1558 Clemson Dr RECEI "" For Office Use
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Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinoinspectionsacitvofeacian.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7/23//e Site Address: /c 04w? Unit#:
Name: A'Tr " vQ ` - t`Yremone:
Resident!
Ower Address/City/Zip:
Applicant is: Owner "Contractor
Description of work: 41 11�se- � xzo
Type of work . IWt-
c�
Construction Cost: '//OO' Multi-Family Building:(Yes 4V/..-No )
Company: /41/7- dor,5771.4(4,7--4,74/ Contact: /11, hey-
Contractor Address: /c//a . 9) e City: /57/4..e"
State:M')' Zip: /? Phone:6S7'Lyt h/ Emaiiityy400cid (p�r3fif1-Z.'nCo�
License#: ZZ- f�� Lead Certificate#:
If the project is exempt from lead certification, please explain why:
iveorete .? ,,,. /971
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 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.citvofeaaan.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.00pherstateonecall.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 wor is not to start without a permit; that the work will be in
accordance with the approve plan in the case of work which requires a review and approv o plans.
x giAAT
Applicants Printed art) Applicants Signature
DO NOT WRITE BELOW THIS LINE l5-sK fe? Svc / 'T
SUB TYPES
Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family)
Single Family Garage Porch(4-Season) _ Exterior Alteration(Multi)
Multi 10 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
P Replace Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation Lit 3/ ea ••o= Occupancy1 g C- 3 MCES System
Plan Review Code Edition Q'Y]Yt ZOI5 SAC Units
(25%_ 100%,ea) Zoning FP City Water
Census Code Stories Booster Pump
#of Units Square Feet 2-° PRV
#of Buildings Length 2 a ' Fire Suppression Required
Type of Construction \) 5 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
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: 1T011I? if f•fr 7,q , Building Inspector
RESIDENTIAL FEES U S ®11 jC.•S.: I-o.> ' is S
Base Fee
Surcharge S /s,pp
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
CITY OF EAGAN WATER 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:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.• Permit Fee:
1 agree to comply with the City of Eagan Surchorge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of I nsp.: I nsp :
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Rpx 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:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
z
3$
c�{or • I "
Use BLUE or BLACK ink
~ -
ForOfflceUse
j Permit I
City of Eajan I Permit Fee: . sa 1
3830 Pilot Knob Road I 10114 - I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 1 I
Fax: (651) 675-5694 I Staff: C? _ I
i -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 5611 l5S' S$~~ yyY 81 ~
~ Unit
Resid Name: ~ 1~ sl Phone: - - 7?11S~.ti2R-
~ntf
Owner' ' Address / City / Zip:
Applicant is: Owner - Contractor
Type of Woi`it Description of work: Remo F-Aa_
Construction Cost:__4-, s S Multi-Family Building: (Yes No _4)
Company: _ C T UG 1 GW _ Contact:
COtI tractor Address: -~J Q3 .2, M i►~~~YJC "t - City: Min nr eal7lf'
State: n2AJ Zip: 55-VO (o Phone: 612- W-1-51506 License ~ 0 6 Z- Lead certificate A1AJ- _ 2 41?7 ::J
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:
Sewer & 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 permi( the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4540082 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.oro
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinance 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 E' r Z &beyA 4~5Yn_ CI'~ x~
Applicant's Printed Name ns ~ -
Appli ca Signature
Page 1 of 3