1575B Baylor Ct CITY uF EAGM4 WATER SERVICE PERMIT
3830•Pilot Knob Road
P. 0. Box 21199 PERMIT NO.:
Eagan, MN 55121 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 with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
B Date Paid:
Date of Insp.: 74 Insp.:
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CITY OF EAGAN SEWER SERVICE PERMIT
3830 Not Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning:
Owner: No. of Units:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances.
Account Deposit:
Permit Fee:
E Surcharge:
Y
Dote of Ins Misc. Charges:
p " Total:
Insp.:
Date Paid:
•
Use BLUE or BLACK Ink
For Office Use ~
j Permit pi
-
t of Wan 1
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: 11)- i
Phone: (651) 675-5675 1 'QeV
1
Fax: (651) 675-5694 1 Staff:
i I
- - - - - - - - - - - -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1b - I Site Address: ►5? / 8 ~ 15 7 r Unidt '-___C -
Name: n — r i/ ~llf1 f S Phone: f =2- -72-. -.Md
Resident/
Owner Address / City / Zip:
Applicant is: Owner - Contractor
Description of work: Rama r--* _
Type Of'Work
Construction Cost:~,$ 5 Multi-Family Building: (Yes _ _ / No
Company: __s~~►T' fJ~~jd~✓~---- Contact:
Contractor Address: M ~r)el~ City:
1C2C2~5
State: r r r rv - Zip: __Jr_syd Phone; 6Zc2 ;?2-1- 5-5-6-6
License - 910 6 2-- Lead Certificate -~AJ-:: 2 ~91fI'7 -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: Phone:
Mechanical Contractor: _ Phone: _ --_A---
Sewer S 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 the 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.aoohersWs2-r ecali.ora
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 fli 2a~bP_4A ee
Applicant's Printed Name Applica s Signature
Page 1 of 3
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For Office Use
CErrY11-F,Et Permit If
' •
APR 16 2020 Pert-n[1.Fee
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
;-"ate Sire Address: 1575- B cr Unit#:
/:/ Att€g_Agv 4400-4.4.,Phone.
Regident
OWnor
:A44,41,„, 44,1".1,&.4614,41' 49r,„seW4widE al
Typc, o Work :rr /
ce) AL, .2000 C2? Multi-Family Building (Yes /I No
/7 nr.vettidijt -
y A yr (f,/1, &re rcrow va Arm e. Au ont a ct 741:13fiz_ AI ileyr
._&/;rE e
Contractor 19_ve
..:7v 47:04 6.5)--2- 4 V$0, E rrl a ktyl4*Vot3011‘e.:4-$ C
Icer,se i9C zz- Lead Certificate 21
lead certification p
hsliotide4"V ,,Attiet/V/ rYISAkt
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEWIWILD.INO
rnbrItfls. bas the City of Eagan issued a permit fora similar plan based on a master plan?
' • ::•<e and aadress o'r-rDste
LIcerrseci loibrbbv.. Phone:
Phone:
Wa'ui',.r.mttactor. Phone:
COntraCtOi". Phone:
ann supporting documents that you submit are considered to be public information. Portiona of the MfOrMatiOn May be
ciassaPed rien,pubfic if you provide specific reasons that would permit the City to conclude that,toy_areAstokolpy*., „.
unr,c.ribe tj?r evewe an electronic notification f,orri the City:if proposed ordinances by signing up for an email update o. o ' 1thc'hzeO n
by 3 budding permit;ssuer., n accorciance with the Minnesota State Building Code must be completed within 180
tii ni
SAL.. 4YO1j5),IC, Gopher State One 454-00C2 ,,uldergrowld ottiltv damage • •
' • ' ' ' with the •
Xht t 04•
. Appii ant's Signature
1
1 A
DO NOT WRITE BELOW THIS LINE s 76- lbs c . (, fl; B /ec
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
Valuation , Doo (,,,1,,,„1/4,,,) Occupancy .�Rc- i MCES System
Plan Review / Code Edition o' o i S SAC Units
(25%_100%_) Zoning P1 City Water
Census Code L/`3 y Stories Booster Pump
#of Units / Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction '8 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) X Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_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: /`�P/sa , Building Inspector
RESIDENTIAL FEES
Base Fee _
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
SSW Permit&Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
Page 2 of 3