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1293 Easter Lane ® EC E U Y -Fo-r G_Ffic e U-se City of Ea an jU®09 Permit1 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Y 241 Tenant: Suite RESIDENT/ OWNER Name: Phone: Address / City i Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost ulti Famil w rng: es A 0 No CONTRACTOR Name: r~l®l ense Address: (0 C C` `2 C i t y : State:r~ z i p = Phone: Contact Person: P JQ_ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category I Worksheet • New Energy Code Worksheet Category Submitted Submitted 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. 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 ap f plans. X _4 Applicant's Printed Name NVI-ica s Signature 44 Page 1 of 3 CITY OF EAGAN WATER SERVICE PERMIT 3195 Pilot Knob Road PERMIT NO.• Eagan, MN 55122 DATE: Zoning: ___ .__ __ —_ No. of Units: Owner: — — Address: Site Address: _- Plumber: Meter No.: __ _ Connection Charge: Size: _ _____ —__ — Account Deposit: Reader No _ Permit Fee: agree omply with the City of Eagan Surcharge: Ordin • - Misc. Charges: Total: B y /MU& Date Paid: D. of Insp.: _7-- 2, Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: _ No. of Units: Owner: Address: Site Address: Plumber: ___ -- — - -- -- - - - -- I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By — Misc. Charges: Date of Insp.: Total: Insp.: _ Date Paid: PERMIT City of Eagan Permit Type:Building Permit Number:EA118247 Date Issued:10/29/2013 Permit Category:ePermit Site Address: 1293 Easter Lane Lot:000 Block: 005 Addition: Wilderness Run 6th PID:10-84355-05-031 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - Lonna R Ortloff 1293 Easter Lane Eagan MN 55123 Custom Creations Remodeling Inc 1321 Andover Blvd NE Ste 112 Andover MN 55304 (763) 441-5907 Applicant/Permitee: Signature Issued By: Signature