3821 Laurel Ct ii"r +a N ` - , YIATer,alliVICE .P:M
PERMIT NO 3712
it1Z1 DATE: 3/24 t81
AIII 14 t 1 `unit ttihse ,`
Denser TGl1efsatt Builders Inc
4t. 3821 Laurel Court L9 B1 Brjar Hill II
ph an b er: Cenz Rvan
dirr No • co on cu 335.00 nd
- Roodhos , No -- Permit Fee: 10 .00 pd
::"1-erseee iir►a. r el* lie CR, of 1 .. Surcharge: . 50 ` pd
0udb.e . 60.00 pd meter
Total: ' '
�- c/P
By Dote Paid:
Date of Insp. Insp.:
10115 :116* thialt( , , . PERMIT NO.: &
Isom 'MN 151 . DATE:; .:
BIII 1 " unit tut J�'o(1in�; � `-. No. of lho
owner - Tollefson Builders Inc
site Adrlresx
Add ress: 3821 Laurel Court L9 X31 Briar Hill II
Piwnber. Cenz Pyap
3/18/81 23792 100.00 pc'
I SOW ill NNW* Mu CftP st tepee Connection Charge: 425 ., C Op d
Ot/iareses. Account Deposit:
Punk Fes: 10 _ CC r
Surcharge: _ " PP I.
By ,1 ijo ,. /, Misc. Chem
Data (01 . / Total:
Imps Dote Paid:
Use BLUE or BLACK Ink
r----
• i. For Office Usej i
MY Permit#: of Eap.
I Permit 1-ee: 1
3830 Pilot Knob (toad
Eagan MN 55122 [date Received:
Phone: (661) 6756675 I I
Fax: (651) 675.5684 I Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 4-30 --43 Site Address:38i9, 38x1, 3F 3, 3SRS" ' 4,4 &Z C. C'T. Unit
Name: fo ACT /V P4 tii 4 61 /14 Z A..) T Y~ C Phone: 7G+3 ~ s'~i 3 - 9y 70
btl or , Address City / zip: Aso tr G w "r--ti g At/ ,c3
/r1-AJ s3'vt 7
Applicant is: Owner Z_Contractor
Typ$ It Description of work: T£A-Q Off" a- QE - P4)0,0=
Cortsbttction cost Multi-Famiy Building: (Yes X' I No
Company: VAE i 6-e-P Contact ~rAviVS,-' fZA r 5
Cor i Address: //o S to 6 D'h ~!7. City: M PL S
State: /VAJ Zip: S rql 9 Phone: ~Opit ?6 i t!a.2 ~/3
. License # t'_ YI / 3 Lead Certificate
If the project is exempt from lead Certification, please explain why: (see Page 3 for additional information)
Qati&S L3r-,eC 14 'I't 7-, PDs.- 19 7 8,
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: Phi:
Mechanical Contractor. Phone:
Sewer S Water Contractor. Phone:
; :~J.; X41: • waea r .•"$Y..i:.
CALL BEFORE YOU DIG. Cad Gopher State One Call at (651) 4544002 for protection against underground ud* damage. Cad 48 hours
before you intend to dig to receive locates of undeMramd utilities. www.oooher er,ecall.oro
1 hereby acknowledge that this inlormsfim is complete and amour* that the work will be in comVmance with the ordinances and codes of the 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 w City of
wid be
accordance wkh the approved pran in the case of work wMM nxlulm a review and approval of plans.
Exterior work ar whad by a building permit Issued In accordance with the Minnesota State Buiidi; Code must be completed within 180
days of permit issuance.
x b1lv,N Pav22rs
Applicants Printed Name x
Applicant's Signature
Page 1 of 3
*at) of Eagall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (661) 675.5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use 1 /�
Permit*: 1��
Permit Fee:
Date Received:
Staff:
J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: - x4/- /'/ Site Address: 5019, 3 R2/, 39,1 3, 3 8„2.s- jAu2E L eY, Unit #:
Resident
Owner
Name: ek 46 1 M4.3 46ErtE.�'1- .:.c:..; C, Phone: 763 - .S s3- 9770
Address / City / Zip: RSo n E C 1 "PV 2 Av, 41. ) A 6040E.. VSE r ��
Applicant is: Owner Contractor Sr y1 7
Type'o�`:'.MVork
Description of work: 1Z14-4-0-, r_ a- R E Pr. :1-c- I/ d, 6a F-41-/ c. / a Mf ,a' L _
Construction Cost / 4 V OZ) • Cru Multi -Family Building: (Yes / No ___^)
•
Contractor
Company: {I EA &� r I 0 2 /y4i J T . ev RP. Contact b4 ✓" 0 a1122i S
Address: 4/O3- 1-i3 &,b — 1. city: /17 PL S
State: /'%^S Zip: . '// 9 Phone: to/ Z • ' % I- La 2 V 3
License #: 41 L 2V// 3 / Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
ill-NeD5- Q,4,-7-' Pos:- /7-7
In the last 12 months,
Yes _No 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: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
NO.TE:' Pn� YRI.Y.. QI tinge,M.MMiIIetto jjh Me"rWi-� 4���i•P�
ITyI�!'� you I9li
�j�� ,,ice �y/��p.. .. 1 r.. yy���y�y��+�p� /,� keit '��
atforr.' its ..
C./ 1 ,'hgy�pp r
'.1
�:4�
CALL BEFORE YOU DIG. can Gopher State Ono Cali 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.aooherstateonoeall_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 en 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 Bu11dlnLCode must be completed within 180
days of permit Issuance.
x 4" 0 fi /2.14
Applicant's Printed Name
90/90 39Cd
x.
Applicants Signature
7 g
Page 1 of 3
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