4258 Boulder Ridge Pt CITYOF EA6AN Permit No: Date:
3830 Pilot Knob Road Meter No: Size:
P.O. Box 21199 Reader No: Date:
Eagan, MN 55121
Owner:
Site Address:
Plumber:
Conn. Chg: Zoning:
Acct. Dep: No. of Units:
Permit Fee:
Surcharge: I agree to comply with the City of Eagan
Tr. Plant Ordinances.
Meter:
Misc.: By 616' ) /; ft
WATER SERVICE PERMIT
•
CITY OF EAGAN Permit No: Date:
3830 Pilot Knob Road B/P No: Date:
P.O. Box 21199
Eagan, MN 55121
Owner:
Site Address:
Plumber
MWCC: Zoning
City Chg: No. of Units:
Acct. Dep: I agree to comply with the City of Eagan
Permit Fee: Ordinances.
Surcharge:
Misc.: By
SEWER SERVICE PERMIT
•
Sep•25. 2013 1046AM Property Claim Solutions No. 1291 P. 1
Use BLUE or BLACK Ink
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City of Ealan'
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3830 Pilot Knob Road n X 1 ermit Fee:
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14 Eagan MN 55122 ` R `r 1 Date Received: - I Phone: (651) 675-5675( t' I I
Fax: (651) 675-5694 1 Staff :
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2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Unit
Name: J)] bnMC5 Phone:
r raldon;1
Address / City / Zi , i
Ovner'.
Applicant is: Owner Contractor
I
Description of work: 0~5Q
,,y'• p'.i%,. h ti•~.k~G~1,*'.;4.•y.Yc.: Construction Cost.
Multi-Family Building: (Yes Z/No
,n . ,3. x .w:.. Company { Contact:
~
iln=
Address:
uy04nff Cam. C'
?w x ;a; Y v`,::> State: Zip: Phone: ' 01
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: Phone; j
Mechanical Contractor: Phone: '
Sewer & Water Contractor: Phone:
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a pportingdocume»ts:`that you ubinltare;;consderecf°itc`6e; "ublic informatlorl~':~Port1o»s`of `
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e!Y nfticnatlon iriayb . e. :cM ........::ssJfletl.. n .,:,,.:...:::.~..ilc,K~ • ; ••-,:•f' Perm
.as:no:pu bof~ povr des pecr f3cre asons.Th atli; lt the:Clty`to;°:
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core
Jud~thetthe •.are f tdesec ets'
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.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 permlt: that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Extsriorwork authorl=ed by a building permit issued in accordance with the Minnesota State Bullding Code must be completed wlthln 160
days ermit issuance.
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Applicant's Pri led ame Ap lican s ature
Page 1 of 3 ;
Nov. 6. 2013-..11:01 AM . Property Claim Solutions_.__... No. 1669. P. 3..
Boulder Ridge-1013279 Use BLUE or BLACK Ink
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1 For Office Use
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I
Permit V f
*City of Ea n
b Permit Fee.
3830 Pilot Knob Road l I
Eagan MN 55122 ; Date Received: ;
Phone: (661) 675-8676 I I
Fax: (651) 6755694 1 Staff I
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11-4-13 site Address: 9.2.5-6-_4258, 4260, 4262 Boulder Ridge Point Unit
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Phone: 612-29-3055
Name: _ Boulder Rld a Townhomes
.
sit
Address/ City /zip: 4256, 4258, 4260, 4262 Boulder Ridge Point
,
Applicant Is: Owner X Contractor
uM ;I.: "Md' hax cu uy3;u Description of work: Repair only siding peices that are damaged. 185Q
"f'VVork
Construction Cost: 8,494 Multi-Family Building: (Yes / No
Company: psS Residential Contact: Patty Hanna
f'p~ n . J
Qr % Address: __7nnr, Pict 02k nriyo City:
State: ~rL Zip: 55122 Phone: 651-255-0609
License BC593158 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 l
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: i
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NQTE:Plansand:SUP :documents:thief:.Qty,,sl~t~ne :aYe:oonsrderad'foi e::u l artwPoifiQris'of''
P.ortrn .
the,»formatron may bla classJtled:as::riorr<- ~b!►~:N .csrl 1mrSrrrt>ie s eic;ea~sv»s meaty aiPd:: ~:>`i`ta Cia'yto
C..~
o o utle>>lii~lt:fi ;:arr2t2~d~"ec
►;=`:°i;
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454.0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities, www.oopherstateonecell.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.appllcation 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 i
days of permit Issuance. 1
i
x.. Patty Hanna/PCS Residential x
Applicant's Printed Name Applicant's i n ture j
Page 1 of 3