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1758 Meadowlark CtCITY OF EAGAN HILLANDALE Addition _ owner- Lot 301 Rik 01 pgrcel 10-32950-301-01 MEADOWLARK COURT EAGAN MN 55122 Blda.#S tlnit #1 Improvement Date Amourtt Annual Years Payment Receipt Date STREET SUfiF. g1ri31 p8 CBZ STREET RESTOFi. GRADING SAN SEW TRUNK origina p rce * SEWEFa LATERAL Ir WATERMAIN * WATERIATERAL 1973 WATER AREA lii? 1975 11.39 ,7 15 Park Donation I 1977 52.82 5.28 10 * STORM SEW TRK 1973 S70RM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILOING PER. SAC PARK CITY OF IiILLANDALE Addition( MEADOWLARK 1ZID(iE: CO-OP . ) .- Lot 302 Qik 01 parcel 10-32950-302-01 1760 MEADOWLARK COURT EAG MN 55122 Owner ' Street Stete Improvement Date Amount Ann Years Payment Receipt Date STREETSURF, R arcel STREET RESTOR . _ GRADING r SAN SEW TRUNK rcel * SEWER LATERAL WATERMAIN * WATER LATERAL 1973 WATER AREA Z 1975 11.39 • 7G 15 Park Donation i1U 1977 52.82 5•28 10 * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PEH. SAC PARK CiTY OF Addition-4 HTLI.ANDALE ADD1Q 'LARK _RIDGF? CO-C IN-i Lo; 303 91k 01 Parcel 10-32950-303-01 Street 1762 MEADOWIjARK COURT state EAGAN NIN 55122 Bldg. #8 Unit #3 Improvement De Amount Annual Years Payment FEeceipt Date STREET SURF, OI'1 inal pi treel STREET RESTOR. GRADING SAN SEW TRUNK ; 2'O 1I181 a cel * SEWER LATERAL of WATERMAIN * WATER LATERAL WATER ARE A Z t'I 11 39 .76 15 Park Donation 00 1977 52.82 5•28 10 * STOFiM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER, SAC PARK CITY O EAGAN HTLLA Addition '? WLARK Owner ? Lot Blk 01. Percel 10 -3 2 QS0-3Q4 -01 street 1764 MEADOWLARIC COURT gtate EAGAN hQV 55122 Bldg.#8 Unit #4 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1 inal rcel STREET RESTOR. GRADIMG SAN 5EW TRUNK original p rcel * SEWER LATERAL I WATERMAIN * WATERLATERAL 1973 k v WATER AREA ZI 1975 •76 Park Donation lu 1977 -Z 2 82 5•28 i o * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY O EAGAN HILLANDALE ADI Addition RIDGE 170- Owner ?' Lot 3?$ Blk nl Parcel 10-32950-305-01 _ f. st«et 1766 MEADOWLARK CQURT State EAGAN MW 55122 Rldv_#R [init #5 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, Ox'1 inal rcel STREET RESTOR. GRADING SAN SEW TRUNIK riginal p rcel * SEWER LATERAL 'y WATERMAIN A WATER LA7ERAL WATER AREA ? 1975 11.39 • 6 Park Donation 001 1977 52.82 5•28 1 * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN HILLARDALE ADDN marks AdditionIMEADOWLARK RIDGE_ CO-OP Lot 306 eik 01 Parcel 10-32950-306-01 r,,.,,,o, ' • Q..m. 1768 MEADOWLARK COURT EAGAN M4V 55122 Bldg.# 8 Unit #6 Improvement Date A unt Annual Years Payment Receipt Date STREETSURF, Y'1 inal rcel STREET RESTOR. GRADING SAN SEW TRUNK 4T'1 lIIAI TC01 * SEWER LATERAL ?f WATERMAIN * WATER LATERAL 1973 WATER AREA 2 1 1975 11.39 .76 Park Doantion lU 1977 52.82 5.2$ * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN HILLAIQDp7,E /1DDRRemar Additionf MEAnowr.aRx U,.tQ? eo-op Owner Street Lat 307 glk 01 pa?cei 10-32950-307-01 1770 MEADOWLARK COURT C,,,,,, EAGAN 14QV 55122 Rltia_#R llnit #7 Improvement Date Amount Annual Years PaVment Receipt Dete STREET SURF. STREET RESTOR. GRADING SAN SEW THUNK OTl. inal rcel * SEWER LATERAL ii WATERMAIN * WATER WTERAL 1973 WATER AREA '] I 1975 I1.39 .76 15 Park Donation 110 1977 52.82 5.28 10 * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CiTY OF EAGAN HTLLAlI Addition 1KEADOWLARK R Owner ? Lot 308 Bik 01 Parcel 10-32950-308-01 S?eet 1772 MEADOWLARK COURT Stete EAGAN NAt 55122 Rldv_#R Itnit #R Improvement Data Amount Annual Years Payment Receipt Date STREET SURF. OTl inal rcel STREET RESTOR. GRADING SAN SEW TRUNK OTl 11111 rCf:l * SEWER LATERAL WATERMAIN * WATER LATERAL 1973 WATER AREA 7- 1 1975 11.39 • 76 Park Donation l 1977 52.82 5•28 10 * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 9UILDING PER. SAC PARK CITY OF EAGAN Addition(MEADQWLARK _C. -0P )_ Lot 309 BIk 01 Pefcei 10-32950-309-01 Owner Screet 1774 MEADOWLARK COURT Stste EAGAN MN 55122 Rldv.#8 Unit #9 Improvement Date A nnual Years Payment Receipt Date STAEET SURF. TO inal a cel STREET RESTOR. t GRADING SAN SEW TRUNK e original p rcel * SEWER LATEFiAL WATERMAIN * WATER LATERAL 1973 WATEA AREA 1975 11.39 • 76 15 Park Donation 1 I 1977 52.$2 5•28 0 * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PEH. SAC PARK CITY OF Addition_ ' Lot 310 Blk 01 Percel 10-32950-310-01 ,. 1776 MEADOWLARK COURT 0-.,, EAGAAI ItiIIV 55122 Rlrla #R llnit #1f1 Improvement Oate Amount Annual Years Payment Receipt Dete ' STREETSURF. OTi 1i181 rcel STREET RESTOR. - GRAOING SAN SEW TRUNK origu?al p rcel * SEWER LATERAL i? WATEFiMAIN WATER LATERAL 1973 WATER AREA 1975 11.39 • 76 Park Donation 1i01 1977 52.82 5•28 10 * STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK , . , . •. r .. . PLUMBING PERMIT For Office Use Only CITY OF EAGAN CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 IDATE: RECEIPT# PRICE PHONE 4548100 _ ? Ivame ,cfi.i[ Lax_ii iA uA. & .. ? Address G G?: Cp Rvzv ti,i c City /-400 rl?' 6,..t! a;e Phone FEES COMM./IND. FEE - t% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APLLIES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMM.IND./FEE $20.00 STATE SURCHARGE PER PERMIT .50 PER EACH $1,000 OF PERMIT FEE) 16- Mult. Add-on Comm. Repair Qth@f RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. --\, FIXTURES T07AL WWer Closet - $3.00 $ Kitchen Sin- Urinal/Bidet - Laundry Tray Floor Drains - Private jQsp. - $10.00 Rough Openings - $1.50 ?itt.ctyt -? ? 6-fERMIT FEE: STATES S/C: GRAND TOTAL: /?, 5 b DAY/DATE ;.,?. TIME COI`MENTS : , ? FTG. FOUNDA?ION FRAMING ROOFING INSULATION FIREPLACE R.I. HTG. AIR TEST R.I. PLBG. FINAL HTG. FINAL PLBG. FINAL C/U DECK FTG. DECK FINAL FOR: lo c? e?vf, GAS WORK ORDER 1082 Payne Ave. 5TANOAFiO St. Paul, MN 55101 M,? ?I , 8 6511772-2449 L!6HEATING?i? & AIR CONDITIONING ? A Blue Do?: Service Co. EQUIPMENT IN ORMATION LAST I&)C} FIRST , e _ . .-. , CITY ZIP ?5 5 I z 7-, HM PH &'5l456 -i ?"d WK PH ' TECH M rC DATE /o f 2 z 49-? TYPE MAKE , MODEL o ,o c ,D p SERIAL 3 062 91 (3? INPUT (o G , D cc-, ORSAT TEST RECORD C02 I °/6 METERED INPUT Cfh CHIMNEY TYPE - l/0,17- 02 % LIMIT SETTING ° FLUE SIZE CO ? % PILOT OUTAGE L ? SeC CONNECTOR SIZE 111. NET STACK TEMP 3-7 3 ° TOTAL CHIMNEY INPUT /d?'. 000 btuh CITY of EAGAN Owee: .... '/ ??J Addrasc (Pzesea!) Q .??....lV.?.Y......?.i<•??`?"^'!--.....?.... ,+. ? Huilder ..............°??i..?'?--....................----......