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4110 Rahn Rd A201 ,r--i T* For Office Use ,/� � _....- k, %,k,,� °� � ;�� r �o�Q ::::: '� E AGA N AUG16Y : Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 f1.6 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections(cz�.cityofeagan.com L ikP Co, 2018 -0017)/// 1 BUILDING PERMIT APPLICATION ',)e'Lf, tf, AZOI Date: g I/5 //e Site Address: (--1)IC) Q e-g aeu `J ?_A , C a+•l /`1N Unit#: ( Name: c- r- '$C.rtJ e5 Phone: 6 1J- _S-76 G(143 Resident/ Owner Address/City/Zip: Lill© C?-c-VA.ly VT.A1 C5-- c,,,..-. MN Applicant is: Owner Contractor Type of Work 1 Description of work: c-c. t-c.. teak - Fre. 0 F C) 5+.°rt t Construction Cost: \ SOC:) Multi-Family Building: (Yes >( /No ) Company: S C.-1-1s Cor.)S c,r•o,.r Contact: –"Sc.Sc,.v 1-tg'r...)-, Address: t4u'7l Ccsve {ars-e_ City: /A%NINv--4 'S-k. Contractor 1` b State:l► Zip: SS3 7c Phone: 6 I,-)c 8 Email: Jc1-1 Coate TNS 6- a(mob, .r License#: d C- a o�7 Lead Certificate#: l If the project is exempt from lead certification, please explain why: 1 i . c-.` 0,_.) s;�(e. oPt-c-k. tvc."*.. e,l's r,,p k G;r„11 r 5iv ccr.)/tom r rc..t.Ae.. COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING a 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: l Licensed Plumber: Phone: I s Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: R, Fire Suppression Contractor: Phone: NOTE:Plan's and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non •ublic if ou •rovide s•ecific reasons that would•ermit the Cit to conclude that the are trade secrets. 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.citvofeagan.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.gopherstateonecall.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 plan x S c jct-J .c- '\ x Applicant's Printed Name Applica s Signature DP NOT WRITE BELOW THIS LINE LI( D P-4,l�r\ 1` ► A2D1 iS \ 7 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 (1 2, -> Occupancy MCES System Plan Review Code Edition fi7 -z rel S— SAC Units (25%_ 100%_) Zoning TZ a'4 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction LIB Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings (Addition)(Deck) . I 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 PanOther: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee `� f.'"?' Surcharge Plan Review "2'y 4 ;/71 U/Yr fe MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3