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1002 Trillium Ct -Permit and zoning app Use BLUE or BLACK Ink r I For Office Use I i ~ Permit r) 1.1 I I I I r City of ~ I Permit Fee: 3830 Pilot Knob Road I 1 Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I L-------- 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: d Site Address: /400Unit on Name: Phone: ~T - Q,/ Resident/ Owner I Address / City / Zip: 19940 00 Applicant is Owner elContractor Type of Work Description of work: -ge..I'-eg X060 /~iG ~ral® t I ea F Construction Cost: Multi-Family Building: (Yes /No Company: 16' P Ae-e-1 b el Contact: Contractor Address: 30 //~,~e. 410 City: ~ot4)0-oa-~ State: lL Zip: 41617 1- Phone: (a day .6~r yo f License Lead Certificate 47 _ 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 documen#s_ that you submit are considered to be public information. Portlons 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.gopherstateonecall.org 1 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 &m4- X 44- 00!~, Applicant's Printed Name Ap icant's S' nature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace s 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 - 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 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