1778 Bluestone Dr E. . . . ? .'N ?.
. . . ?ITY O! r EAGAN . . .
3795 Piot Kerob R+oad Eagain, MN 55122 It - ??
PH": 454-8100 BUILDING PERNAtT ReceiQt
To beused for ? PAtiODe?Ck Est. Vclue 18(3n•o(1 dqft 2,,I?0j 8(}
j
.¦
??w...ile?o.? ?r ;
i
Site Address 177$ E. 31Ueo-vC?rie Erect ,
.
?,
C>ccuparscy
Lot ir Block 9 Sec/sub. ''?'dar Grove z`7 Alter p Zaning 21.
Parcel # RepAir ? Fire Zane ZTI.
Enlarge t7 Type of Canffit.
W Name r'eT'8.1.c3 SCh7qi'?Z Move Q # St+ories II?
,
3 Address 'am Demolish ? Front ,ma ft. '
` o
Ci ';8gwn, ?- Phone 425-4560
Grode
p
t?
epth
? Nome P&t3.o Vi113'r7e /tppmrata Ir?us= . 5
?O
o Address?l , v",(eS'? /-?c? ,.c'itZ'eet
?i
Assessm?nt
.
?'+amiit,
? ug
..L.1I18 :.
926-217171 - Woter & Sew.
Pltione
Cit Police Plan tMock Ti9
E W Plame Fire SAC 2'1£t
?z
Address
Eng.
Water Cem, • 11$ .?
¢'Z " Cit Phone Plunrter 1A?? ?
Councit
I hereby acknowiedge that 1 have read this opplicatic>n o state that ' gld9. Off. 23..9180
the information is.correct and ugree to comply' o icable
APC
fic#+a1
i ?i
State of Minnescrta 5totutes a++•+ ±.;-f?FUgSin s
' l?J . .. ' . .i
Signature of Permittee
T'a tio Village
A Building Permit is issued to:
' tsn 1'ke e
all wark shall be done in rsceordcrnce witM all appliq;;bte: 5tote of Minnesota SYCttfts Ord oty af 6Var?"i?
B
ildi
Offi
i
i
u
ng
c
o 5
I _. .. . 0. , . ti.. . . .s?..,??v.? "
r.mit # oaft holed ?«mmo»
Plumbing
Mechonicol
INSPECTIONS D^TE INSP.
licsupM-In
Firns1
Footings . Q Date InsP. Date hv4x
Found4tion P1umb€rtg
Frame/ins. - Mechonicai
Final
Remarks:
?
?.757 .7-77--
Crr( #F EAGAN
8745 Pidat Kuab Reard Eugan, iM{14 SIM$ ? 54" ?
PHOWt 484-8100 ; Bun.crNG"' Recetpf 2&
?.st? W?.
To be used it?r 9 S C? ., ? Est. Vatue $00• Dgte 11"-28 19 7$
Acf
Site ress ?. ?i E. T3?.L?E? ?i?e I?]C. •?
??
Erect ? ?
Qccuponey
Lot
Block Sec Sub. Alter ? rZoning
' Parcel # I-? 16600 ?0{? ?J?
? Repair ' ? Fire ZEx?e
,
:'1?? a?C?'tfiL'?
Enlor9e ?
TyPe of Const. `
.
; W ?? '' Move ? # Stories
Z _771 F`. ?.t1E` Stcm- ?'.
3 AddreSS
Derrrolisfi ?
Front ft.
? p C' . ? Phone . 5 " r Grade [] Death ft. ?
? Name a C7 VLUacje App*orols ?rt
o' Address ` co TI, ?? 17i ;{"t• Assessment Peranit ' '
-
Ci Phone 92?Z??'. Water & Sew. Surdarge?
? Police Pion choek
,
W Nome . Fire SAC
?? Address Er?. Watar Conn.
d' Ci Rhone
z"
Planner
Watsr Mster
Council
I hereby ncknowledge thot I hcaVe rejsd this application and sfote that 61dg. Off. 6
50
the information is c rect ahd a e to comply with o11 applicable .
State of Minnesota S ...ef :Eagan rdinances. . PC Totai
'
Signature of Permitt"' '
?
A Buildin Permit is issued
??' ?9 on the expme corndiCiort that
oll work sholl be done in oecordance wiZ41 _04 a i?bl?state of Minnesota Stcttsit?es e?+d City af Eag?on ?e?s.
? ?
Building Offitial
;
?
