4447 Lakeshore Terracef
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0 1 Permit #: { // j
Permit Fee:EAGAI L
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I Date Received: o
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1 I
AUG 0 �OZ1 1 Staff: _
(651) 675-5675 ( FAX: (651) 675-5694 ________________
buiidinoinsoections(ftit tofeaoan.com
2021 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:
ResldonV
Owner
Site Address:
Unit #:
Name: W (, ( °L ✓ tXO&A _ Phone: ("61 1641. SD —
Address / City / Zip: 1"t "S!•er o- TC -e f scan 55 I Z
is: Owner X Contractor Owner Email:
Type of Work I Description of work:
t
Construction Cost: 4f J r\ rviuurralIally / NO
Company: Gy����r�-tG✓l Contact: 90.1
Address: �� A��l�-i�l� L' r 1 o c City: )( e- y oA e r
State: 9�— Zip: (oZn� Phone: 651 P1,,4(n%j ODI Email t Lk
t r" Lead Certificate # "
License #: 4� h.� �
If the project is eAempt from
explain why:
�t< r'A
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:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
to be pubik infom► tta t. 9
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.citvofeaq.@n.com/subscdb .
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www aoaherstateonecall.ora for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
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.
Appiican ranted Name
x
Applicant's Signature
F-1-1OFFICE: tom,=ONLY
Site Address: L `1`lI —1 L � Permit #: J -7/ 7
L14
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Miscellaneous
7-1 Single Family _ Garage _ Porch (4-Season) _ Accessory Building
}� Multi — Deck — Porch (Screen/Gazebo/Pergola)
01 of _ Plex Lower Level Pool
WORK TYPES
_ New _ Repair
Addition _ Fire Repair
Alteration — Water Damage
Replace — Egress Window
DESCRIPTION ()0,0
Calculated Valuation
Plan Review
(25%_ 100%)
Census Code
# of Units
# of Buildings
Type of Construction
_ Siding
_ Reroof
_ Windows
Solar
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)4 VIP
Footings (Deck) r,
Footings (Addition) `{ ` t `'
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
_ Retaining Wall
_ Move Building
_ Demolish Building"
.Demolition of entire building — give PCA
handout to applicant
MCES System
SAC Units
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 _ Hood
Pool: _Footings _Air/Gas Tests _Final
Drain Tile
Siding: _,Stucco Lath _Stone Lath ,_Brick _ EFIS
Windows
Retaining Wail: — Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Shower Pan ��/} Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Calculated Valuation
Base Fee
Plan Review
State Surcharge
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Radio Read
Other:
Copies:
TOTAL $ 0.00