3674 Pond View PtINSPECTION RECORD
r' CiTY OF EAGAN 4 PERMIT TYPE:
3836 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date issued:
(612) 681-4675
SITE ADDRESS:
? ?.;.?;: ? . • ? , ??? ,r?.,??;,;
PERMIT SUBTYPE:
APPLICANT:
TYPE OF WORK:
?
i,?
I
INSPECTION DA • D•
; r tI?,
' ?,..
I; I 14/1ltK t. ?' I,iYI";IIP{ 1t11ARl1 1 kt';K'FTI' i I(iN t`. I: F'[iIl l ltt li
? ?
Permit No. Permlt Holder Dete Telephone #
ELECTRIC p?3? , 9S 5
PLUMBING ? /yf ??' 3?- rf
HVAC
Inspectlon te Insp. Commenta
FOOTiNGS
FOUND
FRAMING 7-7s? rn
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE ^
FIREPLACE
AIR TEST
FINAL PLBG
V
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
Wa*#cate nf Cccupancv
(Mj of ftgan
2"artaat vf lamdtiing axoatioK
This Certificate issued pursuant to t1u nquinements of the Uniform Building Code
cenifying that at tJrc linre of rssuance this stractei+e was in compliance witir the various
ordinances ojthe City i+cgtdating buildeng construction or use. For the following:
the Quxificatm: SIT tid: swg. Pnrnrt No. 352QQ
OoaTureY 7ype RIM TaainB Diaio R3 7)'Pe Caast. IPA_
o.-.a ar aWKM (Om VAi71R B1RS Aa&- 9li6i E RIVER mS
emwog Ad&ss 3674 PMVVULAVDTNf' LacalicyTB. HI -
Boi16oE OfGeial
P06T IN A CONSPICVOUS PLACE
Address 3674 PODID VIIW POINf Zip 5512 2
Lot s Blk I Sub rorro vIEw raarHaEs
?
THESE I'TEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (gazage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
?
A A-24
Deck
Please verify with the builder the removal of roof testcaps from the plumbing system and the shuboff of water supplyto
the outside lawn faucet before freeze potential exists. Contad engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy ?
0° g?424
Requ ;t Date Fire N. ough-In Inspeclion Pequiretl n Other Than Roughln
Inspectio
pou mu ?:I inspeclar when qeetly
reetly) ? Now [?'??ill Notiry Inspedor
- iq- Yes ? No Dete Fead
I P licensed contractor ? owner hereby request inspeciion of above electrical work at:
Job Atldress Slraet Box or Route Na.) City
E
1
Seclion No. Townshlp Name or Na. Pange Na. County
Occupam (PRINT) Phone No.
\
C70G U
Power Supplier Atltlress
Q
Eleclrical ConVactor (COmpany Neme) Contreclor s License No.
5-rrisn Elachi? n
Malling Adtlress (COntreator or Owner Meking Instellation)
8- r r n? k.
Aulhorizetl i (COnI mer ing Installatlon) Phone Number
r C'
MINNE50T ATE BOARU OF ELECTpICRY 1{ THIS INSPECTION REOUEST WILL NOT
Griggs-Mltlway Bltlg. - floom 5.128 II I I I I I I I I II I I I I 1 I II BE ACGEPTEO 6V THE STATE BOAFD
1821 UnlvereHy Ave., SI. Peul, MN 55104 I UNLE55 PROPER INSPECTION FEE IS
Phone161216G2-0BOU ENCLOSED.
?Inj'L 3,.GEQUEST FOR ELECTRICAL INSPECTION t,.° °;?, eaooooi-os
6 7/c ? ? See instmctlons for completing IM1is brm on becrc oh ycllow caq,. '$1°j??. ,I/ n/?.?
????? ? "X" Below Work Covered by This Request ?"sv??1 ?y ? r
New tld Rep. Type oi 8uilding •' Appl1'Fnces Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatiny
Apt. Building Dryer Load Management
Comm./Indusirial Furnace Other (Specif
Farm Air Conditioner
, Otner (specily) Conhaclor s Remarks'.
Compute Inspection Fee Below.'
