4901 Steeplechase CtRESIDENT /
OWNER
Name: Ilitri $ /7' 60/2. S6-522 Phone: 6' c3 `'3
Address /City /Zip: ` 7` 92/ 577 Pi C/' E. /I
Applicant is: Owner )( Contractor
TYPE OF WORK
Description of work: ,/ 45, 416 O/ C
Construction C•.` ' ill Multi- Family Building: (Yes d / No )
CONTRACTOR
Company: /jje a Contact: ,e6 ,7E'j
Address: /0 6 5 42 Y$ - City: '
State: e/-7 Zip: 5 3z i Phone: - S7` t ?'-.
License #: a5C oj 397 7 Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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.
City of Eapil
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x ,�o/v G. Y'
Applicant's Printed Name
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Use BLUE or BLACK Ink
Date: Site Address: Unit #:
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.popherstateonecall.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 tie 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 / Air
l.L..
Applicant's Sig ature
Page 1 of 3
SUB TYPES
Foundation
X Single Family
/ Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
S . Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
I
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
Roof: Ice & Water Final
Framing
Fireplace: Rough In Air Test
Insulation
Sheathing
Sheetrock
0 o1-f 6 - 7
Final
TOTAL
DO NOT WRITE BELOW THIS LINE 1 do 1 3 �
M Sty pirh �--
Porch (3- Season)
Porch (4- Season)
Porch (Screen /Gazebo /Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
6ASr p"..-fvf
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
/141\)2(..A
f 0
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: Footings Air/Gas Tests Final
Siding: Stucco Lath Stone Lath
Windows
Retaining Wall: Footings _ Backfill
Radon Control
Erosion Control
Building Inspector
Brick
Final
Page 2 of 3
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179785
Date Issued:10/19/2022
Permit Category:ePermit
Site Address: 4901 Steeplechase Ct
Lot:2 Block: 6 Addition: Steeplechase Of Eagan
PID:10-72540-10-044
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Paul T & Krista A Edsten
4901 Steeplechase Ct
Eagan MN 55122
Parkway Custom Construction Llc
1303 S Frontage Rd
Suite 199
Hastings MN 55033
(651) 480-3797
Applicant/Permitee: Signature Issued By: Signature