4429B Clover Lane CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilo./ Knob Road
P. O. Lox 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:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Dote Paid:
Date of Ins p.• ' " Insp.•
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. 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:
Ordinances.
Account Deposit:
Permit Fee:
B Surcharge:
Y Misc. Charges:
Date of Insp.:
Total:
Insp.: Dote Paid:
Use BLUE or BLACK Ink
For Mce Use
I -11 CX~~ V 1
City 0 Ea ~I~ 1 Permit
(VQ ,
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 1 Date Received: _
Phone: (651) 675-5675 I Staff. 1
Fax: (651) 675-5694 f f
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: ~I 2,9 Uovcr LA
Tenant. Suite
Resident/Owner Name: Phone: _~f J tit
-2------~
Address / City / Zip: _-1 I _P `tom
Name: g}~ pipnc 10C . ` License
App (vlJ l
- -
Address:-- 12850 C-hestnut Blvd. _ City:
Contractor I Shakopee MN- ~3TU
State: Zip: ~52444_8Q3_ Phone: -
Contact: Email:
Type of Work New 1eplacement -Repair - Rebuild Modify Space Work in R.O.W.
Description of work:
~ RESIDENTIAL
Water Heater
-Lawn Irrigation RPZ / PVB) 'Q-r'' ater Softener
Permit Type Add Plumbing Fixtures Main / Lower Level)
Septic System New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround' (includes $5.00 State Surcharge)
`Water Turnaround (add $200.00 it a 5/8" mete`rSs required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
_ TOTAL FEES;_ ~0
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.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 caseof work which requires a review and approval of plans.
x
x
Applicant's Printed Name Applica t' Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-in Air Test Gas Test Final
From:ALLSTAR CONSTRUCTIOR 19529427464 09/17/2013 08:36 #582 P.035/079
Use BLUE or BLACK Ink
For Office Use ~n 1
j Permit I I t I j
4-1h. 1 City of Evan I (30
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: Ot3 j
Phone: (651) 675-5675 1 I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~~5 ~ZbI3 Site Address: 49n I f 1 1 Ur +0 j14431 PJ Clover LQM Unit
~.~.=~.e,.~.,..v...,~.~..~m.. Name: GlAtitr 1 'IIVn CID. ~~S~ih l~Ctmunn~_ Phone:
Resident/ n
-ft Owner. Address/ City/ Zip: (H1e l Vl t,si ~k~((~V yt~Y~t, , M IY ~"7 y
Applicant is: Owner Contractor
Description of work: Tyr (>f qnd YE-I~DDf
Type of Work
Construction Cost~~ 0 ~V Multi-Family Building (Yes / No
Company: A'Mr CbftM00 ftU t LLC Contact:
Address: FJIt-IcJ 1Y1G1US1YICt~ StYal'-4- # ~D3 City: wple, 101 i 1'1
Contractor
State: MN Zip: _5C2-31501 Phone: g5Z_gq2 License W?J Lead Certificate
C (5 WT 20 lvy -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 maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets. rx ~v
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.aopherstateonecall.ora
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 1 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. 0 l
Applicant's Printed Name Appl' ant's Signature
Page 1 of 3
May 13 2014 08:28AM Liberty Comfort Systems 763-422-9669 page 1
UseBLUE or BLACK Ink
For Office Use I
1 Permlt#: 122-&, o
City of Ca aIl I 1
3830 Pilot Knob Road Pprmlt F«: l
Eagan MN 55122
Phone: (651) 675-5675 I Data Re`<L.adl
Fax: (651) 675-5694
I Stagy:
- - - - - - - - - - - - - - - - - -
2014 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: Site Address: CO I. V e R itA!V C
Tenant: r-9 0 W Al 15- (U Suite
_ I.
name: f~YYI Phpne 666 50 3-
R~as3t~nt~w>aer
Address I City l Lip.
nam~: m(=0 ax Sip : At3d04'!!1
a~-
ress:
tractar Add
Cc~ti ~
66
/Q Z
S.5"30- 79 ~3
Concacc~l•'~ w1i I WC Lm
-New 3~L R lacafna,t _Addit-li, -Alteration D.-witlpr
Type of Work Description of work: h Gtr v, AN
' NOTE: Roof mounted and ground rn unted rnmet►aa1 equlpmprft regIre~ to'tie acreened;by City
da. RfeAse cor rct the Mechanical lnspedoir for information an per+ti lttad.s . grtet ds.
RESIDENTIAL p a r
_F,.r,.a . ent
Perm It Type Aircpnd+tipna.
_A,r E=thpne,ar 1 ~.~hF~' '~1L
_ Heat P. m p
e- Ocn er
RESIDENTIAL FEES yy
$60.00 Minimum Aad or all, era clop to an ea sting unit (includes
$J ~ V
$100.00 Reeidanti., N.-'incl~11- $5.00 State S- nar9e) FEE
COMMERCIAL FEES ` X.01
$55.00 Permit Fee Minimum
$70.00 Underground tank installationlremoval ( armft Fee
'Ir contract value,. LESS than $10,010, S- harge = $5.00 1 ~S r<narge`
Ir contract value is GREATER the n $10,010, Surcharge = Contra
Irene project vawaaon IS over $1 million, please call ror Srcq harse = $ TOTAL FEE
Here OY e:knOWled®e th at th is In POrT HCIOn 19 c,-ple[o end acc uraLO the[ this wgrk will be in cOnf-- Oe wRh the dralnp<ces line cpd08 Ortna City or
Eepen, the< undo eland <M1IS IS no[ a permit, dut only an applic atlan for. permit, and IS -t t0 start with0 ut a permit, th etthe work w tl pd rn accordance
with the approved plan In the sa of work wnlcn r.q uiraa a re vlaw and approval o p
/e
x X
Applioan s Pri fed Na a Applica is i re
FOR OFFICE Ul F_,
Requireditnspeetipns " (teNievvad Date-.
a
llr gro~nn Rp,h in AI~TBSL Ga= Sofa e e=~ t (loOri j~ii! F,n , Ht/AC~S~r g
i
® 6 ® B I
o e
®®®® �00 EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(@cityofeagan.com
-------------I
For Office Use
I Building Permit #: U
I I
S&W Permit #:
I
I �r�
Permit Fee: T?I L`l zl I
I
I I
Date Received: I
I I
I I
I Date Issued:
i---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Applicant is: ❑ Owner Contractor
Name: �GCQV\ "b 0-e_ (L>L U'Q_y'S tqs�s & C I ct_4l
i
Address: 14y 3 1 9 ui Lk�2- AIR city: aCt Q
Homeowner
State:% W i .5 2 Phone: Email:
—
Pik
1 Description of work: c
Type of q
Construction Cost
Work
Type of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan T7(�
Building Address: L/&P_) (_. r am W Qs-�_ l tF--� y City:GkVA
Contractor `, 1 _
State:mllh : 553�T Phone61ZJ1/Email. Q \[ �e ✓� �CSti^eo``��`�
�E�x
�z2�_W
License #: iration Date:
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License #: Ex iration Date:
I
I 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. i
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.
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 approval of plans.
Applicant's Printed Name A licant's Signature