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4406 Braddock Tr Parcel Files Cover Sheet Unique ID: 2101 4406 Braddock Tr 104509113001 INSPECTION RECORD O'er' 0175 bl'W6F EAGAN PERMIT TYPE: w 3830 PIM Knob Road Penn ft Number: Eagan, Mfnnesota 55123 Dots issued:` (612) 681-4675 SITE ADDRESS: L O T S 13 R L OC K: I APPLICANT: 4416 RRADDOCR TR PARISH #KT4 A DINVEL CORD LEXINBTO* POINTS IT" (612-) 462-6*44 i PEIFIUBTYPE: TYPE OF WORD M FOOTING t~RAMINa INSULATION FINAL i I i RENAAK6i 6 & W CONTRACTOR ~ TO* 14ESSIAN PLIIA i r- W-7 7~ j I r PamR No. PermR Molder oats 7bbephone # . S/W i PLUMBING HVAC 401rk- '9 V-cu) S ELECTR ELECTRIC tnepectlon Do% kap. car"a " Footings 1 7 Foundation, yl3/~~ kd ~I`a 4 T cllo-~Z Framing Roofing r Rough P". Rough Isul. i L Raw IS-9z 0 Orsat Test Final P%. 7-12 1`2 P". Irbpeclor - Nobly Phmder Cow. Meter eviplan Final DO& Rg. Deck Rnal won Pr. Diep. (Ur#ifiratt of Mrruvaurg , citp of Cagan r ~r r UAW of %at" jMw Thin CerllJrcw Laved pa now to the requirements of Secdon 306 of the Uniform Bnfda W Code certifying that at the time of issuance this structure was In complhowe wide the various ordinances of the Airy regulating bugft construction or use For the following: tin c SF DWG Bkl& Fa Na 18.1 0-Aplaw Type . RUM Tom Dbbia . ROD Type OKA VN oww ocvws ZSPARISFI PKPG b DEV lea. 37 CA MI,N610Q) LAW, DGM At A] LZ[p Si POM ZM Dw- gl~tl; &win POST IN A CONSPICUOUS PLACE Address: 4406 g)14LD" jpAM Lot 13 Blk 1 Sec/Subs pOINiE 7TH These items were/were not complete at the time of the final inspection. Date: 8/27/92 Yes No Final grade (6" from siding) l~ Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck ~_t Please verify with the builder the removal of roof test caps from the plaabing' system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. `36 aa..wrt White - City copy Yellow - Resident copy Pink - Contractor copy ompj? 5 7 R t to Fire No. Rough-In Inspection Required Inspecti her Than Rough-In (You must call inspector w ready) early Now otity Inspect Yes No Date Read I licensed contractor Elowner hereby request inspection of'above electrical work at: Job Vdrrs (Sheet, Box Route No.) City ! ~ II Section No. Township Name or No. Range No. r Occu (PRINT) Phone kkaw AkYL Power upplier Address Elect Contractor (Company Name) Conhadora lJcenso No. n&, A Mailing (Con C'or or ng I lion) A lai MIC'M tractor Installs no N of A 'ool~ AA U REQUEST THIS INSPECTION S , St Pau MN 55104 I p p N I' p p ~I I l~l UE EACCEPTED BY THE STATE BOARD SS ROPER INSPECTION PECTION WILL IS Phone (612) 642-OSW flfl nn p Hp M y 1IN Illlllll ENCLOSED. 7 REQUEST FOR ELECTRICAL INSPECTION _ Q~' ~~l 0- See instructions for completing this form on back of yellow copy. 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 Load Management C Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) -.9 tractors Remarks: - Compute Inspection Fee Below. # Other Fee # Service Entrance Size Fee # CirctntS/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 -Amps SOS Inspector's Use Only: ~Q Irrigation Booms O Special In Alarm/Communication THIS INSTALLATION MAY ORDER ONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO . I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Dat