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3647 Denmark Ave „ Use BLUE or BLACK Ink r------------ ----� • . ” I For O�ce Use I ; � ' � Permit#: �� C�� O� �� I Permit Fee: �� ./I s�� 3830 Pilot Knob Road f � / i � ' � � Eagan MN 55122 .� � 'a � Date Received: �t'� � � Phone:(651)675-5675 �-"`� ` �r,. j I I Fax: (651)675-5694 I Staff: I � I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION �ate: �� Z� � �5 Site Address: 3 6N1 �Q,,nMp.��(. av� � o�., Mnl S�i1Z�nit#: k'�� 5 u �`$�`�� :f � `� ��`l _ _� � �,��rs�,�� Name: O S2.Q i'.� I�.t..� Phone: ��L.� L'LS'"'1 _53"l� � �� p �� f Address/City/Zip: �6 t'�7 �C.v�T"Ark' t�-�l"� l� � Z 3 F � �� „'�- � Applicant is: �Owner Contractor � �� Description of work: �eC.� r`e.��-e-N�'P�v�'� fi��#f�I'� � � ': Construction Cost: � 1�00� Multi-Family Building: (Yes /No� � � � � � Company: Contact: '� � Address: � City: � � ��1��+f#� � ; State: Zip: Phone: Email: � � � �, ,;-,', _�.;; License#: 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: Phone: d�c�er�s� z��ar+��c��s�er�at��e�s�b�i�c��a�+��.� .1�ar�,r�c�' ; �, lU�'3�''�' ��r�'s��'�!. ,� t#��r��`t��zr��c��s�►�'a��+d�s r�r�n��i�`��J�t�a�d�s��r��#��t�r�r�t::��r f� � F � y� � �_, �, ��. 4 Y � ,x..�:'.. . ,,,,�� ,�e ��:�SI�� - 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.qoaherstateonecail.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 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 V0�2IJ� ��C..�Ov� x ApplicanY Printed Name A pl cant's a re Page 1 of 3 ��p�� /�'j�� '�O 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 Buiiding* � 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 �� 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 Insulation Windows Sheathing Retaining Wall:_Footings_ Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Other: ''� Reviewed By: � � , Building Inspector �'" � ,. / �{�� : �,.��'�� RESIDENTIAL FEES ��`r� �2GL.��G Base Fee �!,� Surcharge � �r��,(,/� , Plan Review f� MCES SAC �� City SAC Utility Connection Charge � � � �'r ' � /�� S&W Permit&Surcharge ��'� � Treatment Plant Copies TOTAL Page 2 of 3 � � � � �� 1 � � � � � � � � M rr� .� -� � � i • � � � �� ,�� '� ��e�� . _ � � ��.,�s- , �-. , � . � � �� ,� � �� :� ! � I� ��' � �'� �. � I� �� , A �� , � � � � � � � � � - .�. � .� � � _� _ � � � � _ _ � �" � ��/ <<- � " 1 *fi 3 � � � r x� �� '� �� . �� r � � � � � � � � � � � � �i.� � r I [ l� �� a � � t r 1 For Office Use �� 3, % % e ��i :::: EA : 1)419 i ...... -...• GAN ..;- RECIEVED �- V Date Received: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 MAY 17 2018 Staff: I buildinainsoections(a citvofeaaan.com L ... 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: 4 " Name: ,47 he4--s�,>i0 w-��.., l;c✓" 4 r ei,eS' Phone: ' Sl e � i 7 ..� �_" s ?x`14 tx Address/City/Zip: ' 4eii hiaY4 44..e. L l Applicant is: Owner /'y Contractor c� r &ss 71Ouirl CO» Cyek I'1'5r'i4... 7 C- 1 Description of work: Fp.,d 71' J'/ X175 -,-,:---kr,' ' Construction Cost: ,N p( i OQL) Multi-Family Building:(Yes)( /No ) Company: Cteass 1.0u, , CcnCrc-/✓ Contact: & VCq /e-i c, o #T > Address: �U 3 D iiy/el.r� C'1 oe /1f0OH1/�'lt�yT"," N State Zip: Jam.! / 7Phone: g�a2 – 23 ErTlfa' d e� 611`�7,t/ 4 45 4 Ctr701-..- ',4 License#: Lead Certificate#: fig 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: Phone: 1iOTSE Pla s aid supporting documents t you sub`mrtare consider f.to bepu tlic infor iatiion r, on of**fp:, rmatio rt m` a _ ass�eds i aon pr bltc if a provide specific real ns that rol ler+nit ie �io ncluie rat re�le�ss#a ts#. ° , v Y > , 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.citvofeanan.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.000herstateonecall.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 permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pI s. x e'Q fir.-e.,1. x Applicant's Prim Name Applicant' gnature `f-7DeHr) we-k__ � 1YI3 , 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 )c 01 of Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES _ New — Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior 7*' 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 J( 2)orso• Occupancy "T2 C --3 MCES System Plan Review Code Edition ///0?20/S— SAC Units (25% 7;0 100%_) Zoning -PD City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction ti3 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: )o Footings(Deck) 571:0.j Final/C.O. Required Footings(Addition) b Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test 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: )) i Reviewed By: i v71 01 i tiff , 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