1173 Timbershore LanePERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA109480
Date Issued:03/13/2013
Permit Category:ePermit
Site Address: 1173 Timbershore Lane
Lot:3 Block: 02 Addition: Timbershore 4th
PID:10-76503-02-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Kris Oien
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Pamela S Madison
1173 Timbershore Lane
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
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For Office Use
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3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 Dt, ” . 2018 ` P
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: ,.:.01
buildincinspections( citvofeauan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: //"7 3 / /mabies 0 L/'7 ` Unit#:
IName: Phone:
Resident/
Owner Address/City/Zip:
I
j Applicant is: Owner Contractor i
Type of Work Description of work: IP'6 ''1 1 C d M C v-elS�rfi1
Construction Cost:7 2 I !'0 0 — Multi-Family Building: (Yes N /No )
Company: G USS n w rn (d h C v Cf <Orcerj ct.� ge /1;
Address: 03 y/a,-/ a. /4ity: /U 0 pi/ h� �//-
Contractor /
State:MN Zip:35 %3/ Phone: '95-o Z 3 E P02- 4, 'e 7Llj911" v/, .
s
I License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
I
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:
i
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents documents that you submit are considered to be public information. Portions of the information maybe
classified as non-public if ou rowde s ecific reasons that would ermit the Cit to conclude that the 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.citvofeagan.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.qooherstateonecall.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 lans.
x &V Pof A,i ,J x ...e-__Le. -__
Applicant'§-Printed Name App icant's nature
DO NOT WRITE BELOW THIS LINE
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
lc 01 of 41Plex _ 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
_ Replace _ Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation Soli SIND , Occupancy �Q L ' 3 MCES System
Plan Review Code Edition S4)V12.0/ c SAC Units
(25%?< 100% ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction \6 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
X; Footings jdditiaon) s7-0,0f ? Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas 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: / O m . j , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Copies
TOTAL
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