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4030 Cedar Grove Pkwy ' Use BLUE or BLACK Ink � For Office Use - ---- — I . . � . � ��� �7�� �-�.�. Cl�� af �a�a� � Permit#: � I iPermit Fee:_sT—�� 3830 Pilot Knob Road Eagan MN 55122 � Date Received: j Phone: (651)675-5675 � I I Fax: (651)675-5694 ��� `V � I Staff: I ��� �� �j ?� y, �________________� ! �. ., . 2015 RESIDENTIAL BUILDING PERMIT APPLICATIO f� . G Zo�s / �.SL� �-c1i��. (��''�- Date: sl Site Address: C�aar �v� pkw � N'�°�J �a� � Unit#: ��li� a � � �YLf�W� ��E� Phone: �.�Z'2 Z`l^ 6�.3� ; Name: Residentl � Owner Address/City!Zip: 7s9' ���jrwwt �r � Ec�q (�i-�i�^ft � l�'IN S'.5�,3`/� � � Applicant is: �Owner Contractor � __.�,� ���.�..�.�, �. � m � / Type of Work � Description ofwork:_ a�'^��r RC�iK��� �k�1 Cnny{-v�c�{'�o�'I k� 3 �QCa�'4i��1,}' � Construction Cost: �Ig$I�V�^ Multi-Family Building: (Yes /No� u,.�� ..,,��. �,..,,, �� ._�. � � �r�v�hc.cd Wa(� ,f-�-�-�c-F�r-es L�c �'�'v4 u���c I g Company:_ � Contact: �e Q ' � ( �j��� Contractor Address: ��-r� ✓'��`►�Vl�w Ln City: ��rj��v L�kc h ' � W1N z�p: SS3�Z Pnone:6/2�387-Y7G� Ema�i: .�-rv�.v e ao I . ��w► � State: _ � I License#: n�0. Lead Certificate#: n/A ' v/�/� CE��—��O NOT W IT�BELOW THIS LINE � 5����cc�0 �' 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 ��� 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 Suppression Required Type of Construction 1�� 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 f Insulation Windows 2 _ �� �,���y��""��y,,�-�c:-�� Sheathing � Retaining Wall: �C Footings�Backfill�Final Sheetrock Radon Control � Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control _ --� Other: Reviewed By: � �- ' , Building Inspector RESIDENTIAL FEES Base Fee � Surcharge �� �11�J�`� �''� � Plan Review �ls " 4 � MCES SAC City SAC �� ;��� � � +..�� Utility Connection Charge S8�W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 � � � ���� . LOT SURVEY CHECKLIST FOR RETAINING WALL BUILDING PERMIT APPLICATION � 1 � ! , Address � � f� �����i,�� r- ���(�� .S� �,. �3� �.�-C f �"� ��, ; 7�� Applicant Name: L DATE OF SURVEY: Sl���-�%J LATEST REVISION: a� a� c � **Permits required for Retaining Walls 4 feet high or greater. Y a � o z a DOCUMENT STANDARDS ,� ❑ ❑ • Registered Engineer signature and company Ja' ❑ ❑ • Building Permit Applicant �' ❑ ❑ • Address � ❑ ❑ • Legal description ❑ �+l ❑ • Lot lines/Bearings&dimensions p' ❑ ❑ • North arrow and scale ,2f ❑ ❑ • Street name ,F�1' ❑ ❑ • Show all easements of record and any City utilities within those easements � ❑ ❑ • Setbacks of proposed structure and side yard setback of adjacent existing structures ELEVATIONS ❑ � ❑ . Property corners ❑ �' ❑ • Top of curb at the driveway and property line extensions(only if wall is within 30 ft. of curb) ❑ � ❑ • Elevations of any existing adjacent homes �' ❑ ❑ . Adequate footing depth of structures due to adjacent utility trenches ❑ ,jr7' ❑ • Waterways (pond, stream, etc.) ❑ �' ❑ • At the foundation of the building and/or nearest structure PONDING AREA(if applicablel ❑ �d" ❑ • Easement line ❑ �' ❑ • NWL ❑ � ❑ . HWL ❑ ,� ❑ • Pond#designation � ,B' ❑ • Emergency Overflow Elevation ❑ .s" ❑ • PondNVetland buffer delineation Y . Shoreland Zoning Overlay District Y � • Conservation Easements RETAINING WALL INFORMATION � ❑ ❑ • Location of Retaining Wall on property y3' ❑ ❑ . Top& bottom elevation at each end of wall and any change in elevation in between � ❑ ❑ • Type of material (i.e. modular block, boulder, etc.) �' ❑ ❑ • Directional drainage arrows with slope/gr ent J Reviewed By: � Date � � GFORMS/Building Permit Application-Retaining Walls Rev.5-4-09 � N � �o � � m m m � w c� • ? � F � �� � ��F � a Z ^ ^ W � z� � w�u ' c�o� 9 ,. �'o � o�'"{' 1 ��zo� w m -�I�h- -�izF� -�I£I�- `'�'' � . ��Qi g� �`��c�5 u`��W,� ma �µ� i:��� N �i:z/i � N �"z i �^ �"Z/i �^ v� Zi s / �a o�. r�> 6�, z�v�i o� m� � � ^'� . � ,�g ,>�a3, �a� o�,� �� �N � a � e N m f � " � � z 2�N �O� /~�� � \,\ ` ' OLL � G O � O � O -« z � m O Q � � > F� O �Oxp W 'P� . :' �% �"" � � � � �N � ' �i v -- N �rc � �' x � � ^. � V � � � ��$ �� e���°� v �" — �"�d i�,� � V ��m W :.. W m� � W o ri ` �o %/ oox e '�� ��^d ,\Kq�'\� L �mN �� fn ��N �� N �' ��g fA �oa � z �z O�j. �� �\ '� m \ \�' '` r " � `� o� .. Q `1 0`3W m� Q `-� o z � ? 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