4179 Starbridge Ct SEP-13-2013 12:49 From:7637841426 Pa9e:5,'8
Use BLUE or BLACK Ink
I For 0f7ite tlse _ A
1 1
City of Ea an Permit p; f 4 E I Permit Fee: l0 ~V • r~ I
3830 Pilot Knob Road I I
I
Eagan MN 55122 Date Received; 1
Phone: (651) 675-5675 1 1
Fax: (651) 675-5694 1 Staff:
1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: I2 J 13 Slte Address: I- I 3 Unit
Name: ► `dQ Phone:
0illFif2t Address /City/ Zip:
LAW-
Applicant is: Owner Contractor
Description of work:
.Construction Cost: w Multi-Family Building: (Yes /No
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Company: dT J Contact: ( AbAwmy
.7 Address: City:
State: Mq zip" _5501 ( Phone:
License Lead Certificate wig-I-'- 100 U y, I
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 KNo If yes, date and address of master plan:
Licensed Plumber; Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
"N' gmtatnfd tl toby pub/ic intormprlon. Potions of
yihcpu prptnde 3pecitl~. rlsasr~ns that would permit the City to
MV, r.~fllafr~elt-tf are tr:.4 -goOrtsfS.
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 Co dig to receive locates of underground utilities. www.gooherstateonecall.qrc
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 Min rota State Building Code must be completed within 1e0
days f permit issuance.
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App tca is Printed Name Appl• n s S gnature
Page 1 of 3
Use BLUE or BLACK Ink
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For Office Use Permit#: /Cityof Eathari i
PermFee:t /e90-6 7
3830 Pilot Knob Road
Eagan MN 55122 >yY Date Received: /,t /�
Phone: (651)675-5675 �� l � Staff: `fr
Fax: (651)675-5694 AUG (} 1 1017
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: dif "'"'/7 Site Address: Unit#:
Name: Phone:
les c er t/
wneY Address/City/Zip:
Applicant is: Owner Contractor
e of� . Description of work: /'7 ., 6 -t �1 t ry �r r� .�'�✓/ c. f'
Construction Cost: /73--r- / Multi-Family Building: (Yes /No )
Company: (4:i/c.e/.04/4',$- �X/��ie« .G a� Contact: 9oL•J
Co frac ory Address: /ec-7,9 /i i y City: /G 5/ ' -v/
State/24_Zip:.S f C'// Phone:713J/z 7-5,9"7-mail:
License#: 7,1e) 437 Lead Certificate#: 4/ —/G/L cin✓��`^
If the project is exempt from lead certification, please explain why: 0r4� 'I t1t 5
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:
Fire Suppression Contractor: Phone:
+w°*t7-� y c ^ ..,�,x - is "'"�3"`�� +r N�-f�hQ�.,'e E►reform w►o�ff.},akYsu'�® ®o ^,,►„ .�.o roc, ,,ma 'K issr*n�z at „f aftu��®%m.,'it � .,8 oni''de pub6 iffor
a bclas►fieBo0u1► pecfic,, a o ..�„►on Po�►onsm o�f„�`
hast wou d permit the rttiy o
0nC'ude h t tWey a e 4trade-s ere
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 Building Code must be completed within 180
days of permit issuance.
X DC I .(< _44 17 X al,ef
A licant'sP rinted Name A 9:nature
pp pp
Page 1 of 3
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/f f '7q .Q-AG t OT WRITE BELOW THIS LINE tilt--71
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
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
I ' Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation 2 ibb Occupancy .(,,r MCES System
Plan Review Code Edition 40/10(( 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 ire) Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
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: 1 , Building Inspector
te
RESIDENTIAL FEES :
*)tt'
Base Fee P
•
Surcharge . illicit
Plan Review -4/1/
x
MCES SAC 0( 1;
City SAC
Utility Connection Charge
S&W Permit& Surcharge Oa
Treatment Plant 4 f'
Copies Oil2,64,
TOTAL
• Page 2 of 3