3260 Valley Ridge DrCity of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Date: 4 9(D • a4 // Site Address
Pe A
Applicant's Printed Name
nt's Signature
Use BLUE or BLACK ink
9e74
Permit Fee: it 2'29 / , 75
(
Date Received: ('•d/ -1I
Staff:
Permit #:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
CALL BE FORE 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. Wn+w. gopherstateonecali.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 appvtgvat elan
Page 1 of 3
.... , • %JIM .
RESIDENT /
OWNER
Name: a ,., - - /. hi _ , _ - // a iii Phone: 76.3 - `/y9 - 9/np
Address / City / Zip: i . • 4 ` /O • Al Ali. y ♦ a/
/
Applicant is: Owner x Contractor
TYPE OF WORK
Description of work: RQ - -r-P
Construction Cost ` _5.23 99 Multi- Family Building: (Yes X 1 No )
CONTRACTOR
Company: f t n r ;,s - kr PJfx 67 C Contact i Pa ')-)
I _
Address: 59 7 (o llobc_ 1r e_ City: 3-I-, p ; , t
State: H N Zip: //O Phone: S/ - 76„1 - 9
.295
License #: c615/g Lead Certificate it INIA I - aQ9. 3-0
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 bf
the information may be classified as non-public if you provide specific reasons that would permit the City t
conclude that they are trade secrets.
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Date: 4 9(D • a4 // Site Address
Pe A
Applicant's Printed Name
nt's Signature
Use BLUE or BLACK ink
9e74
Permit Fee: it 2'29 / , 75
(
Date Received: ('•d/ -1I
Staff:
Permit #:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
CALL BE FORE 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. Wn+w. gopherstateonecali.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 appvtgvat elan
Page 1 of 3
Aug 18 1510:57a Sunrise Remodelers 651-762-9395 p.8
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� Sta�f: �
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` !f the pro�ect is�xempt from lead certification,please explain why:
k
���,n^fiz����COMPL�TE THIS�I�EA ONLI'�F C01�STRdJCT6NG}�NEUV BUILDIN�
� fn the iast�Z moret[�s,has the City ot Eagan issued a permit i�or a simila��slan based on a master pian?
�
Yes No If yes,date and address oT master p�an:
- Lic�nsed PiumDer• Phos�e:
� �fechanicaE Contract�r. Phone: —
; Sewer�Water Contractar. Phone: -
,
� �ire Suppressioes Contrac�or. P�o�+e� __
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��1i�d�TE:Plat�s and suppo�Eing alocumen�s fP�a#yor�sa�mi�are consiafered ta bs publdc informatior�. PO�f01i5 6� ;
. �he ie��orma►uon may be�Jassi�ed as�on publ�c�f yoe��r�v�de specific r�asons tha�woud�pe�dt th�Cit�to ,
; .__._aonc/ade fl�att�ey ase_trade secrets. �
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CALL 6EFORE YO�1 DIG. Call Gopher 5tate One C�I at(659)454-0002 tor protection against underground utlluy damage. Ca1148 hnurs
befiore y�intend Fo dig to receive locates of�cndelground ufliGes. www.Qooherstateonecall.ora
I F�e�'e6y acknowledge thal Ihis informatian is complete a�d accurate;that the�vo�ic vrN be in corrtormance with!he ordinances arxt codes of the Gity of
Eagan;that I understand tlris is not a p�tit, but only an appllcaUen for a pe��nit,and wo�C i� not io sta�t ovithout a petmit; that iha+xorts urtli�e in
ri
accordance with the approved plan�the case of work vdnich requires a review and apprnvai of plana
Exte�ior work authorized by a buiEding pemait Issued ic�accardance with t7�e AAinneso9a State Building Code snust 6e completeal wi�hin 980
deys oi permit iss�ance. ---- •
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Applicant's�ri�eted Naene A a s ignature .
