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3312 River Bluff DrGity otkau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 33/e/j/ i/ "i 0i �-- Use BLUE or BLACK Ink For Office Use Permit #: g'r70? I Permit Fee: 139 9 ri5 Date Received: L�._ 2/4 Staff: z 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1-(' c? p • 070// Site Address: 331,E t� r VP,/ 61 Lt D Unit #: RESIDENT / OWNER Name: ny or Address / City / Zip: l4 r acterrtrtrl-I—/ Applicant is: Owner )( Contractor Phone: 76.3 - Y99 -9/op TYPE OF WORK Description of work: Re, --(290-P Construction Cost'2/, 5,13. �J CONTRACTOR Multi -Family Building: (Yes )( / No ) Company:,, Co n ols.e. kn_mood de/CS) SC_ Contact: of P 0-7-) Address: Sri7 .4, City: .S-} Po ct State: M N Zip: 551/o Phone: 65/ - 7601 - 90745 License #: a p j5/ g Lead Certificate #: NAT- q .33 —o 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 City to conclude that they are trade secrets. 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. Nww.gopnerstateonecall.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 1 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 . va1 x �So�l PO-te,0011 Applicant's Printed Name A 's Signature Page 1 of 3 No. .3` CITY OF EA"N 3795 Pilot Knob Road Eagan, Minnesota $5122 Phone: 454-8100 PERMIT Sac, C? sc.> ??- ka-+r? z INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Date: Receipt No.: Single Site Address: Residential Lot Block Sub/Sec. Name ` c Address address S City Phone: Nome ?, ;.;t?t?2 Address City Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinances. 1d7bb New/Alter./Repair Cost of Installation Permit Fee Surcharge Total done in accordance with all applicable State of Building Official CITY OF EAGAN 3795 Pilot Knob Roea Eagan, Minnesota 55122 Phone: 454-8100 -',ATER rOF i'E; a" _ PERMIT )[?kert ka-r4'7-- /241- No 20, 19; )ril Date: Receipt No.: Single I Site Address- , .r' f Residentiol Lot Block Sub/Sec. _ Multi Res., Comm./Ind. Name New/Alter /Re air . p Address Cost of Installation City _ Phone: Permit Fee Name Surcharge Address V City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EA"N 3795 Pilot Knob Rood Eagan, Minnesota 55122 Phone: 454-8100 PERMIT Date: 1{?-1$-78 Site Address: 3316 P.iver_ Bluff Drive Lot Block Sub/Sec. Name ',.,art Cott- 3 Address City Phone: ilkSA? . 2` Cli2t'. A?1. Name g Address 15 Cedar Ave. Vin. s 0 V - City Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinances. No. Receipt No.: Single I Residential Multi Res., Comm./Ind. New/Alter./Repair. Cost of Installation Permit Fee Surcharge Toto I done in accordance with all applicable State of Building Official EAGAN TOWNSHIP BUILDING PERMIT 4(?a^"`.-'v.... ...._--.... .... ..........-----._....-..-. Owner .... . ,.:.. ---... Address (present) iE!i ?-'"-- Builder ........ ..------------------------------ ..................... --...-. Address ............................... -........'-°--°°°..............----_-_.............---' N° a Eagan Township Town Hall L/ 2916 Dale ...d ...°Z?? ? L Stories To Be Used For Front Depth Heigh! Est. Cost i Permit Fee Remarks /s B w'N" A,o43 oeg Sa xo77 CpJ ?`C Gy Eau w.2 , • X12 r I s This permit does not authorise the use of streets, roads, alleys or sidewalks not 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,r4EPPT ON THF, PREMISE WHILE THE WORK IS IN PROGRESS. --------------••has permission to erect O.^._ ..................._u on P This is to certify. that ----- .Yf...!.. ...... COLc the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11, 1955. ..--------. C.:----ll ....... ..:....... Y --'.'-..,.J ... Per ---.........------.c........ . ............-...............-........:.......-.......... 43 Chetrman-v rrB w& tf'= _ Building Inspector It jai/so ? °° 6 0 U 4 / Request Date Fire No. Rough-in In probb n Re?qwired? ? Ready Now 3 Will Notity Inspector 1 8-30-90 iYes ? No When Ready? 