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3859 Palisade PtCITY OF EAGAN Remarks Sew Co= pd• m 12 Addition Cedar Grove #8 Lot 5 6 Owner r?-r-t " ``??'e-? Srroor 3859 Palisade *fmr POi X f 22 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK Z„S 1970 125.00 .QQ 2 Pa3d SEWER LATERAL 1974 1539.10 307. 2 PaiC1 WATERMAIN iE WATER LATERA? 197 WATER AREA STORM SEW TRK STORM SEW LAT 1974 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN, 300,00 7989 ----5-1 -73 BUILDING PER. SAC 2 O.OO 7989 - - PARK INSPECTIaN RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: 4 rtFAK G?lnvE #R (612) 460-3:326 F L I,It I , It I H rr 11 .y f •,:a PERMIT SUBTYPE: TYPE OF WORK: Perrt?R Holder Date Telephone M PLUMBING HVAC Inspection Date Inap. Comments FOOTINGS FOUND FRAMING I ROOFING I ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG , FINAL HTG ORSAT TEST BLOG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUC7IVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ?a S C. (o • VILLAUE OF' r:AGAN 3795 Pilot Knob ttoad Eagan, Niinnesota 55122 PER14IT N0. 348 The Village of Eagan hereby grants to Cedar Grave Casatructiaa Cot o£ 7343 Concord Blvd. Eaet, South St. Pmll a HEATIRI(3 Permit £or; (Owner) ems 3869 xi.nertan circle 14-4-8 -1859 & 3861 Fallsade Pt. 5- - , 1727, at 1MjSxhs.4be 2-4-8 4-4-6 ,1 44P&ant to application dated 5/11 /T3 . Fee Paid: a120.pp dated this 1.5th day of MaV , 7973 3.00 s/c Bui d ng Inspector kechanical Permits: did 'Potal: ? , VILLAGE OF r;AGAN 3195 Pilot Knob xoad Eagan, Minnesota 55122 PIIZi+IIT N0. 337 The Village of Eagan hereby grants to Gadsr {?? CCngyHpt,{CA Gp. of a343 r.?ql,,d niod_ tahat.o aorhh aii. Prt3 a _p1=hi„g Permit for: (Owner) 3869 Rivertoai Circle 14-4-8. 1859 & 3861 Palie p? r?2 n?ft -atCoahra+_e 2 l 8)? A, 1 g? a pursuant to appc-a?e3 ????a 1727a 1718 Fee Paid: 120.00 dated this 15th day of 14fig 3.00 57a Building Inspector Mechanical Permits: did Total: EAGAN TOWNSHIP BUILDING PERMIT ? Owne: ........ CC?!??.-r!?.... ....... _.._. Addtass (Preseni) ........l.?£...?.... c. .................. _.... Builder ....... ..................._......__.---................_...----............._....._...-- Addresa ..... ._--- ............... .......................... __................................... DESCAIPTION N° 3008 Eagen Township Town Hall Defa ................ Siories To Be Used Foz Froni Deplh Heighi Esl. Cosf Permif Fee - amarks A "-`- ??. ?:SG.ca /T? ?tc S n az' /- G).cr 51reei. xoed or oiner Ueicrlpxton oI Loeaxlon ? Lot rilocY Addifion or Tree! P/?/ . . $'t? This permii doea noi aulhorfze the use oi siraela, roada, elleye or eidewalka ifox does it give the ownar oz hia agent the righ!!o creeie eny situaiion which ie e nuisancs or which presents a ha:ard !o the heelih, sefety, conveaianee and general welfare !o anyona in the commuaify. THIS PERMIT MUST BE KEPT 013 THE PR£MffiE WHILE THE WORK IS IN PAOGAESS. „ This ie !o ceriify, fhaf....._.. Q..? ..... .....r:..._?+?-? has permission !o . .............. ........... ...................c......---............................ upon the above deseribed premise aubject fo the provitions of the Building Osdinenae Sor Eagan Township adopled April 11, 1955. ?