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3766 Golden Hill Ter
VILLAGE 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: I agree to comply with the Village of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: `� Date of Insp.: Insp.: VILLAGE OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the Village of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By: Misc. Charges: Date of Insp.• Total: Insp.• Date Paid: 3 bb, 31 to a, 37 c~ 4, 3 b co 3~ f~ $ l 3~~ a (210 d6 QM Wlkk -T-OX Use BLUE or BLACK Ink Far Office Use l I I g 353 ' Permit#: City of Ea~UR l Permit Fee: 1 3830 Pilot Knob Road t Date Received: d sq I Eagan MN 55122 Phone: (651) 675-5675 I Fax: (651) 675-5694 1fi 1 I L tW 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 6;6tdN TCrrQiG~ Date: ko r_Z`l" 13 Site Address: 3760 7 37U°~ 7GrG 37Vg 37>O UnitM Name: Phone: Resident/ t i Owner Address / City / Zip; f Applicant is: Owner Contractor Description of work: ® Type of Work ° Multi-Family Building: (Yes / No Construction Cost: 71 5 1. Q ©O Company: 't- ~tcltvt~r¢c.4J ~~R ns~Vcriv^•- --Contact: t &0 City: (r + + ~ i+ne lka~,l~m- E Address: Contractor i State: 01 A) zip: ~3`43 Phone: I # License f#:L Lead Certificate !MT' If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) S - ~ . t_cJ A- - /A w-4 ~Je- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issueda 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.^Pottions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. r _ 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. 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 Cade must be completed within 180 days of permit issuance. Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA169584 Date Issued:06/02/2021 Permit Category:ePermit Site Address: 3766 Golden Hill Ter Lot:4 Block: 08 Addition: Town View 1st PID:10-77100-08-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Joel E Anderson 3766 Golden Hills Ter Eagan MN 55122 Champion Window Company Of Mpls 5100 HWY 169 N, #B New Hope MN 55428 (763) 574-2054 Applicant/Permitee: Signature Issued By: Signature