1584 Clemson Dr BCity of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA124353
Date Issued: 06/27/2014
Permit Category: ePermit
Site Address: 1584 Clemson Dr B
Lot: 43 Block: 01 Addition: Thomas Lake Heights 2nd
PID: 10-75951-01-430
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Troy Good
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:
PL - Permit Fee (WS &/or WH) $55.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
- Applicant -
Owner:
Nancy Bossenecker
1584 Clemson Dr B
Eagan MN 55122
(651) 808-4122
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
DEC 7 9 2015
r
Use BLUE or BLACK Ink
For Office Use/ Z4./67/ Chk
1
Permit #:
Permit Fee:
Date Received:
Staff:
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ,5?) •
Resident
Owner
Name: i,A✓t D Md
Address / City / Zip: 15 ' `/ /3 e f rMSbrj
Applicant is: k Owner
Contractor
Phone:
Unit #:
v
• � WW1 ,N bak. re rnod2L
Description of work: W 1i�dOW � S
/ j
Construction Cost:
Multi -Family Building: (Yes
Company: "/iri,t,.e illi✓eSVIVttA+) TA'+ienContact: MARL' (Jr/l, MS
Address: '5S C r'cr ''
State: MV Zip: 5-512 3
City: 41:4 /
rCJLCMf.2 /cCc,'
Phone: 657'S 5151 9'f Email:
License #: 17JC. Co3 5f k2_ Lead Certificate #:
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor:
NOTE: Pians ani
the information
Phone:
supporting documents that you submit are considered to be public information. Portions of
ay 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.00pherstateonecall.orq
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 1 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 NI19%2-e i ;,t
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
/5gq CEosafrk �dlL_ ati4f DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
_ Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
�( Alteration
/` Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%)
Census Code •
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
y Lower Level
Porch (3 -Season)
_ Porch (4-Seatson) e
Porch (ScreeniGaZe 0/'Pergola)
Pool
Interior Improvement
Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water _Final
X Framing
Fireplace: _Rough In _Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
i2
_ Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
_ Demolish Building*
Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building — give PCA handout to applicant
-o I(
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test
Gas Line Air Test
Pool: _Footings _Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath Stone Lath _Brick
—A Windows ILI) C.kla,„,,,f
Retaining all: _ Footings _ Backfill Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
, Building Inspector
(10A"
ow/
�� Q 0 0
V' / Page 2 of 3
1
r E AGAr For Office Use
e ; i • f • Permit#:
... •. ...,
..•• ••.0 1#9. Permit Fee: 1
, .f I
>>-, Date Received: Q--/
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 8 `A i
(651)675-56751 TDD:(651)454-8535 I FAX:(651)675- Staff:
b u i ld i n a i nsaectionsecitvofeagan.com
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L 1 7111 11 Site Address: /6-0 g l.6414cL 7'V D� Unit#:
Name: /424,071/-
4,07t 0'/s( h /G 'A1 Phone:
t'
Address/City/Zip:
Applicant is: Owner X Contractor
Description of work: N Alitita. 1 cJ4 r� it i!— .- /t//d 6
peobviiiik 0
Ty
Construction Cost: Multi-Family Budding: (Yes /No )
x Company: C071,4778liLTTef AM) H ec$. ont ,4 i Z
x.� l act: _ A. y
Com '',i' Address: l4-11.2. 6f/'L Z# City: I 'Le �'�,�'jf ei
�,/
State://PV Zip:4 f Phone:G47-a214—Ygkimail: j'1 .Sfiaez.r-s fuee.1"' e,
_ = License#: RZ 2Z 94 Zi Lead Certificate#:
If the project is exempt from lead certification, please explain why:
}/17)449 iLti Atifilie.4 44.40.41 1/7S7
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:
4 r
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
i NOTT1~ , .N. -,. ;: .r . 'l�
k,
6 z 1 �riaybe'
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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.
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.orq
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 pe '; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval lans.
X PALL �, ear Applicant's Printed& Applicant's Signature
DO NOT WRITE BELOW THIS LINE / gL/ CloIan ô,2. 8 / .6'
SUBTYPES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
Multi )0 Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
10 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
pReplace _ Repair _ Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation Z/ '��9'r Occupancy G.-- MCES System
Plan Review Code Edition m•t i i S SAC Units
(25%_ 100% )6) Zoning P h City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) yo Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
Roof:_Ice &Water _Final Pool: Footings Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: 1 JVi 1/t%17i1 , Building Inspector
RESIDENTIAL FEES
Base Fee 19 4 k/i) ' r s 3
/ o y.P7-,
Surcharge 6) it /5; 0 0 se• Ay-
Plan Review
MCES SAC M;/1 , ✓m- "e'p
City SAC
Utility Connection Charge 41C7 i.r," , /ve , o V
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3