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2093 Cliffview DrBUILDING PERMIT =79= rNet Kwob RooA Eeoan, MN as122 PHONE3 4i4-8100 ReceicN # Te be we?d for Est. Vclue Dote _ 19 Slte Addrou Erect ? Occupancy Lot Block $eC/5ub. - - Alter ? Zoninq Porcel # Repoir ? Flre Zone . . Enlarqo ? TYpe of Const. ae Name r Jyc # St i W vva ? or es ; b Addrcss Demolish p Length Ci phone Grcde ? Depth Sq. Ft. °C Nome Ap?ovals Fess ,O ?? ??ess Assessment ~ Cit phone Woter 8 Sew. ? w N Pol ice 9 z ome Fire /lddress Eng, i W Ci pFwne Planner Council I hereby acknowledge thot I have read this opplication and stofe thot gldg. Off. fhe informotion is correct and ugree to comply with oll applitable Stote of Minr?esota Statutes ond City of Eugan Ordinantes. APC Sipnoturo of Permittee ?.,. ._.. ,.,..., Permit Surchorge Plan check ' SAC Woter Conn. Water Meter Road Unit I Totol /1 Bwlding Permit Is iuued to: on the express condition tFxai ell work sholl be done in occordance wlth oll opplicable $tare of Mlnnesoto Statutes and City of Eaqan Ordinonces. Buildiny pfficial Permit No. Permit HoltNr Misc. Permit No. Holder Plumeing ?2 `j3 i ?L2"1'l L`? H.V.A.C. ?!! 3 wt. ? Well Wanr ` Disp. S?wer Eketric C, t C' r? Irapeetion Dm Irnp. Other Faotinpt Foundation Fwminp /-/qt? Rouyh Plbp. ? loop Rouqh HVA Inwl.eion M Finsl PIb4 _ a t Final HVAC -$ Final Waftr Desviha Loeation: YVall 5ewar • Pr. Disp. uf (Orrupttnry Citp of (Eagan Brpar#mrrt of luitbing jns.prrtion Tbis Ccrtificati 1JJifGd PAffJNfifll f0 lGt fGf1J/tflMttlitJ Of Satiox 306 of the Unifwue Buildeng Codc arti f ying thar at the tine o f iJSUame tbir ttnrcturc roar in cmpliancc witb the variau adixaxas o f the City ngrrlating baildireg coa.arxction or ux. For the f ollowrng: un chmiselam ,F TJWG/CAR Mdt hrw, 140. 7033 ?: DW: March 19, 1982 ? m w mwfteuau- . '5. Receipt PLUMBING PERMIT Permit No. ' CITY OF EAGAN Fee FrII in numberoed spaces S/C - Type or Prini /egib/Y T i 1 ot . 1. Date - 2. Installation Cost i ij" 1 V;_? .- ? . 3. Job Address ' ' Lot Blk. r •i • ,. . ? Tract lv? 4. Owner . ? C ' . ! ? LYf^P S 5. Contractor 'ttrov1L t bII idn- Phone 7 , 6. Address "1-37 Oa1,m-r?f-T, lvr• . '. c) . , 7. CitY 1-tij"L.; J;1tPY State x' T Zip 8. Building Type: Residential ? Commercial O Institutional ? 9. Work Description: New C7 Add ? Alter ? Repair ? , 10. Describe 11. No. Fixtures Water Closet No. Fixtures ool/Drainfield Cess Bath tubs p 5eptic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Stop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinanoes and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. - , CITY OF EAGAN Fee '0, 00 Fi/l in numbered spaces S/C •>?) Type or Print /egib/y , Tot. 1. Date 2. Installation Cost ' ? ?%•' ,. :..• • ri•"• ; ? - _? . 3. Job Address Lot Blk. Tract - `- - 4. Owner 1'.CHMAN HOM=, INC. 5. Contractor • ?' 6. Address 4637 Chicago Ave. So. Phone ?5-E867 7. City I P?:?• State Zip 8. Building Type: Residential 0 Commercial ? Institutional O 9. Work Description: New C3 Add O Alter O Repair ? 