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1844 Cliff Lake Ct / r/ Use BLUE or BLACK Ink I For Office Use 1 ~~lVl Permit (fl). ob City of Ealan I Permit Fee: 1 CT162013 1 3830 Pilot Knob Road 0 1 Date Rec ived: Eagan MN 55122 ~I Phone: (651) 675-5675 I staff. Fax: (651) 675-5694 L---------------- - 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date:, I - Sfte Address: ~r l fi`t' ~~A Tenant. Sl~~`~ ra- Suite Name: L C~~ 1'L Y A ago Phone: ~(a~ 1(S r?L l Resident/Owner Address /City /Zip' 1 ~n -1 Name: WALL r License ~4~vt'~1 1 w~ ( Contractor Address: 3(4Y0 `m G bY. city: B( A W n r ~ State: Zip: C ~)1 (1 Phone: 1 5 ~,Q Q (o Contact- ~11l~1~ ~Y ) 13 Email: s Type of -Work - New Replacement _ Repair _ Rebuild - Modify Space Work in R.O.W. Description of work: L 6 W 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 Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 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 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 aopherstateoriecall.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 pla x~\~`Me X Applicant's Printed Name Applican s Signature FOR OFFICE USE Reviewed By: Date: Required inspections: Under Ground Rough-ln -Air Test ,-Gas Test -Final Oct 07 2014 0824AM HP Fax page 7 Use BLUE or BLACK fnk � For Office Use r I C�t O j Permit# I� ��� � Ly f�a�a� ; � ; � Perm�t Fee� � ` I 3830 Pllot Knob Road Ea an MN 55122 � 9 Date Received: � PhonQ:(651)675-5675 � Fex:(651) 675-5694 Staff: I I _�������^�������J 2014 RESIDENTI14L BUILDING PERMIT APP�ICATION '• .P s' ^ �+ . �� Date: �"��� a Site Address; �� ��' i �� f��'l 1,�Yv � � ��� � — unn ai' Name: ��.��='��", ��/=. ,�r'�:� �`;, L,, �„- Phone: ResidenU Owner Address I City I Zip:_' �h?yr�v- Applicant is: Owner �f Contraclor Type of Wcrk Description of work � ��• ��...- �� � • �' •�"�a. / 1 •�; Construction Cost: �7 �Z��Y . � Mulii-Family Building: (Yes G°�No� . r �; o � Company• ��. . ,.' f =:���✓�+ r ``'�1'� , , Contact: �r'.��`9'`�-,t.''�.-�--�--.. ������/ Contractor Address:���':.� '1.7;��l3��•.=e'; Fr��'" �'����>�:i�' � City: ��''��%��`c.-�.��� � State!°`�`�°�'� Zip: �°`5�`�,� Phone: � ���' '?,��� ���Email.���c,c;',_.��r.��*er'���^'si�C�'.��:��•�.�r•+. ---,— � �, License fiE: ,a�%~1��'� �'�,.� Lead Certificate#: .��''���"°�w%°"?.�� " � If the project is exempt from lead certificatlon, 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 Eegan Issued a permit for a aimila�plan based on a master plan? _Yes _No If yes: da4e and address of master plan: Licensed Plumber: Phone: Meehanlcal Contractor: Phone: � Sewer&Water Contractor: Phone: NOTE:Plans and supporting documents that you subm/t a�e considered to be pu6llc Information. Port�ons of the Informatlon may be c/assffied as non public if you provlde specitic raasar►s that wouid permit fhe Clty to 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. Cali 48 hours before you intend to dig to receive iocates of underground utilities. www. o herstateonecall or I hereby acknowledge that this information is complete and accuraie;that the wo�c 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 perrtiit, and woric is not to slart 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. Exterlor ��hortzed by a bullding permlt issued in accordance wlth ihe Minnesota State Bullding Code must e completed wlihln 180 da pe�m�t+7ssuance. -�•---�:,�,:....: �, X_ ��a���rF�-"�--- �""'`� j '.