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1298 Easter LaneC1TY OF EAGAN Remarks Addition WILDERNESS RUN 6TH ADDITION Lot 16. Blk 3 Parcel 10 84355 160 03 owner 'L' `' ?? ? Street 1298 Easter Lane stace Eagan,Minnesota 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1973 161.21 8.04 20 1 SEWER LATERAL WATERMAIN WATER LATERAL WATERAREA 19]] 162.14 ,%0S:66 LS STORM SEW TRK ?.- lq7g $,. SO 12-29-78 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 250. ?? 11199 -- 8 9UILDING PER, sAC 500.00 11199 8-8-78 PARK - - r • CASH RECEIPT ? CITY OF EAGAN 3795 PIIOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE RECEIY6D FROM 19 AMOUNT $ I & DOLLARS 7oo ? CASH ? CHECK White-Payers Copy Yellow-Posting Copy Pink-File Copy ? Tha kYou ? , BY cirY oF EaGAN 3795 Pilot Kno6 Reod Eagan, MN 55122 N2 4926 PHONE: 454-8100 BUILDING PERMIT Te ba und for Est. Value Receipt # Dote , 19 Sfte Address ` Erect Occupancy ' Lot , I Blotk Sec/Sub. ' i?• Alter ? Zoning ' Parcal # Repair p Fire Zone " Enlurge ? Type of Const. 4 ad Name i EZ'T3i1C2 ?. Move ? #' Stories i Address 4924 05t?. Demolish ? 5ts Front h. t ' ^.? ?' fC evines f%L___ Grode fl Deoth 44 k. ce Name + 115e[t ^rr••••••.• Address 27 aOULk: ::;?u ).1 ?, R? Assessment , i2 F ? :tUi L. Ci Phone Woter & Sew. ?- W N Police ame F Fire U? Address Eng. <`Z" Ci Phone Planner I hereby acknowledge thot I have read this applicntion and state that Council gidg. Off. '- the information is correct and agree to comply with all applicable APC State of Minnesota Statutes ond Ciry of Eogan Ordinances. Signoture ef Permittee Permit 1 .1 p •LA'' Surchorge Plan check SAC "`U Water Conn. =? • ?' `" Water Meter ??l • ?'`' I Torat 948' 50 A Building Permit is issued to: on the express condition that all work sholl be done in accordanoe with all applicoble State of Minnesota Stotutes and City of Eogan Ordinonces. Building Officiol f PonM # Oafe Ifwed Pomkt» Plumbing Mechanicol 7S \Ac._ 1 )6 - ?7 -7 - INSPECTI DATE INSP. Rough-In f(nd Foori?,g5 ocrte irksp. nate in.a. Foundntion Plumbing Frame/ins. Mechanical Final I Remarks: . CITY OF EAGAN 3795 Pilot Knob Rood Fagan, Minnesota 55122 Plwne: 454-8100 HEATING _ pERMIT Dote: September 11, 1978 1298 Easter I,ane Site Address: lE: 3 Lot Block Sub/Sec. WR 6th ?:t_I.. -.. ..r. _.-: 7..?. Name . ? Address 627 Snelli.7?•.-r F,viF. <;, ? Ciry St. Paul 55116 Phone: Nome A. Bfndex' & S^ ? ? Address ' ?0 E. f3utler Ave. ? 0 t) City i'dUl Phone: This Permit is issued on the express condition thot ali work shall be Minnesota Statutes ond City of Eogan Ordinances. No. 275 Receipt No.: $ingle Residential Multi Res., Comm./Ind. I new New/Alter. / Repai r Cost of Installation _ ,'01-Mt?S'TION AIR REQUIRF' Permit Fee • Surchorge Total done in accordance with all applicable Stote of Building Official .. ? . Date: - CITY OF EAGAN 3795 Pilot Knob Road - " Eogan, Minnesota 55122 Phone: 454-8100 wATM SOFTTTR PERMIT 10-27-78 Site Address: 1298 Easter Lane Sub/5ec. _ bth Lot 16 Block 3 ?''