-°--°--°°---._.._._ ... Addsew .? . ? N? 3414 3795 Pi1oY Knob Road Eagan, Mix?nesota 55112 454-8100 Dels .....?:..C/...D..::..?jCl._....... Bforiss To Se Ueed For Fzoni Depth Hsighi? Eel. Coo! ssmtt Fea Remask? I fd ?,,? ??? 1 , r94c?a 47 = s LOCATION Slree2, Road or olher Deceripiian o! Locefion ? LW I Sloek ? Addiiion or Trae! k?? I oi ? /o .?a95a This per? does no! aulhorise !he use of s2reets, roads, ellaps or sidewelks nor doee i! give !he ownas os his agen! !he righ!!o ereale anp situaiion which is a nuisance os whieh precenls a hasard !o !he heallh, eafelp, convealaaes aad general welfare Yo anqone in !he communily. THIS PEAMIT MUST B ?ETp??? ON PAEMISE WHILE THE WOAK IS IN PROGRESS. . oe Th[s is !o oarlifp. 3ha1..F.f?..?*:?f1??......? ...............haspermiseion !o erac! a..?...Lr.4 .... .........fi?f.(:......._upon !he ab ve des5 ?' ed remise subjecY fo !he provisions of all applicabl ces t ifp of Eagan. ..?.....{ :...............?-Y..?.............-----.................------. Per ?..._.........._._..-°???--..._....................................... Mayor Huilding Inapsclor BUILDING PERMIT ?-?..??,??°?..... ......? ............... ..... City of Eapn 3830 Pllot Knoh Road Eagan MN 55122 Phone: (651) 8755675 Fax:(65Y)675-5694 ------- ----------- ? For o _H'ice_use ? j Permit#: / ? j ? PermitFee: %(J•?? ? ? Date Received: j ? I I Staff: 1 i ---------------- 2008 RESIDENTIAL BUILDING PERMIT APPLICATION SneAdd??: Mfrart nM Yk. C-A- Tenarn: Suite RESIDENT / OWNER Name: , 111? Phone: ?(? 1_9clq - ? ??? Address / City/ 2ip: ? fann.r-t ?- 5'?? ? A li nt i tr r O t ><C pp ca s: _ wner on ac o TYPE OF WORK Description of wo Construction Cost: ? ? MuIU-Family Buitding: (Yes _ / No ? CONTRACTOR Name: License #: Addres s : I -l V?V C? , / ?? S 1 Y 1r\ ?{1) \j UG' lU -t/ 1 tate: Zip: City: V i Phone: G?r} - v5 1` 3Contact Person: HI r p ?+Ynr(/_?_ COMPLETE THIS AREA ONlY !F CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateoorv 1 Minnesota Rules 7672 Energy Code . pesidential Venlilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 Sllbmi39iOn typC) • Energy Envelope Calculations Submitted In the last 72 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 Contrector: Phone: Sewer & water Contractor: Phone: NOTE: Plans anJ supporting documertts that you submlt are considered to be public information. Portions of the in/ormation may be Gasslfled as non-publlc If you provide specific reasons thaf woWd permit the Clty to conclude that the are trade secrets. I hereby acknowledge that this iMOrmalion is canplete arM accurate; that the work wiN be in confortnenCe wfth the ordin2nces and codes of the City oF Eagarr, that I understand ihis is not a parzn@, but only an applicaUOn (or a permit, and wark is rrot to start without a permik that the work will be in accordance with the epproved plan in the case of work which requi2s a reviaw and approvel of plans. x 1,iss4 ?k4?? ?71? X ApplicanYS Prlnted Name plic t's Sigq tfi 6 Page 1 of 3 ------- ---------- i r-a orr?ce usen,/ /? ?7 I ??? y Of ELLp ? Pefmh FEB: 3830 Pibt KnOh Road ? Eagan MN 55122 j Date fteceived: i Phone: (651) 675-5675 i sran: Fax_ (651) 675-5694 1 2008 REStDENTIAL BUELDING PERMIT APPLtCATtON LZ?F4 /o 'c/ sft aaar"s: 1"187a MEACaDwCAeJC C?T? CgA&A?J rn14 5510-2 TananC Plaone: `?Sa ?`j?? -.5575 RESIDENTlOWNER Name:??5'SE_+?! fll?NA("iElr+?N ? aodress r cay r z.?: ?"C?01 75' 8LIL+-i La Kt R o E.Q.r,q m rr 55y3?t__ Appiicant is: ? Owne? ? Contractor TYPE OF WORK DescaP0on of waric: fY1 i5c r??+ ,.rG S N CATH 1114 ?'w D Rv pjA LL R EP.v iPQ ?y Cortsbtixction Cost: Muiti-Family Building: (Yes _)<? 1 No ] W $Od ._ CONTRACTOfl Narrre: ?GL.Si -•?5T' YIG. ?- i 4cense Address:J'?'? S1? •SYRiaL ; t1 City: ?1nPLE ?lta r+ Srdoe: M,J` zp: Pnone: 'a - - s c«ntaa Person: CpMpLETE T}{{,?r pREp ONLY IF CONSTRUCTING A MEW BUILdING N=------? ni 7_67?eoorv l _ Minnesota fluwas 7672 E?Y Cpdg . ResiOet?a1 ver?lafion CateOarY I wM?shee, ?? Codr woncshaet G*B9bry sLbrnmee CaicWaDOrc Subminea (+j ?On tYPe) • Ener9Y Emefope In ihe last 12 monrths, has tAe Ci4" aEaw° i56uird$Plit tor a similar plen basea on s master pian? -Ye5 IJO 11 yes, daOB ard eddre55 of master plan: Plwoe: Llcensod Pkwibw: Phana: mschancal C4ntractor, phone: p Bt d.vfad+ Convaaot: NOTE: P13rp af?d suPAWI?+A d;id tf?at you submlt are Qar+s7de? t0 be P?k =theVWZ' W?c f? ynu Arovide sped?k ?eaaons drai would pooncwae rrmt u,e a.c uade aecrets. tb e b??ormadun rrof' be cfasstAed ss non-Pv a?CUrdie. tnat NB worx nwNV b6 In contortnance vNffi Ilw uwWruu1C85 anu oo0es wifla0e ? ??We tllffi U?s ifdoml?? ? o??e and cation la a PeR^. e[q work Ls not m srort wi+1n?[7 i h Eapn: erebl ? l IgdBls?O Ws !s not a p0frta?. but W u^h e^ ePPiiu'ses a re?new a++? aGP?a? Wa wilh the aPPo'? P? in the wse a wak wrtid? reQ ? Y 1 Q x `.?NECL L.Lf+N " nppllc.ms 51e m ?e , o, 3 ?'g p?i ed Ntme L'd 0099-6Lti-£9L aaAnneg euena dZg:Zp g0 ZO 1o0 DO NO7 WRlTE BELOW TH1S LINE SUB TYPES ? Foundatfon ? OSplex O 16-ple?c ? Acc?sory 9uil?ng O Poo? ? Sinple FamNy 0 OB-plex ? Pireplace ? Poroh (3-soson) ? Fxt- /NS. - Mutl ? 01 of L Pbx ? 07-plez ? Garage ? Porch (4sason) ? Ex4 Att_- SF C7 02-Plea Q b8-plax Cl Deek ? PoreM (acreeN9ezebo+Pw9da) ? IWItl Misc. ? 03PIex ? 70pieX O Lower Lsvd ? Storm Damage ? 04-Plex ? 12-plet 0 Misriellanaou8 WORK TYPES O New ? ItqeriW ImprovemeM ? Siding Q Qemolish ?Iltling, a ndan+on ? Mwve eurknny ? ReKor a oemoas, lrde.or ? N6eratlon ? Flre Hepai? ? Wlndows ? pemolishFwttldelion ?ReonoeMM C3 Egress Window J? WaLCi oamage ' LlernbBtian (an9re Wilmn9) -9ive PCA handout oo eppliraK DESqi1MpN: o, Valuatlon 060 "-' OccupanaY T 2c, -3 MCES 5Yston - - ?- Plan Hevlarr - Code EdtGOn ao 3AC Unks ? ?2s? too9s-? zoning R-3 qtYweftr - Census Code y 3?_ Startes Baoster PuMP - / 0 of Unfts Scpiare Feet PRV ? 9 d&aldin9s / Length - Fi[e SprtnKters ? Type of Const ? Wkith gFMJIRED INSPEC170NS Footlrgs (new 61d9) Sheeu°d? J ---- ?? (??) Flnal/C.O. ? Footin8s (addFtlOn) ? Final/No C.O. ' Foundedon livAC -- Drain lVe - _ Other: Footirgs A'vlGas Tests Pool: ,Rnal HOOI: ^ICB 8 We?Br ,Finai ,_ SMing-_20tticco Lath _Stone Lath _Brick ? F??g R.I. Fkepbcw. NrTest _Fnal _ Windows , Retaining Wal{ InsuIation _ Revlewed 6y: Base Fee S,ronarge Plan Reriew NClES SAC City SAC Utility Conneedon CherP S8W Peomtt 8 Surdmrge Building Inspector tiG a'? 