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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