1707 Hickory Hill
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For Office Use
1 I _
+t, I Permit 5 ~ I
City of E
I e~
1 Permit Fee.
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: /
Phone: (651) 675-5675 I --T I
Fax: (651) 675-5694 i Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:/ - D ?~GiC~2 Il L~-
Tenant: 2 4IIz L-1 t/ /JWLTS1) n> Suite
RESIDENT/ OWNER Name: 51R LW Phone:
Address / City / Zip: fl 7 0 17 - 1T 1G 1c D/L (j 241 LL
Applicant is: Owner X1 Contractor 400F
TYPE OF WORK Description of work; T C+/l - OFF IL Construction Cost: S/ / Multi-Family Building: (Yes / No
CONTRACTOR Name: C f2 COP/ NCi License 9r1/•1/
Address:: ~ ~ (D / q - 014-! T-E /Cory- kc)A--~
City: A L) 1C rJS 0/ (_-L C State: Zip: ~~~3 /
Phone: 9 ~L / / % - 0 01UContact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(1i submission type) • Energy Envelope Calculations Submitted
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 they are trade secrets.
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 o plans.
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Applicant's Printed Name Applica is Sig atu
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use City 0~ EaRdD n Permit
' C l
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I '
Staff:
Fax: (651) 675-5694 L _________________I
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 2- ~7 1 Site Address: l~
Tenant: Suite
RESIDENT / OWNER Name: cJ ( V' ( i 7 TT~~~► Phone: 61S Y' VS /Y jd
Address / City / Zip: D -7 [7~? c kj~IL I'l
Name: R v License Le V A/t!2
CONTRACTOR Address: ) C,) / I Aee, City: ayjbt,
State: Zip: Phone: tPs(' 3 3 J
Contact: Email:
TYPE OF WORK -New replacement -Repair _Rebuild - Modify Space - Work in R.O.W.
Description of work:
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 $166.00 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.aoi)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 tart without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and app al of plans.
X c 1 h~l~ x
Applicant's Printed NanYe App ant's Signatur
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
VILLAGE OF EAGAN WATER SERVICElPPERMIT
PERMIT NO.: /15/74
37%S Pilpt,#nob Road
Eagan, MR 55122 DATE:
No. of Units:
Zoning: s ~ppg 7tt~ II
Owner:
Address:
Site Address: 05--OT Hickv Hill
Plumber: iR S m Plumbi CO-
Connection Charge
Meter No.:
Size: Account Deposit:
p~
Permit Fee: lO..QQ 0
Reader No.: 50 PC
1 agree to comply with the Village of Eagan Surcharge:
Misc. Charges:
Ordinances. Total:
Date Paid:
By
Insp.:
Date of Insp.:
VILLAGE OF EAGAN SEWER SERVICE PER MIT 23
3795, Pilat Kwob Road PERMIT NO.: 1 15
Eagan, MN 55122 DATE:
Zoning: pUD No. of Units:
New Horizon Hom s liood a►t B 11
Owner:.
Address:
Site Address: 1701-03-05-07 Hicko Hill
Plumber: Thompson Plumbing Co-
oe c
i ewe to comply with the Village of Eagan Connection Charge: l
Ordinances. Account Deposit:
10.00 Pd
Permit Fee: .50 pd
Surcharge:
Misc. Charges:
sy:
Date of Insp.: Total:
Date Paid;
Insp..
Use BLUE or BLACK Ink
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I For Office Use /// �
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3830 P,lot Knob Road
Eagan�IIN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: I
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2015 RESIDENTIAL BUILDING PERMIT APPLICATI�V
��.G�UrY , // 1��
Date: Site Address: �� l 7� �i � 7US- � 7�7 Unit#:
Name: Phone:
Ri:��dE:nt1�, :� �
���� � Address/City/Zip: �
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Applicant is: Owner Contractor
' Description of work: �''e�''��
�"3+P� Qf 1�0�'k
� ' Construction Cost: ��a�� Multi-Family Building: (Yes I/ /No� !�
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I Company: . � �-l'�` �Gn S�`�.tcf� o1" Contact: J�saM-$ ���r�°c II
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� � � Address� Z�o 2�3 1S� ��' Sf" ✓U�-�✓ City: Z•�^�'r"'-'2.�`"`�"'�.
�o��ra�ct��r �.
: State: /1/�/�iZip: SS?`� � Phone: 7(v3—Y77-Z�Email: ;��constr��f�a,. �.�zoo�,-r��z.��
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` -� � License#: �� 6 y 1 � 9 7 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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�ontractor: Phone:
Fire Suppression Contractor: Phone:
; �DT�:T'latas a��t�u�pa�r�d��cc���rts t�at;�otr;subt�.�#are,�vn���t�r�d t+�;be pub�ic 1��'orrri���an.�'vrt��x�of ''
tl�e`irr��o�ma�ac�t�r��y be cl�ssi-#'"�aal"as�on-.�t�b�i��f;y��r pro�r�crke specif��reaso�:�#wawJt�per�i��e;Crs`ty tr�
con���iaf�tha�tt��- are�r�ale:�e�,t�i'�. . '
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. uwuw.aopherstateonecall.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 Minnesota State Building Code must be completed within 180
days of permit issuance.
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Ap cant's Print�d Name licant's Signature
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