1573 Antler PtRESIDENT /
OWNER
Name: Phone:
/
Address / City / Zip: /57/ /�•�J / ' A/ Zi:9ua .L. 9:3 Z Z
Applicant is: Owner l Contractor i.1 C(,(eCJ# 1 53
TYPE OF WORK
Description of work: l= gpc
Construction Cost: l2, b o 6 Multi- Family Building: (Yes X / No )
CONTRACTOR
C PO LE
Company:lM Ca E frA) Contact: av€ Ro rr►Me
Address: /7549_ er,_, Ole, E City: Pc 5
State: tirJ Zip: 557P 4 Phone: 7 to - L120 3 to °7
License #: ao/ rj ` 1 Z Lead Certificate #:
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:
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.
CityofEaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x
Applica
tore
r
Permit Fee: a(97
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Use BLUE or BLACK Ink
Date: Site Address: Unit #:
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.gopherstateonecall.orq
1 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, . is not to start without a permit; that the work wit be in
accordance with the approved plan in the case of work which requires a review and .pproval of p
x 1�oa
Applicant's Printed Name
Page 1 of 3
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use I
Permit#:
City of EaRd~ I
Permit Fee: l0
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 7` ~3 ~3 I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: l
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: S1te Address: (S-71 / ~7-3 64"- Ar1kJr Unit
Name: Ll l~tJ i✓C1~ TQU_),AJ ff'diIf ~ Ski i l9l~1 /Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Type of Work Description of work: 0G r~~J ~iiti-c 6✓-
Construction Cost: Multi-Family Building: (Yes / No )
Company: Contact:
Contractor Address: rz City: C.11f 7 891 l~¢c
State: 1 Zip: Phone: ~6 cw 0 7
License t6C 661076) Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
0996
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:
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.gopherstateonecall.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 autho 'k,z ed by a building permit issued in accordance with the Minnesota State Buildin de must be completed within 180
days of per s ance / L>
X x
Applican ' 'nted Name Applicant ignature
Page 1 of 3
I
r
Use BLUE or BLACK Ink
r-----------------•
I For Office Use �
' � Permit#: /e� cJ �o��7' �
���J O� ��6�� I Permit Fee: � , �S �
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: , "� "� �
Phone: (651)675-5675 I �,�% I
.�,�
Fax: (651)675-5694 i Staff: i
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ��.3 �n�"�ts �/ Unit#:
' Name: Le� Phone:
� Resident! ��.�� ����� ��--
OW11eC : Address/City/Zip:
Applicant is: Owner �Contractor
Type Of Work ', Description ofwork: �e SiU�� ti �i nC�vwS
Construction Cost: � ���/GC� — Multi-Family Building: (Yes !No�
Company: ffihc�,2�,n ��,12 Contact: Ly� ���e�
Contractor Address: ��7� ��J� City: �n/ht� ��� ���
' ' State: ��'11�Zip: 5��� Phone: ,, v� �1G�'�`���Email:
� �`
License#: (� ��� Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
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 wou/d permif 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 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 /'lic��1 C,�, X � �
ApplicanYs Printed Na Applican Signature
Page 1 of 3
Use BLUE or BLACK Ink
• � r----------------� /� '
i For Office Use ��
Clty• � l��� I Permit#: ���C�� � j�AI�
of ����� ������ � . . � --7 �� ��
Permit Fee. % /�
3830 Pilot Knob Road � 0 6 Z��� �,
Eagan MN 55122 ��� � Date Received: �� r � I
Phone: (651)675-5675 � I
Fax: (651)675-5694 I Staff: '� �
I I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ���� " � ,� Site Address:�S 7.3 r'4^�� ��°'� I" 't Unit#:
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Name: ��!��� Phone: G Sl` �lOS� ���
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"� . � Qwrlel' �� Address/City/Zip: tS�3 �.U���rt, l�'f` %�r�.�� M n� ��/� 2
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������ = Applicant is: X Owner Contractor
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� h �� t° Description of work: c���-k ��
T�p� f Wa i
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��; Construction Cost: � 7y�o� p��+s Multi-Family Building:(Yes /No )
�: . _..M.
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� ,�� � Company: ..�� �� ��Ps'lo.v �s�,s"'��t+�c�l�w' Contac•
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A�����
Address: /��i '� S�i� �-P ��' City: g� l�G ���Iu 'e
COi���'1GtOT�
� � ' State: �Il�, Zip: S'`Ga ll P . '7tv3 �a��/�9�'�EmaiL• �I��{ `��`�� G`>''�• �"^
��
�:r License#: Lea ificate#:
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:
N��"�z P/ans�an ���r�Portr�gr�dQcu �.�at,��� ���.�rr�e cor�s�al�red�r� �publ�+c�n �' �t� � <:
#t�e mforn�at�on�na�rbe c%��srfed�a p�u�lr� �u p:rovid�spe��Fc re�is�a�s'�� " #!��C� n � r'
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t� �
����� , �� � �r:��<, ���nclr� y��a#��ie5 are#r d r.�ts :
; �:.