3 B 0_!C_ Treatment Piant Copies Total 66'd 0099-6Lb-£9L jeRnneg ausna pg8g 2 W 3 d55 Z0 80 ZO 3o0 ------------------ '. ? Frn Office Use? 1 O? Eap I Permit FEe: 3830 Pllot KnOb RDad Esgell MN 55122 j Oate Received: i Phone: (651) 6755675 i smn. c Fax:(657) 675-5594 I 2008 RESIDENTIAL BUILDING PERMI7 APPLICATION oa?.: 'c/ s?aea?.,:_1`7'7a mcArw?(??lcCT EA +J SS,?., suim a- Tenan? RESIDENT 1 OWNER Name: GA55 ? n.l f119nf AC F!?'i CN I _ Phore: -.5S75 Address / cay I zP: _7a 75 6,,1L H c,a KF- R o Fn1+ q m4 SSN3`"? Appficane is: _Owner X-corHraccor • •?Gr w?aLLRc A?r2S TYPEOFWDRK DescripUanotwak: , c. F?3tvr?.••r6 S+?E"?'r+/ ConStructionCosl: 47 SOC Mutti-FamilyBuilding:(Ves?lNO? 3?t4? rEnergy ACTOF[ Name: 4LLSiea-r2 fYlG,mT License8: Address:5`/S ?DrIS-?i?iaL 5" ? s?,e: m ? z?: ? 35 ? c;,,,: mqacE 0 ca,N r.?? SAr.•?vt? PYione: ?IS-a -?Si - ?SB ContactPerson: n118 CpNIQLETE THIS AREA (}NLY 1F CONSTRUCTIWG - o•.? 7670 Cateaorv 1 S A NEW BU?LDING n rA?, Ru?es 7872 ----M - ? - wo?snee[ . Mew Eneror ? wawreo1 Code • aee?ae? Vm+viauwn Categ«v i suhm?ned tegory sudnwee ission type) . &.My E`"`elwo cal"wmore swmuea In the Isst 12 monttfs. !ms tho dtY m Ea9sn laaued a P"t tor e simiffir plan Wsed on a master p1an4 Yas ,hW lt yes, deba and address of master plan: Phone: Licenead Plumbe?- Pfaoa: machardral Canlrae0on Phone: Smwer & Wabr Contlaeton to - NOTE Pfaris and aup?+tk8 docwments thar you subm the krformaUon ?r+ay b?e classltled aa +wn-Publtc H youprovide sPec?t?reason t?nat fwo b epen++it r Ctry r opnclude that tlre ere ?rnde secf°t9. I M9by BCKjmvWpUWtlbodmrlabon iS aomGkne arb 2GGNm: N8[ l11e vKNK wl{I b¢ m cOfrtorrn2nce wlm Ihn wwi wwes i?? ork vnil?ha ? E.agan; theR I irtd?d INs e not a pemii? flut onry an aPW'?°O" tor a permlt, and Hart? is rot to stsrt M+thout? g?ep rilh p?e ePP? pa' in fio ease ot walc whidh rewuas a reviaw a`W ap{nw? ? x J N?[.L. L.CA N ?,,??g s?s re pgge 1 ot 3 q?ptica?s Prt ted Neme Ol d 0099-6Lb-£9L aaAmeg euen4 d£9 Z0 80 ZO 1o0 ,. . ,, gty of Eap 9g90 Pi1ot Knob Road Eagan MN 55122 PhOne:(657)675-5875 Fex:(651)675-6694 ---- ----__,__ ? Fa orece use ? c9 ? Permit x: ; PxmftFee: I ? ? Date Reravetl: I i ? i StaH: ? L ------------YIESStI? 2oas REStDENTfAL BUILDING PERM+T APPLIcATIoN iE??n_, oate_ sieanwd.e?: t7lr? mEe??,,??c.fl?k Cr E?rAd ss Tenant: suiue x: G `? ?c?•+! Phone: FlESIDENT/OWNEFt ASn Gm Name: fT FinIACa _ F1 ndd?essic4rzjp:_ -7a 75 8LIL„ tAk?F- Ro ED..+A AppliCaftt is: _ ?M X- conDractor TYPEOFWORK Descriptionofwork:f?"1?5c Fam•.+? SI?Ef?TNl??+D:Zv?,.9.aLLRcP.????S Construction Cast: 41 ?00 Mulro-Famity 9uilding_ (Ves -X.1 No GONTRACTOA Name: ,!-??.5j'?h? ?--•,J$'f, l1'\!v m i LiCenSe 7l: 31S2 -L.! -- - Address:s'/5 ?U.SYRi4C. 5' # /O?f Stata: MrJ zip. Ciry: ff)AAL? ?L/-? 14 PhOM: 5d'a - ;25s -?dssi ContactPerso?: ?- S s?.+%?{?'`? COMpLETE -fHlS pREq QIyLY IF CON TR CTING A NEW BUILDING ti».,, ,.e aiwa 7670 Cateaorv 1 _ Minnasota Rutes 7672 va?wenon cuaeorr ? wa.kshae? • New Fne.ev coae w«NSh«' ?y (`.O(?@ ' RCiden9W Su01rdLLLL6d ri8t8QDTy SUIXnN9tl (4 SIbrnIS8iO11 4") ' EneW Ermelow CalcuIall0lis SubmiReO In Ufe 1as172 roaNM An tlha Glty Of Ea9B^ iswad a permi[ for a sYnilar plan 4ased on anmmw Plw? Yes No If yes, de.te ard addres ol master ptan_ ? Phone• - uce+sae Pn,mber- qwire: aftchardCA1 Cpnpmct°rs Plrone: 9eW9r 61lfiRlr LOntrac[or- sr?+8 C'?^ts that ya+? sunnra a rrelRce on aPec??lc th wour permk d?e clry to' HQTE: Pisns and +?° stderedrea orr?that e (ntormatfon meY be c18651lfed as tion-PubUc H you pm concfude dut are erade seerets. I herebY a?d? tlt? tlrs iMomrelion is oomWbte antl acwrare; Nat Ine wom wltl be In cmtom?ance wiln Vw urUU?pa?rwna?s, anc wdas d ure Ciry ot 90n ?or a PBm?M1? ??k ? nat W st9R wNhou[ a lhe wofk w+fl De in ??. tl? l undeml0cd Udc B no1 8 pannil. W! OMy an app?iGfl , epmrAm,on wMn me evnmvd plan n ma cese af wwk wnKn rewhes a revfew m,d aI+Pav?'? •? f/ • C7 ?' `? EGL .+4 F1 x x?? -- PNCariA*s St re page 1 W 3 q?}?anYs Pr !ad Nsmo Ol'd 009"Lb-£9L aaAnneg eusna , dtic,:ZO 80 ZO 1oC OFFICE USE ONLY Sub Types ? Ol Foundation ? 14 Apartmenfs ? 15 Lodging ? 25 Miscellaneous Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement ? 26 Public Facility ? 30 Accessory Building -• , ? 27 Commercial/Industrial ? 32 Ext Alt Apaztments 0 28 Greenhouse ? 34 Ext Alt-Commercial ? 29 Antennae ? 35 Ext Alt-Public Facility ? 37 Nail Salon ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 WindowslDoors "Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation -5040 OAI ? Occupancy Census Code 4;11_ Zoning SAC Units -U - Staries Nbr. of Units Sq. Ft. Nbr. of Bldgs I Length Type of Const ?` B Width Required Inspections _ Footings (new bldg) _ Footings (deck) _ Footings (addirion) _ Foundati on /??gQK?,E ?? Drain Tile / p-' 7- ? Roof ? Ice Pr _ Decking _ Insul _ Final ? Framing _ Fueplace _ R.I. _ Air Test , Fiaal MCE5 System City Water Booster Pump PRV Fire Sprinklered ? Inculation FinaUC.O. ? FinaUNo C.O. j' Other .?'VLE?3 0 GRT7hG'$PA'? - ,? _ Pool Ftgs Air/Gas Tests _ Final _ Siding _ Stucco _ Stone _ Windows Approved By: Planning Building Inspector Base Fee Surcharge Plan Review MCES SAC City SAC Water Supply & Storage (WAC) S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Copies Water Trunk SewerTrunk Other Total S1 UNIT LOCATION PLAN r BI}tCKHAWK ROAD BLDG. fi n m ? t, @ e `? a w $ a °0 ? m rn ? ., a a+ m w ro ?{yyJnAyRIJ?E (FOI 1 ' ? O ? ? ?. B 1774 ? C 1?7R r C 7770 0 B '1768 ? B 97&fi ' C i7s.t Ug G 1782 A 0 S' n s ? 8 A ?y . . mmppyyex CoWI . f 710 I . . . a m o ?? o? A A m ? . a ' •?,.y •-.'. . -9? . .. . .. . . . , ? ? . . . ? ..- _ . .? - . . i ?. ? . 'e , ' . . . 1753 A ' _ -' • 7751 9 1749 C 1747 C r ?. ,745 C • • ? 1743 C ? ? ? 1741 C ? • --'? s 77s9 C' O - 1737 8 . ? ? . ' ? ....,... . _- " ?_ ,.? f ;.: . : . .. - ,? _ :,?' • .. ° 2Q BUII..DING PERNIIT APPLICATION r • - City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 //3 7 s- • SWCturai Plans (2) sets • Architectural Plans (2) sets • Architecturel Plans (2) sefs • CivilPlans (2) • SWcturalPlans (2) • CodeAnalysis (1)" . CertificateofSurvey (7) • CivilPlans (2) • Projec[Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Projed Specs (1) • Code Malysis (1)" • Master Exit Pian (1) • Spec. Insp. & Testing Schedule " • Certficate of Survey (1) • Energy Calculations (1) not always"* • Shcs Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always'« . Meter size musl be established • Meter s¢e must be esta6lished • Meter size must be established-'rf applipble 1 • ProjectSpecs (1) b • EnergyCalculations (1) " y y . Electric Power & Lighting Fortn (1) L . Master Exit Plan (1) l L • Emergency Response Site Plan (1) 1 . SalsReport (1) L . SAC detertninaUOn - caU 651-602-1000 • SAC detertnination - call 651-602-1000 SAC delemifnalion - call 651-602-1000 Call MN Dept of Health at 651-215-0700 for details regardmg food & beverage or ladging faci6Ges. Contact Building Inspections for sample and if required when it stazes "not always" . "** Permit for new building or addiHon will n ot be processed without Emergency Response Site Plan. Date 10 / is- 16 ? )7150 Cog$tructionCost rOUti Site Address UniUSte Tenant Name ? 