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