10. Describe '.Fuel Type 11. No. ' Enuinment BTU - M. Ea. Forced Air No. EQUipment CFM Handlin Ai : Mfg. r g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. ? Gas, Piping Outlets 12. I hereby certify tfiat the above information is true and correct, and I agree to camply with all ordinances and codes governing this tYpe of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 CITY OF EAGAN Remarks Additton - CEDAR CLIPF 2ND ADDN. Lot- 10 Rlk 2 Parcel_jo oWner -zL? r./:, i„CI ,, street 2093 Cliffview Drive stace Ea¢an. NQV Improvement Date Amount Annual Years Peyment Receipt Date STREET SURF, 1776.56 C007766 8-2-82 RESTOR. GRADING 104.57 5 522.84 C007832 9-13-82 SAN SEW TRUNK 1973 119.14 7.94 15 39.74 A411028 4-15-82 • SEUYER LATEFiAL 21$2.5$ C007$32 9-13-82 WATERMAIN * WATER I.ATERAL WATER AREA 1975 107.22 7.15 15 50. 0 A011028 4-15-82 * STORM SEW TRK 1981 452.03 90.14 5 271.23 A011028 4-15-82 STORM SEW LAT 1 19s . . 605. Z 0 0 8 4-15-82 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. ? 13UILDING PER. 7033 SAC ,25.00 98090 PAR K CITY OF EAGAN I 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: 11; j I t I i t!' I N W 1?1< I PERMIT SUBTYPE: , ,... iiri i I Nw, I I I I I NRI SPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: iH +ni 111 r APPLICANT: i , ??,r.?? ?i?, TYPE OF WORK: rtl?Ii i?tn?a N.'-0 i `??? .1f i t1VY Pertnit No. Permft Holder Date TeNphone Y S/W PLUMBING HVAC ELECTRIC EIECTRIC Inapectlon Date insp. CommeMs Footings I Foundation Framing Roofing Rough Plbg. Rough Fitg. Isui. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. InspeCtor - No6fy Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. ? Deck Final Well Pr. Disp. WATER SERVICE PERMIT GITY OF EAGAN 3795 Pilof Knob Rood PERMIT NO.: Eayae, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: - j_1:7 R2 i;:E!dar C7 i f i i7r Plixnnber: Meter No.: Connection Chorge: Size: Account Deposit: Reoder No.: Percnit Fee: 1 agree M eanplp wkb tbe CiFr of Eegow 5urchorge: Ordin Charges: Mlsc anas. . Total: By Dote Paid: Date of Insp.: Insp.: CITY OF EAGAN 3795 M:at Kneb Resa PERMIT NO.: Eagan, MN 65122 DATE: Zoning: No. of Units: Uvner: Address: Site Address: Pltanber. ?., t::-. ?,?l;l?.?i •>s•?r? , _' _. . 1 egme M aompb wilb !ha Ci1Y ef Eoyon Connedion Charge: Ordinanees. Account Deposit: Permit Fae: - Surcharge: B Misc. Charoes: y Dote of Insp.: Total: Ins Dofe Paid: p.: This request void ?8 niohf rom 88527 ?"d- .23q-77 .,3 -7, Sln Re est Date ?y?'? FVre No. Rouph-?n InsVection R qu?red? ?Readv N??w ?II NotifV InsPec- /!?? ??/ ! /? ? C V?l ? Nu tor When Ready A Licensed Electricall Contractor 1 hereby requast inspeetion ot above [-] Owner electrical work installed aL: Street Address, Box or Route No. C C?? ieutQ..i R City C-,-A G ra"1 ection o. Township Name or No. Rangu No. Coun(y L) AkG T-A, Occupant IPRINT) Phone No. AN 14(j Kc. - O Po D SuDPlier ? Address !c Um C& C,T " o - 6 j E?A (L r'v G 10 4 Conlractor's License No. Electrical Contractor ICompany Namel 1, ?Y Q- C ?- ai in Address (Co tractor or Owner Makinp Instaila n) 555? 3Z ? E ? , c? . U ti ( ' Aut IZP.d SIQnaSUfP 1 ntre . Owner Makiny InstallTtionl Phanr; Number ? ? ti ? ? ?. -?- - - - 2 ? 