4216 Meghan LaneRESIDENT
OWNE R',
CONTRACTOR
Mechanical Contractor:
City of Etall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: � � to Addre ��� /j p`pt t
NOTE Plans -and supporting documents that you sub mit are considered to b publ inf Port ions,o
the information maybe classified as non public if you provide specrfi reasons °that would permit the City to
conclude„that the are;:trade secrets
Name: C I ((z (ZOLOCiocL IC..,"c3c' L`flor Phone:
Address / City / Zip:
Applicant is:
Sewer & Water Contractor:
RECEIVED
JAN 242012
Owner Contractor
Description of work: Rev fat
l 11 )4inc,c J t a�v� st�l l2ep/. a /20
Construction Cost: CIO C' °U Multi - Family Building: (Yes Y / No )
Company: tv' J P S r4.. UL,
Address: 1 1S4 (Ou✓t j i City: K) 0r i.ti
State: I \ ' Zip: . 5" -- (-0 C d Phone:
License #: was, co 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:
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Buil
days of permit issuance.
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Applicant's Printed Name
x
pp
lean
Phone:
Phone:
Phone:
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
Co t c aL 1 `7 4-1 0
A AvvPoik-
.� ture
Use BLUE or BLACK Ink
Unit #:
Contact 7:\ r 1�' - kf`l
in ode d st be completed within 180
Page 1 of 3
SUB TYPES
Foundation Fireplace
_ Single Family Garage
Multi Deck
01 of _ Plex Lower Level
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25 %_ 100% y )
Census Code
# of Units
# of Buildings
Type of Construction
Interior Improvement
Move Building
Fire Repair
Repair
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water Final
Framing
Fireplace: _Rough In _Air Test Final
Insulation
Sheathing
Sheetrock
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
DO NOT WRITE BELOW THIS LINE
TOTAL
_ Porch (3- Season)
Porch (4- Season)
Porch (Screen /Gazebo /Pergola)
Pool
F
12-
Siding
Reroof
Windows
Egress Window
*Demolition of entire building —
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Seryice Test Gas Line Air Test
(, Other: %C r c
1 Pool: _ Footings Air/Gas Tests _Final
x Siding: _Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: Footings _ Backfill Final
Radon Control
Erosion Control
, Building Inspector
P644471
,. r
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
give PCA handout to applicant
Page 2 of 3
Use BLUE or BLACK Ink
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -
I
I For Office Use G
Permit fti J 1
,ilk I
City of E1 0-7
1 Permit Fee: I
3830 Pilot Knob Road i n 1
Eagan MN 55122 Date Received:
Lx /0
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: 1
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: _d) -Q 1-1 Site Address: to-2 _ co il k,,, Unit M
Name: Q L?AfJr~ ~fx~ I Can -APA 2Ad.12S PhoneW-(O_7y -(a
Resident/ L_Lt Zc,y - ~lZ I u ( zl
Owner Address City / Zipy: Z-CCo - yZ U - y a1t~ ' f 2I z= 6T c v L
Applicant is: Owner Contractor &/Lw
Type of Work Description of work: adQ-
Ype f
Construction Cosh` 3 S_ 0( Multi-Family Building: (Yes Y / No
Company: OJYI~k Contacfi.7n
Contractor Address: S-0 S_ ('~Va ~ M, 33 City: I~ WOCY
State:Uw Zip: 'C Phone: lZ- 1 I L 77L9)
License Lead Certificate
t
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
x f- G C 7
COMPLETE THI AREA ONLY IF CONSTRUCTING A NEW BUILDING
I
i 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:
In....
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 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.
x 'c t-1 x ~
Applicant's Printed Name PP r 'mature
Page 1 of 3