1626 River Bluff CtCiti otEagau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-56944 1� I-544,36 i Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Use BLUE Or LAK Ink
}ora( Use
Permit #: ! Fri IJP
Permit Fee: 4#39 g 75
Date Received: y -,)'/ !/
Date: L -f 'ao • .2 ii Site Address: 1&,-,Z4, P ►1N r
Unit #:
RESIDENT /
OWNER
Name: O)77
Address / City / Zip:
Phone: 763 - y19 - 91on
Applicant is: Owner
X Contractor
TYPE OF WORK
Description of work: Re., -1-00c
Construction Cost ir,2 /, 5a23. 91
CONTRACTOR
MuIli-Family Building: (Yes X / No )
Company:, co n r,,ke yv,<)fJ &I&a) 47 Contact:
0( Pe-le.rscm
Address: ,55% 7 6 gob. / n c_ City: 3 -I -.Pa u'
State: M N Zip: £5//0 Phone: (p51 - 7601 - 907 q5
License#: a(:)0$/$/$ Lead Certificate#: NAY-- ,2,Del 33 -0
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 o
the information may be classified as non-public if you provide spec reasons Met 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.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 {theme approved plan in the case of work which requires a review and app�val of -plan
x L1O'' 1 l?i�e o i
Applicant's Printed Name
cant's Signature
Page 1 of 3
4/11'.
CityofEaafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
SEP q 3 2010
Use BLUE or BLACK Ink
Permit*: c s
Permit Fee:
Date Received:
Staff:
j,� (� 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: "I - 1 ' 0
Site Address: 1(2 (a Rt'iet Pi uc Cott( E
J
Tenant: Suite #:
RESIDENT / OWNER
Name: a 6 L..Z ri `.11 Phone: 0—:549 a-33/
Address / City / Zip: C(/fl QJ 64 v 14 55/al
CONTRACTOR
Champion 1 iumoln
Name: # 6177Q -PM License#:
Address: 651-365-1340 City:
Dodd Rd.
3670
State: zip:Ea9an, MN 55123 Phone:
Contact: ( 5 Email:
TYPE OF WORK
New {Replacement Rebuild Modify/ISpace _ Work in R.O.W.
_ _F_Q YtRepair _
_
Description of work: Jt/c (8) i A C Verb-
PERMIT TYPE
RESIDENTIAL
Water Softener
V Water Heater
Add Plumbing Fixtures ( Main / _ Lower Level)
Lawn Irrigation ( RPZ / PVB)
_
Water Turnaround
Septic System
New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $ tAC
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gooherstateonecall.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 wi h the approved plan in the case of work which requires a review and approval of plans.
C ROFFICE USE
equired rnspectior
Lf7w, tfO
EAGAN TOWNSHIP
BUILDING PERMIT
Owner .... GC(x?' ``C`' ..........n.. ? .............
Address (present) '? y `? 0u-?-?-
Builder ......... 4-4.` ...................."'............""-........."-.............
Address .... .............................. _.........................................°_.............
DESCRIPTION
V11
N° 2916
Eagan Township
Town Hall
Date .-........... ^ 7L
. . ....... Storie To Be Used Foz Front Depth Heigh! Est. Cost ermi! Fee Remarks
gpt I •Los/3,o? 2/sP•S°
/079-
C - /r y f ."y
,
., II
^.-'-•'-"--? LOCATION a37--As-
i!, Road or other Description of Location I Lo! Block p Addition or
This permit does aot authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE Jij{EPyTyO-N THFPREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that .......... .........'!-!..... .....???......................has permission to erect a...?sZg..f!?!!:.•?Tc.?._. -T
P
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955.
........./.Y.`.^' -.`..:` .....C.:....0........i?•....... ? Per ..................
JV : .......... Q............°..:-...".........
j Charrm'. Building Inspector A
jai- ,fV
4,0-4el-14- /calms
MASTER CARD
Issued To
Permit No. Issued Contractor Owner
BUILDING Z ?y
PLUMBING
-776 t 41
61
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING 4V6
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION , CESSPOOL
FRAMING
FINAL
ELECTRICAL TILE FIELD FT.
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
,:5-.
UKt A
LAND AS S 0( y > 4)
LAND
?, so
CITY USE ONLY
L Aa- BL
SUBD.
L C7
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
RECEIPT* 0135
DATE:
Please complete for:Xsingle family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
_ Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: J zz t?
