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4465B Clover LaneCITY OF EAGAN 3830 Pilot Knob Road P. O. Sox 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 agree to comply with the City of Eagan Surcharge. Ordinances. By r ( (3' Date of I nsp. • /(_ r _ F Misc. Charges. Total. Dote Paid• Insp • CITY OF EAGAN 3830 Pilot Knob Road P. O..Box 21199 Eagan, MN 55121 Zoning: Owner: Address: Site Address: Plumber: SEWER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: 1 agree to comply with the City of Eagan Ordinances. By Date of Insp.: Insp.: Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:29 #582 P.017/079 *City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use I� Permit #. l Iti`�'9 303 c° Permit Fee: Date Received Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 41S12.013 Site Address: `t`1t1Sr9'4 B,94 11440(3 CIOVtr LCtl%e/ Unit #: J Resident/ Owner . Name: ECtth VIVI C10 • CIMSiiYl tompQlny Phone: 1.. Address / City/ Zip: tot -iv, G I v1 W. PaYkWay ECttI1 Name, MN LS3L14 I Applicant is: Owner Contractor Type of Work Contractor Description of work: Z'TGY off and Ve-roof Construction Cost S 1 Ui"ir) • DO Multi -Family Building: (Yes / No ) rI` Company: t� a WYI uCtiOn Mani f: en"tsU,C,Contact t j italttead Address: 51h 1, 111111011W S1YCet 0103 City: Move, Plain n gill- State: N/111 Zip: 55WOG) Phone: '157,- q`-IZ` 1y5y License #: 12C,P3191S Lead Certificate #: NAT'" 20q -D If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: _Yes Licensed Plumber: Phone: Mechanical Contractor: Sewer 8 Water Contractor:-- Phone: Phone: NOTE: Plans and the information • supporting documents that you submit are considered to be public information. Portions of - 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 Cali 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.000herstateonecaltorq 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. x due ttIsltad Applicant's Printed Name 0 's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:04 #301 P.017/022 4116City afkali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675.5694 Use BLUE or BLACK Ink For Office Use 3�bLit Permit #: Permit Fee: Date Received: Staff; 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I//O / Co Site Address: `f'/GS- WO �i`/0Vele- Lr**•G Unit N: A ►3 Resident/ Owner , Address / City / Zip: 'HIPS- G✓8 L- Lie Name: WA/ 4' A th h%Ofl Type of Work Contractor Phone: /t'//, J Applicant is: Owner X/ Contractor Description of work: /Si -54 W/7 ti y/ 67A'/ j - t /Am'a/04;4OAIy (J Construction Cost: I U/ VOW — Multi -Family Building: ;.: .., .:... _ ty 9 (Yes No Company: A11544,t 6, 41. Baan / // /I /,-dera l Ct° Contact: vi i on A dErn kr Address: C./ (n1i4 4-r; A I S?_ _5-1.4 /4 3 City: M}ple.- TLA-; l State: /4 Zip:663.59 Phone:g0-90•7'I5t% Email: /%14444-1/5114,-r• ••'7--_ x License #: OQO3Ss ® Lead Certificate #: /'i+7 - ,78 9eP V If the project is exempt from lead certification, please explain why: Blit 1. ,,tr `e4 /9g3 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. Cali Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecali,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 Suildin r +-amu jl . mpleted within 180 days of permit issuance. v� x C..)I r, n x Applicant's Printed Name Applic , nt's Signature Page 1 of 3 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(a-)cityofeagan.com r--------------------- I For Office Use I I (% / I I Building Permit #:� 0' lC I I I I I S&W Permit #: I 91. Permit Fee: 0 ' I I I I Date Received: I I I I I I Date Issued: I t- - - - - - - - - - - - - - - - - - - - - J RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3h I el 12 Site Address: Applicant is: ❑ Owner aContractor Unit #: 1 Name: �GC t/� -} 0 o,/ e— CS I '23 C-2 C ► Ct_41 6 l/\� Homeowner Address: H&S Ai R yqV-- AIR City: kaQ0. ,'I10V�v Lv� Stater 1/R: 512-Z Phone: Email: Description of work: P,Q- C� Type of 1 Work Construction Cost, 2 19 of building: ❑ Single Family ❑ Townhome, of units J4,Twin Home Compan L Thy /-, Contact: Building Address:/LlPWQST T City:tr;cCPy-, le Contractor State ftkip:.55.3�T`� Phone6tZ-J'/5 EmaiICVtke�C Ae,,1j(- -6 ^ems` Ui O Z Cp License #: D =�l �r�C Expiration Date: Sewer & Company: Contact: Water Contractor Address: City: Required for State: Zip: Phone: Email: new construction License #: Expiration Date: [_I l 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 L are trade secrets. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.orq 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. Applicant's Printed Name A licant's Signature