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1580 Clemson Dr 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 Surcharge: Ordinaneu� Misc. Charges: ((/�,�� Total: By Date Paid: Date of Insp.: Q) -- 7 c -r - Insp.• `d l.� 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: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Totol: Insp.: Dote Paid: v \ , ti City of Eakall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use i I Permit # 1 10 SCO I Permit Fee (i Date Received. 5 11/13 Staff; 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: t 553(3 C._ L9 msc n Tr' Tenant: Resident!Owner Contractor Type of Work Permit Type 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) $105.00 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 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. vAvw.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 accord a -th the approved plan in the case of work which requires a review and approval of plans X isL) 5-eoN C Applicant's ignatu e Name: EC/4/4 OW Address / City / Zip: Phone: Suite Name: 3() Pre) ID( cArvilcict License #: Address: !ZS 2_7 ceil±r, I A_vte- 3.,tV glci; State: M Aj Zip: 5 S. Li 3 6( Phone: 76'2 — 2- YcS) Contact 7-1) kiq (-- all: 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 L Main / Lower Level) Water Tumaround Applicant's Printed Name FOR OFFICE USE Required inspections: Under Ground Rot:Ian-In Air _ Test Gas Test Final Reviewed By:. Use BLUE or BLACK Ink � r-----------------+ I For Office Use � � � Permit#: � �� I C��J �� I Permit Fee: �� 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: I I I 2o�s RESIDENTIAL BUILDING PERnniT aPPucaTioN Date: Site Address: Unit#: � � � ; Name:_ �Q i1� �1� ��Pr� Phone: �� 3./�� . 1��1�x�, j �jr�d 6 � ��ia Vl �r(v� � �� Address/City/Zip: � � � � Applicant is: Owner �,Contractor � s� ' �� Description ofwork: W�v�U`U� �LII''�kGP��fs ,�/�� S( L--� ` �� T ��; F .a Construction Cost: � U U Multi-Family Building: (Yes /No� � z � , ' � ' Company. Y V� G L Ul. �.c f�u n C Contact:�Cc Y�'�t � �{ V� � � � 2 ,��z�� !s"n Q �`� ` ' �� °. Address: U City: ��#`A�'��'�?� . � . >>��l State:�Zip: ��C Phone: �(7 Z�" Email: � �,�r � �, �l�d� n �-r s � < License#: � U Lead Certificate#:. (�-� �� J l� I�Y U��I(� 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: ;� ��`��u�t?C�'��tll'�� `dl7��i��'S��,��11'`��t#�#'1�C��`�� #�� ` ', �rc'�f��.�,�i�re �C��e#�T,��t?�? u�t�il��'j��ci'�i�'��e',��`�~t��tY,��` �`� ��r�� !� __ > �� v�.,... ��_.- _..,... �..s�� - = ��?�� "+'�� ',._.... > �._ ''r �b� � � �� .:, � � �� ? 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.qopherstateonecall.org 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 wil� 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 Stat Building Code must be completed within 180 days of per it issuance. � C �� X �IM�� X Applicant's Printed Name Applica s Signature Page 1 of 3 Use BLUE or BLAC Ink . . � .� � . r—————————————— —i . I For Office Use � Cit of�a aIl ; Pe�,�t#: � 3�� Y � � ��a� ; 3830 Pilot Knob Road I Permit Fee: Eagan MN 55122 � I Phone: (651)675-5675 , � Date Received: � Fax:(651)675-5694 I � J Staff: � �-----------------� 2015 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. �s � � �- - � s ts�� I � �.. ��;.� � � vn �� Date: Site Address: 'S Tenant: Suite#: _ �� , �� ,�,�� / v�� : Name: �\ - ' �' �"S�� Phone:l�� 7 �� l� 3� ��I? � �Q�' , �` �. �� ,'; �w�" Address/City/Zip: � a � Name: ��Q �-� �� `��C� � �L License#: � � �� n � � \ � � � �-7 � . �� a� � �j�'' � c.� �� Address:�I / �j � �S� �� City: �✓ x � � �r� �� (� ` :, �� State: V�r` Zip: �� Phone: �� '- p� � � . f3 1 ! � �� y �� j; t� '(�s�t/�.� � v �q�A MC�.o�n�a;I � P�r � ��..