1209 Timbershore Lane /
9 For Office use �',/�r)�/'
* r # Permit#:
t ',.t. ,�r �,s
E AG A
".m. .. '�..,_ ,,1'4—'1 Permit Fee: 9:3 , 1e), 1
4:1;i - li i
-, 1, Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 )i' I ; ,��j
(651)675-5675(TDD: (651)454-8535 I FAX: (651)675-5694 .r 2010 Staff:
buildinginspectionsacitvofeacian.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
0
Date: Site Address: / (2C7 /(�(YiG -5-7O .e Zi?. Unit#:
I Name: Phone:
Resident/ j
Owner I Address/City/Zip:
s' j Applicant is: Owner Contractor
Type of Work
Description of work: Ivo r� �a nCve/�' � ��� .��. _ _, .�o „
Construction Cost:i 2 r 0 0 0 — _ _ Multi Family Building: (Yes )C' /No )
/ /9r e 71
Company: G v 4,“io(v� Cp H G tr � �4 Yi CC ntact: 6 k*
tt
I i Address: 9 03 6 ° i x/a rpt d £ 4( ity: _ 154 0✓,,/ ,in 5 la v-\,
Contractor 1
State:MN Zip:35/3/ Phone: 9,5-c) 2 3 �EtSi lPQZ 7ij
6 f e ' G 1/ -er-i-,-..
i 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:
sMechanical Contractor: Phone:
i
t Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
i
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be
classified as non-public if o yroyide specific reasons that would ermit the.City to conclude that they 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.citvofeaoan.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.gooherstateonecall.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{edplan in the case of work which requires a review and approval of lans.
x VVe / i;e 1'9 x
Applicant' rinted Name J App icant's 'nature
oq "Ti'irvioc4-c-14012-6-- /41. )..5--( 0 --
DO NOT WRITE BELOW THIS LINE f
` 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
lc 01 of 'I 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 Sol)000 . — Occupancy ✓R ( ` 3 MCES System
Plan Review Code Edition N)✓t 201 c SAC Units
(25%K 100% ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction \,/t5 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) p Final/C.O. Required
K" Footings (4dditaon.) 5?-00 f' ?q 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 !V1 , 1 4 yI , 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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