14licensed contractor Downer hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City 3320 Riverbluff Dr Eagan Section No. Township Neme or No. Range No. County Dakota Occupant (PRINT) Phone No. Torchwood Management 452-4884 Power Supplier Address Dakota Electric Farmington Electrical Contractor (Company Name) Gontracwr5 License No. Hilite Electric Inc. 040445 Mailing Address (Contractor or Owner Making Installation) 1953 Shaw ee Rd Eagan, MN 55122 Authorized Signature con1 a caner Making Install Lion) ? 7Z ??? C 1 Phone Number 562-8886 MINNESOTA STATE BOARD OF ELEc1`RICITV THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612)(I42-l)M ENCLOSED. ?1400 2 46051 REQUEST FOR ELECTRICAL INSPECTION ?.See instructions for complet.ng this form on back of yellow copy. X" Below Work Covered by This Request E&00001-07 9 P1_ New .e Typeof Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance size Fee Circuits/Feeders Fee Swimming Pool 1 0 to 200 Amps 10 a o 100 Amps 24. Transformers Above 200 Amps 1 Amps Signs inspectors use Only: ?? OTAL Irrigation Booms ?f 39.50 Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical inspector, hereby certify that the above inspection has been made. Rough-in Final /1 / Date w OFFICE USE ONLY tw `" -' e 4 This request void 18 months from #2618 gss/:? 2007 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 x*. 50 Please complete for modifications to existing residential dwellings. Do not combine inside and outside plumbing on the same application; separate applications and permits are re wired. Date 1( / lI,-) f or-l 7 Site Street Address A 3 211 VAcct ?? Jt Unit # Property Owner r Q Telephone # ("j 1) j SS- 1?7 I Champion Contractor 651-365. Telephone # ( ) Address 3670 Rd. #100 State ciity Zip The Applicant is: - Owner & Occupant , Licensed Plumbing Contractor Septic System - New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee applies when extensive plumbing repairs are made to a building. Alterations to existing dwelling $ 50.00 - Add plumbing fixtures to main level _ lower level. This fee includes installation of a water softener and/or water heater at the same time. if you are installing only a water softener and/or wafer heater, do not complete this section, move to the next section and place a checkmark next to the appliance(s) you are installing. U/ iC 5 LP W/ -Septic System Abandonment I n ) ? i f -Water Turnaround (add $136.00 if a 5/8" meter is required) Q C T 3 1 200 U Other: _ Water Softener ?ate r Heater $ 15.00 new replacement Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 State Surcharge .50 $ T t l r{ $ o a 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. V- C)f(5iP &"&= - Applicant's Printed Name Applicant's signature arIN MECHANICAL (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date Site Address ue r uu Unit # O P t Eecorc Telephone # 4c> l) `1,5 >' ` l wner roper y Contractor STANDARD HEATING a :aIR CONDITIONING Street Address 410 WFAT LAKE STREET City MINNEAPOLIS, MN 55408-299 State 612 824-2ggg Zip Telephone # ( ) The Applicant is Owner Contractor Other Add-on, modification or alteration to existing dwelling unit $ 30.00 t X f l acemen urnace rep ?y air exchanger ?\ air conditioner other State Surcharge $ 50 l T t $ o a I hereby apply for a Residential 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 witho p t; that or t be in accordance with the approved plan in the case of work which requires a review and approval o laps. n Applicant's Printed Name Applicant's 7c U LS l-to IS IJ U p AUG 1 31003 U MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) The Applicant is Owner Contractor Other Work Type - New construction Underground Tank -Install -Remove - Interior Improvement Call for inspection during installation/removal of tank Processed Piping Nature of Work: Permit Fee S50.50 Minimum Fee (includes State Surcharge) Contract Value $ x 1% _ $ Permit Fee • I f permit fee is $1,000 or less, add $.50 $ State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Permit Fee $ Total Fee t hereby apply for 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 1 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 Date: 41300 ROBERT KARATZ RIVER BLUFF DRIVE Condo Unit # 3300/ 10 41300 073 05 73 3302/ 074 05 74 3304/ 075 05 75 3306/ 076 05 76 3308/ 077 05 77 3310 078 05 78 3312/ 10 41300 079 05 79 3314/ 080 05 80 3316/ 08105 81 3318/ 082 05 82 33202 _ - 083 05 - 83. 