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4580 Horizon Cir � � ,� �...� Y ' ER SCR � ` tr,,-..., ! Ewa,. ' PERMIT NO ,� �'f Ep I DATE (-/ ej s ZOeairig; , _ No, of Units: rte. owner: 7 ,-,— : . .y - t- a , r x r t t r . f u t Address: . Site Address: F€ e r a T '0 r'''f _ ^'ire°1 ° . 1 fr, 1:- iv,- arty:, t Piember. � * � i�;T, , ,, s�c�r7� :' fcs�1 '� Meter No,: -// 7 ./ �Ssk i Con i . Y .1 ° . q Size: - .q 7— g.9 Accou posit: Reader No.: Permit Fee: 1 r ; 1 terse to comply with the City 4 of Eagan ''Surcharge. , r.CF Ordinances. Misc. Cho 6''.nn �,C L, )' �, Total, By Paid: I pate of insp.: $/ lisp.: i CITY KAGAN — , SEWER SERVICE PERMIT 3 Iel ' Knob Road PERMIT NO.: "== . '- t n, o - 531 � u bATE: 6 / 1 y, r' t RITI o. of Rlite:N 1/2 sh� 'gx Owner: Joseph Miller C Address: Site Address: 458 orizon Circ'l.e L6 C Mar E 4th Plumber: stern Mechanic a = ; p... \ 25424' J ry - 100.00 pd 1 agree to c o m p l y ' o f E o g r i ' , urge: 42121 pd Ordinances: Account Deposit: b A Permit Fee: a 10.00 pd Suecharge: + .50 pd } BY 7 . .\ Misc.. Charges: 1 Dote , c < � . total I Insp.: 7-7 ii ' , bate'' Paid: City of Ea�all 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink r For Office Use Permit #: 1 f 1 Permit Fee: I`05.35 Date Received: I obw /13 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: a'zet'" / 3 Site Address: Licso Unit #: Resident! Owner Name: Ciuero`t £ CIA 7At ra /1/ L- 6uja Phone: 6)Z Z3Z - Ve9.22. 1 be - Address / City / Zip: y o l o zo , k, ('j' "c Applicant pis: Owner )(Contractor T e of Work Yp Description of work: /e )49 Construction Cost: 0 000 Multi -Family Building: (Yes )( / No ) Contractor Company: CIO ) Je,��i(�.*iOlil .rr-C'. Contact: S7' 7V& tl a )`tom . /4Vk' City: (>ubrit a k,j4h/)Z Address: l � #1,—.1 e f (� /, State: ��/(/ Zip: ccliii Phone: l /03 "'�7/ f –00c72— License #: 0 e(03,5-2/0/ Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, _Yes %o 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: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe 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) 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. 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. x Ste 6-4/4Th Applicant's Printed Name x fl G f Applica 's Signature Page 1 of 3