1643 River Bluff Ctki
CityofEaffall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
416(1-13,'-(3;117,Liq
Use BLUE or BLACK Ink
Fas £3tilde Use
Permit #: -1 0 i / xi
Permit Fee: S'399.. 75
Date Received: (1-2141
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:4' S p • 2c9// Site Address: 4,3 3 q ,R1 a. Unit #:
RESIDENT /
OWNER
Name:
Address / City / Zip:
Applicant is: Owner x Contractor
TYPE OF WORK
Description of work: (fie,-
Construction Cost `ocii 5023• 77
CONTRACTOR
Company:, ct,t r<<S.Z, (e7_1,v1(.9d1 eJMM.(3 ) d C..
Multi -Family Building: (Yes ?C / No )
Contact:
eJ Peiie_rs0-7-)
Address: 64 7 6II c2 1-cji e_ City: P0 LA I
State: M N Zip: £//O Phone: 66/ - 76D1 - 9.295
License #: aOC S/$/g Lead Certificate #: NAT.- a2`%.33-0
lithe 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.gopherstateonecali.orq
1 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 1 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 app val n
x 5 oe-I Pe -4 -e_ -(S01-2
Applicant's Printed Name
cant's Signature
Page 1 of 3
41' City or EoRaff
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Per Office aie
Permit #:
Permit Fee:
Date Received:
Staff:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1)61 Site Address: /0/2. gilk-,i4 Ci -
Tenant:
Suite #:
RESIDENT / OWNER Name: r cto h r) Phone: 5,1' :1
Address / City / Zip:
tqcaM iqi• 5 6 / t___
CONTRACTOR Narne: tOr) iel) Ilia) b e License if: 70 - Ezti
-1' 7 D Ooci d
Address:
City: - at
Phone: C.
3,4_0
Contact Person:
State:
1 f3 .) 2-1?))
TYPE OF WORK
New ://Replacement _ Repair Rebuild Modify Space _ Work in R.O.W.
Description of work: Re4jeice.
PERMIT TYPE RESIDENTIAL
.v -Water !teeter
Water Softener
g„t.&
_ Lawn Irrigation Add Plumbing Fixtures
( RPZ / PVB) (___ Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL 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)
*Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $ 50 50
I hereby acknowledge that this information is complete and accurate: that the woik will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is riot a perrnit, 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 Pi kited Nafrie
FOR OFFICE USE
Required Inspections:
Under Ground
x
Applicant's Sign
Reviewed By: Date:
Rotigf)-Iri Air Test Gas Test Final
Aug 181511:02a
Sunrise Remodelers
City of Badu
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
651-762-9395 p.15
r
Use BLUE or BLACK Ink
For Office Use
Permit*: /:3-g 6*()
Permit Fee: go-3-
Date
o-3
Date Received:
Staff.
p.41ecK0 L� � G��QA�Ch•Ci►Yr
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
C-€ cLt B -,
To -' £ r
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lir
Date: %�" I Site Address: 1( pv.ve Y C3(�r� tt "Co art" 5513{ Unit#:
._._ 3j_ - GW11 711 � L0 �i-�=�,. -- _ ,..—
Name: l Phone:
J
Resident!
Owner
Address f City / Zip:
Applicant is: Owner Contractor
Type of Work' Description of work: �; i
-14
Contractor
•
Construction Cost: i !: 000 �J Multi -Family Budding: (Yes / No )
Company: 5 1,k. In, v- R•e vv1 r S Contact: .S<'..k .10.1
� l L5i
Address: 5 _ [nt 1 -t-6O D—C Lei i-� City: ` . . t t
State: / GAJ, Zip: q.; C 1 /0 Phone: Email: i t—CO e frvi ccr-e: ; S,
License*: CRSII Lead Certicate #: / 1 7 3•" .
lithe project is exempt from lead certification, please explain why:
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 S Water Contractor. Phone:
Fire Suppression Contractor. Phone:
NOTE: Pians 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 Haat 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 utildy damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www gooherstateonecallorq
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 1 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
X
S Ci v")
Applicant's Printed Name
Ignature
Page 1 of 3
City of Eaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use f
Permit #: / 3L1/
/ 70
Permit Fee: le �' 3
Date Received:
Staff:
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ,✓) /(.// �/ /ES / /Pi /W5 /64/7 44 V' Unit #:
Name:
Phone:
Address / City / Zip: , 3 '"/ R t L4 'OP Cr EAf-CTA+N). wit,. 5'5/-2-3
Applicant is: Owner Contractor
Description of work: REPL4C6 gi9.2A-ot3' "40114
Construction Cost: 3 600 to
Company: Co) UM u, gAlt.ik66 cJ(9irir1.4, M2- Contact: STOW- c -Jo W")
Multi -Family Building: (Yes x / No
State://t) Zip: 55009 Phone: &S/- .795- d3// Email: SJoH*oseml eC4rAvoNt%C
License #:
Lead Certificate #: N/'4 -
If the project is exempt from lead certification, please explain why:
No (,L.4-0
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:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
!hoeTE: Plans and supporting documents that you
tinformation may be classified as non public you
conclude that
Phone:
Phone:
Phone:
Phone:
are considered to bepublic:inform ion. 1
ot specific reasons that would°permit is
re tr
de 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.gopherstateonecali.orq
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.
x 57731/v V DISSa.)
Applicants Printed Name
41.0114111,
Applic
nature
Page 1 of 3