1761 Meadowlark Ct VILLAGE' OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the Village of Eagan Surcharge:
Ordinan es. Misc. Charges:
Total:
By Date Paid:
Date f Insp.: ` f $' 7f Insp.:
VILLAGE OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the Village of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By: L C Misc. Charges:
Date of Irk Jr � 7j Total:
Insp.: Date Paid:
` Use BLUE or BLACK Ink
r-----------------�
I For Office Use �
' RECEI`JED
� /��(
� Permit#: �vv j
City of ����� � �
3830 Pilot Knob Road
AUG Q 4 201�6 � Permit Fee:�G�, �
Eagan MN 55122 � Date Received: ' �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: �� I
I I
-----------------{'�-�
2014 RESIDENTIAL BUILDING PERMIT APPLICATION �
��?� 1 } � �� ��
Date:_���� �- �� Site Address: ���G��CU'*�%'�Ctii �t�"� (.,� Unit#: �
� `°� Name: l,,(i'�'� ��C'`(�1 � Phone:�v� � " ���'"' � t'�J t.
R�����n� � 1�r ��c���� � � �� ��� ,
; �jy�yF��� ;� Address/City/Zip: �. �
Applicant is: Owner �Contractor
' Description ofwork: ���'F-
Type ��Wc�rk��
'' Construction Cost: ���, Multi-Family Building: (Yes � /No �
Company: ��� ��1"t�=- �C~��U�Z1N� ���,C�S l�c Contact:
C+Dt1'�t'�C��f : Address: '��S`� i''(�i4�Y)t�3i..l�i1o� �� City: �i�i4l� _
;.' State: �N- Zip: �v, _ Phone: 6��-`��-�76�Email: U�+��-��i��G .3��i i't�i�,cC!�h.
' License#: �����v��7� 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:
Nf}TE:P`lans ar�d suppo�ir�g d��urri`ents#hat,��u�subrr�t are cvt�sidered:to#ie pc�blic fnf�rrr�a#fv,n. P��i�r�s n� ����
th�int`ormatis�n.may b�c�as�rtiei�;��nort�ublr'�if you prnuia►�specific reasoras:that wr�c�l'd�ermit t��City fo
�r�nclu,de"�l�af fhe are#rade�ecref�.'
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.qopherstateonecall.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
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 �r` 1� ,� ',t�% X �� -�.� ,; ���f G����--,,
- A
- -_____.._. . .
ApplicanYs Printed Name Applicant's Signature j
Page 1 of 3
- ° l�� � I�I.Q�r;Qo�...�"lQ r�- G� �.�"(���
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ 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 ��j �'"
Valuation ��� Occupancy -�3 MCES System
Plan Review / Code Edition �_ SAC Units --
(25%_ 100% Y) Zoning j1�� City Water ---
Census Code 1�3t/ Stories ---" Booster Pump """"
#of Units / Square Feet ^ PRV '�'-
#of Buildings / Length �" Fire Sprinklers �-
Type of Construction �— Width "i
�.----
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) � Final/No C.O. Required
Foundation �� HVAC Gas Service Test Gas Line Air Test
� Roof:�.���Final Pool:_Footings _Air/Gas Tests _Final
Framing Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:,�,Stucco Lath _Stone Lath _Brick
Insulation ti� Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls - Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES nr�k /30�� /�" � JR�d �
Base Fee / �',��- ��� 9�
Surcharge p�tr�v ��
Plan Review G �� ��O �
MCES SAC �
City SAC sT'l��� /��TG/� ��'��"
Utility Connection Charge
S&W Permit& Surcharge ���D
Treatment Plant
Copies G� '
TOTAL
Page 2 of 3
.�
�
Use BLUE or BLACK Ink
�_____--____�-.__-�
I For Office Use 1
' I � �� I
Clt of �a a� � Permit#: �
� � � �� � �
I Permit Fee: �
3830 Pilot Knob Road � I
Eagan MN 55122 � �
I Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 � I
� Staff: �
�-----------------�
2014 COMMERCIAL BUILDING PERMIT APPLICATION
Date: I �I S � Site Address:
Tenant Name: jM z �d\d v.., \�.Y� �;����� � v+ g�
Tenant is: New/ [� Existin Suite#:
Former Tenant
Name:_�c s cM.ti`n�- �, ��ei �� � !1 Phone:
Property Owner Address�Cit �Zi i �> ���� , ! �
y P� 3 � b �1, �7b'� l '� bS t '9( `3� 17b\ � 1'15 �1 l?S?
�7SS
Applicant is: Owner Contractor c�.�w�h� �,�—�
Type of Work Description of work: SF� . �.. 1��r�N 1 h���,,�z��
ca�
Construction Cost:���.�1i�'
Name: C Kt V�vr���� ��� C o v.i�''y c���� License#: (���5.� C
COntraCtOr � Address: Z �'7`� �/�?�����i rr� Q�- City: V; c�,'1`���
State: � h Zip: �S 3 �' b Phone: G S� " d �� " �� rv b
Contact: %e �'�'� z.�. Email: .�. � .�1 �.�- �O L_�.�w�
.
Name: Registration#:
Architect/Engineer Address: City:
State: Zip: Phone:
', Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone#:
NOTE;Plans and supporting documents fhaf you submit are considered to be public information. Portions of'
the information may be classified as non-public if you provide specific reasons thaf wou/d permit fhe City to :
:conclude that theyare tratle 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.orq
I hereby acknowledge that this information is complete and accurate; that the w rk w II be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an ap c tion`for a permit, and work is not to sta�t without a
permit; that the work will be in accordance with the approved plan in the case of r whi h requires a review and approval of plans.
x `✓�e � t�� g v� � ��e•^) x
Applicant's Printed Name ApplicanYs Sig
Page 1 of 3
City of Eagan
Cash Receipt
Receipt Date 11/26/2014 � � �� �Q�)
Receipt Number 202034
o �
D&S HOME REMODELING
CK 1035
0801.4242 50.00 )���
REINSPECTION FEE C (�(� `-�)
A�^����
V��
Total Receipt Amount 50.00
104037 15:37:00
Use BLUE or BLACK Ink
LayFor Office Use of Eaaau Permit#:
Permit Fee:
1 �.
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675
buiidinoinsoectionsecitvofeaaan.com Staff: "m
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 9-8-17 Site Address: 1-7U 1 64, ou J„ft. CT Unit#:
CnZ/ 5Y- .
Name: Phone:
r` rAddress/C' it • 1761 � at�5/ P c-r
Applicant is: Owner Contractor
,; Description of work: Suppply and install new windows or doors - ov«'-
• r w . Construction Cost: Multi-Family Building:(Yes X /No
Austin Remodeling Contact: Mike
Company:
19306 Oelke Dr City: Prior Lake
a Address:
MN55372 62-221-4429 mike@austinremodel.net
State: Zip.. Phone: Email:
BC664409 NAT-F158156-1
u�N 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 fbr arsimilar 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:
ty314.1. ** ig;okvii."4A-zzA,44wait-,.1 a r t4 ... °� 'r f t° r "t 6 r rr a 3 '
rA
�wx
,r ;xuty..wa x �l¢,4 t};: .._� 3.';: u .. ,... _g' 4104"4iPw.d..:.
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.aooherstateonecall.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 oif
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
accordancedancwith the approved plan in the case of work which requires a review and approval of plans.
x dell it.Ati 61[kJ x
Applicant's Printed Name Applicant's Sig ure
Page 1 of 3