+t . .......................... ?_...... V. :.... . ....._ .....:_?7:.-?... ........ Pez _ ? e _..._....._.....-?.?. ? ................................ Cheirman o Tnwn Board? Huildin Ineae}or oe i& na -q\4 un&e 2 EAGAN TOWNSHIP BUILDING PERMIT N? Owner &'^-'t`^„ ......'. _. _' .................... ?..... _.......... _ ... ?,............ _........... ...' .'.. _. . Addeeu (Preseni) _.......... 44......... e-1-.1.1?.....:....?c::-.?-:5 ............. Builder ......................._.------.._-°--................................................... Address ........... DESCRIPTION Lb•OP/ ;. 2928 Eagan Township Town Hall Date ..._....... S2orias To Be Used For Fson1 Depih Heigh! Est. Cosf Permi! Fee Remazks l ? 9 LOCATION 17-' S' Sireei. Road or olher DeacripSion ot Loeahon I Lo! I Bloek Addiiion or Trao! T6is pecmif does not auihorize the use of slteefa,. zoads, a(leps or sidewelks nos doee it give the oanas or his agen! the righlfo create anp siluafion which is a nuisanee or which presenis a hesard !o the health, safefy, eonvenienea and genecal weliare fo anqoae in the communifp. THIS PERMIT MUST SE KEPT ON THE PREMISE WHILE THE WORK IS IN PAOGRES3, ?--r _ . Thts is !o cerfifY. !hel.... ....._ ?.:c.J..-.z :.......:.... ...hr.................haapermusion !o ereef ?:?} ..._.F.eq^::e . upon the above deeccibed psemise su6jeef !o the provisiona o! !he Building Ordinance for Eagan To?nship ado !ed Aprii 11. 1955. %t-L"'?-. -J Yk-:- Per .? .-...._ ---° .L_...._. ...-- - -'-C .. -..._.....c=--.. :+::-:.y_. .....' .......................... I,!j Suildinp Impeclor _,6 CSTY OF EAC,AN CASH.T.ERa S TERMINAL NOe 773 I1FdTEe 08/12/98 TTPfE: 15:42:52 IDa tdAME: PHIIL.IP M MrCl._ATN 3210 3001 38,°r3 F'AL..ISAIiF 1-"' 87.25 2155 9001 3853 F'ALIfaADE F' 2.00 Total. F.eceipt Amoun+,? 89.25 CFU96154 USEFi ITl; NANCY PERMi'1' ? CIYY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMITTYPE: euiLozNG Permit Number: 0 3 2 B 9 3 Date Issued: 0 8/ 12 / 9 8 3859 PALISADE PT LOT: 5 BLOCK: 2 CEDAR 6ROVE #8 P.S.N.: 10-16707-050-02 DESCRIPTION: a-? REROOF B,juild,mPermit Type 3F (MISC.) $uilding EJo,rk Type REPATR ?nCensuS Cotle434 AI.T. RESTDEN7IAL REMARKS FEE SUMMARY: ?r a -3 <. ...._. VALUATTON $4,000 8ase Fee $57.25 Surcharge y_ $2.00 Total Fee $89.25 CONTRACTOR: - Applicant - sT. LIC. OWNER: ABETTER ROOFING CO 14603326 2014413 HOVIND JANE 428 CNIPPENOpLE UNIT A 3859 PALISADE PT ARMINGTON MN 55024 EAGAN MN 55122 612) 460-3326 (651)452-2454 I hereby acknowledge that Z have read this applicatian and state that the ; infarmation is correct and agree to Cnmply with all applicable State of Mn. StatuCes and City of Ea'gan Qrdinanees: {?_ : APPIICANT/PERMI7EE SIGNATURE I SUED BV: SIGNA URE • " 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 681-4675 iJew Construetion Reauirements ? 3 registered site suneys ? 2 copies of plans (inGude beam & window sizes; pouretl fiG. design; etc.) ? 1 energy calculations • 3 copies of tree preservation plan N bt platted after 7/7/93 required: _Yes No DATE: ?? 9 0 DESCRIPT N OF V1i STREET ADDRESS: RemodaVReoair Reauirements ? 2 co0ies cT plan ? 2 site surveys (exterior add'Rions 8 deeks) ? 