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928 Oakwood Heights Cir CITY '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 City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By �i`. Date Paid: Date of Insp.: L Insp.• CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eaton, MN 55122 DATE: Zoning: No. of Units: Owner: _ Address: Site Address: Plumber: 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: Use BLUE or BLACK Ink I For Office Uise1 ; Permit *City of Ea ~d ii 1 .15 ; Permit Fee: 1 3830 Pilot Knob Road Eagan MN 55122 ; Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff. 5 I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Z.- b O wt'~* Name:_ hK (`a - /l#►~L ~r pa: ~ 2. 73 t -2ol Resident! Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: K*- Construction Cost: il-c-D o Multi-Family Building: (Yes ! No Company: It'{3 a + ±ks offl'u N~ Contact: T1 u a Contractor Address: (i za el " 4 City: EA'c State: M ice' Zip: M ~-3 Phone: (P I Z ° 2f © 4n (v License f~c -7 Lead Certificate #:X14-~`' q I Ige, _f 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: NOTES Plants 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 the 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..go2herstateonecall.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 1 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 compk"d within 180 days of permit issuance. R Applicanrs PrInTed Name Applicant's gnature Page 1 of 3 Use BLUE or BLACK Ink r—————————————————+ I For Office Use � ' � Permit#: / � �j City of �a�a� � o � — � � Permit Fee:� � � 3830 Pilot Knob Road � I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING PERMIT APPLICATION �` Date: �-OI Site Address:_ ^ � � � (����(`�� ��-f G�.S co�P Unit#: ���lrty , v��ZS � ' � ;�� Name: �A-{LGtld I� �i�h.� �nn��orn rn��u.,_ �,�Phone: fo�f t/�� -D��3 Resident/ owner :>> aaaress�c�ry�z�p: °� �4 C�I�l1 � �o e.�G,� C'r v�� ��- r �Y�G/�-� E: ; 4 t� � ! Applicant is: Owner _�Contractor T H e Of WOI'k Description of work: 1/�( r itl�c�w (Z.�Q��r� ��p,�" YP ' Construction Cost: 5 Multi-Family Building:(Yes � /No ) Company: �-�j��L���5� �.. Contacfi l�p���tp2V'�T7a� � ��]Rt� City: �i�G K! /lJ Contractor ; Address: Z (� �tr tr-rvl /r� �c�,,,c�K'ta State:�Zip:�3 Phone: (oI 2 ZI(y-'I (�(o�mail:�ir��1r"�O�V V �� �/,o License#: �Z� p St�S��c,� Lead Certificate#: �f 1�1' "��4 Q��� 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 Plans antl support�ng tlocuments that you subm�t are cons�deretl to be pubhc informat�on Port�on�af the�nformatron may be classcfied as non publ»c rf you proviale spec�fic rQasons thaf woultl p�rrrut fhe C�ty to � , < .concluale`that,fhe'' a��trade:secrets;�. �` ` � � �'� �� -.�. CALL BEFORE Y�U 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 sta�t 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 ��i a�, �t VJ 1� P�°�s`.► x App�l' anY rinted Nam�— Appl�canY ignature Page 1 of 3