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3818 Lodestone LaneCITY OF EAGAN Remarks AdditionCIDAR GROVE #11 Lot 4 Blk 2 Parcel Owner? YZZ ?o LJStreet 3818 Lodestose Lane State 'T'a'8an t M 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ? -1971 2 / ?.;? ?;:c /o STREET RESTOR. ?1975 124.31 12.43 ZO GRADING 5 10 SAN SEW TRUNK - 1 6 60,09 2.00 O / 4C iF SEWER LATERA : -1975 19493.96 298,79 ; Water lat ?& area 1975 5 WATERMAIN WATER LATERAL & area 1975 200.4 13.36 1 Z- WATER AREA , ? Storm Sewer Trunk 31 1 6 268,39 .68 ' STORM SEW TFjK _ 1971 33-56 1.6 QO ;•? u: ?'? STORM SEW LRT 0 1971 22. 7 1.U 20 CURB & GUTTER ' SIDEWALK 195 197$ 137.52 18.7$ STREET LIGHT ? ?,,,_ ?? ? WATER CONN. 7_21_78 BUILDING PER. 4999 ' SAC PARK I I f CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-189-, (612) 681-4675 ?I SITE ADDRESSc I ? 1 Ut;lr ?,I'n'JV N.1 1 PERMIT SUBTYPE: a 'N • I INSPECTION RECORD PERMIT TYPE: Permit Number: ? Date Issued: APPLICANT: i nat , : TYPE OF WORK: IiF `,CF+7P 1 111 tJ MUt1 tI1Ngi H:ifS1'<'4 8f, /3N/ti)l lnplri ErrPAtp tC.ilOFlNfl1 Permit No. Permlt Holder Date Telephane N ELECTRIC PLUMBING HVAC Inapection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBINO PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE RECEI V ED 19 AMOUNT $ 4 DOLLARS ?oo 0 CASH 0 CHECK White-Payers Copy Yellow-Posting Copy Pink-File Copy Th nk You -?, 6Y ?? } ? CITY OF EAGAN - 3795 Pllot Knob Road Eagaa, MN 55142 N2 4898 PHONE: 454-8100 BUILDING PERMIT Receipt # To ba uxd for - ` Est. Value Dote , 19 Site Address Erect ? Occupancy Lot Block Sec/Sub. ` Alter ? Zooing Parcel # Repair ? Fire Zone _ I E l T e of Const _ n orge ? yp . W Nome Move ? # Stories 3 Addre ss ,21G'r . Demolish ? Front ft. 06- Grade ? Depth ft. o Name ?? U Address ~ Ci Phone GW Name ?W =Z Address I hereby acknowledge that 1 have read this application and state that the information is correct ond agree to comply with ofl applicable State of Minnesoto Statutes and City of Eagan Ordinances. Signoture of Permittee _ A Building Permit is issued all work shall be done in a 8uilding Officiol Avvrovah Fees Assessment - Water & Sew. Police Fire Eng. Planner _ Council _ Bldg. Off. _ APC Permit _ Surchorge Plan check SAC WMer Conn. Water Meter Total = " on the express condition that State of Minnesota Statutes and City of Eogan Ordinances. Pormk # Dab looed ?wsMfw Plumbing /'/LL= 9 ?.i lL' -- Mechonical i z yo r'?-ZS- Ay £c,. INSPECTIONS DATE INSP. RoupF-ln Final Footings Date Insp. Date Irap. Foundotion Plumbing $- Frame/ins. j ? Mechanical Final n Remarks: ? • CITY CF EAGAN 3795 Pilot Knob Road Eagan, Minneaota 55122 Phono: 454-8100 HEAI: i ? _ PERMIT Dote: I Site Address; Lot ? Block Sub/Sec. _" - Name ? Address -00 Lyndale Ave. <;_ . City .:: oomington Phone: a:. !y welter Heatina Name . . `i ?,h1CdJ0 g Address ? v City ?s. 554L'7 -Phone: This Permit i s issued on the express condition that all work shall be Minnesota Statutes ond City of Eogan Ordinances. No. ,....` Receipt No.: I Single F; Residential Multi Res., Comm./Ind. New/Alter./Repair Cost of Installation ?n Pertnit Fee :C Surcharge Tota I done in occordance with all appliwble State of Building Official ' CITY OF EAGAN 64 0 17957 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-81 00 /"? '? ; BUILDING PERMIT Receipt # ? ? tl9000 DECK Jm To be used for Est. Value Oate , 79 3818 tADSB'[ONE LAti6 Site Adk ess ? OFFICE USE ONLY Lot Block Sec/Sub. PBfCeI NO. Occupancy - FEES jgyy Zoning - :ZS*00 W Name (Adual) Const - Bidg. Parmil o AddfBSS (Allowable) - Surcharge City Phone r oi siodes - Length _ Plan Review ??1?E? , o Name Deplh - SAC, City oi Address 4 S.F. Total - SAC, MCWCC ? 