been made. OFFICE USE ONLY This request void 18 months from Request Date Fire No. Rough-in Inspection Regw ? ❑ Ready Now 81W Notify Inspector `r s ❑ No When Ready? Licensed contractor D owner hereby request inspection of above electrical worts at: Job Address Street, Box or F3pute No.) City Section No. Township Name or No. Range No. - Occ nt (PRINT) Phone No. ow Supplier - Ad re - - - Ele ical Contractor)ompany Name) U1-- s License No. fling (Contractor or Owner ing Inflallation) Authorize Signature (Contractor/Owner. Making - Ilation) Phone Number _ 4/ MINNESOTA STATE HOARD OF ELECTRICITY THIS INSPECTION REQUEST WILLNOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD' 1821 Universiq Ave.; St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 64210800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 ► See insvuctions,for completing this form on back of yellow copy. J 9. fi X" Below Work Covered by This Request? e Add Rep. TypeofBuilding 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's Remarks: Compute Inspection Fee Below: # Other Fee # ServiceEntrancoSize ` ee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 125' JZ 67 0 to 100 Amps Transformers Above 200 Amps Above 100 - Amps Signs Inspector's Use oily: TOTAL r Irrigation Booms, Special Inspection AWm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN r I, the Electrical Inspector, hereby Rough-in Date certify that the above ins ction has Final Date i' been made. lep 4'7 OFFICE USE ONLY - Thisrequest void 18 months from T- PERMIT Control No. 0175 CITY OF EAGAN~ 3830 Pilot Knob Road PERMIT TYPE: BUILDING Permit Number: •00 Eagan, Minnesota 55123 181 (612) 681-4675 Date Issued: 04/06/92 SITE ADDRESS: 4416 BRADDOCK TR LOT: 13 BLOCK: 1 LEXINGTON POINTE 7TH DESCRIPTION: Building Permit Type SF'OWG Building Work Type NEW USC Occupancy R-3 0-1 Construction Type V-N Zoning PO R-1 Building Length 41 Building Width 46 REMARKS: C~ 0 ! g S i W CONTRACTOR - TOM HESSIAN PLBG FEE SUMMARY: VALUATION $84,090 Base Fee $567.50 MISCELLANEOUS fi.61l.¢! Plan Review $366.88 Total Fee $3.288.88 Surcharge $42 . • SAC $700.0 SAC ! 100 SAC Units 1 Subtotal $1.678.36 COVA&S TOMiTG i DEVEL CORPp 14526644 0001 5;WPIMH MKTG i DEV CORP 3799 BRIARWOOD LM 3799 BRIARWOOD LM EABAN MM 55123 EAGAN MN 55123 (612) 452-6644 (612)452-6644 I hereby acknowledge that I have read this application and state that the information is'-correct and agree to comply with all applicable State of Mn. Stotutss ity of Eagan Ordinances._ r APPLICANT/PERMITEE SIGNATURE ISSUE BY. SIGNATUFkE INSPECTION RECORD I Control No. 0175 CITY'OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 600181 Eagan, Minnesota 55123 Date Issued: 04/06/92 (612) 681-4675 SITE ADDRESS: LOT: 13 BLOCK: i APPLICANT: 4406 BRADDOCK TR PARISH MKTG & DEVEL CORP LEXINGTON POINTE 7TH (612) 462-6644 PESVIISUBTYPE: TYPE OF WORK: NEW INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. FOOTING FRAMING INSULATION FINAL FIREPLACE REMARKS: S & W CONTRACTOR - TOM HESSIAN PLBG PERMIT # CITY OF EAGAN 4 1992 BUILDING PERMIT APPLICATION 681-4675 *R 0 2 RECn SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made r lot change is re guested once ermit_is issued. Date 4-2-92 Valuation of