1574 Sherwood Ct- Residential building permit app
Use BLUE or BLACK Ink
F-----------------
I For Office Use I
j Permit
City of EaEdIl I Permit Fee: Al1`'P
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I fii
Fax: (651) 675-5694 1 Staff: I
I I
-
2013 RESIDENTIAL BUILDING PERMIT APPLICATION IV,"1~►~'
Date: C Site Address: IS 7e-l Si eyr 4- Unit ~t I
Name: X t~ Phone:
Resident/
Owner Address /City /Zip: d
Applicant is: Owner Contractor
Type of Work Description of work: t if, tAo d ~ 1
Construction Cost: *364 oco Multi-Family Building: (Yes / No
Company: U"\~ -Chl\S UCii-l_c,tn Contact: -KYC-V\ S e kVG l
Contractor Address: lS q C _ 6-r_0 ( 0 C,City: ~Ay e l{ vc"< <+r Y
State: Zip: J Z 1 Phone: C9~ 4 2 `-l 3 1 1 Iwo
License Lead Certificate NA t -6!? ?j W - 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 _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 specific reasons that would permit the City to
conclude that the 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.aooherstateonecall.org
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_ ~XCW\' x
Applicant's Printed Name lr nt's nature
Page 1 of 3
~~y 5 U
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
_ 01 of Plex _ Lower Level _ Pool Miscellaneous
Accessory Building
WORK TYPES (~itit t ►7~' ~b'~ . tL
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 Coo V Occupancy d='~ MCES System
Plan Review Code Edition 1114- l Zr:V? SAC Units
(25%100% Zoning City Water
Census Code rr Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction V 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
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough in -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee L~~°' E~
Surcharge ' " r v
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3