1 energy wlculations for heated addkions q,V LOT: S BLOCK: -Q- SUBD./P.I.D. #: G ?(O \I -C- ? 6 vvo \/1?" Name: Phone #: PROPERTY 1.asc Firsc OWNER ?(1c??`7 ??, Street Address:ti .- •,? City State:_ CONTRACTOR Zip: ????Z?-, ,,? r///?p /,l 90- 113/N ?--/ -' ? ?{-(p/? Company:,p?¢1- Phone #: 6,y 0-?:?3Q6 Ciry '/.?NzT A License Stare: M/I Zip: ARCHITECT/ ENGINEER Company: Phone #: _ Name: ? Registration #: Street Address: City Sewer & water licensed plumber (new constructlon only): and lot change is requested once permit is issued. Sffite: I hereby acknowledge that I have read this application and sTate that the State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No Not Zip: . Penaity applies when address chang is correct and agree ta comply with all applicabi _ . 12. 1-217- , .. 7) -, CONSTRUCTION COST; K BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-piex ? 05 SF Misc. ? 10 = plex WORK TYPE D 31 New O 33 Alterations ? 32 Addition K34 R?pair GENERAL INFORMATION Const. (Actuai) (Atlowable) t16C Occupancy Zoning # of Stories Length Depth OFFICE USE ONLY ? 11 Apt./Lodging O 12 Multi RepaidRem. ? 13 Garage/Accessory ? 14 Firepiace ? 15 Deck ? 36 Move 0 37 DQmol;tlinn Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. APPROVALS Planning Permit Fee Surcharge Plan Rsview License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S!W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total % SAC SAC Units ? 16 Basement Finish ? 17 Swim Pool ? 20 Public Facility ? 21 Miscellaneous I il MGWS System City Water Fire Sprinkler?ed PRV Booster Pump Census Code: SAC Code I Census Bldg ' Census Unit Building Engineering Varia I ce v gT? Valuation: $ u, o O O. a- . I MASTER CARD LOCATI OWNER STRUCTURE AND LAND USED A$ Permit No. Issued Issued To Contractor Owner BUILDING PLUMBING CESSPOOL - SEPTIC TANK WELL ELKTRICAL I HEATING ?' y GAS INSTALLING SANITARY SEWER /.3 q?.? i OTHER OTHER I I I I}ems Approved (Initial) Date Remarks Distance From Well FOOTING 6--/S J SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING p DEPTH OF WELL GAS INSTALLATION I SEPTIC TANK . CESSPOOL DRAINFIELD PLUMBING WELL - Zj' 7 SANITARY SEWER Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USEO ONIY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. DATE OF INSPECTION 1:1 ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPLIANCE. BWLDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DEIAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED DATE OF REINSPEC?ION REINSPECTION REVEALED CERTI FICATION -1 certify that I have carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein all significant conditions oLserved to he at variance with ordinances of the Town of Eagan, apProved plans and specifications, and any specific require- ments for off-site improvements relating to the propeny inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR COMMENTS: pATE 23 EAGFN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION nate:5/15/73 (12/29/72) Number: 1201 Billing Name:Cedar Grove Construction Co$ite Address: ,zr 3 Owner: sane Billing Addresi2859 Pa7-isade Point Plumber: Stein's Connection I Meter .300.00 pd 5/15I73 Meter No. ?Permit Fee10.00 d 12429/72 . 