���� � �:����> ��r,� ���, �.�x - }
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)4540002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.ora
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 ��A'v�c� M h.e L x fi�\ 1�'"/ ��i
Applicant's Printed Name Appl ignature
Page 1 of 3
/�`�..� �4�1�I�-,� �-F �
DO NOT WRITE BELOW THIS LINE ����1, -,
:� �
SUB TYPES
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family)
_ Single Family Garage _ Porch(4-Season) _ Exterior Alteration (Multi)
_ Multi �y�, Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
_ 01 of_Plex T 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
RetBining Wall *Demolition of entire building-give PCA handout to appiicant
DESCRIPTION
Valuation �� ¢ � Occupancy �,��� MCES System
Plan Review Code Edition ����'` SAC Units
(25%_100%�, Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
� Footings (Deck) Final/C.O. Required
Footings (Addition) � Final/No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final
Framing Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Other:
Reviewed By: ���' , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge � �
Plan Review
MCES SAC
City SAC
Utility Connection Charge � � I:� � t�
( �` � "
S&W Permit 8�Surcharge - �
Treatment Plant
Copies
TOTAL
Page 2 of 3
-----
. - • � � � �ER'T'IFICATE �F �LTRVE� �
for / ����f
C CJOD �VALUE HO�MES /� � ��,�-1c� �-��,
PROPQSED BUiLDfNG �LEVATIONS
7op of foundatian ���•� ,_� Front •of hause -1'�'��• � p
G�rage floor �--- Rear of house ���'_�'J_'C°?._.,_.
Lowest fioor Z�Q_,,,,_ Waikaut __________ � '
- �.--- arraw denotes drt�inoge direction per developrnent plan. � �
. C�,�
890E denotes existing spot elevation
890P denotes proposed spot elevation ��+���G.�
BENCHMARK USEQ: ,. � �• ����.�
-Tc�P � R. o w mo►�r�mc�rr f1,�$���--�"��4 �• Ca
�.'S�L� es� #���Lu�jt`�
�` Qv� ���� � �k 15' O/S to
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9uildtn Envel e � '
��1 t�iF- �[NT"1!V F�- � � �.r�� �c� ��� $ �(i
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Not to Scale �-- �`L
�Af��.;"��Id�Ti�ft+:�RL'�7ts D�FT.
� LEGAL DESCRIPTION
NOTE: ALL D1MEN�IONS ARE F�UMDATION DISTANCES
( ) = RECORD INFORINAT30N Lo�S 7 ClC1d 8, BIOCk 'I, DEERW��D
o a�Na i Es 1/2" IROhE P(PE & CAP SET TOWNHOMES, occording ta the plot af
�.s. � 2�945 _ record thet�eof Dakota County, Minnesatc�.
� DENOTES IRON PiFE-SET I hereby csrtify thc�t this survey was
FOR BUILDII�G -OF�SET prepared by me or under my direct
o DENQTES WOOD LA�H SET � supervision, ar�d thot 1 am a duly
FOR EXCAVATfQN pN�.Y L.ieensed Land Surveyar under the
QASHED LII�E DENOTES ORAINAGE .,--_ laws of the state of Minnesata.
ANQ UTfLITY EASEMENT AS PER PLAT. �-
E INEERINQ INC.
BEQI�TEi�D PROFE58IdNAL�LhND 3t1�VEY4Rs Dona#d E. Sigety� MN � . �3945
944b EAST RI�VER A4AD, 9UiTE 208 ! Date: C1/�I�5
CC10N RAPIDS, MN 5ti488 ��
Tei. {BL� 7g6-6�4Q Fax. {61Z) 7bb-]882
JOB N(}: 93-34 SCALE: 1 INCH -_?o__���r �i��fl sooK:�p� PAGE: DRAWhE BY: CkP
' nccor+or� n�ain
Use BLUE or BLACK Ink
�________________�
> I For Office Use �
' � Permit#: �� I ��� I
Clt� Of ����Il ��c��;��� � . � �� �
Permit Fee:
3830 Pilot Knob Road ��� � 5 20�� � . ��� � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I -� I
Fax: (651)675-5694 I Staff: _� I
�----------------�lt�'
2015 RESIDENTIAL BUILDING PERMIT APPLICATION ��a����
� ( J /��L �
Date: �'°�5 Site Address: f$�� �w 7`�✓� 1 r 7 Unit#:
� � /
� Name: ��i�� d �e �S ` �J'�' .5�� �5� 3
Phone: � � �
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���,�
4 � , Address/City/Zip: /.�7� �Q,,�•f jc�n. ��- ��,�,,. /cl w 5S'r '�y
� Applicant is: �Owner Contractor
�:� _.
� Z
���.�,��,��� Description of work: N�� �'v y
i��� ,
���5��'r ;-��� ` Construction Cost: Multi-Family Building: (Yes /No�
�..
�fi k �
Company: Contact:
�������, � Address: City:
�.
� � � �
� : ;' State: Zip: Phone: Email:
:�
License#: Lead Certificate#:
If the project is exempt from lead certification, ptease 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:
: ,�li�?T�*i�l�a�r►��d�c#����#�I�����►�;�, �'��c���d`�"'e��� ��'�f�� 1��'�z�i�'
�- � ,4�, � � � ��
�e ir#''��tv�-�+��e+r�ss��t��t�?��-�?�����rr��+���������r���`��������n
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��
, . , ,�, . .. _ - .� = y �
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�,
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.ora �
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 �:��r� ���' _ `�
x
ApplicanYs Printed Name App' s Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE � 3 ��
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 { x , ��
Valuation � � Occupancy �'� MCES System
Plan Review Code Edition � SAC Units
(25%_100%�) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV �
#of Buildings Length Fire Suppression Required
Type of Construction _��� Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) �nal/No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
�oof: Ice&Water Final Pool: Footings _Air/Gas Tests Final
r/ Framing Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick I,
Insulation Windows '
Sheathing Retaining WaIL•_Footings_Backfill_Final '
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee � � ,`�"'Q
�
Surcharge � � � '�
j �A, n
Plan Review � '� - ��y �
MCES SAC � �
�
City SAC �`, �
Utility Connection Charge
S�W Permit 8�Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3