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3854 Heather Dr'4'pty otBaQau 3830 Pilot Knob Road Eagan MN 55122 Phone: (661) 675-5675 Fu: (651) 6754694 Use BLUE or BLACK Ink For Moe Use Permit *: [ 3 l 1 ) `) Permit Fee: Date Received: Staff 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: h/- 9-"/ Site Address: 3Y s H 4 7N £, 2 bR, • _Unite: Retldetlt/ Owner Name: e% 46 i !)4046£/ ENS �w r✓ Address r city / Zip: 8So b Z c 4 `rt) Applicant is: Owner 2fContractor Av, ,J Phone; 763 - s Say 9770 CgoLDS/.. V 2 /OA) SS' l/.2 7 Type ot:lltlork, Conor Description of work: R.L P41 1 Ps. r/ o b dz)2 Construction Cost • Multi -Family Building: (Yes / No Company: Cio E i e r tot %)%i.J'7' . eciat Contact Eut.i, t il✓2QiS Address: 4/D$ w to D* .1 State: /'SAS zip: 5r4// Q Licenses: L 2Y/ / 3 / city: m PL S Phone: 4711 - 6/ - 2 4/ s Lead Certificate 9: If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information) Posr ,F7Y' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING in the last 12 month% 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: Mechanical Contractor: _ Phone: Phone: CALL BEFORE YOU DIG. Call Gopher State One Call at (851) 454.0002 for protection against underground utility damage. Cal 48 hours before you Intend to dig to receive bates of underground utiIth . www.aoaherstateonecell.orrt 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 Dem*, but only an application for a n•nmit, and work is not to start without a permit: that the work will be In accordance win 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 Build Code must be completed within 180 days of permit issuance. x 4 0 ,S Applicant's Printed Name EZ/50 39td x Applicant's Signature Page 1 of 3 INIvW IX3 I3g L9Z9T98ZT9 LZ:bT bTOZ/TT/b0 OF.EAGAN knob Road 21199 55121 PUD Address: Site Address. 3854 Heather: 1)r 146 51 Briar Hill 4th Plumber: Gritz Ryan AT 'PERMIT= NO • DATE: No. of Units i + 1lIez Tollefson Bldgs Meter No.• Connection Charge: Size: Account Deposit. Reader No • Permit Fee: I agree to Ply bof Eagen Surcharge: _ 0 Misc. Charges: 60. Total: Date Paid: 4 hasp #►GAN ;�sR p3i ,Knob Viand 21199 Eaga�t. > 55121 Zoning., UD Owner: Toll ei sort ., Address: 1 Site Address: • . �` Plumber lfER'SERVICE PERMIT ttMIT rro :.. 6173 DATE: 9-22 3 No. afUnits: 1. of 4 1 100. Qty pd 9'2l -cid..,,, ?, 1 Dares b aonapy with the City ofSon Con action a Xie 4;5100 Ordinances. 1 Accountp it, , __ r Permit Fee: 1 Q i Q0 p4 /L Surcharge; ' Misc Charges: Date By of .,/ i! � ' Total. Imp • ' Afi ,1ii•► Dote Paid. City otlate 3834 Pilot Knob Road Eagan MN 55122 Phone: (661) 6754675 Fax: (651) 676.8664 Use BLUE or BLACK Ink For Office Use I L-27° 273- Date Received: 1D/JI3 Per•mit Pamir Fee: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /O -,j t/ 1 SitaAddles= 32'0,3IA3gsz,3Bsy / ('TTHbk. units: Name: t% / r "4 4614.)TAlt4 a phi 741 -5'93 - 9 7 i0 Address i City i zp: , SD IN E. a or -r— Q Av AA p goa z.1 I/rK -s3-441 Applicant is: Owner „- Contractor Type*Work Description of work TSotoe © 8 2E - F Construction Cost ,11.1. lob - Multi -Family Building: (Yeex' / No Company: 4E I £',� -roe/o,Q 014N e2.P contact IS Av, r $ Address: VD 6DIL City: MPL S . State: rip: .S V/ 9 Phone: i''z - Il o- 4.2 'f3 Lkonse #: igC X S/I / / Lead CerldlcatG #: If the project is exempt from lead certification. please explain why: (see Pege 3 for additional information) lies- /aS Let.