57 Clty Phone 431-4 S.F. Footprints - On Site Sewage _ Water Conn ? W W Name On Site Well - Waler Meter _= Address MWCC System - Acct. Deposit i W City PhOnB Ciry Water - PRV Fequired - SJW Permit I hereby acknowlege that I have read this applicatioryand/state that the Booster Pump - SMI Surcharge infarmation is cortect and agree to com ly with a,VgppycaWe State of Minnesota Statutes and City of Eagan OnBng@s. ? Treatment PI v Signature of Permilee ? ` APPROVALS Road Unif ? A Building Permit is issued to! BU1?ERS Planner - Park Ded. on the express condition that all work shall be done in accordance with all Council - applicable State of Minnes o yp8tatutes and Cily of Eagan Ordinances. Off Bldg Copies $25 30 ? . . _ * , Building OffiCial _ _ ??-?--?-- ?' ??? ?`- ` ?= ?r.'?- Variance - TOTAL .. . . . . . . r . _ .. . . ..., . PermN No. Permit Holder Date Telephone N WATER SEWER PLUMBING H.VAC. ELECTRIC Inspsction Date Msp. Comments Footings I • Foundation ' Framirg Rootirg Ragh Plbg. Rou9h Htg. Isul. Freplate final Hig. Final Plbg. ConsCMeter Plbg. Inspeclor - Notify Plumber Ergr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN 3795 Pilot Knob Road Eogan, MN 55122 Zoning: _ Owner: _ Address. Site Address: Plumber. _- 1 agree to rnmply with the City of Eagan Connection Charge: Ordinancee. Account Deposit: _ Permit Fee: - Surcharge: BY Misc. Charges: - Date of Insp.: Total: Insp.: _ Dcte Paid: SEWER SERVICE PERMIT PERMIT NO.: - - DATE: - No. of Units: Pilot Knob Road MN 55122 No.: to eomply wit6 the City of Eagan WATER SERVICE PERMIT Connection Charge: Account Deposit: - Permit Fee: Surcharge: - Misc. Charges: Total: Date Paid: cirir oF EAGAN . 3795 Pilor Knob Road Eagon, MN 55122 N2 4898 " PHONB: 45487 00 `o/- ? BUILDING PERMIT APPLICATION Receipt # - - To be used fur SF DW].CJ. &('i3YEst. Value 36 ?0 0 0 Dote 7/21 -, 19 7$ Site Address 3111 $ T.nr7act,onn Erect ?j OccupancyBl,T Lot 4 Block 2 sec/sub. Cedar Gz'OV2 ll. Alter ? Zoning Ri Parcal # 10 16711 040 02 Repair ? Fire Zone 3 E ? l e of Const -14 T arge n _ . yp Nome .Tar3 Rnn Move p .#'Stories W 3 Address 10800 Lvndale AV2. Demolish ? Pront - ft. ? _ B100ICl1rigtOri 884-7225 Grade p Depth ft. Phone c p Name S?e Approvels Fees - Z ? Assessment 7 9 1 7 8 Permit 05. 50 ? Address . a iy Woter & Sew. Surchorge 18 • 0 0 ~ Ci Phone police Plan check ?W Nnme Fi SAC 500.00 re _? Address Eng. Water Conr2 5 0 • 0 0 aW Ci phone Planner WaterMeter Co,,,,c;l Road Unit 75.0t 1 herebyacknowledge that I have read this application and stote that gld9. pff. P3rk Uri].t 75.01 the informotion is correct and agree to rnmply with all applicable APC Total 1023.50 State of Minnesota Statutes and City ot Engon Ordinances. Signcture of Permittee _ A Building Permit is issued all work shall be done in c on the express condition thet Stote of Minnewta Statutes and City of Eagan Ordinonces. Building Officiol CITY OF EAGAN No 17957 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 BUILDING PERMIT Receipt To be used for DECK Est. Value $1, 000 Date JUNE 4 19 90 Site Address 3818 LODESTONE LANE Lot 4 Block 2 Sec/Sub. CEDAR GROVE 11T OFFICE USE ONLY P8fC81 