4232 Meghan LaneCity of Eapll
Date:
3830 Pilot Knob Road
Eagan MN 55122 LE' / �/��
Phone: (651) 675 -567 M
Fax: (651) 675 -5694 N Z 4 1 ®�?
2011 RESIDENTIAL BUIL
Address: 1
Company: M1 S
Address: 1 `I 5 (bt.* i4-4-.1 ftr4 33
State: .Vti \) Zip: .S S Phone:
License #: (1 1
ING PERMIT APPLICATION
Description of work: CA 1 ) rr�;c t, \VlL SIC`I►'t�j J� �J�C,tF l2Pr 0014 -s
Construction Cost: (IO O Multi- Family Building: (Yes Y / No )
Lead Certificate #:
t -i- S oi 1 - l-f 0
If the project is exempt from lead certific tion, please explain why: (see Page 3 for additional information)
CAL( / /9qZ
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:
Mechanical Contractor:
Sewer & Water Contractor:
• NOTE Plans and supporting docu that y sub mit are considered t be public information Portions of
t �nformat�on may: be classified as non public �f you provftle specific reasons that would permi ir +�
conclude .tha't:"they a 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.qopherstateonecall.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.
X hi
Applicant's Printed Name
x
n• ode st be completed within 180
aA f
nu re
pplican
n
Phone:
Phone:
Phone:
For Office Use
Permit #:
Date Received: / ✓ / v /
Permit Fee:
Staff:
Contact l i LhS
City: )0. Or i& ood
Use BLUE or BLACK Ink
Unit #:
Page 1 of 3
21 D ON T WRITE BELOW THIS LINE
5
SUB TYPES
Foundation
f, Single Family
Multi
01 of Plex
Accessory Building
WORK TYPES
_ New / Interior Improvement
Addition _ Move Building
Alteration Fire Repair
Repair
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25 %_ 100% 1)
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Fireplace
Garage
Deck
Lower Level
I t d o
vM
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Porch (3- Season)
Porch (4- Season)
Pool
Porch (Screen /Gazebo /Pergola) Exterior Alteration (Multi)
Miscellaneous
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Roof: _Ice & Water Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Reviewed By:
Siding
Reroof
Windows
Egress Window
*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 ` 9,9s Se is Test _
Other: c5 (- ( <f c
Storm Damage
_ Exterior Alteration (Single Family)
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
Gas Line Air Test
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
L/ C (. 00
Page 2 of 3
Use BLUE or BLACK Ink
ADM- r - - - - - - - - - - - - - - - - -
I For Office Use I
non I I
~ Permit
City-of Ea I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 I Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: -I3 Site Address: ~TZI ''4 2 Yv"Lte,L, LiA Unit
Name: rUY t ~fX~ 9 Cr(cSY~ , rn~ S Phone:~),_2-&_7
Resident/ yZi~ ZZv L> - 4
Owner Address / City / Zip: JZ2Z -L17 ZI-4 -y7 7- C, -y7 7 SQ. )(KV,- IV_ V-1 LCI
Applicant is: Owner Contractor 1
Type of Work Description of work: ~R 1~ r~In~C
-
Construction Cosf"` J ocx-D Multi-Family Building: (Yes Y / No
Company: Contact: t
t-~
Contractor Address: j~ S ('2~uv1~ r 1 33 City: 0VU-)OO
State.VW Zip: ~ 3_~- "C' Phone:
~l_icense ~ (~'c ~ ~S ~ Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
MCC-
i%► G 7
COMPLETE THI AREA ONLY IF CONSTRUCTING A NEW BUILDING
E
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
f 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.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. A
x
Applicant's Printed Name pp mature
Page 1 of 3