4725 Anne Pt WATER SERVICE PERMIT
CITY OFEAGAN
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: — No. of Units: _
Owner:
Address:
Site Address:
Plumber: Connection Charge: —
Meter No.: —
Account Deposit:
Size:
Reader No.:
Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. - Misc. Charges: -
Total:
By Date Paid:
Date of Insp.: f st 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:
agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By —___ Misc. Charges: _
Date of Insp.: Totol:
Insp.: — _ Date Paid:
•
' For Office Use i
4 • , ( 5 1 117
N r Permit#:
E AG N
Permit Fee:
Date Received: '1- ��l
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 i FAX:(651)675-5694 stet
buildinginsoectionsCa)_cityofeauan.com
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: '?/t /' Site Address: Unit#:
Name:IP1�e.--e....LI Ff FI�% H,0,4, Phone:
Resident!
Owner Address/City/Zip: _ +�.i — � M i , -, _ 4
Applicant is: Owner —Contractor
Type of Work Description of work: 2Aie--Re 7 /C714-7-/..0044) /Q e R.
Construction Cos t ao,00 Multi-Family Building:(Yes I No 1''—)
Company: Ake*iA k 7��eiwc r1 A-C- Contact q'e
Address*, f 41 ), -r - City:
��Contractor
State:/ ii.Zip<59Qei Phone:Id2q-* Email:p ( *2e707(M44/L
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: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.
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
t 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 l 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
,�{
prplan in thee case of work which requires a review and approval of plans.
x
Applicant's Printed Name Ap. icant's gnature
DO NOT WRITE BELOW THIS LINE � 5-7?- hi194.---, � f 5 17
SUB TYPES / J
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
1 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 Occupancy3MCES System
Plan Review Code Edition ,, Al SAC Units
,
(25%_ 100%�O Zoning City Water
Census Code �' Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction _ Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) Final/ 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: IL , Building Inspector
RESIDENTIAL FEES el
Base Feetetit OP is
Surcharge
Plan Review `"401-4(,„ f
MCES SAC
City SAC
Utility Connection Charge i 10
tr), LOV
S&W Permit& Surcharge All tis3j2i 1
Treatment Plant
Copies 1(4:ef (r-
TOTAL
Page 2 of 3