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1982 Timber Wolf Tr S- Building permit app Use BLUE or BLACK Ink ~ For Office Use City of Eakan ; Permit I Permit Fee: I 3830 Pilot Knob Road I 1 Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Dm& 1"ff ly Unit Resident/ Name: M %Lf G Phone: Owner Address / City I Zip: 211 Applicant is: Owner Contractor Type of Work Description of work: T f Y dli(, ohk- ~Q. Construction Cost: C o'p ~I ~llulti-F Building: (YesW ' r La Company: flr )YIGI C~,rtc~Qe- IIX P11n ` ntact:'' t/-J'S Contractor Address: Ic~(3 xa-ubsibv- 60d T City: • vl~iS r" State: h Zip:r~l 161 Phone:~02- c! f s ~t~+o~ . . License 0-4LOC) j (U CH Lead Certificate Prt r,6 3 - If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A N LDING In the last 12 months, has the City of Eagan issued a permit for a si iii 11; an based on a master plan? _Yes _No If yes, date and address of mast Licensed Plumber: Phone: Mechanical actor: Phone: ewer & Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of L-, I 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.cioDherstateonecall.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 c mpleted within 180 days of permit issuance. x1~~ ~S x Applicant's Printed Name Appli ant' ign e Page 1 of 3 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/GazebolPergola) _ Exterior Alteration (Multi) _ 01 of _ Plex _ Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES _ New Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building s 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 Occupancy MCES System Plan Review Code Edition SAC Units (25%-100%--) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length - Fire Sprinklers. Type of Construction 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 Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3