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4446 Lakeshore Ter ýý ÿ þ ÿÿ þýüûüûúú ùþþÿÿøøøîíÿö î ýä÷ ììî ÿõ ýüûú ù ø ÷ö ÷ ø÷ú ù õ ô ÷ùø ÷ö ÷ ó ÷ýò ó ÷ú ù ó ü ü÷ ÷ý ÷ õü ñ õü ýò ð÷ ï ÿ îíìñ ÿ þ î íîíî ÷ æååì ôù ýü÷ä ÷ÿ ëã æåâåâ óýýò õñð ùù ä ùü úä ù îíìñåþßí ä÷ ú ÷ ÿ óõî ÿ óõ êíçîíî ä ÷ û ô ÿ ä ä á ÷ ä ùù ä ä ÷ ÷÷ ÿ÷ ù ôä ùù û ý ó ý ü ÿ ï÷ å ùù è ÷ ü ýÿ ü÷ Use BLUE or BLACK ink r————————————————� I For Office Use � ' � Permit#: � �� j Clty of ��a� � ] �� I Permit Fee: l � � � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING PERMIT APPLICATION �1� I�/I Sr �''! `1 �'' C�,�� ,�t.�/ �il/�� 'C; �c�G�v�, ��9� �Uni#: Date: Site Address: �� Name:�. �IIP'��d... _�u��e�,�_e.m��.oV��._.�.�.�,.m .�.�...2,��.�,�.,.�,. �Phone:�,��...u... ��. � � ResitleTa�/ ` � � � Q�y��r � Address/City/Zip: 0�'Y"�' , � - .��' Applicant is: Owner Contractor � �.»....�.,,�.�.a,,�,�,,. .,,�a.�,,,.��.� �.�.,.��,.,.�.��..�_��_.�.,...�,...�.,�„ �.� a�� Description ofwork: ��✓�� : ` � Construction Cost: Multi-Family Building: (Yes /No� � �'� � Company: �t��' .� n�� (.�''"��G�l� �hc. Contact: G.r�rl.J ��t �� --- ...�.�...�.� � � ulfr y°z'` � �lj � � Cantract�or � Aaa�ess: �Sa-a �'�.�bw�� S �s� c�ty: �� Zi �Sy�� Phone: "7G,�-5.��.ar._�� L� G� ,.w/ (;s��"J. � State: p: Email: �oN .I�r�n,m,c � License#: �C �� 7q.3 Lead Certificate#: ��..,._,..��,�..,...�.�.�..,�,��.W...�...�....�.�,�.,�,.��.,e�...��u�� _..,�,��..�,M.,��..,._�.,,.��„�,,.��,�..��,,�,...�.��...�„��. .,�....,...�,�,.�.�,,.�,..�, �.� ° 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? � � i Yes No If yes, date and address of master plan: � � � � Licensed Plumber: Phone: � Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: „��NOTE:PI�f'1:S�I��SU��JO#��t��ilfi3�El�#5�'I7r��',�O�l 5W�7l��!`@ CQI?�It�EI'@t��'O�?E�3#,�;I�IJ��O�°f��l�`��, Po;r�Qr�o� � �e r�►�'vrr�a��n r�ay be'cl��si�d a�r�an p�bf�c.�y��pro�a►e�pec�'i+�t�e�s��s tf�a��ror�#�1 p�r�i�t�:'Ci#y t�o �.� c��cl�ale t�t�e are tra�le see�e�. � 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 I 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 S t Building Code must be completed within 180 days of permit issuance. X �u�� /�y(��°�-�� ' e X ApplicanYs Printed Name Appli s Sign ture Page 1 of 3 Vim" EAGAN,- 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 a ZOy (651) 675-5675 1 FAX: (651) 675-5694 hi ildinainsgectionsCcr7cityofeaoan.com ---------- For Office +Use I Permit #: j Permit Fee: U ✓ D i I (r Date Received I I i Staff:------- 2021 RESIDENTIAL BUILDING PERMIT APPLICATION Unit #: Date: Site Address: Name: Phone: esfdetl i%�t� 3(`1�Sblt — Resni► n Address / City / zip:'gy N6 Tc rr6ce �o�e4�r� Applicant is: Owner Contractor Owner Email: 0. Description of work: Type of Work Construction Cost: \,4, Multi -Family Building: (Yes I / No ) Company: 1 k(.4I'iG✓1 Contact: It, cit Address: 15 � 1 � r/-- J frl� �' A ) C city: � QU I � U Contractor 1 �o / State: B t r " Zip: (ot."l Phone: trey I G2�(Q� oOI Email:�► C� (�D Y Furs^ (�Utiltf 1 o C License #: D ` )- 7-1— _ Lead Certificate R. 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: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: are considered to be Phone: Phone: Phone: Phone: 4-., wens of the lefonnadon may be W You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website a www .citvofeaQan.com/subscribe. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www aopherstateoneca{i.org for protection against underground utility damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities. 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 Applicants Signature Applican ' rioted Name SUB TYPES — Foundation Single Family }� Multi 01 of _ Plex WORK TYPES New Addition Alteration Replace FQR OFTICEMSE: ONLY ��Site Address: Permit #: _ Fireplace _ Porch (3-Season) _ Miscellaneous _ Garage _ Porch (4-Season) _ Accessory Building _ Deck _ Porch (Screen/Gazebo/Pergola) — Lower Level _ Pool — Repair _ Fire Repair _ Water Damage Egress Window DESCRIPTION Calculated Valuation Plan Review (25%_ 100%—\�) Census Code # of Units # of Buildings Type of Construction _ _ Siding _ Reroof _ Windows Solar Occupancy ato Code Edition 0 Zoning Stories Square Feet Length Width _ Retaining Wall _ Move Building _ Demolish Building* `Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required REQUIRED INSPECTIONS Footings (New Building) (\ Meter Size: 4 Footings (Deck) Final / C.O. Required �/ Footings (Addition)U `i ` t `' Final ! No C.O. Required Footings (Addi Foundation Foundation Before Backfili HVAC _Service Test Gas Line Air Test _Hood Pool: _Footings Air/Gas Tests _Final Roof: _Ice & Water _Final 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 — Backflll _Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In _Final Braced Walls Erosion Control Shower Pan ��jj Other: Reviewed By: 1iJr , Building Inspector RESIDENTIAL FEES Calculated Valuation Base Fee Plan Review State Surcharge MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Radio Read Other: Copies: TOTAL $ 0.00