4492B Clover Lane CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: —_
Eagan, MN 55122 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. 'V Misc. Charges:
Total:
By i. Date Paid:
Date of Insp.: 1 q Insp.:
C4TY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.•
Eagan, MN 55122 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:
Surcharge:
By Misc. Charges: -
Date of Ins _ — Total:
P•:
Insp.:— —
Date Paid:
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:52 #582 P.074/079
Use BLUE or BLACK Ink
I For Office Use I
j Permit City of Eap I Permit Fee: - 5 C,
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received: n (13
j
Phone: (651)675.5675 I I
Fax: (651) 675-5694 I Staff: I
I 1
Q 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1- - 1:3 Site Address: ~~}`1'1O ~y O 4 Z -Iy~ Z eti bane Unit
Name: W*J ►M 010 1 GQftll CWUV1N Phone:
Resident/ 'n Q I/►~p~
Owner Address / City / Zip: W~3 G11 vt V 1Wi pafgy I l~1JltJ1 , ~n~. MN 553'-H
Applicant is: Owner ^ Contractor
Type of Work Description of work: Tear off avid Ye'Vik
Construction Cost: $20 Z 1 tp Multi-Family Building: (Yes x ! No
Company: MAT 11YL=mi Wnaait ttt, I-Lt Contact: Jue ftlistow
Contractor Address: 5Iy5 I11twftal ,1 `tA -0103 City: Mo fti n
State: ► Zip: GY7YO ) Phone: 'I J - IIH -IL4I'7L
License L7~, ~3~'✓1Gj Lead Certificate Nr I T- ~VI 1p~t
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
~m~_ _ 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.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.
x clueitl~teAd x
Applicant's Pri ted Name Appl'c is Signature
kJ Page 1 of 3
From:ALLSTAR CONSTRUCTION 19529427464 10/21/2015 12:33 #269 P.019/020
Use BLE1E or BLACK Ink
� For Office Use ` �
� j Permit#: � �� �"`''" j
C1ty of���a� ECEIVED ; � �� �
R � Permit Fee: f �
3830 Pilot Knob Road c �
Eagan MN 55122 OC� 1 � Z��J � Oate Received: �
Phone:(654)675-5675 � �
Fax:(651)675-5694 I Staff: �
i ►
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2015 R�������CE`4L ��1�LDi[�!G PE�IVf[�`a4P�L1CATtQI�
Date: Site Address: Unit#:
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� � Name: L�n��✓�: 1��31t� -' �'�..t - ` �';
I"1c�� Phone: /1/�� I
[ Resident/
� Owner � Address�City/Zip: LI'�9���W�2- C��,,�� f ,�,��, �'i�-��,,.,
:
:
A licant is
pp : Owner � Contractor ` I
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` Descriptionofwork: ��•- '�f�� �,�/o'�� I�;.�E'�r� �Ll'.n(` •��R �
' Type of VUork
` Construction Cost: �Z�,�`�U'� Multi-Family Building:(Yes �No
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� P Y�� A/t- 1� .��f/�d�•'� Gi7Lq h�L� Contact: _` ,r*,
� � Address:S'��5 �n1�u15'l�'�,�L 5�' - Su�e��- IG� r �
� Contractor . - �'�Y� ��� 1���"� �
State:�Zip: �s��`3 Phone: ��``j✓2�7�5"�Email: i�'1't��ci 1�S'�z�P", b'�- �
�icense#: .�C lr9�'� ���G► Lead Certificate#: /�/�►• ��� � Z—
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If the project is exempi from lead certification, please explain why: ,��`�, ;,,�p ���3 �
�
:
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f
COIViPLETE THIS AREi4 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 8�Water Contractor Phone: �
�
�Fire Suppression Contractor: Phone•
.�..,..�..� , n:.�.,.r... _ r.:,....,r w. �..�a�,.�.� ,ry.,:,._...M..� .. ...�..�.,.� '
� NOTE:Plans and supporfing documenfs that you submit are considered to be public information.RPortions of
;
� the information may be c/assified as non-publlc if you provide speci�c reasons that wou/d permif the City to � ;
conc/ude that they are trade secrets.
�
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CALL BEFORE YOU DIG. Call Gophe�State One Call at(651)45A-0002 for protection against underground utility damage. Call 48 hours �
before you intend to dig to receive locaies oi underground utilities. www.aooherstateonecall.oro
I hereby acknowledge that this information is complete and ac�u�ate;that the work will be in confortnance wilh the ordinances and codes of the City of
Eagan; that I understand this is noi a permit, but only an application for a permit, and work is not to start withoui a permit; that the work wiil 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 co pleted within 180
days of permit issuance. rt _ .. �,�-�^�
;
x �'�. �//�.�,� X �� �
Applica�t's Printed Name �.�, Applic nt's Signature �
Page 9 oi 3
F"
GL M 4I 9
� 1
1 I
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections@cityofeagan.com
-----------
For Office Use I
t�tiO4b
I Building Permit #: I
I I
j S&W Permit #:
I
Permit Fee:
I I
I i
Date Received: I
I
I I
I Date Issued: I
I---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �hqhQ23&te Address: -
Applicant is: ❑ Owner aContractor
nit #:
IName: ��L � 14 b vy,e- O L U--c_,v'S fa!5 (b aI a4 k b l/-N,
Homeowner Address:4q*) 14/13 qy q a ,41 B Clguev Lv-, city:,o`ct a
State:/ Vl V"-EiD: !D___� (.1- L Phone: Email:
Description of work: Pik QC. t -
Type of I 2 / f
Work Construction Cos t;J '7
of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan)T?Q�f71/l�%h c.LL o\A Contact:`r e f 1`C
Building Address:! L/39 ii .tl WeSi" + K— y City:e,
Contractor `� /
State)-Wip: 5.3�T Phone>�rZ�y5- Emailt_�/UIQ�C �e�/�
K2L6q� bzt�coxpir3/31 /�y2S
License #: EationDate: ,
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
i License #: Expiration Date:
?�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.
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. /J
Applicant's Printed Name A licant's Signature