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-
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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
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