7 S?S' ` ? 1 7 b Former Tenant Name V n Description of Work SJiIC.(,O k & 9ac L Q-p.tl?'t-?? r i PropertyOwner I"?ovJJW? W ?A 6rveOVJ1v4.dS Telephone#((IZ)?IL? Z'3SS Contractor TVM uAl ?M, Address '1StZ ?' ?? City Q? 14 State f h N Zip Telephone #(G lL) 96 IS?(o Arch/Engr Registratian# Address Qv BD)-e 3900-& 3 City JAVVr4\1¢,wP1A• 5 _ State ?fw 1-I Zip <43j Telephone # (WL 5'L004 Licensed plumber installing new sewer/water service: Phone #: l1 B I hereby apply for a Commercial Building Permit and acknowledge that the informahon is comp te an accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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 ofplans. -1p f i 1k° r,? , f V1, , D u'(rny ? ?dl? ?J?/,, ?z Applicant's Printed Name Applicant's Signature sub rypes ? 01 Foundation O 14 Aparlments ? IS L,odging ? 25 Miscellaneous Work Types ? 31 New ? 32 Additbn ? 33 Alteration 0 34 Replacement OFFICE USE ONLY 0 26 Public Facility ? 27 CommerciaUIndushial ? 28 Crreenhouse ? 29 Antennae ? 35 Int Improvement ? 38 ? 36 Move Bldg. ? 42 ? 37 Demolish (Bidg)' ? 43 'Demolition (Entire Bldg only) • Give P Valuation 5-0o0? Occupancy vy Census Code q3f_ Zoning _ SAC Units r C9 "' Staries Nbr. of Units Sq. Ft. _ Nbr. of Bldgs ? Length _ Type of Const Width Required Inspections _ Footings (new bldg) _ Footiags(deck) . _ Footings (addition) Foundation DrainTil ' ?NSP- Roof Ic Pr Decldng Insul Final Framing _ ? Fireplace ^ U. _ Air Test _ Final ? 30 Accessory Building ' ? 32 Fact Alt-Apartments ? 34 Fact Alt-Commercial ? 35 Ext Alt-Public Facility ? 37 Nail Salon Demolish (Interior) ? 44 Siding Demolish (Foundation) ? 45 Fire Repair Reroof ? 46 Windows/Doors CA handout to applicant MCES System City Water Booster Pump PRV Fire Sprinklered y Insulation FinaUC.O. FinaUNo C.O. _ Other `J'NtCO? -? _ Pool _ Ftgs _ Air/Gas Tcsts _ Final _ Siding ? Stucco _ Stone _ Windows Approved By: Planning CfUYlG-r Building Inspector Base Fee Surcharge Plan Review MCES SAC City SAC Water Suppfy & Storage (WAC) SIW Permit 5/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Copies Water Trunk Sewer Trunk Other Total UNIT LOCATIOIrI PLAN 61ACK1-lAWlf ROAD . • BLDG. f a mnn ?mm ao?> ? .?il MBi?lalE (?m . . ? . A 1776 ? ? - ? w E 8 1774 1773 ik • ?r , W C 1773 Q - • 777Tf 9 o C3 r Q G 6 7T7o 7788' ? ? l'?G8 1767 G C . ? r ? A . y?? B 1765 ? ? ! 1=a? 0 ? ,7B3 C ? - ? C 1?82 a ? 778?1 C ¦ ? ? y ?? s? 6 • ? - , . turo?wwio?x coui . ts n ? . . „ . p ? V N M ? i ?+1 N V ? m a m n n c, ? c, o m . ?- ? a .;• .?. . _. : :?=, BL Q G ?9? • ? ? - . . ,. . ,, . , . , . . , nsa A ?. ' •?' . . 1751 9 . ? : n 1749 C 174 C 7 r 1748 C Q • • ? ? 1T43 C ? 1741 G ? ? .•?'? ? a 1739 C" Q - ?' ? 7737 B . ' . 2t U RESIDENTIAL PLUMBING ??SSb Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complete for: Single Family Dwellings Townhomes and Condos when pemuts are required for each unit Date I 'i / b Ll Addr ss Sit U it # e e n Property Owner 0,C)??? Telephone Contractor H ?pIpEWORK.4 , 5670 DODD ROAD Address MN 55123 -EhFllN C'ty , (651) 365 1340 State Zip Telephone # ( ) The Applicant is _ Owner Contractor , Other Septic System New _ Refurbishetl Submit 2 sets of plans and MPC license $ 100.00 Indutles Counry fee. Atlditional consuitant fees may apply. Alterations to eaisting dwelling $ 50.00 _ Add fxdures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed -$121.00) Other: _ RPZ _ new _ repair _ re6uild ?? V $ 30.00 _ Lawn irrigation system O `? ,? 2003 ? 1 v Water softener _ Water heater By $ 15.00 replacement _ additionai State Surcharge $ 50 T [ l $ 1j15 131 o a I hereby apply For a Residenrial Plumbing Permit and acknowledge that the informarion is complete and accurate; tLat the work will be in conformauce with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a peimit, but only an applicahon for a permit, and work is not to start without a pemvt; that the work will be in accordance with the approved 1an in the case of work wluch requires a review and approval of plans. i ? Applicant's Pr' Applicant's ature PERMIT ?Q I I _5 CITY USE ONLY RECEIPT DATE: 2002 ftESIDENT[AL MECHANICAL PEfiMTT APPLICATION CITY OF EAfiAN 3$30 PILOT KNOB RD tA6AN !HA 55122 651-681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: (O te/(DD/ SITE ADDRESS: OWNER NAME: tio rC Y) C??4 STANDARD HEATING & AIR CONDRIONING C0. INSTALLER NAME: 410 WEST IAKE STREET MINNEAPOIIS, MN 55408-2998 612-824-2656 STREET ADDRESS: CITY: STATE: Place a check mark next to ehe permit work type ?'CZIP? v ? / ? Add-on, modification or alteration to existin dwelling unit ?y $ 30.00 • furnace replacement • air exchanger • air conditioner ' • other Nature of work: State Surchar e $ .50 rotal S '?v -? SIGNATURE O i/o2 TELEPHONE TELEPHONE #: CITY USE ONLY PERMIT # APPROVED BY: INSPECTOR RECEIPT DATE: 2002 COMMERCIl4L MECHANICAL PEitMIT APPLICATION CITY OF El4fiA1V 3$30 PILOT KNOB RD EAH,+4N,1NN 55122 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: TENANTNAME (IMPROVEMENTS ONL1): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER STREET ADDRESS: CITY: TELEPHONE #: WORK TYPE _ New construction Interior Improvement _ Processed Piping Specify Nature of Work Install U.G. Tank Remove U.G. Tank When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is grearer. Underground tank removaVinstallation = minimum fee Contract price: $ x 1%= $ (Base Fee) State surcharge calculate at $.50 for each $ 1,000 Base Fee TOTAL $ SIGNATURE OF PERM[TTEE STATE: ZIP: Updated 1/02 PERMIT# C) -,)-- RECEIPT OATE: 8008 Rn1DEN77AL PLUMBIA6 PEiM1T APPLICATION crrY og EAs,ax 8$30 PILOT KA08 RD e,e?sAN, auQ 55122 651-681-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, - backflow preventer for ircigation system SITEADDRESS: 1/J8 IY(ea/'?DtilJlQ-rR, l'.I1I? OWNER NAME: :F-L- Fred TELEPHONE #: (051 JDU- 6321 (AREA CODE) INSTALLER NAME: Zm0C5 TELEPHONE #: bSI ,"?f.?? ??r? ?o?? g I,?) (AREA COOF) STREET AD?RESS: CITY: ?K.aCL? STATE: t'I ? ZIP: S _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consuitant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fiu[ures to lower levels or room additions, excluding water soReners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118) Other: _ RPZ: new installationlrepairlre6uild $ 30.00 _ lawn irrigation system ReplacemenUadditional: _ water softener L water heater $ 15.00 IUL 1 1 2002 State Surcharge , $ 50 By $ ? ]?? 