4422 Cinnamon Ridge Cir a. 7 • .J i `/'1 ir, °: i`�' hrkiti Lei PEItMi(
3830 Pilot Knob Road
P. 0. Box 21199 PERMIT NO.:
Eagan, MN 55121 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 Y
Date Paid:
Date of Insp.: 72 ,(3 Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. 9. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge: f?n,
Ordinances. Account Deposit:
Permit Fee:
By Surcharge:
Y Misc. Charges:
Date of Insp.:
Total:
I nsp.:
Date Paid:
Oct.18, 2013 8:59AM Crest Exteriors 651-463-8095 P 15
Use BLUE or BLACK Ink
I -ForONlceUse J^
I 'mil ` ~ I
I
j Permit
City of Eap Permll Fee:
3630 Pilot Knob Road I
Eagan MN 55122 I Date Received: I
Phone: (661) 676.6675 1 I
Staff: I
Fax, (661)676-6694 I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit fl:
_ Name: t~ v Pttone:
:.Real etlt/s= L L ?-Z CA
yap r ' Address / City / Zip:
Applicant is: Owner Contractor O
Descriptlon of work: Re-K
Construction Cost: W Multi-Family Building: (Yes J / No
42 Company: j e ox`s f Contact:
-s - ; .
Ity:
r i'r> Address:
A CO Z
' State: 100 r\J Zlp: l Phone 2-
License 2 C_ b 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 ZNo If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor; Phone:
.Ito "hc M(orm~s~n:Po' ns of
f p:1'E-' an.~:s d:s "•'o`" in , ~do"' a . ° s" :c
. nio . a ions 4, e.c e s ons: f wo~ilt~ pe~• . erC~r ;~o,• .
.:~:,~,~M• ~rcono. u af.f H .a e;, g.~ 1?9
CAL • BEFORE YOU D1G_• Call Gopher State Ona Call at (6ti1) 464-0002 for prolecuon against underground uGllly damage. Call 46 hours
before you intend to dig to receive locales of underground uUlfUes. o her one r
1 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 epprovat of plans.
Exterlorwork authorized by a building permit Issued in accordance with the Minnesota State Building Coda must be completed within 180
days of permit Issuance.
x x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use
J -1
Permit#:
I
City of Ea Ed~a
I Permit Fee: 1
I
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received: 1
Phone: (651) 675-5675 I I
1
Fax: (651) 675-5694 I Staff:
1 I
- - - - - - - - - -
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
~A 11111 Site Address: gL./nit
Date: 3 el
_ -t
Name: ti w'-~' :::,s°f - Phone:
Resident)
92
Owner Address /City/Zip:
Applicant is: Owner Contractor
Description of work: S C ` 5 `~'~~25
Type of Work
Construction Cost: Multi-Family Building: (Yes / No )
. I•s. 1 r Jr t Ai/► 7 ?rALa'''r lU t'~-..~
Company: tjete'% ~ G- +v F^1v T.i,+,fe' ontact: /
Address: ~,t 57 City:
Contractor
State: Zip: / ` Z Phone: 642- 16' , sr
License ~ ? 2.2-4,10 Lead Certificate /V4'= 3 7
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 maybe 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.qopherstateonggall.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 0-----
days of permit issuance.
x k/r Lztsk e ,r` x
Applicant's Printed Name Applicant's Signatu _
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use
4 ~7,r ~ I Permit I
City of EaEd
~ Permit Fee: I
3830 Pilot Knob Road I 111 I
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: r Site Address: CI Unit#:
Name: d .i ~'asl,rGr- fr=c:. Phone:.
Resident/
Owner Address / City / Zip: C z , d% ! t v'Ir%? = X ~ '
Applicant is: Owner Contractor
Type of Work ' Description of work: A-e- JZ~ C7
)
Construction Cost: ~ 7s Multi-Family Building: (Yes /No
Company: 4- c i Av T P-V't'!Lr ontact: e- r
Address: 57 City: _ 7 IV5 r-11
Contractor I
State: f Zip:.
~y Phone:
-
License aG-' Lead Certificate /t!,47- - 27
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 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 gopherstateonecall.o[g
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 withi
days of permit issuance.
x Wrtalt,4 A
Applicant's Printed Name Applican s Si ature
Page 1 of 3