�..„�. .x .--"°�.i�-7.�,,.-_. ��-•.,'`� ---•.__„ Appllcant's Printed Neme ApplicanYs Slgneture j Page t ot 3 Use BLUE or BLACK Ink r————————————————� I For Office Use � ' � Permit#: �� j Clt� 0� ����Il ' ��,'��� ' � Permit Fee: � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Fax: (651)675-5694 I Staff: I � I 2015 RESIDENTIAL BUILDING PERMIT APPLICATI�� ��.�z� Date: �� ��/�S� Site Address: � "��� �/��� ��G �o� `" )� Unit#: ��, �.� .. ; Name:�.. , C�I�YY�, . ... ����i{.��,,..�j�Gc/�,.�w.w�.r�4_.._. �.�_�.......�.,�.�.m,_Phone:�.�,.��.<.�...�,..�.��,.,.�,e._,...�.,..._._s _ .. � � R�S�tl�r�fi1 ` s � Q�y�Er � Address/City/Zip: ��"�'' � � � a • � � Apphcant is. Owner Contractor � - ,,.�..�.�.,�..��.�,,..��,,�.�„_ .�.�_ „�,..���, ���,.,m�_.,.�......_.� „�.x.:,...,..�.�..�....�,....,.�.._,..�...��, � � ����� � Descriptionofwork: ��✓�� �^r� � Ty�e 0�'lill�ri� � � � Construction Cos#: Multi-Family Building: (Yes /No_) � ¢�., � �x�...m.�...,�.._�.,�,.����,�.,.�,....�..,�..,�.,...�...,.,...�.,�..�.�.,�.�,�.,N�,.�.. �...�m._,�._�„�..�.��.,��.,i � .,.�.�.�-�--- �..�.��_��.,..u� � ( Company:�tNf�� (�-{?�� ��G��1� �h�, Contact: �f �Ut r�� , a � . . j �! l//" N SI.tl7G ��� ���� � � � � Address: ��� Vl�G���'� �sI City: � Cot�#ra�t��r � ,, ,y ; State:�Zip: �Sy�� Phone: `7U3-S,S�.Un'�1 Email: ��� � �ov�.19�in.o+-�f�yY�"�vf_ � � � � � � License# �G `��� ��� Lead Certificate# �o�,.�,��,x .�,...�..�.,.�.��a�...�. ,,�,,.,�,.,.�.. .., ,.,.�W..,w�.��.�,.��.�.w �N�.._....,,.�.�p,.wm..��.A��.,w.�_ ,�N��.�.a.� �ou�,�L,.�,.�..�,.�� ..�,.��.�,..�.�..�.....��,..�..�.�..�.a � If the project is exempt from lead certification, please explain why: ....�,.,�... ..,�.�m..,�....v�.��,...��._.��.�. .,_,..ry..._._�..�,..�_�.,.�, a._,�x...�..�,�.a,.�.,�.,..�,,,.,..�..�,�..w..e.��_�...�...a._....�.,.__.�.�..�.�.,��,....,.._.._.�..�.,,� 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 lf yes,date and address of master plan: � i � z Licensed Plumber: Phone: � Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor• Phone. � IV�JT�':l��a�s.a��tr�vo���g dor�t�€���t�at,�ow s����e co��t`t�l�red to be paa�����'��, I�c��'r�of � ; t��►��orr�a�� r�a��ie Gl�ss��'ed�nQn p�a6��%�yot�pro�e s�er�r�ea��►�s t�at w�t�per��"t��Cf�to � ��.,�. cor��Jude t�ia�t�s are t�a�s�r�. � .��...w; CALL BEFORE YOU DIG. Cali 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.qopherstateonecall.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 perrnit, and work is not to start without a permit; that the work will be in accordance with the approved p�an 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 S t Building Code must be completed within 180 days of permit issuance. `�� X �u�f� �y`'��,��°'-�"� X b Applicant's Printed Name Appli s Sign ture Page 1 of 3