCTING A NEW IBU DING
In the Iaet 12 months, has the City of Eagan issued a permit fora similar plan based en a master plan?
_Yes _No If yes, date and address of master plan;
Licensed Plumber. Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Fops and *Opqrf;1 9f self? COnaieTeilh ril:¢:
the deo/i deo/Mit/on
CALL BEFORE YOU DIG Call Gopher State one Gall at (651) 454-0002 for protection agairst underground utility damage- CaU 48 hours
before you Intend to dig to receive locates of underground utilities. www, looher6tateonecall.oro
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
Eaoan: that I understand this Is nota permit. but only an application for a paand work is not to start without a permit; that the work will be in
accordance wirmlt, th the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit hauled in accordance with the Minnesota State Building, Code must be completed within 180
days of permit issuance.
x A ✓' 0 Ru/t1L,f
Applicant's Printed Name
90/170 39Cd
Applicant's Signature
X,
Page 1 of 3
1NI17W 1X3 I3S L9Z9T98ZT9 SS:TT bTOZ/172/80