1545 Greenwood Ct N4b.
City of hp (00 `p' "s
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3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
[MBAR 7 9 7011
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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
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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