N Other Fee # Service Entrance Size Fee N Cirwits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Am s A6ove 100 _Am s
Si ri5 inspectors Use Onqi TOTAL
Irrigation Booms ? , OU 5?
Special Ins ection ?
Alarm/Communication THIS INSTALLAT MAV ED DISCONNECTED IF NOT
Other Fee COMPLETED 18
I, the Electrical Inspector, hereby Rou9nam
?
certify that the above inspeciion has
been made. Final ? Oa h /
z
OFFICE lISE ONLV I
This request voitl 18 months imm '
L CITY USE ONLY RECEIPT#:Co
t? BL I
SU6?? a? ?6tN?t.t DATE: '///-q/9S
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc.
Date:
FEES
? Minimum Fee: Add-on/Remodei (existing residence only) $20.00
? HVAC: 0-100 M BTU '_7sj0_zyv 24.00 -
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each) 6.Oa
? State Surcharge .50
sO
TOTAL Ja f-
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
SITE ADDREBS: 3 co??
OWNER
GCZct I
PHONE #:
INSTALLER NAME:P)
STREET ADDRESS: 4t? ?j
CITY: vk- STATE: ynf-' 21P: 55 ia"p
PHONE#: ((p/Z) 533-L/ 357 /? ??
ciTr use oNLY
L BL
SUBD.
RECEIPT #:
DATE:
7995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commerciaUindustrial buildings.
? multi-family buildings when separate permits are = required
for each dweiling unit.
DATE:
CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: - $25.00 minimum fee 4L 1% of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of Rffpft fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME: (innPROVenneNrs oNLY)
INSTALLER:
ADDRESS:_
cinr:
PHONE #:
TELEPHONE #:
STATE: ZIP:
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
CITY USE ONLY ?
L ? BL 1_ RECEIPT #:
SUBD.? U,,,tkMr:./' DATE: `5 7 S
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55722
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH NO. TOTAL
Shower 3.00 x I = 31 C50
Water Closet 3.00 x _?3 _ Q- aG
Bath Tub 3.00 x I = 3"(7'D
Lavatory 3.00 x ? = 9•c3o
Kitchen Sink 3.00 x f = 3• 6D
Laundry Tray 3.00 x I = 3•r3D
Hot Tub/Spa 3.00 x
Water Heater 3.00 x f = ??
Floor Drain 3.00 x
Gas Piping Outlet * minimum - 1 3.00 x I =
Rough Openings 1.50 x 'D
Water Softener 5.00 x =
Private Disposal ' Dakota Cty. license 20.00 =
U.G. Sprinkler * home under const. 3.00 =
Alterations " to existing 20.00 =
Water Tum Around 20.00
STATE SURCHARGE .50
TOTAL ??. OrD
SITEADDRESS: 3O 4 `6'-Y-A?161J 4'
OWNER
INSTALLER
STREET ADI
cinr: ??-
PHONE #: ( )
?,33?'?357
aii2? Z4??-J-
SIGNATURE
STATE: ?" l? ZI P: 675 JA
OFFICE USE ONLY
L
SUBD.
BL
RECEIPT #:
DATE:
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6874675
Please complete for: . all commercialfindustrial buildings.
? multi-family buildings when separate permits are IIQt required for each dwelling
unit.
DATE: CONTRACT PRICE:
WDRK TYPE: ` NEW CONSTRUCTION _ ADD ON _ REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW' GPM. ARE FLUSHOMETERS TO BE INSTALLED? YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1°k of contract price, whichever is greater. State surCharge of $.50 per
$1,000 of pgcms fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER:
ADDRESS:
ciTr:
PHONE #:
SIGNATURE:
OFFICE USE ONLY
METER SIZE: " DATE
STE. #
STATE: ZIP:
APPLICANT
INSPECTOR:
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE
Permit Number:
Date Issued:
C?o ?$S9s
BUILDING
025299
03/31/95
SITE ADDRESS:
P.I.N.: 10-58361-080-01
DESCRIPTION:
?1--?, -, (zeao-Lnr-Lrtie)
B,J6ild3ng1,Permit Type SF DWG
Building Wthxk, Type NEW
?USC 4?cupa??:y"?, R-3 M-i
Cpnstructio-n Fype V-N
R-3
BUildin.g Larng'th ? 30
Builefitjg Wa¢th 60
2
1,542
REMARKS:
PERMIT
3674 POND VIEW P7
LOT: B BLOCK: 1
pONp VIEW TtlWNHOMES
? t
5;° ...t 7 i+d?
