4340 Meghan LaneCity of Eapll
Date:
3830 Pilot Knob Road
Eagan MN 55122 RECEIVED Date Received:
Phone: (651) 675 -5675 Staff:
Fax: (651) 675 -5694 JAN 2 4 2012
2011 RESIDENTIAL BUIL ING PERMIT APPLICATION
/ to Address: l - - -573 D r W i ig'q tio
Name: r.A- K- t Du n 0 G3 G"'.. k0j11 .( i
Mechanical Contractor:
Sewer & Water Contractor:
Address / City / Zip:
Applicant is: Owner Contractor
Description of work: cy„ k CA 1 rrx„c k' d (-'k V1 _j I SI CAI pit, cF Pr; lll`n1.s �k
Construction Cost: (90 0 Multi- Family Building: (Yes Y / No )
Company: MV Yt -�j L-L L,
Address: l `I 50
State: W Zip: Phone:
License #: 1--- `7 Lead Certificate #:
If the project is exempt from lead certific tion, please explain why: (see Page 3 for additional information)
at/ /9
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:
Applicant's Printed Name
Contact I�ckf�l C:S
City: Ai 0 f' 10 ° 0
Co c a'1 (- - 44 0
Phone:
Phone:
Phone:
NOTE . Plans and supporting documents that you submit are considered to be public information
the information ►nay; be classified as non public if you provide specific reasons that would permit
conclude that they are tradesecrets
Permit #:
Phone:
Use BLUE or BLACK Ink
For Office Use
102$:
Permit Fee:
Unit #:
ode st be completed within 180
pplican '1'ture
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.
Page 1 of 3
,
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25 %_ 100% V )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
V c,
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
wt hay
J DO NOT WRITE BELOW THIS LINE
TOTAL
Porch (3- Season) _ Storm Damage
— Porch (4- Season) _ Exterior Alteration (Single Family)
— Porch (Screen /Gazebo /Pergola) _ Exterior Alteration (Multi)
Pool Miscellaneous
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Roof: _Ice & Water _Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Siding
Reroof
Windows
Egress Window
3
Reviewed By: , Building Inspector
7o o
rrAvr5
5 70f-7) 4 --
atim
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*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 s Servic Test ( Gas Line Air Test
Other: be (
Pool: _Footings _Air /Gas Tests _Final
• Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings Backfill _ Final
Radon Control
Erosion Control
L' Go G7c.)
i pvir 1-0
Page 2 of 3
Use BLUE or BLACK Ink
_ _ _ _ - _ _ _ _ - _ _ -
I For Office Usej I
1 Permit
City of Ean~fl I 1531.
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: l
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: jQ -Q I -Site Address: 330 3 V- Unit
Name: ~A;r(f~AVt.~ ~C~Z~ I Cc c as Phone:W);~-&_7D -(2 I
Resident/ y33~ 1, 3`I - t(39
Owner Address / City TZip: -x(-13-1
-~j33(o -~I.33-~ 3 yo h L~
Applicant is: Owner -L Contractor AI&O
Description of work: R_c'~
Type of Work
Construction Cosi Multi-Family Building: (Yes Y / No
{ Company: _ L" e S ~ Contacfi J-t2d e~-(L~~
Contractor Address: (~~y-t~ Rpj' City: N_ 00
State:V'V'Jkj zip: Phone: tZ--'t ~-7~tv
License ( ('o J '~5 Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I <
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:
6
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 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.oopherstateonecall.org
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 - PP mature
Page 1 of 3