Loading...
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 r----------------� 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 �',�q� Yr gZ �rsf� r� Date: l Site Address: � Unit#: � � � �` �����.� � � �� �,, Name: ��It�����--� ��� Phone: �`�Resident/ � � �Ow�er � _' Address/City/Zip: �� � ���� � � �,�.� �` � �`�����' A licant is: Owner �Contractor �.. .: ��. ,����. . .�,.:� Pp � � � � � � ��� ' n �� � Description of work: �� �" �t�/�. �,�TYp� of Work ,� ��..,�� g�:�„��� ��,�� Construction Cost: Z'�d�p Multi-Family Building:(Yes � /No ) �� ��� �� �; � ..-„ � � ���-� , ' P Y'�71T�/-�IZI��—�G�.-- , � � Com an � OL � Contact: �� �� � ��� � ,�� � , ��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