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1106 Kirkwood Dr Use BLUE or BLACK Ink F----------------- I For Office `Use( ~j I ` j Permit City ofEa Ina Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I - - - - - - - - - 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: 64'0'0~ 1 MIl's s Phone: 47 336 -60'5-8 tClc Resident/ y 04 Owner Address/ City/ Zip: 11 4- /0 O K) if`k W-,qad Applicant is: Owner Contractor Type of Work Description of work: W Construction Cost: 1 3 ©2o . Multi-Family Building: (Yesx_ / No ) Company: 4Wl,(5J.AUC44bA Contact: z Contractor Address: 7:71 3 _-t~ Z City: r-a/2/10A Ft/ts State: MA) Zip: S6_005 (o I L z - / T T License .7-34 1 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 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 protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gor)herstateonecall.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 Minnes a Building Code must be completed within 180 days of permit issuance. *J~ x VJ -S . LAr f x Applicant's Printed Name Applicant's Signature Page 1 of 3 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: � g//0 Permit Fee: /05 Date Received Staff: 3IP-OS- 2014 / /c 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Resident/ Owner pp Name: Phone: ihiL, 3/ Address / City / Zip: Hot? n i? J,,1)i-v,• Applicant is: Owner Contractor Type of Work Description of work: io 11 a,, 1:(.4)24 9•00 Construction Cost: ?'SO . Multi -Family Building: (Yes K / No ) Contractor 6u� Company:CContact: r `ii Address: el 7- I 31 - - 24)r- City: (1_15fln0n f:11(C J State: Zip: �6.-001 Phone: 611 722.- 1 'V- License #: aC-2-6 3-31 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, _Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they 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.gooherstateonecall.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 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 nne •ta State Building Code must be compled within 180 day(s o it issuance. L Applicant's Printed Name Applicant's Signature 1 Page 1 of 3