7 3322 084 05 84 3313/ 10 41300 120 05 120 3315/ 119 05 119 3317/ 118 05 118 3319/ 117 05 117 3321/ 116 05 116 3323 115 05 115 (6-plex - Cedar Bluff Townhomes) (6-plex - Cedar Bluff Townhomes) (6-plex - Cedar Bluff Townhomes) 3325 10 41300 120 01 (office/storage - Cedar Bluff Townhomes) 16 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: 1173 Billing Name:Rj-yprva.4illa Bldg. 3 Site Address: - - River Bluff Dr. Owner: Plumber: Bexftiorst Plumbing Co. Building is a: Residence Multiple x No, units 6 Commercial Industrial Other Billing Address 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. JOP 66 Meter Meter No-O.APAIi N Permit Fee 16.00 pd 12/26/72 -r -pTTT//26/72 s/c Meter Reading`- Meter Dep Meter Sealed: Yea Add'l Chg. ? NO Total Chg. Inspected by Date Remarks; t`v'ZN FED-??qq ,ownho QVRv?QEZ\-? . By: Chief Inspector y0 I/ 3l 0 r 3 6 EAGAN TOWNSHIP /a/- 61/ 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: 12/29/72 (4/25/73) NUMBER 1317 OWNER: Rivergate Villa-Bldg. 3 Address ?' ? River Bluff Drive PLUMBER Berghosbt Plumbing Co. TYPE OF PIPE heavy cast iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units xc 6 (townhouses) Location of Connections: Connection Charge 1170.00 billed 4/25/73 -?' ? _ Permit Fee 10.00 d 12426/72 J 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 Please notify when ready for inspection and connection and before any portion of the work is covered. COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. DATE OF INSPECTION 1:1 ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ITEMIZED AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTIFICATION -I certify that I have carefully 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 BUILDING INSPECTOR COMMENTS: a. /4/- -/ ¢ 3 ,6("V Iraf MASTER CARD LOCATION /Ilutw./?r/???? (tJw 9312 -1q, STRUCTURE AND LAND USED AS Permit No. Issued ssued To Contractor Owner BUILDING qq H 7?p ?' 7 Z /w PLUMBING ./ (? /feryl? CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING D GAS INSTALLING SANITARY SEWER OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTING f- /?' 73 SEPTIC FOUNDATION It ').3 CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING 1-2 -3' DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD P41, 7P 1 PLUMBING ?y. WELL SANITARY SEWER r?!-z Violations Noted on Back COMMENTS: U o Ko PLUMBING (RESIDENTIAL) Permit Application/s! City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit 03 - 30 U 1 / Date PECORA, KARI Site Address 3320 RIVER BLUFF DRIVE Unit # EAGAN, MN 55121 (651)452.4082 Property Owner elephone # ( ) Contractor NORBLOM PLUMBING CO, (612) 827-4033 Address City • ip Telephone # ( ) State MINNFA-POUS, MN The Applicant is Owner Contractor Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 - Adding fixtures to lower levels or roam additions, excluding water softener and water heater - Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed - $121.00) Other: _ RPZ _ new installation _ repair _ rebuild $ 30.00 - Lawn irrigation system - Water softener X Water heater $ 15.00 X replacement _ additional $ .50 State Surcharge Total 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 with the Plumbing Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a pet& that the_work-will_hcj} accordance with the approved plan in the case of work which requires a review and approval of plans. Jlp--? ?oL)CUaw? Applicant's Printed Name App, ant's Signature `41300 ROBERT KARATZ 3300/ 10 41300 073 05 3302/ 074 05 3304/ 075 05 3306/ 076 05 3308/ 077 05 3310 078 05 RIVER BLUFF DRIVE Condo Unit # 73 74 75 76 77 78 3312/ 10 41300 079 05 79 3314/ 080 05 80 3316/ 08105 81 3318/ 082 05 82 3320/ 083 05 83 3322 084 05 3313/ 10 41300 120 05 120 3315/ 119 05 119 3317/ 118 05 118 3319/ 117 05 117 3321/ 116 05 116 3323 115 05 115 (6-plex - Cedar Bluff Townhomes) (6-plex - Cedar Bluff Townhomes) (6-plex - Cedar Bluff Townhomes) 3325 10 41300 120 01 (office/storage - Cedar Bluff Townhomes) 16 /3 52 PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX 9 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date 7 / ?