4835 Sheffield Dr - COCCity of Eagan
City Approved7G L2
Property Address: � �/ e / (
COMPLIANCE WITH INITIAL INSPECTION
n Ihis is to certify that the property listed above has been inspected by authorized City personnel on , 201_
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required.
COMPLIANCE AFTER CORRECTIVE WORK PERFORMED
is is to certify that the property listed above has been found to be in compliance with Section 3 40 of the City Code
after satisfactorily completing the required corrective repair work under (check all that apply):
1.�
n City Sanitary Sewer Permit City Plumbing Permit
NOTE: Applicable only if box is checked: (Based on a review of the Sewer Service video inspectionheport on file, it is
recommended that periodic cleaning or future inspections be performed to minimize a potential blockage due tar
Grease Build -up, Root Intl usion, Dip /Settlement in Pipe, Other:
Print name
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Eagan, Minnesota
1 /
Signature Date
Yellow Copy: City of Eagan (Parcel F ile)
City of Etall
rev. 2 23 2010
-I
For Office Use
Permit#: ` l D
,a ,, '' '/ E AG A N ..,
/tet
.... • Permit Fee: `/
RE C
~` EIV Date Received: '''.7—
ate"+
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 AUG 0 2 1018
(651)675-56751 TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinainspectionst cityofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: iWc:)-1)/g Site Address; 64 g 6 'S 1}6.. .1_{N / A/ Unit#:
Name: -3-i if". 1C 4 se,V S Phone: to 5/-36 a-19®5
Resident! l--i. O
OWner Address/City/Zip: F 3 6 Ss � (iy\ * h.,... .S 61 c ..)-
Applicant is: Owner Contractor
Type of Work Description of work: ga 0F
Construction Cost: D® — Multi-Family Building: (Yes /No g---r-
Company: 514 Yr�_Q�.Y Contact:
�QJ�/2�t9't�
Contractor Address: . -. _. City:
State: Zip: P e: Email:
License#:
Lead Certificate#:
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?
1
Yes T No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public Infonnatlon. Portions of the information maybe
classified as non •ublic if •u•rovide s•eciflc reasons that would• rm the CI to conclude that the are trade secrets.
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 at www.citvofeagan.com/subscribe.
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.
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.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 i 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 o ns.
x 1 vv. �® -e 1- s x _246--
Applicant's Printed Nailhe Appii 's Signature