1979 Gold TrCITY OF EAGAN WATER SERVICE PERMIT
3795 =ilot Knob Road PERMIT NO •
Eagan, MN 55122 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
By�/� Date Paid•
Dote of Insp.: 4gDt Z 9 r 6 '4- air 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:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Dep
osit:
Permit Fee:
B Surcharge
Y Misc. Charges.
Dote of Insp.: Total.
Insp.: Date Paid:
Use BLUE or BLACK Ink
City otEaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date: _1
For Office Use
Permit #: I H173
z
Permit Fee: G r
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION of $ r A- qp s
Site Address:
Name:
Address / City / Zip: 3 g 13 Gold. / 9
Applicant is: Owner >6 Contractor
19 $3 A—Q B
-EL Unit #:
fres, Gwer te-s. Phone: fog
Description of work: _ RP ., ' ( 'e'
Construction Cost:
kc(4uY\)
Multi -Family Building: (Yes / No )
companytiVAL.e. RiVt& CfrhilYIACII M Contact: FIVIA.A 1 1/`a
Address: � (5x, �ct A City: 2O Y)
State: M% Zip: S 5 _ 1 Lkti Phone: L71 • (OD-1
License #: C A cYb
Lead Certificate #:
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
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.gooherstateonecall.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 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 /44/1- / fihfr f'G
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
C!tyofEaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit#: / 30 c?
Permit Fee: 76. e/'54
Date Received: 7 ('"
Staff: 4f
�] 2015 RESIDENTIAL BUILDING
ING PERMIT APPLICATION
Date: 1-(31 I i1 Site Address: CI 1-9 Li 01 "�11J ro 4 t L- pcpc......E 4 Unit #:
Sint/
w r
Name: Tivl c6iv00 Li-C Phone: C'12• 224-•
161Y
Address / City / Zip: 517 !"1 A-4cv h E f F A I : 1��- PCs
Applicant is: Owner X, Contractor —ii
Type o , 0
Description of work: '1) - LJ C f:- NI i ( �ez, mr
I
Construction Cost: 7 .) f 0'6 Multi -Family Building: (Yes / No
)
}
Company: l \CC SS C(L-Y l-icy-`^ .S' L-L'- Contact: /-/N 0 7
Address: (/o .i S'- - /4.1/4)J 5 - City: S _ Cr i 1--
State: LAC' Zip:< C-01 Phone: 4 fi Lis-0 5121 Email: , VtL4-".1- 14 C /' =SSN4 /46144.5. L
License #: tb4 �� S Lead Certificate #: iki d'}-T La `7 i " 1
If the project is exempt from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE: Plan t- • s• ortin�i�• ent at� rtarecon,id • ' •lt�cihforn� •
the informs • e la • no ub tr pr � 1e specs ould
p •> deb = de sec :...r s.. z
nsof
R
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.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
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 fuilding Code must be completed within 180
days of permit issuance.
x bt2--11 &Cos`'
Applicant's Printed Name
x
Applicant's Signature
• [.A/1
Page 1 of 3
19 '/ %o(( c:O OT WRITE BELOW THIS LINE
SUB TYPES
Foundation Porch (3-Season)
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
(25% 100% y )
Census Code
# of Units
# of Buildings
Type of Construction
P6
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: Ice & Water _Final
Framing
Fireplace: _Rough In Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Porch (4-Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: Footings _Air/Gas Tests Final
Drain Tile
Siding: Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: _ Footings Backfill Final
Radon Control
Fire Suppression: Rough In Final
Erosion Control
Other:
Reviewed By: �' , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
(9( 62 (9p
57,
`) Page 2 of 3
r
Use BLUE or BLACK Ink
C!tyofEaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use
Permit#: t
Permit Fee: 60- ob
Date Received:
Staff:
L
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: Q"v rke/
Tenant: e
Suite #:
��II+t��tt/Owner
;xA
Name: -e- r / ^CY Phone:
/ 6CX /?'%` I l /1i�
Address /City /Zip: � �`3'�'`" if% �5��,,�
ontrec. ,.
/�!
Name: /'i /`l "7Gr 4I1 NS'-d / License #: 4((p lit( f 7/
Address: 74'71 1O -S7 '1 / City: Z'P?*,�.el/,,/
State: A /11 Zip: SS I9 8' Phone: 2&aS ' 6,914/
Contact: / 0/7 Email: 7`iv.4 /''i S K:749( . 49 11-I
Type�ork�
a
New )‘)Replacement Repair Rebuild Modify Space Work in R.O.W.
Description of work: ADM- 9/'. 6,4 / 6,i / 6t,,c / �G6 -f
.tr
Permit ;
RESIDENTIAL
Water Heater
Ale CA-? <4/74C-keh) S.%✓ZColAa�o,4c.,
Water Softener
Lawn Irrigation (— RPZ / PVB)
Add PlumbingFixtures Main / Lower Level)
(
—
Septic System
—
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,
$60.00 Lawn Irrigation
$60.00 Add Plumbing
"Water Turnaround
$115.00 Septic System
Water Softener, or Water Heater and Softener
(includes State Surcharge)
Turnaround* (includes State Surcharge)
TOTAL FEES $
(includes State Surcharge)
Fixtures, Septic System Abandonment, Water
(add $210.00 if a 5/8" meter is required)
New (includes County fee and State Surcharge)
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 with t 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.
75 /1 ' lei//%,el C/
Applicant's Printed Name
Applicant's Sig ature
Sewer & Water Contractor:
EAGANRECEIVEN
JUL 16ZOZ9
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buildinciinsoections ancitvofeaaan.com
rFor Office U � IQ
�Q�
Permit #:
Permit Fee: O • S0
Date Received:
Staff:
J
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / - 9 ' ZG Site Address: Unit #:
Name: JVs
Address / City / Zip: 147 9 4
Gtoe. le;
Applicant is: Owner A Contractor
Phone:
94140% . Ms), Ss1a2
Waft aee. Dose 'A $ SN4nr� be*ftlt
Description of work:
Construction Cost: -/QQ
r %DO Multi -Family Building: (Yes )A / No
Company: Be iy a is 4fe r ? o t-S Contact: To h,Al 2 7 f' Z f e f
Address: 5 I'(S rA d wgi-rT . S i t a +r Sate 1 City: hl ^ p 1 s Pica
State: TAP Zip: SS3 51 Phone: i to 3 - .t to - Email: J O hA Sr. Q be rq t 1fr4{r'; a rS . cah
License #: BC-32,44 2.11 Sad Certificate #: J
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:
Phone:
Fire Suppression Contractor. Phone:
Ph
urs and supporting documents that you submit are considered to be public Information. Portions of the information may be
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.comisubscrtbe.
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. CaII 48 hours before you
intend to dig to receive locates of underground utilities. www.aoaherstateonecaliorq
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 witFjout 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 -\O �� #2jr:
Applicant's Printed Name
Aptillcant