? No. 243 Receipt No.: 1219() 5ingle Ix Residential Multi Res., Comm./Ind. I I'll8@Tl gOmt9 Nome New/Alter./Repoir - 627 Sa. Snelling 3 Address CosY of Installation 0 SL. Paul 6,98-5501 29.5.00 City Phone: Pertnit Fee Liadsa7 Water Grnid. Sof-. Sc., In?^, .5?' Name Surchorge . ? 4215 Cedar Av?. 50. ddress e U City Phone: Total This Permit is issued on the express condition thot oll work shall be done in accordance with oll applicoble State of Minnesota Statutes ond City of Eagan Ordinonces. Building Official CITY OF EAGAN -49 17JZ$ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 . - , BUILDING PERMIT Receipt # -r To be used for ??E ADDITYON Est. Value =7•000 Date SEP 6 ,1 989 Site Address 1298 EASTLTR LN 16 Block 3 SeciSub. i?1ILDERlY'E5S RUN b Lot OFFIC E USE ONLY PdfC@I No. Occupancy M'1 FEFS Zoning W Name 7'ERRANCE CARlSON (Adual) COnst Y'N Bldg. Permit ?•? 1298 EA$T£R ? V? o Address (Allowable) Surcharge 3.? City EAG" Phone 452-7186 # o( Stories 221 Plan Review Lenglh o Name S? Depth 29 SAC Cily , 0? Address S.F. Tolal - SAC, nnCwcC ? Clty Ph0118 S.F. Footprints - Water Conn On Site Sewage _ ? ? W Name On Site Well - Waler Meter _= U = Address MWCC System _ Acct. Oeposit a W City Phone ciry water - +W P it S PRV Required _ erm . I hereby acknowlege that I have read this application and state that the Boosler Pump - SfW Surcharge intormation is correct and 2gree to comply with all applicable State of Minnesota Statutes and City ot Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: rERuNCE cARt,soN Planner - Park Oed. on the express condition that all work shall be done in accordance with all Council -- applicable State of Minnesota Statutes and City of Eagan Ordinances. gldg, pff. _ Copies Building Ofiicial ? Variance - TOTAL 93.50 Permit No. Permit Holder Oate Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Foornys i 9?/ r,9 4J Foundation Framing Roo(ing Ragh Plbg. Rou9h Htg. Isul. Freplace Final Htg. Fnal Plbg. Consl. Meter Plbg. Inspeclor - Notify Plumber Engr.IPian eldg. Final Oeck Ftg. Deck Final wen Pr. Disp. OF EAGAN .795 Pilof Knob Road Eagon, MN 55122 Zoning: _ Owner. Address: Site Address: T Plumber: Meter No.: _ Size: _ Reader No.: I agree to comply wiffi the City of Eagan Ordinances, BY - Dote of . OF EAGAN .795 Pilot Knob Roed Eogun, MN 55132 zoning: Owner: Address: _ Site Address: _ Plumber: ? I agree to eomplp with !he City of Eagan Ordinances, Bv Connection Charge: .: f .? . 