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3748 Burgundy Dr n Use BLUE or BLACK Ink I For Office Use I --I 1 City of Ea Permit#: IbJ I o~, T I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: I )1031 3 RESIDENTIAL BUILDING PERMIT APPLICATION 7~~ y . Date: Site Address;_92~/ Or - S" ?&4q 7 Unit Name: l.C )004 ,S Phone: Resident/ n Owner Address / City I Zip: 375W-3751-6- 37`~~ ,t /-~C1 2 (j s✓t Applicant is: Owner Contractor Description of work: Type of Work Construction Cost: ® _;/00 Multi-Family Building: (Yes / No Company: 4L~111er ~A/rlJa/hCf7C C, Contact: Ry/ carol < Address: a100 ,~ijM 77ef--'✓ YJ go city: Contractor State: Zip: Ja Z// 13 Phone: 49/a _Sy - 9_45~59 License #:Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: 1 Licensed Plumber: Phone: Mechanical Contractor: Phone: i Sewer & Water Contractor: Phone: z 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 utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.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 Stale Building Code must be com 0 days of permit issuance. X_ L L Applicant's Printed Name Applic nt's Signature Page 1 of 3 Fr To: Page 2 of 3 2017-03-23 16:34:23(GMT) 16518340044om: Revamp Remodeling&Design tl•se • :or•BLACK in. t:: 1k i "For if?#fii4 ez tis _ y / / i i � .. . Maio :! • . //� "........4...:...... a all.•.::,;..i.,:,........._.., i Re rrti{Fee: i4, :: Com."�/ 3830:P.ilot Knob Road:: 1 : .. sari."Re eived: - _ — r. ,..:. : fde : . . • • g` StaffPax:.. t: 675- 9 ;. ..:. ..::, : UILI GPE2I N ALB • —unit* • t*0RE DY 1R..`/ • 3748 BU GUN _... : " -' : : :: .:. R PLPICAT ON • 322/20: .... Sika.Ad.. ." .. '. .-.-3/22. r a IT .;;:.., Resid , f rsI C,. 1Zi'. . :.am: .. . ..-k �..::,:,.:::::::.,:<.:...^:�..:,•':.:,t'.;:...,,:� :f�?.�cant.'as_ ..... . ..._Cwtaer.. Cofrtrec�tar,:::..; • " . . E7eso ti€ieart of workf,1•'• '• L DRESS t',LID' Ft VtF51DOW 4$"V31�c t$".ht,`�IEADER:ADD 2 LVL (1Q,. .: , pe of Work ° onstrtttttsn^dost:" i? tt (Y . -- ." t�[ultt�aanit �ul�dl g•. es " f""No REVAMP l �•[�i1�C?E€�I�II .; ,f7iII+�I � c : 612 '91 -}Q .`.'. k �rrtriparty: �11rtt2�' .. ' 5:,„>.?rl :,'<i:=iii:}"2:,;�{ :;:� s��tl'.�: .....?. .'.:.'..'.:. . : �� ..:--•-••••••-..i,.• ..:;_. .... �". .. .:... ."" • �D I EW �t I: 4Q PL.. STE 145 "• TILLWATER 34pctot: , aritlress fritY° • • I • 5508.2. &12 859-6294 res.a8lpd.esigt' . 5f3te __ 2ip._ .:.,,. _ f'horaa.. Emait:"w _ dTTCaS$� . BC634654"; � 14840-i Lrcecsse,#: E ea----,,,,, 777.t.7•,..--',.,:•:,.-,:."77-- ."77Cate' .. ..aftheproject:s: xern pt:fror lead dyeri , t n, Ecase • • : . -:. ..; OMP LETE•THIS.: At.ONLY IF.,CONSTRUCTI dt"NE Bt ILDI 1 :::;.. :... ...-.-:. t"In the lest 12'r •: -• '.has Cit of Ea n:issued a .omit far,a siriruiar: lan based on•,a Inas._ ,P "pl�i es . ,t«!o":�€';yes,''date:arad:address^:ofr�aste .:-x....:...r::�;:,�._.�— :: a `": . ... : g'licensed i lumber: l ore; Mechanical CantractPr; :.:.j:. •"':.::. ,. .,....�lactrse= t Sew r: "Water Contractor::::;.... • `s:'Phone: : • • a �IreSaE�i�ras�L :C:r�rstrac#or,.::-.•:<.'.' .::.... ;<�ttgtf!e: .'*ame ... :.�:: .�+�?tu?++ ::. ....• .•. .�xi'm..' :�:x. :.;.v":' �>.�: w>,a�,+n sus .�:ar f. ..�4,P :'tr ?? �; vS a _ 'fie +tii��:� - =. :_..:.::'� ..... � ....: . ...�. .. :. .... ..$�...:. ►�: :;iiia.>�. ... ..... .�� .. ", .,,, �"y[y�.�..I ��.y/.;}as,,, .���,ryyy�{�y .. ...,...: �`.. ,(( ".-•::'i ....,: .,.kms,:. �„ kr. :. .. .. :., ... _.... ., x'77 �.4� '..t...'•:';',"7,---... �, .... �. ...:......„,,,:-.:::::,4„.;.„,4.,.....7-..."-.47..„...„:, .'�. .,...:...•..�:,.,.. .:ra.a.,«:.+. ,c�.s>:.�;i«A:e.aa .�.t,. :a-'...:m:k I,ti:w,P.--'::.., ..• u,v ,"7,—:=— '”.ii.a:i,+ ,tt s...,++ W � -,t" :..�,t y 7a ,.rtxa , CALL t, C3. :Y :`DIC�:.Ca';' erStafe:bii�e.Gait01-.05ti 4 4sptt2#nr'prcat o.: ^gift-...:ct• Jao rdetitity:tlarriage.: iA tthe ..' ,:: ,. :-.40,,--.7..77-:.••••:r ntend<to`dig to receivefocatr.*s o.:k1 nderground trfl i v +i•a•.�fi a rsf....zr si�i; f:r� I:tiereityy.arckn•wle§...4 at tli:s inforrtiet oit.is: epieEe<ai'id,i tis#.:that it;e.:ywaik mate..in:conic"stance with.tlio vrdinar ces..'and i oiles':o the City"of Fagan:that 1 un nci this is trot a"p unit but only an applicatis n for a:perrnidt,Arid work,is not to start withou t:a J Irmit;tin• tiie'•work vill be.In ccordarieewith`tfie,approved plan'iii:the?else of:work'+ihich iegirirssareview grid app'ruuai C'•P---,.:::',,:•-...,..- .piar. . . :'; 5xterior:work thorized..lsya building=p rmtt issued.in a�coar(en a with the win. i nine .State Buildin Coos must tie.com :wi•-..n:'18Q..•••. :.: 9 ^ Pl days of permit issuance .:: :.: ..'.. `s::'P[itite�#.�ar�e' . . .. . ...`.... .. .... $' • .. :�?iaif" ig stoats • ^ 710 5 L t{4d(y /-'100 NOT WRITE BELOW THIS LINE lq/ 7 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 f/ 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 21 VDT) Occupancy :S..V 4- I MCES System Plan Review Code Edition oiri 2®(.'- SAC Units (25%_100°/1O) Zoning R -3 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction \to 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 Roof:_Ice &Water Final Pool: Footings Air/Gas Tests _Final ,X, Framing Drain Tile Fireplace:_Rough In Air Test Final Siding: Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall: Footings Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In__Final Braced Walls Erosion Control Other: Reviewed By: `d Al. 11C lL� , Building Inspector RESIDENTIAL FEES / Base Fee ' "�✓M �e <- Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3