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4282 Boulder Ridge Pt CITY OF P=AGAN Permit Nam Date: 3830 Pilot Knob Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 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. Lr Misc.: By 7S — Z WATER SERVICE PERMIT (t5P) 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 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