_ l v?.0 Site Address Unit # Property Owner4'? Telephone # (lp rSIJ'-?08 oZ Contractor ? Q Address City ?d c Telephone # C Zi St t p a e "h er The Applicant is Owner Contractor Septic System _ New - Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 Adding fixtures to lower levels or room additions, excluding water softener and water heater 1 _ Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed - $121.00) Other: _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system _ Water softener - Water heater $ 15.00 replacement _ additional $ .50 State Surcharge ` Itt I n 7 ';?^ II I'•''1 l r ' I ? y ' ?' $ l"c l , • Tota I hereby apply for a Residential Plumbing Permit and acknowlecia that the mtormanon is curjplu.e ulw dcculaLc, be in conformance with the ordinances and codes of the City of agan and with the-PlurribingCodes; that I understand this is not a ermit; th t the work wtrdance with the permit, but only an application for a permit, and work is not to start without a p Zin approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature J?(131 )F-6& Dart AL ? 3J b -16 200 BUILDING PERMIT APPLICATION City Of Eagan 04 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 l 1 1 l l S • SAC determination - call 651-602-1000 Dent of Health at 651-201.4500 & beverage or • Architectural Plans (2) sets • Code Analysis. (1) • Project Specs (1) • Key Plan (1) • Master Exit Plan (1) • Energy Calculations (1) not always" • Elec. Pourer & Lighting Form (1) not always- • Meter size must be established-if applicable • SAC determination -call 651-602-1000 ** 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 (o-7 Construction Cost $ • 000 / Site Address ?J 3l 2 Q ° V z/C 61 UF/-- D )e Unit/Ste # Tenant Name Former Tenant Name 35iLl 3310 33 ? 332 3322. ` Description of Work G 1 e .)A Z) wS I ' o ?d0? s Property Owner Telephone # ( ) Contractor Applicant is: _ Owner Contact#: (?(a) ?v?/ ?33?? // Contractor d w S- W rrN / d c7 L,) e= Address 2 ?3°I 111 ? •^? e e 6?_ City 1 G S State rn/ Zip S 06 "` Telephone # ( lV -7a Arch/Engr Registrati Address City IN MAY 0 2007 State 7 Zip Telephone # ( ) Licensed plumber installing new sewer/water service: Phone #: I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work wits 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 pemrit, 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,$fgt e • Soils Report (1) • Certificate of Survey (1) • Structural Plans (2) • Architectural Plans (2) sets to HVAC units req'd. on bldg elev. ! site plan Civil Plans (2) Landscaping Plans (2) • Code Analysis (1)" • Energy Calculations (1) " • Emergency Response Site Plan (1) • Spec. Insp. & Testing Schedule (1) " • Electric Power & Lighting Form (1) " • Project Specs (1) • Master Exit Plan (1) • SAC determination - call 651-602-1 000 • Fire Stopping Submittals • Fire Suppression/Alarm Form • Meter size must be established Aug 18 1510;55a Sunrise Remodelers 651-762-9395 p.5 i Use BLUE or BLACK Ink r�.__��—_�.____.__�.�� I For OffFce Us� 4 � t . � Pertnil�k: ������ f Clt� of�a��Il � PermitFee: ���-�i � 3630 Pitot Knob Road � � EagaA MN 35122 � Date Recei�ed: i Fhone:(651)67�-5675 � ' � Staff: I Eax:{65'I)6?5-5694 � ! '�Yr 1��.-ir / �._�_�._____�_.�����.7 � �s �• �1�l' K�`� L.�� Gf ��2.G+-�C.Y1 • C,a:Yy' 2o�s RESIDENTIA� BUILDING PERMIT APPLICATION �-e c��Y' L�(iN+-� TC��v n h 4..� S-e�s pats:�-��'I �'J Site Address: ���� �'1�V't�� �c.l�►- ��'��!2- ��131 t�nit#: �`��`��-s�33�� 3'�I b��'�1$� 3 � ' :=v►r.t+�c `?i�'�"3�� a { � Name: � Phone: x � Residentl ' Owner `, Address J Cily/Zip: ; F � ; Applicant is: Owner �Contractor �.