2ib Al11NNESOTA S-WTE BOAHD OF ELECTRICITY Grigps-Midway Bldg, - Room N-191 1821 University Ave., St. Peul, MM 56104 Phone (612f 297-2111 THIS INSPECTION NEQUESI riILL N07 BE ACCEPTED BY TNE STqTE BOARO UNLESS PROPER INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-OU001-03 See instruclions for completing this form on back of yellow copy. T-8 527? "X" Belaw Wark Covered by Thrs Request ?15q-1 7 e Add ^ep. Type o1 Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Fumace Silo Unluader Industrial Bidg. Air Conditioner Bulk Milk Tank Farm Other peci V ther (SueciFy) t er pecify Ol er Oiiher Rough the Elactrical U w?i? 'D Inspector, hereby Final ?? ' '' ertify that the above - ,? ? ' inspection hzis been ? ..----- --'- --- - - -? ?? -- .,i?1?-- -- inis requesi voia 18 nanths hom 2004 RESIDEPiTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN (o?j0o S 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date iU 1 30 1OLI, sitestreetAddress oZoq-,5 C`,ssSsJ'.eW 0,-iV_<1 Y-4W'MM GJ`]13? unit# Property Owner T-Qy) "ee1 S Telephone # (10I?? ?o- ( M I Contractor ll PV1 1aQ,U(DokS Address `3b`-lo podd M. cicy Telephone #(?) 3 13?-1 FQka-?1 State M N Zip "61a3 The Applicant is: _ Owner Contractor _Other Altexations to existing dwelling $ 50.00 _Add fxtures to rooms, excluding water softener and water heater _Septic System Abandonment -Water Turnaround (add $121.00 if a 5i8" meter is required) Other: Water Softener K Water Heater $ 15.00 ? replacement _ additional _ Lawn Irrigation System RPZ_ new _ repair' Lrebuild,? , $ 30.00 State Surcharge 4 $ 50 Total s 6 I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the uvork will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. soi ev, C,Pih Applicant's Printed Name Applicant's Signature (5-5o PERMIT ?? y CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road 9 U I L D I N G Eagan, Minnesota 55123 Permit Number: 024198 (612) 681-4675 Date Issued: 0 7/ 21 / 9 4 SITE ADDRESS: 2993 CI.IFFVIEW DR LOT: 10 BLOCK: 2 CEDAR CLTFF 2ND P.T.N.: 16-16601-100-02 DESCRIPTION: ? .... _ 4 B;uiIding•-permit Type f?Building W'd,e.k Type ? DECK NEW REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $.59 Total Fee $30.50 CONTRACTOR: OWNER: - wpplicant - RUZICH JEFFERY 2093 CLIFFVIEW DR EAGAN MN 55122 (612)452-7477 I hereby acknowledge t.hat I have read this,application arrd stat.e that the infarmation is earrect and agrRs to comply with a13 applic?able State of Mn. 5tatuCes and City p'F Eagan Qrdfnances. L j'pL? 02144?X? A LICANT/PERMIT E SIGNA R1?E? ,firx,.n &1j I 1712 ISSUED SIG TURE J 14i9i CITY OF FAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 -?3Dofo Pn d1f] rl-.:n SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site nergy calcs. .? (, I. 1 8 199?r COMMERCIAL 2 sets of architectural & structura plans, 1 set of specifications, 1 copy of energy ca ------- Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date7 - ? ?Valuation of work ,?QGF1 rte Address: :1 G a' 2 l'/;jZF&. ew 1-s'bc2_ STREET SUtTE H Tenant Name: (commercial only) LOT ? BLOCK ? SUBD.Ge??y?., oG A r f?adi Descri tion of work: The applicant is: J$ Owner ? Contractor ? Other (Describe) Name 'C P h o n e 7y77" Property LAST FIRST Owner qddress a/it 3 ?