__. _ . .. , _....?..,._.._ , .. ,..;a?
P+esnsit # p+N !mai PaMifT"
Plumbing
Mechonecal
iNSPECTIONS DATE INSP• RuugR-in Riexal
Footings Dcte ,
Insp. Dafie Ir"P. -
Foundatior+ p{umbirg
Frame/ins. Mectuaniovl
Final f
Remorks:
CITY OF EAGAN Remarks
Addition CEDAR GR.?VE #7 Lot 10 Bik 9 Parcel Il 00 100 09
Owner6??iV1? a. A"dyts' L. S'+?+?Street 1778 E. BlueStone Drive StateBWA?1, rIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 5;` 197 ?"j8. 8 2.08 2 Paid
• SEWER LATERAL 1971 20
WATERMAIN
• WATER LATERAL
WATER AREA
yt STORM SEW TRK 97
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 260.00 3396 4-6-7
BUfLDING PER.
SAC 200.00 4-6-71
PARK
CITY OF EAGAN
3795 Pilot Knob Rood Eagun, MN 55122 N2 5615
? PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt #
'ro be used for Patio Deck Est. Value 1$00.00 Date 2/20/ , tq 80
Site Address 177$ E. Bluestone Erect [1? Occupancy R3
Lot 10 Block 9 Sec/Sub. Cedar Grove #7 Aiter ? Zoning Ri
Parce1 # Repoir ? Fire Zone TTT
Enlarge ? Type of Const. v
W Name Gerald Schmitz ?Ve p # Stories Ila
3 Address Same Demolish ? Front na ft.
? Ci Eagan' MN Phone 425-4560 Grade ? Depth na ft.
p Name Patio Village APP.ovals Fees
?? Address`?91gaWest Li.9Z Street _
~ Ci Phone
Name
Address
I hereby ocknowledge that I have read this appiication an state that
the informotion is correct ond a ee to comply a licable
State of Minnesota Statut s a og di es ,
Signcture of Permittee . ?
Assessment
Water & Sew.
Police
Fire
Eng.
Pfanner
Councii
BIdg.Off. 2 1 80
APC
Permit 7. vv
SurcFwrge 1.00
Plan check na
SAC na
Wcter Conn. ria
Water Meter ria
Total 10 . 00
A Building Permit is issued to; Patio Vllla 2 on the express condition that
all work sholl be done in acwrdonceJwith ull app' le State of Minnesota Statutes and Ciry of Eagan Ordinances.
Building Official
CITY OF EAGAN Include 2 sEts of plans,
M ~ - 1 site plan w/elevations &
BUILDING PERfviIT APPLICATION l set of energy calculations.
Zb Be Used For Valuation Date t???'? r
Site Address 3 F s L
Lot Bloak ? Sec. /Sub.
Parcel #:
Owner :
Address :
T
City/Zip Code • ?WG 1qj
Phone # :
Contractor: 3'/Wo
Address: 737(r?,?
City/Zip Code:
Phone # : - 2 7 7 (
Arc11./Eng. .
Address:
City/Zip Code:
Phone #:
/ OFFICE USE ONLY
Erect 'v occupancy
Alter Zoning
Repair Fire Zone
Enlarge Type of Const.
Nbve # Stories h_..
Den?olish Front n ft.
Grade Depth hook ft.
APPROVAIS FEES
_ ---
Assessmexits Permit
Taater/Sewer . Sureharge )
Police Plari Check
Fire SAC
Eng. Water Conn. -y?
Planner Water Meter ,i/a'!
Council Road Unit A/A
Bldg. Off:1,! -4'
APC
TOTAL
.
?. ?
TOGJN OF EAGAN
3795 Pilot I:nob P.oad
St. Paul, Minn. 55111
PERMIT Pdd, lfll
The Board of Supervisors hereby grants toCltdar Grrottt Cvnsttuctioa
ca- o? ?anco,.d BW E. o.:th St_ Pgy. 55073 a
PL iNC Perma.t for: (Owner) :s at
1778 E. B?uatat0ne, 1835 and 1847 Rarcenita Tzail,
1787 E. glu"tots, 1795 CarntliAtA and , pursuant to application dated
1856 TaconiLs Trsil. J0-0; 16-1, 13-1, 19-8, 19-9„ an+d 2•2 oi CG #7
A&=11 -1----1-271
Fee Paid: 120,00 Dated this ??tIL,,.day of Uril , 197_L.
Building Inspector
c'• !s, .
