1284 Deercliff LaneCity of Ekall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use l>.'e- or BLACK Ink
For Office Use
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Permit Fee L/ 3u�
Date Receved: C' 3 - IS
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
t
Date: CI \ .61 e Site Address: )'2'$0 -, 32. " 8 - 8�Db„ 042-` 4 j Unit #:
Name: IUDV^Q�j 1i))' ",x►r i hone_ ( 5I "46—Z. —XILIQ
Resident!
Owner Address r City I Zip: P. .. al 6B-7 _ FACp,e...1 (Ilk) SSt
Applicant is: Owner Contractor
Type of Work Description of work: Re_--gq0
Contractor
Construction Cost: j
Multi -Family Building: (Yes y No
Company: A -,1 u+- T'r' T --to u S Contact: ih u 6 R .
Address: 9 10 CO e ri "rC�IPt i L City: OA 0 A04.
State: Nht Zip: 5S1 13 Phone: (j 1 1— 2-4 0 —1 (2(,) y
License #: BC, 54 5 7 68 Lead Certificate*: it - g j T91-1
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:
Phone:
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 they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at {651) 454-0002 for protection against underground utilty damage Gall 48 hours
bekr e you 'mend to dig lo receive locates of undergraurrd uttlllies
I hereby acknowledge that this informaton is complete and accurate that the work will be in conformance with the ordinances and codes of the City of
1- actan Ilial I undrrsland this is nol a permit it only an appftation for a permit and work is not lo start without a permit !nal the work will he 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.
Applicant's Printed NaMe
reriz
Applicant's ignature
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA121302
Date Issued: 03/25/2014
Permit Category: ePermit
Site Address: 1284 Deercliff Lane
Lot: 009 Block: 003 Addition: Windcrest
PID: 10-84460-03-090
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Softener
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.
Josh Mcguire
1424 3rd St N
Minneapolis, MN 55411
Fee Summary:
PL - Permit Fee (WS &/or WH) $55.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Benjamin Franklin Plumbing
1424 N 3rd St.
Minneapolis MN 55411
(612) 604-4285 X61
- Applicant -
Owner:
Kim Torkelson
1284 Deercliff Lane
Eagan MN 55123--143
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.
Applicant/Permitee: Signature
Issued By: Signature
Use BLUE or BLACK Ink
For
I Office Use
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AppReenre
/„sq De2LI f \ i h OT WRITE BELOW
THIS LINE
SUB TYPES
Foundation — Fireplace
Single Family _ Garage
— Multi v Deck
01 of _ Plex _ Lower Level
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%X
Census Code
# of Units
# of Buildings
Type of Construction
_ Interior Improvement
Move Building
Fire Repair
Repair
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
_ Roof: Ice & Water _Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
_ Shower Pan
Reviewed By:
— 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
y, 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:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3