_/.?,?,?v?.ew- , STREET STE N City ? w State ,14 A/ Z i p ? S1-2 -?L- Company Phone Co ntractor Address License # Exp. rity c±ato Z;P Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. 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. Signature of Applicant: ?? . G.ALVlN H. HEDLUND ?y 9609 Olrord Avenue Soutn a?d Surv•ror Clvll Enqineer ZJ20 Bloominqlon,Mlnnesota 5545, C ? Phone:88B-2080 Surrlevorw eeffili"-wxte ? JOB NO? ZP 7 Sll(iVEY FOR: Zachman Homea :€SCP,IBED A8: Lot 10, Block 2 CEDAR CLIFF SECOND ADDITION, City of ?iin, Dakota County, Mihneanta and reserving.the drainage and i'.ilitj? easementa ae ehown on the record plat thereof. I _ ?l i" ?j IO,CI 5da ,p cf block 90r•.0 >aSement floor 891o.43 ''*aira9e ''rc?PnseC? ' xislin'3 ? i,:0nfe5 floor 89°I.ln direc+ion ----?- eleva.tlons ? eleva}lons Iron Manu mCn}' 4 0 m _ /No,c rN i J- S i lo'& SfAkes a M 897.1 896.8 ? ?tTIFICATE OF SURVEY I hereby certify that on / I11610/ I surveyed the property describsd above and thot tne above plot ia o correcf representofion of said aurvty. Calvin H. Hedlund, Minn. Rag. No. 5942 A- CLIFFVIF-w OaIvE, BUILDING PERMIT To 6e umd 1er S.'' 1.' Sita Address Lot ZO Parcel # - W I Name _Zdchman T-Trxma? 7nr ; Address 7760 M1.tC?],1 Rlk-LC? b o Name ?1? Z? Ou Addresy ? r:.., ..?. _ Nnme_ Address CITY OF EAGAN 9793 Pllef KnoA Reed Eegan, MN 55I22 N? 7033 PHONE= 454-8100 ReceipY i . Est. Value $40.000 omP DeaP_mher 7!1 ?n R1 eiak 2 sac/sun. Cedar Cliff 2nd 10 16601 100 02 1 here6y acknowledge thuf I have read th'rs opplication ond state that the inlormotion is correct and ogree to wmply with oll oppficuble Slate of Minnewta Stotutes and Cily of Eogan Ordirwnces. Sipnafure of Pem+ittee A Building Permif Is issued to: all wo.k sholl 6e done in occordance wifh oll Building Officiol %' ? BUIL[)I] 'Ib Be Used For ? 4?AE" Site Ai''dress: Iot s, /d Bloclc' 7 Se :/Sub ? i Parcel ?: ? ? --??? mo C? r Raner: ? Pddress. 7 ? City/Zip Ca3e?: cvoln Phone #: / 737 Contractor: Pddress: AnA City/Zip Code: Phone #: Arch. /FYtg _ : Pddress: City/Zio Ccde: Phone #: Erect gK Occuponcy x S Alrer ? Zoning PD Repoir ? Fire Zone m Enlarge ? Type of Const. Vn Move p # Stories Demolish ? Length 46 Grade ? Depth 32 Sq. Ft.- APDrovob Pees AssessmeM _ Water 8 Sew. Police _ Fi.e Eng. Plonner - Council _ Bldg. Off. _ APC Permit LJtS.UV SurcFwrge 20•00 Pian check 119,00 snc 525.00 Water Conn. 335.00 Woter Meter 60.00 Raod Unit 1$5_00 rocol $1482.0 O on the Gxpress cordiHOn Ihnt o?nne?C»to Statutes und City of Eagun Ordinances. ¦ Include 2 sets of plans, ,q?? 1 site plan w/elevations & ? 1 set of energy calculations. --- Date OFFICE USE OIVZY ?rect ? OccupancY Alter' Zoning Repair Fire Zone Enlarge 7ype of Const. ? Move # Stories Denolish Front ? ft. Grade _ Depth ft. ? Assessments PesTnit .?? Water/Sewer Surcharge ? Police Plan Check Fire SAC p gnq. Water Conn. .'?2 5`a0 d plannes Water Meter Q O d Council Road Unit Bldg. Off. P,PC TOTAL -? I ?-°. 1 cc ?IO 2? `?j CZTY OF EACaN ..?,1 ( "??,A?LVIN H. HEDLUND 9809 Olrard Avenue Sourn Lnnd Svrveyer Clvll EnplnNr . 8loominqron,Mionasora 5543; PhOM ? 