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