1928 Kyle Way
Use BLUE or BLACK Ink
For Office Use I
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i
y . Z`a r~' l Permit 11P
Clty of EaEd~ I Permit Fee:
3830 Pilot Knob Road t I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: fi
-
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L/ Site Address: Unit #
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Name: ([~F~ Lk 4"s'71 f ~Phone: Resident/ r S7` .
Owner Address / City l Zip:> t 2) G~ >fM
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Applicant is Owner Contractor
Description of work: V
Type of Work -
Construction Cost: 2 Multi-Family Building: (Yes / No ) I
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Company. Contact: 3~l r lr t i
Address-211>1)-514 ttitlIfA 5r, A) T' !"h 2City: Y Vil) /~c
Contractor ) I'
~pp
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p. Phone: 2 ,3 'y t
` State. Zi
?-6 2 2-Y 0
License 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
conciti(la that they are trade secret,
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.aotl
I heret~y ackno•rrled(le U )at this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eaga,,, that I kilid :rstanrl 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 tlu; 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 1,BA
days of permit issuance.
xe
-t - Applicant s Si mature' "
Applicant's Printed Name 9
Page 1 of 3
'Yell
1 For bWAce. Use
City o a Permit I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received; I
Phone: (651) 675-5675 j staff:
Fax: (651) 675-5694
200 RESIDE
NTIAL BUILDING PERMIT APPLICATION
/9,17 M37
Date: l Site Address: 11 r 11`~ f 24132r c'.• j' ItLk
rte.
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Tenant: Suite
I
RESIDENT / OWNER Name: Phone:
i
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of world' xey~
i,
Construction Cost: E Multi-Family Building: (Yes / No---)
/
CONTRACTOR Name: ~
L~1 Y>/! j~~Y/ 1'7C'~ License
Address: /~~GGYt7rt2z°!'t f z~? ~G~
City: J: ?e~/~.~5 State: //I12t'I Zip:
Phone: Contact Person: ~"'7r /W~~
•
COMPLETE THIS ARE, ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Core Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
submission type) m Energy Envelope Calculations Submitted
In the last 'l 2 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 sypporitin,gdocuments that you summit 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 : aee,trade secrets.
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
,ccordanc/Iewith the approved plan in the case of work which requires a review and approval of plans.
x v~
App icant's Printed Name Applicant's Signature
Page
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA125778
Date Issued:08/04/2014
Permit Category:ePermit
Site Address: 1928 Kyle Way
Lot:077 Block: 02 Addition: Cliff Lake Townhomes
PID:10-17790-02-077
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Troy Good
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Tricia Oberg
1928 Kyle Way
Eagan MN 55122
(651) 707-7291
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature