Loading...
923 Oakwood Heights Cir CITY OF EAGAN WATER SERVICE PERMIT 37!5 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: agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: D. of Insp.: — � - Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 37M Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: _ Address: Site Address: Plumber: I agree to comply with the City of Eagan Connection Charge: —. Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Dote of Insp.: Total: Insp.: Date Paid: Use BLUE or BLACK Ink -For Of-RceUse j Permit City of Eqan I ~ oat I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I ~.----------------J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 04ALW* 4e Date: ltiZ Site Address: D Name: 4''Atrtnus (CQ/U+JkSj- e_C&h hone: o ~ c.. Resident/ Owner Address / City / Zip: Applicant Is: Owner Contractor Type of Work Description of work: re --k=24 Construction Cost: 1 , Mufti-Family Building: (Yes ! No Company: tiJV*: Contact: VoyeL Contractor Address: 7,0 ,u_ city: State: a r J Zip: o ~r 1,3 Phone: 2,10 -1 License 3Q_ 5 q S -7 4 9 Lead Certificate AJJ*N- 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 may be 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 (661) 464-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstatoonecall.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_ k)t-~ 1-C ?Jv~cati+ -iSr-f x 044 Applicant's Printed N Applicants ignature V 'V_ Page 1 of 3 Use BLUE or BLACK Ink r----------------� I For Office Use � ' � Permit#: /�(��� � � j City of �a��� � �o�: ��-� � Permit Fee: 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Fax:(651)675-5694 I Staff: I I � 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: rJ � Zo Site Address: _ . � �� f10 HC.'1 C�j" Unit#: _,,,,__ �e�+.� /-,���v�S �;� �; Name: 17�' A/Qp � �►�cc��1.'{'� Cb�ornW�u%,�.. , S , Phone:�1 — c� TV—t�Zf 3 Residei�t/ , ° �=�Owner � adaress i c�ty i z�p: d fF�fC.w oo� -F��a h-4e �Y �(�- F 1`�4C�/t� � # { , Applicant is: Owner �Contractor � � ` Description of work: �f N 0 Gu {�e�d...�.1(°�mPn�'� Type of Work —� ` Construction Cost: �� Q � Muiti-Family Building:(Yes�/No ) � Company:� 1��U`}' `t'� -t—�.�SC� �C _ Contact: �X�ctX�� (�c �nr�v--i� . — Contractor ��� Address: 2 (� � �� city: � ���4� /�� N�e State:�Zip: �S'�i 2� Phone: (a(Z-2.(0--�(p���ail: �V'I �n,�1��'�d� V���,��— License#:� O 5�� 7�0$ Lead Certificate#: �(1'4-'�~�r', ����1` ( 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 8 Water Contractor: Phone: NOTE P/ans,and supporting,tlocuments#baf you subm�t are cons�dered fa be publ�c rnformat�on Portrons�f the�nformat�on may be class�fed as non-publ�c�f you prowde spec�fic reasons that wou/d perm�t t�e City�to �='con"clude'that the` are�tratle secre#s-;-: '. � ;` {�$ ` 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 conforma�ce 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��e L�S �� v�,n e�-�� x��.l, A c��;�;���'_� A p pli anYs�ted Name �� A p pli c ant' Si gna ur�l v Page 1 of 3