888-208h surr?er?or?? G'ert?j"?ate ? ?zP. 7 JOB NO. 5URVEY FOR: 7,achman Homea ' i?€SCP.l9EQ A3: Lot 10, Block 2 CEDAR CLIFF SECOND ADDITION, City of ',cian, Dakota Covnty, Minnesota and reserving the dreinage and ? "xt,i.lit}n easementa ae ahown on the record plat thereof. i $9,--0 ? --- 7 ? - - - ? - - - - --? . I I ?NoRTN i 10?0 5#,kes ` ?• ?? - 2 t \ Top of bioe-K 900.0 17 (jasement fIeor 81195 ° GAR N, 1 C ? lo 4P 5V-'T"R Siukes \\`? ? '?foor 8?1°l.(v lw5 :,)rair?age direc+ion -?--?^' t"pA?? 5 ? Propnsed ¢leva+ions (-7 ? ?- xisl ing eleva}lons I ???p "p i Cit,nohes lron monumen{"C J - i 7 .00 CLI FFVt EW DRIVE 897.t - y i { CERT_Ifl"GATE OF SURVEY ' Y hrrehy certify tMpt on I surveyed fhe properfy describad oDove ond that ? 4 the above plof is o correcf represeetntfon of sofd suney. Calvin H. Medlund, Minn. Re¢ No. 5942 k4 ? . .., _... ? kiSCROW ACREEMi:NT POR PENDING ASSESSMEN'fS llate April 8, 1982 Case No. TD 11545 Property Address: 2093 Cliffview, Eagan Lugnl Ucscrip[iou: _Lot 10, Block 2, CEDnR CLIFF 2nd ADDITION ? It is hereUy agreed by and beiween ZACIIMIIN IIOM?S INC. , sellers of the above property, and Alen Nelson and Kat er ne e son buyers of the property, tliat [hc following sum wil.l he held in escrow Uy Guaranl'y Titl lnc., in a aon-interest bearing fiduciary account for payment of the following pending spccial assessments against said property. ASSECSMLNTS Utilities Streeta rSTIMATLD COST 2692.00 -2-9-3--rr-.fr? Poll 1te#VoA7V6/o ?"l-a - % -." AAtOUNT }IELD 6283.75 1'oeal$ 6283.75 lt is ;igreed [hat after paymen[ of Lhe assoss^ents the balance oF fund:, held in escrcw, hti- Cu:iran[y Titlc, luc•. tih;ill bc pald to: __ Zachman Hcmesf Inc. A'I 7760 Mitchell Rd. Eden Prairie 1[ is furcher agreed [hat if the nmount wit.hheld for assessments is insufFicient the sellet, Laill, upon notification Uy the srild Company, reimburse the Company for Che nddiLional amoun[ necessary for paymcnc. ln the event Lha[ any dispuce or question arises concerning the appropriate dis[ributi or disposition of the funds and/or documents deposi[ed hereuncbcr, the paities heieto liareby agree and auuhorize the l:scrow Agent, at it, election, to hold any money and/ot Jocuinents deposited hereunder until an aclSon :;h.ill be hrought in n(:ourt of campecent juri:.diccion to de[ermLne the right.s of the pnrCics licreto, or to luLerplcad said paz b} an :iction brouUht in any such Court. 1)eposlc Uy F.serow Agent of said documents anc funds, nCter deduccing thereCrnm [iscrow Agonc's charges nnd expenses and at[orney's fers incurred in connection with any such Court aclion, shall relieve Gscrow Agent uf all furChcr liability and responsibili[y. 'I'hr parCies here[o do liereby indcmilfy and savr_ harmle,s P.scrow Agent against all .04;s,_d;:mages,- a-:lc:ney's fecs , expensey ancS liabiiities, wiiich i[ may incurr of suscain in connec[inn with Lhese instruc[ions or the escrow created hereby, or any Cuurr action arising [heretrnm and will pay same upon demand and, Escrow Agent sha11 hAve the right to deduc[ such ilems frnm escrowed.funds being held Uy it. Property Illl1: I).iLe of Compl. Villagc or Ci[y (esL) Unknown Eagan =/ (-2 sell sell 6uye