FEES
? Minimum Fee: Add-on/Remodel (existing residence only $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @ $3.00 each)
? State Surcharge 50
O, SIJ
TOTAL
SITE ADDRESS: ,ll3a a.
OWNER NAME: PHONE#: _757_ WV
INSTALLER NAME: Ad"5P?25--?-y Z G'-
STREET ADDRESS: Z?y? 141
CITY: e!5e STATE: ZIP:
PHONE #: (
?-m lSha
EAGAN TOWNSHIP
3795 Pilot Knob Road
St, Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: 12/29/72 (4/25/73)
??rbcc?
NUMBER 1322
OWNER:Rivereate Villa-Bldg' 8 Address 1626-28-30-32-34-36 River Bluff Court
PLUMBER Rerehorst Plumbin_a Co. TYPE OF PIPE heave rtac+, irnn
DESCRIPTION OF BUILDING
Industrial+ Commerciall Residential Multiple Dwelling No, of units
o - townnouses
Location of Connections: Connection Charge 1170.00 billed 4/25/73
Permit Fee 10.00 pd 12/26/72
.50 Pd -I
72
Street Repairs
Total
Inspected by:
Date
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
By.
Berghorst Plumbing Co.
Please notify when ready for inspection and connection and before any portion
of the work is covered.
69&2t. wagh,
EAGAN TOWNSHIP
3795 Pilot Knob Road
St, Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date:4/25/73 (12/29/72)
Billing Name: Rivergate Villa-Bldg. 8
Number: 1178
Site Address•1626-28-30-32-34-136 River Bluff Ct.
Owner: Billing Address
Plumber: Berahorst Plumbine Co.
Location of Connection Meter Size / a 'i Connection Chg. ed 4/25/73
.3 g W7 - Me
Meter No jee . S 414 Permit Fee 10.00 pd 12/26/72
.50 p /26/72 a/c
Meter Reading Meter ?g??p.
Meter Sealed: Yea Add', Cl 1- S
NO Total Chg.
Building is a:
Residence
Multiple x No. Units
Commercial
Industrial
Other
Inspected by
Date
Remarks: ? 0 h?S? ro.
tow s??QQvv( `6,
R
)MN?
By:
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
Berghorst Plumbing Co.
Please notify the above office when ready for inspection and connection.
6
4SIDC&T1r+L, 4 3/8,75
2007 UILDING PERMIT APPLICATION
City Of Eagan 0
Cfp- d4-
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Plans are considered public information unless you state they are trade secret and why.
• Structural Plans (2) sets
• Civil Plans (2)
• Certificate of Survey (1)
• Code Analysis (1) "
• Project Specs (1)
• Spec Insp & Testing Schedule (1) "'
• Soils Report (1)
• Meter size must be established
1
1
1
1
1
1
• SAC determination -call 651-602-1000
** Contact Buildir
*** Permit for new
• Soils Report (1)
• Certificate of Survey (1)
• Structural Plans (2)
• Architectural Plans (2) sets.
• HVAC units req'd. on bldg elev. / site plan
• Civil Plans (2)
• Landscaping Plans (2)
• Code Analysis (1) "
• Energy Calculations (1)
• Emergency Response Site Plan (1)
• Spec. Insp. & Testing Schedule (1) "
• Electric Power & Lighting Form (1) "
• Project Specs (1)
• Master Exit Plan (1)
• SAC determination - call 651-602-1 000
• Fire Stopping Submittals
• Fire Suppression/Alarm Form
• Code Analysis (1) "
• Project Specs (1)
• Key Plan (1)
• Master Exit Plan (1)
• Energy Calculations (1) not always-
• Elec. Power & Lighting Form (1) not always"
• Meter size must be established-4f applicable
l
1
1
1
l
• SAC determination -call 651-602-1000
at 651-201-4500 for details regarding food & beverage or lodging facilities.
(ions to see if it is required and for a sample.
or addition will not be processed without Emergency Response Site Plan.
Date 7 / 7 Construction Cost / C 00
Site Address ?/ ?? R I U e 2 ?L uF F CT Unittste #
Tenant Name Former Tenant Name
Description of Work W r°nl o WS / ?lfT r U p ao2 S
Property Owner Telephone # ( )
Applicant is: - Owner
Contractor d d W Contractor
e CJ (?U b /o w Contact #: (la (?) ?o? ' ???3 3
C?c C)
Address a?, 39 14 U City /Vl? GS
State Zip,.5-L/06 Telephone # (6 QL) ?o? ! X333
Arch/Engr Registratio
Address City
State Zip Telephone # ( AAA, n nm
Licensed plumber installing new sewerlwater service: Phone #: ()
I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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.
6/att4- Y /MleTk? -
Applicant's Printed Name Ap s Signature
DO NOT WRITE BELOW THIS LINE
Sub Types
? 01 Foundation
? 14 Apartments
? 15 Lodging
? 25 Miscellaneous
? 26 Public Facility
27 Commercial/Industrial
? 28 Greenhouse
? 29 Antennae
? 30 Accessory Building
? 32 Ext Alt-Apartments
? 34 Ext Alt-Commercial
? 35 Ext Alt-Public Facility
? 37 Nail Salon
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition Building • Give PCA handout to applicant
Valuation Type of Const Width
Plan Rev 100% 25% Occupancy MCES System
SAC Units Zoning City Water
Nbr. of Units Stories Booster Pump
Nbr. of Bldgs Sq. Ft. PRV
Fire Sprinklered Length
Required Inspections
- Footings (new bldg) _ Fireplace _ R.I. _A ir Test -Final
- Footings (deck) _ Insulation
Footings (addition) Sheetrock
Foundation _
_ Final/C.O.
_ Drain Tile Final/No C.O.
_ Driveway Apron _
Other
- Roof _ Ice Pr - Decking Insul _ Final _
_ Pool _ Ftgs _ Air/Gas Tests _ Final
Framing _ Siding _ Stucco Lath - Stone Lath - Final
Windows
Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes -No
Approved By: Planning Building Inspector
Base Fee
Surcharge
Plan Review
SAC-MCES
SAC-City
S/W Permit
SM Surcharge
Treatment Plant
Treatment Plant (Irrigation)
Park Dedication
Trail Dedication
Water Quality
Water Supply & Storage (WAC)
Financial Guarantee
Storm Sewer Trunk
Sewer Lateral
Street
Water Lateral
Other
Total
Sewer Trunk
Water Trunk
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
(oS? ?' City Of Eagan .C
T 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 C g _ ?}
New Construction Reouiremems RemodeVRedair Recuirements
3 registered site surveys showing sq. tt of lot, sq. ft of house; and ell roofed areas 2 copies of plan
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, eta 1 site survey for additions & decks
l set of Energy Calculations Addition - indkete iron-sRe septic, system
3 copies of Tree Preservation Plan 'd lot plated after VIM
Rim Joist Detail Options selection sheet (ttdgs with 3 or less units
-7 1?
Date / /-?-/ c? ! ?o
Construction Cost f?
Site Address i bzL kkUE,r 13+ (1,1
Ea4vc? S 'ED 12-1 I
4 COLT r-}- Unit/Ste #
Description of Work ut UJIli kjo trfY1 Y {)(.IIIIYLt' 1? Ir Gt td/fff'y
t rn 'Flue e/1I
r
room,
Multi-Family Bldg Y ]? N Fireplace(s) ?0 _ 1 _ 2
Property Owner t11u l???ruYT Telephone#(6Cj1) 6?65?D-GR
Contractor Nave -
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Category 1
(J submission type) • Residential Ventilation Category 1 Worksheet
Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
_ Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Y _ N If so, 25% plan review
Telephone #(
Telephone #( II O
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the inform urate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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.
Ji1\ \R?noanA?? ,
Appl an s Printed Name A plicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Aft - Multi
? 03 01 of - plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
- ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Zj O®o Occupancy t ` MCES System
Census Code q Zoning R-3 City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const 1
y y1 Width
- Footings (new bldg)
Footings (deck)
Footings (addition)
_ Foundation
Drain Tile
Roof _ Ice & Water _ Final
Framing
Fireplace _ R.I. -Air Test -Final
Insulation
Approved By: (9 Vy\ ft) ? L I
REQUIRED INSPECTIONS
Final/C.O.
Final/No C.O.
Plumbing
_ HVAC
Other
Pool _ Ftgs _ Air/Gas Tests _ Final
Siding _ Stucco - Stone _ Brick
Windows
Retaining Wall
Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
0 w ety r e v&_ i r- IJrT Fife
r
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#: /ri fiff i C
Permit Fee: 620 • 00
Date Received:
Staff:
2012 RESIDENTIAL I {Q4)
PLUMBING PERMIT APPLICATION
{{//4`�) h lc
Date: � iA ` I � Site Address: 0� � 1 � C� �(� � C
Tenant: Suite #:
RESIDENT / OWNER
Name: 7, Phone:
Address / City / Zip:
CONTRACTOR
Name: aLv---IL t License #:
Address: t• 6.) 4-4..9 V"--- All, City: C
—
State: /11W Zip: 1,(3 Phone:CA_----1--16))-6G1-7c&
Contact: Email:
TYPE OF WORK
— New Replacement pair Rebuild Modify Space Work in R.O.W.
_
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater
Water
(���r \ t''t't�� 4 /31A
VV
Softener
Plumbing Fixtures ( Main / Lower Level)
Lawn Irrigation (_ RPZ / PVB)
Add
_
Septic System
Water
_
Turnaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water
Heater, Water Softener, or Water Heater
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water
and Softener
(includes $5.00 State Surcharge)
(includes $5.00 State Surcharge)
State Surcharge) ( LJ�
TOTAL FEES $ l 0 LJ� J
$60.00 Lawn Irrigation
$60.00 Add Plumbing
`Water Turnaround
$105.00 Septic System
Turnaround*
and $5.00
(add $189.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee
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
Eagan; that I understand this is not a permit, but only an application for a permit, an
accord nce wit the approved plan i case of work which requires a review and app
x
cel
Applicant's Printed Name
conformance .'th the ordinances and codes of the City of
ork is o .Xrt wi i• - •ermit; that the work will be in
I of
ica r<'s Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: " _Under Ground _Rough -In Air Test Gas Test Final
City of Rap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: D c> ( 4
(./),
Permit Fee: (N
Date Received:
Staff:
2012 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: IL - t °1- 1 . Site Address:
Tenant:
e.CA
D 00
2-2.x- R
(62_6 ""i3'tJ c -F Couc r
Suite #:
Name: S cc. ,'A Cc r0
Address / City / Zip: ( 6 2. - 1
Phone: q 5 Z ' 215 - 6 318'
Ct.
5 12I
Name: 513. n'4 •o. \ \ e •"'N
License #:
Address: It 15 °i, '-\`'e SI • J City: ,-e `,pe) 1 '5
State: Ni Zip: 3 5 461 Phone:
Contact: A n
I z- 'My- \got.4
Email: Okn n. L • L� \Nt. e^ •t.T\ . C.o L
New x Replacement Additional Alteration
Description of work:
Demolition
RESIDENTIAL
Furnace Care <c.r ,�jci'«S A • -
�s 00o
iC' Air Conditioner C x r < 2-110Seo
Air Exchanger L• p roe
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under / Above ground Tank (_ Install / _ Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace bumed out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
CP _ $ 6O o
TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge)
$60.00 Minimum (indudes State Surcharge)
*If the project valuation is over $1 million, please call for Surcharge
OR Contract Value $ x 1%
= $ Permit Fee
_ $ 5.00 Surcharge*
= $ TOTAL FEE
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 i
Eagan; that I understand this is not a permit, but only an application for a permit, and work is n
with the approved plan in the case of work which requires a review and approval of plans.
x 'J a. can C-0
Applicants Printed Name
x
formance ' h th ordinances and codes of the City of
o start witho a p t; that the work will be in accordance
Applice(nf's Signature
Aug 18 1511:01a Sunrise Remodelers 651-762-9395 p.13
Use BLUE or BLACK Ink
r----�'-----__—_�_i
I For OFflce Use �
1 �
�' � Permit#: /���(� � I
�b� O����LLli � _�� �- ,�t`} I
I Permit Fee: �
3830 Pt1ot Knob Road � j
Eagan MN 55122 � Date Recewed: �
Phone:{657�G75-5673 , � �
Fax:(651)675-6694 � Sta�F: I
'�Y r I�.i ' �� � , �(���i�� C:!"` G' �4�1.7C,n G.�:rY� !----------------''
2015 RESI�EIVTIAL BUILDING PERMIT APP�ICATION
�-e d�Y' G��-� Tb��r► H►��i s-rr s('
�ate:�-��-E � Site Address: �tfUp��P ���V�Y 171L�t�t' ���1� rjGl 31 Unitti:
;,�,_,.. . .._-�,.-:a,x...��
; ,�v�c,t�c� �: �tp�S, ��03� I Cv"3�. , 3�� , I(0 3 G� €
3 Name: � Phone: �
t �
� Resident! - s
i Qy�n� � Address 1 City 1 Zip:
; s Apptica�t is: Owner �Conlractor t
�._,.�.,.,..:._._,�..,._�.. , �,x.��.�w.,. — --.w--�- -
� ' Des cripEion of wQrk: ��: C� /�� ''
� Type of Work � �
� a Construction Cost: � 1�: �C�Q•Q Multi-Family$�.olding:(Yes�/Na�
�_�.r..��.....�....,._.._�._...,_.;,----�_.,..,.�.�_...._,_.� ._._....u.�..__,,,..-..�... ..,,w...�. - - ...._.:...._
>: :
, e ` e
t � Company:�j�:'�Y1 ir ��-� ��vv� cx�_4-e�S Contact: .]t.',C'_.� ��--4-e.� ���1
} ; Add :����G' 'I��C:�E... �ci 111-�'_ Ciry: ��'• �t.�t � �
's Corttrd¢tor �ss �
�, � a
� � State: !L`Zip: � c/ /v Phone: Email: ��1�Yt� P'. �-�1�r-�'y r�v+ucl-el�e�.s�
s ,C.c r►-
! ; L�ce�se#: L � (y �I� � � Lead Gertificate#: �7'3 �'�_3�'� `
�..�.�..p...._,.�.�....,�..._�--�- - -- -----�- �� "
{ � �
� !f the project is exernpt from lead certificatio�,�lease expiain w�y: �
k � ��
:
�
�....---. ,.�, � - . . ;
= COMPLETE THIS AREA ONLY IF CONSTRUCTING A NE1N BUILDING
; In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
�
4
c Yes No If yes,date and address of master plan: '
; lice�ssd Plumber: P�one:
t
5 Mechanica�Contractor: Phone•
1.
a
iSewer�Water Co�hactor. Phone:
i
� Fi�e Suppression Contractor. Phone: ?
��NQTE:Plans and supporting documents that you snbmff are considered to be pub►ic inforrnatior�. Por�fons of j
' the information may be classified as non•public if you pruvide speci�ic reasons t/iat waLld pemtit the City#o '
,
;
� conclude that the�r are trade secrefs.M��.��.�- _ ---__-�����:
CALL BEFORE YOU DIG. Catl Gophar State One Call at(651)454-0002ior protedion against under�ound util9ty damage. Cail 48 hours
befire you irrtend to dig to receive locates of underground utilities. www,aonherstafeonecall.oro
I hereby acknowledge that ttvs ir�#ormation is camplete and accurate;that the vuark w�'ll be in confortnance with the ord9nances and codes of the£ity of
Eagan: that I understand fhis is not a permit, buE Only an appfication for a permit, and work is nol to ste�t witfiout a permit; Ihat the wodc wiA be in
accordance with t3�e approved plan in the case of woric which requires a review and approval of plans,
ExteNor woric authorizsd by a bufl�ing permif issued in accordancewith the M9nnesota Staie Bu�diflg Code must be complelgd within 180
daysofpem�itissuanoe. � _..._.
X ,�,l ��L.--�-E�i1r.� c r^� -.�.�
Appiicant's Pr[nted Name A � 's igRature .
,•' Page 1�f 3
Use BLUE or BLACK Ink
r--___---
--------�,4�����
I For Office Use
I
' � Permit#: � � � �S
Clty of ����� ,J
� /a�. �� ��
� Permit Fee:
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
/ f �� �- /�=�(�
Date: Site Address: �/)�:((.0 E- �����'v��� �� �� Unit#:
Name: Phone:
I���iCler��' /�
(�y��;� , Address/City/Zip: ��o�t� }��Vl,��lt�,f^P Cl� �A�c'�,9�r�. 7'YJN• S5i�3
Applicant is: Owner Contractor
Description of work: �6Pt.�GE 1�3�2�cy3 ��
T�I'p@ c}�Ws�?rk
w
' Construction Cost: `� 3 0 Multi-Family Building: (Yes�/No�
Company: 0�1 �r+d GC.L Contact: STIy'L(�' ��5��
.
Cc�ntr�ctar Address: 3578o yo f`-" A�.� c�ty: c�.�uo� �.1�u.s
State:�N Zip: .S.SOD Phone:�O..S/-a`/5- d3�J Email: SJol+Nso��('�4�vo�11��lCs�th�+' ,�
License#: fV IA Lead Certificate#: N�9- �
If the project is exempt from lead certification, please explain why:
No l,t.ao �F�ss"rr
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:
Fire Suppression Contractor: Phone:
11�flT�':P�a»s a�ads�p�c�rl�n�alr�ci�ts�ts��#yot,r�ub�are ca�asld�t�etl to:be pt�b1��`f�fr�r�a��a�a 1?i�,r���s of
' �he ir��rrna�#r�rr rn��!b�e cias��#'ied a�s��:p�#l����'yc��prrr�l�e s�e���"ic reas�t���rat ti�a�fd j�e�r��t��C�fy t� '
concfe►de`�i�at t�� �re�ad�se�r�;�. '
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Ca1148 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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 780
days of permit issuance.
x -J�??I31/� �J d 1�t1 o�+J x
ApplicanYs Printed Name Applic 's nature
Page 1 of 3
•
RECEIVILIT)
MAR 0 8 2019 '
71
y li : + For OffIce.Use
s Permit IP
' ' N
•
,............,„....4. Permit Fee: IPU ,v
•
3830 PILOT KNOB ROAD I EAGAN,.MN•55122.18.10
Dale Received: 5 - -1
(651)675,5675 I TDD;(651)454-$535.i FAX; (651)•675.5694
.bultdlnelnspectjpns{acityofea9an.eom Staff:
•
U J
.2018 RESIDENTIAL PLUMBING PERNiIII APPLICATION
Data 41)1'19 ' tea/
Site Address:e: I ,�y�l L
Tenant: • f
� b ggi 1
• Yr'rr�'`j /6 if _Ani —I Suite#Q«7�
t{,�
Phone:
:; 1:1 :, •,tt Name: MILBERT COMPANY dba C LIGAN WATER WC641376
1.490it )i)s`�r'; Address: 1801 50TH STREET EASTUcense#:' 't� t bac •, a }t; City: INVER GROVE HEIGHTS
�sf�r q'
St,, h3�,` Q i,.P.sti,4 a dt,tq State' MN, q>i 's�,cl)1, 4 oh, Zip: 55077 Phone: 651-451-2241
2n:,y,, r:,,( Vit.).. i
t.
,��r�>h3 �i ,..•. } Contact: BILL MILBERT Email: •loria.abas�culligan4water,co
• s:, l i,tt , t m
t ,v .5
r
*.ft�.,l. 1 ;r y New Replacement _Repair Rebuild ModifySpace,rii, p Work in.R.b.W.
t`,� (l f `(
tf1` gt};l.a%•r(,.� .fis,
Descriptionof work:
4.,KifJ lii4'r;ttri 11.91.1.
RESIDENTIAL • --____—_,----
1.
-- . ..,. .—
s , 4't
.141. rf:[4ii t,�,A,.I .�:p,V) Water Heater
'.i�7_=tJ�,4����H�,�x.''t:{.�i�`P'rrtu•S`tii
.11
at
er Softener' Lawn Irrigation(_RPZ/ V8)3 pe,t fGIt'Tn YAdd Plumbing F
ixtures
ale./ Lower Level)h .y � ;iSeptic SystemF+s7 t i.?��Fl ,( ,1r, ( . New Water Turnaroundth• "� eI? Fy, r
•
` t'+`fp`t't- _Abandonment
"" -V___ _ _ _
$60,00 Water Heater,Water Softener, or Water Heater and Softener(Includes Stalo•Surch'a•rge) _V .�--F �� '
RESIDENTIAL FEES:
$60,00 Lawn Irrigation(Includes Stale Surcharge)
$60.00 Add Plumbing Fixturestic System Abanrinnr„
'Water Turnarou[id(add $•280,00 If a 3/4"meter Is required)Water Turnaround"(Includes State Surcharge)
$115,00 Septic System New(Includes County fee and State Surcharge)
•CALL to dig
t E:YOU DIG, Call underground
One Call al(651)45-0 F for protection against underground TOTAL
Lt FEES
$ 60.00 o 0
Intend to dig to receive locates-of underound utilities, www.•ouherslaleonecall orq
You niay•subscrlbo to receive an electronic notlflcall from9 Call48 hours be ore you
website at ubsc ibe t receive
coal/subscribe, the City of proposed ordinances by signing up for an small update on the City's
I hereby acknowledge'that this Ihformalion Is complet'e.and accurate; that the work will be in conformance with the ordinances and codes of the Cilof
Eagan; that I understand !Ns Is not a permit, but only en application tot a permit, and work Is notlo start without a permit; that the work will b
ac ordancewi h he approved plan n the c s of.work w Ich requital a review and approval of plans. ye In
(U,1A ' '
Applicant's Printed Name x_______Alnir) tr
JA/ ff
r,h t Appi cant's
L 1� n �•t:� Signature
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