.W
;
TOGJN OF EAGAN
3795 Pilot Kiiob Road
5t. Paul, Minn. 55111
PEPMIT N0. 96
The Board of Supervisors hereby grants to C4dar ftaye CMtrnctit>n
_._l;o. of a
?gg,aXM I'ermit for: (bwner) Ong at
1778 L. Bluastoas, 1835 aad 1847 Tacsnite Traii,
1287 E. Blueatone&„ 1795 Qj;g1,jjkn jUNL_, pursuant to applicaCion dated
1$56 TiCOAite 'C'rJllil• 10-9. 16??t 13•1t 14?8# 19-9# #1Qd 2•2 of CG #7
April l,_i271
Fee Paid; $12000 Dated this 6th day of A,p,r11 , 197_?.
Building Inspector
-J
,,..,.
.
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122
PHON6: 454-8100
BUILDING PERMIT APPLICATION
Re lace existing wind?
To be used forW S11C?].ri? C7.OOY' Est. olue $00.
Site Address 1778 E. BlU2 St:Ori2 DT.
Lot 10 Block 9 Sec/Sub. OG 7
Parcel # 11 16600 100 09
cc Name Blll SC17Ti1.1tZ
z Address 1778 E. Biue Stone Dr.
o ,,,- Eagan 452-7534
lm Neme Patio V].lldg2
il?- Address 3918 W. 49 1/2 St.
I- r:... Ed]_Tla pL,,,.,e 926-277I
Name _
Address
I hereby acknowledge that I
the information is cQrrect
State of Minnesota St?uo
this application and state that
to comply with nll applicable
_DVtaaan ,Qrdinonces.
N2 5068
? ?.
Receipt #
Date 11-7$ _-, 19-7$__
Erect ? Occupancy I
Alter 0 Zoning Rl
Repcir ? Fire Zone
Enlarge ? v
Type of Const.
Move ? # Stories
Demolish [] Front ft•
Grade ? Depth ft.
Approvols Fees
Assessment Permit 6•00 _
Water & Sew. Surcharge • 50
Police Plan check
Fire SAC
Eng. Water Conn.
Plonner Water Meter
Councii
Off
Bld
.
g. .
APC ratal
Signoture of Permitt e9/ `-- ?
A Building Permit is issued ?O 1111 on the express condition that
ull work shall be done in •rdante bi tate of Minnesota Stotutes and City of Eagan Ordinances.
Buiiding Officiol -?-J?' ? ? ?
.-
?-
DATE
BUILDING PERMIT APPLICATION
Inclhde 2 sets of plans, l site plan w/e,,llefvations and 1 set of energy calcuations.
i4- L.A.E: i(= ? S c ? i.l<:.j W+rl? D",r-? ? o e?
To be used for vj f S L„ D o ac, Valuation 8v?
Site Address:
Lot Block Sec./Sub.
I (:? (i C C-.. -7
Parcel Number
Owner ?i IA. Telephone
?
Address _ / 77 --)Lvia J? l.?i? ???L ,
Contractor Lk ? 1L.L1? '' ? Telephone ..? 7'7 ?
Address ?? j A ?,,J , 49
Arch/Eng.
Address
Erect
Telephone
OFFICE USE ONLY
Alter
Repair
Enlarge
Move
Demolish
Grade
Date of Approval and Initial
Assessment
Water/Sewer
Police
Fire
Engineer
Planner
Council '
Bldg. Off.
A.P.C.
Occupancy .i?
Zoning -
Fire Zone
Type of Const.
# of Stories
Front
Depth
Fees ?.
Permit
Surcharge ?
Plan Check
SAC
Water Connection
Water Meter
TOTAL
1999 BUILDING PERMIT APPLICATlON (RE51DENTtAL)
CITY OP EAGAN
3830 PILOT KNOB RD - 55122 c?
651-681-4675
New Construction Rec1u1cements
? 3 registered sffe surveys showing sq. ft. of lot, sq. ff. of house
and all roofed areas (20% maximum lot coverove aliowed)
? 2 copies of plans show beam & window sizes; poured ind. design; etc.)
? t set of energy aiculations
? 3 copies of h prese ion plan if lot platFed qfter 711 /93
DATE: I?
DESCRIPTION OF WORK: ?t?- S' ._y
STREET ADDRESS:
LOT: A V BLOCK: . ?1_ SUBD./P.I.D. #:
Remodel/Repair Reauirements
2 copies of plan
1 set of energy calculctions for heated addffions
1 sffe survey for exterior additions 8 decks
7'LLLA . ot. Ov
CO TRUCTION COST:
?
?t??
?
Name: ? ?z.n.? Phone #: c
PROPERTY last Pirst
OWNER
Street Address: ?A1711 City State: Zip:
Company:
Phone #:
(area code)
CONTRACTOR !5A,7,1 e,,::-
Street Address: License # Exp.
