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3878 Dolomite Dr'III` City of liaiall 3830 Pilot Knob Road Eagan MN 66122 Phone: (661) 6764675 Fax: (651) 6784684 Use BLUE or BLACK Ink For Otllos IJsa Pennitlk �� I C Permit Fee: � 05:3' r DateR.1.4: �� f Staff 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: q- 5 --/ Lf sit. Address: 3117 l>e4.0/4I / rE ReaidenU Owner Units: J Name: e% /le /y144 4 6L lac L a , .s: c., Phone: 763 • S-77, - 9'7 7 Address / City / Zip: PSO S s4 7 L, 2 4 v, A) , ,14 -,P1-6Se.s A.Aos r /JA) SS_ ¥L7 Applicant is: Owner ,CContractor Type. ouVliork, Contractor Description of work Q 4=P4 4 C Z /11O LT", P1, L. (.,)i.) Construction Cost . _ Multi -Family Building: (Yea / No _„„) Company: CIE I ex' r €.e/ 2 )Z.ifi N r. Co 2P. Contact bay, rJ 4.4 /t.d.i S Address: YDS. t.J loD/1' '. City: /77 State: /VAS Zip: Sr 4// 9 Phone: !o/ 1' S (o / -1 2 4/3 License x: 4.3 t 2 `// / 3 / Lead Certificate #. If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) I14.141,0S_ �,�1(`f' PosY JS7SI COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 menthe, has the City of Fagan Issued a permit for a similar plan bawd on a master plan? _Yes No If yes, date and address of master plan: Ucensed Plumber: Phone: Mechanical Contactor: Phone: Sewer & Water Contractor: Phi: 1407---—Pkiiis and CALL BFtFORE you DIG. Can Gopher Spats 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. murimooneretateonecaltong I hereby ac kno Ledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codas of the City of Engen s w1 tpiu approved this is not a permit but only an aDDaoatien fora tomtit and work is not to start without a permit: that the work wall be in plan In the cased wont much requires a review and approval of prens. days of pen,* issuance. Warier Woik authorirad by a building permit Issued In accordance with the Minnesota Stat. BulldirtgCode must be completed within 160 Nrl'✓/dN/ /S Applicant's Printed Name 8T/ZT 3JCd X Applicant's Signature Page 1 of 3 .LNICW lX3 I3S L9Z9T98Z19 9T:t,T bTOZ/TT/b0 City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA108009 Date Issued: 11/09/2012 Permit Category: ePermit Site Address: 3878 Dolomite Dr Lot: 32 Block: 01 Addition: Briar Hill 3rd PID: 10-14992-01-320 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Window World AKA Probuilt America 2211 11th Ave E, #130 N St. Paul MN 55109 (651) 770-5570 - Applicant - Owner: Scott C Miller 616 McFaddens Trl Eagan MN 55123 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. Applicant/Permitee: Signature Issued By: Signature 41'City atEke 3630 Pitot Knob Road Eagan MN 55122 Phone: (661) 675.6675 Fax: (651)676.5694 Use BLUE or BLACK Ink r For Qlhce dee Perm* 6 l CI()- Permit Fee: .. -1.-a5" Data Received: 1 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPucATION Date: • SIN Address: 3174,, 3 7'S, 3 eS.0, 81F,1j tZtooLork er i AQ. Unit ft: Name: c A C 7 not; ti) r4 rb 1 E a..r i -.710 C Phone: 7401 - .s'4 3 -19 7 7o Address / City I Zip: �St> a Z: t 4 7--u,2 ,�1.J N p 604E.-1 V+Ki *' Ar -SrilA Applicant is: Owner 2, Contractor Description of work: '7"£'A,2 OFF. e• O.E - QvoF Construction Cost 9 VO CTO Multi -Family Building: (Yes / No Company: E J /DRlb.a , R Contact tow 12•,F. r S Address: 90 s- 6DtiS? . state: / i -1 zip: .5rv/ 9 City: /'h PG 5 Phone: LD'z License #: .t y J 3 / Lead Certificate #: If the project Is exempt from Wad certification, please explain why: (see Page 3 for additional information) fit. 4.5 LE C- ,tr Pas; i,,r COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW UJLDING In the Fast 12 months, hes 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: tt et, i 77,.rL�rtii .�.t,�y at Tr Zwsc xw • aaJ� :. 7 R ! �2(r�Y :�S ✓� u d^•�(f'- ''N• �1 .. .�,. ...15♦ ...^iA,. .G� w 4:'• T��. .Int' hM.l L.� "�'.�.7�1�1,lrnn' CALL BEF E Y DJG Call Gopher Stats One Call at (651) 4640002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities. vnwr.00pherstateonmall.oro I hereby acknowledge that this information is complete and accurate; that the work vriil be in conformance with the ordinances and codes of the City of Eagan: understand this la not a permit. but only an application for a pemlit, and work is not to start without a permit that the work vrill be In approved plan In MG case orwork which requires a revlew and approval of plana. days Exterior work authorixad of permit Issuance. by a building permit issued in accordance with the Minnesota Stara Sultan Code must be completed within 180 x_ b oqv i 4__ _S Applicant's Pri_nted Name ZOIZO 39vd 1NIt1W 1X3 I3S x Applicant's Signature Page 1 of 3 L9Z9I98Zt9 OZ:ZT ETOZ/bT/tT