4678 Lista Pt
2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
-$ 30 !E)o
Date (AP / cA-1 / Q(p
Site Address L-kbI L.k -,?AGl "Vp i Mfi
Unit #
Property Owner Q Zc1''\ U rq z.Q,r-k ? Telephone # ( (051
Contractor ?`?7n.Ipn.Qat otrxKa) GNL? '
Aif 52r1/1UL
- ,
S'K.
StreetAddress i
City
State m('? Zip Cv5 \01- Telephone #(' Ip`-j ) Z'2-b1 lqO
Bond #• Expires:
The Applicant is _ Owner A _ Contractor Other
Add-on or alteraNon to existing dwelling unit $ 30.00
_ fumace
_Additional
?LReplacement
f
New -
"--
air exchanger _
air conditioner ??
i i
heatpump ,
_?u;
_
other
5tate Surcharge $ .50
Total $
I hereby apply for a Residential Mechanical Permit and acknowledge that the informarion is complete and accurate; that the wock will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an applicadon for a permit, and work is not co 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 p\l?ans.
I ? ?
?_?- ? C?n4-
Apphcant's Pnnted Name Apphcant,s Signature
RESIDENT OWNER
7
Name: 'J'I J 6 Phone:
Address City Zip: 7 1 ZtSl 7``
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: r/'
Construction Cost: /4 75 Multi Family Building: (Yes No
CONTRACTOR
Name: N e CO CSji\O (.&L* S License 2(.) (03(03(05
Address: 2 2 0_,(0V& \('i 1 r•
City: c Votbk State: fl Zip: 3 4I
r
Phone: (p 7 Contact Person: j'ed (A' I (P1
COMPLETE
In the last 12 months, has
No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_Yes
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.
City of Eagan
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Applicant's Printed Name
Appli
r
Use BLUE or BLACK Ink
For Office Use
Permit C cC
Permit Fee:
Date Received:
Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /(7.-) 1 Site Address:
Suite
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.popherstateonecall.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 t e approved plan in the case of work which requires a review and approval of plans.
Page 1 of 3
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
t
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the -City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Dote of Insp.: %, - 7 �- 0
C Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Plot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Address: — - - - - -- -------- - - - - -- - -- - - --
Site Address:
Plumber: — — — — -- - --
agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
B Surcharge:
Y Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
Use BLUE or BLACK Ink
r
For Office Use
• I jl
City of EanRdon , Permit#:
I Permit Fee: 1
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 Staff: I
I I
- - - - - - - - - - - - - - - -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: v f 3 Site Address: q07,1491 R&ATOh !L?~Y,Jd G51 pfi Unit
Name: g J V&A1C L (rF- f S~ Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Description of work: 0 re y
Type of Work
Construction Col ~'y '0 y Multi-Family Building: (Yes > / No )
Company: hto1L1Z'W -t t f&A ''e --tm Contact: Lie N J' 't "
Contractor Address: I ~>os- SACr-fiG4-o Gt City: ,Jy/ fyu~
State: Zip: T-l?? 7 Phone: C0r~_ - 9/ (s `'f -0 1
- 4 4
License 2-U3 gpU / 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:
F NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
L__~e information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they 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.cioi)herstateonecall.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.
T
Applican s Printed Name Appli s Sig ure
Page 1 of 3
41°
City of Eapi
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
/2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: y 7'_4'4 Site Address: 14 7,YL8'% Ihniteri y17F y`12 664 ~" Unit #:
Resident/
Owner
Name: IID 6 e C L /Fre (c t Phone:
�J�
Address / City / Zip: L_ it41
Applicant is: Owner Contractor
T e of Work
yp
Description of work: -5/07115
Construction Cost: (0 . (,L;(� Multi -Family Building: (Yes X / No )
Contractor
Company:/0e/2od1 /1i4dt C'. 1i/1 Contact: A 11 G-- 41.567V -e vel
/
Address: / 30Q Gs .0/ / e� Gt' City: ge.J/LL1.54/7(! "t'
f/°
State: f � Zip: Sr S— 7 Phone: U!/®1 — F/ t "- 7 P U
X33
License #:42 v /
3 ko G G Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
_Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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.gooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codeeof 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 ork 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 complete within 180
days of permit issuance.
/ y
e
J''� '/fort x � .rF`
A Printed Nafiew
PP Ap'. cant's gnature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA149426
Date Issued:05/22/2018
Permit Category:ePermit
Site Address: 4678 Lista Pt
Lot:1 Block: 03 Addition: Ridgecliffe 3rd
PID:10-63982-03-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Vernon Gragert
4678 Lista Pt
Eagan MN 55122
(651) 454-3259
Bonfe's Plumbing & Heating
455 Hardman Ave
South St. Paul MN 55075
(651) 228-7140
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA152156
Date Issued:10/01/2018
Permit Category:ePermit
Site Address: 4678 Lista Pt
Lot:1 Block: 03 Addition: Ridgecliffe 3rd
PID:10-63982-03-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater & Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Vernon Gragert
4678 Lista Pt
Eagan MN 55122
(651) 454-3259
Bonfe's Plumbing & Heating
455 Hardman Ave
South St. Paul MN 55075
(651) 228-7140
Applicant/Permitee: Signature Issued By: Signature