GYPSUM BOARD ZNSPECTION Z5 REQUIRED
FEE SUMMARY:
vpLuarxoN
o-
4`
f E"?? ? ?r a Y"` ?,? { y ? •„ '
$126,000
Base Fee
Plan Review
Surcharge
SAC
5flC %
SAC Units
5ubtotal
$730.50
$474.83
$63.@0
$850.00
100
$2.118.33
MISCEILANE0U5 $1,892.50
Total Fee $4,610.83
CONTRACTOR: - flpplicant - sT. LIC. OWNER:
Gptlp VALUE HOMES 17559793 0001583 G00D VALUE HOMES
9445 E RIVER RD 9445 E RIVER RD
COON RAPIDS MN 55433 COON RAPIDS MN 55433
(612) 755-9793 (612)755-9793
I hsre[ry aekno,wledge that?-I havePead tbis app].?a;itlon and seatothat ehe
infdt-mation i?s corr?o-?ct artd? sgre#?to cQmply wi?kh all'aPAliG?able State of?Mn.
Statu'Ges aricf City of Eagan Ordirkanees.
? ? : ` ? • ??. _ . ? ?. e ?
? ?d-
LICANT/P MITEE SIGNATURE I SUED EYISIGNATURE
?-
AP P
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knoh Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
BUILDING
@25299
03/31/95
SITE ADDRESS:
Lor: e sLocK:
3674 POND VIEW PT
POND VIEW TOWNHtlMES
PERMIT SUBTYPE:
SF DWG
APPLICANT:
i
GOOD VALUE HOMES
(612) 755-9793
TYPE OF WORK:
DESCRIPTION
NEW
(2ER0-LOT-LSNE)
INSPECTION
FOO7ING5 .. .
FOUNDATION DA
FRAMING ROOFING
INSULATION FIREPLACE
ROUGH ZN PLBG ROUGH TN HTG
FINAL PLBG FINAL
? z
? CITY OF EAGAN ?40f OJ
9 3830 PILOT KNOB RD - 55122 ,
91995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
? 3 registered site surveys ? 2 wpies of plan
? 2 copies of plans (inclutle beam & window sizes; poured fid, design; etc.) ? 2 site surveys (eztarior additians 8 decka)
? 1 energy plculationa ? 1 energy calculations Tor heated additions
? 1 hee preservatlon plan if lat pletted after 7l1/93
required: _ Yes _ No
DATE: 3 hSI9 ? CONSTRUCTION COST:
DESCRIPTION OF WORK: RI( Dlq` ??-`u °`l-, C,
STREET ADDRESS:
LOT 0 BLOCK I_ SUBD./P.I.D. #: ? N?V t? ? TDJriI1D ?
S-Oct)e °''/ Ldrs (o, -7. F, to
PROPERTY Name: 000D VA-LU€ O??ss Phone#: L7--7SS-92932
OWNER ""' """
Street Address- K-i vE,z,
City: 6.,1 State: /MKi Zip: ss¢33
CONTRACTOR Company: S?=-s As Phone #:
Street Address: License #- / 583
ARCHITECT! Company: '?E i{c A-r,•?cT7
ENGINEER
Name:
Phone #:
Registration
Street Address•
City:
State:
Zip:
Sewer 8 water licensed plumber. Q 14 Ss,.?sk rf Penalty applies when address change and lot
change are requested once permit is issued.
1 hereby acknowledge that I have read this application and state that the iniormation is corred and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. /
Signature of P,ppticant:
OFFICE USE ONLY
Certificates of Survey Received
Yes _ No
MQi7 1 8 1??i:
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
?..
BUILDING PERMIT TYPE
? 09 Foundafion o 06 Duplex ? 11 Apt./Lodging ?
j3C' 02 SF Dwelling ? 07 4-plex ? 12 Multi (Misc.) ?