11 f.". Account Deposit: Permit Fee: • ? Surcharge: Misc. CMrges: Totol; Date Poid: SEWER SERVICE PERMIT PERMIT NO.: - DATE: - - --- -- ? No, of Units: Connection Chorge: Atcount Deposit: Permit Fee: Surchorge: Misc. Charges: Totol: Date Puld: Oote of Insp,: I nsp.: - WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: _ _? _ _ CITY OF EAGAN NO 17028 -• 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 q BUILDINGPERMIT Receiptu ? o+'a? Tobeusedfor GARAGE ADDITION Esi.Value $7>000 Date SEP 6 , 1989 Site Address 1298 EASTER LN Lot 16 Block 3 Sec/Sub. Parcel No. W Name TERRANCE CARLSON 3: Address 1298 EASTER LN ° Cjty EAGAN Phone 452-7186 o Name SAMR tU ?a Address ¢ City Phone ?. ww Name 0? Address aW City Phone I hereby acknowlege that I have read this application and state that the informanon is correct an r lo comply with allippplic?ble State ol Mmnesola Statutes and ot E an Ordmances. /P /Y Signature ol Permnee/ _la„A Xe4-0-`/ A euilding Permit is issued to: TERRANCE CARLSON on the espress condrtion ihat all work shall be done in accordance with all applicable State of M/?mnesota Stalutes and City of Eagan Ordmances BuildingOfficial .1?I1Aih olll. I lb k '3 OFFICE USE ONLY Occupancy M-1 FEFS Zoning (ACluap Const V-N Bldg. Permit 90•00 (aiiowaoie) V'N Suroharge 3.50 N ol Stories Lenglh 22' Plan Remew Dapih SAC, Cny S.f. Tolal - SAC, MCWCC S F. Footprints _ On Ste Sewage _ Water Conn On Site Well - Water Meter MWCC System - qcct. Deposit Ciry water - PRV Reqwre0 _ 3NV Permit Boos[er Pump - S/yy Surcharge Treatmem PI APPROVALS Road Unit Planner - Park Ded. Council &dg.Ofl. _ CoPies Variance - TO7AL 93.50 crrr oF EncaN 5795 Pilot Knob Raad Eagan, MN 55122 N? 4926 PHONE: 4548100 BUILDING PERMIT APPLICATION Rece+pt To be used for$F DWlg. 8 Gar. Est Value 41,000 Dafe 8/7 1978 -_ . ? Site Address 1298 Easter Lane Erect E] Occuponcy I Lot 16 Block 3 $ec/Sub. W11(a. Run b Alter ? Zoning Rl Repair ? Fire Zone 3 Porcel # V Enlarge ? Type of Con st. m Nome Terrance Carlson Move ? # Stories ; Addre 4924 105th Lane N.E. pe,,,oush ? Fronr 58 ft. o CI 1TC e ines Phme Grade ? Depth - 44 ft. T1• 15@n ApprovoH Fees ? Nome o?< Addre ss, 627 South Snelling VF f?n, b• dU Pl.nna . Name I hereby ackrwwledge thot I hove recd this application and state that the infnrmation fs correct end egree to wmply with all applicabie Stah of Minnesota SMtutes and City af Eagan Ordinances. Signature of Permittee - A Building Permit is issued cll work shail be done in c Assessment?47478 WOtEf Ri $EW. Police Fire Eng. Plonner CAUncil Bldg. Off. _8/7/711_ APC Permit ++o.vv _ Surcherge 20•50 Plan check SAC 500.00 Water Conn. 250.00 WaterMeter 60•00 Total 948 • 50 on the express condiNon thct oll oppli 1 cate of Minnewtq Stntutes and City of Eo9en Ordinances. Building Official TO 3uest void 18 months from / / 7,0 ? 