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4140 Ruby Lane Use BLUE or BLACK Ink r For Office Use City of E(, Permit#: I Permit Fee: 0_0 3830 Pilot Knob Road l Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Cam, Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: e%1 - !24 Site Address: iz `a Tenant: Cc_, O;na~G Suite RESIDENT / OWNER Name: Phone: O1S'Z V2- tz Address/ City /Zip: b`"1 C1 L r= ;rye w Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes, / No CONTRACTOR Name: ~"3 r'~ } L L License Address: City: L State: N-r)T,3 Zip: S 5 ~y `-I Phone: V l - 272.. 4 l-t Contact Person: 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. 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 per it; 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 ure Page 1 of 3 îó ÿ ÿþþ ýü îü ûû úþþóûó ì ëó óããúôîîë ë óëó ÿþö þýüûúùø÷öôýûúù øûúùõù ù ôýôóïýù ú ò þñý ð Ú þ óóóþ æ ÿçæ ðä ä é ê é ê õú þý å ý ä éë å ý óÿ é ôóûòñ öðï ùù õ÷ íããúíâú õýüú õìçæ çæ ëë à ßë üú ÷ ì ùù ãî îùú÷ ùù üþ ãç þ ý ôúã ï é ùù öîþ ý ýúþ ý Sep 30 13 08:55a LS West, Ilc 9522368445 p.6 Use BLUE or BLACK Ink For Office Use I PermitM p My ~ Ea I Permit Fee: r-7 1 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: j Phone: (651) 675-5675 i i Fax: (651) 675-5694 t Staff. i 1 I 2013. RESIDENTIAL BUILDINGI PERMIT APPLICATION it V-.1 Date: t t 3 Site Address: N. AtJ 11, N N L~ U in t Name: _ tJt T1 ti n+VIW4.+S ~h ~ 1 i Ovi Phone: Res identf Owner Address I City I Zip: Applicant is: Ow''n'er ~ Contractor Type of Work Description of work.. _1_e r- og a- r'Gnn7 J6d✓'~/~c~~ihd✓t r If Construction Cost: _1~ 3I Multi-Family Building: (Yes / No __J Company: 2s )P'S4 Contact: )zbA'(el L1 e S•L Contractor Address: Ze u ke-4ae-, City: LA~@tA , Stater -7ip: _d y ) Phone: License JVS61 ~ Lead Certificate lVff , r ^I Ij 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.copherstateonecall.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 ode must be completed within 180 days of permit issuan x • SdH D e-4---- x Applicant`s Printed Name Applicant` ignature Page 1 of 3 � �. .f , t . � � . �� Use BLUE or BLACK Ink i-----------------, � For Office Use � Cl� of Ea a� �� , _�� ; y � 4 � Permit#: � U� 3830 Pilot Knob Road �� j Permit Fee: � j Eagan MN 55122 � � I Date Received: I , Phone: (651)675-5675 i I Fax: (651) 675-5694 � Staff: � ___��_��__�____�J 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: Tenant: � �� ,�� r�� Suite#: �� hF3'`}2t[��-� Fl:�q�`P . Name: ��-��_7� � ��S�Id�11'F��/tl�, �'� Phone: o L''.(��' �� " '� ' Address/City/Zip: � � " � � �S � �____ � . �� ' �� `�� 3 Name:� T`'�'�ert Co�pany Inc dba Culligan�Vater WC�641376 � " " '� License#: � s � � � _ �� aadress: 18Qt 50ih St East� Inver Grove H ts. ' CQ #r C O�p City: g � 55077 ��S C ��- C�� . .... � ,�.�� state: Mn 6 51-4 51-2 241 � � �� Zip: Phone: � � William R Milbert �� „ ��°�`�� Contact: � �'" '� �� EmaiL• � • � �'` , k; � �� `"� � � - � ' _. . .�� j �a�:��, _New _Replacement _Repair Rebuiid _Madify 3pace Work in R.O.W. �Y� � r�-�e — — �'-��.� �r ��'` � Description ofwork: � � � � � � � � � � = �� RESIDENTIAL � �� , , � �� Water Heater � �� Water Softener �� Lawn�lrrigation(_RPZ/ PVB) � �P��' 1�3� J — � �� Add Plumbin Fixtures �� Septic System 9 (_Main/_Lower Level) � New Water Tumaround �� — �� " �� n Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) $60.00 Lawn Irrigation(includes$5.00 minimum 8tate Surcharge) $6J•0�Ad� �lurrm�i�g Fixtures, Septic Svstem Abancionment,Water Tumaround"(includes$5.00 State Surcharge) "Water Turnaround(add$200.00 if a 5/8"meter is required) $115.00 Septic Svstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) /� TOTAL FEES$ �/ O O 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 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. � X w�C1��,. �' �vl,z��-�.�" � _ ApplicanYs Prmted Name Applicant's Signature , � e�.� �fin� �� .- � � �� ` g�`lll�B� 17S G ��, � �� , _ e '�� ,��t�. ��$�,' ��. $� � PERMIT City of Eagan Permit Type:Building Permit Number:EA157230 Date Issued:08/12/2019 Permit Category:ePermit Site Address: 4140 Ruby Lane Lot:230 Block: 03 Addition: Diffley Commons 2nd PID:10-20451-03-230 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Jeffrey J Hyde 4140 Ruby Lane Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature