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CITY of , EAq N SEWER SERVICE PERMIT
3 agf ,Pilo,;AAob Roo ' PERMIT NO. 4R 24
Ea `MN 53122 '( DATE: 7/10181
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trier. .TriBep h Miller Construct an. CO
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Site Address: •• ■. �,, CM ; ; IV
Plumber: ? i western ec nica;, i
7/ /F1 25572 100.00 pd
1 agree to complyort City of Eagan • nnection Charge: 4,9.. nn rd
Ordinances. Account Deposit:
‘‘ o J Permit Fee: ` 10 nn prl
s Surcharge: I _ 50 Pd
By Misc. Charges: e
Date of __ _ Total:
Insp.: 7 (s"�) Date' Paid:
Use BLUE or BLACK Ink
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CitY r of Ea a~ ; Permit#: I
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Permit Fee: Coto,
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
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2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
)4-b tt Z n r\ L\' C' Unit
Name: Cpl 12eY1 Y~ (C~t1~sS Phone: ~I-a $ S-~/y3 3
Resident/
Owner Address / City/ Zip: 959-7 6J y
Applicant is: Owner Contractor
Type of Work Description of work: Q\e -gv
R_Y~-)v-e- boo
Construction Cost: 5110.> ou Multi-Family Building: (Yes No )
Company: / ' W-1 S `yvc Contact: ~ 6
Contractor Address: \ wi-13~ City: A
State: AP Zip: S ! a C'f Phone: LOcDi '7D Jj --S02)
License 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:
Mechanical Contractor: Phone:
Sewer & Water Contractor: 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.org
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________ M).. . 5 x .v
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA173625
Date Issued:11/22/2021
Permit Category:ePermit
Site Address: 4597 Horizon Cir
Lot:11 Block: 01 Addition: Ches Mar East 4th
PID:10-17153-01-110
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Britany Torres
4597 Horizon Cir
Eagan MN 55123
Bayport Roofing And Siding Llc
2240 Edgewood Ave S, Suite 201
St. Louis Park MN 55426
(612) 235-7663
Applicant/Permitee: Signature Issued By: Signature