10 Total . I here6y acknowledge that I have read this application, stale that lhe information is correct, and agree to complywith all applicable Ciryot Eagan ordinances. It is the applican['s responsibiliry to notiy the property owner thal the City of Eagan assumes no liab/i?'Jy for any damages usetl by the City during its normal ',? r? l? operational and maintenance acLvities to the facilihes consW cted under this permit withm City prppe ^1r?MOf-wa?e sertt?np ? ? ? [/ SIGNATU?j(E O?r PERMITTEE 1/02 (? i? ?? { C ? RY USE ONLY 1 ?^ SUBD. RECEIPT #. llfylello RECEIPT DATE: 101107/ / PERMIT # 5 .JO 1999 PLITM$INfi PERbllT (ftES1DER17AW crrYoFr.*sax 3930 PnAr turoa su ? RAs".lur551Es : (asu seI-+675 Please complete for. D aingle family dwellings D townhomes and condos when pertnits are required for each unit D backflow prevernerfor underground sprinkler system FIXTURES EACH 8 1 t05 f?I A B3!h tliN $ 1.u7 Floor drain 3.00 x = $ G83 i in OuUet ' minimum - 1 3.00 x - $ Hot tub/s a 3.00 x = $ Kitchen sink 100 x = $ laund tra 3.00 x - $ Lavato 3.00 x - $ Minimum fee alteretions to existin dwellin 30.00 x = $ Private Dis osal S stem new/refurbished ' re uires MPC itc. 75.00 x - $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x - $ Rou h o enin 1.50 x = $ Shower 3.00 x - $ Under round s rinkler ff dwellin is under construction 3.00 x - $ Under roun s rinkler if existin dwellin 30.00 x - $ V Wate 3.00 x = $ ater heater 3.00 x - $ o? Walar S er if dwellin under construction 5.00 x - $ Water softener if existin dwellin 30.00 x - $ Water tumaround 30.00 x -- - $ State Surchar e .50 -> -> -> $ .50 Tota1 _> -> -> --> a s-v Remfnder. Calt for inspections of alterations, t.e. water heaters, water soTtenars, etc. ----------------•--------------•--••-.....------ --•-•--•--•--•--•---------• •--•-------•--•----•--•--•-••-•---._.--•-•°-•--•-------••-•--• ... I hereby atlmouYtedpe that I heve read this applintlon, stale Mst tlie infamatian Is carrect, and apree lo mmply with all applicade (Sty M Eagan ordinances. It is the appliwnCS responsidlity b noWy 1!re property oxmer Mat the City of Eapan assumes nro Ilabiiily for any damapes caused by the City during its nortnel operatlonal and maintenance actlvitles toAe facillities.oqnstrycted under lhis pertntt wfThin City property/ripht-of-wayleasement. SITE ADDRESS: OWNER NAME: : ? lrrJO-?C TELEPHONE #: _z/v 5/- S?la 9?7? (AREA CODE) , INSTALLER NAME: TELEPHONE #: 1'z- (AREA CODE) STREET ADDRESS: ciTY: STATE: ZIP: 86N'ATUR PERMITTEE ' • - . ?.3 a S", 8 i RECORD OF COMPLAINT Date ? 2?1-f s' Complaint taken 1 Type of buflding Name Addres; I.egal description Phone number ?)` Complaint Action taken Comments • T-- , r Signature lb) -? -Ic)4ul ? a _ 5 0 2005 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 Date J / ?? ? ?? SiteAddress l-E32 Unit# Property Owner 1('y'1 ?? C(A(:l \C9, Telephone # ( (oS 3(] Contractor \tij-1c_ - Street Address y"'r' y' ??'C • VV City State t V\? Zip J J?5 Telephone #( Bond Expires: The Applicant is _ Owner ?ontractor _ Other Add-on or alteration to existing dwelling unit $ 30.00 furnace _Additional _Replacement air exchanger air conditioner _New fReplacement other ? 1\ , 50 $ State Surcharge . ? - . / ? ' 6,j $ Total '? I herehy apply for a Residential Mechanical Permit and acknowledge that the information is complete and acwrate; that the work 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 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. Applicant's Printed Name " Applicant's Signature ?? 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commercial/industrial buildings multi-family buildings when separate permits are not required for each dweiling unit Date Site S[reet Address Unit # Tenant Name (if applica6le) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond #: Expires: The Applicant is _ Owner _ Contractor _ Other Work Type _ New Construction _ Underground Tank _ Instail _Remove "'see below Interiorlmprovement _ InstallPiping _ Processed _Gas Nature of Work: '*When insfalling/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspecfor Permit Fees: $70.50 Underground tank installation/removal $50.50 Miieimum (includes Stale Surcharge) or Contract Value $ x l% _ $ Permit Fee • If ep rmit fee is $1,000 or less, add $.50 ==> $ State Surcharge If ermit fee is over $1,000, add $50 for every $1,000 ermit fee $ Total Fee I hereby apply For a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be' in conformance wi[h the ordinances and codes of the City of Eagan and with the Mechanica] Codes; that I understand this is not a permit, but only an application for a permit, and work is not m stan 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. Applicant's Printed Name Applicant's Signawre Approved By: , Inspecror Date: t , , d3.??? y„plk?:HLIRrJ4iaT1'T?G??jCl'1,4.L'W??,? .• , 1'i?esa cosirplete far; srtg?e tAmily dweiltti?§?8C'i?ic?rltf3?iie?Jr,?ri'dtsg `t#+b`?n, l?? aYb`-te'lNir`ut?'?`?r pdt¢h tiufC `' •` ? a`'° ` . . _ . _ ...,_ . .,_ __ ., ,.... ? ' . f . Property OWner I Gbntr,aetntr r- 1?2 StYeet AHdftss C,ity Stare Zip. ?r1 Telophou.e# Pr4--) ?. , y 1?4e A?'ki.t 19 P? (7*iicY ? cocttlr ? btliet A'ddron on a1Cerat9mt?totxiating dsvCllie'g wiit $ 30M . ? „ furroece ? ,qcIditional, air excYra?nger .? ..?., , ? ? ? ?._. „ .._,r .?. ._... ._ _,... ,.,... ....,. _ ? ? ? _ cohtlitioner ' New F?e?pl8?ernent i n?reby apply for a R?§ideiihal hTecr?sgt r€[$ns? ?nfl ?el?w?wv?lectge?hat t1Se??di?saa?Y`is ciirtt?vPe? ariil aGdumt?; ?i?ht'WdilY wi?1 be`iii eaHfori?aitba iu4Yh dse irm?diY?an?,a ?nc? ??sde§ cst` rl? ;G'.ity of ?,ag9ii a?tc1 ivi?"?t'e t?iYe?h'aruc?l Coc?9,; trmY r?rs?r,a #15ia i? Y?ti ? permit, but u?tq an application for pemri? an ?t•evart?'Ss ntfe ta 9t?IrE?ftYtoYZt=? p?t3titt;'?haY t]ie v?brk"?i1? lre ?? ac?ifz?aYice' V?i?'fr[?a Y pleu in flie ?ase wor h ?ires a nevi?w asidapprovat o?'p?at?e, Ap ,icant's P ' ted'iVarne P;?PP?icant's ?a?u? -102-Ict 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dwellings & rownhomes/condos when permits are required for each unit ? ??. Date $ / 3 / 0J SiteAddress / 76?Q /Y)?