3678 Vermilion Ct NRESIDENT / OWNER
Name: eq la eNZ - Phone: /a? -d PD - , 3j �?/
Addres / City / Zip: 3 70 ay/N(/ki, d 1 0
CONTRACTOR
Name: + L <- ?boy [ok2 1:7/ L-- (-- L License #: aVa 1
/(,
Address: / C('7 20 /4e b k� C- l/
City: A '
State: 41 Zip:5 (( Phone: l e. v5e9 - ace'
Contact: C r) - Cr1 Email:.
. TYPE OF WORK
_ New placement Repair Rebuild - Modify Space Work in R.O.W.
_ — _
Description of work:
PERMIT TYPE
RESIDENTIAL
`'° Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
( RPZ / PVB) ( Main Lower Level)
_ _
Septic System Water Turnaround
New
_
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
"Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
City of Eagan
Date:
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x 'I acc
App ant's P tinted ame
Permit #:
Permit Fee:
Date Received:
Staff:
Use BLUE or BLACK Ink
q 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
3-" ! -- c2 1 6: 2 /o Site Address:
Suite #:
q 300 -
0
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.00pherstateonecall.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
accord ce with the approved plan in the case of work which requires a review and approval of p s.
x
Applicants Signature
. evie rfed
FOR OFF
Required Inspections: _Ci nder Ground Roug
it Test
s Te
Fram:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:18 #482 P.035/043
3(olo8t 3(0_1(Ji 3&19Lt 36"741 31;c
3bb't 3to13a , 34a gjq, 3(o$(o t 3(.Psa 1 3to9v Use BLUE or BLACK Ink
For Office Use /
APer
Clt o f EaEd
mits/: rllll Permit Fee: ✓ a ' a✓~ I
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:. 1-3 11
Phone: (651) 675-5675 I I
Fax: (651) 675.5694 1 Staff. I
I I
n 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: v 21 20 3 Site Address: S60b -36qb.UeVlMi0V1 COW Nort l Unit#:
24 f
i Name: Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Type of Work Description of work. -roof 74 yo Y L- 51rAi Ia
Construction Cost: 01, L 0 c Multi-Family Building: (Yes / No )
Company: 81ftIr UMIAChIX 1 MIIV1710Aeffi t Contact: 00e, R71I&A"01 F
Contractor. ; Address: 511-15 IVW"_ Al St. Sine ~ 103 City: M-ADIti PI'Ai n
State: M R Zip: &353501 Phone: 952." C142" 195"1
License U Lead Certificate NAT 7-(AIPL4 -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:
i
Sewer & Water Contractor: Phone: i
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 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.ora
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 Minneso late Building Code must be completed within 180
days of permit issuance.
lot ~ x at S4leZt x
Applicant's Printed Name Appli r s Signat e
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