1928 Glenfield CtRESIDENT 1 OWNER
Name: 2 P&OPeRTy <AL.E /Ale Phone: 651 – 5 9? 4/9
Address / City / Zip: P 0. Box Z12s /N t/2 C 2oVE - I 64 TS j 6 570 76
,Lb
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: R CMOI/E r4ND (Lls'Pt -A C
Construction Cost: ' 21, ob0 Multi- Family Building: (Yes / No )
CONTRACTOR
Name: 13E1 EX-TO– Ipj2 MilINT CORD? License #: 20,21///3/
Address: 6 10 s W 60 t S1YLEe' r City: /�lcAmfa - F/G,J
A'
State: MN Zip: S54/ 9 Phone: (,1 - g( - 6 2 '/3
Contact: PA-U, L N. Email: itt�v C. bei,ca/t . CO /71
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:
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.
Date:
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Forfliffic* JSe
Permit # � 6 7
Permit Fee: Oi 30
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
/a/2 o ho
!00 /
Use BLUE or BLACK Ink
Site Address: /9/8, / 9 20 10 22 192.4!, 2(0 1 928 i 'LSO 4- 1932 t.ritt FtetA Case,r-
Tenant:
Suite #:
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.org
Applicant's Printed Name
Applicant's Signature
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.
Cg ,e/f Xf/ri.acPS
Page 1 of 2
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN
3830 Pilot Knob Rd. METER # PERMIT DATE 12/04/91
Eagan, MN 55122 -1897 CHIP # PERMIT # 12416
METER SIZE / B.P. RECEIPT # C 15423
ISSUE DATE B.P. RECEIPT DATE 09/17/91
DATE 9 -18 -91
PRV BOOSTER PUMP
1918 1920 1922 1924 1926 1928 1930 1932
SITE ADDRESS Bikaspoixik2 (I RNFTRTI) (T PERMIT REQUESTED
LOT 2 BLOCK —SEC /SUB DIFFT,EY COMMONS
X SEWER X WATER TAPS
APPLICANT: The Rottlund Co.
ADDRESS: 5201 East River Rd. COMM /IND RESIDENTIAL
CITY, STATE Fridley, MN zip 55421 X NEW EXISTING.
PHONE: ( 612) 571 -0304
Lawn Sprinkler Meters are to be Installed
PLUMBER: V a 1 1 Py P1 iimh i ng A - . of Domestic Meters on Water Eine.
ADDRESS: 610 CrPPk Lane Cr ILL NOT be •' -n for Deduct Meters.
CITY, STATE Jordan. Mkt ZIP 55352 r
PHONE: ( 612) 492 -2121
AGRE ° TO C ► MP Y WITH CITY OF
OWNER: The Rottlund Co_ EAGAN ORDI NCES
ADDRESS: 5201 East River Rd.
CITY, STATE PriA1Py, MN ZIP 55471
PHO E: ( 6122) 5 - 030 SIGNATURE WHEN METER ISSUED
PL S ALL T W W oR ING ( D F'OFi PROCESSING. CALL 454 -5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. lPs'P
06/17/2014 15:04 Les Jones Roofing,Inc. �AX�528817009 P.003/020
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� Permit Fee: � �
3830 Pllot Knob Road
Eagan MN 55122 � oa1B Receivad: �
Phone:(661)675-6675 1 1
Fax:(651)67G-5694 , � S�ff� �
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02/19/2014 12:31 Les Jones Roofing,Inc. �AK�528817009 P.003/020
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it� of B��a� �'`�LC�i��Q I parmit Fee: ����� �
3830 Pllot Knob Road
�agan MN 55122 F� � 9101b � Defe Recelved: i
Phone:(6�1)67'6-6676 I I
Fax:(651)675�5694 . I Staff: I
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2014 IZ�SIDENTIAL BUILDING PERMIT APPLICATION �
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Date: � 9 / 31te Address: / 8 / 30 / 2 �FI�'�O - Unit�:
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If the project is exempt from lead ce�tfficatlon, please explain why: (see Page 3 for additional information)
COMPI.ETE THIS AREA ONL.Y IF CONSTRUCTING A NEW BUILDING
In the last 12 montha,has the Ctty of Eagan Issuad a permtt for a slmila�plan based on a rnaster plan?
_Yes No IF yes,dete end address of master plan:
Llcensed Plumber: Phone:
Mechanical Contractor: phone:
Sewer&Water Contractor: Phone:
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CALI. BEFQR�YOU DIG. Cell Oophar State One Call at(667)464-0002 ior profecUon egalnat under�ound u111Hy demage. Ce114B hour8
b91oro you Intend lo dlg to reCelve IoCete6 Of unde�around uU111188, wuvw.aooherstateanecall.ora
1 hereby ecknowtedge thet thle infonnallon le complele anQ accurate;lhat the work will be In conformence with the ordinancee and codea of the Clty of
� Eapan; Ihat I unde�stand thla le not a permit, but only an aqpliceHon tor a permlt, antl work Is not to start without e pennit;thet the work will ba In
aocorcJence with the approved plen In the ceee of work whlch requlree e revlew end approval of plana.
�xteriorwork authorized by a building permlt leeued in accordance with the Minneaota stat�Bullding Code must be compl•ted wlthln 180
days of permlt lesuance.
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Appllcant's Printed Name Applicant's Slgnature
Page 1 0l 3