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For Office Use I
E
o g¢ Permit it: /S 7 -1
�� ..�0 AGA NRECIE�/ Permit Fee: /
:2,2, &CA
JUL - G Date Received: �-/ --/O j
'
3830 PILOT KNOB ROAD!EAGAN,MN 55122-1810 i
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff I
buildinoinsoections@citvofeagan.cam L vv I
2018 RESIDENTIAL BJILDING PERMIT APPLICATION
K E Way
Date: i%—1(6 Site Address LP&5 4 --- ,_. Unit#:
I Name:
Residerttl l nal- /.A. _ Phone:
Owner Address/City/Zip: Nf'o~JN !-.= -`Di"
j.—:-.3----
Applicant is: Owner X Contractor
Type of WorkDescription of work: g f VY7OVC &-V\G/ Yep la C.C.-Prole& -I ‘--
'
Construction Cost: S5,11+0,�=
' Multi-Family Building:(Yes /No
-3-1-M -
CoConc - a-4-W&t rproo ifl�{ �.. ._
Company: J Contact:Alar IC Se.'"rood r
x Address: a 3 5 P o�. j I y ct
l b51 city: RoSeDl.l of
Contractor
State:POI Zip:55D( Phone: 3ACi-'77 41 Email:Ja.rid m C4..nci(,VI cLD) • ,
License#: v CC I CL-1+ COrI'fil' Lead Certificate# Q I-y 3G3q-/3 'Dd S to/
If the project is exempt from lead certification,please explain why:
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:
Fire Suppression Contractor: Phone:
NOTE:Plans ands
.h,
supporting documents that you submit are..,,. to ho pPublicbrfemrraticnPortions of the Wormation maybe
classified as no ub#c If a reasons that would the , to conclude that, ate trade secrets.
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,000herstateonecall.orc
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 approv. plans.
XS cin m �C--h ro colt-r-- 410 i... / 1 4.., ,i,
Applicant's Printed Name
Applic is Signature
DO NOT WRITE BELOW THIS LINE 4/66C7 Peri4De Q'PLI /5(J 7q
SUB TYPE
— Foundation _ Fireplace Porch (3-Season) _ Exterior Alteration (Single Family)
Single Family Garage Porch(4-Season) Exterior Alteration (Multi)
k6 Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
01 of_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
43
Valuation Occupancy MCES System
Plan Review (4Code Edition ...L .ei–Ar, SAC Units
(25%_ 100% ) Zonin r t
g City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction to Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) X 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: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge A Ifrad
Plan Review (`'
MCES SAC
3
City SAC 61119
UtilityConnection Charge harge
S&W Permit& Surcharge
Treatment Plant
Copies
TOTAL
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