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4409 Cinnamon Ridge Cir02/16/2004 19:39 6514362488 GRINCKY CC City of Eaaaxi 3630 Pilot Knob Road Eagan MN 55122 Phone: (651) 675.5676 Fax: (651) 675-5694 PAGE 01 Use BLUE or BLACK Ink For Office Uso 9t-°° Permit Permit Fee: Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Cc, J Unit RESIDENT / OWNER Name: 9 Phone: Address I City / Zip: 6/VC) C) 7 9 N0 7 C\.r•t\ o..M. O,9, i •ti (' . Applicant is: Owner k Contractor TYPE OF WORK Description of work �,�•kn�� C» `l..a-��J` Construction Cost Mufti -Family Building: (Yes / No ) Company: � f"`o:C%t_rclt`*a\,..r.'N Contact ,N. Address: \... ,0�1 �QCC 6\4%-‘,%��-�` city:_,.. 'S-1'N.L\, State: t.4-- Zip; S i Rhone: LS \- SOV -1.2.12,, ',.7 License #: ...";71—.063 `Z�:' e' Lead Certificate*: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, 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: ^Yes 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 chat they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (551) 464.0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gonherstateonecall.om I hereby acknowledge that this Information is complete end accurate; that the work will be In conformance with the ordinances and codes of the City of Eagan; that I understand this la 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 iseuod In accordance with the Minnesota Stab Building Code must be completed within 180 days of permit Issuance. x 1�\t,\<, Applicant's Printed Name x AppllcanYs Signature Page 1 of 3 a.. a 7 EY r.,-A—il. 3830 Pilot Knob Road WATER SkliVICE PERMIT P. O. Box 21199 Egan, MN 55121 PERMIT NO.: DATE: Zoning: Owner. __ _ No. of Units: Address: Site Address: Plumber: Meter No.: _ _ Size: Connection Charge: Reader No.: ____�__ Account Deposit 1 agree to comply with the City of Eagan Permit Fee: Ordinances, Surcharge: ___ Misc. Charges: ___ By ‘ l: _ +— Date of Ins ,� Date Paid: p T ` Insp.. CITY OF EAGAN SEWER SERVICE PERMIT 3830 Knob Road Ps O. Box 21199 PERMIT NO.: Eagan, MN 55121 Zonin DATE: N Owner: o. of Units: Address: Site Address: Plumber: 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: By Surcharge: Date of Insp.: Misc. Charges: Insp.: - �; Total: Dote Paid: Oct.18, 2013 8:58AM Crest Exteriors 651-463-8095 P. 8 Use BLUE or BLACK Ink For office Use j off t I ; Permit I City of Evan I permit Fee: I 3630 Pilot Knob Road I Eagan MN 66122 1 vale Received: Phone: (661) 676-5676 I Stall: I Fax: (661) 6764694 I 2013 RESIDENTI/A~/L1~3UILDING PERMIT APPLICATION Date: '3 Site Address: `1 v 1 Unit M. Name: -TP n'u1 ~At cAt Jl )1 L Phone: :;Res tlAD net' " Address/ City/ Zlp: L4qocl m Ma Applicant is; -Owner V Contractor ' Description of work: Construction Cost Multi-Famlly Building: (Yes l No MIX, `(1 ~fl `(10.`C~~ Contact l.Kiy`r v Company: /L e~ m " Address: 712- Cl C; S y l ~s Phone. ~9 ?x% State:1 Zlp: y Z~0 2 V 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: o e s of. TE _ • U.s t. ~~x ' P G'oi o NO ' s a d!s' uppttl eed to" ftst. lnform~ l~fo 1 aycjess~ d I /P lit .r ,.~,x: s<r •.~,?=a-^x~ . r. seers , %T~.; t.. 6 ~are~ a co CALL 13EFOREYOU DIG, Call Gopher State One Call at (651) 464-0002 for protectlon against underground ulllity, damage. Call 48 hours before you Intend to dig to receive locales of underground utilities, www.qopherstaLconecall.