4 >l? - 3 r,v2 &h?d R 4627 Date of this Request 9-13..1978 I, asik Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 1298 Eaater Lane City. Fagan Section Township 1Vhich is occupied by Tileen Homes Range County DBkota Is a roughin inspection required on this job? No ? Yes Pgx Ready Now ? Will Call Ox Power Supplier Dakota Ety. Address Farminaton Electrical Contractor O.B. Thompaon Electxic Co. Contractor's License No?33735 (COmpany Name) Mailing Address 12201 Mtka Blvd. $ Mtka 5,5343 Authorized Signature nQn o OQG°3D or Vwner MaNing rnls Inztallaxlon) ,?u-?Phonexo. 933.•2_5.21. This inspectian requast will not he accepted 6y ffie State Board unfess proper inspection fee is enclosed. Minnesota State Board of Electricity 'fA4 University Ave., St. Paul, Minn. 55104-Phone 645-7703 ; REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WOKK COVERED BY THIS REQUEST // 70-e-I ? 4627 Type of Budding New Add. Rep. Check Apptiances Wired Foi Check Fquipment Wired For Home CC ? ? Range ? Temporaty W'ving ? Duplex ? ? ? Watet Heate[ ? Lighting F'ixtuies ? Apt. Bldg. ? ? ? Dry Electric Heating ? Commercial Bldg. ? ? ? F Fum ? Silo Unloader ? Industrial Bldg. ? ? ? Air Buik Milk Tank ? Farm List List Other ? ? ? peheis? y Oehers? Fi COMPUTE INSPECTION FEE BELOW Service Enttance Size: # Fee Feeders$Su6fcedeis: # Eee Cucuits: # Fee 0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am etes 8 101 m 200 Amp 31 to 100 Am eres 31 to 100 Am res Above 200 Amps. qbove 100 Amps, Above 100 Amps. Transformeis RemoteContiolCirc. Partial or other fee . 5' ns Special Ins ection Minimum fee Remarks F?gll TOTAL F E? 0.50 I,the Electricallnspector,hereby ce?Y at a veflnspection has been made. ? (Rough-in) Date 9- (Final) ?,2r ? . it,, Date 1„2-1-7Y This request void 18 months from REQUEST FOR ELECTRICAL INSPECTION ee oo/am/-m ' n ?$ee mslmcGOn5:4Uzmpletrtg Mis form On back ol yelbw copy 7 g X" Below Work Covered by This Request ew Adtl Rep. Typeof8uilding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Elechic Heating ApL Building Dryer Olher (Specify) Comm./Industrial Furnace Farm ' Air Conditioner Other (specity) ConVacror§ Remarks: Compute lnspection Fee Befow: # Other Fee # ServiceEniranceSiza Fee # Circuits/Feetlers Fee Swimming Pool 0 to 200 Amps o ta 1oD Amps TranSformers Above 200 _ Amps Above 700 _ Amps Signs inspectors use onN! 70iAL Irrigation Booms Special Inspection L? Alartn/Communication Other Fee I, the Electrical Inspector, hereby Kif h h AougMm • Oat ?/ 4 O ce y t ai t e above inspection has been made. F,nei , OFFICE USE ONLY This requeSt vatl 18 monMS from `?/&, /lj C' _-? ZI-;V1 5 N 95979 ?. G°-? Request Oete / 5 e ` Fre No. Fough-in Inspeclion ire0? ? Reedy Now WIII Notity Inspeclor R d ? Wh b Yes ? No en y ea I p licensed contraclor kowner hereby request inspection of above electricel work at: Job Atldress (SVeet, Boz or Routa No ) la 5ke;1sT.e qry Sectbn No Taxnship Name or No. Renge W. Courp?O 64 V OcCUpaM (PRIN'n Cee.q.1 r C?J?ISan/ Phoire N. ?5" - 7/?Ga Pa erSuppb Atldress Elec i I Contractor (GOmparry Neme) S` Conrcacror9 Licenu No Malirg Adtlreys (ConM1actor w Owrier Making Inatelletnn) or' ed Signature (COnlracfor/qvnar Meldng la?on) Phone Number MINNESOTA STA1E BOAqD OF ELECTHICITY THIS INSPECfION REOUEST WILL NOT Grigga-MiEway Bidg. - Raom 8-173 BE ACGEPTEO BY THE STATE BOARD 1821 UnWerotly Ave., SL iaul, MN 55104 UNLE55 PqOPER INSPECTION FEE IS Phona(672)865-0800 ENCLOSEO. RESIDENTIAL . ` BUILDINC PERMIT APPLICATION /-? CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New ConsWCtion ReuuiremeMs • 3 registered site surveys showing sq. ft of lot, sq. fl. at house; and all roofed areas (20°k mazimum lot coverage allowed) • 2 copies of plan shaxing beam & window saes; poured found design, elc.) • 1 sel of Energy Calalafions • 3 copies ot Tree Preservation Plan it lot platted aRer 711193 . Rim Joist Depil Optrore selection sheet (bidgs wNh 3 or less uniis) DATE 61a?-?- SITE ADDRESS TYPE OF APPLICANT j?,s+er- lk/7Q- STREET ADDRESS `l /Q7 I J i"RP /I TELEPHONE # '7G3`6II "03i CELL PHONE # MULTI-FAMILY BLDG _Y /N FIREPLACE(S) _ 0 _ 1 _ 2 iAVZ STATE /q.-/ ZIP-q0Y1 FAX # PROPERTYOWNER ???V lnCJll TELEPHONE# Ca5h- ? -------------------------------------------------°-------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNFSOTA RIJLFS 7670 CATEGORY I (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Caiculations Submitted Plumbing Contractor: __ Plumbing systcm includes: Mechanical Contractor. Mcchanical system includes: Sewer/Water Contractor: Air Condilioning _ Hca[ Recovery System Phone # Phone # Fer. $70.00 -----°-----•--°-------------°----°-°--------°------°--------...-°------------------------------------------------- I hereby acknowledge that i have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinan Signature of AppllcaM , OFFICE USE ONLY Water Softener _ Water Heatcr No. of Baths _ Phone # Lawn Spiinkler No. of R.I. Baths .-? RemodellReoair Reauirements . 2 copies of plan . 1 set of Energy Calculations for heated additians • 1 sAe survey for exterior additions & decks • Indicate if home served by septic system for additions VALUATION it cm o Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4102 ? . D... 6 -';z 1--7 S SUILDZNG PERMIT APPLICATION include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations. 7b be used far ?j?'?, T Valuation / 1I00 Site }lddresc; ! (0 {4i- Lot Block Sec. Sub, Parcel Number oamerc?Q-C?2- GCUZ.6e117Y?J Address AAR 49a y'll . N. E" ' Contractor C) ?O?YYLk,O o(7??' Address (007 ?'.t • /?'1?1? • SSI 1 Arch./Eng. Address Telephone 766 " / /8 7 Telephone & 98 / Telephone OFFICE USE Erect Alter Fepair Enlarge Nbve nenolish Grade OFFICE USE Date of Approval & Initial Assessment water/Sewer Police Fire Eng. Planner Cbuncil Bldg. Off. A.P.C. Occupancy / Zoning Fire Zone Type of Const. S of Stories Front 6`Sf Depth FF,ES ? O Perinit ? ?O Surcharqe ? St o Plan Check SAC V OJ c_? Ftater Conn• z6"O S•later Meter ( 0 ? TOTA7 q g, So SIIiGLE FJINILY DYELLI8G5 2 SETS OF PL9NS - 3 BEGISTEAED SITE 3DR9EYS _1 ser oF Maci ceLCS. 