4410 Clover LaneCITY OF EAGAN
3830 Pilot Knob Road
P.C.Box 21199
Eagan, MN 55121
WATER SERVICE PERMIT
PERMIT NO •
DATE.
Zoning: No. of Units -
Owner:
Address.
Site Address -
Plumber:
Meter No.: Connection Charge -
Size: Account Deposit.
Reader No.: Permit Fee.
1 egrets to comply with the City of Eagan Surcharge.
Ordinances. Misc. Charges'
Total.
By Dote Paid -
Date of Insp.: R_w I nsp •
CITY OF EAGAN
3830 P;Ioti Knob Road
P. O. Box 21199
Eagan, MN 55121
Zoning:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
Owner: No. of Units:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances.
Account Deposit:
Permit Fee:
8 Surcharge:
Y Misc. Charges:
Dote of Insp.: Total:
Insp.:
Date Paid:
J
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:43 #582 P.053/079
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: I I `U ,5 S
Permit Fee: )5
Date Received: e' It -1(13
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: LIHN 9-10e611+110 LHIOP, Cts LCI hei
Unit #:
J
Name: ECith ttTh t Clo: Gaccevi CDYYII any Phone:
Resident/ n v 1n'
Owner Address /City /Zip: li P CA 9 Y �ikV((�y, Arai riC N ISI
(M
Applicant is: Owner Contractor
Description of work: Tec In l avidYe-vock
Type of Work
Construction Cost $19 l 4fa) • 00 Multi -Family Building: (Yes / No )
Company: Aillat Cbnsfiiuc ian Manap'nt1 LLC,Contact. On I-ta IS-tead
j Address: vt-15 InduStf►aI sheet # 103 Cp1. Plaih
Contractor
State: MN Zip: G5CO3M Phone:-1"✓1—C4y2^ --MCA
License #: 1:3Cto31e215 Lead Certificate #: N e T" 2J) by -D
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 they 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.aooherstateonecall.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 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
days of permit
issuance�
�
(i V l� 1V1.1 c
Applicant's Printed Name
x
Lf t •
Ap}iiijrant's Signature
Page 1 of 3
From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 12:56 #301 P.005/022
41,11 City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax; (651) 675-5694
Use BLUE or BLACK Ink
For Office Use 1 � �� ��
Permit #: L�
Permit Fee: L ,
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ../4 //Ce Site Address: rM9 1✓1/42
v142 -'.e-4-- 101-4r0e-- Unit #: /7i 'B
Name: goyfildor,f4 /IA - 4:11C/4 /O,4 Phone: /11/4
Resident/
Owner z' Address / City / Zip: 7il/r/ ' 7(/40 dA/eic
Type of Work
Contractor
Applicant is: Owner X1 Contractor
Description of work: �P ®O �S W,T% t4n y/ �a
Construction Cost: g, GM/ — Multi -Family Building: (Yes / No _)
Company: 40- ditlette4d e?»1 diavdentnce Contact e w. A 11E111s vg
Address: Cf q5 / r a&* 4-r.A Si--'�5 rI-t j`' /03 City: tkPL- ;ti
State: ITh Zip: $5359 Phone:q5J "'99%"7�/�� Email: /;74444S -/-4.r. 42_
License #: & 6403S 3S D Lead Certificate #: A/AT- T- o?O 9to - o�
If the project is exempt from lead certification, please explain why: ;LT. ;Ai /993
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:
Fire Suppression 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 they 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.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 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 Buiidin j mpleted within 160
days of permit issuance.
x i rh I4)/ tnal'
t Appi�nt's Signature
Applicant's Printed Name
Page 1 of 3
®11®
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EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(cbcityofeagan.com
-------------I
For Office Use
I Building Permit #:
G I
I I
I S&W Permit #:
I I
I Permit Fee: i
I
I I
Date Received: I
I I
I I
I Date Issued:
i---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: .3hSite Address: _
Applicant is: ❑ Owner Contractor
Homeowner
Type of
Work
nit #:
Name: �GC 14b Vl�e_Cn, ._-,
Address:41 49 iqle !YqfO 1918 CLUB I /_' n City: �l C(OL �
Phone: Email:
Description of work: P"2 C,
Construction Cost 2 19, _11y
Type of building: ❑ Single Family ❑ Townhome, of units NTwin Home
Compan T7CM r� P Contact: (2 �t of M,
Building Address3p) rr& es-� \A1 y City:�GLE�'�
Contractor /J '/ /?
State:A p: 553�T Phone6tI—J7 �' EmaiI0-Me.�[ �e V
-'�/�9� o�t2(o 3/31/2s License #: ' D Expiration Date:
Sewer &
Water
Contractor
Company:
Address:
Contact:
Required for State: Zip: Phone: Email:
new construction
License #: Expiration Date:
City:
` 1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
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 they
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
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.
x
Applicant's Printed Name A licant's Signature