3780 Red Robin Lane
Use BLUE or BLACK Ink
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For Office Use I'
• I Permit #.-11 L/
C1ty of Eap Permit Fee:
3830 Pilot Knob Road I _L 1 _L
Eagan MN 55122 Date Received.
Phone: (651) 675-5675 Staff
Fax: (651) 675.5694 i I
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
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Date: - - Site Address:
~ I
Tenant: Suite
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RESIDENT J OWNER Name: Cjp Phone{--- -
Address ! City / Zip: _ ~C G l GO (ice?
Name. License
12850 Chestnut Blvd.
CONTRACTOR Address: - _e, City:
ShakopelOfT~55
s State: --------9~2 45480__ Phone:
Contact: i C 1 _X ~ Email: _
TYPE OF WORK New !X Replacement - Repair Rebuild - Modify Space Work in R_O.W.
Description of work:
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation RPZ PVB)
PERMIT TYPE Add Plumbing Fixtures Main / Lower Level)
Septic System
New _ Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharges
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecali.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans. Jn
(I X 'a
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Applicant's-Printed Marne Applica Y Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In -Air Test -Gas Test -Final
(o 0 3~ 2 3~ 8 (o ~ 'Rdla1 n
Use BLUE or BLACK Ink
For Office Use I
1 I
I ,
City of Eap 1 Permit
1 Permit Fee:
3830 Pilot Knob Road I ~a I
Eagan MN 55122 t Date Received:.
1 t
Phone: (651) 675-5675 t t
Fax: (651) 675-5694 1 Safi' -a
L---------------
-elo
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: iQ "-95-13 Site Address: ~J7"7a? 3-2Wo0 377$ 3 28o, 378a, 37$'u -Unit
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Name: Phone:
i
Resident/
Owner Address / City / Zip:
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Applicant is: Owner Contractor
Type of Work Description of work: cc, is • n4y
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Construction Cost: 5 1 od Multi-Family Building: (Yes t No )
€ ! Company: Contact: 1 "'0' C>R
i Address: City: 3, Inc-,)C
Contractor
State. f f Zip: ~5 3 `>S j Phone: 1116 ~1 - ' f Gy " 09ac)
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License 06L`¢ c1 Lead Certificate #
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
/ { - -Vc e,
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:
MOTE: Plans and supporting documents that you submit are considered to be public information Portions of
t 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.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protechon against underground utility damage. Gall 48 hours
before you intend to dig to receive locates of underground utilities
I hereby acknowledge that this information is complete and accwate. the work w.ll be n 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 ~c _ `•c c r- x 1 J?
Applicant's Printed Name Applicant's Signature
Page 9 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159403
Date Issued:12/16/2019
Permit Category:ePermit
Site Address: 3780 Red Robin Lane
Lot:4 Block: 17 Addition: Town View 1st
PID:10-77100-17-040
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 -
Roberta Johnston
3780 Red Robin Lane
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature