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3300 River Bluff DrCit of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 incl a5sO f O /I 049,1101 /0 Use BLUE or BACK Ink Frrr Office hiss Permit #: / nao Permit Fee: )q. t75 Date Received: 94-1/ Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: l- ' 90 • a0// Site Address: R; vet P 1--) Unit #: RESIDENT / OWNER Name: hi_A. ,L. _1 mit Address / City / Zip: Phone: 763 -V €19 -Woo Applicant is: Owner x Contractor hi 1 TYPE OF WORK CONTRACTOR Description of work: Re--coo-P Construction Cost a), 5,23. 99 Multi -Family Building: (Yes >( / No ) Company:cS(,tftr;s.t. ke.pn,DniPJ1r(3) AG Contact: e,( +l- c -y - Address: E 76. /1p&. Lan City: 334. P0,4 I State: M N Zip: 55//0 Phone: 66/ - 76;, - 9,245 License #: ,ROc5/5/ Z Lead Certificate #: "VAT- ,Z)133 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 the information may be classified as non-public if you provide specific reasons that would permit the Cityto conclude that they are trade secrets. CALL BEFORE YOU DIG. Cali 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 app , val . n x :501 Pe e (Sot Applicant's Printed Name cant's Signature Page 1 of 3 BUILDING PERMIT Owner ....k4x?..:`..... `........ .?..... ._. Address (present) . j`.r.`?....... f!..'._e ...._'...";' ................ Builder .......:`.' ................................................................ Address ....... ........................... ...................... DERCRTPTTON EAGAN TOWNSHIP N° Eagan Township Town Hall (/ 2916 Date .....a'.-..a7- 72i Stories To Be Used For Front I Depth I Heigh! Est. Cost (I ed? ?oy3 Permit Fee 2isf•SO Remarks .¢ fem. t ,o Pe I or a.37'?r- ao 1 of or This permit does riot 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 XEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that ..... ......... ....?....... ....,........................... has permission to erect a Ipl?.. .tea...^..T! _upon the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11, 1955. ....----./°t""°'`^:' :.---Ozmasvf ....... Per ...................Nrs:Q:C...--•--.!?ce.-?.-......._. t 43 Choi 0 W-B4azd. Building Inspector d$ This request void `6 ' t 4.0.Y 18 tntnths from 5 56275 i Date of this Request Fire No. 1, as (&Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. ?J3/? ?Ptletr B (t!* Dr. City E Section Township Range County T7aK0+-u. Which is occupied by Is a roughin inspection required on this job? No O Yes ? Ready Now ? Will Call ? Power Supplier Address Q Ace e1 c C Fr Contractor's L n3 No7?s Electrical Contractor (Company Name) Mailing Address 6 `f37 (!Sd-,od roe 1^ ve . ma (s . 55 26 (Electrica Contractor or Ownar Making Tels tnstallat on- Authorized Signature Phone No. 9Z 10'LNoO (Electri Contractor or Owner Making This Installation) S?WV`h p OQ2© ?aPUThis inspection request willnotbeaccepted bythe State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity Griggs Midway Bldg. - Room N191 3 3 ` E13-0090 1-0 2 IbELOW ruversity Ave., St. Paul, Minn. 55104 - Phone 297-2111 J ^ EQUEST FOR ELECTRICAL INSPECTION J 56275 WORK COVERED BY THIS REQUEST of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For me uplex Apt. Bldg. Commercial Bldg. ? ? ? ? ? L1 ? ? ? El ? ? Range ? Wpteater ? Dr? Fu Temporary Wiring Lighting Fixtures Electric Heating Silo Unloader ? Industrial Bldg. Faun ? 1:1 ? ? ? ? A' ;r ? List 1y Bulk Milk Tank List ? Other ? ? ? Heiersl Hehers? COMPUTE INSPECTION FEE BELOW Service Entrance Size: s` Fee Feedersd Subfeeders: # Fee Circuits: s Fee 0 [0 100 Am 0 to 30 Amperes 0 to 30 Amperes Z - -0c 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes Above 200_Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Ciro. Partial or other fee 5 Signs Special Ins ection Minimum fee $5.00 Remarks Wir`I m Yt ? Ou}Stde loft L 5 +S, g reet- ig +?ng T?TAL FEE cop I, the Electrical Inspector, hereby ce p epbove inspectigq,has?)qe I e. p 1 (Rough-in) ? s- I 6- Date (Final) Date - This request void 18 months from G9 ?_l 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for single family dwellings & towmhomes/condos when permits are required for each unit Date Site Address Unit # Isla Property Owner ?? L CCU ffa?/27 Telephone # (?p$ ?) S S?? l U(DC) Contractor Street Address City State ( ) Zip Telephone # Bond #: Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 S furnace -Additional Replacement _ air exchanger air conditioner -New Replacement other State Surcharge $ .50 Total $ I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in confo a with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permi t o an application fora pemtit, and work is not to start without a permit; that the work will be in accordance with the ape pd p thecaseof w Fk wl ' h re es a review and approval of plans ,? // AZ?t;'e !`_, 0GI??IZ pplicant's Printed Name Applicant's Signature 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip ( ) Telephone # Bond #: Expires: The Applicant is Owner Contractor Other Work Type - New Construction - Underground Tank _ Install -Remove *"see below - Interior Improvement _ Install Piping - Processed -Gas Nature of Work: **When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank ingtallation/removal $50.50 Minimum (includes State Surcharge) or Contract Value $ x I% Permit Fee • If permit fee is $1,000 or less, add $50 a $ State Surcharge If permit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee i nerepy apply toy a Commercial Mechanical 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 with the Mechanical Codes; 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 Applicant's Signature Approved By: Inspector Z 7 ? ? ?CG MAST CARD OWNER STRUCTURE AND LAND USED AS Permit No. Issued Issu Contractor ed To Owner BUILDING PLUMBING CESSPOOL - SEPTIC TANK WELL IJ2? -? -[-R-- ELECTRICAL HEATING C' ?C?7J GAS INSTALLING 'C SANITARY SEWER OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTING FOUNDATION SEPTIC CESSPOOL FRAMING FINAL ELECTRICAL .-/>- ?.i TILE FIELD FT. HEATING / - -7 DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD ?! ? X10 •o L-13+73 PLUMBING WELL SANITARY EWER S - ?? .?/LN^M ? D f a b Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. . ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTI FI CATION -I certify that I have careful IV inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require. ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED eui 2. City of 3830 PILOT KNOB ROAD. P.O. BOX 21199 EAGAN. MINNESOTA 55121 PHONE: (612) 454-8100 July 10, 1986 ,CEDkRwBLUFF TOWNHOUSES ,3310 RIVER BLUFF-DR-? EAGAN, MN 55121 ATTENTION: ALLAN & KATHLEEN HUMMELL PROPERTY MANAGERS Dear Mr. & Mrs. Rummell: BEA BLOMQUIST lvl y r THOMAS EGAN JAMES A. SMITH MC ELLISON THEODORE WACHTER Council Members THOMAS HEDGES CIN Adminlsfr EUGENE VAN OVERBEKE Cny Clerk This is a follow-up letter to our meeting of July 7, 1986 and review of our agreement. Dug toAtIW probl+eWTE'WfereseO).WitltHprkiug: (Weabfng a problem for fire department access, it is necessary that fire lanes be established in your development no later than August 1, 1986. The signs are to read, "No Parking - Fire Lane" and be placed as per our site plan. If you have any questions or concerns, please feel free to contact me at this office. Sine ely, Doug Reid -' Fire Marshal DR/js CC: Police Department THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 An& ??' /C/_ D/ PERMIT FOR SEWER SERVICE CONNECTION DATE: 12/29/72 (4/25/73) NUMBER 1316 OWNER: Rivergate Villa-Bldg. 2 AddresRiver Bluff Drive PLUMBERBerghorst Plumbing TYPE OF PIPE heavy cast iron x DESCRIPTION OF BUILDING Industrial Commercial Residential I Multiple Dwelling No, of units xx Location of Connections: 6 Connection Charge 1170.00 billed 4/25/73 Permit Fee 10.00 d 1,1/2 72 .0 pd 12/26/72 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. 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) Number: 1172 Billing Name:Rivergate Villa Bldg. 2 Site Address:1626 29 3& - - River Bluff Driv Owner: Plumber: erehgX„t Plumb' e Co. E Connection Billing Address Meter Size Connection Chg 0.00 billed 4/25/73 4v ej 19 - -=? ? Meter EO Permit Fee 10.00 d 12/26/72 a' moo/ 0 pd 12/26/72 s/c Meter R00:1L Meter Dep. Meter Sealed: Yes Add 11 Chg. r/ ?S NO I Total Chg. Building is a: Residence Multiple x No. Units 6 Commercial Industrial Other inspected by Date Remarks: FEE EQ;%S ownhouses \?SQEC? F0 ????R 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 Couu?nty, Minnesota. By:? tz D? Berghorst Plumbing Co. Please notify the above office when ready for inspection and connection. O, V 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ) I I !- I OS Site Street Address 3? S IRI ye - 81 u P-F Unit # Property Owner ?rl sc-o I Telephone # ( ) Contractor rizy,a--d.. &,s RL,41 f klen_ Telephone# (763,)7SY 6'1(a? Address 7 -/Ui A?tN a/ ?. City C&ori 1?4 State /,?1 Zip 53W,? The Applicant is: _ Owner VContractor -Other Alterations to existing dwelling Add plumbing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). _Septic System Abandonment Water Turnaround (add $125.00 if a 5/8" meter is required) Other: $ 50.00 / Water Softener V Water Heater - new _ replacement $ 15.00 Lawn Irrigation _RPZ _PV13 -new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $ /5-16-0 I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. Ta.tjj (;4Wt C / - Applicant's Printed Name Applicant's Signature 2007COMMERGiAL BUILDING PERMIT APPLICATION V v City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 v 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) • Solis Report (t) • Meter size must be established 1 l l l 1 1 • SAC determination - call 651-602.1000 • 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-if applicable SAC determination -call 651-602-1000 Call MN Dent of Health at 6S1 -961 -4W) far details reanrdina fnnd .G heverape nr Indoino * * Contact Building Inspections to see if it is required and for a sample. *** Permit for new building or addition will not be processed without Emergency Response Site Plan. Date 2__/ Construction Cost f? Site Address 33oa {? ° V Qk O 6G UF/-- DX Unit/Ste # Tenant Name Former Tenant Name 3302- 33c>44 3 4 33 3310 P ? " i LJ e $ Z Description of Work (1 i /J T t D n: Property Owner Telephone # ( ) Applicant is: _ Owner Contractor Contact #: (? ??) c? 233 ?? // // Contractor V J CJ-?? $ `? GJ ,`?tJ ?{ g7 uJ G Address ,2-731 lt1 r?? ^J e a City State on/\-/ Zjp=! S 06' Telephone#(6(? _7c) Arch/Engr Registration Address City Y ?007 State MA 0 7 Zip Telephone # ( ) Licensed plumber installing new sewer/water service: Phone #: L) 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. rA&2 t,?E c,J Applicant's Printed Name Applicant's e DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Foundation ? 14 Apartments ? 15 Lodging ? 25 Miscellaneous Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Plan Rev 100% 25% SAC Units Nbr. of Units Nbr. of Bldgs Fire Sprinklered Required Inspections Footings (new bldg) - Footings (deck) Footings (addition) _ Foundation _ Drain Tile - Driveway Apron Roof _ Ice Pr - Decking Framing ? 26 Public Facility ? 27 Commercial/Industrial ? 28 Greenhouse ? 29 Antennae ? 35 Int Improvement ? 36 ? 36 Move Bldg. ? 42 ? 37 Demolish (Bldg)" ? 43 'Demolition Building -Give PCA hand ? 30 ? 32 ? 34 ? 35 ? 37 Demolish (Interior) Demolish (Foundai Reroof )ut to applicant Accessory Building Ext Alt Apartments Ext Alt Commercial Ext Alt-Public Facility Nail Salon ? 44 Siding ion) ? 45 Fire Repair ? 46 Windows/Doors Type of Const Width Occupancy MCES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length _ Fireplace _ R.I. _ Air Test _ Final _ Insulation Sheetrock _ Final/C.O. _ Final/No C.O. Other Insul _ Final - Pool _ Ftgs _ Air/Gas Tests Final - 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 09/09/2014 09:31 7634761143 HOMEEN RGYCENTEP. PAGE 01/01 r————————— ————`� � F�r office Use ���� � I � Clt o� �a a� � Pe�mit�: � Y � � ���.� ; 3830 Pilot Knob Raad i Permit Fee: I Eagan MN 55122 � Date P.eceived; j Phone: (651) 675-5675 � � F�x: (6S1)675-5694 � � staff: � , 4...,—^-------------I 2009 MECHANICAL PER IT APPLICATION �' � 73 Date: Site Address: �0 �f✓ � Tenant• � Suite#• r0/ . .3�' RESIDENT/OVUNER Name: 1 /�� Phone: °� � � ��� Address/City!Zip• CONTRACTOR Name:_ Hom.e Fz�,ergy Center License#: Address z��5 Annapolis Lane N#�7 Plymouth MN�5441 �'�Y��-763-476-1990 fax 763-476-1 J,43 —5tate: �ip: Phone: Co �act rerson; TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: NOTE:Both roof mounted and gro d mountad mechanica!equipment is required to be screened by City Cade. Pleas contact the MechanPca!/nspector or one of the P/anners for informatP n on ern�;tted screenin methods. �ERMIT TYpE � RESID,EfVTIA� COMMERCIAL ,_,".Fumece New Constructian _Interior Improvement �onditloner tnst911 Piping �Procossed �Alr E�cchanger Gas �,Cx4orior HVAC Unit _Hoat Pump Under/Above ground Tank (_Install/�ftemove) "'When installing/ramoving tank(s),call for Inspectlon by Flre Other Marshat and Plumbing InspecCOr RE5/DENTfAL FEES; ��c asc c�,,� � � ,,.��. � v�SR � $50.50 Minimum Add-on or alteration to an existing unit(includes$. 0 Stata Surcharge),-�,�Q� ��3.-��d '��/30�. $90.50 Flfe 1'�pall'(replace bumed out appliances,ductwork,etc.)(includes$. 0 State Sureharge) ' , c�I�o �r �o tir,,� e.�1�,r c���t'.✓. c.�b.. TOTAL FEE COMMERC/AL FEES: � $70.50 Underground tank installation/removal OR Gont�actvalue$ x 1°/a $50.50 Minimum (includes State Surcharge) �$ Permit Fee -If Permi �,e is Iess than S1,U00,surcharge is$,50, -tf Permlt Fea is>$1,UOO,surch9rge increases by$.5o for aacn =$ Stdte SurCharge $1,000 Permit�ee(i,e,a 51,001-S2,o00 Permit Fee r2quires e S1.00 surcharge}, $ TOTALFEE 1 hefeby aCkllowladge that this infortnaiion ls complete and eCCUI'dte;IhAt the work wlll be n confo�rnanCQ wlth the ordina�CCS and CodCS of LhA Gty Of EdAan;tl 1 undersland this is nof e permit,but only en epplication for a permlt,and work is not to ste �vlthout a ennit;that the Work vrlll be In acwrdance wlth the appro� pl�n i�the 6e af wo�1c whlch requlres a revleW and approvai of pians. � _ x d � Appli an 's Printed ame pplica - nature FOR OFFIC�U5E � • Reviewed By; Date: koqwired Inspectlons: _Under Ground �Rough In �Air Yest Gas Servlce Test ^,,,_,In-floor Heat wFinal c„�...�....u�ie� c..�,,,.., .. �...........:.... Aug 18 1510:55a Sunrise Remodelers 651-762-9395 p.4 Use BLUE or BLACK Ink r-___�___________� li" I for Offlce Uss � �c��� � ���� ��6� �l L� �� � Permit#: , � j � � I Pertnif Fee: C.`� C..-' V 3830 Pflot Knob Road � � 1 Eagan NiN 55122 � DaEe Reoeived: Phone:(651)675-5675 � � I Fax:�651)675-5894 i StafF: I -�v�n�..�` i �. � . -����.+�€� �.� i z !----------------, C.; c �'Q� ��� .c t�v^ 2015 RESI�ENTIAL BUILDING PERMIT APPLICATiON C-e c#.,�r i3�u�'� Tc�:,� h��� s-t s Date:����'� S Site Add�ess: ���� ����i'C�;� �„)�����',v'� ��/�(Unit#: � �ZV1C.