=6006J? J9Re Kd Unit# PropertyOwner &ti,014 ScRa(?. G-?A-)_S Telephone#(?a.S? ) ?e6 rs&a3 Contractor (,!(Aq- StreetAddress City aSply1aL4// State ? A) Zip Telephone # (&5-1 ) ,3QoZ - 97a y? Bond #: Expires: The Applicant is _ Owner ? Conhactor _ Other Add-on or alteration to existing dwelling unit $ 30.00 furnace _Additional _Replacement air exchanger ? airconditioner _New ?Replacement other State Surcharge $ 50 Totel s 30. 6-O I hereby apply for a Residential Mechanical Permi[ and acknowledge that the information is complete and accurate; that the work 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 application for a permit, and work is not to start without a permit; that the work will be in acwrdance with the approved plan in the case of work which requires a review and approval of lans. \ OAn.47 t?j sac.e? Applicant's Printed Name Ap icant's Signature 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for, commerciaUindusVial buildings multi-family buildings when separa[e permits aze not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owcer Telephone # ( ) Contractor Street Address City. State Zip Telephone # ( ) Bond Expires: The Applicant is _ Owner _ Contractor Other Work Type _ New Construction _ Underground Tank _ Install _Remove "see below _ Interior Improvement _ Install Piping _ Processed _Gas Nature of Work: 'When installing/removing underground tank, call for Inspection by Fire Maishal and Plumbing lnspector Permit Fe¢5: $70.50 Underground tank installatiodremoval $50.50 Mtnlmum (includes State Surcharge) or Contract Value $ x I% _ $ Permit Fee • If ermit fee is $1,000 or less, add $.50 => $ State Surcharge If ep rmit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that 1 understand this is not a permit, but only an application For a permit, and work is not to start without a permit; ttiat the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: Inspector 2005 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 petmits are required for each unit .? v Date I 1 / -1 / 0S Site Addreas 1--)CD O Me?ada v? ?°' R k Gi Unit # Property Owner joV?Tf h ie-il 4C) Telephone # ( ) V Contractor O'CONMOR Street Add Plumbing, Heaxing & Cooling City 1904Vermillion St State Hascings, MN 55033 Telephone #( ) Bond #: Expires: The Appticant is ? Owner _ Contractor _ Other ? Add-on or alteration to caisting dwellivg unit $ 30.00 ? furnace _Additional 4Replacement air exchanger airconditioner _New _Replacement other State Surcharge $ .50 Total $ 15ei I hereby apply for a ResidenUal Mechanical Pernut and aclawwledge that the informauon is complete and accurate; that tYie work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; tttat I understand this is not a pernut, but only an application for a pemut, and work is not to start without a perniit; that the work will be in accordance with the approved plan in the case of work which rec{uires a review and approval of plans. 1"( . knJ-Rpp Applicant's Printed Name Applicant's ignatur 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please camplete for: commerciaUmdustrial buildings multi-family buildings when sepacate pemu[s aze not requved for each dwelhng wut Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Strect Address City State Zip Telephone # ( ) Band #: Espires: The Applicant is _ Owner _ Contractor _ Other Wark Type New Construction _ Underground Tank _ Install _Remove "see belpw Interior Improvemerrt _ Install Piping _ Processed _Gas Nature of Work: "When insta!ling/removing underground fank, ca!! forlnspection by Fire Marshal and Plum6ing Inspector P¢iTllitFCCe: $70.50 UndergroundtankinstallaUUdremoval $50.50 Minimum (includes State Surcharge) or Contract Value $ x 1% _ $ Permit Fee • If nemut fee is $1,000 ar less, add $.50 ? $ State Surcharge If et fee is over $1,000, add $.50 for every $1,000 nermit fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work 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 pernut, but only an application foi a permit, and work is not to stari 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. ApplicanYs Prin[ed Name ApplicanYs Signature Apprwed By: , Inspector Date: ?v :?? ?3° . •'?? 2006 RESIDENTIAL MECHANICAL rERMiT arrLicnTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Ptease complcte for. single family dwellings & townhomes/condos when pertnits are required for each unit ? Dete ? ?? k r) U i ? Sitc Address n t Own r P t elephone # ( 67/) 99?l-03?a2- roper y e ? + Contractor Street Address CitY State Zip Telephone # ( ?.71 ) ft </ - ! / / Bond #: Expires: The Applicant is _ Owner V Contractor _ Other Add-on or slteration to existing dwelling uni[ $ 30.00 furnace _Additional V Replacement _ New air exchanger diti ? i r con oner a _ heat pump ? other State Surcharge $ .50 ? 3D.5"d Total I hereby apply for a Residential Mechanical Permit and aclnowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; [hat I unders[and this is no[ a permit, 6ut only an application for a permit, and work is not to start withou[ emvt; that the wor II 6e in accordance with the apprQved plan in [he case of„work which requires a review and approval of pla? ? A '-?>i'?h c tL f-l'YI -P t?S D ? Applicant's Printed Name Appl canYs Signature City olf 3830 Pilot Knob Road Eagan MN 55122 Phone:(657)675-5675 Fax: (651) 675-5694 ---------------- ForOfficeUse - ? Permit #: ' % -3 ` ?j -3 Ii I Permit Fee: ? I ? ? Date Recerved: i I ? ? Staff: ? L ----------------- 2008 RESIDENTIAL PLUMBING PERMIT APPLICATtON Date: Z?2 k IQ O Site Address: ?1? _1 ?-?? ??"?`??LGr • Tenant: RESIDENTlOWNER CONTRACTOR TYPE OF WORK PERMIT TYPE Suita #: Name: Phone: Cn4- L?"94"f?7 Address / City / Zip: Name: Addres City: zn\V(A,;X State: IY11 I Zip: Phone: "" '1 CAntact Person: k 1 1 11 ?