3819 Windcrest CtRESIDENT !
OWNER
Name: ' ) A 0 c `[- T t 1 y l 3 S C G ( t r Phone: y
6251 -- 4 _ 2. , a7.-1.0
Address / City / Zip: - W's 621 < s L -s1 { sfl") j 1 2 3
Applicant is: Owner .). Contractor
TYPE OF WORK
Description of work: t. / ` " '0 K. Ro r, al �ti 2p fit:: L.0
Construction Cost d L( ,SLR.. Multi- Family Building: (Yes n / No )
CONTRACTOR
Company: b.: ;;.T Tins= - 7 tc v .A Contact ; > g t
Address: C ! o? O Cu - i a W t L. city: = cA 6 iq r,)
State: AAA) Zip: ! Phone: C, );--2-1 C) — ) 6 y-
License #: (9o4 S ID /t3 Lead Certificate #: A:? 149 —1
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 8 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. ,
4t City of Eapi
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x V r u (? r- r
Applicants Printed Nanrlt
RECEIVED
JUL 0 7 2011
Use BLUE or BLACK Ink
For Office Use
Permit*. /60
Permit Fee: / 2 ` �✓ J �
1 Date Received: ' 4
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION 6-U/4-4k
Date: 7 7 i i - Lo U U Site Address: !g yy► li.0 n cP $1 0410 r` ` 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.gopherstateonecali.orq,
I hereby acknowledge that this information is complete and actuate; that the worts will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but arly an application for a permit, and work is not to start without a permit that the wort will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Page 1 of 3
SUB TYPES
Foundation
_ Single Family
Multi Deck
01 of __ Plex Lower Level
Accessory Building
WORK TYPES
New
Addition
Alteration
4 �I! Replace
` Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25 %_ 100% ' )
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck) --- - } r
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: Rough In _ Air Test
Insulation
Sheathing
Sheetrock
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
C DO t tR ' ITE BELOW THIS LINE
Fireplace
Garage
Interior Improvement
Move Building
Fire Repair
Repair
TOTAL
Porch (3-Season)
Porch (4-Season)
Porch (ScreenlGazebolPergola) _
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Reviewed By: ( ,
Siding
Reroof
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
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings _Air/Gas Tests -
Siding: _Stucco Lath _ Stone Lath
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
Building Inspector
Final
Brick
Page 2 of 3
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN METER# PERMIT DATE 07/26/91
3830 Pilot Knob Rd. 12178
Eagan, MN 55122 -1897 CHIP # PERMIT #
METER SIZE B.P. RECEIPT # C 14652
DATE JUL 24, 1991 ISSUE DATE B.P. RECEIPT DATE 07/25/91
_ PRV — BOOSTER PUMP
SITE ADDRESS 3819 WINDCREST CT PERMIT REQUESTED
LOT 2 BLOCK 1 SEC /SUB WINDCREST 2ND
X SEWER X WATER TAPS
APPLICANT: g
ADDRESS: COMM /IND RESIDENTIAL
CITY, STATE ZIP X NEW EXISTING
PHONE:
Lawn Sprinkler Meters are to be Installed
PLUMBER: VALLEY PLUMBING CO INC Ahead o Domestic Meters on Water Line.
ADDRESS: 610 CREEK LN Credit L OT . gi Deduct Meters.
CITY, STATE JORDAN MN ZIP 55352 / //Z
PRONE: 492 - 2121
c - TO COMPLY WITH CITY OF
OWNER: PRIME BUILDERS INC EAGAN ORDINANCES
ADDRESS: 4910 VALLEY FORGE LN
CITY, STATE PLYMOUTH MN ZIP f1 /XXXI iii 55442
PHODIE: � y 550 -1346 /� c � �j SIGNATURE WHEN METER ISSUED
PLEASEE TWO 46RKING DAYS FOR PROCESSING. CALL 454 -5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
Use or BLACK Ink
t For Office Use
i
City of Eakan t Perrntt tt J . ✓.-3 I c>,/ il
i Permit Fee
3830 Pilot Knob Road t
Eagan MN 55122 Date Receved: 313 r
Phone: (651) 675.5675 t
Fax: (651) 675-5694 1 Staff:
t
2413 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Ze [ 1 Site Address: 3g . is ► 9 - j„f W I"n CU~,.4! caG N& Unit
Name: ~ R.fn Y Q 'T'-3J4'3 pr~'b, ~C.,.hone: (or> i 46 Z - 14o
Resident!
Owner Address i City % Zip: L e~ E'K oo MA.) ; S1 W
Applicant Is: Omer Contractor
Type of Work Description of work: -Re- -Q'I 0 V
Construction Cost: ~l y -5 Multi-Family Building: (Yes i No )
Company: Wm:= 1T+- TV10 A0 1, Contact: u R . „ e xn a t
Contractor Address: CZv City:
State: K( Zip: 52'2-Z,3 Phone: to I Z -2-10 ) L(, License y; 7 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 utiltty damage. Call 48 hours
betoio you ntend to dig to receive locates of underg{owid utilities
I hereby ack mviedge that this inforriaton is complete and accurate that the work will be in conformance with the ordinances and codes of the City of
1- agan Mall I undo sland this is not a ponnil, rot only an application for a permit: and work is nat to start without a permit. tnat the. work wl 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 Cade must be completed within 180
days of permit issuance. J^#
x `1 )i i I t R%\A IP'4-v 6d`.~ x ti
Applicant's P ' led Name Applicant's ignature