1989 BOILDIAG PEAMIT APPLICASIOti CITY OF Eil io MULTIPLE DWELLINGS 2 SEiS OF PLStIS BEGI3iMSD 3IiE 3QROEI3 - (CMM iRifl HLDG DI9. ) 1 3Kf OF' BMEAGI Ctl.6S. 1lULTIPLE DWELLING3 BEIiTAL DNI'P3 FOA SLLE UbITS f OF IIBITS N0?Et ADDAFS3ES F09 CORAER I.OTS - CO1vTAlCTOH/80tEOiiREA M.ST DOIGNdiE iTBICfl 1DDRFSS IS DESIAED. BO CHANGFS AZLL BE iLLOWED ONCE HIIII.DING PERMIT 13 ISSOED.. SLr{iER i FA2£R PERFSIT FEE3 iND ?CCOONT DEPOSIT FM iIII.L Bfi INCLDDED YITH SHE SUILDINa PERMIT FES. FAOCFSSI?iG !IM FOA SEWEA 1ND QATER PERMIIS I3 TiiO DAYS ONCE A PERMIT HA3 HEEN COMPLETED INDICATIAG A LICEIiSED PLOWEfl. PENALTY APPLIES WFIENs PENMIT IS NOT PAID FOR IN SAME MONTH IT IS REQiJESTED. ` LOT CAANGE IS REQUESTED ONCE PERMIT IS ISSIIED. G??kfkCrE ADD?zlnr.j To Be Used For: r4? ? j,,/O!C"aluation:L?? Date: Slt@ Addl'ess Lot &7 Block ? Parcel/Sub W; lWe,eAJr55 l4wd (o Owner lddress Xd, Citq/Zip Code mAl, Phone 44vl2 ' 7/Pt Contractor S e /F Oceupanep !"j - I Zoning Actual Const ? Allowable # of stories Length Z Z ' Depth 20' S.F. Total Footprint S.F. On site sewage On aite well _ MWCC System _ City water _ PAV required _ Booater Pump _ CDMKERCIAL '•) -" ? .rf, 2 3ETS OF lBCHISECTURAI. i SiHDCTURIL PLENS 1 3Ef OF BPECIFICATIONS 1 8ET OF EBERGT CALC3. Hldg. Permit Sureharge Plan Reviev SAC, City SAC, MNCC iiater Conn Nater Meter Acet. Deposit S/N Permit S/H Surcharge TreatmenE Y1. doad IIASt Park Ded. Copies ?_ 39BTOTAL Penaltq TOTAL •nn Address Citp/Zip Code Yhone Arch./Engr. lddress City/Zip Code Phone # '7' /.3 1PPADVAIS Planner • Couneil Bldg. Off. Yariance A L?I? , i 1 L "=l ? I ? ? uNt? N , ?---- ' I I a ?a I ? No?sE ? ? n , , ??oPE.e rv ct ?A LiNE zJ ?s0-D?rZ ? ? LoT ? BLOCK ? ? O I ?c,Z?e? u ?le-rr,. c?0 o6?z-C. • i F?LOT 1 L AN . _ r ?. I ? we i . 3 $? ? ?XIST?N? ? lu ? Q --- ', , gaq 5e? ? j'P-9QRn1 C,E l &P/so,J /,4 9k- EfIST-e 4 4,J. I 4 of l(o a1oci ?3] l.v; /de,e,uess /jwil (o . j •/S e?J l?IGM e.'S ?G /0" IFIqStMItNr dnrf P4 oT- N Ny PERMIT City of Eagan Permit Type:Building Permit Number:EA115261 Date Issued:09/24/2013 Permit Category:ePermit Site Address: 1298 Easter Lane Lot:016 Block: 003 Addition: Wilderness Run 6th PID:10-84355-03-160 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Ryan Davis Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Kevin Geppert 1298 Easter Lane Eagan MN 55123 R Davis Construction Inc 710 N 4th St #306 Minneapolis MN 55401 (612) 259-5363 Applicant/Permitee: Signature Issued By: Signature M� ,�. t � {•':. . ' „t; � 7 1•,r� 1 .�Y, y. , ' . . . ' � � �t� ��yl. ,�� . � . . .. . � - � . . .