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For Office Use
®� Permit#: /50—7g... --
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E AGA N
RECIEVED Permit Fee: /�-�' 6 ,/
4'1
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 2118DReceived: �� f
JULuL w1Cii i
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: ./ I
buildinainspections(a�citvofeagan.c om L i
2018 RESIDENTIAL BUILDINP PERMIT APPLICATION
Date:7 /Cl/SSsite Address:`t�da `l/—,Q-,d jeCf i{{pt-
Unit#
Name: Phone:
Resident/
Owner i Address/City/zip:ti 0 y '/�- i� �d CI iri Dr
e.. 3
Applicant is: Owner contractor
Type of Work Description of work: R e rN D V e G-ilci Y'f_Pc IAcfrori'f s1 e..p S
Construction Cost:f S aLto.°a Multi Family Building:(Yes /No )
Company:J m tJrz�✓� °f' W Conttact: n /n a r K SC hr-d C d
J lel Fl vel
) Contractor Address: City: e YY�O U Cl t
State: nl ill; �;Sob Phone: S I �j2�j_ Email: H k u1 d . d l C 0
License#: F 'G'•c�l �k{ Ccn.+i
..,;, Lead Certificate#:12—,�-N�5 4 3q—/3-o 0 S&/
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 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:Pians and supporting documents that you submit are considered to be public information. Portions of the information may be
classified es ubfic if u .reasons that would , the G to conclude that are Erode
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.cityofeaoan,comfsubscribe.
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)464-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.000herstateonecall.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 sr , .ut a permit;that the work will be in
accordance with the approved plan in the case of work which requires a review and ro I of plans.
Applicant's Printed Name Ap c s Signature
DO NOT WRITE BELOW THIS LINE L---/6 o ' V /,�.�-Q_E-_
SUB TYPE
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
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
_to.j
Valuation Occupancy MCES System
Plan Review Code Edition af(i SAC Units
(25%_ 100%lk. Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction tio Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) X Final I 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
I
Surcharge
Plan Review
MCES SAC *(1t— ��°`'
City SAC }
UtilityConnection o nection Charge 9/.Q
S&W Permit& Surcharge
Treatment Plant
Copies
TOTAL
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