1763 Meadowlark Ct VILLAGE' OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the Village of Eagan Surcharge:
Ordinan es. Misc. Charges:
Total:
By Date Paid:
Date f Insp.: ` f $' 7f Insp.:
VILLAGE OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the Village of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By: L C Misc. Charges:
Date of Irk Jr � 7j Total:
Insp.: Date Paid:
.�
�
Use BLUE or BLACK Ink
�_____--____�-.__-�
I For Office Use 1
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Clt of �a a� � Permit#: �
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I Permit Fee: �
3830 Pilot Knob Road � I
Eagan MN 55122 � �
I Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 � I
� Staff: �
�-----------------�
2014 COMMERCIAL BUILDING PERMIT APPLICATION
Date: I �I S � Site Address:
Tenant Name: jM z �d\d v.., \�.Y� �;����� � v+ g�
Tenant is: New/ [� Existin Suite#:
Former Tenant
Name:_�c s cM.ti`n�- �, ��ei �� � !1 Phone:
Property Owner Address�Cit �Zi i �> ���� , ! �
y P� 3 � b �1, �7b'� l '� bS t '9( `3� 17b\ � 1'15 �1 l?S?
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Applicant is: Owner Contractor c�.�w�h� �,�—�
Type of Work Description of work: SF� . �.. 1��r�N 1 h���,,�z��
ca�
Construction Cost:���.�1i�'
Name: C Kt V�vr���� ��� C o v.i�''y c���� License#: (���5.� C
COntraCtOr � Address: Z �'7`� �/�?�����i rr� Q�- City: V; c�,'1`���
State: � h Zip: �S 3 �' b Phone: G S� " d �� " �� rv b
Contact: %e �'�'� z.�. Email: .�. � .�1 �.�- �O L_�.�w�
.
Name: Registration#:
Architect/Engineer Address: City:
State: Zip: Phone:
', Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone#:
NOTE;Plans and supporting documents fhaf you submit are considered to be public information. Portions of'
the information may be classified as non-public if you provide specific reasons thaf wou/d permit fhe City to :
:conclude that theyare tratle 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 w rk w II be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an ap c tion`for a permit, and work is not to sta�t without a
permit; that the work will be in accordance with the approved plan in the case of r whi h requires a review and approval of plans.
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Applicant's Printed Name ApplicanYs Sig
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use 11'
• Permit#: � /��
�� Ol ����� Permit Fee: 03 a
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675
buildinuinst ons citvofeacian.com Staff:
V J
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
9-8-1776 3 71—
Date: Site Address: � �D J a1�C �. Unit#:
Name: / ., y Phone: 651-330'/61 Q.
} Address/City/Zip: /76-3 i ', 011/,) d it,C C
ti Applicant is: Owner Contractor
Suppply and install new windows or doors
4 c: Description of work:
Construction Costliag00 Multi-Family Building:(Yes X /No )
Austin Remodeling Mike
Company: Contact:
19306 Oelke Dr Prior Lake
Address: City:
MN 55372 62-221-4429 mike@austinremodel.net
State: Zip: Phone: Email:
BC664409 NAT-F158156-1
License#: Lead Certificate#:
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: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
-77
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You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on
the City's website at www.citvofeaaan.comisubscribe.
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.
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.aooherstateonecali.ora
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.
x ',:C/Aft � �v r x
Applicant's Printed Name Applicant's Sig ure
Page 1 of 3