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peuati
ch Coed ue Reuss
site fir- 4 a Q. a Dri L r t
• lw! .: t. JjAY Ne-
agraik tw o=:;:; wall the Cies at Nt • $ a� s.
APNIvaripar
Atassirik
Date of IeKp a �f� • 6
Data Pa%
lir ,
For Office Use
I Permit#:
..lb •�,21 E AGA N
Permit Fee: / 2.2• b 1
REciEv ^'�
Date Received: / -/ -/a
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 Ai.
(651)675-5675 I TDD:(651)454-85351 FAX:(651)675-5694 J U L 1 9 2018 Staff:
buildinginsoectionsiq�citvofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 9//e'//4$ Site Address: r O9 �d d c/i J,r
Unit#:
Name: Phone:
Resident/ ;/ ,--
p ( '1-- /pY
lwwner Address/City/Zip: 1/66 O f 5e.
4 Applicant is: Owner X Contractor
Type;of Description of work: e r yee Gt l�Lcx Pe - rjy11- e
as
Construction Cost: Ste'tf"D Multi Family Building:(Yes /No )
Company`s Vh Conc r-dE`I L'Cd Y v0 .,. ..Contact:kY1Cs`v(!...a C rc' d. ....
Contractor Address: �3 7�'d� I tic City: (2 -rv\o cA®'\ t
State:/',)�► Zip Phone:�%SI �j2cf�7 fEmaii:=mail: ,I v✓i. c QI tk) ct..k.t G( •C v `
J
License# 1'�`,fy CCI •h Lead Certificate#:R-I-'/3 b m-/3 -00 5-6/
,_�. ..,...a.� ..._.. .�.. �.�_. ..
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?
1 Yes No If yes,date and address of master plan: 1
)
I Licensed Plumber: Phone:
Mechanical Contractor: Phone:
fi
Sewer&Water Contractor: Phone:
i
) Fire Suppression Contractor: Phone: 3
t NOTE:Plans and supporting documents that you submit are considered to be public Information. Portions of .h�tion may
)classified as ublic if you A+rovide ific reasons that would mit the C to conclude that, are 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.comtsubscribe.
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 Cali 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.uooherstateonecali.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 wit be in
accordswith the approved plan in the case of work which requires a review and approval of plans.
oa.bei Al Gliro celv ii/L. jii,,,tp.,eiree„,1_,
Applicant's Printed Name
1 ns Signature
DO NOT WRITE BELOW THIS LINE LADie156. t,... 1 i C bit - / ? "-7
a f
SUB TYPEG
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
4Valuation /2(0Occupancy MCES System
Plan Review Code Edition , O SAC Units
(25%_ 100% ) Zoning ,1 City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction yfy 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
ector
RESIDENTIAL FEES
Base Fee
Surcharge A ,,
Plan Review .
�"
MCES SAC
City SAC 6 ( P'''''
Utility Connection Charge 9/0 LP 0
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
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