927 Oakwood Heights CirCITY OF EAGAN WATER SERVICE PERMIT
3795,Pilot Knob Road 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•
1 agree to comply Vitt the City of Eagan Surcharge•
Ordinances. Misc. Charges.
Total -
By Date Paid
D. a of Insp Insp •
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO •
Eagan, MN 55122 DATE.
Zoning: No. of Units -
Owner:
Address:
Site Address:
Plumber
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit.
Permit Fee.
Surcharge.
By Misc. Charges.
Date of Insp.: Total.
Insp.• Date Paid.
411'
CityofEaftau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use (�
Permit #: t
Permit Fee: 341.
Date Received: 1/9s!
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: LOI7<1-141?j
J
Site Address:1 t a 5 Za - z3 - k z;
City of Eaan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
Use BLUE or BLACK Ink
For Office Use
Permit #: /;6/6 0
Permit Fee:
Date Received: i - c23-/
Staff: /n&
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION G
Site Address: ! e97 ( C( L J42 iJ/s
ytica4
Tenant:
Resident/Owner:
J
Name:
Phone:
Suite #:
Address / City / Zip:
Name: o' p14,,n,b/e127 License #: 04/0 (-(0 /42!y/
Address: f t i yno City:
Phone: % (t9 0 '/ /PI/
State: 144 ( Zip: SS^%
Contact:
Email:
New _ Replacement _ Repair _ Rebuild = Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gooherstateonecall.orq
1 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 vyith the approved plan in the case of work which requires a review and approval of plans.
x
Applicants Printed Name
0 Lv?
x
Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Staff:
4,011
City of Eatan REcENE°
d
3830 Pilot Knob Road 1 10Vt*
Eagan MN 55122 jp17
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
L
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:
Unit #:
Name: tigN l' aer n1 Phone:
Resident!
Owner Address / City / Zip: ?t* ? tOei z e1 e : / rr1 = C -P1`('
Applicant is: Owner
Contractor
Type of Work
Description of work:
,3s7iF, >3 47W j ), fil
Construction Cost: / ePia Multi -Family Building: (Yes (/' / No )
Contractor
Company: Mils eAA c .L (3OJ1%41^3ZA Contact: L,,,, Q' //
t
Address: c>110/13' J/ /Ota`/ ` e i X f1 -e City: / y„�;r�y Ti 'yes
State: /77/1 Zip: iij--r t5'11 Phone: 144'7 0t2 -/'C2 6
Lead Certificate #: NA I M J 06 0 0 y -/
License #: yee
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
c' o' T6R��; r, , ,4 C7 /9 7F
1°D
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:
Phone:
Sewer & Water Contractor:
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.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 myst be completed within 180
days of permit issuance.
x 04.40t,e,v/e...2cy/
Applicant's Printed Name
x
nature
Page 1 of 3
u; `,1 C ey
DO NOT WRITE BEL W HIS LINE
SUB TYPES
Foundation
Single Family
Multi
IL 01 of i r�
Piex
WORK TYPES
New
Addition
E Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% / )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
_ Porch (3 -Season) _
Porch (4 -Season) _
_ Porch (Screen/Gazebo/Pergola) _
— Interior Improvement
_ Move Building
_ Fire Repair
Repair
otew
1/34
1
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
7.13
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water Final
AC Framing
Fireplace: _Rough In _Air Test _Final
,,)( Insulation
Sheathing
Sheetrock
,e Fire Walls
Braced Walls
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
_ Demolish Building*
_ Demolish Interior
— Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
/Pc -3
MCES System
SAC Units
PD City Water
Booster Pump
PRV
Fire Sprinklers
•
r
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC — Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests _Final
Drain Tile
Siding: Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Erosion Control
Other:
Building Inspector
7 3 'r- 3° 40 g ,v7°- / cow
tv-
- @ ..rfi
Page 2 of 3
City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: / $ ,5 "
Permit Fee: /C/,
Date Received:
Staff:
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: S f (S lzo l ( Site Address: _ )1
Name:
Unit#:
Off' oo c • I4e k5k-ts ColvciornINt /ass .
Phone:
.et LIk114 d$
C�S)—y5-Y—o243
Address / City / Zip: 924 6 MON Oar) Ci y L
Applicant is: Owner Contractor
Description of work: W t N 'QO w Re +tv cr'
Construction Cost: 67.bQ a Multi -Family Building: (Yes / / No
Company: 4 b u+ tk A ---\cm se LLC Contact: v 6 R r e2.1.-'AD6u
Address: Z 0 a/ v-1 f (L City: J Ar
State: j-1\),1 Zip: '-12) Phone: (of 2-7..(o—( (,, (p ail: £V't f vbbsv D1 Awl_
License #: g C 2.0 54S 76;8 Lead Certificate #: ,&t *t — Vn(Rtt —1
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
TE: Plans and supporting documents that you submit are considered to be public informatioi
e information maybe classified as non -pd. kif you provide spec!fic reasons that would permrt$t
conclude that they are;trade secret
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 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.
l qL , rk�
Applic nt's Bunted Na! e \ e e
x
xlA
Applicant' Signa ur
Page 1 of 3