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 '
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I I
Date Received: I
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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