� � �� F� Contact: Emau: �5 �pQ,''� �� \ � �� . �� ,�� New eplacement Additional Alteration Demolition � � �p��'��°�° , Descript�on of work �� ,�� 1`�r� �t�a'�� T�a �i� Car eq� i�t� � .. .�� `"�� cc�n.,' ° �� or f�r infor��i� � ��d��n��thoc�� r�� r., ..�.....��.._ .. �,«- .,,, ,..,, .. •.., , ,. ,, ;, , ...... �� ,:��< "� 1��'� ' �� '� RESIDENTIAL COMMERCIAL x � �, ` �, �, v�� _ umace New Construction Interior Improvement °�`�� `' �fiP' � � Air Conditioner Install Piping Processed �� t�l� � ��'� — � � ��. � Air Exchanger Gas Exterior HUAC Unit T�� — :�� _Heat Pump Under/Above ground Tank �Install/_Remove) � � `s� , � ��' Other Ya. �„a RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) _ �� 2 a� $100.00 Residential'New(includes$5.00 State Surcharge) -$ J �D TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee *If contract value is LESS than$10,010,Surcharge=$5.00 =� Surcharge* "*If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 **'If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE 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. X w'.�`� °`,�^ t�`'��J �- 1 X ��=�`�` Applicant's Printed Name ApplicanYs Signature ��r�� u , �� , � �� ,i� �� s � �<; �� ,`� � ', � �� ,, �°� �,�� n�� Ta�� '�� @��i��1S��ri�� '�\\�� \� �� a� ��i�� . �\. �\ �: �w`�,, R : ge��,��\�� v. � .� . � � pC�y'. �v �,� ' n��.. : r r�t � ;: ,-;�"aa l�� °'�.� �� ,°�a� ° � .��✓��. �� Fl�v �: �� c4 �� J,c.F..,, �.: '!!.w',�^rt^*Y�' �. ., , e;,. � : :��+ - . .,in ,_.�-...,f ' .�.�h....a,. . ��..�P � �`.�.a`wean:rtaRq\,�� .� �C'. For Office Use EAGAN /7 , ED Perm!'Fee /4-/-TsE. /,PR 162020 • 5545 ' X ! Staff 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Dat s:V9/11,-401 C Site Address. cro C I 601 ery iuve Unit#: ger—a:jell I /1t‘.44.0- :4Cdo4,PhOne si . / Redent! Owner Tyr:: -,ttf A44,46.if' 4.40,4-4"4"6"'" Type of or 3000 Mu;1.-Fn'!y BLffiding Yes e e..ec- 4 tvc //3yr 404) /474e .1--r*Itirta.2.1 Attyr 1-7ve citv fl-pt. e Corktractor v' woy 4.511 VieCi Ernai! reete-Li)ityr e-esyliv , License # 2-7 ,Z Lead Certificate#: stx(etttpt'tzi.!rn lead certification. ptease explain why: Aitiff441 /If 7 t1,44,14 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 'us '2 months, has the City of Eagan issued a permit for a similar plan based on a master plan? .are art.c! at.oress t_-tt"nt.tristetpt- LiCense.,1 Phone: .1-ontraCt0r. Phone: "'Ara - COntractor. Phone: Hee Skippresbion Contractor Phone:• . - • NOTE:Pian ane supporting documents that you submit are c.onsidered to be public information. Portions of the Information may be classified as hon-pubfic if you provide specific reasons that woutd permit the City to conclude that they are trade secrets. the at, etectrottic 'tom the Ct.,-!!)!F proposed ordinances by signing up for an email update cu p: .tt,.e.i2t.ed by :1 budding permit tssued tn accotrian!,-;€ w!trt the Minnesota State Building Code must be completed withlo 180 •iay5- ALL dEI-CE Ypu giG State One Cait .;.651;4544,1002 unciergtound damat,te Ca!! , , ti wor,, r),-3 cOnfOr,,,,,irCi with he o-dinancts o-ttL, ..,t rem-, ,Intt ,ott lc start with ou cermr, that the /914 01 x - - APPI,cant a Printed Name yr Ap. icant's ignature DO NOT WRITE BELOW THIS LINE / O CIE/1/I 6v4 Ct2 , /6 0‘;/-7 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi X 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 $3,bcaic, Occupancy -TR - 1 MCES System Plan Review Code Edition SAC Units (25%_100%_) Zoning City Water Census Code 4'3cf Stories Booster Pump #of Units / Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction S'R Width • REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) i< 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: /Yr�S0-. , 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