4692 Lista PtRESIDENT OWNER
4 Phone:
Name: V 2/
Address City Zip: -7'l( j i, ac-
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: I F- 2b 8 1
Construction Cost: 4, Multi- Family Building: (Yes No
CONTRACTOR
Name: N License #4.)(0 3 (p3 (e S
Z�
Address: b C (d\Icc RI -3C1
le
City: Cr k-CA- State: Zip: 5 3 8
Phone: i Z 3 C2 C 7 Contact Person:
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY W CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
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.
City of Ea�all
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
z /I e
Applicant's Printed Name
x
Applic
re
or Office Us
II r
Permit i
Permit Fee: CX
Date Received:
Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
r
Date: Site Address: 1,/ r r rt 7
Suite
Use BLUE or BLACK Ink
10
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.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 approve plan i the case of work which requires a review and approval of pl s.
Page 1 of 3
CITY Or 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:
agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By ,/ /Y/' Date Paid:
Date of Insp.. ,,I Insp.:
•
CITY OP EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address: -— - - -- - -- -- - --
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: _ Date Paid:
Use BLUE or BLACK Ink
r
I For Office Use
I _ v I
City of EaEdn , Permit#:
J l~ a I
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff:
I .T I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: D l Site Address: glAY141 &M Pt- y40j y` C 11 Pt Unit
Name: I \ 1,PGL°C_L I s7 Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner contractor
Type of Work Description of work:.-,/~ /+e /-G y r
Construction Cost: Z 7~y~ Multi-Family Building: (Yes No
Company: D ~h •l Vole 1 "l Contact: L A5 e
Contractor Address: 1ey ev` City:
r
State: Zip: S~f ~3 3-7 Phone: LJI~ -
License 01-V ? ~FG 6 4(_'7 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
I 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.
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 must be completed within 180
days of permit issuance. l
x 04-11 L! 7 jL° x
Applica 's Printed Name Applicant's Sig ature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA127771
Date Issued:10/15/2014
Permit Category:ePermit
Site Address: 4692 Lista Pt
Lot:4 Block: 08 Addition: Ridgecliffe 3rd
PID:10-63982-08-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ann Hoffman
505 Randolph Ave
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
Eric W Campbell
4692 Lista Pt
Eagan MN 55122
(612) 205-9137
Bonfe's Plumbing & Heating
505 Randolph Ave
St Paul MN 55102
(651) 228-9071
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
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I For Office Use �
� � Permit#: t ��� �
City of �a��� ; . ;
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 � I
Fax: (651)675-5694 I Staff: I
1 I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: l Site Address: � Unit#:
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�����.� � � �� �,, Name: ��It�����--� ��� Phone:
�`�Resident/ �
� �Ow�er � _' Address/City/Zip:
�� � ���� � �
�,�.� �` � �`�����' A licant is: Owner �Contractor
�.. .: ��. ,����. . .�,.:� Pp
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� ��� ' n
�� � Description of work: �� �" �t�/�.
�,�TYp� of Work ,�
��..,�� g�:�„��� ��,�� Construction Cost: Z'�d�p Multi-Family Building:(Yes � /No )
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� � ���-� , ' P Y'�71T�/-�IZI��—�G�.--
, � � Com an � OL � Contact: ��
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� ,�� � , ��Sr �i�t�tu�Y> C�' _c�ty: ��/�«t'�'�.
�� 3� xt.� � ��: Address:
Contractor - �- ,
� ., �� � �. State:��Zip:��� Phone: -�`G� ��maiL
�� �� �;
� �� ;����. t License#:�3����� 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 based on a master plan? �I
_Yes _No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
� NOTE Plans antl supporf�ng doc�uments that you submit are*co�ns�%red to��e pub/ic�nform�:t�on� ortrons of�
��the rnformat or��raay�be�c/ass�fieal as n�o�i publ�G rf�you��ro�fde�sp�eci��ic reasort��fh�f wou� Fe r�# ��fo��;
��
��;_ ; ���.�.�` ��:� �.�� ��x . � �conclude�tha#=the ,TMare,�trade.seci ets.��...��a >��4� �;� ,�,.., ,�; -�'�
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.popherstateonecall.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 S�tate Building C e ust be completed within 180
days of ermit issuance. �
���s
x �.
x
ApplicanYs Printed me App icanYs S ature
Page 1 of 3