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4461 Clover Lane - Unit BCity of Eaaaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION is Signatur Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: /2 j J CALL BEFOR 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.000herstateonecail.ora 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 • it issuance. _ Page 1 of 3 Site Address L HLQ k CAN 0-)1 L Y 1 Unit #: Date: 0 k A� Name: '° � LA-Yre.., Phone: � Address / City / Zip: . A L \� k C7 CV , \J e.,.)( (--V Applicant is Owner Contractor .. .. we r .. ` .... + Description of work: Re-butt l d- +e� S-I-j ( dieCI Construction Cosftt S C Multi- Family Building: (Yes 4._ / No ) r < *r Company: G I34 30l, Contact: -, O ° t r , ` 4a-4 I �Itp 5 & Cne Va VP -1V City: 00a le- Address: Cit State: (' `I v Zip: / a-+ Phone: 6 31-717- 3 y 3 '�I License #: 3 L ead Certificate # J' _ If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) is , ; ill /A/ / 9kir In the last 12 months, _Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING N has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: ;e f *p yy a _ Phone: Phone: Phone: �y 'y e s a♦ ! $ ..i.�_ a �a� s da�tf} City of Eaaaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION is Signatur Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: /2 j J CALL BEFOR 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.000herstateonecail.ora 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 • it issuance. _ Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES _ New _ Interior Improvement Addition _ Move Building Alteration _ Fire Repair Replace _ Repair _ Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% // ) Census Code #of Units # of Buildings Type of Construction Fireplace _ Garage z e Deck Lower Level Gr6 REQUIRED INSPECTIONS Footings (New Building) J Footings (Deck) Footings(Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In Air Test __ Final Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S &W Permit & Surcharge Treatment Plant Copies AG otl TOTAL DO NOT WRITE BELOW THIS LINE ge -a, C( v &-v. L l � (j f & 73 — 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 PI) gO /D MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers /D 650 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous — Demolish Building* _ Demolish Interior Demolish Foundation _ Water Damage *Demolition of entire building - give PCA handout to applicant Meter Size: Final / C.O. Required - Final / No C:O.Requiretl HVAC _ Gas Service Test Gas Line Air Test Other: Pool: _Footings Air /Gas Tests __Final Siding: _Stucco Lath _Stone Lath Brick Windows Retaining Wall: _ Footings a Backfill Final Radon Control Erosion Control , Building Inspector Page 2 of 3 ROBE A- t CONSULTING ENGINEERS E NGINEERING PLANNERS and LAND SURVEYORS COMPANY INC. EAST 1461A STREET, BURNSVILLE, MINNESOTA 55337 PH 432 - 3000 9 •tr'vey l igg i ls f e_ r LOTS !, 2, 3, AND 4, Bloc < 1, EDEIV AOD/T /oN • DAKOTA CoUN`TY MINNE, t . REVIL7WED NJOR SCALE: r= 304 WALKING SURFACES GREATER TIIEN 30" ABOVE AREA BELOW REQUIRE GUARDRAILS MINIMUM 36" IN HEIGHT AND DESIGNED SUCH THAT A 4" SPHERE WILL NOT PASS THROUGH <90. r� •cd) 1 ,\ i -∎ \ \ Ns\ ....w.........- r c (Via) DENOTES cX /ST /NE 4. - ' \ �. ELE VAT /ON •I...._ s ( /o.o) DENOT 5 PROPasE0 / � ,4. ' ELEVAT /aN ' --- INDICATES D /RECT /ON OF SURFACE DRA/I1A ./M / 6HED 648A 6E ,CI ODg tLEVATloN 714-. 30' FRoNT SulL0/A/ S6TetACK LI BY: DATE: 7`/' - 1J 89 58' L L I N Gi 97.27 0'r ^7 DRA 1 NAGE AND r , N a 4 1 1 51 Y hereby certify that this is a true and correct representation of a tract of land as shown'and described hereon.. As prepared by me on this / �.. L day of SEigTE>nsee , 19 ft5 . .� - Minn. Reg. No. /Gd CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. D. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: _ No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.• Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Dote Paid: Date of Insp.: Insp.: // gam CITY OF.EAGAN SEWER SERVICE PERMIT 3830 Pifot Knob Road P. Q. Box 21199 PERMIT NO.• Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Dote of Insp.: _ Total: Insp.• Dote Paid: From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:30 #582 P.020/079 Use BLUE or BLACK Ink ForOfflceUse---------- I j Permit 114~ 1 City of Cagan I (J 1J Permit Fee: 3830 Pilot Knob Road C.~ 2 Eagan MN 55122 Date Received: l L1 Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 41512213 Site Address:'iy59i44595,4401,441oIP5 CIDYev LWf,, Unit Resident/ Name: EMI ftDft CN * (*`ili W WMDQh_ J- Phone: Owner Address If City / zip: WH;5? UhA Wit IlMW, Witt 20d, MN %NS Applicant is: Owner Contractor Type of Work Description of work: Rat Off aild Yt-npf Construction Cost Multi-Family Building: (Yes X / No ) C Company:A11ft (zles 1►U(i 1elyi MGhU mbit ~ontact: BaS Ie d y -t-~/°~ 2 a t Address: 5'y5 lWuslylal S►'I,GI * `103 City: Contractor State: q Phone: a5Z-NI-114514 MN Zip: 5535 MFtT- License 5GIV3151S Lead Certificate M 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: I 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 r, ~~F~_` y ~mTt{~ T conclude that they are trade secrets - ry r~y= 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.ooi3herstateonecall.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_ (jut I l/tl~lA~ x ~f Applicant's Printed Name Ap6lic nt's Signature L Page 1 of 3 -------------- � For Office Use 1 Building Permit #: %I � � / i %-�% ���' EAGAN S&WPermit#: I Permit Fee: ` - 0 I I ^1 1 I I Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1 I 1 (651) 675-5675 �FAX: (651) 675-5694 I I Date Issued: I buildinginspections(cDcityofeagan.com I---------------------� RESIDENTIAL BUILDING PERMIT APPLICATION Date:. �"I LZLL, Site Address: Unit #: Applicant is: ❑ Owner JELContractor Name: ��;Ce t/� —t b vv.e- C> V_ AS'S t, C? 1, a-4 i b U-,., Homeowner Address: q` 5-q 6/B u q C+� 1 r city: �aQ 0. V, r State:fm Wip: Phone:: Email: Description of work: 2 Q is C:,,- Type of Q i Work Construction Cost l Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan Thy Building Address City:�GcP�G��ti �� Contractor / State: Zip: 5-3,1- V P h o n e 6 t z-i2115 Emaill aMQ �C �,�e��CSN� MQ°` License #: � D Expiration Date: Sewer & Company: Water Contractor Address: Required for State: Zip: Phone: Contact: Email: City: new construction License iration Date. `*I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications. 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. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility damage. Contact Gopher State One Call 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 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. Applicant's Printed Name A licant's Signature