? 03 SF Addition ? OS 8-piex ? 13 Garage/Accessory ?
0 04 SF Pofch- ? 09 12-plex ? 14 Fireplace ?
? 05 g?Misc. ? 19--RAa4t+{ itional) ? 15 Deck
?Eez o - Lo r - G?r?E
W TYPE
ca(-31 New ? 33 Alterations ? 36 Move
? 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Aliowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
16 Basement Finish
97 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft. MC/W5 System 44
;3L-!v Main level sq. ft. J,ioy City Water ?
-3 ?.,-1 ? sq. ft. -75-2- Fire Sprinklered
ie -3 sq. ft. PRV
2?-?17rwr sq. ft. Booster Pump
70 sq. ft. Census Code.
/oc Footprint sq. ft. sfZ SAC Code ?i
Census Bidg
Census Unit
Permit Fee
Surcharge
Plan Review
License
MCM/S SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S/W 5urcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Building Engineering Variance
Valuation: $ /2loj 00-11
?v
?
i,or 1 _ S
? f
• ?? - r f,
PCO ??
?? ?" ?,r'"
U I ? ? ? &Atp 5 '
°k SAC /
SAC Units
?U
??A
1 ????
2005 RESIDENTIAL PLUM??NG PERMiT APPLtCATION
CITY OF EAGAN
3830 PILOT KNOB RQAD, EAGAN MN 55122
551-675-5675
? 15 5?
?ase complete for modifications fo existing residential dweliings.
te `? , /? ??/__[? ? ?,/f? ?? ?? V
:e Street Address ?[? 7 LS?U Y/ Unit # I
operty Owner r?e?H ?? ? Telephone #? j?) J? S
?
' i Telephone # ????
?
?ntractor
? I'
f State?
r?/C? Zi
?
WhIA
idress City ?„ ,
Lt p
:
ie Applicant is _ Owner ,? Contractor _ Other
New ? Refurbished Submit 2 sets of plans and MPC license
:ptic System ?nt?fee
Incfude$ jo
_ ?
Per as-built $ 10.00
lierations to existing dwelling $ 5D.00
Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. If you are installing onlv a wafer soitener and/or water
heafer, do not complete this seciion; move to '.he next section and check 1he
appliance(s) you are installing. ? ? ? ? ? ?n
D v
Septic System Abandonment D
D
-
Water Turnaround (add ?130.D0 if a 5/8" meter is required) SEP 1 B 2006
Other:
?j+Nater Softener _ Water Heater $ 15.D0
new replacement
Lawn Irrigation _ftPZ _PVB `new _repair _rebuild $ 30.00
5 50
?tate Surcharge
?? ??
?
"otal
hereby appiy for a Residential Plumbing Permit and acknowledge that the information is compleie and accurate; that the
?ork will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
?nderstand this is not a permit, but only an application for a permit, work is not to siart without a permit and work will be in
iccordance with the approved plan in the event a pian is required to s r viewed an approved.
?oberf- 5?0 ?
?pplicanYs Printed Name ? Applicant's Signature
??2ati
2006 RESIDENTIAL PLUMBING PERMIT APPL1CATlON
CtTY OF EAGAN
3830 PILOT KNOB ROAd, EaGAfY_MiV 55122
651.675-5675
Pleasa complete for modifications to existing residential dweliings.
-A I55°
Oate 0911 50 6/
STEIN,BETTY
SItB S}?@8t A(Id1'ES5 3674 POND VIEW POINT UnIt # -
, EAGAN, MN 55122
(651) 454-5469
Property Owner Telephone # ( )
ContracYor _ N DrbiGYYl pLu, j°n b! t'I C7 Telephone #((p I Y) _?'L7 -?10?3
Address 2905 ela,r-11?etd A-v. 4a cit„ YYt.Dts Statem fl) ZipZ5q09
The Applicant is: _ Owner Y Cantractor _Other
Septic System _ New _ ftefurbished Submit 2 sets of plans and MPC license tnciudes County fee
$ 100.00
+
Per as-buiB $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plum4ing fixtures. This Fee inciudes installation of a water softener andlor water
heater at the same time. !f you are /nstaNing onl a water softener and/or water
heater, do not complete this section; move to the next section and check the
appiiance(s) you are instalting.