buye crrY usE oxi,Y PERMIT #: RECEIPT DATE: LI- D I MID$ftTIAL 14IECRANICAI. PERbI1T i4PP'LICATIOft crrY or E?ssx 3830 Pn.ar [uuoe [to EkBAR A!R $518E 851-681-4895 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: O S? G2-/ 0 I SITE ADDRESS: OWNERNAME: TELEPHONE#: `CoSI_452 (AREA CODE) INSTALLER NAME: TELEPHONE #: (45 I,372-S5Z ? (AREA CODE) STREET ADDRESS: ?, t-'. G, CITY: Q? STATE: 1 Y??J ZIP: ???o `? Place a check mark nert 4n 4hn nermif werk tvnn New residential dwelling unit under constructionand not owner/occupied $ 70.00 ? Add-on, modification or alteration to existina dwelling unit $ 50.00 • furnace replacement • air exchanger • air candRioner • other Nature of work: State Surchar e $ .50 Total $? .6e 6c) Reminder: Call for inspeetions. SIG TURE OF PERMI E Updated t/O1 . . .7uly 2, 1982 2093 Cliffview Drive Eagan, MN 55122 Ken Powis Zachman Homes 7760 Mitchell Road Eden Prairie, MN 55343 Dear Mr. Powis, Per our phone conversation today, I have attached the Notice of Special Assessment from the City of Eagan totaling $1,776.56. Which will be or has been paid by Guaranty Title, Inc. Thank you for your information and assistance. Sincerely, Katherine M. Nelson cc: City of Eagan ? ? Jf 4? ? , r?.??... Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - I For Office Use j~ Permit* ✓ l~'' City of Eap I Permit Fee: ~s 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3`°Z0'IoZ Site Address: Uq3 C/=fFve Unit M Name: lp i, / ~o( e: Phone: RESIDENT / p OWNER Address / City / Zip: ® / 3 Q Pte- Applicant is: X Owner Contractor TYPE OF WORK Description of work: r e - 'I'aaT' Construction Cost: 0 do Multi-Family Building: (Yes / No X ) Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: 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.gopherstateonecall.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. X fa ~I r L6? Gf S (°,r) x Applicant's Printed Name Applicant's Signature Page 1 of 3 For Office Use ;,0 Permit#: /fig/ -76 EAGANPermit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: huqiriinyinernertinne�r•rleltrmfanan cnm Kms,. 2018 RESIDENTIAL BUILDING PERMIT APPLICATION ,p /i Date: c� Site Address: j 0 7.S e /, 'e V/`„ Unit#: Name: PA'>9/ L c1 !.f r 561 Phone: i/v2 Resident/ Owner I Address/City/Zip: a 550 63`e'f>1° Applicant is: Owner Contractor Type of Work I Description of work: r'C' lir c e- S 0,,`m _S >° —'G via' '— t^�J/1 (%'�" LYpLA),-/101&62 � ��' 10f 6 /I SES U'��Ce a Construction Cost: t ► Multi-Family Bui a •:(Ye i No X ) /.9ryt dori • Company: Contact: Contractor t Address: City: State: Zip: Phone: Email: License#: 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 Contractor: Phone: Fire Suppression 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 ou •rovide •ecific reasons that would •ermit the C to conclude that the are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.com/subscribe. 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. 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. ‘Nvivy.cop;er stateonec"a U orq 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. x Pa/4/ ' x 12dej Applicant's Printed Name Applicant's Signature