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3843 Heather Dr �» CM t6iIllGAN WATER SERVICE PERMIT Knob Rend PERMIT NO.: 4674 MN 55122 DATE: 4/28/83 Zoning: RIV No. of Units: I unit tnhse Owner :., Tollefson Bui Hers Address: Site Address: 384 Breather Dive 1,72 R1 'Arisr 114 4 Plumber: Ge�1 n Meter No.: Connection Charge: 450.00 pd Size: Account Deposit: Reader No.: Permit Fee: 10.00 pd • agree to comply with the City of Eagan Surcharge: .; pd Ord Misc. Charges: 60.00 pd met Total: BY Date Paid: , Dat of I nsp.: '' /`� Insp. v :plod a;o :•dsul t"r7 :l0 4o1, — :•dsul pa a;od kid ob • 46 8 Lid lUZ,iI 6a j • d,��,l,�u+ad , v k- e sodaajoy . , •seauaulp.0 pd 00 r Z • \ a ., u = u� uuov uo6o3 3o X41* eN 401/4 Aida= o; aaBo 1 pd o(}' 00I ' ' -` Z£6i7£ 8 /£Z /£ ua a aa J LJa9 Id 7 III irlTl8 Ili ZZ1 ang.ztl / Trail £'73£ :ssGippy a3IS ' :ssazppv ssapiTna uos;aital, :Ammo asqu4 3Tun :s !uf1 id 'oN Aid :auluoz •� =LSS NW 'upoo .*ON 1IW213d pool' gou31 mid S6L8 , ' InNa340tiiifibAAas NVOV3 dO A113 Use BLUE or BLACK Ink For I Office Use , j +w I Fa ' T-- ; Pem ft MY ~a 4- of Batin, 3830 Pilot Knob Road I Eagan MN 55122 Date Recxived: t' l I Phone: 6755675 I Staff _ l Fax: (6511) 1) 67 675-5694 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /0-9-/3 Site Addrees: VY / 3 F'q3 3 Sr1/s 38'/7 114~f7"~l,R U.. Unit Name: /4-4 . '4 & E /tit L A-) i Phone: 74.1 - S'9 3 - 917 0 1v q e 7- R t/ Address / City / Zip: VSO kN F- C r4 'r-v Q AV A3 A n goa SN Applicant is: Owner Contractor r., Description of work: T £.4~2 ©F'~= a 2 E - R-YoF Type. W : Construction Cost: / Do • 00 Multi-Family Building: (Yes No Company: 6jE i E>-reAloR 6aContact tAvld iZR 5 Address: -"/O -S- City: /h PG S . Ccar ° ' State: /VAJ Zip: Z yi 9 Phone: 10 z - g6 &.2 ~(3 Ucense Lead Cergficate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 91-6&S LzEar- ROJLT Pos.- l 97 £T 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: Mechanical Contractor. Phone: Sewer & Water Contractor: Phone: NO(TIE. ie/BriE>.iaiiple>rr~n6. t~/Q • `JI/i® i/iIQ.7~7 F • ";9• ' a4 L . .yy. ype l CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 4540002 for protection against underground utility damage. Call 48 hams before you intend to dig to receive locates of underground ublitim, www.aooherstateonecall.or4 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 wait will be in accordance with me approved plan in the case of wore which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Build! Code must be completed within 180 days of permit issuance. x ~Av~tJ g~22is x Applicant's Printed Name Applicants Signature Page 1 of 3 Use BLUE or BLACK Ink I For Office 1 I 1 ;x 2~ l l Permit aty of Wan I I Permit Fee: 3830 Pilot Knob Road Eagan MN 66122 1 Oahe Received: ; Phone: (651) 675.5675 I Staff //y/ L I Fax: (651) STS-5694 I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 3 YVI, 3 Yy-7, 3 y y s', '3 -:l''f 7 &.4'7-,V,5A Q k. Units: Nerve: -/0 Ai C / 4 r4 4, £ he z a i .s:..1 C. Phone: 76 3 - S'Jr 3 - 9 7 p ReWderrv Owner Address / City I zip: , 85'0 A Z c 14 ru 2 Av. A), A C 414 h ZA~ 11944S Y Sr ~x 7 Applicant is: Owner Contractor TYPE of: llOrk, Description of work: RZ- o tr a, R S P L +1-t.1: 5. & ,J to b F ;mac r a Al j v-8 L Construction Cost lA,► • Mind-Family Building: (Yes / No Company: E ~,r r y o /Z /Viii,)"f . 10,2A. Contact N ✓ f eJ 1Q-J2A,0S Coft.actor Address- 4/p- CJ lopes City: M PG :S State: /r1 A~ Zip: 5'5-V19 Phone: 4P/-t- 40 2 4!-3 License M. fr 2 Y/ / 7 / Lead Certificate If the project is exempt from lead certiflcatlon, please explain why: (see Page 3 for additional information) au/L-2- PoS Jy'7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING i In the last 12 months. has the city of Fagan 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; IAechanloal Contractor: Phone; Sewer & Water Contractor: Phone: 14. Oirj NOTE. Afalts arrip►"n9^' py~I'F•; 1$:•~c ~h~r►»atiort~r~y~,~ c/ae~ll~e~f,~ , ~ Ji~ ~~A~'°. ~ el:._ • '~Y ' town. CALL BEFORE YQU DIG, Call Gopher Siabo One Call at (661) 46 4002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates Of underground utilities, pm" „gpheretateonecau.om I hereby acknowledge that this Infametion is oomplete and accurate; that the work will be in conformance YA the ordinances and owes of the City of Eagan; that 1 understand We is not a permit, but only an application for a permit, and work is not to stun without a permit: that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans, Exterior work authorized by* building permit issued In accordance with the Minnesota State 8ulldl Code ns)Stb9 compl$W w•i"n 180 days of permit issuance. x t~4v, 4 19,a-2is x Applicant's Prirrted Name Appiicant's Signature Page 1 of $ Z0/Z0 3!DVd 1NIVW 1X3 139 L9Z9T983T9 ct, :ST ETOZ/8T/TT