`Septic System Abandonment
`Water Tumaround (add $130.00 if a 5/8" meter is required)
Other:
/
_ Water Softener
Water Heater $ 15.00
/
new V replacement
_ Lawn lrrigation _RPZ ,PVB -new ^repair _rebuild $ 30.00
State Surcharge Q?( ? $ .50
5 1Do6
?
S?P ?
Total $ 15 .50
i ncreoy appry ior a rcesioen[iai rlumning Permtt antl acknowfetlge that the InfoRflatlon I5 eomplet8 and accur2ie; th8t the
work will be in conformance with the ordinances and codes of the City' of Eagan and the plumbing codes; That i
undersiand this is not a pertnit, but oniy an application for a petmit, work is n t to start without a permit and work wip be in
accordance with the approved plan in the event a plan is required'tR be vi ed a approved.
Applicant's Prin dName Appii6anYs Signature
v
,rg Use BLUE or BLACK Ink
~ I For Office Use I
' t p
l O rl V l~ Permit (I O O ~-q
City of Ea ~a~ ap
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 0
I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: fl 1 3 Site Address: ,31x7® - 3G7F AndyleLd #0 Unit
Name: for)( J U `t e W W C
/9 A e 114L Phone:
Resident/
Owner Address / City / Zip: Q . c 3 p2 73
Applicant is: Owner Contractor
Type of Work Description of work: _/fir 0-4' l e- - T&0 ~ ~ iq~ RAP $/G~Q
Construction Cost: d 7 -Z Multi-Family Building: (Yes / No
Company.. 1u Contact: I✓~ Gl 01'1 S #tm~~r-
Contractor 5S1 4P Address. _ ~ rt V~ V~ . City /6/Wk~tcq
t V
State: Zip: 6 -L12- Phone: _6 fob . 3 f/, f~
License PA" -99 76 1 Lead Certificate CJ
t
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
i
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:
i Sewer & Water Contractor: Phone:
E 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 m st be completed within 180
days of permit issuance.
x Tayy)tS ~4wv4er x
Applicant's Printed Name p icant's Signature
Page 1 of 3
For Office Use
. 1Z ; ; Pemid ti.
,
0
...
"....,▪•... .4.,0 Pemiit Fee:
I
EAGAN
-
..........
*94
Date Received: 1
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 I
1
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: i
buildinclinspectionsOcitvofeactamcom L -1
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site)' *1 1'15 3101
1 0.+ ik•bl. 4t 3 til Li 3 1 kirt . .k401‘.6 cb14\I'tw '
Site Address: Unit#:
SCM
Name:ON\NA 'Kv- eo\ (1?tondatew A-b\dvAvvie57)phone: Cgi d.-4R)k..\
Resident/ . j-
1110k _1(1.0\,e,rAr. yLA EoLL6v.,‘ m
Owner Add /Oty/Zi - I -..... It'`') -.3\''')\
Address/City/Zip:i p. 5cn ' I
1 Applicant is: Owner Contractor
1 ,
4
Type of Work
Description of work: - ear- b aiv-\-. Y-ti\rwcc.
.
!
[ Construction Cost: 15 il) 13 Multi-Family Building:(Yes X /No ) 1
Company: CA () 0
OW(kA. CYO/ AIN I. V1 Contact: L kr.-`\ ')Woknakurixi\
17
. 'la---1 0kin Lovw_ 3\,,A,,/
Address. City: AVUZkitir
1 Contractor
state:14)Zip: r-51)6L1 Phone: 10G-ZRO-GM9 Email: \\PtalALL( OeriVI' tbk/V1
1
1 License#: tbC5 i a q 1 k‘a Lead Certificate#: LC0 CI 3 clk 1
If the project is exempt from lead certification, please explain why:
ll
0
I 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?
I Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone: 1
1
111 Sewer&Water Contractor: Phone:
1 1
Fire Suppression Contractor: Phone: 1
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.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeartan.corriisubscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Cali 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. wwwoopherstateonecallorg
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.
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