4480B Clover Lane CITY G EAGAN WATER 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:
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 Dote Paid:
Dote of Insp.: / -
� _ Insp.:
Ciro bF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.: _—
P. O. Box 21199 DATE:
Eagan, MN 5512 i I
Zoning: No. of Units:
Owner: E —__ _
Address:
,-,
Site Address:
Plumber:
i agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp..
nsp. / ..n Total:
Insp.• ' + ` ('� Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:51 #582 P.071/079
Use BLUE or BLACK Ink
I For Office Use I
j Permittf: L4 4(d
j
City of Ea[i~ti 1 1
~ Permit Fee: 1
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j - Ott
Phone: (651) 675-5675
I I
Fax: (651) 675.5694 1 staff: I
1 I
`------.-----------J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: q 1b f 2013 Site ~Address: L1ygUl Lly~l,yLIk21 y4k2t3 UMY Lahti, -Unit
Name: CduI CID. bung Phone:
Resident/ l,~ I ~p
Owner. Address / City / Zip: (07M ft wet PAMWI V Vim'1,, 1 wou it, MW %Nq
Applicant is: Owner x Contractor
Type of Work Description of work: mar off and rC roof
Construction Cost 4ZDJL4qU •C0 Multi-Family Building: (Yes Y ! No
k Company: I{JUr I=Dh AIAUT ►r*I L Contact: VAt I IIAIS~ead
Address: 514 11111E1 AI s eT Oo City: Nir1
COltfaCtO' State: MO Zip: _ 55359 Phone: 96),J 941" - Oq i
License gC ~D31CJ15 Lead Certificate NAT- W% q -0
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 pro vide 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.Qooherstateonecall.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 within 180
days of permit issuance.
k
X_ JOE tW~ x c~
Applicant's Printed Name Ap(p`I cant's Signature
Page 1 of 3
From:ALLSTAR CONSTRUCTION 19529427464 10/2112015 12:27 #269 P.011 /020
Use�LUE or BLACK Ink
� For Office Use �
� i Permit#: `���"� j
�Ity of�a��Il ���EIVED ; _ `'� �
Permit Fee: v �
3830 Pilot Knob Road � I
Eagan MN 55122 �C� � � Z�� � Date Received: �
Phone:(651)675-5675 � �
Fax:(651)675-5694 I Staff: I
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2015 RESIE3ENT[AL �I��LD��G F�E�Ni1�° i4PPLiCi4TION
Date: Site Address: Unit�i:
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� ` rva�iie. �,t n��n, e r�v�o c.,..-+G.�c ( 7uo'1' F'hOne: /1///1
� Resident/ �
� Owner � Address/City/Zip: N`�F�'G�'�/'��%� �/.,��¢. f ��� �'�.�;,,�., �
Applicant is: Owner J� Contracior �
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� T e.Of W01'k � Description ofwork: c'•- �� t� ;,�: . ,�, �
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Construction Cost: �Z��G� Multi-Family Building�( �N
,
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. Yes o )
� Company:�I�S�l4s� Ct�r►S���L��G�"1 sT�lterr�Gi7l�itLG: Contact: y�k�°r 6Q���:.. ...� _„v-,�...�....� ,r�
g
� �� �
� Address:�'iys �n�u'51��+�`!- �+� /Q� �� n , °
� Contractor S� " �", c�cy: 11�1 R.�1�. P �,.. �
k Siate:�Zip: �s.s'-��` `� Phone: ��2"`�'y2=7�.5��Email: f�'►•t�c��t�,/S'�et f. b'Z- �
�
. �icense#: �C !c'9�� .�s�t� Lead Certificate#: d�/�T Z�J (�� Z. �
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� !f the project is exempt from lead certification, please exptain why: ��r L, ;,,,� P�B� �
� �
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COMPLETE THIS A,REA OIVLY 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:
�1 Licensed Plumber: �
Phone; �
�
� Mechanical Contractor: Phone: �
� Sewer 8 Water Contractor: Phone: � I
� �
� Fire Suppression Contractor: Phone: i
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NQTE:Plans and supporting documents that you submit are considered to be pubiic information. Portions of =
, the information may be classi�ed as noa-pubiic if you provide speci�c reasons that would permit the City to
k`p conclude thaf the are trade secrets. `
fi-�:�::rr,x_,..x..V.,.�-,...:w�vvr.as..+..,-�r..see__e.,-w�-.e-.a++.�,.+�.ac.,;vs:ne.r..w�:.�-.+�x-..x:.mz�.xxa.e»r_.�.x..•-:--- :,�maw�.:...vr.=.asaa..+as��+.��xsa.n...ax_-v,v �vemv..a�r.•xa.xo-�am,r-:....w�.-n-e:..:x,�-a.�wnor:a+`-+:r-exs.=�-v«,a..z�.r�r.•:.�-.sn�n:wc3
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.aoaherstateonecall.ora
I hereby acknowledge that Ihis 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 Minneso4a State Building Code must be cor�pleted within 180 '
days of permit issuance. ,.p..__......•........ e„�
�„-,-... .-
.�.i;�, .�//f�.�1 �r -y�t ..
X x
Applicant's Printed Name �„ Appiic nYs 5ignature �
Page 1 ot 3
ff
3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspectionsta7cityofeagan.com
------------I
For Office Use
I I
I Building Permit#:
I I
S&W Permit #:
I Permit Fee: I
I I
1
I Date Received: I
I I
I
I Date Issued:
I---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date:q,6Q23 .3h Site Address:
Applicant is: ❑ Owner Contractor
Unit #:
Name:�e—d�,� t�v-S ,lf't�Sc-:;,C'lG< i 6In
Homeowner Address: * 2 JA Ig Ui pa 0/? jey Z>^. City: �; `Ck L-
State) pl VI-Eip: ( /-L Phone: Email:
Description of work: P,e- Q t::,-
Type of 2
Work Construction Cost '7
Building
Contractor
Sewer &
Water
Contractor
Type of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan :;?QM // !S-V- �_ C�\lam Cvontact: ( -e_y-
Address: ��� 1� I & W QS - l 1F- y City:,(;-kY�
State:Wip: 553g_ Phone6tZ-�2l 5-
i -CQ� 3/ �/ hzi� c�
License #: � D Expiration Date: �
Company: Contact:
Address:
Required for State: Zip: Phone:
new construction
License #:
Email:
iration Date:
City:
1,�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
I 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.
>�Q V t-�� I�e`c �'+ x
Applicant's Printed Name A licant's Signature