�.�.�..,.-.....�....,�..,R-,...� �...�..�.,.�. .�.�..�..�...�....�,.-o.-�.. . . ....m......,�. j. ' � G � '• Descri Uon nf work: ��� � � y � Type of Work ' P �� � ' : Construction Cost: � 1�: Q U�'• M�Iti-Family B�lding:(Yes�/No_) : ��.�.....,..,��..«..�.+.�...e.,.. t..x�w....,.. . .,c.a.:..L�............�.....,.......,,... .�....r.�.s.,e-..,..-.-..-.- d . ' � ` S-� �-e rf1 ex�1�-e t'� Conted: �C,L� �.�'.y' ���'► � � � Corr�pany:�t,�Y� Y� % � � : ; � � � , (� ' = Address:� �''� �G? 't'1L' ��. �,.-�� 'V1-� City: S�'" � �"'�C�-� � ; Contractar ; y S�ate: �JlV�Zip: � �/ /C� Phone: Email:,� � � �''" S�-�h�� ��z►�n uc-�-e.�e`s= � f License#: � � �j � � Lead Certificabe#:���f�� �3�~ � � �_�..,._.,_..,��...�_..,.,...,,,�,... ��`�'i"'—=a.....--__._.�..._.___ d �_.�--- ; s if the project is exempt from lead certificadon,please explair�why: � 3 ; :� s - - ' COMPLETE THIS AREA 4NLY IF CONSTRUCTING A NEW BU�LDING ; r t In the last 12�onths, has the City of Eagan issued a pemiit for a similar plan based ort a rreaster plan? � 5 Yes No If yes,date and address ot master plan: � _ � " Lieensed Plu�ber. PhQne: ; � �' Mechanical Corriraetor. Phane: ° x ; Sewer�Water Cont�actor. Phorte: � .: : Fire Suppression Contractor. Phone: j NQTE:Ptans and supporti►rg ducumenis tf�at yoa s�bmii are cansidered ta 6e publlc information. Porfions of ��a ' the infcrrmation rr�ay 6e c/assi�ied as non public if you provide spe�c r+easons that woufd permif#he Cfty to ..�._...�__� - - .,�,�,.._� - -conclude thaf the,�are trade secrefs,� �.���_,_,�,�,� --- - - CALL BEFORE YOU DIG. Cali Gopher Sfats One Call at(651)454-Q002 for prateclion against unrierground utiNty damage. Call 46 hours beEore you iMend to dig to receive locates of undergrourid utilRies. wvwv.aoaherstaieonecall.ora I hereby eckrw�+Aedge ihat this informal�on is oomplete and accurate;thai the work will be in conformanoe wfth the ordinancea artd codes oi the City of Eagan;that I understand Ihis is not a perm9t, but only an applieation for a permit, and vworlc is not to s1aA withoul a permil; thal the wodc will be � accordance with the approved plan in ihe case of work which requires e rewew and approval of pians. Exleriorwork authorized by a bullding permit�sued(n accordanee with the Minnesota State Building Code must be complebed wlEhin 180 days of psemit tssuance. ---• Y „��\ 'i `'�--�1''� C+�^� X � Applicant's Prie�bed Name A a s ignatc�re Page i of 3 Use BLUE or BLACK Ink r-----------------+ I For O�ce Use � C' � Permit#: J � r �� � j ��� 0� ����� I Permit Fee: ���� � Y � 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone:(651)675-5675 I I Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING PERMIT APPLICATION �- � � Date: Site Address:� �� ' ��`-�' �� � ��� ���d � Uni# Name: Phone: 1��5it1#�t�l`/ .��% ,� (����;� ; `i Address/City/Zip: �iVLR13l.u.�F .�IL . �g6�ir 7YIn�• SS/�3 �`: ���" � . ,�� Applicant is: Owner �Contractor ' Descriptionofwork: �G'Pt_.A�c� �sr�-R.�-crd �o��� T�e of 1A1at��C w Construction Cost: � .3 Multi-Family Building: (Yes�/No� Company.l.ff-M�/onJ VM.t.�w, �t,�Cn° �iz�� [.(,C� Contact: �7Fl���Dy�►'�srAJ GQ��C���.�' Address:�57�0 91��` .A1.�. City: (_.i9�N.✓���LS T State: 7nJ Zip: SSUO Phone: (cr5'/-<2y5-l�3�l Email: SJo1�n�Swu B Gy,�nwN✓,t-��r.y�i¢.4od� 25.t�„ ` License#: IJ�� Lead Certificate#: 1�1��f} If the project is exempt from lead certification, please explain why: ,1V0 L6� �R f t t,Nr� 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: �1�T�.Pla��ar�,tl:sc�ppor�?�g c��c�t►r���its th�t yow�ubtr��#a�e co�r��"dered to tie�Sr�b�ic�i��irn�a��ri�,P'o�tions��' ; the���'ort���"Qn r�ay ti��lass��'lea►as r�o�=�w�ic�f,you�ra��F�e s��,�rc re�asc�tha�#�o�fr��er►r��#�r3e ��f�r.ta� co�c��?de th�t�e .are tr;�d�s�r`ets, 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.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. x STEI/� �/�NSc)rJ x ApplicanYs Printed Name Appli ant's Signatu e Page 1 of 3