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2078 Bluestone Dr E Use BLUE or BLACK Ink RECEIVED i Fg'rQffit~`~i;fse I Clay of Eap Gov ~ g 2010 i Permit ` I 'Permit Fee: 3830 Pilot Knob Road i Eagan MN 55122 j Date Received: Phone: (651) 675-5675 i Fax: (651) 675-5694 I Staff: i ! 2010 MECHANICAL PERMIT APPLICATION Date: Site Address: DC71 O r~_~TC 1 t° 0-- i,:::_1 Tenant: & lU( S M lc SLjk-,cn Suite RESIDENT / OWNER Name: 'VL)lU, S4'~C 3~ 1 1 r 15~ r Phone( QS ("`~~Zs' Address / City / Zip: ~ t I O V - ;l, ~o CONTRACTOR Name: _ iRn0411LE. HEA "N" License #:y I Address: 3451 W. BUmsville Parkway City: Suite 120 l _n (4~cxf State: ~II1S.Y~, MN 55337- Contact: rCA Email: TYPE OF WORK New _X_ Replacement Additional Alteration Demolition Description of work: Q ail NOTE: Roof mounted and ground nnounte rndchahlcat equipment is required to be scre W'by City Code. 'Please contact the Mechanical,in"tor for Information g.psrrn tked scroankt8 methods, RESIDENTIAL COMMERCIAL PERMIT TYPE Furnace _ New Construction _ Interior Improvement Air Conditioner Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under/ Above ground Tank Install / _ Remove) X Other i Vt When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ X11% $50.50 Minimum (includes State Surcharge) = $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge). = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 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 th pproved plan in the case of work which requires a review and approval of plans, x x ~Irj Applicant's Printed Name Applicant's Signature FOR OFFICE USE Revaewed By: , Date: _ Required Inspections: Under Ground Rough In Air Test Gas Service Test fn-floor. Heat Final Exterior HVAC Screening Inspection: Parcel Files Cover Sheet Unique ID: 1875 2078 Bluestone Dr E 101670202007 CITY OF EAGAN Remarks Oed: Grove A.oC,(u ' ition Addition . Cedar Grove 3 _ In 6709 020 07 f 2 aI~ Parcel, 1 o 4ZAe Street 207$, BlU.estane . State'' a an, MN 55122 Owner Improvement Date Amount Annual Years Payme t Receipt Data STREET SURF. STREET RESTOR. GRADING II SAN SEW TRUNK A7 SEWER L ERAL I 12 1 52,16. WATERMAIN WATER LATERAL 1 2 WATER AREA I i STORM SEW TRK STORM SEW LAt CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. sUtLDlNGPER. t ~f,ado Oc+ l,S,DO SAC PARK "'PECT RE ; a a, cam` ~ . , OA1 PE r~ ` 3W blot KWb 14oad p Q'i Eagan; Mkg 65123 Cafe (612) 681-4¢75 A©L RES3: r APPUCAN t, "07x; Ni:llz ~1#l1~ 01? P14J*1:Hf `sTL'I CJ-11AR falrtOVE 31411 a i'>.~ 3 296'; 716*- ~ Pamff 'SUBTYPE: TYPE OF M FINISH At:MJ4 AT, T 6W. 1-Wflr i A i t f1 d`l.ulait 1f4 $FltOt$ Lld# 1 Y R1;NJ?iPZP `ti: 1.f, A0-AI1: f.'V.RHf TS, AR 3~1'ilttlhl l3 V01l A144 Ill AJ fI.tNb 0 R tjf4, '11T.CA t-JkfNK Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECT Da~/~ /!i q 0 fI ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing 7 y (1 Roofing ` Rough Plbg. Rough Htg. Isul. LV~ Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final 0 Deck Ftg. Deck Final Well Pr. Disp. t _ J l9 c~ N 0 2 5 OZ4 19,17 Request Date Fite No. rmgectioRequired Inspection Other Th Rough-In /S' u mus all inspector when ready) [:3 Ready NowWill Notify Inspector Yes ❑ No Date Ready I ❑ licensed contractor owner hereby request inspection of above electrical work at: Job Address (Street. Box oute City o?'8 Section No. Township Name or No. Range No. County nt (PRINT Phone No. J5 17 1 ~ 1 It Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. o lm e © cvr~ e~-- Mai ing q ress (Contractor or Owner Making Installation) OVF Authorized Signature Coimrac t o Owner Making Installation) Phone Number 21-5 MINNESOTA STATE BOARD OF ELECTRICITY - THIS INSPECTION REQUEST. WILL NOT Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone(612)642-0800 ENCLOSED. es-ooool REQUEST FOR ELECTRICAL INSPECTION -oa / ► See instructions for completing this form on back of yellow copy. * i"••4 / Q/ `X" Beloyi Work Covered. by This Request N G2500 / New Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remark Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps b 100 Amps Signs Inspector's Use Only: TOTA Irrigation Booms C v ,Special Inspection Alarm/Communication THIS INSTALLATION MAY BE NECTED IF NOT Other Fee COMPLETED WITHIN 18 O I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final a Date been made. OFFICE USE ONLY This request void 18 months from K 4501 1130 95 ~ ,Q Reque¢¢¢I Date Fire No. Rough-in Inspection Required? eady Now 0 Will Notify Inspector { I / q Yes o When Ready? t Vicensed contractor D owner hereby request inspection of above electrical work at: Job Address (Strut. Box or Ro e No.) City( C._78 AC j1 Dy, l- l aAAJ Section No. Township Name or No. Range No. Tw - Occ ant (PRINT) Phone No. Power Supplier Address Ele n Contractor (Comp Name) Contractor's License No. t L( Mailing Ad ess (Contractor Owner Making Infs. tion) lax - Au oriled gnature,(ontractor/Owner Making Installation) .--R o Number MINNESOTA STAT B A. Q. S- OF LECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midwaq BI g. 73 BE ACCEPTED BY THE STATE BOARD 1821 Univer3ityAv t. Pau. 56104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. ©3p/,- REOUESY`FOR ELECTRICAL INSPECTION Ee-ooool-oa K 54501 , See instructions for completing this form on back of yellow copy. 3 1004, SIB X" Below Work-Covered by This Request New Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other{Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor§ Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: " TOTAL Irrigation Booms 1, Special Inspection < i Alarm/Communication THIS INSTALLATION MAY BE ORDER CONNECTED IF NOT Other Fee COMPLETED WITHIN 181 ONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final OatO - been made. OFFICE USE ONLY This request void 18 months from EAGAN TOWNSHIP o BUILDING PERMIT N• 1262 Owner --?.-,...-4r" `•----0; Eagan Township Address (present) Town Hall Builder Date Address DESCRIPTION Sioriesl To Be Used For Front Depth Height Est. Cost Permit Fee Remarks 8,0 LOCATIO Street, Road or other Description of Location I of Block Addition or Tract Y/ A/ 3 4/ 7 This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BED~ KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that-........ (f r..n ...............has permission to erect a....!~ __.._....Upon the above described premise subject to the provisions of the Building Ordinance for Eagalip adop d April 11, 1955. - Per .i .....C Chairman o Tnwn Board Building Inspector Q .B . CITY OF EAGAN CASHIER: JS TERMINAL NO: 763 DATE: 09/11/00 TIME: 10:33:30 r ID: NAME: BILL D PRIEBE 3210 9001 2078 BLUSTN DR 43.00 2155 9001 2078 BLUSTN DR 0.50 i Total Receipt Amount: 43.50 CR137204 USER ID: JAN 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) + CITY OF EAOAN V R6 3830 PILOT KNOB RD - 55122 ~f !ice" - - ' 651-681-4675 7 3 .~a Now Construction Requirements 4-U Remodel/Repair Requirements / 3 registered site surveys showing sq. fL of lot, sq. ft. of house 2 copies of plan and g(I roofed areas Q% maximum lot coverage allowed) 1 set of energy calculations for heated additions D 2 copies of plans (show boom & window sizes; poured fnd. design; etc.) 1 site survey for exterior additions & decks 1 set of energy calculations D 3 copies of tree preservation plan if lot platted after 7/1/93 /000. 00 DATE: DA i / / CONSTRUCTION COST: DESCRIPTION OF WORK: lIA,L1a STREET ADDRESS: a n Q < LOT: BLOCK: SUED./P.I.D. C e day LI` 6 q #3 1 C i V 7 U "2 0 -~LC1 0~ Name: (C' b + -Sha KW Phone ~a5~1 8 a f s "~r l PROPERTY Last First OWNER n ~W' Street Address: ~tio city 4 a h State: rYIN Zip: 55/(a Company J~ Phone (area code) CONTRACTOR Street Address: License # Exp. City State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone ( ) Street Address: Registration City State: Zip: Sewertwater licensed plumbgr (if installing sewertwaterPhone I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable Stare of Minnesota Statutes and City of Eagan Ordinances. ^ i Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY BUILDING PERMIT SUBTYPES ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt -Multi ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Mufti ❑ 04 02-plex ❑ 10 08-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 05 03-plex ❑ 11 10-plex Plbg Y or _ N ❑ 25 Miscellaneous ❑ 06 04-plex ❑ 12 12-plex ❑ 20 Pool ❑ 30 Accessory Bldg. WORK TYPE ❑ 31 New ❑ 36 Move Bldg. ❑ 43 Reroof ❑ 32 Addition ❑ 37 Demolish (Bldg)* ❑ 44 Siding ❑ 33 Alteration ❑ 38 Demolish (Interior) ❑ 45 Fire Repair ❑ 34 Repair ❑ 42 Demolish (Foundation) ❑ 46 Windows/Doors * Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code # of Stories sq. ft. No. of Units Length sq. ft. No. of Buildings Width Footprint sq. ft. Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. MC/ES System UBC Occupancy sq. ft. City Water Zoning sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ❑ Stucco/Stone APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit t S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC PERMIT C2 3 ~6 CITY-OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BU 1 L D T G Eagan, Minnesota 55123 Permit Number: 022951. (612) 681-4675 Date Issued: 02/1.5/94 SITE ADDRESS: 2078 BLUESTONE DR LOT: 2 BLOCK: 7 CEDAR GROVE. 3RO DESCRIPTION: B!i J Permit,' T"ype BASEMENT FINISH rk fvpe ALTERATION REMARKS: SEP'ARA'F PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY- Base Fee A:3r , 0 Sw'charge fota,t Fee ,.bO CONTRACTOR: OWNER: Applicant PRIL BE BILL. 2078 BLUESTONE DR EAGAN MN 55122 C E:Si12 ) 296--7150 I ~r 1 l APPLIC NA T/PERMITEE SIGNATURE ISSUED . SIG E CITY OF EAGAN G L;~ 1994 BUILDING PERMIT APPLICATION ± g 9 0 19 -9 4 681-4675 9 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, l copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date F.Ib 11 / 9 / 199 Valuation of work = 2 Site Address:_ 2-07 8lve4,aAe ~ ~ ~ SS~zZ STREET Tenant Name: (commercial only) LOT Z BLOCK ~ SUBD. C P.I.D. # Description of work: 7►~s~ b0.Stmer 5 "A K 40. voon^ The applicant is: 0 Owner ❑ Contractor ❑ Other (Describe) u~er►c a'lfo-7~5a Name P~ie,bef Q►1 Phone sw.- ba8-W'Z. Property LAST FIRST Owner Address Z0 r7 6 81vf-540nt, ~ r. STREET STE # City a. State Zip 5s'~1Z2-- Company Phone Contractor Address License # Exp. City State Zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this apppplication and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY wt BUILDING PERMIT TYPE i ❑ 01 Foundation ❑ 06 Duplex 0 11 Apt./Lodging iZ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi Add'l ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE 31 New 133 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst Fl. sq. ft. City Water _ UBC Occupancy 2nd F1. sq. ft. PRV Required pp Zoning Sq. Ft. total Booster Pum # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code m Depth On-site sewage SAC Code. Census Bldg -7- APPROVALS Census Unit Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ .Site ❑ Footing -Q Framing 0 Insulation 11 Wallboard J Final ❑ Draintile ❑ fireplace Permit fee vatustia,: S Surcharge L Plan Rpvipw License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surchargge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total SAC % SAC Units ........:..:.:::::?tn . ..::Y•}}::: r:v.:v.v.v:.::v:: :•{::::::}.r.::::::::::::::......................... r.. 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'i~::F! , A:::::::::::::::: ;•r.rr::::::::x;}r.•.{•r}h......r.......1......v..vv:.v:.•:nv.:.v........v..::n....:....:...~G.,~.•::xxn n. n... nv m:::.v:rxvr}: Jl.•~,•,n~, •{,~i,•:?.,k.'..iS}::}::i^ }}:•iii::;iytii:}J:ri::}}:L+:: i. 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. - - - NO. FIXTURES EACH TOTAL SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum - r 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. - DaiLay. iic. 20.00 U.G. SPRINKLER • home under cont. 3.00 ALTERATIONS • to exiting 20.00 ~?y WATER TURN AROUND 20.00 STATE SURCHARGE d 50 TOTAL: R , . S CD SITE ADDRESS: ~-o r kJ [ v-eSivrl e ~ rl OWNER NAME: + G INSTALLER: ADDRESS: 2-(D7 g Cv-es ' ~ h CITY: F-A-bA-1) STATE: A4 A ZIP CODE: 2 PHONE ((U(-) lI t5-0 Wyk 88 2(52- ko mo SIGN RE PERM E .rh•:..'