0 pd 12 29/72 Meter Reading Meter Dep. Meter Sealed: Yea_ lAdd'1 Chg. NO , Total Chg. Building is a: Residence xx Multiple tio, Commercial Ixtdus t ria 1 Other Inspected by Date Remarka: $25.00 RE•1NISPECTION FEE FOR IM00PERLY iiiSTALLED h9ETEi;S. Bq: Chief Tnspector In conaideration of the issue and delivery to me of the above permit, I hereby agree to do ttm proposed woxk in accordance with the rules and regulations of Eagan Township, DakoCa County, Minaesota. $Y: SteinI s Please aotify the above office when ready for inspection and connection. tlILLAOE OF EAOAN SIE WER SERVBE PERMIT 3795 Pilat Nnob Rood PERMIT N 13 - 2- - ? Eagan, MN 551I2 7 ? 7? 7?? ?/ 1?? UATE: 1 z??9inr`T ?/? ' Zoning: No. of Uni[s: ()wner: _S.eSj2S' SiLQYg_ G.911StI'UCt,1on (.'O. Address: ?q ??- Site qddre?: _2?(-?S ?77 Pis3de -P_0Ut Plumber: ?eiTL.s_ 1 agrce ro comply wifh fho Villoga of Eogon Cunnectlon Chazge: 260•00 pd 51151 Ordinontes. Accbunt Depoel[: Permtt Fee: _ 10.00 Ad 12/29/72 Surchazge: .50 Dd 12/29/72 BY: Miea Chazges: Date of Insp.: Total: Inep.: Date Pald: City of Eagan 3795 Pilot Knob Road Eagan, MN 55122 Date: November S, 1980 St Paul Title Insurnace Q 301 W Burnsville Pkwy yP?`IAL ASSESShtENT SEARCH Burnsville, MN 55337 RE: ORDEF D-6985 Lot 5, Block 2 Cedar Grove #8 3859 Palisade Way, Eagan, hIN 55122 Parcel N10 16707 050 02 Enclosed herein is the search which you requested made on the a6ove described property: Kind of Improvement Runs Beginning Original Amount Balance Due None I further certify that according to the records of said office, the following improvements are contemplated or pending after having been approved, and are now in the process of planning or completion. Kind of Improvement Approximate date Completion Approximate Cost None Waiver: Neither the City of Eagan nor its employees guarantees the accuracy of the above information which was requested by the person or persons indicated. Nor does the City of its employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form, and for all other consideration of any nature whatsoever, any claim against the City of its employees rising there from is hereby expressly waived. Levied assessments to he paid to the Couhty Auditor at Hastings, MN 55033 Very truly yours, SPECIAL ASSESSMENT DEPARTMENT ST `,'2,lJ l TITLE INSUGiANCE COAPORATION- - - -- -"- -- ? . ' . ........r...,...,._. ^.im!, iti (El_'19?1 $$?"? 1235U1;1NS'.,.,<'-L5 I.:R:!a554U2 l61Z7 33c?B94 - ...6THANDW49PSNA,ST.vFUL,MINN_>5101 (6111 224 4E81 301 W. BURNSV ILLE PKN'v., BURnSV iLLE, KUNN.5533] (612) E94 -5020 ORDER NO. D- 6985 DATE October 21, 1980 SPECIAL ASSESSMENT SEAFiCH Legal Description: Lbt 5, Block 2, Cedar Grove #8 Addition County of: Dakota Property Address: 3859 Palisade Point Eagan Plat: Parcel SPEGIAL ASSESSMENTS NOW PAYABLE ARE AS FOLLOWS: Beginning No. of No. Remaining Levy No. Type of Improvemeni Year Years Years BALANCE BALANCE PENDING ASSESSMENTS ARE FS FOLLOWS: Project Current Status APPROXIMATE COMPLETION DATE FOR PENDING ASSESSMENT IS: Estimated Cost AUTMORIZEO SIGNqTURE I ..._ _, $.12iJe •?.'.? ? City of Eag3n 3795 Pilot r-ic, Aoad Eagan, KN 551-l: Oate: September 12. 1980 St Pnul Title Insurance Co .>J1 '! &urnsvillc Pl:wy Sr`-CI>L aSSESS"T'?i SE4F.CH Burnsvmlic ?