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1692 Covington Lane Use BLUE or BLACK Ink r For Office Use Permit#: City of EaRd Permit Fee: tt 3830 Pilot Knob Road Eagan MN 55122 I Date Received: 7 Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2 2013 RESIDENTIAL BUILDING PERMIT APPLICATION W Date: 16- 3 Site Address: 16-72- COV I06Tor1 L/ y Unit il Name: JCo 1 _ A IDErl Phone: 651-167-7W2_ Resident/ Owner Address/ City/ Zip: 1692_ C®v in o O L d CA61g IJ , m>j X511 Z- Applicant is: Owner ✓ Contractor S Type of Work Description of work: ~~Mo y ) o l Cori I oX I6 cxc.K fVi 1L 10 XL 1!', DE5-I5- ap Construction Cost: ~O) I OD Multi-Family Building: (Yes V" / No ) Company: I RoyS C~ ~"iS'gWooo~ence.S Contact: I goy .r Address: 12_800 &erMAtJEAyc 10G City: W'&- VA)!~y Contractor State: N Zip: 5512- %il Phone: 1,397 License BC 58 Io~SG] Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional informatio ) 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 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 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. y ID/oN 711PIN00 l 41H Applicant's Printed Name s Signa re Page 1 of 3 qo? Go~tn~n l / I DO NOT WRITE BELOW THIS LINE 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 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 4040 ! Occupancy MCES System Plan Review Code Edition W7 SAC Units (25% 100%_zz Zoning A-3 City Water Census Code ly.1 ly Stories - Booster Pump # of Units 1 Square Feet PRV # of Buildings / Length /d Fire Sprinklers Type of Construction Width oL/, d 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 ~ / ~ /~j ,(ERG ~ ~ 3 ~.~►;I Base Fee /O 3 4~+ Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 i w v ' 4 i Q z -14 v ~m W <m ° z v C7 00 ~ x Q ~ e ti~ c N) n AqJ /7 � � I C�g�--(, � ��' , l c��Z � � tlse�LUE ar BLACK Int� ! ForC�EiceU�ae--------- f � i Permit# �� j �� t� of�a�a� ; : . � o-�.� � � Pe�,��. . 3 � 3830 Pilot Knob Road ; Eaga�MN 55122 j Date Receiv�d: � Phone:(657)675-5675 I i Fax:(651)675-5694 i Staff: I 1 { . : . . . � � . . . . V��.��.� �� .��.�J. . 2014 RESIDENTIAL BUILDING PERMIT APPLICATIQN , �� 16 �a �- Ib�� c�� -��-�� Date: �!'"�!� Site Add�ess: Unit#: f� .� r��'�J� Name: ��?�T"/�i�� ... !t�e��Gt�i C..� Phone: Residentf ownec add�e�s i c�ty i z��:_��'��- �i� aPPiicant is: (3Hmec � Gontractor --.� Type c�f lAfo�ic; Qescriptionofwbrk: ��'''�''' �?�� 'G" '��` � t�� " . Cans#ntction Cost: � � Multi-Family'8uilding`(Yes � /Na_,� �� / P1 G- �{ �' Company:[t/C?YZr��5� G vYi�t�r��'�fh�5 '� Contact c/�'f'�'a'/�G�iJ�f% Cantra�tor Address:Q�1.��'l �✓�'ir��` !�� Lr,�-y�z �s c;�y:��'�'�- �!�t,�� G I''� ) State:�Zip: .��`1 Phone:��''��'"D'rEmail:,lrm�$7�1t3v'L��`7'��v�`�d��r� Liaense#: �� 7� �s�c�-C.�r�-�. t.eaa certificate#:/V.�a.r°,-r»�t'�3 °I if the project is exempt from Jead eertification, piease exptain why: (see Page 3 for additional infermation) C�MPLETE THtS AREA ONtY fF CON�TRUCTiNG A NEW BUILDING � . 4 � . .. �. . . . . . . . . . . . .. . . . . . . . . � . . . �� In the Fast 12 mont , agt `he Cily of Eagan iss�d a permit€or a similar plan based arr a master ptan? .Yes _No !f yes,date and add f master p(an: Ucensed Piumi�r: Phone: Mechanicai Contractor: . Sewer�Water CaM _ Phone: � -�_` /�F!?TE: s and�u#ipo�r�g dacum►enf�tha#ya��6r��t�re consfdered`tc�be p�blic ir�re�m�#��. ��o�s�t' ; mf�rrrt�ation�ray be�/"a�s►�`ie�if�s non prrhiic if�otr�►ravf�►e spec�c rea�oRS that wqufd�it#�i+s�r�jr'#o � - � ��co»cluc�t� � ' � �� s�iae�ir`ar,�e s�r�ets. � � ;, � � �;. - � -� CAtL B�EORE YOU DIG. Cali Gophet&ta�One Ca11 at(651}454-0002 for prutectian against underground utiiiity damage_ Cai!-48 hours be#o�e you intend ta dig to recefve locate.s of underground uiilities. www:aooherstateonecatl.ofa I'hereby acknowledge that#his infarmation is c�np[ete and accurate;that the wrorlcc wilt be in�onformance with the ordinance.s ar�cx�des of ihe City af Eagan;that 1 understand fhis is not a permit,but oniy an apptication for a peimit, and v+�rk is not to star#with<wt a permit; that the work wil#be in accorclance with the approved plan in the case of wrortc whiet�requireg a reviewr and approvat of ptans. Exterior work autharized by a buiidir�g permlt issued in acc�dance with the Minn�ota&take Id1ng Cade m�t be compieted with9n 180 days of'p�rmit issuance. '�c �� x it/�1�'�? �G ` l? ` ' '`�i � x ApplicanYs Printed Name ^ anYs Sigrtatute ' ; Page i af 3