3463 Trails End RdRESIDENT OWNER
Name: Phone:
Address City Zip:
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: P( ..O -h T
Construction Cost: 2 Multi- Family Building: (Yes No
CONTRACTOR
Name: (L; t.-- L c. -r✓ AP-rtl License ')-v fd)"/ 0 X
Address: l ,-_'7t' C' e L- Ut,
City: ‘...-001.1-t) e State: 7y1 Zip: j l j
Phone: 5 t c) a2 C 2- Contact Person:
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF 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:
documents that you submit are considered to be public information. Portions of
be classified as non public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
NOTE. Plans and supporting
the information may
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Use BLUE or BLACK Ink
For _Office Use CI Permit 1 1
Permit Fee:
Date Received:
Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: J` //2/
1-76 f z/t 6 7 F Suite
Tenant:
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 approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name AV p cant Signature
Page 1 of 3
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN METER # PERMIT DATE 09/03/91
3830 Pilot Knob Rd.
Eagan, MN 55122 -1897 CHIP # PERMIT # 12253
METER SIZE B.P. RECEIPT # C 14997
DATE AUG 19, 1991 4 ' ISSUE DATE B.P. RECEIPT DATE 08/19/91
PRV BOOSTER PUMP
SITE ADDRESS 3463 TRAILS END RD PERMIT REQUESTED
LOT 8 BLOCK 2 SEC /SLUB1 WESCOTT SQUARE ,
4 ;0 X S X WATER TAPS
APPLICANT:
COMM /IND X RESIDENTIAL
ADDRESS:
CITY, STATE ZIP X NEW EXISTING
PHONE:
Lawn Sprinkler Meters are to be Installed
PLUMBER: PLYMOUTH PLUMBING INC Ahead of Domestic Meters on Water Line.
ADDRESS: 9290 ZACHARY LN Credit WILL NOT be given for Deduct Meters.
CITY, STATE MAPLE GROVE MN ZIP 55369 I Q '
PHONE: 493 -2474 ow lc ,
1 AGREE TO COMPLY WITH CITY OF
OWNER: NEW HORIZON HOMES INC EAGAN ORDINANCES
ADDRESS: 12201 MINNETONKA BLVD
CITY, STATE MINNETONKA MN ZIP 55343
PHONE. 933-2521 SIGNATURE WHEN METER ISSUED
-1 PLE LO b OR 454 -5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING EP A uP k, L► ,l� 07t..,/ ,;//