work $-20. O ©0 Site Location: 4406 Braddock Trail STREET STE / Tenant Name: LOT 13 BLOCK 1 suBD. Lexington Pointe 7th P.I.D. N Description of work: Single Family Home The applicant is: ❑ Owner ® Contractor ❑ Other (Describe) Name Parish Marketing & Development Corp. Phone 452-6644 Property LAST FIRST Owner Address 3799 Briarwood Lane STREET STE B City Eagan State Minn. Zip 55123 Company same Phone Contractor Address License # `:)105 Exp. City State Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber -Tm hessian Plumbing& 432-6898 Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application 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: . i Y OFFICE USE ONLY i BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Garage/Accessory ❑ 11 Res. Add. /Porch ❑ 16 Agricultural X02 SF Dwg. ❑ 07 Fireplace ❑ 12 Comm./Ind. New ❑ 17 Building Move ❑ 03 Two family ❑ 08 Deck ❑ 13 Comm./Ind. Add ❑ 18 Demolition ❑ 04 Multi-fam. T.H. ❑ 09 Basement Finish ❑ 14 Comm./Ind. Rem. ❑ 20 Miscellaneous ❑ 05 Apt. Bldg. ❑ 10 Swim Pool ❑ 15 Public Fac. WORK TYPE 19 31 New ❑ 34 Remodel ❑ 37 Move ❑ 32 Addition ❑ 35 Repair ❑ 38 Demolish ❑ 33 Alterations ❑ 36 Tenant Finish ❑ 99 Undefined I GENERAL INFORMATION Occupancy Basement sq. ft. MWCC System YES Zoning 1st Fl. sq. ft. City Water yes Const. (Actual) y-N 2nd F1. sq. ft. PRV Required (Allowable) V-N Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length H1, On-site well Census Code 01 Depth y6' On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee 5('],50 valuation: $ 8g3000~ Surcharge d-12, o _ GA, %A,(.;; ; ZZ. X 20 - yy o Y. 1fi a Plan Review 89 License MWCC SAC 700 • cw X 3~ = 50 4 City SAC 2 .oo Z u26= 517- Water y ~00 Conn. 'Ar15, 00 ~c g Water Meter %,00- Acct. Deposit 30,100 )1 1 (o*g IS = IL,940 S/W Permit 30.E 1rr S/W Surcharge Treatment Pl. 300100 Road Unit 38a~po Park Ded. $XZ= 10 Trails Ded. Copies IIZ.CoX 53 = 5 67~. Other Total: $ 4 S $ SAC X 100 SAC Units J C.E. DAHLGREN/TRI-LAND 1743 Randolph Avenue ALAN SURVEYING & ASSOCIATES St. Paul MN 55105 612-6".3224 w w SITE PLAN FOR QARISH LEGAL DESCRIFLTION; LOTAL,BLOCK I LEXICIG oU rorNrE 17TH ACCORDING TO THE RECORDED PLAT THEREOF DAE-018 COUNTY, MINNESOTA 3~y,3., mac ~ -11.,4 ° 9s~2, . S' 'P72.E 10 I Nom) moose (1~ O) LOT_~' DoT Z QN WI ~ C\ L R o a D ~I By Date IN NT I G DEPT NSr' hbWEiG L OA,)£ 7'x.32 _ .S NO©° 0 9'39"E LE-- GE Q INVERT ELEVATION AT SERVICE EXTENSION= o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION ■ ~5, n DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION= -757..s ~4.5 DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR = t, 17. 0_ ELEVATION ELEVATION (?6',o) DENOTES PEOPOSSEE SPOT w~ DENOTES DRAINAGE DIRECTION NOTE VERIFY ALL FLOOR HEIGHTS WITH Il. l FINAL HOUSE PLANS 1 hereby certify that this survey,plon or report was prepared by me or under my direct supervision and that I am a duly Bradleyoo J Swenson, Mn. Reg. No. 13235 Registered Land Surveyor under the Laws of the State of Minnesota Date q' 2'92 EXTERION RNVEGOI'1. AVERAGE "U" C0;11'UTATt011 1 GWNER / SITE ADDuEss L.oT J , FLOC C ( ~.~dC/N!