� . . ••�• . � . . . ' ' . , ' . ' • ' .. . . . � Use BLUE or BLACK Ink . . . • �____--__ _ . . � � • � For Oiftca Uso�� ———-- �� .Clt of . ,. �a aIl , � Pe����: � � � � . � � � . . . � . � 3830 Pllot Knob Road i Pe`�'��FB�� � ��� � Eagan MN 6b122 , , � � Phone: (651)$76-6676 . j Date Receivec7:���. � . Fax: (661)676L6694 � � � I StaB: i . . ,ti ' �.��.�.r� ___.__ __ I � 2011 RESIDE�ITlAL 6UIL.'`DING�PERMIT APPLICATION Oate: . �� C Site Addre�s: � C •� (�/l/�� • Unit�; Name: '�i • ��(�lS ��.�l1.S'T!z t,�CT/Dlv �• .. �—�S`C°� RESIDENT/ , , Phone: �5 ��q� r •� OWNER . Address/City I Z(p;_��-.��� E��S��/� !_.;JI.� � �6¢l�rtJ j"��,,�� , Appilcant is: � .Own�er. �.Contractor• . , -• •,.: _ TYPE OF WORK Oescriptlon o(wotk�_7��.�'G�L�v �i'�'�..A�lsF 1�� Constructlon CosC � ��r��� . • • Muld-Femliy B ild(ng: (Yes_�No�� � Company:'��`C.d�'�!(�t4�}(� �R G.¢,� Contact:�?���° �`/���1.�4��lL , CONTRACTOR Address�_��/ ��'j��'�_ • ' �m,; �}'J�L� , State:�_z(p.•`5����4� Rhone: • .S• ' 8 i . ,.,�f , '� �. �9 �'�54 � �� ucense�:� �''-��3.5�o�S�'�—� r: l.oad�Cett►flcate#: /V'14,7`� 7 --/ �, � ,:.;, If the project is exempt.from lead certlflcatlort, please ex,plaln Why:(see Page 3�for additfonai information) � ��. � .. . 3�,r • . ..:• r�. .:2�`�r:�7u. �„ . .. , . . . . �. , • -;'r;' .:e%� , . �:•�. . . COMPLETE THIS AR�A QN��F_CQNS�RUCTIN;A NE,____W BUII.DING , . . , ; In the last 12 months,has the City of Eagan'Issued a pertnit fo�.a slmliaw,plan basad�on a master plan? _Yes _No If yes,date a�d addtesa of master plan: � • �' . l;Jcensed Plumber. ' __ Phone: Mechsnica!Contractor. ' � Phone: ` Sewer b Water Contractor. • � ' ' . phone; NOTE:P/ans and supporting docur»en }tha�,�ypu;stibin/t.�t'!�cp�.s/,�/�red.to.be pubilc lnforrrraUon. Portlons of . the lnformaUon may be�classlfl�I a��,pp:�,u�l/C,Ifyvu p,�v,Yf.de�s�l�fil�lr�ressons that wou/d permlt'the Clty ro . . '. ,�cd�icludA'�f at:tXe�:ar�. d � � 't� �.sear.e�:. CALL 6EFORE YOU DIQ. a � ' "' r..�.;�,,.•.• ..3 ...;•: �.•::,� . �; y, .; :.... ���o C A Gophor Stiu O�v,Ci!!�l t46,1)�4b{-QQQZ��pf pfp(pCtlpt18fl81tt8t underyround uQlity damage. Call 48 hou� yW IrltBtld l0 dl�10 f6C81V8�OCBIQi 0�UfX�6l�f0Ur1d U�ll�l�{� . . . . '.�. ..:1�.�st� };.�,'�'�:�.��� �`�ii�•:e^'i'''j'�iK kr �s��Y,,•: .ti,,..��• - I hereby acknowted9e U7at Ws In1om18Uon is COmpl9(@ g�d BCCUra(8;4het!h8 Y�Nr1f 1MU b8'In Cpnformence ydlh lhe ordinances and codes of tne City o� Eagan; �hat I understand Uila Is not a p�'rmlt, but oNy an eppucaUon for e permit, �ndr;yyprk is,nol to atert without a permit; lhaf Ihe work rrili be in , axoroance wilh!he approved plan in the'case o(wv�ic wfilch roqvlro'a raNew arid epprovai of.plano.• . Exterlor work autha�ized by�bulldinp pertnit Itsued U accordanCe With'the Minn��ota Statp 8ullding Code muat be completed within 180 days ol perm(t Issuance. . . , X Sf�''G' �i40�/�214�E'/2� . . � �. App!(cant's Pr►nted Name X Ap cant's Slgnature � Page t o1