815 Wescott Square4b°
City otEap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
Permit#: 3 —7 7
Permit Fee: Life o
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 6-7q l t O Site Address: 13e.i: f it , 8 13, S 1 S (,(1 e-sG. TT 5%,
Tenant:
Suite #:
RESIDENT / OWNER
Name: aeti K5 17,-(44, how1,F, S�Z Phone: 63 1- cl� `(- 1/323'
Address / City / Zip:
�t
Applicant is: Owner /C Contractor
TYPE OF WORK
Description of work: 7/ / re,vmof- LE P l
Construction Cost: [ 3 00 Multi -Family Building: (Yes (` / No )
CONTRACTOR
Name: 1��`�� cJt� �r�t� - Y LLC; License #: Z.0136leo
Address: 1 10 S 1 t -f i� 34 -,_LVE City: 61a, 4e--
A L{ Phone: 6 1 Z -Z -'z- 2 i c-9`1
State: MAV Zip: `
/j33
Contact: Se )(o.,..14 /4/�,,./b .,,+ Email: p cr t-oc_1==Py^ Gr �ivtGc�S L7'C, `
COMPLETE
In the last 12 months, has
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:
_Yes
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE Plans and supporting documents that you submit are considered to be public infermat ori; irtfons of
fhe information maybe classified as non pub goy you provide specific reasons thatwouldpermit the qty to �
conclude:tha#: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. www.bopherstateonecall.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.
Y1 411 p l -l-
Applicant's Printed Name LJ
x i�-'T�✓l
Applicant's Signature
Page 1 of 2
411,01 Gity of Eaaafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: / 3 (/ / /
O10�j (
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5/25/2016 Site Address: 15 LU Q sCit±t S
Unit #:
J
Resident/
Owner
Type of Work
Name: Eagan Oaks Town Home Assn/ rl�sex Phone: 952-238-1121
Address / City / zip: c/o Personal Touch PO Box 5233 Hopkins, MN 55343
Applicant is: Owner ✓ Contractor
Description of work: Garage door replacement
Construction Cost: $1,152.64
Multi -Family Building: (Yes ✓ /
o )
Contractor
Company: Custom Door Sales, Inc
Address: 5005 Hillsboro Ave N
Contact: Amy Egan
State: MN Zip: 55428 Phone: 763-535-0042
License #:
City: New Hope
Email: aegan@customdoorsales.com
Lead Certificate #:
If the project is exempt from lead certification, please explain why:
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:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
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 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.Qooherstateonecall.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 BuildinU f'adetnust be completed within 180
days of permit issuance. 1 /
x �,rn �l
Applicantrs P
dad Name
ppli - 's Sig tune
Page 1 of 3