4280 Boulder Ridge Pt CITY OF EAGAN 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. _ Z6 Y ?
Misc.. By
AVATER SERVICE PER IT (P .,)
CITY OIYEAGAN 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 10:50AM Property Claim Solutions - No.1291 P. 12
Use BLUE or BLACK Ink
For Offtce Use-------T_
I I Permit I
of Eap Lfz";D I
Ny
Permit Fee:
3830 Pilot Knob Road + l I t
Eagan MN 55122 Date Received: V
Phone: (651) 675-6675 I I
Fax: (651) 675-0684 1 Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
i
Date: Site Address: Unit
Name: e7 Phone:
.
y. •>s: Address/
OvVner:; City /Zip:
Applicant Is: Owner Contractor
y: Description of work: i
YIFPe>,o .qr.(5
x •';,:'ia."e'~,lr`~~2~ 1 "aye C°rw:.;:.
Construction Cost: 1-941 Mufti-Family Building: es /No
r%?~ >K•;.I:%i:.':ry~>,w•`ri~.`r~ x~ Company: Contact:
Address: - City:
an:f Ac o ..1
State: Zip: Phone: t' Qr9 1 -a
~ 7 ~0
<f''; + License Lead Certlflcate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I
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: i
Sewer & Water Contractor: Phone:
N01'E~'P/ans'ands
upportrng,do umentsahat:yousubmtz`are:considered'tobe. ubl/c./nfbrMaVdn.: P etions::of I
the rnformat/o» maybe CJassrfied as non .pubhe if you provede spec Tc telasons t`hat.would permitahe City to C
co%iblude.-Ma>! flee `aie'trBde secfefs
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.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 1
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
day ermlttssua~-lnm 96) x f
x
App ice inted Name Applicant' i nature !
Page 1 of 3 j
I
___._.....N ov, 6. 2013 11:00AM Property Claim Solutions No. 1669... ..P. 1.....:...
'Boulder Ridge-1013279 ^w^ Use BLUE or BLACK ink
For Office Use
I PermR 0: j
City of Ealan ;
-I 1>
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 65122 Date Received: j
Phone: (651) 6755675 1 I
Fax: (651) 675-5694 Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11-4-13 Site Address: 4278, 4280, 4282, 4284 Soul er Ridg "nt Unit 9:
Name: Boulder Ridge Townhomes Phone: 612-290-3055
a"K Address / City / Zip: 4278, 4280, 4282, 4284 Boulder Ridge Point i
E?~Dre '
. I
Applicant is: Owner x Contractor
Description of work: Repair only siding Deices that are damaged,13SQ _ i
xpt °.p1lAoir~C;
Construction cost 6,418 Muhl-Famlly Building: (Yes / No _X-) f
Company: ACS Residential contact: Pazj Hanna
Address: _ inns Pin Oak Drive City: Fggan
tc/ s
State:
MN
_ Zip: 55122 Phone: 651-255-0609
t_Icense m BC593158 Lead Certlftcate
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 BUILOL
In the last 12 months, has the City of Eagan issued a permit fora similar plan based on a master plan?
-Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
i
Mechanical Contractor: Phone: j
i
Sewer & Water Contractor: Phone:
KQTE; l~lane snd supportfng;a~ocurrients:litat l(alu;ubiriitaie coiisidearaaiti be~pulSllG:Irrformadonri,- Potions of
tits lfrfo`rmatlon ma he classired 3is no»%ublioi protr~da,speclfic i'iis>fftatwoiild efti»It die °Cit fo
.t,:
x~
:t
c ode,.
ih'a <l1ht "a
con
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.oooherstateonecalLorq
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 i
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 I
accordance with the approved plan In the case of work which requires a review and approval of plans. j
Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 160
days of permit issuance. j
j
x Patty Hanna/PCS Residential x
Applicant's Printed Name Appl cant' Igneture l
I
Page 1 of 3 I