•.*.i 55337 fLE' Lot 5 131ock 2 Cedar Grove NE 02;)iiil # D-6745 3859 Palidacle '.t;ay; Fanan 17N 55122 Enclosed hezein is the search ::hich you reqt.jSgjda?4?46gj97t%,Oa9ae described property: :na: :-? r,t 3a: a?.ce ::z Rur.s 3e :nn:^ Cr:• None I Euz:?er certify that according to the records of said office, the fellowing i^p:oce^ents are con;e^placed or per.dino ai:er havir.g been a;proved, and are nov in the ?rocess of pianning or cocp:eti-Or,. ..,?o: i".,..:e- None :ox:-a:e :a•e .ca:-.ace WAI'.TR: tie::her the City of Eagar. nor its ecrployees guaran:ees the accurscy of 2he abeve info:mation which was requeste?i by the person or persons indicated. !lor does the City of its er.pleyees assume any lia6ility far the c-rrec2ness :hereof. In consideracion for the supplying of the indicated info nac:an in the abe•+e forr.i, and for all otner consi?leration of any nature uFatsoeve:, any claim agains: t4e City of its employees rising there from is hereby expressly waived. Levied assessaents to be paid to the County Auditor at Hastings, tlinr.esota 55033. Very t:vly yours, ,e-::) SPECIAL ASSESS;IE.YT JEPAATMENR' &PAULTITLE INSURANCE CORPORATIONORDER NO._ DATE $/25/80 SPECIAL ASSESSMENT SEARCH Legal Description: Lot 5, Block 2, Cedar Grovz No. ° Dakota County of: 3859 Palisade Point, Eagan Property Address: Plat: Parcel: SPECIAL ASSESSMENTS NOW PAYABLE ARE AS FOLLOWS: Beginning No. of No. Remaining Levy No. Type of Improvement Year Years Years BALANCE PENDING ASSESSMENTS ARE AS FOLLOWS: Project Current Status APPROXIMATE COMPLETION DATE FOR PENDING ASSESSMENT IS: Anoka County 100 EAST MAIN, ANOKA, MINN. 55303 (6121 421 5882 HennepinCOUnty 12350UTH7THST.,MPLS.,MINN.55402 1612) 339-4890 Ramsey Counry 6TH ANO WABASHA, ST. PAUL, MINN. 55101 I6121 224-7681 Dakoia County 301 W. BURNSVILLE PKWV., BURNSVII.IE. MINN.5533] 16121 8945020 BALANCE Estimated Cost AUTMOR¢EO SIGNATURE D-6745 .440-9'AS 32/79 Alhlialc ol Tne $I. Paul Companies Inc. om d? ' A'dtVmFeaqcn 3830 PIlOT KNOB ROAD, P.O. BOX 21199 eEA BLOMgUiST EAGAN, MINNESOTA 55721 nfoyor PHONE: (672) 454-8100 . 7HOMAS EGAN JAMES A. SMITM JERRV iHOMAS DATE: TNEODORE WACHiER MarCh 6, 1985 co?amemoers THOMA$ HEDGES Clfy NpIf1WVfO101 EUGENE VAN OVERBEKE Clry Ciere PENDING ASSESSMENT SEARCA RE: Lot 5, Block 2 `Cedar Grove 48 3859 Palisade Point Requested by: DAKOTA COUNTY ABSTRACT C0. 1250 Highway 55-P. 0. Box 456 Aastings, MN 55033 I CERTIFY THAT ACCORDING TO THE RECORDS OF SAID OFFICE, THE FOLLOWING P1PROVEMENTS ARE CONTEIPLATED OR PENDING AFTER HAVING BEEN APPROVED, AND ARE NOW IN THE PROCESS OF PLANNING OR CO:ff'LETION. Kind of Improvement Approximate Date of Completion ApDroximate Cost NOTHING CURRENTLY PENDING. WAIVER: Neither the City of Eagan nor its employees guarantees the accuracy of the above in- formation which was requested by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form, and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly waived. Levied assessments to be paid to the CITY OF EAGAN, 3830 Pilot Knob Road, P.O. Sox 21199, Eagan, MN 55121. Very truly yours, Donna Muench SPECZAL ASSESSMENT DIVISION THE LONE OAK TREE.. .THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIiY City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3859 Palisade Pt Lot: 5 Block: 2 Addition: Cedar Grove 8th PID:10- 16707 - 050 -02 Use: Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: Fee Summary: Contractor: Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437 -0338 Quesetions regarding elec 952- 445 -2840 Larry Leacock 15966 Fennel Ct. Total: Applicant/Permitee: Signature PERMIT City of Eaan Permit Type: Permit Number: Date Issued: Permit Category: cal permit requirements should be directed to Mark Anderson, State Elec ME - Permit Fee (Replacements) Surcharge -Fixed - Applicant - Owner: Jane E Hovind 3859 Palisade Pt Eagan MN 55122 $50.00 0801.4088 $0.50 9001.2195 $50.50 Mechanical EA089611 06/09/2009 ePermit cal Inspector, I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature           ùïï  ÿ þýý  ûüÿûü     úýý ðùïý ò Ü ìë à   þýö  þýüûúù ó  ûúùöø   ù ó ã þÛã ûúùãýéý  þ öýôü õôöýôü þÛ  ý å  í ñà õ  ÿôñ   ôîáþÝ÷ óßæêê õú  þý ë îèæêäêä  ôïóï ö òñ ùù òëôù ýôü âóì ñà õêÿÚñä     ãöñ ãö áàßñàñ ë üúø ë ëì ë ùù ëëé ô   ôùúøëùùüþ éã þý òúé í  ê ùù÷  ôþ ý  ýúþ ý  Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - For Office Use City of EaRRo n Permit I I I Permit Fee: l 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 11I3 Site Address: Unit Name: ✓ o e- hI ) yI/I o Phone: GSA" 7.52 2 Yrzf Resident/ ✓5-~I 4~15A1A /07- Owner Address /City /Zip: , Applicant is: Owner Contractor Type of Work Description of work: /D S/- f /hSGI Construction Cost: `o ld dot, Multi-Family Building: (Yes / No ) Company: ~zah Contact: aot ~e~ ~~c1~► Contractor Address: /Sa City: SJw~ State: kKkl zip: M31 Phone: Go-" d t (0- , V License G29 c3 66 ( G7 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 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.aopherstateonecall.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. _ xe x Applicant's Printed Name Applicant's Si ture Page 1 of 3 Use BLUE or BLACK Ink � r________________� � For Office Use ����� � ��� �� �� �� � Permit#: � Y � � �� �:�a � I Permit Fee: � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: � I I 2015 RESIDENTIAL BUILDING PERIMIT APPLICATION Date: �`'���r � Site Address: �v��� �Q r��S�e ��� Unit#: -�� > �' Name:_, �Gl � �L7 U l �I � Phone: Address/City/Zip: ', g�� 1"��.�ciG�- r�� '�j�r-S�,-� Applicant is: Owner /� Contractor Description of work: Y�°� Y�U�� Construction Cost: � � ��b Multi-Family Building: (Yes /No� Company: �`(U��vl �'�t�� �h?�` Contact: .�/`t� �SC 1 G�C f,✓� � � Address: � ,7��S ����"D � _City: _�(�'l�dt s,%lG� t an <� E = State:�Zip; SS �3� Phone:�-��Eirail: �. ���£ � ;�� License#:�G3�v��� Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTIING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan krased on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: - �- 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.aopherstateonecall.org, I hereby acknowledge that this information is complete and accurate;that the work will be in amformance 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 S�tate Building Cod ust be completed within 180 days of permit issuance. X�� ��y� � , X Applicant's Printed Name Appli s Sig ure Page 1 of 3