4312 Meghan LaneCity of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675 RECD': V r )
Fax: (651) 675 -5694
JAN 2 4 Lo,/,
Date:
Mechanical Contractor:
Sewer & Water Contractor:
Applicant is: Owner Contractor
Address: I S 0 S (en -*4Lj Q 33
State: VW Zip: c (o Phone: CO fy -Y ° ) -1 c- ty
License #: (Q 3CSd3 1
Lead Certificate #:
City: )._ t.ti)fk7c.V
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:
Phone:
Phone:
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2011 RESIDENTIAL BUIL ING PERMIT APPLICATION
/ Site Address: 14°7
c_:-. Ij IQ's borne
, \
Name: ■.__, N_ 2 (;)00(1 T o b .11.0r1
Phone:
If the project is exempt from mead certific tion, please explain why: (see Page 3 for additional information)
(/ /q
Unit #:
Address / City / Zip:
Description of work: „ es. kA CA I f)An G c L stcAi aep/6,a f2evPur`as ��CQ
Construction Cost: / (90 C Multi- Family Building: (Yes Y / No )
Company: MF L - Yl S tt- ContactTV eckri t :5
NOTE: Plans end supporting documents` that you submit are considered to be pub lic inform ation f
may
t he information be ast
cl as non publ ic if you provide specific reasons that would permit f
c they a "re 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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Buil , in • ' ode st be completed within 180
days / of permit issuance. 1 �, 1►®
x hii `� i �e c -�C rte. �j X _ffi
--
Applicant's Printed Name pp ican `Ifture
J
Page 1 of 3
SUB TYPES
Foundation Fireplace
Garage
Deck
Lower Level
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
/ Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
j� C( Z--ci kl �--
h DO NOT WRITE BELOW THIS LINE
(25 %_ 100% y.)
Census Code
# of Units
# of Buildings
Type of Construction
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
Interior Improvement
Move Building
Fire Repair
Repair
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
TOTAL
Porch (3- Season)
Porch (4- Season) _
Porch (Screen /Gazebo /Pergola) _
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
*Demolition of entire building - give PCA handout to applicant
J !I'/ t ./ gut) 7
Reviewed By: l , Building Inspector
HVAC _ as Servi Test Gas Line Air Test
Other: of (i &
Pool: _ Footings _ Air /Gas Tests _ Final
Siding: Stucco Lath _ Stone Lath _ Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
la 00(
v
ca)p7/4-
Meter Size:
Final / C.O. Required
Final / No C.O. Required
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Li 001)
/62,ng'
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Page 2 of 3
Use BLUE or BLACK Ink
r
For Office Usiieff I
1 I
Permit
City of Eano~fln 15U J oa
Permit Fee: I
3830 Pilot Knob Road I / I
Eagan MN 55122 Date Received: I ®~a~ r 17
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: jQ -Q 1-13 Site Address: '42- Ci V"-' q3 1-2- v'k LO Unit
I
Name: l 0. ~~k 1 C ~ ~QS Phone:l ),2--&_70 -(a
Resident/ ~zy~ ~3~0._ _ &~; ~32 _
Owner ddress / ity / Zip's Ua - Fs GI
~~vr
Applicant is: Owner _I_ Contractor
Type of Work Description of work:- t7 I~ )'0 f
Construction Cos A ; Multi-Family Building: (Yes X / No I-~
Company: Contactv 122 (LV>~J"
Contractor Address: '1 C;r~ I~o~' 33 City: ~WOCco
State-.VW Zip: Phone: _-74V
I License _c '~5 0'-~ ` Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
' _ 7
COMPLETE THI 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:
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:oopherstateonecall.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 mu t be completed within 180
days of permit issuance. I
x x
Applicant's Printed Name ature
Page 1 of 3