4200 Hilltop Laner
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Licensed Plumber:
City of Ea�all
Sewer & Water Contractor:
Exterior wor
days of
Applicant's Printed Name
Applicant is:
Owner Contractor
coH5(0
Use BLUE or BLACK Ink
For Office Use
Permit #: /
Permit Fee:
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION CI16
/0 - ! 2 // Site Address: t1t 0 0 /it I i for /ate
Name: /14_4-1_, IS err fCuni (ASvi PR S ■JP 4(57- a Cis
Address / City / Zip: "/ 02 d 0 l :Th- D j 14. ✓L
Contact: r f T
City: Ea.� ( 11
If the p t is exem t rom lead certification, please explain why: (see Page 3 for additional information)
(t q I C
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?
Unit #:
Description of work: P-41_, � / C €_ e--)C
Construction Cost: q coo Multi - Family Building: (Yes
Company: 1)e_-x + s /7C
Address: 7375 13044 5 tJ
State: i Zip: J 1 0e / Phone: S/- 36 6
4 /c 2 7
License 4:02030 Lead Certificate #:
/ N
Yes No If yes, date and address of master plan:
Phone:
Mechanical Contractor: Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions
the information may be classified as non- public if you provide specific reasons that would permit t'` City
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.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.
thorized by a buildi . . permit issued in accordance with the Minnesota State Building Code must be completed within 180
Applicant's Signature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
• DO NOT WRITE BELOW THIS LINE
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
co Ili J ( 4 / .
Fireplace
Garage
y Deck
Lower Level
WORK TYPES
New
Addition Move Building
Alteration _ Fire Repair
Replace _ Repair
Retaining Wall
TOTAL
Porch (3- Season) _ Storm Damage
Exterior Alteration (Single Family)
Porch (Screen /Gazebo /Pergola) _ Exterior Alteration (Multi)
Pool Miscellaneous
REQUIRED INSPECTIONS
Footings (New Building)
)C Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Framing
Fireplace: Rough In Air Test Final
Insulation
Sheathing
Sheetrock
Reviewed By:
Porch (4- Season)
Interior Improvement _ Siding _ Demolish Building*
Reroof Demolish Interior
Windows Demolish Foundation
Egress Window _ Water Damage
*Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy
Plan Review Code Edition
(25% 100% " ) Zoning
Census Code Stories
# of Units Square Feet
# of Buildings Length
Type of Construction ( Width
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 _Final
Siding: _Stucco Lath Stone Lath _Brick
Windows
Retaining Wall: Footings • Backfill _ Final
Radon Control
Erosion Control
Building Inspector
Page 2 of 3
CITY ,al P "t N- i ' WATER SERVICE PERMIT
379i'Cnob :Rood PERMIT NO.:
MN 53122 DATE: j
Zoning ' '
No. of Units:
Owner: T'# tt€.°;,( ?T . '.er ? .ruction
Address: c'; :' _ irrtOt'" Lap
Plumber: 1
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee: 1'..1.0 pf
1 to comply with the City of Eagan Surcharge: ' „+
Misc. Charges: 5494:130 9. imt - FS
Total:
By Date Paid:
Date of Insp.: _,g - 2,_, Insp.:
CITY OF (AGAN SEINER SERMI E PERMIT
37 S IWI Knob Road PERMIT NO.: 5239
n, MK 55122 bATE: 8 17/82
Zoning: RIv No. of Units: p ex •
Owner. Develop 6Const� _
Address: 4188, 41 6, 4190 419 , 4194, 419 , 4198,
Site Add
ress& 200 H lltop 14
Plumber: Wenzel Mechanicp.l. " i s
6/17/82 30582 300. poi
1 agree to comply with the City of Eagan Connection Chisyg .1.4:9 •00 hd ,
Ord,ess. Account Depos ,` y -�
Permit Fee: 10 . 60 p
. Surcharge: . 50 pd
..W
By / Misc. Charges:
D. 1, . / .. Total: 1
Insp.: , . /7 �+ Date Paid: 1
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