- 11,.»/.7-' Post' J9y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW 8ULING In the Met 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. Mechanlaal Contractor: Sewer & Water Contractor Phone: Phone: .ware 2 1 C.,r:sk i t bef J you BEtntOd E YOU 019 Call Gopher � p f Sado One Call at (651) ss/ -Dost for protection again underground u Juty aanwge. Cali 48 hours underground utilities. 84 meo_L_ hereby acknowledge that Ibis irlbrmadop is complete and accurate; that the wor1c will be in conformance with the ordinances and codes of the City of -OnceLthal nd this Is nota permit, but only an ambition on for a permit, and work is not to stent without a permit that the 14,01* Wal be in ernanw a Plan In v+e ogeework wk.', requires a rallow end approval or plana - days Exterior work authorized of permit issuance.by a building permit bowed In accordance with be Minnesota Stab BuIk5 Code must be completed within 180 X 64v,Ma. S Applicant's printed Name SO/90 39 d 1NItiW 1X3 I3S Applicant's Signature Page 1 of 3 L9Z9T98ZT9 ES:ST CTOZ/t,Z/0T *City otEagan 3830 Pilot Knob Road Eagan MN 66122 Phone: (661) 6754675 Fax: (551) 675.6684 Use BLUE or BLACK Ink For Office Use j Permit e: 1 �/ Permit Fee: al k /• Date Received: 3,111 LI - Staff: �'1► 2013 RESIDENTIAL BUILDING PERMIT APPLICATION • 2 - 7/ �� Site Addroas• 3 8 V 3 rs-o 3 S SI 3 Vs" V ligi4•Thie4 L2- Unit it: . Raalldi9tW Owner Name: e4) 4 C / "4.4 R b E IM Z Ali- ..� C. Phone: 74 3 - .S -F1- 9 / i 0 Address / City / Zip: 8SO Q t: C 4 Yu A. A. A) , 1 /; 6.246E.... 144 -LLE y /04 Ss VA 7 Applicant is: Owner )cContractnr ' ' otWork, Description of work: IZ£g-,-c � E a- R.£ Pl. et-c.f.- 1 d / 6 a F"orsL/ a /4 £ •riA L. Construction Cost / y 4'O • t Mufti -Family Building: (Yes., / No __) . contractor • . Company: a £ l e>< >!.2/ ID 2 Midi br'r . Co aP. Contact N ✓ r f old / s Address: _4J r L. loD .17-- City: m PL_ s Stare; /414S Zip: SS -V/ 95 Phone: 4/ Z • Y (o / - Co 2 V3 License #: 4.3 C-• 2 EP / 3 / Lead Certificate #: If the project is exempt ill 4t . from lead certification, please explain why: (see Page 3 for additional information) i3,0/(Y Posy /,77r In the last 12 months, _Yes _No If Licensed Plumber: Mechanical Contractor: Sewer S Water Contractor: 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: Phone: Phone: _ Phone; NOTE: flips encl. sl wiflnortrO . ' ! , •. � drq,ftrbnrrApan rtyr,Ifa( c/aa v�_lc,,�e��yyyyk�.7l�flmpu�� gper, fir►# � . p�iet?31i, ... • i►iir, dude th t,��, y. .. A',, . . <z-: .. •,:: . ,�i' h, CALL BEFOIg YOU DIG. CaII Gopher State One Call at (631) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities, www.000hargt¢toonecall.orrt 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 t- n; that I understand this i4 nota permit, but only an application for a porri+n, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of worlc which requires a review and approval of plans. Exterior work euthoriz d by a building permit Issued in accordance with the Minnesota State 6uildn Code must be completed within 180 days of permit issuance. x �A✓°� %��.�ZlLif Applicant's Printed Name E0/t0 39 d X Applicant's Signature / 34.0 7P0 Page 1 of 3 1NIdW 1X3 ISS L9Z9t98ZI9 ZI:OI VIOZ/L0/E0