3440 Golfview Dr Unit 312�
Use BLUE or BLACK Ink
^-----------------
� For Office Use �
' j Permit#: Z��� I I
Cl�� of �a�a� � ,�� . � �
R���'��D � Permit Fee: �
3830 Pilot Knob Road �
Ea an MN 55122 P- � Date Received: �
Phone:(651)675-5675 ��� � '' ��14 � '��
Fax:(651)675-5694 I Staff: � ;, "I•
. I I
— — ---- —
��,�,�,��,��. �-- --- - c��d°� �a �
2014 � BUILDING PERMIT APPLICATION
Date: � ��'J� Site Address: ��f �C1 �Q ���"i��1;4.� �'� Unit#: � ';���
n /at— f,
Name: � i�''�)�;. /—`d"�c� rllr� ��� Phone: [s�U �`���/ � "���
Resident/ /� ,.f.� ,{� �f
�c �
3D `v� Gz
° Address/Cit /Zi : V �� � /V ^
Qwner Y P
� �
' : Applicant is: Own�r "� Conf�'actor
�, .
T @ Of WOCk ', Description of work: L t�� �1 V ,d �V�� V�� 1 � ���� '
yp ` Construction Cost: -� f"1 Multi-Family�Building:(Yes v /No )
��� � �
.�.�
��� Company: �''1���'v!l�r' � �'v�1 ��- Contact:
Contractor Address: � ��� I�- Cj , � � 1 � City: �Gl M''�.�iJ�� l C�
State: ,��Zip: .J Z 0 �Phone: b��°Z��-,�i�✓"�mail:�C�'��CJ��C'C�Vi�\4rl'lt=1 rC��l �hC,GG?°
License#: ����� �"I � 7 Lead Certificate#: 6� �-�.�'��"�
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:P/ans and supporting documents that you,submit are con�+�ered.to be publ�c information Port�ons,of..:
the information may be classified as non public�f.you provide specr�c reasons that would perm�f the C�ty to
' concicide that the are trade'secrets. ' �`} . �. .� �
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection ag2inst underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orct
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 Build' g Code must be completed within 180
days of permit issuance�
�_
x �9���\� �� x
Applic t's Printed Name Appli n s ignature
Page 1 of 3
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 � II
Valuation 3� Occupancy ��G ' �;Z. MCES System --"
Plan Review Code Edition � SAC Units "
(25%_100%� Zoning �'2-� City Water -'
Census Code 'ti'3� 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
Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final
� Framing Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
_� Insulatian Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee f/g' �
Surcharge �•5 b
Plan Review 7( ?°-
MCES SAC
City SAC
Utility Connection Charge
S8�W Permit&Surcharge
Treatment Plant
Copies
TOTAL '7, �D
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA149954
Date Issued:06/14/2018
Permit Category:ePermit
Site Address: 3440 Golfview Dr 312
Lot:373 Block: 03 Addition: Tomark
PID:10-76900-03-373
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
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.
Contractor:Owner:- Applicant -
Eric M Anderson
13 - 104th St W
Bloomington MN 55420
(612) 720-6788
Pro Exteriors Llc
9001 E Bloomington Freeway, Suite 126
Bloomington MN 55420
(952) 250-0767
Applicant/Permitee: Signature Issued By: Signature