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1302 Deercliff Lane Use ; . or BLACK Ink For Office Use t t~{?fr1r1 ?S ~ City of Eapn / t Permit Fee 3834 Pilot Knob Road Eagan MN 55122 Date Receved: 3` 3 Phone: (651) 675.5675 Fax: (651) 675-5694 1 staff. 1 1 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ] O ID -02 ~,r eta fr' tttnit Name: jAll i i2 c`L Tc•3~--'--an`~ f~3rbr~t hone: Resident/ Owner Address! City I zip: Applicant is: O:<mer --tr - Contractor Type of Work Description of work: Q --R a Construction Cost: 119.1 y Multi-Family Building: (Yes t fro _ ) Company: U+ " T'~ A8 U C. Ii-I Contact: a f> n > Contractor Address: 97,0 CU V ru "rte t city: A 0 & State: --N\N( Zip:j 1 2'_ Phone:, Z { _ (Q License= : . A S7 b 9 Lead Certificate A I gIctl I If the project is exempt from lead certification, please explain 1why: (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 & 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 speck reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground util ty damage. Call 48 hours beto e,, you intend to dig to receive locate; of underground utilities I hereby { cknotviedge that this information is complete and accurate:. that the work will be in conformance with the ordinances and codes of the City of t agan, that I understand this is not a permit; but only an appleration for a permit, and work is not to start wiihoul a permit that the work tt he in accordance with the approved plan in the case of work i4,41ich 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 P ted Dame Applicanrs ignature 1< rE For Office Use •y r 0 .,, JUN � � � Permit#:E AGA N TT 2019 / O ••' '•• Permit Fee: Date Received: 3830 PILOT KNOB ROAD(EAGAN,MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: bui ldinginspections(acitvofeagan.com / 2019 RESIDENTIAL BUILDING/� PERMITLAPPLICATION Date: 0/191! /[ Site Address: �0� IJ 44r ,/ - -F LA) Unit#: Name: AfeCia. r"`_ / rvv 1l.eA. 4LIA2L Phone: 65/^ 4'c 7i3,' Resident/ Owner I Address/City/Zip: v',1‘1,e___ 6;0612 /t4 5:r0/ 4 e (774 Applicant is: Owner Contractor s'-IN Type of WorkDescription of work: rf a.Mev/ O�c� WM) Si't's /)437141/13' p EP 57415/r41; 0 Construction Cost 9/00^ Multi-Family Building:(Yes X /No ) Q Company: L cy yfemwria _rte- Contact: 77m. 1))42,I4 966 � Address: 1'�l%+�v Ave_�v� S19. City: �O�sC-(� 6�p ti.� Contractor / � t/— State: 1K N Zip: Scold Phone: 6$/-3 t/"3g Email: ,1d4 out ray GO••-c0i.f7 NST License#: a-66 6 3 6 797 Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW 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: N TE:Pis and supporting documents that you submit are considered to be public information. Portions of the inforrnation maybe classified as • , bhc if • • • . «;- reasons that would• the ' to conclude that , are trade secrets. Youmay 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 w .citvoteaoan.cornisubscribe. 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:goohecstazacoecadi_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 accordancepwith the approved plan in the case of work which requires a review and approval of plans. x /%ko Oeiw4 a x Applicant's Printed Name Applicant's Signature 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 a — Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 10 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 �4 Replace _ Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation Ligq/Do. - Occupancy ,�(ZC -3 MCES System Plan Review Code Edition ,yj i2 Z n I c SAC Units (25%_100%p ) Zoning P 2 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings t Length Fire Suppression Required Type of Construction I, Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) M_nn Final/C.O. Required Footings•{Addition) 51_ t' e!) Final/No C.O.Required p 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 L Other: Reviewed By: f O Wk-- M ' Y i y/'f ,Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge SSW Permit&Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3