1380 Jurdy Rd CITY OF,. EAGAN { WATER SERVICE PERMIT
3795 pilot Knob Rood - PERMIT NO.:
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Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner: _
Address:
Site Address: "; '.
Plumber: - ..
Meter No.: Connection Charge
Size: Account Deposit: •
Reader No.:
Permit Fee: •
agree to comply with the City of Eagan Surcharge:
Ordinances.
Misc. Charges:
Total:
By _/ Da - 'aid:
Date of Insp.: , �/ Insp.:
CITY-OF EAGAN SEWER SERVICE PERMIT
3795 ?ilia Knob 'Road PERMIT NO.:
Ea3aii." MN 55122 DATE: . `
Zoning: No. of Units: { -
Owner: - m ° : :.
Address: \ /
Site Address: '
Plumber —
agree to comply with the City of Eagan' Connection Chargec.4-
Ordinances. Account Dei3ooit
Permit Fee: •
Surcharge:
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By T
Dote of Insp.: '' Total:
Insp.: Date
Paid:
City of Eagall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
12016 RESIDENTIALBUILDINGPERMIT APPLICATION
Date: 1 o -1T-ft, Site Address: I ', O JLti l 9 'Rd Unit #:
Name: IYAN exortPhone:
Resident/
Owner i
Address / City / Zip: 1 ib (rDY k4 �AtikN MA,. 55111
Type of Work
Contractor
Applicant is: Owner K Contractor
Description of work: ft R Lkvouhtt `? jM 1/Jrfjt aul - t' Sim"
Construction Cost: f i Vf9 Multi -Family Building: (Yes / No D( )
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Company: K�(-rla igur Li/iCY A E -i��Mk- fort/awl l Contact: Ita<1'(11 f..1 Si t..A
Address: NH] V1-W.Sok C . City: faDt)Al1
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State: MAI Zip: SSoae Phone: qSZ-37y- 7021. Email:�dT(k (i 8611/04/4z)44 f . 1 n1 ! O
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License #: BC bg7-lLig Lead Certificate #: NAT- f 14-1+14t- I
If the project is exempt from lead certification, please explain why:
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
Fire Suppression Contractor: Phone:
fr
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of I
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets y�
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
f plans.
Exterior work authorized by a building permit issued in accordance with the Minneso {: State Building Code must be completed within 180
days
of permit issuance.
1 -rix .6 6 L3TE
Applicant's Printed Name
x
Applicant's ignature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177701
Date Issued:07/14/2022
Permit Category:ePermit
Site Address: 1380 Jurdy Rd
Lot:34 Block: 04 Addition: Donnywood
PID:10-20960-04-340
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 -
Carman Ip
1380 Jurdy Rd
Eagan MN 55121
(612) 840-6288
Exteriors Of Excellence
1502 Cnty Rd 42 E
Burnsville MN 55337
(952) 239-0560
Applicant/Permitee: Signature Issued By: Signature