3660 Denmark AveJul 0912 10:50a Gates General Contractors 7634387710 p.4
1 , 11 ' City of EaaII
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
RESIDENT /
OWNER Address / City / Zip: d 0. 1 o 1( 2—/ C G (
Applicant is: Owner contractor
CONTRACTOR
Permit #:
For Office Use
Permit Fee:
Use BLUE or BLACK Ink
Dale Received;
Staff:
c�
State: 01 Ai Zip: 5 y Phone: 6' (Z 7? 3 -6'T yr"
License #: G 7 5 3 Lead Certificate #: /' c/ Z 3 5
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7 / i /i z — Site Address: 3 36G o, 3G 6 cN►�r 47th /t/c .Unit #: Q
Name: /1 2 4 , 71; G��i�t 071-e_ .:_,. .. ... ,,. Phone: t/ 7 - //g
TYPE OF WORK
Description of work r r
Construction Cost: / ! / c9 / Multi- Family Building; (Yes / No
Company: Ui¢?S� 6' e ' AlC_Contact:
Address: 35 V s13 vs (--ef `/i A- City: t>/tfm0-(1/4
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.I v ww.gopherstateonecall..orn l
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:
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 they are trade secrets.
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.
/ 1.t/C v5 x
Applicant's Printed Nam App ant's Signature
Page 1 of 3
/
/
For Office Use
a
ti ti `� Permit#: -
----- C16,/
,,,,,,, %„ .P .0 E AGAN
`'"`` 4.,,,A' Permit Fee: �67:5q' i
Date Received: G/-F /
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: ,
buildinginspectionsCo�citvofeacian.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
PLICATION
Date: Site Address: 5� 'Z.10 )0/c-17.71-1/9-ie 4Tl "- Unit#:
II Name: Phone:
Resident/ t i
Owner I Address/City/Zip:
I Applicant is: Owner Contractor ;
.ara�.,,-....._.,.�..., ...�.,.�.._...� Description ofwork: /v�� �� -� Ca NG�-P�r° S�� �'� ,�����,r..,..�.�.�,a� _�
Type of Work i
Construction Cost: 2 , G o D — _ _Multi-Family Building: (Yes /No ) ;
Company .v�° vSS�o( ' 6oHcvc/ �4iiL ntact .M w _ ie_/�_.v._ .
d
/ 1 a✓t A/ a_
/ 2 / rt/ ,Ini; 7c//.
Contractor Address: 903 6 ` l �/ r2 c /=�L�ity: ,[� (J D v� / `
State:MN Zip:55/3/ Phone:/ 93-) - 3 9-`14-' Qo G, )e�ij G! / (--07?- -
t I License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why: I
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has 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:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the-in-formation maybe
classified as non publicou provide specific reasons that would permit the Cit to conclude that tlay are trade secrets. _ _ i
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaoan.com/subscribe.
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.
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.gooherstateonecall.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 lans.
x &t,P 1✓c ✓ x .,..e.;_e___ ___,--
Applicanfb'Printed Name App icant's/Pnature
. / /,) ~fid ' / :".2 *
47
DO NOT WRITE BELOW THIS LINE (� l-
SUB TYPES
Foundation — Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
lc 01 of q Plex _ Lower Level _ Pool _ 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 Sp.,aet) , — Occupancy ".2 C ` 3 MCES System
Plan Review Code Edition YYW1 Z' / c SAC Units
(25%X 100% ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V.6 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) � Final/C.O. Required
Footings (Md#iau) a 57 QQ t Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
Roof: Ice&Water _Final Pool:_Footings Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test Final Siding: Stucco Lath _Stone Lath Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:—Footings_Backfill Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In Final
Braced Walls , Erosion Control
Shower Pan Other:
Reviewed By: / O rY1 pi; 1411/1- , 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