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1591 Four Oak RdsCityofEaafl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 5 2611 Use BLUE or BLACK Ink Permit #:� ��- 00 Permit Fee: Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: –23-11 Site Address: Tenant: Fur Oak's Road ] 66/?/ Suite #: RESIDENT / OWNER Name: 1'I'►1 Yn a /1 C4 e / C a n c cab Phone: / (7 610 286 6 Address / City / Zip: 15 (1/�D t f r Oak 5 Rd 5-57 a / Applicant is: Owner /< Contractor TYPE OF WORK Description of work: f 1 C,t G2 -3 W 1 ncl ©w s 1 h e- i s 4 r9 opera' Construction Cost:4. '—i 7 7.• ®0 Multi -Family Building: (Yes / No ) CONTRACTOR Name: J•• \IRAo.J.3 Cc:sv-c e 4 *S License#: ad' (s z 4 (- Address: 990 Lone O0i1C qd)#HL% City: ea 0.r) State: AA, 1, /v Zip: 6E 1 1 Phone: &6 1 90 010 Contact: 1 v 0.Y C� �o Email: 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: E37 ► r �l supe' i ng lop' si 11 r c� +6 T ,r r a iti ► a ns �p nformation il►c'y be clas fled s cion -public if you ro d ?eCl 5 1 oul h �; conclude hat they are trade secrets mss :; CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Calf 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 approval of plans. x NarNCL/ cCi1YY11 ec 7Y1 Applicant's Prihted Name Applicant's Sig x of 2 3 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Building EA088742 04/15/2009 ePermit Site Address: 1591 Four Oaks Rd Lot: 2 Block: 06 Addition: Coachman Land Co 1st PID:10-18150-020-06 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K Surcharge - Based on Valuation $3K $88.50 0801.4085 $1.50 9001.2195 Total: $90.00 Contractor: Crew2 Inc 2650 Minnehaha Ave Minneapolis MN 55406 (612) 276-1680 - Applicant - Owner: Emmanuel Canaan 1591 Four Oaks Rd Eagan MN 55121 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply of Minnesota Statutes and City of Eagan Ordinances. h all applicable State Applicant/Permitee: Signature Issued By: Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA103146 Date Issued: 02/28/2012 Permit Category: ePermit Site Address: 1591 Four Oaks Rd Lot: 2 Block: 06 PID: 10-18150-06-020 Use: Addition: Coachman Land Co 1st Description: Sub Type: e-Windows/Doors Work Type: Replace Description: Census Code: Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Perry Firkus 2650 Minnehaha Avenue Minneapolis, MN 55406 612-276-1680 Fee Summary: Valuation: 500.00 BL - Base Fee $500 $40.00 Surcharge - Based on Valuation $500 $0.50 0801.4085 9001.2195 Total: $40.50 Contractor: Crew2 Inc 2650 Minnehaha Ave Minneapolis MN 55406 (612) 276-1680 - Applicant - Owner: Emmanuel Canaan 1591 Four Oaks Rd Eagan MN 55121 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA103160 Date Issued: 03/01/2012 Permit Category: ePermit Site Address: 1591 Four Oaks Rd Lot: 2 Block: 06 PID: 10-18150-06-020 Use: Addition: Coachman Land Co 1st Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Replace Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: JoAnne Burr 990 Lone Oak Road Ste. 114 Eagan, MN 55121 651-905-0105 Fee Summary: Valuation: 500.00 BL - Base Fee $500 $40.00 Surcharge - Based on Valuation $500 $0.50 0801.4085 9001.2195 Total: $40.50 Contractor: Window Concepts MN 990 Lone Oak Rd #114 Eagan MN 55121 (651) 905-0105 - Applicant - Owner: Emmanuel Canaan 1591 Four Oaks Rd Eagan MN 55121 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA104735 Date Issued: 06/07/2012 Permit Category: ePermit Site Address: 1591 Four Oaks Rd Lot: 2 Block: 06 PID: 10-18150-06-020 Use: Addition: Coachman Land Co 1st Description: Sub Type: e -Fireplace Construction Type: Work Type: Gas Insert Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K $88.50 Surcharge - Based on Valuation $3K $1.50 0801.4085 9001.2195 Total: $90.00 Contractor: Hearth and Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 638-3309 - Applicant - Owner: Emmanuel Canaan 1591 Four Oaks Rd Eagan MN 55121 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot -Knob Rood PERMIT NO • Eagen, MN 55122 DATE. Zoning: No. of Units: Owner: Address. Site Address: Plumber Meter No • Connection Charge• Size: Account Deposit -- Reader No.: Permit Fee• 1 agree to comply with the City of Eagan Surcharge• Ordinances. By Date of Insp.: ,07' Misc. Charges. Total • Date Paid• Insp • CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO • Eagan, MN 55122 DATE - Zoning: No. of Units - Owner: Address - Site Address: Plumber: agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit - Permit Fee - Surcharge. By Misc. Charges - Date of Insp.: Total• Insp.: Dote Paid - 1