1577B Baylor Ct 3830 Pilot Knob Road
P. ?EMIT
P. O. 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:
i ogee to comply with the City of Eagan Surcharge:
Ordinances. / Misc. Charges:
Total:
B y Date Paid:
Date of Ins.
Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.•
Eagan, MN 55121 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:
B Surcharge:
Y Misc. Charges:
Date of Insp.• _
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
. *a
Por Office Use
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Alp Ren-nii, , Fee
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NN f',IN ',--'5127-'P:i.i:: I
,H535 FAX 1iTi':.:i ' .575-560,I, ; '-taff
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
/L.'ate. t f./1-40-7-‘' Site Address: /5-77 8 1-314yuzle... Ci , unit#:
,,,,,,_ 17.crif2/erki
ReSidenti
Owner ('::'.';:e,'i . C.t... /.!c• ..
1
, ...... 1
1 ; .
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,, f iasixt;74., 4.4-.0.01 .:.‘,.._c-4-rti Az ts.‘,,f0,,,,e.ov":
Type ipt Work
,.., ,,,,,-, ,...cs'.
- 2,1,00 tt.. Multi-Famly Buildinv r'Yes No
......._
...4--• nitiveffie.401- ..-t-nic., ,
y_it (/7 elne&ft'L.F,,..vaihr,v,e ...1-01- Co-ntact. /_")^__4,444 i oArr
Contractor ibe , ci,, fl-fifi L e Viiti.--€1
SI2'i in&Z,V 44;41-Y 1,ho-,, 4,57-,lyt vsc, Email: ,44(.4.--_6i-j ihyteast,ems,44-4, c.'wk
1 icense :,- fe 2-i ._.,, z z— Lead Certificate#.
: ,,:f : . •f : - --.: ff,,,,(411-1:f from lead certification : ea-Fe Evxprain why:
//1741'ni,-44e'' VI „.~.01 4elekl_ 1/f tr7
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW.BUILDiNG
In the iast 1; months. has the City of Eagan issued a permit for a similar plan based on a master plan?
and address,:f poser pia,
LtCeS42oPirnb,(.-:(' Phone:
. ..____ _ ..— ::-
WIce::1,,-1.1-, = troctorPhone:
.
Phone.
:---ir sri
: lon C:oiracto4 Phone: .., ... .! • . . . .
, . ..•
NOTE Plans and supporting documents that you submit are considered to be public information. PartiOns Of the InfOrtitation May be
cias.si(ed as non-public if you provide specific reasons that would permit the City to conclude thattkelbatAkedeseorett..
0:1v subscribe to i eceive an electronic notification from the City of proposed ordinances by signing up for an email update on th City s
L'xtef ic,, woriir authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within ISO
•I.vsi ot ni,•rmit issuance
i.AL.1311-iijqE Y OU DIG Thi'Gopher State One Call .---• (6511 454-0002 lin-proir.-iK.tiod against underground utility damage Call 4'(3',0'W-1-' H=' ,' .':,,
,' • '' ' ,''' 2E' '. : ' .., ' '1=r-1()(1 IS .,',cT,r,';:••;e.e ,,,,i acc:..:rate ..n,-.: !--'p won,-.II oi-2 in conformance with the oidinanc.:es arid Lode., cr i i- • i;. ,
ri, ., •ii .3 t:errniii. but c-J, ...ri ,-„,1,10,,?.t,,,,, i;;; :-.: nei-rnii. :Ind ,Nork i- not to start withouta permit that Is frvr-k
and an
tne cse 111,
. '' • • ''' '''' ."':•('''''r',,:'- .;: - r ar,\\id:K'.^.-,,C,',re'.1.i,rf,_, 3'ei;eisii: circ,..1 c :ns „
11 I - /
Appncpnt's Printed Name Appl ant's Signature i
DO NOT WRITE BELOW THIS LINE /� 6,4 ���� �1' �6e 7
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
_
2( Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation ' .0k-)000. (w ) Occupancy 7•Rc- I MCES System
Plan Review Code Edition anis SAC Units
(25%_100%_) Zoning P1 City Water
Census Code 4/34/ Stories Booster Pump
#of Units 1 Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction $/3 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: •• t°/5",— , Building Inspector
RESIDENTIAL FEES
Base Fee _
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
Page 2 of 3