City State: Zip:
ARCHITECT/
ENGINEER Compcny: Name:
Telephone #: area code ( )
Street Addresr. Registration #:
City State• Zip:
Sewer 8 water licensed piumber (reauired for new construction onlv):
PenaHy app!(es when oddress change andJot change is reques#ed once permit is issued.
i hereby acknowledge that I have read this appiication, state that the information i ?
State of Minnesota Statutes and City of Eagan Ordinances.
x-,
Signoture of AppH l
OF
FICE USE Certificates of Survey Received Yes
Tree Preservation Plan Received Yes
No
No
Not Required
to comply with all applicabl
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex
13 02 SF Dweiling ? 07 5-p{ex
? 03 1 of _ plex ? 08 6-plex
? 04 2-plex E3 09 7-plex
? 05 3-plex d 10 8-plex
OFF{CE USE ONLY
? 11 10-plex 0 16 Fireplace
? 12 12-pfex ? 17 Garage
? 13 16-plex ? 18 Deck
? 14 Apartments ? 19 Lower Level
? 15 Lodging ? 20 Poo{
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4sea.
? 23 Porch (screened)
? 24 Storm Damage
? 25 Misceifaneous
WORK TYPE
13 31 New ? 35 Tenant Impr 0 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bfdg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
Give PCA handou t to applicant for demolition permit
GENERAL tNFORMATlON
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. Na of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Bu ilding Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PL
Park Ded. Trails Ded.
Other
Copies
TotaL•
SAC Units
% SAC
? EAGAN TOWNSHIP
BUILDING PERMIT lq°• 2411
Owner .-•. . ..... -?!__.?::__.._••-........... -• Eagan Township
Address (presen!) ........... 4dz ....................................................... Town Hall
Builder ........•••••-••-•-•---•--••---••--• ................•-•--•---•---------••--•---•-•--•
•--••-•-•-• -3?* 171
Date ...........................
...••--••-••--..:•--.
Address .._....-•--•---•-•--•--•._...__..__.•-•...........••-••-•--••-••--•-._._._...-•-._.....•--•--•
DESCRIPTION
Siories To Be Used For Fron! Depth Height Est. Cost ' Permi! Fee Remarks
LOCATION
Sireet, Road or other DescripYion of Location I Loi_.._,? 81ock I Addition or Trac!
0
This permit does not suihorize the use of streets, roads, alleya or sidewalks nor does it give the ovirner or his agent
!he righ! !o create any situation which is a nuisance or which p:esen2s a haaard to the health, safety, convenience and
general weifare !o anyone in !he communi2y.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGREIS
This is io certify, lhat__....has permission io erect A__. ............. .......... ....?...._....-------- _upon
the above described premise subject to !he provisions of the Building Ordinance for Eagan ownship adopted April 11,
1955.
. ........................................ Per .............. -...........................
. •-•••••--- ••-• -
.-°-----...•--•- --•••-• -
of Tnwn Board Buildin.:Q .. Ins.... pector.......---•-•••----•---......_...
Chai man ?-4
??
MASTER CARaD
? LOCATION
OWNER
STRUCTURE AND ?? ?
LAND USED AS 7
Permit
No.
Issued Issued To
Contractor I Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
V'?ELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER '
OTHER
.
OTHER ?
?
Items Approved
(Initial)
Date
Remarks
Distance From Well
FGOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PWMBING
WELL
SANITARY SEWER 4*
? Viofations Noted
on Back
COMMENTS: r? 04`
COMPLIANCE INSPECTION REPORTS "
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
?
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
F-I COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL
ITEMIZED AND DESCRIBED AS FOLLOWS:
is
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CE RTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions oL-served to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
7 ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COMMENTS:
DATE
23
41 %%.
EAGAN TOWNSHIP
3795 Pilot Knob Road
SC. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date• April l, 1971
Billing Name: Cedar Grove Const. Co L
Owner: Same
Plumber: Stein, Inc.
Number:
10-9-7
Site Address; 1778 F_,u1„P-qj,-n„a a-r4l,7o
Billing Fddress 7343 Concord Blvd. E.
out t. Paul, Minn.
55075
tion of Connection Meter Siz e_ Connection Chg.26oy oo.pd 4/6/71
Meter No. lPermit Fee 10.00 pd 4/6/71
Meter Reading ,Meter Dep.
Meter Sealed: Yes- 1 Add'1 Chg.
NO iTotal Chg.
Building is a:
Residence xxx
t'Iultiple R'o. Units
Commercia 1
Industrial
flther
Inspected by
Date
Remarks;
Sy:
Chief InspecCor
In coasideration of the issue and delivery to me of the above permit, I
hereby agree to do ttm proposed work in accordance with the rules aad
regulations of Eagaa Township, Dakota County, MinnesoCa.
