2171 Cool Stream Cir Use BLUE or BLACK In
r-----------------
I For Office Use
Permit#: '
City of Ea
Edii ; Permit
e t Fee:
3830 Pilot Knob Road I ,ice
Eagan MN 55122 Date Received:
Phone: (651)675-5675 I U°,, I I
Fax: (651)675-5694 3 4 7 016 1 Staff: I
I I
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:
C9-Zt>, - I e Site Address: Z Coo �S' by-61(— E Qn �S 12,2-
Unit M
Name: ►t e) I J sk f Phone: (p "'Z��" !�O t
Res-d— '
'Older Address/City/Zip: 2 �1 b ��� EG G1 �N
Applicant is: Owner -^ Contractor pt
' Description of work: a 0 tor
Type of Work
Construction Cost: U! Multi-Family Building:(Yes /No )
Company: Contact:
CJ6Intr Act 0P Address: City:
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:
NOTE:Plans and stappor#179 C ...Men#s that you sudinrt are=consideretl to;be u lac infdr�nati n Portion f
the lnforination rnaye classified as nor-p6icf youFproaile spectic seasons that awonld�erm�t City fo;
conclude#lint tfie ire#rade 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.aopherstateonecall.ora
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.
xM,e) i.u -- /-)n r
Applicant's Printed Name pplicant's Signature
Page 1 of 3
1 ! t
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
�4 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 4 y DOD Occupancy ' 2 C,- 1 MCES System
Plan Review Code Edition WJA zot S 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 y 13 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) o Final/No C.O. Required
Foundation - HVAC_Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: _Footings Air/Gas Tests _Final
C, Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
1O 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: 76 Al %IcI m , Building Inspector
RESIDENTIAL FEES `
Base Fee
Surcharge Zo•D° Sy' • 04/—
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit &Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
r---------------
I For Office Use
111100 Permit#: ���� `'' 1 �
City of EaEd�
r � Permit Fee:
( ; ,, c
3830 Pilot Knob Road fit` j
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 JuN j Start: Dy�/
Fax: (651) 675-5694 L-----------------I
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ( -Z(O-1 kO Site Address: I CO 0 tyT-(k M Ci C cake F c,$C-n V\ 5 I'Z,Z
Tenant: 1 r\� \ f S� _`` � s Suite#:
1�1�liss� fines 12 -z2,-�� ��
Pi Name: Phone:
�
�{ �` �;4 Address/City/Zip: Z 1 - U%t S—`.^'' C1 rcAe A» X11 N
Name: License#: nAG
cr
tea: Address: City: �1
Con#ractor I �
State: Zip: Phone:
LpOPP Contact: Email:
New Replacement —Repair _Rebuild —Modify Space
Type of� — acemen epa — '
v.a�. 1 �e� 1 ev
Description of work: � O eR
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation(_RPZ/_PVB)
ypsW Add Plumbing Fixtures(-Main/ Lower Level)
Septic System
?; —
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge)
TOTAL FEES$
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.
X MelissA X Al
Applicant's Printed Name Ap cant's Signature
A.
ROM
Requtr nspections .Under
efer Ratsd It
..