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1545 Greenwood Ct N4b. City of hp (00 `p' "s pe, -TEK?.12y 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 [MBAR 7 9 7011 G Lk( rzelc( Use BLUE or BLACK Ink Permit Fee: ! - -75 Date Received:, , Staff: 2011 RESIDENTIAL BUILDING PEWIT APPLICATION CP R Date://j q - r 1 7/// Site Address: Ijg7/ breed I/I�ooda n Unit #: RESIDENT / OWNER Name: 4n%1e ry li-Cf /Vol/ ifin Phone: (!i I2 7t' i✓ II y Address / City / Zip: 22 / � b tee j/ V d /,1/er "C/<5 AI /v 5, 7 / Applicant is: Owner Contractor TYPE OF WORK Description of work: AO(ICI i 15.o 60atiot 'fee/ cA' uattfi"tn k,ivged 51ed-r0ek Construction Cost:$2600 Multi -Family Building: (Yes / No ) CONTRACTOR Company: lid 1 c,I� y £1h4 d 4rned'Won Contact: /%7'/'11 .�.,& o%1 Address:3 /32 (1P!1mark lifAv City: tly,n State: /v►/V 5J 1-27�' Phone: 054�37g1 . /,,Zip: L License #:20 (3 '113..-2/ 7� Lead Certificate #: R ;,h --30 3 5i- /0 -01 J Li Does this project require If no, please explain: Lead Remediation? ❑ Yes XNo (see Page 3 for additional information) ore L✓p s bti i f f ,t-\ /9 g3 In the last 12 months, No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: _Yes Licensed Plumber: Mechanical Contractor: Sewer & Water 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. �:�� . w . 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.qopherstateonecall.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. x b r\ Applicant's Pyfnted Name x Ap • rcant's Signature Page 1 of 3 /5y5 6/16-601600al DO NOT WRITE BELOW THIS LINE SUB TYPES — Foundation Fireplace Single Family Garage _` Multi Deck 01 of _ Plex — Lower Level Accessory Building WORK TYPES New Addition _ Interior Improvement Move Building Alteration Fire Repair Replace _ Repair Retaining Wall Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool DESCRIPTION Valuation Occupancy Plan Review a a . L EW Code Edition (25%_ 100% y) — ��� Zoning Census Code Stories # of Units Square Feet # of Buildings Length Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In Air Test _Final Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Siding Reroof Windows _ Egress Window — Storm Damage _ Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous _ Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant t MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required !` Final / No C.O. Required HVAC Other: Pool: Footings Air/Gas Tests _Final Siding: Stucco Lath _Stone Lath _Brick Windows Retaining Wall: Footings Backfill Final Radon Control Erosion Control , Building Inspector P-rri4 delit,0411- k„knat roi (Dono Fr 0120 Page 2 of 3 Aug. 1. 2012 12:37PM Sela Accounting No.1661 P. 15 City of Evan 3830 Pilot Knob Road Eagan MN 65122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use (� Permit ft: / J , 61 Permit Pee: c -'--f 7 • Oats Received: Staff: 1 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: S/ I /1 Z Site Address: (53°1,1 Sul 115113, )946 Green tel (2*. (l Unit #: RESIDENT / OWNER Name•J .el \-,�}-s rw�%�o i- , C. Phone: (1 5,::t -03 i —I 3 3 1 Pa 1 (rO� r cGt :k-y\e T- Address / City / Zip: �tj 3iS CA -1-v LJe*i- A_k-L.l.'t �/ tr-,A1.fl c`('t;l�'r+\ v. 1 n'1 rl (:3 Li L/ Applicant is: Owner X. Contractor TYPE OF WORK Description of Work: re. coo C` Construction Cost: 1A D • S—, (-X) Multi -Family Building: (Yes / No ) CONTRACTOR 1 Company: 6 c -l& Quo 1 vt1 d- R m r:d ei t v1 Contact: Kct r- t i–• Address: Lit CU tXCt�1 Sl o r ( \ V 1City: 5t , L.bi-kis Pet r -t_ State: }rY\i'\ Zip: 55'11 U, Phone: C) 63:1.-9 1 5 -- —7c)rZ G License #: C tit DC) 1 0 $ (, Lead Certificate #: ,1fAT — a 5 Lb 3 it — i if the project Is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes _No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, 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. 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. Cell Gopher state One call at (051) 454-0002 for protection agaInst underground utility damage. Ca1148 hours before you intend to dig to receive locates of underground utilities. w.nv.00pherstateonecall.orq I hereby acknowledge That this Information Is complete and accurate; Ihat the work will be In conformance with the ordinances and codes of the City of Eagan; that I understand Ihls Is not a permit, but only an application for a permit, and work Is not to start without a pennll; that the work will be in accordance with the approved plan In the case of work which requires a review and approval of plans. Exterlor work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. x ) r 1 Yl & r 411 Applicant's Printed Name x I�IAA.v` V Ct-- Applicant's Signature . Page 1 of 3