,% Page 1 of 3
Use BLUE or BLACK Ink
r----------------"'�
I For Office Use �
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Clt of �� a� j Permit#: �
� � � Permit Fee: ��� �� I
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I �
Fax: (651)675-5694 � Staff: I
� I
2015 RESIDENTIAL BUILDING PERMIT APPLICATIO�� ����
Date: Site Address: � v�.� S� � .�c��a� �Unit#:
Name: Phone:
Res��i�� ,/ n
QW��� Address/City/Zip: ��5� Y�L��H IC�Dfr6 .DR, �6r��. `�N. .$�.5��3
' Applicant is: Owner Contractor
': Description of work: ��P�A[ s� �I�1dL�46��
T�°�r� of W��k
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' Construction Cost: '� 3 Multi-Family Building: (Yes�/No�
' Company:���/�y� �� ��wS�_ LLG Contact: S'T6b� �t�/�1�cv
� � � �� Address: .�S�gO �D�" ,�Lt� City: (.�vr�� �u.S
�{?�i1'�ra�0�'
' ' State: 'l�N Zip:155�� Phone: �S/-aNs-03/� Email: SJoNn+Sc�B c.,��ar�ku.s•�(r�it�t��.
License#: rl� (� Lead Certificate#: Nl�
If the project is exempt from lead certification, please explain why:
N� ( q�c,�ti�ti�r
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber; Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
' I11D7'�:P���and s�tp�Zn�l'Ing t��curn��ts t�l�#yr�u�ubmi#are cvr�����ed to be pr�b���a#or►�atran. f�c�,r�rt�,�t' '
th+e in#orm�tio�a r�ray tie ctass�f�ed as t��nyv�bf�c if,��u p�ro�t�ale;�i�"f�rea�art��aa�vv�d�e���`li���#�� '
'ccir�c��d�e tt��t�1� are tra:de sec�s.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance. �'
x S"7$V� ��I�NSo,� x
Applicant's Printed Name Applic t's Signature
Page 1 of 3
Use BLUE or BLACK Ink
• For Office Use
City Eaftli ::::
/ 3'
3830 Pilot Knob Road Date Received: L� ��
Eagan MN 55122 RECEIVED
Phone:(651)675-5675
Fax:(651)675-5694 APR 0 7 2017 Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
17x7 I
Date: Site Address: ��� 1 � Q. ` .1 \. I,/,` 011 Unit#:
!Rein\fOu.be l Phone:
',�= ��� Name: �[/� `
' � IDE),:).� l I_h -0
Address/City/Zip: 3aU V ��� � ei ....j _
m,7 %taf
Applicant is: Owner A Contractor
•
Description of work: bt.6 la, pSS`" I')vb j onnonlooat loeann5 ocal
. ,. tmf 4 Construction Cost: l V Multi-Family Building:(Yes /No X )
•
x G �''// '( r j Contact: ! Parent
✓ � Company:�ttir � �'C.TTI�Ie I�� I^S�
Address:
15175 W✓t 7.r-$c.. ig1v'4t City: &+fr k-`S {bac
�„,,�� Zip: SPhone: blaa 1S � t�'
state:ITN �`l�1F' ail: �
nrsLicense#: t�.��G' �ui Lead Certificate#:
NA1'-[05'41®"
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
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.gooherstateonecall.org
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
A4SLel
earendo
Applicant's Printed Name Applicant's Signature
Page 1 of 3
32D VAW
DO NOT WRITE BE W THI I �(�J
SUB TYPES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) Miscellaneous
01 of,'Plex _ Lower Level _ Pool Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
— Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
— Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
—
DESCRIPTION _
Valuation 0/ /SO-- Occupancy .5/26- ! MCES System
Plan Review Code Edition r/f/1 745/5— SAC Units
(25%_100% )6 ) - Zoning 7Z -3 City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction 'V 3 Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) i Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water Final Pool:_Footings _Air/Gas Tests _Final
j'i Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: 7-1)14// l )( fTh , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3