►~[~ ~7N Ap-.0 r/ • CONTRACTOR '*;rC/s.V A1AstilEfi~di rru _ DATE PHONE Determine working square footage: of each. 1. Total exposed wail area , 1806.0 Sri. ft. x / .D sq. ft. x •025 _ ..nf}•2 2. Total roof.ceiling area Total exposed wall area above floor /8A(i.Q a. Total-wall window area.' /os•.3 b. Total door area _ C. Total sliding glass door area L• y d, Total Cireplace wall area D e. Total wall framing area (average lOt) o. f. Total net wall area above floor g. Total rim joist area /Z 3.3 Total exposed foundation area = ~~•S~ h. Total foundation window area........'.... v i. Total net foundation area above grade.... Determine "U" value of each wall segment, a . /a s, 3 x "U" , r'S- s .379 ~ 3. b, 3A6 X "U" F07 00 X "U", d. O X "U" a X "u" x "u" . .oY.7 _ _ .....s.~ . o yt ••11" ~ : V R f • ] ......................................Total If item 13 in the same as, or lauri than item It. you teavo mat this tntunt of SHC 6006(c)2. -013(/~~.7, 404W sec. Goo to (C) L Total exposed roof/ceilmy area = //mod, 0 j. Total skylight area _do k. Total roof/ceiling framing area (average L0%) 1. Total net insulated roof/cuilinq area.......: %O/a•/ Determine "U" value for each roof/ceiling segment. j• O x "u" o n k./~: G X «U" , off/ y i x "v" 4 .............................;,....,,Total ~•7 If total of 14 is the same as, or less than 12, you have met the intent of SBC 6006 (c) 1, a f! /a 7,7 ) Z (018. , . ?h*~ y~~t. 5 406 :ti Alternate Building Envelope Design To utLlize the total envelope system method, the values ustablishisd by'the sum of items 13 and 14. shall not be greater than the sum of items II and N2. 1. /9~• 7 2,, ze. a _ 22 fi ~a:,': 3 19k-2 + 4 7 = ~~~,y t{ rir o /-s 2: C ~-z-G,.fi , 3 t f! "00,':2o,y y~,'►_ Pee i f - STATE OF MINNESOTA . j ~e e~ 1 STATE OF MN DEPT, OF COMMERCE DEPARTMENT OF CQMMERC,E 133 East` Seventh::. " I' S 133 ''East Seventh St, t. Pal, MN 35101 ' (bSt. Paul; MN 53101 12> 29b-6319 (612) 296-6319 BUILDING :CONTRACTOR I.. 'BUILDING CONTRACTOR 10000105 RESIDENTIAL, CONTRACTOR ID#0001054: CORPORATION.:; j RESIDENTIAL CONTRACTOR I. CORPORATION Issued: 12.09/91 Expires: 03%31/94 - I ssued _._12!09/91-03/31!94. _ ARDITH A PARISH ARDITH A PARISH PARISH MKTGLiEV CORP 3799 I PARISH MKTG BR D I EV AR C O R . P W OD L N O 3799 BRIARWOOD LN EAGAN MN,65123";:70000 j EAGAN.MN 55123-0000 oM-uos.s _ I I 'L ;Z~ tr .r: ,.fig '4re?,,. 4,?;*3t• 4 >:'~.~m'ks sr -yn~•._..i; ':Y;:;sc~;rtf5~r ';w ,~6~`:.~`;"'!~'aR ~#~'x. A~T:fc .,3,~7,i CITY OYLY K L 8L RECEIPT ram 9s SUBD.GZf:6~~ DATE: 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681.4675 Please complete for: single family dwellings ► townhomes and condos when permits are required for each unit New construction Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: FEES ► Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ► HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ► Gas Outlets (minimum of 1 required @ $3.00 each) ► State Surcharge .50 TOTAL SITE ADDRESS: W OWNER NAME: + 1 f" chuc PHONE INSTALLER NAME: I STREET ADDRESS: CITY: STATE: 1~1 \ ZIP: PHONE 6 sit tU"REOt PERMITTEE- i Cry ONLY L BL RECEFt'#; SUED. DATE: 1995 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for all commercial/industrial buildings. ► multi-family buildings when separate permits are DA required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ► $25.00 