1165 Timbershore Lane% 4 1
.
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 ECEIVE
(651) 675-5675 1 FAX: (651) 675-5694 MAY 112122
buildinginspections a citvofeagan.com
2022 RESIDENTIAL
-------------
For Office Use
I-410 12, 3 l
I Permit #.
1 Permit Fee:
I I
I
Date Received: S I
Staff:
------------------
APPLICATION
Date: '5-a—aaL Site Address: 11(p5 Tin147er3hore_ Ln, Eagpn rnn) 55IZ.3 Unit#:
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.citvofeacian.com/subscribe.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.aopherstateonecall.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.
X X e bl,'i,nk, C. MU
Applicant's Printed Name Applicant's Signature
Name: hristi 11e- rr u ld f f' Phone: (0) L-644-61 zo
Resident/{
Owner
Address /city/ Zip: 1 I (o Ti ni h r'ihor e l� n r° r yCl n �M1�%SSI z3
Applicant is: X Owner Contractor Owner Email: GhrlStiyle- Mu]d f,,r1Q1)0+ kk
Type of ll�l�r�C
Description of work: V e e l a ce rae� � Q2,t;,IC
:.,
Construction Cost:Multi-Family Building: (Yes / No
Company: Contact:
g
=
Conir+�ctor
Address: City:
�.
State: Zip: Phone: Email:
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why:
ft ma��riu lS - Lecrc� {'►��
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: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE -fl,ans and suppon+lag documents that you submit are'cohs/tiered fo be p�ibllc TnformatPo/►y PortJons of the infirmatioii /hay`be`
,
N.
classified a roti � ubllc It ibu ro`v"lde s ec%fic reasons that would ` ermit the Ci to conclude that4he ,are lade secrets. " ti
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.citvofeacian.com/subscribe.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.aopherstateonecall.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.
X X e bl,'i,nk, C. MU
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE ONLY
p
Site Address: W-410& 1 -fin C Permit #:
SUB TYPES
Foundation _ Fireplace _ Porch (3 -Season) _ Miscellaneous
_ Single Family Garage _ Porch (4 -Season) _ Accessory Building
Multi Deck _ Porch (Screen/Gazebo/Pergola)
01 of _ Plex _ Lower Level _ Pool
WORK TYPES
New
_ Addition
Alteration
�C Replace
_ Repair
Fire Repair
_ Water Damage
Egress Window
DESCRIPTION
Calculated Valuation 42400
Plan Review
(25%_ 100%,Y N
Census Code
# of Units �-
# of Buildings I
Type of Construction d$
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation Foundation Before Backfill
Roof: _Ice & Water _Final
�4 Framing __)(_ 30 Minutes 1 Hour
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls n l
Shower Pan
Reviewed By:
RESIDENTIAL FEES
Calculated Valuationo'� I
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
Siding
_ Reroof
Windows
Solar
Occupancy 112G'3
Code Edition y,.jac- ;o. -+o
Zoning �fl
Stories
Square Feet
Length
Width
_ 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 Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
Building Inspector
gX 20 _ iro
Include on site
Provide all that apply;Include ori plank
survey <.
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