1649 Hickory HillDate:
City of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Cc ?
RECEIVED
v„ 11 JUN 0 2 2011
r
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION 7'
2 f Site Address: `� ' c� y /rye �l Unit #:
RESIDENT /
OWNER
Name: inw fte /11 e- So -c—, Phone: GSI - Z-41(9 31-1z2._
Address / City / Zip: 7611 9 A'/� {4-. gApplicant
is: Owner V Contractor
TYPE OF WORK
Description of work: A3 a.),
&I-
Construction Cost:4 30 Li ' 1 Multi -Family Building: (Yes / No )( )
CONTRACTOR
Company: P� / jDu- lifo,,.._. -4- Ccrre5+ , Contact: „IL Ce.. u. -r
P
Address: /S7-07 (0 p /J ,, City: 11apL
State: 1 tJ Zip:S„,3 Phone: (nv i ---/i4"') ^ 17 . 11-1
License #: 10 (, -3 2.94 I Lead Certificate #: t
rif r.,.)
If the project is exempt
GA -4.
from lead certification, please explain why: (see Page 3 for additional I information)
C.. 1 -,r -- u NV b- cliU 0 u
In the last 12 months,
If
CPLETE 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 _No
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. ''
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 witout 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.
A
6re i* -14r ,),
Applicant's Printed Name
x
App
nt's Signature
Page 1 of 3
_L / 7
/--/j_.0/4' C Y (13_ NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%)
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
o �D
Irp
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: _Rough In Air Test Final
4_ Insulation
Sheathing
Sheetrock
Reviewed By:
Siding
Re roof
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
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
'sr Final I No C.O. Required
HVAC Gas Service Test Gas Line Air Test
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
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
1,JK,.
firtYvix
%711.
vio vw1
L.,p-vm.611.0014A
Page 2 of 3
Vitaidt4F EAGAN
SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: 2157
Eagan, MN 55122 DATE: 2/27/74
PUD
Zoning: No. of Units: 4 unit TB
Owner: Woodgate - New. BDXizon Homes
Address:
Site Address- 1649-47-45-43 HiCkory Bili
Plumber: Thd psOf Plumbing Co.
d
I agree to comply with the Village of Eagan Connection Charge:15 0.00 12/3
Ordinances. Account Deposit:
Permit Fee: IO'00 Rd
Surcharge:
By: Misc. Charges:
Date of Insp.: Total:
Insp.r Date Paid:
.50 polo
V LL GE SOF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.: 1404
Eagan, MN 55122 DATE: 2/27/74
Zoning: PITT? No. of Units. 4 unit
Owner. New Horizon Humes
Address:
Site Address: 1643-45-47-49 Hickory Hill
Plumber: Thompson Plumbing Co.
Meter No.• Connection Charge: $520.00 billed
Size: Account Deposit:
Permit Fee. 10.00 pd
Reader No.• .50 Pa
1 agree to comply with the Village of Eagan Surcharge•
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
40Pb
City of Ea�afl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date: 1
Tenant:.
Fo"rm
110 046
Permit #: /% 7 9 If
C0
Permit Fee: go _--
Date Received: //".(1' /c71-
Staff: ",
ESIDENTIAL BUILDING PERMIT APPLICATION
!a. Site Address: 7 / /o �' "VI
4wr-ee� 1 sJE'$o V
Suite #:
J
RESIDENT / OWNER
I Name: Mut o ✓t P so-- Phone: (D C I "`a$41-3 'YeFa I
Address / City /
Applicant is:
Zip: /6Y? / [h/i& 1//I
, r
Owner Contractor
gLoi.ite/ 672r/
TYPE OF WORK
Description of work:
Construction Cost:
6.11. f Se v--
1 3 C b '40.0 Multi -Family Building: (Yes ` / No )
l
CONTRACTOR
Name: g a EC() C Y it C.144 wri S License #:
Address: /7 W (64 611"`( C.t,
City: I-ltZ
S State:
Zip: 333
Phone: (!5(_L!3 --AE Contact Person:
COMPLETE
Energy Code
Category
(I submission type)
In the last 12 months, has
_Yes _No If yes,
THIS
_ Minnesota
AREA ONLY IF CONSTRUCTING A NEW BUILDING
Rules 7670 Category 1 Minnesota Rules 7672
• Residential
Submitted
• Energy
the City of Eagan
date and address
Ventilation Category 1 Worksheet • New Energy Code Worksheet
Submitted
Envelope Calculations Submitted
issued a permit for a similar plan based on a master plan?
of master plan:
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents, that yousubmit 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,
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 p
accordance with the approved plan in the case of work which requires a review and approval of plans.
42
x n
W4/
f
Applicant' Printed Name'J x
Applicant's
gnature
Page 1 of 3