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1076 Kirkwood Dr o _gy : ; ` SERVlc 3798 dot . " Roth - MIT NO.: - Iti i 35122 ' DATE ` / ±: , :ii,- Ir ' I T Na. of Units: Owner: (rpsz €: Letana.n _ZnG . > : Address: Site Address: 1076 Firkwaacd Lane L8 B2 CLes liat 4,at Plumber: WW'eier e Meter • No.. Connection Charge: 305 .00 0 p i Site: Account Deposit: Reader Na Permit Fee: It i . pd 1 avow to sees* witi Iths City Bogen Surcharge: .50 `; Ordhogi ere. Misc. Charges: F C t'47 1:-.,.1 ,t a t' a ?. r Total: By j Date Paid: Date Insp.: Insp.: r DER SERVICE PERMIT' $� Road PERMIT NO.: Segigo, " - =55122 DATE: , Zoning N - ; : ' � ' .o, of Units: r Yf Oemer: :r, C. Address: ' site Addre , 1 rl 7 b i 1-I:r t o t.' - I c a n e F:; 7 ? r F Plumber: 01.C?..,.. .. . .4 1 epee to + wink f' 8 Egan ', Connec ok Marge ''' , . Account Deposit: 111 �1 r By 4 Misc. Charges: t4 Date off • 1' i � . � Total: r insp.: ;,.1 - -a ; ,,,,,, • ✓, _,...<"t ‘ - Date Paid: Use BLUE or BLACK Ink r I For Office Use I I f tCiy O1 Permit#: f1(B 7©P I Permit Fee: _ 1195. 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: lr7 l0f3 I Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: , b-117" OL?S Site Address: l l~ c~ J Unit Name:tAU`u Ga.u-Ca-Mz&c .'.r" -e- Phone, 5/ Resident/ Owner Address /city /zip: Applicant is: Owner L- ~Contractor Type of Work Description of work: C' -b Construction Cost: Multi-Family Building: (Yes / No ) Company: ©C G t &3, c-k e,- 15 1 F.A.t Contact: e_') C 1 C Address: City: Contractor ~ - l State: Zip: LJ Phone: License - Lead Certificate 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: 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. 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.gopherstateonecall.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 ork au ized by building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days ~VN s ce. X UCx 0'1 Ad Applica Pr d Name Applicant' sigf~ ature Page 1 of 3 , For Office Use4 - w ® ® a i e Q N i U�4 Permit#: /1-4 JG -5 jr.) „„, E AG N Permit Fee: /1/ Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildindinspectionsecitvofeadan.com L 2018 RESIDENTIAL L BUILDING PERMIT APPLICATIONMNI 123 Date: 12-(5/f 8 Site Address: ( /61 Kl eknl C0d0 "De. C-AaAsii•I• Unit#: • APet ANS A MA071( l - Phone: CD51 -307-7236 Name: QWCIeC ,M�� Address/City/Zip: I W760 kl�E'KV�!oc 7 pQluE Ant, MPI ✓" 5123 Applicant is: ✓Owner Contractor Description of work: eert-A 17 EGG Type of!vb.* Construction Cost: 30045 Multi-Family Building: (Yes /No ) t lii;1a,, „ t ifi "4m Company: Contact: �0Address: City: timA;mMAState: Zip: Phone: Email: T.00TIal7Oo?-OT- , y License#: Lead Certificate#: 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:Pla,s a�,�t ing ct car fir+ h b p ie"consi erect to be publif�'a m ;1 ortions of'th' 'trtf ay be '° classified s 4kol,pu.lie If j ou pr'o d pe easons:>that would rermit tett*ity to con ude ' secref 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.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.ciooherstateonecall.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 accor anc with the approved plan in the case of work which requires a review and approvArA • : . i, x +(tC-ta c:.. It !. x ; - Ap licant's Printed Name '•;`Rn ism rs DO NOT WRITE BELOW THIS LINE / S:---Deg SUB TYPE'S /0-76 g%g--g(-000 D - - — 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 Valuation 3l0vz>-— Occupancy LE G -z- MCES System Plan Review Code Edition .W1i2 2v/3' SAC Units (25%_ 100% )4) Zoning 47 2 City Water Census Code Stories Booster Pump #of Units Square Feet PRV V of Buildings Length Fire Suppression Required typei/of Construction f Width tEQU1RED INSPECTIONS . _ Footings(New Building) Meter Size: _ Footings(Deck) Final/C.O. Required _ Footings(Addition) _ ?e) Final/No C.O.Required _ Foundation HVAC_Gas Service Test Gas Line Air Test Roof: Ice&Water ^Final Pool:_Footings Air/Gas Tests _Final _ Framing Drain Tile _ Fireplace: Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath Brick Insulation Windows — _ Sheathing Retaining Wall: Footings—Backfill_Final — Sheetrock Radon Control — _ Fire Walls Fire Suppression:_Rough In_Final — Braced Walls Erosion Control — Other: dewed By: —7 /72 //~k}47 ,Building inspector >IDENTIAL FEES • Base Fee a X l-7 Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge treatment Plant :opies TOTAL Page 2 0'13