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3873 Dolomite Dr4/1"` CityofEaau 3830 Pilot Knob Road Eagan MN 66122 Phone: (651) 676.56676 Fax: (651) 675.6884 Uso BLUE or BLACK Ink For Orrice ilea Pemrit * Permit Fee: 10 Date Received: ti' Stab 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: i' 5--/L/ Site Address: 3 S' 7 3 1 L'si i TZ D2 . Unit It: Reosiident' Owner Type•ofWOrk, Contractor Name: e4 ,41 % %%%k.4 46L IK E Arr. ;.-1-74 cr Phone: 76 3 - S9 3 ,- 9 7 7 0 Address / City / Zip: 8So b c t 4-ru 2 AV, ,� ,t F 60t. b£*i Wou,cz r l>7.4) Sr la 7 Applicant is: Owner )(Contractor Description of work: Q t:PL C P. Ah L Y, Pi L Wia tar,�.�5 Construction Cost - Multi -Family Building: (Yes X / No Company: la f ee• Y £.e/ o 2 Mho a r, a�o 2A Contact Ns ✓, 4 Address: dos" L %08' ¢. state: /''IA1 ,zip: ss -v' q Licensed: t- VP/ / 3 J city: /y1 Pi S Phone: !o/ .L - e to f - Le Ve3 Lead Certificate #: If the project is exempt from lead cert ficatlon, please explain why: (see Page 3 for additional information) f�LL1(os- Q���r Poste /s7r 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 basad on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Z Want CALL_ B ORE you G. can Gopher Slits Ons tall at (651) 454-0002 for protection against underground unity damage. Cart 48 hours before you to dig to receive locates Of underground udpie5. yrww aophsTtat$ohecau.org I hereby acknowledge that this Information Is complete and accurate; that the vatic MI be in conformance with the ordinances and codes of the Cit af loan: that I undwatand this is not s pahyt, bvt only an sppfipayp, for a peamiit, and work is not to start without a p nnit that the work will be in a : odance with rhe approval plan in the case of worts which requires a review era approval of pat& Exterior work authorized days of � issuance. by a building permit issued In accordance with the Mlnrwtrom Stant Code must be canpeeed within 180 x 4 ✓ ' 0 2.42./ Appllcanre Printed Name ET/E0 B9Vd r.-ir--- AppllcsnCs SIgrwwre Page 1 of 3 1NIt7W lX3 I3S L9Z9T98Z19 9T:VI t'TOZ/TT/t'0 All' City ol8atau Date: 3830 Pilot Knob Road Eagan MN 56122 Phone: (651) 67545675 Fax: (651) 6764684 Use BLUE or BLACK Ink For Office rise Permit V Permit Fee: Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address• 38L9, 3 r71, 6 8 7 3, 3 75" ppl. o M' T' 2. Unit #: Reildetttl Owner Name: e4 46 `~ /1'1».3 4 6 t Nt E N ..•� •�: C. , Phone: 76 3-S-71— 97743 � Address / City / zip: :SO Q C Ce4 ry 2 Av, j , 1 A aoaD £.s 14 L _y 7 Applicant is: Owner ,Contractor Type oMork, Contractor Deacription of work: { i o ' €- aw RE PS. 6/ J 6 a P.4'4 Al z 7-4 I. - Construction Cost / 9,00o• CIL_ Multi -Family Building: (Yes / No Company: a £ I £,r r a 2 /%7ih.JT . Cv cep Contact: DA ✓ r 9 a�2ai S Address: 5/0 �' W (a 1 /1- J7 - State: /''? SS'y// City MPLS Phone: lo/z- S'6/-1. 2y'3 License#: '4 C- 4' / 3 / Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional inf enation) FLSIvS- g�Il'r PoS:' JS7r COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit fora 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: NOM; �y'` �� •,iiiowsedio tftaistonit CALL BFrPORE YOU 019, Cat Gopher State Ono Catl of (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoaherstateontacaLtpt I hereby acknowledge that this Intonnation Is complete and aoxtrate; that the work will be corifomtance with the ordinances and coda of dhe City of Bacon: tat I undeatand this is nota permit. but only en application for a pent, and work is not to start without a permit: that Mie wont WII$ be in accordance with the approved plan in the case or work which requires a review and approval of plane. Exterior work authorized by a building permit issued In accordance with the Minnesota Stam Build nflCode must be completed v/811111180 days of permit issuance. xI ',2...Q_' Applicant's Printed Name ZO/Z0 3Jbd Applicant's Signature Page 1of3 1NIVW 1X3 ISS L9Z9t98Z19 LO:ZZ bTOZ/9Z/Z0 CllyofEagall 3830 Pilot Knob Road Eagan MN 36122 Phone: (661) 676-6675 Fax: (661) 675-6684 Use BLUE or BLACK Ink For Office Use 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: • I— S — /I/ Site Address: 384 y, 3 7 '7 /, 3V73, 3 87? Qo La 141r rE A iL . Unit #: Name: -J 1@r, , Address / City / Zip: VS—c. C. a r4 ry Q Air rt.) 'a` Z A oL E•.J L4KL£lr' -sr4.th Applicant is: Owner ,K Contractor Description of work: 7— EA -2 0%1-1 a• I2 E - Paor- , Cost 13 7 o'O- Cr° Multi -Family Building: (Yes � / No ) Company. 41E I Sic 'r'c a'ode 0/47.417. emeP Contact J Avrd fld� RR S Address: 4/0 s tt.) 6 , City: _ m PG $ . State: /X1oci Zip: Sri,✓ 5' Phone: !o'Z r6/^ 6 z ya License ft. 4 C z N 1/ 3/ Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for addition& information) tos Eta L. 14arLr Pos; 197 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 _Io If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor. Phone: Phone: Sewer & Water Contractor: CALL BEFORE YpU DI(. CaU 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. 1yww.000heratateonerall.orq I hereby acknowedge 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 1s not a permit, but only an application for a permit, and work is not to start without a permit; that the work %dU be In accordance with the approve° plan In the one of %writ which requires 8 review and approval of plans. Exterior work authorized by a building permit Issued In accordance with the Minnesota State Buflth Code must be completed within 180 days of permit isauance. x btiivra Qui RAlS Applicants Printed Name 80/TO 39Vd 1NIt7W 1X3 I3fi x Applicant's Signature Page 1 of 3 L9Z9T98Z19 LO:OT tTOZ/80/I0 City of Eagan PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA130414 Date Issued: 04/23/2015 Permit Category: ePermit Site Address: 3873 Dolomite Dr Lot: 15 Block: 01 Addition: Briar Hill 3rd PID: 10-14992-01-150 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Applicant: Andrea Preusse 4145 Sibley Memorial Hwy Fee Summary: ME - Permit Fee (Replacements) $55.00 Surcharge -Fixed $5.00 0801.4088 9001.2195 Total: $60.00 Contractor: Wenzel Heating & Air Conditioning 4145 Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 - Applicant - Owner: Gerald R Rogers 3873 Dolomite Dr Eagan MN 55122 (651) 454-4824 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 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA172313 Date Issued:09/24/2021 Permit Category:ePermit Site Address: 3873 Dolomite Dr Lot:15 Block: 01 Addition: Briar Hill 3rd PID:10-14992-01-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Invilla Llc Po Box 2066 Burnsville MN 55337 (952) 217-2766 All Ways Plumbing 14667 Chestnut Rd Milaca MN 56353 (763) 286-8328 Applicant/Permitee: Signature Issued By: Signature