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1995 Gold Tr
CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Edgan, 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. Misc. Charges: - Total: B Date Paid: Date of Insp.: /1 ' /i- Insp.: — CITY OT 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 p.• — Total: Insp.— -- Date Paid: — Use BLUE or BLACK Ink r For Office Use S Permit City of Ea ~a~ I n~ Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Z~ Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: (r ~2 • tJ Site Address: P? l ! J l U (50LD 7~lL Unit t Name: I~ ~Srrll~ W~~-UO Phone: Resident/ l Owner Address /City /Zip: l9'9 3~-f9 2S 601-D 772.A-C9T (Z Z. Applicant is: Owner Contractor P-00F Type of Work ;Description of work: Construction Cost: Multi-Family Building: (Yes /No Company: f 10bST &-mke" hA.• Contact: IV frt Contractor Address: l Dl7 ~I~S WudD City: State: MF4 Zip:12do Phone: 12-Jqp, 0155 License fJ~l ©3 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: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of j the information may be classified as non-public if you provide specific reasons that would permit the City to I conclude that the 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 " 1\i mot Tkui&ov x ~ Applicant's Printed Name Applicant' ignature Page 1 of 3 Use BLUE or BLACK Ink r------_____�--__� I For Office Use � ClbOl �� �11 � Permit#: t_,�L�% C'� I Y � � � 3830 Pilot Knob Road I Permit Fee: �� �� � � I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 � I Fax: (651)675-5694 I � I Staff: � �—————————————————I 2015 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: Site Address: �G(�� ���--1� Y5�-1'��t- Tenant: Suite#: � z�� � c Name: Phone: Address/City/Zip: � . � �a,.�� ����� ��uj� �_'� �: Name: ��l�Ivl( �...� �.�%�Uhti ��� License#: ��tX7�.��� � �i','�� � _ �� Address:�0`L��(� C1l�Q U�- City: �����'-� � -o :r ' � 3 2�1t� �5�°� �� - � ���el���� State: M� Zip: �'�"��' Phone:��- . ��n ` r i ��� � an Contact: �I�Li� Email: ��°i c�.t;�,1U�''1O1Y1 �' � 1 . -w� �� ��� �.' . New �,Replacement Additional Alteration Demolition h�� _ ���� y = p; Description of work �� _ �:�=�-. .�=,�r :, .� - �. i - � � � . " i � �� �-� ���� Q '�'r� $ @��t�t11CA= $_ Et ��� -� ��-�:��.�� ��..-� � �� �.��:��.�- �- -�. ��n� �,�.. , �, �� � � RESIDENTIAL COMMERC/AL - ,.';�, � �/ �� x Furnace New Construction Interior Improvement _y ,. . , �,�� ° _ _Air Conditioner Install Piping Processed � r p� ��- _Air Exchanger Gas Exterior HVAC Unit �������� a, � £���:��� �,� � _Heat Pump _Under/Above ground Tank �Install/_Remove) � ��`����-� � � '� ����' Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIAL FEES Contract Value� x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee "If contract value is LESS than$10,010,Surcharge=$5.00 =� Surcharge* "*If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 **"If the project valuation is over$1 million, please call for Surcharge =� TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work ' be in conforman 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,an ork not to start w' out 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 lans. ; f X ��� ���1 G� X Applicant s Printed Name plicant' ' ture ,�„r. ,n. -.�._._ _.�� . _. z �- _ :� � . _f = . . .. F r��E,��L ,,. __._ � �.. _ _ . �. �equi e�t c� • : _..r_ . g � ����=11n �rgre���.� s �����h�r� Ai�.�s ?,�����. � �