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3775 Robin Lane
a ~ Use BLUE or BLACK Ink I For Office Use I bZ D City Permit (o 0 Eap Permit Fee: 3830 Pilot Knob Road J/y Eagan MN 55122 j Date Received: I I Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: I 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2- Site Address: . G p') 661 Z 2- Unit Name: bei-hooy Amcl e, Phone: q52- 31 " ✓2 ?0 RESIDENT / 3-13' bbirl Lki, E619 Q ri 5~)► 2Z OWNER Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Ye0 jQGi JQQ~/JP d Pi'CK 11 ~~-olvnyloos~4 Construction Cost: I Vo®` Multi-Family Building: (Yes / No ) Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) Heet5 Cer oo hstc on e -7-> 6 0M 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 permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoaherstateonecall.oro 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. ~~y xLtootly a(~'K.~ e- x Applicant's Printed Name Applicant's gnature Page 1 of 3 DO NOT WRITE BELOW THIS LINE / DzI SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of - Plex _ Lower Level _ Pool _ Miscellaneous 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 tt11 Valuation Occupancy MCES System Plan Review Code Edition ~~11 SAC Units (25%_ 100%-X) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: - Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee / Surcharge t~ Plan Review MCES SAC%, ~j City SAC u Utility Connection Charge S&W Permit & Surcharge Treatment Plant' Copies TOTAL f Page 2 of 3 o /t~ - N O 0 IO E /000 * Link. Fence inside/ ro er L~~c _ ~ ~ i Jo 'er 1 x v \ ` ' N G-1 ~ j J ~ 3e; Foy I ~ 14 \G) U 1 D r 3 Jo U! H F v O I~~;rJ' o 7p m F I 0 gj# / o o ~ ~ ~ a h D / ` f Ya ~ V /0 \ P !f N D .oe Sc _ } 1 Q 'rte Q m X m T z sv ^ X C3 4 .3. F re I ~ ~ . ~ u ~ °i,~ - s w 3•l U ~ ~ Y 01 ti Ala 1011, 0 42 / ♦ cos -I. 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I -0 61, 1 09/30/2013 09:55 6513447137 AMANDA HANSON PAGE 02 Use BLUE or BLACK Ink - ^ For Office Use j Permit 0: ' 15 S;J 1 I City of Ealan I 51 .s© Permit Fee: 1 3830 Pilot Knob Road I I Eagan MN 66122 Date Received: j Phone: (661) 6784876 Fax: (851) 675-6894 1 Staff; 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: site ddresss 3"1 ' 77 3 7 Name: Phone(iiil Address I City /Zip: Ltj ~}a " Applicant is: _ Owner Contractor Description of work: I~,C~.d1V Y -T~ -63 Construction Cost: ~ CCO, 00 Multi-Family Building: (Yes -YI/ No Company:SMW)~ UL-T) Contact: LSI Address: t2,zbO 6c)L,0-T AIQ S City; Rum 11 /AYI-ra~KI State: Jat4 Zip: 55431 Phone: lQ ( ~l~ L ~Izl License ~C-b 3 j 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: Phone: Mechanical Contractor: Phone: Sewer 6 Water Contractor: Phone: ~ - t • 'r• ° iii IN s.: 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. mM.9Qoherstaleonenall.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 pemMt Issuance- x x Ap Ilcant's Printed Name ' 1 L~~ pl nt's Sgnature 6 Page 1 of 3 05/02/2014 14:30 (FAX) P.001/003 Use BLUE or BLACK Ink I - For Office use I Permit 0: 12 y3 City of Pap -7 3, 3 r 1 I Pannlt Fee: 3630 Pilot Knob Road Eagan MN 55122 Date Received: Phone:(651)675.5675 I I (Stall; I Fax: (651) 675.5694 .31 -3 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 'S-2-t Site Address: a?7 3 'S-?V-7 TZdb ,Lam, Unll X: Name' Phone: Resldent7, Address ! City I Zip: I; 'w Applicant Is: Owner Contractor C. i; Description of work: _ t_w ^ t'8^ ~t S ~c Type of Work . ;i ;A I ;,1.;, i Construction Cost: "3 f't ~UU. c, Multi-Family Building: (Yes / No I' Company: u1a A ce) 6 S4/u L. ~t U,-, Contact: `Je. va C C 1' Address' CXOV tv. OltrAdtor b o l~- &k::r S City: 7~%1 vin ow., uA ~o State: jMZlp: :i2a{ L Phone: ee t. a.- '3 33 EM811: c D Y-A Q r, IN <<nri..JUi C. ?(o ' License Gr uen (a ( Lead Certificate k) A T' (1 CJY If ^ If the project Is exempt from lead eartiflcatlon, please explain why: (see Page 3 for additional Informatlon) 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: O.TE:!P,.lana andsupporting,documan'94tt at~yoi~4 if 11brn 'are 'conslderedl't ` "udllc;'lnforriiat/onPoitiers"of'!!! r.:!lofo'rr itlon;ma less.I:,.l.f/od.un,'a8; d :n,i: roola . i : : n.,, ai,.. L . ~r r,:. u•Gr .I,.. d,~elp,..n.,, ..,I I, L the.: ,nvn;puliNclliyou, piT~ v/de:;apeclilc reaso sit/iat;would:per 1t;~C/ty'rollil'I yc . ;uy~.d,l ,•..~h";I~.p~ rLr .a,: diz ,L:... i' n. cn,i.n.vrc i,.,,•~ ,I~IrPhi p,;'fi rir•. ~ ,P.i I'itr~Il P ! I.• II ~ G.i i ' I iconc/ual 00 th`e LLIIjji!Iji CALL BEFORE YOU DIG. Call Gopher State One Call at (831) 454-0002 for protection against underground utility damage, Cell 48 hours before you Intend to dig to receive locales of underground utilities. www,pooherstateonecall.om 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 plane. Exterior work authorized by a building permit Issuad In accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X ~ar ~-cnVW x Applicant's Printed Name Applicant's Signature Page 1 of 3