1240 Timbershore Lanei For Office Use
Petmit #:1(O 510 3
113, 31
Permit Fee:
Date Received: /8 a40
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5875 f TDD: (651) 454-8535 1 FAX (651) 675-5694
buildinoinsp€ctions(acityo`eagan.com
2020 RESIDENTIAL BUILliiiiGLPERNIT APPLI ATION
Date: /0 0 e."" - O Site Address 1 Unit #:
Resident/
Owner
Type of Work
Contractor
Name:
Address / City / Zip
Applicant is: Owner Contracto
Description of work:
Construction Cost:
Staff:
Phone:
0 -- Multi -Family Building:: (Yesj / No
Company: e.I.S l eo,ter
Address: ` t,231
State:1/2,4' Zip: 5
License*
the project is exempt from lead certification, please explain why:
Contact (2 r
L i2City: 3 ro e; ,.45 7/
Phone:7.5-0? -a >-yU1J, mail: �Y:- r l Csr �J�c, Wit+ r r�„ci /
Lead Certificate it:
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 pier based on a master plan?
Yes No If yes, date and address of master plan:
Ucensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public Information. Portions oftheinformatlon may be
classified as non-public if you provide specific reasons that would permit the City to conclude that
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the Citys
webslte at www.citvoreacpn.comisutoscrlbe.
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 Cali at (661) 454-0002 for protection against underground utility damage. Call 48 hours before you
Intend to dig to receive locates of underground utilities. E .v. coph=rstateone,^a11.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 1 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.
Applicant's
nt+ed Name
X
Appllcan
ignature
M
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
_ Single Family
Multi
—]—vrar e-
WORK TYPES
New _ Interior Improvement
Move Building
_ Fire Repair
Repair
Fireplace
_ Garage
Deck
Lower Level
J2 o T h
1.0_1/) sL
15108
_ Porch (3-Season) Exterior Alteration (Single Family)
_ Porch (4-Season) •W Exterior Alteration (Multi)
_ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
Pool _ Accessory Building
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%q
Census Code he 3K
# of Units l
# of Buildings
Type of Construction
_ Siding
Reroof
Windows
Demolish Building*
Demolish Interior
Demolish Foundation
_ Egress Window _ Water Damage
*Demolition of entire building - give PCA handout to applicant
Occupancy I 12G
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
_ Foundation Foundation Before Backfill
_ Roof: _Ice & Water Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
RESIDENTIAL FE
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
SSW Permit & Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
/037=
1,671
1.D AP
MCES System
SAC Units
J'0 City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Service Test Gas Line Air Test _ Flood
Pool: _Footings Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick _ EFIS
Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Fire Suppression: _Rough in _Final
Erosion Control
Other:
, Building Inspector
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