-?. ut New `IL Replacement rtion of work: _ RESlDENTIAL ? Water Heater Lawn Irrigation I RPZ / _ PVB) Septic System New Abandonment Repair _ Rebuild _ Modify Space _ Work in R.O.W Water Softener Add Plumbing FiMures ? Main _ Lower Level) W ater Turnaround RESIDENTfAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) 'Waler Tumaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includ'es County fee and $.50 State Surcharge) $90.50 Fire Repair (replace bumed out appliances, duchvork, etc.) (includes $.50 State Surcharge) FEES $_n2)cl i hereby acknowledge lhat Nis informahon is complete and accurate: that the work will be in contortnance wrth the ordinances and codes of the Giry ot cagan: that I untlerstand this is not a peRnit, but only an applicatlon for a pertnit, and work is not to start without a permrt; that the work will be in accordance with Ne approved plan in the case of vrork which reqwres a review and approval of plans. x ?.?1?P ul 10& X l?f`?.Q? Applicant's Printed Name Appli ant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: _Under Ground _Rough-In _Air Test _Gas Test _Final Aug 20 08 1126a Duane Sawyer Git? af Bapu 5830 Ppot Knob Ro9d Fagen iNN 55122 Phone: (651) 6754675 Fax:(G5i) 675-669a 763-479$600 p.5 ? FarOflicells9 - - - - - - - - - - I 1 j Pemit#: ??? ?5l j PercNt I smx: i ?---------------- 2Q08 RESlDENTIAL BUILDING PERMIT APPLICATION lnE4aowc.9ak ?^?' patW sroe Addrem: %? ? a?? fArr ?.0?5 f7Gy?! 77_ oy! 1`la E.??.a..t m,.r. SSla.?. - SuHe#: RE'•,IDHN7/ OWNER Name: CASS ,4 ITT 6»'?7- Pnone: 95a -9,;3 aS7S Address 1 CiFy /7?p: '7-X15 13r:SN L.K r20 EDiALR, m wi Appltrantis: _.Owner _CoMacLOr TYPE OF WORK Dastrption of work: ?l,9T r?cnf=.vRcVc C;49,9GC 429? 34 ,?16 LV*nraS Construcuon Cos&&g&% cC MudG-FamdY Buildirg: (Yes X_! Po GONFRACTOR Name: 4/ ? i p,aa- Lor.iS i. h'7G,r7" i License , - adAress: '7a 7S BvSN Ly Re7 , aW. En, ti, ^ _ scace: mi 1 ziv-??-?3?. Pfione: -a53 -4958 cuntact Person: 1-5?&11?l 44?AfV CQMPLETE TH15 /AREA ONLY IF CON3TRUGTING A H, E??I f BUILOING Minnesola Ru1es 7070 Cateaorv 1 _ Mirmeaota Rules 7672 F.nergy Code .P46dw" venwaeon caUVon i wonmneet •Now Enerev [xae wakdnaec Cate9nrY sudnimad ? ? Cakul=ns Submifted c4?n+,mar • bi the Iast 12 marnhs, trs the CHy ot FaW Iswed a PemR for s a(mimr plan boed oa a masu plaK! Yes _No N yes, deAe and address of mtsiter plen_ Lltxnsed Plunbar. PMnx madmaica1 CoNveUor: pbww. Sewer & WaRa+ Contrador' Phancy nrorF- aAmris anvsypyom„V do«mmnxs umr yw, subaW am conakkred m ae pubrc hvilarnma99,. Pwr+ons a rme &dbn7mrron mar ae cras~ as r+o,rVue+rc rrrouw? •easom ther wauw pevma N+e dey ao rauncGrale tfW &eyarv rrsdb sacr+eots. t hereM adaiaxl0*e tlot ttus irdamation is aoWe[e azW aoarraoa;n ?rt, e?d wak is?n n smtdt v?khout e Per+ni? ?at ilm wak v?ll ba "i E?atS that i unde?s?rd Ads is rot a perms. hut ddy an ap?icOo acmrdence nBm ue eppmvm plan in n,e rasa or+rank whide rewos a rvAew aW appwal Of pWs. x U`J-!&GL.-f Li?a ?+y x Appbcmt„a-----Pdeftd Mme , canPs SiHi re Pa9a I of 3 3 ?----------------- ? I j Permit It: V73 '" 4 j ? Permit Fee: ? ? • ? I I ? Date Recerved: I S[aff: / I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: k\) 08? Site Address. 11 S,q c p 7enant: 17 (sO, (ea (o . ?(c 25 o '70, 7 a Suite #: RESIDENT / OWNER ? n ?p Name: ? V«`?J eVi)? ? A- Phone: Address/City/Zip: ?`? 5? J??(A?tlwCn21L Q? p/??2ti MN Applicant is: _ Owner ? Contractor TYPE OF WORK Description of work: ?OE p ??C S CZC'' ? Construction Cost: 11 3 5-1, t ) Multi-Family Building: (Yes No ? CONTRACTOR Name: iU C ?M , License #: ?0W) Address: -7,? 7 L4L Q- 0 City: C D 1'-?i . State: YYi n' zip: y?- as3-y9s f ? i Phonei? ? Z) Contact Person: } e rY`? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential VenHlation Category 1 Wwksheel • New Energy Code Worksheet Category sunmined suwnined (4 9u6miSSiOn typE) • Energy Envelope Calculations Su6mitled 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: MechanicalContractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and,supportlnq dacr?mee#ts that yau-submif are:consrdered fo be public itrformattan. Portions of the Informatfon may be classl/ied as<noa-pubffc it.yorrprovfde.specftic reasons that wauld permit the City to cetncVude,thatthe .are:trade:secrets., I hereby acknovAedge that this information is complete and accurate; tha[ the work wiil he in confortnance with the ordinances and codes of the Cily of Eagan; that I understand this is not a permi[, but only an application for a permit, and work is not to start without a permit; iha[ the work will be in accordance vrith the approved plan in the case of work which requires ievreq ? mval of plans. x?k r? X ApplicanYs Prin d Name ApplicanYs tknature Page 1 of 3 ? Clty of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 - For O ffi ce-Use - - - - - - - - - - - ? ? ? Pertnit #. MAR 81 Permit Fee' I 2 ? ? Date Received: I Stafl: __"t? AA ir? n..l1 I?' .,?^ ? - - - - - - - - ?- -sr????r! 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ??? _ Site Address: 17?? Tenant: Suite #: RESIDENT! OWNER Name: Phone: _______ Address / City! ZiP: r?a Appiicant is: ___ Owner Contrector TYPE OF WORK r?a??l2??i??1?.-??r_-L6e?J'szull.-?k?? Description of work: Zuhi,14.¢ Construction Cost: Multi-Family Building: (Yes}C _?YN CONTRACTOR Name:?f?SfssC?-?.i+????--?1JS-s= License#:_?20i?3!S?11_ Address: ------ ---------- - - - , ? ? ) Cib .?rf?? 0?1di.i------------------- State: C/?dL--- ZiP Phone: ?Z?_ `?_-7jT_'/____ Con[act Person: &./Gn COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilalion Calegory 1 Worksheet • New Energy Code Worksheel Category Submiltetl Submrtted (4 SubmissiOn type) • Energy Envelope Calculations Submitted In the 1as112 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 ConVactor. ----- ------------------------------- Phone: -------------------- NOTE: Plans and supporting documents that you submit are considered to be public informatfon. PoRions 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. _ I hereby acknowledge that this informalion is complete and accurate; lha[ the work will be in conformance with the ordinances and codes of the City of Eagan; thal I understand this is not a permil, bul only an application for a permit, and vrork is not lo start without a pertnit; that the work will he in accordance with the approved plan in the case of work which requires a review and approval of plans. X_ Ga//.n_?cd?rrrnzo? x--- - -L.??l-?---- ---------- ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 TS e-s ??? (v ? 