1742 Bluebill Dr
Use BLUE or BLACK Ink
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I For Office Use I
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Permit City of Ea~a I I Permit Fee: -7z-/, -7
I
3830 Pilot Knob Road l
Eagan MN 55122 g Date Received: v
Phone: (651) 675-5675 i:. ED l
I Staff: I
Fax: (651) 675-5694 APR L 0 2012 1
2012 RESIDENTIAL BUILDING PERMIT APPLICATION C~
Date: Site Address: Unit
Name: At, S Phone:
RESIDENT /
OWNER Address/City/Zip: / `1a~ 'LJ1~ 0 ( Ce n,N S5/I?
Applicant is: Owner A Contractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes / No )
Company: (a w ~T ~Yci7 Gf / ~t/Lt/i Contact:
017
City: /Vll5 6,5
CONTRACTOR Address: /
-3 7 - /S,r0
Stater Zip: Phone: Y
License I6 CJ 0 V c( I E& 0 Lead Certificate 7
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 mon the City of Eagan issued a permit fora 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.aoaherstateonecall.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 22~l
Applicant's Printed Name p icant's Signatu
Page 1 of 3
r 7 `7 , DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace Porch (3-Season) _ Storm Damage
Single Family Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi D
eck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of&A`Plex _ Lower Level Pool _ Miscellaneous
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
Valuation Occupancy It 27 1 V MCES System
Plan Review CAde Edition e p SAC Units
(25% 100%) grkf Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction "!r Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) _je~ Final / No C.O. Required
Foundation HVAC - Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: `Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock / Erosion Control
Reviewed By: :6--p t t , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
it
A- t13~ 0 t~l 4a , 1~l4 4 v-0, V'_' tt D_Y_
~ Use BLUE or BLACK Ink
For Office Use I
1
Permit r 3~ ~I
411100 I
City of Ea a~ I Permit Fee: -1aa. 7S j
3830 Pilot Knob Road I 1
Eagan MN 55122 I Date Received: 2-~ !
Phone: (651) 675-5675 Q.n_
Fax: (651) 675-5694 1 Staff -67~-GZ-
it i3 L
2013 RESIDENTIAL BUILDINGPERMIT APPLICATION,
Date: Site Address: 173$ I ,7q(7 17Na 1-7444 JQbit~ ut Unit
Name: Phone;
Resident!
Owner Address f City f Zip[
l
y Applicant is: Owner Contractor
t i
I Description of work: Ck {
Type of Work I
Construction Cost t Muhl-Family Building: (Yes f No )
Company:C ~t+~{r~ 42 d.QJ° '~nytc~ra°y Contact
d
;Address: <rc.u. ~r . City:
Contractor {
State: ()I A) Zip: Phone:
License f6c <)q(y b q 5 Lead Certificate f) PT - o~UC1a'? °
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 plait 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
I the Information may be classified as non-public if you provide specific reasons that would permit the City to
conclude thaf they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for urctection against underground utility damage. Cali 48 hours
before you intend to dig to receive locates of underground utilities.
I hereby acknowledge that this information is complete and accurate; that the work vritl he 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 penn t, wid 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 mast be completed within 180
days of permit issuance.
x o - c_k t x
Applicant's Printed Name Applicant's Signature
Page 1 of 3