N0. Occupancy - FEES 6 JEFF MORTON Name Zoning (Acluaq Const - - Bldg. Permit $25.00 W o AddfESS (Allowable) - Surchar e .50 City PhOnO # of Stories g - Plan Review Length _ o Name ?S BUILDERS Deplh - SAC, City , ?4 Address 845 MCINTOSH DR S.F. Total - MCWCC a City APPLE VAL phone 431-4457 S.F. Footprints SAC, _ Water Conn On Site Sewage - ? W Name On Site Well - Water Meter W = ? Address MWCC S stem y - c Accl. Deposit a W City Phone city water - 5/W Permit PRV Required _ I hereby acknowlege thal I have read this applicatio and state that the ' eoostei Pump - SNJ Surcharge agree to comply with a pp able State of information is correct 'd , Minnesola Statutes a d rt of Eagan O n6es. Trealment PI Signature of Permitee APPROVALS Road Unit A Building Permil is issued to: S BUILDERS Planner - park Ded. on ihe express condition thal all work shall be done in accordance with all Council Sand City o Eagan Ordinances. applicable State of Minneso Bldg. OH. CoPies = $2$.50 Building Official ? Variance - TOTAL ? This request void 18 months from Date o this Request ?? ?? 6 4 468 I, as l?Licensed Electrical C ntractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: I/ C Street Address or Route No. 3?1? ?,?" ? C'tyt` Section Township Range County 1Nhich is occupied by `"l \ (Nameo Occupant) Is a roughin inspection required on this job? No ? Yes ? Ready Now O Will Call ? Power 5upplier Address Electrical Contractor '\0L`xA M&t C441s- Contractor's License No.37?4L" Mailing Address or No' 9Qb-»4 Authorized 5ignature `V (Electrical C SIJ W LI E 00L=i111t10 It'actol or Ownef MaKliy§ T1115 Installatlon) This inspection request will not be accepted by ffie OW State Board unless proper inspection fee is enclosed. rvimnesota state tsoara oT tiectricity 1954.University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WOKK COVERED BY THIS REQUEST //1694. ? 64468 Type ot Building New Add. Rep. Check Appliances Wired For Check Ecjuipment Wired For Home ? ? Range ? 'Cemporazy Wiring ? Duplex ? ? Water Heate[ ? Lighting Fixtures ? Apt. Bldg. ? ? ? Dryex ? Electric Heating ? Commercial Bldg. ? ? ? Fumace ? Silo Unloader ? Industrial Btdg. ? ? ? Au Conditioner ? Bulk Milk Tank ? Farm ? ? ? List List Other ? ? ? p Heiets p Hehers? COMPUTE INSPECTION FEE BELOW ? ??n Service Enuance S'ue: #,. Fee 11 Feedeif, ubf F. 11 Cucuits: # Fce 1 101 to 200 Amps. 1' 31 to lOD Amperes ? to 100 Amperes ? ?Above 200_ Amvs. Above 100 Amos. Above 100 Amus. Remarks r I,the Electrical Inspector, hereby cer4 4" thd4 (Rough-in) ? r (Final) Minimum fee TOTALF tEP?O?tO has been ma-ffe Date This request void 18 months from C.LTY OF EFlGAN GASH.l'f:k: S TFF.M:CNAL NOe 99 fiA7E.: 05/30/97 7IMEn 13:59e58 ID ; NAMEr .70HN t tt7NES 321.0 9001 3818 L..ODErTCINE 74.75 205 9001 30£1 !_qD`;:iTtlNE: 1.50 Total. I;er..eipt Amoun+,e 76.25 CRQi44?3 t.ISf:"F :f.Lio NANCY ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P . I . N . : 10-16711--040-02 DESCRIPTION: ; ;?nsuS Cc??e ? Av X° " F WS ? i k+ . . _ =fs i- . ? ?L •. . .. _ .... PERMIT TYPE: Bu zLDz NG Permit Number: 030124 Date Issued: 0 5/ 3 0/ 9 7 3o1^a LODcSTDNE I_ANE LC1T: 4 BLOCKs 2 CFDAR GROVE #11 -?_ (ROOFTNG) B ??jCl:d itt ?gl??_„qe r rn J. t T y p e BqLildi?t? 6Jq?s. k. TYPe SF (MTSC.) REPAIR 434 AL7. RESIDEN'CTAL Y4.V91 a :r' fr"i h , ?a ? w?? E.":9 { ? 