2- DO NOT WRITE BELOW THIS LINE IL SUB TYPES _ Foundalion _ Single Family _ Multi 01 of _ Plex Accessory Building WORK TYPES New _ Additfon Alteretion ? Replace _ Fireplace _ Porch (3-Season) _ Storm Damage Garage Porch (4Season) Exterior Alteration (Single Family) ? Deck _ Porch (ScreenlGazebolPergola) _ Exterior Alteretion (Multq Lower Level Pool Miscellaneous Interior Improvement Move Building Fire Repair Repair Siding Reroof Windows Egress Window Demolish Building' Demolish Interior Demolish Foundation Water Damage `Demolition of entire 6uilding - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition SAC Units {25°/0___ 100%___) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width _ Footings (New Building) Footings (Deck) _ Footings (Addition) Foundation Drain Tile Roof: __Ice & Water __Final ? Framing _ Fireplace: ___Rough In __Air Test ___Final lnsulation Meter Size: Reviewed By: _ Sheetrock Final / C.O. Required ? Final I No C.O. Required HVAC Other: -------------- Pool: ___Footings __Air/Gas Tests ___Final Siding: ___Stucco Lath ___Stone Lath __Brick Windows Retaining Wall Erosion Control Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 7o - City af Eakan s?-/_- ? Permd Fcre: ??y?_ _.._ ? 3830 Plbt Knob Road ? oate aeceivea: i Eagan MN 55f22 i , Phone: (651) 675-6675 Fax:(651) 675-5694 I ? 6dS?%ye 2008 RESIDENTIAL BUILDING PERMIT APPLlCATION L??? 1?T osu: ' c? sne aearess: !'7[?a MERao ?,.? LRR.k C r EF! ?0?1 ?-1 ?l Tenant: sulte #: RESIDENT/dWNER Name:GA`i_56nJ f}IA NEiGs FmmEN 1- Phone: `l50 `-?5$75 Ad7te5s ! CitY I ?rP,. -7.?7f L? v: i N L4 kr.. R D ?L)irl A IYl rl ,.S$43`?'7 - Applicant is: _ Cvww L`-- Contractor TYPE OF WORK Des<xiption of work: ?1 ,5_t F'3v" LL R c R19 i+2`. Constnuctian Cosl_ ? SC'D Multi-Famly 9uilding: {Yes _X 1No-J Name. 4LL.51`Rr? L`.C?ST. f1`14?r?,- LiceoseA: (?NTRpCTOR A,ddress:S X?t? '3'?R 4L ': tt p. State: /r1 r? ZP: Gily: Phone: ?S'a - .?5?-3 -?!S$ CAnWCt Persun: COMPLETE 7HIS AREA ONLY IF CdNSTRUCTING A NEW BUILDING ¦x.. c??a Rules 7670? t?eaorv; _ M1`^^PS°ta Rkites 7972 t Wanisheac • New Ener6Y CWe Worksheet Ene[8Y C? • Pasaenum Vamaanon Gacewrr Suo+mnea catewv suwnmen `4 sube'elon type) , Enegy Enyeippe CaitaJations SuDmined In the last 12 morrths. Ma the dtY Of E°9s^ isswd apwmit for a similar plan based on a masier p1anY ^yes No H yes, date snd address Of maste' plan: PYwne: Lioensad Plumber: PIwm= Medrnlcal comracwr: ?--_. gd?wer i Weter Oanl?acm- e? NOTE: Plew and supPa'«+19 ??menta rha[ You submn ar+e consWared to da Publ7c MlarmatlonR thPortion e Clry?to !c H ProvMe specNlc reasona thet wouk! penn fhe lnforrnadon u+eY De t?a? ??^?? you owrehide thar 7he are bsda secrets. wr? uw wubwnws ara coaes m cne c?ry w ?I+e?eh9 a??Be tl?ffi ttis WAamaiiM ? cortplete arq a0ciuate? m?Vie? +'h i ?? ? wfltwut a P?^ ' that tne work vdu ha m I e?f; thW 1 und?tl Vds is twt a pem?i4 4a onh' ? aPP?o^ and apPro+'a? . vYk rMien raWd ?? ? rdth V?e aPP? P? in tlfs Casa o1 O? ?? J?E( l?u14 f"? - ppnltce?'s page t oi 3 •....11?y d ?IIIE n?u?.....-Ila S 96'd 0099-6Lti-£9L leAMeg euenQ dgg:ZO 80 ZO 3o0 DO NUT WRITE BELOW 7HIS LINE sue rrPE.s ? rmmaation n os-pw ?I"Ie: ? accessmy ewWng ? aoa ? Single Famlly ? 06plex O Fireplece ? Porch (3-season) Ll Ert. AIt. - MWti ;% 01 ot ffZ Plex D 07-plex 0 Qarage ? Porch (4seasun) 0 Facr. wtt_ - SF ? 02-Plex ? OB-ple: 0 Dadc ? Porch (screeNgazabolPw9ula) ? Yultl Misc. ? 09-Pmx ? t0-plex ? Lovrer Level O Slorm [)amage O aq~ ? tp-piex C7 Mixallanewus WORK TYPES O NeYr ? IMerior Improrament O 9ding ? Demdish BWIDing• O AAdltlon ? Yove Building 0 HerooF ? Demdbh Intarlor ? Altorelfon ? Flre Repeir O Witdors Q DemoBsh FoutWation ? FieplseortmR ? Egress WfiAOw X Water Damape ' Demoitlun (enlre Euilding) -9ive PGl hantlou[ ta app6cant DESCFiIPTtON• vawauon 106,0"- ? occupancy ac- 3 Nces systwn - nm„ Reviaw - ? ooae r?a, a? ? sac unns - ? (?_ 1 ppry, ? Zoning R-? Olty Vllater census oom 3Y swrrs Baoster Pump _ # of Unlts ? Sqwre Feet - PRV _ # Of BuOdirg3 / - Length Flre SDrlnklers Tyrpe of Canst. ? -J?lJ vAdul J REQUtREE) RaPECTKM FOOti11g! (116W bldQ) ?? (dock) ? Fppthgs (additlOn) - Foundntbn - Drain 7i18 i Rool: ?ICe 8 VYaRer ,Final ? Fmndng FImPlacs:_R.I. PUr Test _Finai ? tnauMdon FOeviewed B)r: _ $II9aiCOCk FlnaIfC.O. ? FinsI/No C.O. HVAC - OMrer. - Pool: _Footin9s AidGas Tesis _Finat ? Sidin9: _A6SWcao Lalh -Stone lath _9rick Mrindnws ? Retmnirig NfaO Building Inspector EA17iAL FEES: Beae Fse Su?cMarge ' P1an Reriew 3 MC/ES SAC cKy sac ucuny connecaon Cha.eB saw Aer+nn a surcnarge Yreatment Plarrt copie$ :L a? I" ea Totel page 2 of 3 OZ'd 0099-6Gb-£9L aeAnneg auen4 dL9:Z0 90 ZO 100 VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 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: I agree to comply with the Village of Eagan Surcharge: Ordinances Misc. Charges: Total: By Date Paid: Date of sp.: J a j ` �� Insp.: VILLAGE 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 Village of Eagan Connection Charge: Ordinances. Account Deposit: �� Surcharge: Permit Fee: By: � Misc. Charges: Date of Inspj.• .T j ' () Total: Insp.: Date Paid: � Use BLUE or BLACK Ink - r------------------„ I For Office Use � . I � I � Permit#:�� clt of �� Q�( � � Y � � Permit Fee: C/vll•a � 3830 Pilot Knob Road � I Eagan MN 55122 � I Phone: (651) 675-5675 I Date Received: I I I Fax: (651) 675-5694 I I � Staff: � �-----------------� 2014 COMMERCIAL BUILDING PERMIT APPLICATION Date: i / IS ► Site Address: Tenant Name: �e �.�.p.,�.,`�,� �;�� (Tenant is: New/ � Existing) Suite#: Former Tenant: Name: v �-c s ct�,+,,,,`K�- X, c�� a � � Phone: Property Owner_ Address i cit i zi t �7 b , t�� v P�_ ? . t '�12, i '�'�� 3 t '� ��} t '� (, b � t '1 b I 1 , �2 � � t °l �yC)t 1'7 S�� 1�tv.��`w�r� C� Applicant is: Owner Contractor Type of Work ` Description of work: s!� . �,.��N� r i�w1 t.,�� Construction Cost:��.�� 2v�� `� Name: C� W�vr�� Cov.y�lLC��v� �icense#: C�3�S.� � Contractor � Address: �Z �'�'> �/�7�.��i,�a. Q�_ city: V; ��.::�� " State: � h Zip:_�S � �' � Phone: G SZ ^ �l' �� " �� v b ' Contact: he �'�'� �.� Email: .,� � ��i �.�- �-O �--.��.,� .� Name: Registration#: ' Architect/Engineer Address: City: State: Zip: Phone: ' Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: NOTE;P/ans and supporting documents that you submit are considered to be public information. Porfions of the information may be classified as non-public ifyou provide specific reasons that would permit the'City fo :conc/ude that the are traale 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:qopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the w rk w I be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an ap c tion'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 r whi h requires a review and approval of plans: x �e �� gv� � t�e.�) x ApplicanYs Printed Name AppticanYs Sig Page 1 of 3