1352 Jurdy RdRESIDENT / OWNER
Name: y V itQ. R 0 CI r L?C-Z, Phone: l5 7v 7 qq
Address / City / Zip: l3 5c t rc&. f c) (et5gA M 4C/ 5 2
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Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: Rey 666-c.
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Cost: /5000 Multi - Family Building: (Yes / No
.)
CONTRACTOR
Name: H4/0C-r) S RoCy1"j q License #: (20 b 3 / 3 6
Address: C % 9 / \ -- Ave-- J City: f):
State: r Zip: -SS � (a3 Phone: q — d (0 4- [ 6 1 — as
Contact: fee r?C[cdo (� Afro 4. Email: IQr -SRQv(`� / (,P 0 Osio CO -1
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:
Sewer & Water Contractor:
Phone:
Phone:
NOTE: Plans, and supporting documents that you submit are considered to be public information Po o
the informatio may be cla s s ified as non public if you= provide specific reason t hat would permit the Ci to
n` f
conclude that they are trade secrets.; ,,.. ,._
City of Eaall
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
R e-=04106:2 (t
Applicant's Printed Name
r
Applicant's Signature
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: IAA / � Site Address: 35a 3"J fay 6'(-9\
Use BLUE or BLACK Ink
Permit #: V 9 Jy3 Y
Permit Fee: ho Q
Date Received: l — - ID
Staff:
Suite #:
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.gopherstateonecall.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 apgrof plans.
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Page 1 of 3
CIT O�F RAGAN WATER SERVICE 'PERMIT
3791ot Knob Road PERMIT NO.: "r°'
Eagan- itN 55122 ' DATE- ,
, Zoning: it. S"'Y
No. o f u n i ts:
Owner'
c z,c_ Vi ,_ ,:. ' Address:
I Site Address: -./._.:.,,, .:,...: fi
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Plumber: ,- 'tz 1 „
Meter No.: ' Connection Charge: „ " e . ,_''
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge: _ , ''`
Ordinances. Misc..Charges: r'' %
Total
By -7 Date Paid:
Date of Insp.. — / - 7� Insp.:
SEWER SERVICE PERMIT
CITY`F EAGAN 'ra
3 - l: Rood .:
Eag an, Pi MNt ot Knob 55122 DAT PERMIT NOE: _, _ _
1 No. of Un t ' "
Zoning: 1 ; i
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Owner: t N- Address: a i
Site Address: - Y ?
Plumber: ,/,s "`-� ;,
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1 agree to comp w the City of Eagan Conne Charge ," ; - i
Ordinances. Account Deposit: -'
Permit Fee: r ' P
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Surcharge:
.
Misc.
By Charges:
Dote of Insp.: - "* , •
' ° Total :
insp.:
Date Paid:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140343
Date Issued:12/09/2016
Permit Category:ePermit
Site Address: 1352 Jurdy Rd
Lot:14 Block: 04 Addition: Donnywood
PID:10-20960-04-140
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
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.
Contractor:Owner:- Applicant -
Yvette D Rodriguez
1352 Jurdy Rd
Eagan MN 55121
R & R Remodeling Inc
4351 Parklawn Ave Ste 108E
Edina MN 55435
(952) 210-4988
Applicant/Permitee: Signature Issued By: Signature