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 appllcalion for a permit, and work Is not to start without a permll; that the work will be In accordance with the approved plan in the case of work which requires a review and approval of plans. Exterlorwork authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 1130 days of permit Issuance. x x Applicant's Printed Name Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink x For Office Use 1 J a~~r' n j Permit I ` City of Ra11 I ~ Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 I Date Received: I I Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff- 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3 h Site Address: Ti D ~~iL"✓~trnct~t~ f~% i✓ nit fName: Phone: .f ePG Resident/ Owner Address / City / Zip: 0,-" Applicant is: Owner Contractor Description of work: 'A-", Type of Work Construction Cost: Multi-Family Building: (Yes / No ) i Company: iv C dot t KC,vIt ers ontact: XIF Contractor Address:_; City: State: JW^J Zip: 2---'*)- Phone: f - License ~ 6 4.1 Lead Cert ificate IVY - 3 7. 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: WO-TE: 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 the 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 authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. Applicant's Printed Name ~ppricant' Signature Page 1 of 3 For Office Use OCT0 2018 '7 /�/ °�' i a '' Permit ft: >/ ''1 W/O �-V� s/ ,'� .... Permit Fee: /35i Date Received: (PI 1 3830 PILOT KNOB ROAD 1 EAGAN,MN 55122-1810 (651)675-56751 TDD:(651)454-65351 FAX:(651)675-5694 Staff: �J buildinginspectionstacityofeagan.com L, 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: kO lc' i Site Address: , A � t n u.,v - :1 t,, _ , Unit#: Name: i„ `:. 'y Wit,:.vot V 4 <:... Phone: -i t . 5. . Asx.:. ..% Resident! Owner Address/City/Zip: . °:=Cil ( ,,(Aa<,e ., s .;,-', r . ".i,( , i Applicant is Owner ` - Contractor Type of Work Description of work: ,a :a 1rw,_t '-; ?:, _ T 4 s( , *"s tk X .k ' C r:: r i 1c :, CA" Construction Cost: i 1 1 Multi-Family Building (Yes ‘7No ) i Company: A rev-.f t f.(:a s ik:t° V <�/ ''"'".5 Contact: ci ( : Contractor `Address: z�. la i t t-=0) v i Lk.) f:)C City: ''} .`: r'c State: Zip; '(e,3 phone: :: 35,, 3j mail: yv :. C, rv,,-,r;,c:r-s - , .- A- �,su r ,---, License# '"`e' -1:39.5 Lead Certificate* T 1C:> t k If the project is exempt from lead certification, please explain catty: / ‘c\) I 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? 1 P Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: 1 1 Sewer&Water Contractor: Phone: t 1 Fire Suppression Contractor: Phone: 1 , NOTE:Plans and supporting documents that you submit are considered to be public Information. Portions of the information may be ) . classified as non ubilc If ou provide specific reasons that would permit the Cityto conclude that theyare trade secrets. i You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeaoan.comisubscribe. 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. 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.000herstateonecalLorq 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. X 1.'.\r t y It A \- 'C )i x t. '.,, � ;t1,,,,,,, ,,` Applicant's Pinted Name Applicant's Sture k{t-foci @-,0 na tivv 6),1 ( acj Q CCL ('J File . DO NOT WRITE BELOW THIS LINE 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 of71 Piex 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 / el Valuation 0 Occupancy ..PAL---"9"' MCES System Plan Review Code Edition „ A ) SAC Units (25%_100%0') Zoning 40` City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Y '✓ Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) )( Final/No C.O.Required Foundation Foundation Before Backfill ' HVAC Gas Service Test Gas Line Air Test Hood Roof: Ice&Water ^_Final Pool:_Footings Air/Gas Tests Final Framing 30 Minutes 1 Hour )( Drain Tile Fireplace: Rough In _Air Test __.Final Siding: Stucco Lath _Stone Lath _Brick—EFIS Insulation Windows Sheathing Retaining Wall:_Footings`Backfill^Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In Final Braced Walls Erosion Control ........................... Shower Pan Other: Reviewed By: 11,/ , Building Inspector RESIDENTIAL FEES Base Fee al Surcharge 11 10, Plan Review ` MCES SAC 0 ve i 1...# City SAC "*.'''') 1 Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies / TOTAL Page 2 of 3