4670 Ridge Cliffe DrCityofEaaari
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
Tenant:
'4 3
REV
Use BLUE or BLACK Ink
Permit #: q/
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Permit Fee:
Date Received:
Staff:
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2010 MECHANICAL PERMIT APPLICATION
Site Address: 41670TD )i l��// j Picr Dr: Oaj-)
E 1 her 1--
Suite #:�
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RESIDENT / OWNER
Name: .rrYtni -7 l r✓QC/I fr _/' Phone: (7 ) l�J
Address / City / Zip: 4(2 G `� �' � Thy-)
CONTRACTOR
Name:
Com( --o
Address: /1Z la "reif Cit;:
State: rnn Zip: '�Phone: 1 ` 4d7 —05.3/
Contact:
mail:
TYPE OF WORK
PERMIT TYPE
New
)6r"
Replacement
Additional Alteration Demolition
Description of work:
rr;
atie P . ,co •
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
` Heat Pump
Other
COMMERCIAL
New Construction ! Interior Improvement
Install Piping Processed
Gas — Exterior HVAC Unit
Under 1 Above ground Tank ( Install / Remove)
* When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (include
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (include
$,50 State Surcharge)
$.50 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR.
$50.50 Minimum (includes State Surcharge)
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Pen -nit Fee is > $1,000, surcharge increases by $.50 for each
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharg
).
Contract Idaiue $ x 1%
_ $ (3b Permit Fee
_ $ Surcharge
=$ 'Lb TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-00«2 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.q•pherstateonecail.orq
I hereby acknowledge that this information is complete and accurate; that the ork 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 .f pla
Applicant's Prjnted Name
x
Applicant's S
ture
CITY "OFA EAGAN
3t Knob` .Road
MN 55122
WATER SERVICE PERMIT
PERMIT'No -1te
DATE 1st
No of
Units-;
vner.
Address.
Site •Address:
Plumber "+ 1 '
' Meter, No i
Size:
Reader NO.:
agreeto comply with he City of'Eaganr Surcharge. 5� tri
Ordinances.
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Connection Charge:27
Account Deposit:"
Permit Fee-
Misc. - Charges: (C .00 nd nim
Total:
Date' Poid•
Insp •
CITY - OF EAGAN
3795 Piot Knob Road PERMIT NO •
Eagan, MN 55122 DATE:
Zoning: No. of Units•
SEWER SERVICE PERMIT
Owner:
Address:
Site Address:
Plumber:
1 agree to comply withtbe\City of Eagan ' Connection Charge -
Ordinances. ' ` Account Deposit -
By
Date' ,of Insp:
Insp'
Permit Fee:
Surcharge:
Misc. Charges
Total:
Date Poid:
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Lew-I/L(6(0G t-tcpby
City of Eatali
3830, Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
12-T73J
Permit Fee: )v
r I
Date Received:
Staff:
2014 RESIDENTIAL BUILDING /PERMIT APPLICATION
Date: Site Address: Ili 1 — "/ j 7P A 4c- I/ unit #:
Resident/
Owner
Name: L1) ,42, ' /`l L !; 14-'4 her liertsPhone:
Address / City / Zip: t771' /�
Applicant is: Owner ✓L Contractor
Description of work: f e c'i f
Construction Cost: f 6, d OP Multi -Family Building: (Yes .X. / No )
Company: A%r-ui t", 5 %~ G o h r r/s+6,122 S' ContacC tr' i G flay
Address:6 6 2 Z•41/7 X-/- 4,)144- 4-4-3ITZ Al,City: y k 6:ft0
State: /2 -1/1, -Zip: 5`' " 3 ` 1 Phone: v �' D Email , J r nrei) f7, )jP W65 OO 4e,
License # ' I a l 7 3 Lead Certificate #: N =, r--;/ / / / a 3 —1
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
the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and add
Licensed Plumber:
Mechanical Contractor:
f master plan:
Phone:
ng docu
is .that you submit are con.
on :public if you provide s
onclude that they are trade
'derecf to be public infor,
�cfic parsons that wouli
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.gooherstateonecall.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 l 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 wilt be in
accordance with the approved ptan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building penult issuedin accordance with the Minnesota State : 'tding Code must be
days of permit issuance.
x ieH
Applicant's Printed Name
City of Eagan
PERMIT
41' City of Eaan
Permit Type: Building
Permit Number: EA146523
Date Issued: 10/30/2017
Permit Category: ePermit
Site Address: 4670 Ridge Cliffe Dr
Lot: 3 Block: 08 Addition: Johnny Cake Ridge 2nd
PID: 10-39801-08-030
Use:
Description:
Sub Type: Fireplace Construction Type:
Work Type: Gas Insert
Description:
Census Code: 434 - Residential Additions, Alterations 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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:
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(952) 985-6675
- Applicant -
Owner:
Mary Ellen Elbert
4670 Ridge Cliffe Dr
Eagan MN 55122
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