minimum fee 2c 1% of contract price, whichever is greater. Processed piping - $25.00 State surcharge of $.50 per $1,000 of pgnft fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE M SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR t CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT PHONE: (612) 454-8100 RECEIPT # Z4 Va. DATE : a KS PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: j~ NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 REPAIR -7 WATER CLOSET 3.00 7 BATH TUB 3.00 LAVATORY 3.00 OWNER NAME: KITCHEN SINK 3.00 SITE ADDRESS:. b 7,,--t- HOTNTUB/SPAY 3.00 -7 WATER HEATER 3.00 LOT:_a BLOCK SUBD.A/JEle- )C~, ? :]T FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: / (MINIMUM - 1) 3.00 TOM HESSIAN PLUMBING, INC. ROUGH OPENINGS 1.50 .Sd ADDRESS: IZ1P'50140cw OTHER APPLE YALLEI(, MN 55124 WATER SOFTENER 5.00 CITY: ZIP: PRIVATE DISP. 15.00 V U.G. SPRINKLER 3.00 PHONE _ SUBTOTAL $ 3Ii S~ ST. SURCHARGE .50 SIGNA E OF PERMITTEE TOTAL: G71 }MIR!C!IITST PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN y CITY OF EAGAN FOR CITY USE ONLY V o r 3830 PILOT KNOB ROAD EAGAN, ME 55122 PERMIT PHONE: (612) 454-8100 RECEIPT A V, OAT= GH#NIArM DATE : ,IAI PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS A TOWNHOMES/CONDOS 'WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESC IPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON HVAC 0_100K BTU .00 REPAIR ADDITIONAL 50 M BTU 6. GAS OUTLETS - MINIMUM .00 OWNER NAME: OF 1 PER PERMIT ~ SUBTOTAL: $I ~ SITE ADDRESS : 04 Zi-A ddo ck, :r a / J STATE SURCHARGE: .50 LOT:/_ BLOCK SUBD.(2a . ~•tt. TOTAL: $ 5 INSTALLER: ADDRESS: 12481 Rhode Island Ave. So. NATUM OF PERMITTEE Savage, IVIN 55378 1122 CITY: 894-002PP: a- -CIA V h e~ (s g~f~o ss'6 PHONE 0: aC.- -ter 7 R AI.J t!1DUS'tI' PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. m - CONTRACT PRICE. FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x It $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE' (SIGNATURE) FOR: CITY OF EAGAN City of Eaan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use I Permit #: 1 I !S ry O Permit Fee: Goy • 'S; Date Received: I I O j �3 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Resident/ Owner Name: 66( ( iZCGC6-,-/2,7ACite..4----- Phone: f> - ?9 7 `-/W33 j ���� Address / City / Zip: L79/9 8�4���� G��'"�C) r 6 Applicant is: Owner / Contractor Type of Work Description of work: (/(f i r1 L -r 000"-- / -$ Construction Cost: P'/f 0 d S „ U v Multi -Family Building: (Yes / No ,/ ) Contractor Company:J: 2 ()SON) G&SS'b)12. &Z -s. Contact: 4/6 jte Address: I 7 7 �i 5 k- t l`' City: Xpp/ al / k V State: Mill Zip: 5-----5-7? y Phone: 7 & # .--.?/ 3 - /- l) ? ,` License #: 671, (O(2 6'c) 7 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, _Yes _No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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 they are trade secrets. 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.qopherstateonecall.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 Exterior work authorized by a building permit issued in accordance with the Minnesot• tate Bui ing Code must be completed within 180 days of permit issuance. Applicant's Printed Name Page 1 of 3