1`i x k?l ar i. ;,..?'am 'w.?1a.? ,?:r .a: s, v?.v?lre REMARKS: FEE SUMMARY: Base Fce Surcharge Total Fee VALUATION $74.75 5 0 $76.25 gs,smm CONTRACTOR: s T hereby aQl4nowledgi tha.t T, ha ve. I E infi?rmetia?t is ?°c?rrct ?r'i?#:?gree 1 ? -_ _'- -_ ?._ ... ..._ ...... ,.. ,_..?......?... .?.:?. APPLICAN7/PERMITEE SIGNATURE PERMIT OWNER: - Applicant -' JONES JOHM 3818 LODES7QNE LN ?AG;AN MN 55122 (612)452--7086 3011 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681 -4675 New Construdion Reaufromertts $emodeVReoair Reauiremanb ? 3 registered site surveya ? 2 copies of plan ? 2 copies of plans (indude beam & window s¢es; poured fid. design; etc.) ? 2 site surveys (exterior addidona 8 decks) ? 1 energy calcuiatlons ? 7 energy calaladons for heated addidons i 3 copies of tree preservatlon plan H lot platted after 711/93 required: _ Yes _ No " DATE: 7 I o29 CONSTRUCTION COST: DESCRIPTION OF WORK: Qe°GL?!4 ir ? STREET ADDRESS: 19 LOT ? BLOCK I_ SUBD./P.I.D. PROPERTY Name: S btAz5 C oku Phone #: ?52 7c6?S? OWNER „?.. ?.. Street Address: 31S G.?6540u.e G.-4 City: State: u\aN Zip: ? ?12Z CONTRACTOR Company: Phone #: Street Address: License City: State: Zip: ARCHITECTI Company: Phone #: ENGINEER Name: Registration Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): . Penalty applies when address change and lot change are requested once permit is issued. 1 hereby acknowledge tfiat I have read this appliption and state that the in o is ct and agree to comply with all applicable 4ii State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY - Certificates of Suroey Received _ Yes _ No Tree Preservation Plan Received Yes No Not / ys7 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLZNGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE FERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE W1-IICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. jjRY RFfT To Be Used For: -? Valuation Site Address ?}/.es)6? Date: -? 3/ ?O OFFICE USE ONLY Lot ? Block ? Occupancy Zoning Parcel/Sub CEbAR GPlQVIE "Nfl, 11 Actual Const Allowable Owner 3 # of stories Length Address Depth S.F. Total City/Zip Code Foo*_print S.F. Phone Contractor 44//? Address City/Zip Code Phone Arch./Engr. Address City/Zip Code On site sewage_ On site well _ MWCC System ? City water _ PRV _ Booster Pump _ APPROVALS Planner Council Bldg. Off. 'jg6/( Variance FEES Bldg. Permit e2Dt? Surcharge so Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Copies SUBTOTAL Penalty TOTAL COIS. SO Phone # ? USUAMAM ? r ? -•?: ? XwV^LY?rn.?y ? ?wi 7..iV ? 1?M ..n+?`V ? L? ??I Certificate o! Survey for MpRF?L /t y ?t ? 4?1 \VP ? ?.6? ••: Q6354 »/ ?, {! y M?? F- t• ?, ? ?,- -__--' --+;-"I"a"'-N_rw•.. ...--'`1' V.- ?! REAL-TY,.ING. Cpt tk 441 y % 32 161 LOT A BIoc K 2 , c C-DAQ ?aovc uo. H (b(o{Q Coun;y 1 o- ??no(¢5 irbn mo'1uni¢d 5ca/¢ : _ 4 o 1 A?.eb? ??.?i1r 11?e? rAi? i? a Iru• owd Nr•??1 .?p???nr?1??n •I •?u.r?? •I ?A• beundari?? e/ rM o0?-• Mu.,bod Iend, ond ei IM le.aliew oi o11 ru:ldings, ri.e.een? •wd all r,,,41• •na•vo4Mn.9n16, il enY, I.oT r et, _?J. soid Iowd. A. w.veyod ?y T• VAis_dey el A O. 1iP SUBURlAN ENGINEEtINCi, INC. Iw?iw??r? ??•% Su.ve yq.? l . by ?? , /« Lr• ? >>t? - 1415 -;t ?tr 9 p nATE BUILDIfdG PERMIT APPLICATION Include 2 sets of plaas, 1 site plan w/elevations and 1 set of energy calculations. ? To be used far S?r+? Valuation 3b o00 Site Hddress: Lot l? Block Sec. Sub. Pa?rcel Number 09'jq p 1 C-2?Ar C71aII2 Qk+ner Telephone P.ddress zn/^ contractor Address / ? Telephone _ Arch. /I:ng. Address Telephone OFFICE USE Erect Alter P,epair Enlarge Move nemolish Grade Occupancy 2oning Fixe Zone Type of Const. # of Stories Front Depth OFFICE USE Date of ApiDroval & Initial Assessment Water/Sewer Police Fire Eng. Planner Council Bldg. Off. A.P.C. FEES Pezmit Surcharge ! ?f ?'