� u ..5'. '. _Dv�i �`� � � � 'i � � �'� , Plame: Phone: � ResidentJ � Owner Address 1 City!Zip: Applicant is: Owner �Contracior k p � Type of Work 4 DEsc►�ptiorl of WOrk: ��i � f1 c� � � o� � C Y Canstruction Cost: � 1�i (7 UQ� IUiulti-Family Build9ng: (Yes�/No_� j . . .., � Company:�tA.Y1 r� S-2 �-e.w1 cx�..1-e�S Contact: �G�.1 �."�-F-�f��c�'1 � {� y� ,_ � Address:� -l'� �G � 1�'�. �...�1 1/1'� City: s"t� �.�,t � � Corrtractor 4 ���_�6� � 9'.�'�� , 4 a Slate: �111 Zip: � �l l U Phone. Email:�� � S..e y�r:���r r►vi ocl�. ys, � � �^, i �'/'1 i:�- F] �L�r►-, s Licenss#: _C l�' �1 � �Lsad Certificate#:,��" �02 -133'"' � If the project is exempt from lead certification, please expEain why: � COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDlNG � In!he last 1T months, has the City of Eagan issued a permit fur a similar plao based on a master p�an? � � Yes lVo if yes,date and address oi master plan: � � h Licensed Plumber: Phone• � I � Mechanical Contractor. Phone: � Sewer&Water Contr�tor: Phone• Fine Suppression Corrtractor. Phone� � IIfOTE:P/ans and supporting documents that you submit are consider+e�d to be pu6lic irtfornratiflrr. Portions of � the info�mation may 6e c/ass"rtred as non-publi�ii you provide specific reasons that wovid permif the Clty to � 9 _ conc/ude that lhey are Made secrets. CALL BEFORE YOU �IG. Call 6ophe►5tate One Call at(651)454-00021or prolection aga'u►st underground utitity damage. CaH 48 hours before you intend to dig to receive locates of underground utilities. www.goaherstateonecall.ora i hereby acknowledge that ihis intormation is complete and aocvrate;thai the work wiH be in corrfo�mance with tlie ordioances and codes af the City of Eagan; that I understand ihis ls not a pennit, 6ut oNy an applica[ian for a permit, and work is nof to stari without a perrnit;that the wrork will be in accordance wilh the app�oved plan in the case oi work which requires a review and approval of plans. Exteriorwork authorized by a building perm9t issued in accordance with the Mim�esota Stabe Building Code must be completed within 180 days of permit issuance. .-�C,� �i-�-�-' c�►-� __� __._. x x A��OlicanYs Printed Name A a 's ignature ;� Page 1 af 3 Use BLUE or BLACK Ink r-----------------"� � For Office Use � C' � Permit#: ��//O j ity of �a�a� I Permit Fee: /V � ��--� � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (657)675-5675 I I Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: SiteAddress:� � �v� � � ��� � ���� �J�L�� "� ��Uni#: � �� ��� � ��� Name: Phone: �a �������� � Address/Cit /Zi ���L,� �iV�R.t3l,id,FF .�I� • �36+er1 �YIn!• -55/23 ?QW.Ci�t' • =' Y P� � � : Applicant is: Owner �Contractor � �� ', ' Description of work: �GPt_.�4�cx. ��n-R.�.Frd �oOR.� r�p� of r�t�rk ; w ' Construction Cost: � .3 Multi-Family Building: (Yes.,�/No� , ���,� ���= Company:�Ipr1 Vi1-w�w, �'�,�9�rr� �izs�,L[,c� Contact: �'7L�Y������'"� �� � ` Address:357�0 9n� �1,E'. City: C..�ivN�'y✓�i12LS �'�11�1`dC�C��'�,. 'r State: InJ Zip: SSUO Phone: (aS/-�y5- b3�/ Email: SJoNNtSau�C�F,✓�vON✓�1-w��Q4�''Q 2S.�va, ' License#: 1V�� Lead Certificate#: N�I� If the project is exempt from lead certification, please explain why: JVo (,e� �it f t 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: NC7T�'..:Ptan��r�c�:�up�i�r�;�r���o��r�er�f�tha�y�?t��`�bt�it are c�r���d�red tab�,�ublic�rafcarrrr��t�ra: Port�c��r�af .` t�e inforrr��t�nn tn�,��ie�la�����1��r�+�n:per�ili+c�f yc�u;"prc��r�a1e spe�rfic reascin�s that wQutd perrr��t��ae�ity tc� °;' � � �`� v � ��r��t��'e:that fh�',are�r��Ie,s�c,re#s. 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.qopherstateonecall.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 �.�[c VE- �I�NSON x ApplicanYs Printed Name Appli ant's Signatu e Page 1 of 3