..?'-.:•%v:4•}}}:?+: iiY••.: v :•»Y v;.;:y {..:..yv.:v::: w:.:..... ,;.X.• :YAX{a}: .•%i n}i}}}}}%.>:•fi.{• nv.v....:.:: vw::::++ ' v..:: vv v. ~i{//. r. \v:.:........::. n:.f..: Y:;•::.,,•....::.. X, d^Giy'. } }:?.}:.•.v.{ ;{.4.}'a::{?: •.i•.: J:nv.....:- .nk•..'+h w. . ..:/.a •i}:yak':•:.•?: :}i%•:.v. w. i::}:vu r.:.; rv: n•: Fv?tk :n•, {a?ti . 'v'.n. $ : . n•:::::::::;, :f.':.::}::.... an•.vrk:{'.:......•: x}:;h a}}%:?•: .v.vv.:nnn.n. 3 .iiv •.v}:n.... i;:.v::x ?an:..v: w... v?.v: hvl: •:.:v...::::.: •:h: y.... 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R: .y..•r:...:... m.S?s.. .:5...~/rfh.:n ~.a::. w......3...n......... .4..: h.:•......,,,. n. n.::::.v:.v • n.. y:,:•.:v .v.....:...,:'a.:.:.v: a, ....:.,.}h. •:::xk..y ::...:{.:y........ {:-.%.,G.:..C nva;i: F::: n:.::.::•:.,•:::::::::::. vnA•.vw:: . v::.::::.J>J??;::::.~:::::::::.~.vnvny}y.'•ik:S;•S Sii;•::::.:,::.?•'t:i'•:, r:......:•,- m:::::::: x:: n.: .n..:, , n.:. :'4•. }'f. v...X%... } ,:•:.k..a....r .'{f. hy. . r:.:. v r} r ..r my .Y...:. r..:.. r.. r n. .::•}i{:$$?{k;•• i..... nai.{^:+{a}}:ai}:O?ii::? .v... .:vi ,+v{v'a••33;;5}}..a........ •n.. ^ n}?';- n}:.v..: a.+'vii• x ...................................n..v:::4:::}}??r.,}}:aX-3%.}:•}ii J::$:?:a:??: h \ :•{v.?{.:i% irf{?:3{+:: .....::,+:::::::::::::.:.:•.xf:..t•::.\,£tckta~ixtw.aoaa::}rr...b3wh',Jn:.n.::.a'''''.3~ih:.3Sw}9.d?a•~x•.,,a.,.:4:X•::•}iJ•::kr:•%•:u: }..w.d.~.r.h•.....i.nn:fi~ ~$.k'?}.:•}h}:.J.~::.:?•?:• i::•: }h:a: 1994 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCIAIANDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. NEW CONSTRUCTION ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF ' FEE. PrIIl`7UNIUM FEE: $ 25.:0 CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL $ SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: PHONE FOR: CITY OF EAGAN APPLICANT i ~raYr i For Office Use Permit l I 1 I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 j Date Received: l - o)-,ID j Phone: (651) 675-5675 i staff: Fax: (651) 675-5694 1 I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ,,~i~ Site Address: C 1 7 ~ [A tsfu r, e V-. Tenant: 1 Q ,VJ Suite RESIDENT / OWNER Name:F Phone: i~ `r`~3 Address/ City/ Zip: (31/~1 Q 5 " 1M J Applicant is: Owner v--contractor TYPE OF WORK Description of work: it V~ Construction Cost. C7oo Multi-Family Building: (Yes No CONTRACTOR Name: LVc7yr CLicense#: 2-0Tg7Z60 Address: ! ~(I/t'~,d At w z City: -S-+, p4tj State: ILVA Zip: J-j-//7 Phone: 60 S ' c ~P b Contact Person: `t~ ✓~i C COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? i _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: 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 you provide specific reasons that would permit the City to conclude that the are trade secrets. 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 S'v✓7gi x Applicant's Printed Name Applicant's Signature Page 1 of 3 r For Office Use i % /, Permit#: /C /.� r ..,.., ,,, ., E AG A N .._... __., /�.6)-`� C. Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections ar cityofeagan.com - 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name:___44.1__ �" Phone: b51-6 S8 2 '--0- Resident/Resident/ r Owner Address/City/Zip: � 7 8 B(0e 5 40/t P 1)r-. Applicant is: X Owner Contractor Type of Work Description of work: Rep tcc-t_ to;Jaw 5 6:, Construction Cost: Multi-Family Building: (Yes /No X ) Company: Contact: Contractor Address: City: State: Zip: Phone: Email: 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: 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 of the information maybe classified as non-public if you provide specific reasons that would permit 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.citvofeaaan.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.aopherstateonecall.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 plan in the case of work which requires a review and approval of plans. x - 6pR 1 e,e e xFA:Atio:A_A-Q Applicant's Printed Name Applica is Signatur