1585 Antler Pt Use BLUE or BLACK Ink
r________________�
I For Office Use �
C' � Permit#: ����� � �
lty of ����� � Permit Fee: I llf - `�� �
3830 Pilot Knob Road � /� �� /� �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
,� Name: Phone:
�r��R�SIC�rB�`i����a„ � � ` ,(� -
',��OYj'jl��r ` . ��� Address/City/Zip: ������y� d c� � �'�
� ��,,.� � ..��� �a�+��h
; Applicant is: Owner Contractor
Typ� Of WOPk Description of work: �iV ��^ �� � S
Construction Cost: �� �� Multi-Family Building: (Yes /No�
, -
Company:�p�i(�� �� � �� ��, Contacfi C�L� G
i
�C011'�Cc1CtOT . , Address: �� � �('� � City: �T ��Cv�Cv 1
State�✓f. Zip: Phone: Email:
u `� � �� 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:P/ans and supporting documents that you submit are considered to be public infcrr►r�ativrr. Portians of :
the information may be classified as non-public if you pro�ride specific reasons fhat would permit fhe City to
,''�:eonclud�:that the '��are fratle 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.aopherstateonecall.orp
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 'Iding Code must be completed within 180
days of permit issuance.
X �c� �3��� S X
Applicant's Printed Name ApplicanYs Signature �
Page 1 of 3
RESIDENT /
OWNER
Name: Phone:
�
Address / City / Zip: /53 3 A")-7 / ,. 44) 5S'/7 7
Applicant is: Owner de Contractor : Jr / ( (l 1 5 r5
TYPE OF WORK
Description of work: QP pc
Construction Cost: l „,2 0 O 6 Multi - Family Building: (Yes / No
CONTRACTOR
Company:41 ` A c (G RE f1G .) Contact: 3 ^/VIE
Address: /757,,L ( .r, ATIP7 Qte, E City: Pcncleg.. 5
State: Mt.) t J Zip: ` 5 5 3 * - 7 4 Phone: 7 1 2 . o / 3/ 0- 2
License #: QO/ 5 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.
City of Baran
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
X 0 vE- Rrt j
Applicant's Printed Name
Permit #: , M�
Permit Fee: ?2 7 S0
Date Rece ?ed:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Use BLUE or BLACK Ink
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.gobherstateonecall.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, 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 proval of p
Applicant's Si
ture
Page 1 of 3
Use BLUE or BLACK Ink
r
For Office Use I
I I
Permit
fill
City of Ea ~a~ i / aS
Permit Fee: lD~
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I j~ I
Fax: (651) 675-5694 I Staff:
I I
J2~013 RESIDENTIAL /BUILDING PERMIT APPLICATION
Date: Site Address: J ' / 1 n664 f Unit
Name:- tJI- /04),!lj tE9lAtr y SOi I-14 /Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
~d v~~"L~`} Cis-c'f✓
Type of Work Description of work:
Construction Cost: Multi-Family Building: (Yes /No
)
Company: Contact: ../('1'n-c G_O'&&.IA-J
f~-Tr ~ ~
Contractor Address: City: 11
State: /t-./ Zip: Phone: , Y 20 - 1/ O 7
License .,~6 C ~61 O~y Lead Certificate S 974f lecGclt_~
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
/(77S 07?6
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 ized by a building permit issued in accordance with the Minnesota State Buildin de must be completed within 180
days of per s ance
x q~ '61 Ci X
Applican ' nted Name Applicant' ignature
Page 1 of 3
s Dec 10 13 09:30a
Victor & Kathy Berke 507-625-3343 p.2
City of 8,all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
10
r
Use BLUE or BLACK Ink
For Office Use
Permit* ji�"'®j X151
Permit Fee: ` 1 1t/ • 3
Date Received: (./D-11(1,
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: rt t b. 15 Site Address: i f5(45 �t l 1 Pt" Unit #:
Resident/
Owner
Type of Work
Contractor
Name:
Address / City / Zip: 16 f nt I-tr P-f—
Applicant is: Owner Contractor
Phone:616Z—
Description of work: -i Ytf l l o rat r sump T
Construction Cost:
Company: rC
Multi -Family Building: (Yes _ / No
N i eh, S rifSContact: j _"'th
Address: 51604 f ron
city: Man A/n�A t`V Zip: 61POD, Phone: -a*
State: 1_ 41 � ,7�j / O
R 7
License #: 100,14 ].'] ?17 Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
k?: 3... 1qq{o
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:
Phone:
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. can Gopher State One Cali 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
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.
Freivvef
Applican sPrin�Name Applican s Signature
Page 1 of 3
Dec 10 13 09:30a
Victor & Kath Berke
15g5 Ayratir fol
507-625-3343 p.3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
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
Porch (3 -Season)
_ Porch (4 -Season)
_ Porch (Screen/Gazebo/Pergola)
Pool
Interior Improvement
Move Building
ileac
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
_ Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: Ice & Water _Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
— Sheathing
Sheetrock
Fire Walls
Braced Walls
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
_ 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
Final/No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests _Final
• Drain Tile
Siding: _Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: Footings Backfill _ Final
Radon Control
Erosion Control
Other:
Reviewed By: L[ , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies 4'
TOTAL
/o3 IT
G 7 11
Page 2 of 3
IC Use BLUE or BLACK Ink
- - - - - - - - - - - - - - - - -
For Office Use
Permit
City of Ea~~~
I
I Permit Fee: 162
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:
Site Address: /~~3 JCS / Unit
40 Z-11-
I
Name: Z_i 6 ~C v%~a Phone:
Resident/
Owner Address /City / Zip:
Applicant is: Owner Contractor
Description of work:
Type of Work d
Construction Cost: Multi-Family Building: (Yes Ai / No
Company: ✓i~ ~C Contact:
Address: ~1176- City:
Contractor _
State: ,,//LL,, /'~/Zip: Phone:
License 1_*C 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 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.orp
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 'Ai `4 el I / C Gy~l . x
Applicant's Printed Name Applicant's Signature
Page 1 of 3