1112 Kirkwood DrND :.
122 ,, DATE 1,% 14/81
P4I T No. of Units:
Jolser. h Miller ins true : t 3_tin
Connection •Cheraw 305.00 :pd
Acemint Deposit
No:• Pen-41Flb:
!: seiga /r ewe* with am City eii:Seems Sar9a:
. Std pd
'Misc. Charges: . lid me
Total -
Date Pat:
SAGAN SEWER SERE .
—PERMITNiel Knob Retell 4O: T .
MN 55122 DATE: �' t
Zoning: No. of Units:
dws*r TCS ,t-!
:lite_ !,on st,ruCtit
1 \\
1112' i ,T!)!1r' Tj T n^t ."VITT
e.^.,ter n
1,17/L1 iL1 7 7
agree to empty with ` iie Oly of gegen _ orfiject1p1Ch
n arge:
Ordisesteee.� me
- p'osit•
I Permit Fee:
Surcharge: 1:0
Misc. Charges:
Total:
Ir►tp Date Paid:
Site Address.
Plumber:
411'
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#:
/O77°
Permit Fee: V�
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Name: a-Ej (1 r� Phone:
Address / City / Zip: %V) ��. Y' 1,/(G/
Applicant is: Owner <Contractor
TYPE. OF WORK
Description of work:
Construction Cost: 0e
Cc
Multi -Family Building: (Yes / No )
Company: Sf`%Yh f £%'/4r/ C Contact:
Address: crc.) Ah1/ IJY rI3 /J/i S City: ai/Dkeite
State: Mr./ Zip: _c/a
Phone: 7c3 -
License
c3 -
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:
Mechanical Contractor:
Phone:
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.qopherstateonecall.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.
Appilicant's Printe laame A. licant's �f nature
1�"' p t' -
Page 1 of 3
tyofEaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit C.
11 x'23
Pa,mt! oo.
I G 00.
Date Received:
Staff:
L J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 1) Z /4 R 14
Unit#:
Resident!
Owner
Type of Work
Name:
»64'i✓ ApE/ /Li /)pre-/ Phone: 65/- STz-3772
Address / City/Zip: 1947 7)3 PCt2 t.,e-n G,ar
,�/ SSG 7�
Applicant is: Owner I!� Contractor
Description of work: A «. eel
Construction Cost (21 t2DeJ Multi -Family Building: (Yes Y / No )
Contractor
Company: &-htk(d 1 -4. -Qt" -�r�ale I/e eWS Contact STc Pt/�.t,
Address: RP C r AAlebeet,,l.AY' city:
Sty: r Zip: S'S r 72- Phone: L 5/-- 452--
Incense it: / C 3 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 Pltattber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor. Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. on. Porrtaions of
the Information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cal 48 hours
before you intend to dig to receive locates of underground utilities. www.000herstateonecaliorq
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 penult; that the work wB be in
accordance with the approved Man 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 Bui must be comped within 180
days of permit issuance.
x r f /) E L Y011/.6'
Applicant's Printed Name
x
Applicant's S 'nature
Page 1 of 3