By; CEDAR GROVE CONSTRUCTION COMPANY
Please notify the above office when ready for inspection and connect3.on.
At ?11
EAGAN TOtJNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE:April 1, 1971
_._.._..`..r........_
OWNEF.: Cedar Grove Const. Co.
TYPE OF PIPE Cast Iron
(Lot 10, Block 9, Cedar Grove #7)
Address 1778 E. Bluestone Drive
PLI?MBER S t e in , In c.
D ESCRIPTION OF BUILD ING
.
Industrial Commercial Residential Multiple Dwelling No. of uniCs
xxx
Location of Connections:
NUMBER 0 718
Connection Charge 200.00 pd 4/6/71
Permit Fee 10.00 pd 4/6/71
Street Repairs
Tota 1
Inspected by:
DaCe
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed wortt in accordaace with the ruies ancl
regulations of Eagan Township, Dakota-County, Minnesota
By CEDAR GROVE CONSTRUCTION COMPANY
Please noCify when resdy for inspection and connecCion and before any poreion
of the work is covered.
Jun 23 08 01:19p Kathy
4110? City of Eaian
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
952-492-6828 p.2
------------
? For OlfiCe Use ^. - !. -` E
?
? Permit#_
E ?I
? Permit Fee:
j Date Received: ?
? d
f Staft: 1
I I
?--w---r-.----....---rJ
200$ RESIDENT1AL BUILDtNG PERMiT aPPLiCaTIoN
date: Site Addrass•
Tenant: ? e-('?[ -S_.., Suite
RESIDENT / OWNER Name: Cclrn?s Phone:
Address ! City / Zip: ?
? 7'?? ?1(' t
Applicant is: Ovrrner _2!?'Con#ractoc
TYPE OF WQRK qescription of work: f`? e, -F, () 6_?
Construction Gost: L0 Multi-Family Buildirxg: (Yes / No
CONTRACTOR '? C ?
Name: 1 ? ? Licertse #: 30
Address: --A(1050 VV abd &
City: `J 0 rde, n State: I+ ? Zip:
Phone: ?? ?? 1??' 3Conlact Person: 1 1 t?? K retJrjQ't''r
COMPLETE THIS AREA QNLY IF COAISTRUCTEMG A NEW BUILDING
_ Minnesoia Rules 7670 Categorv 1 Minnesota Rufes 7672
Energy COde • Residerrtial Ven6lation Category 1 Wor[csheet ~* Plew Energy Gode Warksheet
CSfegOP'yI 5ubrriitted Submitted
(4 submission type) • Energy Envelape Calculatians Submitted
In ihe last 12 months, has the City of Eagan issued a permit far a similar plan based on a masler plan?
_Yes `No If yes, date and address of master plan:
Licensed Plumber• Phpne-
AAechanical Contractor: phane•
Sewer & Waber Contractor: Phone•
NOTE: Plans and supportfng dacuments that you submlt are considared tn he puWfc Jnformaifon. Portions of
the infcrmativn rnay be ctassified as norr--pwwblic if you provide specific reasons that would pamift the Clty to
conclude that the are trade secrefs.
i hereby aCknowledge that this irltarmation is complete and aocurate; that the urork will be in corrformance with the ordnances and cades of the Ciry of
Eagan; ihat f understand this is not a permit, but only an appbcation for a permit, and work is not to start wiihout a permit; that the woris wilf be in
accordanee with the approved plan in the case of work which requires a review and approval of plan5.
x ??G1? ?ef)
AppficanYs Printed Mame
x
,Applicant's Sigrature
Page I of 3
Use BLUE or BLACK Ink
r
For Office Use C 1
Permit
City of EaRo~an I » _as-;
1 Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: ;
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit M
F._...._..-_.....-. 0 Name: ! C-~
Resident/ F C-f k 1 c Phone: foy~'
Owner Address /City /Zip: _ ~p Ccf~
X77
Applicant is: Owner ) Contractor
Description of work:
Type of Work
Construction Cost: 6(10 °a Multi-Family Building: (Yes / No
Company: 2-eEiGeAh-a.C Contact: (I& r_a_ ~~«5~-►~
Address: A Q V0 V, xtYl_d /1°tys ~Q City:
1 Contractor II
? State: r Zip: -3 Phone: Yl - W,6 - /3 5? /y
C /C
± 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
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.clopherstateonecall.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 Stat ding Code must be completed within 180
days of p rmit issuance.
x -e SY) 661- x
Applicant's Printed Name Appl' an ' Signature
Page 1 of 3
I
I