1983B Gold TrCITY OF, EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO •
Eagorn, MN 55122 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• r)
Ordinances. Misc. Charges. �`b 50
B ��6� Total
Y 7 ��� Date Paid
•
Date of Insp.: t � Insp.:
CITY 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•
Dote of Insp.: Total•
Insp.: Date Paid•
Use BLUE or BLACK Ink
City otEaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date: _1
For Office Use
Permit #: I H173
z
Permit Fee: G r
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION of $ r A- qp s
Site Address:
Name:
Address / City / Zip: 3 g 13 Gold. / 9
Applicant is: Owner >6 Contractor
19 $3 A—Q B
-EL Unit #:
fres, Gwer te-s. Phone: fog
Description of work: _ RP ., ' ( 'e'
Construction Cost:
kc(4uY\)
Multi -Family Building: (Yes / No )
companytiVAL.e. RiVt& CfrhilYIACII M Contact: FIVIA.A 1 1/`a
Address: � (5x, �ct A City: 2O Y)
State: M% Zip: S 5 _ 1 Lkti Phone: L71 • (OD-1
License #: C A cYb
Lead Certificate #:
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
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.gooherstateonecall.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 /44/1- / fihfr f'G
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
REGE
JUL 15 2020
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buildinginspections a(�cityofeagan.com
E For Office Use
Q2gtoto
Permit #:
Permit Fee: 1 a0 • % o
Date Received:
Staff:
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: % �r'2-0
Site Address: ( CS a Gail T-ra: Ea aft MN S4•122 Unit#: I Ett 3 a
J
Resident!.
Owner
Name: CO,r % I,4"r Phone: C012-'M0 • S4'11 0
Address / City / Zip: 1113 S G. a 14 ° m., i (, Pa 4,7 a r(, N1 Imo? , SS- t 2. 2
Applicant is: Owner X Contractor
Type of Work--
9-1414tt N w:Ametoe.ab :, ( Poor 4ti trmt'1+tnef evens„ S
Description of work: i 4
Construction Cost: Pi 703' Multi -Family Building: (Yes / No )
Contractor
Company: cry a tC +e r ? o r'3 Contact: Te blft, 2 4y 2, to F .F
Address: 5 I L4T rt d va.Sarri e, % Stre a 4- Stm. +c 1 City: li ^ p! Pia. N.
State: 6N Zip: SS3S9 Phone: "7to3 - 2.4GP • Email:) OhA Him[ belewt.-c iorS.Cati
3417z
License #: >3c-32.12.11 Lead Certificate #:
If the project is exempt from lead certification, please explain why:
In the last 12 months,
Yes No
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?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
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.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a buliding permit Issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
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.gooherstateonecall.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 approvedplanin the case of work which requires a review and approval of plans.
x Job*, tditiiFF-
Applicant's Printed Name
plicare