- P2an Check ? SAC I-Tater Conn. 1•15*r 'Peter ,0 . ??gp b+ wr,< •?!? N.r?wl N•. R• r? ? NOIMteRINO ; w,M?.v,'•• M+++tiv ?w+: l:4ouU'.. ? ilI ll? ...? 4.ti1 DAo Certificate of Survey for MARELL REALTY.) Nc. ? ? y t?o COV ,'? tirRr c ? \ PC'? R1354 ? • - B ? ?00<`' ow, _ \" /?s ` i ? 3w 0 N /?`? \ \ 1 ? ?•\_-- - ?- ? LoT A gLoc K 2 cCr)AQ GQovc No. H , , . f?kofa f'oun;y ? o ? t?riOlQS 1?bn n70?7urrtQJ1T 5ca?e ? / ?= 40 , - - - - _ I?¢not¢5 droina9¢ • ?t?-?t? eo??"?e.?; , I 6e.e6f 1,99i1y tFat 16is is a vu• owd cerrwcf r?p.???n?el?on ef esur.0y el •ti• bounda.irr+ ol r6e uhe.• d*saribed land, ond ai IA• leaal:en d ail br:Idings-tA,rvon, oed al) .i%;bl• •na.oeahmenls, il ony. I.nm e? ws soid land. A. +u•vey.d by m• rAi. dey o/?,f'i• 0. H?. ^ SUSURSAN ENGINEEIIN(i, INC. Iwpiweers yy a=',Y• /-.v ?r•! .7l?_ C? 7.4 1 ri Use BLUE or BLACK Ink r For Office Use I Permit City of Ea~a~ I Permit Fee: I G 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 i Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Q/ q) f'% 13 Site Address: t- OAC-S'Oh P L o n `e Unit M I Name: CL~ h , C3 n S Phone: I ' '-S~ ' > y J Resident/ l c~ / Owner Address / City / Zip: oC 7 Sa Le CA, d nar ~ V I /te y /t't L S°~/o),y Applicant is: Owner Contractor Type of Work Description of work: C_ r D o { yt.o„ y Q Qi n S- e J1 Construction Cost: Multi-Family Building: (Yes / No f Company: Rel',a a,/ J*f1 t; 5`f / e v~+ T k c . Contact: Q S© / ` c e lr Address: 1 r 95040 City: ~r of La k e Contractor State: Zip: 5!9 3 7 d, Phone: License VC, L 5 D I I l Lead Certificate I\ ' ~ 3 L 3 -0014 b 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 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.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. Applicant's Printed Name Applic t s Signature Page 1 of 3 Reliabuilders 4tak. City of 1aali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 952-226-5514 p.1 Use BLUE or BLACK Ink For Office Use Permit#: l C///-2 Permit Fee: /0-7` Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 10-10-16 Site Address: 3818 Lodestone Lane J Unit #: Resident/ Owner John Jones 612-751-3101 Name: Phone: 3818 Lodestone Lane Address 1 City /Zip: Applicant is: Owner x Contractor 1 Type of Work Remove and replace asphalt shingled roof Description of work: Construction Cost 10,000.00Multi Family Building: (Yes 1 No x ) Contractor Company: Reliabuilders Construction, Inc. Contact: Jason Michels Address: 3351 Griggs St. S.W. City: Prior Lake State: MN Zip: 55372 Phone: 612-581-6255 Email:lason@retia-builders.com License #: BC650191 R -I-30358-13-00160 Lead certificate: If the project is exempt No paint is being from lead certification, please explain why: disturbed. In the Last 12 months, Yes No 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? If yes, date and address of master plan: Licensed Plumber: s Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor. Phone: 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 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. xJason Michels Applicant's Printed Name x Applicant's Signature Page 1 of 3