4518 Mallard Tr S
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,ilk I For Office Use
JA- Q I
I Permit
14
City of Ea
I Permit Fee: o'~ I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 1-2, 1
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Unit
Name: 1-1Z20~`~+Z c Phone:
Resident/
Owner Address / City / Zip: J ° ~F r~Cc~~ ~v r ~~y~y}1
Applicant is: Owner I- Contractor
Type of Work Description of work: h-•G ro0
Construction Cost: 000 CIO Multi-Family Building: (Yes / No )
Company: ~ ~ l~.S Contact: let c.kC0
It,) 01
Address: 3,Ou %Av o~ 4` it :
Contractor y ~C
vState: ZiP Phone:
: all
License SC 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: 4
Licensed Plumber: I
I Phone:
Mechanical Contractor: Phone:
i
Sewer & Water Contractor: Phone:
a NOTE: Plans and supporting documents that you submit- are considered to be public -information- . Po-rtions ofA
the information may be classified as non-public if you provide specific reasons that would permit the City to
i 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 b
be completed within 180
days of permit issuance.
al i
x Z~ , As C) x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
i
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA121632
Date Issued:04/10/2014
Permit Category:ePermit
Site Address: 4518 Mallard Tr S
Lot:28 Block: 03 Addition: Thomas Lake Woods
PID:10-76100-03-280
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Calvin A Sorensen
4518 Mallard Tr S
Eagan MN 55122
(651) 683-9417
Sandau Construction
9925 Lyndale Avenue South
Bloomington MN 55420
(952) 403-9100
Applicant/Permitee: Signature Issued By: Signature