3853 Heather Dr N WATER SERVICE PERMIT
3S Knob Reed PERMIT NO 46u3
Eagan, MN 55122 DATE: .5/2/F
Zoning: RIV No. of Units: 1 unit tnhse
Owner: Tollefson Builders
Address:
Site Address :. 3853 Heather Dr 127 B1 Briar Hill 4
Plumber: ' Cenz Ryan
Meter No.: Connection Charge: 450.00 pd
Size: `i :count. Peposit:
Reader No.: Permit Fee: 10.00 pd
1 agree to comply with the City of Eagan Surcharge: . 50 ,.pd
Ordinances. Misc. Charges: 60.00 pd meter
Total:
8, r'' / .. Date Paid:
Date of Insp.: I
rte.:
anr,v,,,EAGoi SEWER SERVICE PERMIT
• witi.Pirpt Knob Road PERMIT NO,: 5770
sEoeren, MN 55122 DATE: 5 2 33
Zoning: • Mal
Owner:
Address:
r
Site Address: 14 , f. 1
Plumber: J 1 1
�
1 roe to comply wiNribe Cd Charge: 425.00 pd
Ordinonces. Account Deposit:
Permit Fee: I0.Uzt 'pry
Surcharge: • Si) pc!
By
Misc. Charges:
Dote of In a, Total: � 1 :,� Tota Dote Paid:
the BLUE or BLACK Ink
I , for OF" U"
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ties to I
PVTM
of latan I Z,5~ -1,77'
bill
ragan 100 Received
Phone: 6651) STS-Wra
FM (661) mom
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
13pte: 10-ILl- 1.3, 3bAddrm: ~8y4, 38s~, aF~s3; 38.rS- H6f77/014-tZ DR• 'Unit#;
Narne: ~~o A G 7" AV r4 A3 A 4 ~ /4 L AJ -r e- Phone: -7" -.sr9 3 0
Address! City I Dp~Sb ~j i4'---v e 19 gaE.S U101,
Applicant la: -owner K Contrawr
`7r'ER,2 O (QE - IMF
Construction Cost Mull-Fam4 Building: (yes -K I No
Company: E 1 ~a~ 7-L2ro~ Alt h,,~ eAap Contact- b^i/ A %a (?Jo S
Addr //oS 6D S~ , Gp, JylQG 5
State: )FYAI zip: Irryi Phone: !o'z - r'~ G Z y
LJoense *t 8 C A q1J 3 / Lead Coriiflcats rk
If the project is exempt from lead cmdficadw, phase explain why: (see Page 3 for addldonal Information)
RL~ws tJ::e~.' r Post 1 p7 Sr
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NIRN I&DING
In ehe t 12ma+Mq. has the qq o/ Eagan fastrsd a permit for a slmUar plan lased on a ntwar plan?
Yes No It Yes. date and address of meftr plan:
Licensed Plumber: Phone:
MschanloW ConpgcW: Phone_
Sewer S Waist contractor: Phone;
Now--- 11 pill
tfre:jfiia
W" you k"'d 1104iEiia~ a Can Goptwr Sbla oft am at (661) 45a0o02 for mvwwon against underground u ft damoga Call 48 hours y
locates of undwWamw LdItiee. %mft
+e n.ora
e hereby adub'*0 d1m On wftrQ6ap Is -
Eagan; ft I w* st&W this is and &=n* that to
VA)* will to in wribramw with to ardkrencas and codes of the Oty of
aaeauaMW wdh Ow not a rppner,.a pl,,, in m bd an. aAD iorl for a Aerml and wont is not to Seam wldmA a oennix ow the work vA bs to
Uqukcs a slew Ow appmw of plan,
&bd*r work ft*-wft*4 by ~ of Pmt lmuarrom a twilling permit Issued in accordance with tM IAtmeeott Stft ftUm Code must be complebd wWn 180
~jiv11J ~u RR rS
Applicant's Printed Warne
Appllcaneg Slgnotum
Pate 1 of s
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Use BLUE or BLACK Ink
_ -
I For OM CO U30 ----I
1
My of ~ Pem,rt ~ I
Ealan I
I PemtiE Fee: I
3830 POot Knob Road j l
Eagan MN 66122 i pate Received:
Phone: (651) 6756676 1
Fax: (651) 67411-6694 S'taQh j
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date; 3 Site Address: 3$y9 3 Ys', 3 95I, 3 fss" &,*7-WeA Unit
Name: alb r✓ In.44 4 & is m x 4 j . ~ ~ r✓ Phone: 76 3 - SrJ 3 ' 9 7 7
Rt i~ertt/ S O QSc~s~-u2 Ate, A) 14 GoGD£u 1/*a'X Y /n.)
Owner Address/ City ~ Zip:, ~
Ss y~ 7
Applicant is: Owner ,Contractor
O71':~Af01'K Description ofwoek: Ps-ou c a, RE Pt .Kt~ S~ d /C, d > ,a-x a ly1 £ r •e L
Typo' .
Construction Cost / y 410D CFO Multi-Family Building: (Yes ~ / No
Company: Q E 1 ~`,r r 6e v 2 IY~*-i .~`r . do 10 Contact: DA tJ 14 I(~~ 22i S
Co>ttacvr address: /o w ~o S~ City: M Pz. S
State: /V-*~ Zip: Phone: log .L - 9 /v Co V/3
License fP: 4 C v p lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
qt-N&S- QIiLr Posy /5'-2,
COMPLETE THIS AREA ONLY I 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 S Water Contractor. Phone;
NOTE: a>nd iAI~Y •sti'br~1['~r 1Ni>t•~e• vamF"
• tlr~:prarr!oins?loni:.~ d~' ~ . t?~ R~;~~. a'P~~ai~tt~, s ° ' ' ji+ ~D::-•: i;'
CALL BEFORE YOU [Me. Coo Gopher State One tail at (631) 434-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to (00010 locates of underground miss. www.goeherstateonecall.om
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 wodt will be in
accordance with the approved plan In the case of work which requires a review and approval of plans.
Exterior work authorkad by a building permit issued In 11=0rd4noe with the Minnesota state, Suildi
daps of permit issuance n Code must be Completed within 180
.
x ~~~r ~ ~u2.JLiS x ~
Applicant's Printed Name Applicant's Signature
Page 1 of 3
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