1197 Timbershore Lane For Office JUse /�
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t x « : z Permit#:
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U(j2 Date Received:/0-i(�/g
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 2018
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: "r
buildinoinspectionse.cityofeadan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: (Ci i ! ( ho Ln r Unit#:
�.......�,. ...-.._____ .
Name: �,..�. � ,...� ..,_._ �� Phone: i
Resident! i
Owner I Address/City/Zip:
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Applicant is: Owner_ Contractor_ _ t
i___ Description of work: � 6 r� a{?G v ee Si�' _. � ,
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Type of Work ig
Construction Cost:70i 2 t 6?Q 0 — Multi-Family Building: (Yes K' /No ) I
1 Company: v�SS oGvpi (aiiCvc7 ..,`�ItJI'iC0'mntact lei
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Contractor I Address: 903 6 /17/a h 4CL4' ity: ,3/U 0✓ri •h.' i'd I--N. `
State:41N Zip:5SL/3/ Phone: 93-9) 3 9-"E(nWiilP - 6/0f
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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:
f
l Mechanical Contractor: Phone:
G Sewer&Water Contractor: Phone:
I
Fire Suppression Contractor: Phone:
NOTE;Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe
' classified as non- ublic if ou provide specific reasons that would ermit the Cit to conclude that yi,ey 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 inthecase of work which requires a review and approval of lans.
x &VP_r) A/e 7 ✓ 9 X
Applicant' rinted Name J App icant's nature
THIS LINE 1 I C1 7 I 1 ,I►I' 6112-----4 '-'61Lv -
/ -� �
DO NOT WRITE BELOW H S
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 41 Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New _ Interior Improvement Siding _ Demolish Building*
Addition _ Move Building Reroof Demolish Interior
e( 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 $0.jflfl0 , Occupancy 32 ( ' 3 MCES System
Plan Review Code Edition F 7✓12o/ c SAC Units
(25%?4 100% ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction if6 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
X Footings dditkw4 Sr OD p 7q Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
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:
Reviewed By: / O � pi; 1`1 jJ , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
SSW Permit& Surcharge
Treatment Plant
Copies
TOTAL
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