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unit 473rAt,d EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 I FAX: (651) 675-5694 buildi noinspections(aacityofeaoan. com Date: Y. ED r For Office Use Permit #: t T 1 J $12.2--. Permit Fee: Date Received: 1 J g Staff: 2022 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: /ss (n a a Gy ,,v. G J } 1 4 7 5' Unit #: Name: 7 to Address / City / Zip: Phone: GS -,j 60 'S6oi /(h 4.044 n /2j K— t, 6 6 44h k3 Applicant is: Owner Contractor Owner Email: Y3 S rn ' ffY c/AAq % (itr4.7 Description of work: 4-ek, n,. tG 6 q" 4 , to s 714 u �,'a �h 1N 3 %nw6,/ a 4, /- Construction Cost: I DLL Ot) Multi -Family Building: (Yes )( / No ) Company: My Con Ara c fo,r _H G Contact: GcK A, /n oe- Address: / / / 3 3 Et n.4 /,i e S City: ,Bj p o ^^ State: /4 /V Zip: SSC/3 7 Phone: % /,2 -S9O-d /33Emaii: I ' u ® my c ih 1-rq LAY i r1C Cdw License #:Sa D 3 a 7 Lead Certificate #: If the project is exempt from lead certification, please explain why: , ,// / f / 9 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: Mechanical Contractor: Phone: Phone: Sewer & Water Contractor: Phone: Fire Suppression Contractor. Phone: 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. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.aooherstateonecall.orq 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. X 6"'e �� �v. ni 2 x Applicant's Printed Name App scants Signatu FOR OFFICE USE ONLY Site Address: 2 J S S Q,,Ack►mah , `11' 3 Permit #: 1' 4( 6) S SUB TYPES _ Foundation — Fireplace — Porch (3-Season) Single Family — Garage — Porch (4-Season) (' Multi — Deck _ Porch (Screen/Gazebo/Pergola) 01 of _ Plex — Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES New _ Repair _ Siding _ Retaining Wall _ Addition _ Fire Repair _ Reroof _ Move Building IC, Alteration _ Water Damage _ Windows — Demolish Building* _ Replace _ Egress Window _ Solar *Demolition of entire building - give PCA handout to applicant DESCRIPTION Calculated Valuation tZ, 00©. c>o Occupancy , c 2- MCES System Plan Review A Code Edition .Z p a ci 144k,'/3 � SAC Units (25%_ 100% )C) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Suppression Required Type of Construction V l3 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Foundation Before Backfill HVAC _ 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 Stormwater Management Shower Pan Other: Permit Required: Reviewed By: /14d , Building Inspector RESIDENTIAL FEES Calculated Valuation Base Fee Plan Review State Surcharge MCES SAC City SAC Treatment Plant Water Supply & Storage S&W Permit & Surcharge Radio Read Other: g ys sf 900.00 0 y 7.9q 0) 00 �vt 1) . Lv Copies: TOTAL I Z Z (o e/