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4280 Blackhawk Rd/CITY OF EAGAN ERVIC 3830 Pilot Knob Load WATERTS rw IL. .? P. O. Box 21199 PERMIT NO.: 5785 Eagan,, MN 55 L 1 DATE: Zoning: tcl No.oj Unitt? Owner: Russell r e n (Wm Qua y Address: 4280 ac w oaa 10-02900-020-06 Site Address: Weierke- Excav Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 0.00 Pd I agree to comply with the City of Eagon Surcharge: .50 Pd Ordinance. Misc. Charges: Total: By Date Paid: Date of Insp.: Insp.: CITY Of EAGAN SEWER SFAVICE 3830 Pilot.Knob RBad PERMIT NO.: 6975 P. O. Box 21199 10- 4-8 Eagan, MN 551 DATE: Zoning: No, of Units: Owner: Russell B Oehrlein (WWin W Ouadav) Address: Site Address: 4280 Blackhgwk Road Plumber: Weierke Trench I ogre. to comply with the qty of Eegee Connection Charge: Ordioan ces. Account Deposit: Permit Fee: 10.00 pd Surcharge: .50 pd By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road ? P. 0. Box 711E+9-,..: • PERMIT NO.: Eagan, M4 55121 ,. !BATE: ,. ZoPSi: - p? W. Of Units: Owner: William Quaday Address: Site Address: 4260 Blacklta.wk R ad 10 02900 020 06 Plumber: William '.sadly Meter No.: Connection Charge: 500.00p d Size: Account Deposit: 15.00pd Reader No.: Permit Fee: 10 OO pd I agree to comply with the City of Began Surcharge: ` 50 `d Ordlnancus. Misc. Charges: 156.001>1 1o Total: . 3 ,s0pd mate By Date Paid: Date of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road 8981 P. O. Box 21199 PERMIT NO.: Eagan, MN, 55121 DATE: 8-28-86 Zoning: R1 No. of Units: 1 Owner: William Quaday Address: Site Address: 4280 Blackhawt. Road 10 02900 020 06 Plumber: Wiliam Q wda 8-27-86 66018 lf0.OOpd I agree to coerply with the City of Eagan Connection Charge: 47 5.Gt3, Ordinareoes. Account Deposit: 15.O0pd Permit Fee: lO.OOpd Surcharge: - Said By Misc. Charges: Date of Insp.: Total: Insp.: Dote Paid: iM11 1??0 K P 1$CLOU* PATZO AT 1 I4OUT t1FWL AMA *-1 **$ PO WI TO 0441K *01 T ?,.. ,? n a . _ ,__ _. & DOLLARS 100 Q CASH [] CHECK FOR Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File COPY CASH RECEt'T CITY O AEAGAN- 4,. P O. BOX 21-199 E;-, 1 tNESdT1 53121 PAVE 19 PROM . W, AMOUNT -?"' & DOLLARS 0 CASH E] CHECK P'tdNO ?S CODE AMOUNT 'thank YOU : BY i ' . g,3 Wte-pavom copy Yellow-Posting Copy Pink-Fite Copy PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 CONTRACT PRICE: PHONE: 454-8100 Site Addres3 ?`~' ?' a??rf f Lot Block Sec/Sub Name 11401 a pia .' ft o Address ;Si - 8o r v f h u ray c City Phone -5 3 6 6 U i Name t //L-t_/,mot- / L y 3 Address f /2 C A . i1 O City G T ?y? Phond - 0 FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE O PE MI , EE 'SMZ 10-6 - f6 .?. - -nc,W FOR: CITY OF EAGAN PERMIT # RECEIPT # 4- r DATE: BLDG. TYPE N Res. ?- Mult Comm. Other WORK DESCRIPTION New Add-on Repair NO. FIXTURES TOTAL 1- Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 '-Shower - $3.00 Kitchen Sink - $3.0b Urinal/Bidet - $3.00 Laundry Tray - $3.00 =Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: GRAND TOTAL: ?' = i CONTRACT PRICE: ..- PERMIT # -" PLUMBING PERMIT RECEIPT # CITY OF EAGAN r,. 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: PHONE: 454-8100 Site Address y? `J i Lot L Block Sec/Sub Name r * N 4e).4 v Address 80 t.r? if City ETL Phone Z Name A1.14-4-1AYx 3 Address z- o g c A_ cww p City SAG T? 4 Phon z- J FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) s f ; ;Jli it SIGNATUF3E PE?MI?rEE -6-? ?.FrD rt-? 7zcJe?f rr.tJ +0 ?o -/6-f. rl ©• BLDG. TYPE WORK DESCRIPTION Res. _ New Mult. Add-on Comm. Repair Other N FIXTURES TOTAL -- Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.©Q f-Shower - $3.00''',., -Kitchen Sink - $3.66,1_1 Urinal/Bidet - $3.00 ,f' Laundry Tray - $3.00 ` Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets- $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: A" ?' FOR: CITY OF EAGAN GRAND TOTAL- 4 CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 `SecI)o/7 c .(d-,l -Dto PERMIT NO.:- 183 The City of Eagan hereby grants to Risson's W'ei.l Drilling of 3600 Kennebec Drive, Eagan 55122 a WELL Permit for: (Owner) Bob Ostertaa at 4280 Blackhawk Road , pursuant to application dated 3/12/74 C Fee Paid: _,$10.00 dated this 12th day of March , 19--24-- .50 s/c Building Inspector Mechanical Permits: Bid Total: CITY B WAYS SON " VIM IPWftk,Xjwb Road , PERMIT NO.: 78 7 Eagsn, MN 55121 ---i E: -2 8 -8 6 R 1 No. of Units: 1 7 ` Ow"er. Wi12 iam . Qtsaday . Site Address,. 4280 B1ackhaWk Road 101 02900 020 06 Plumber: Qua" - ada Meter No. jo o 500.00 d P_ ? Size: • 15 00pd r ? Reader No.:i ?' 10 00 ! aurae to eorMirir wig the` urth r Qrdt++oeaa- 4ltafses 156. 00pd TP Total: 6 , 50pd ap- gr- By Dons Paid: Date of insp : CITY OF EAGAN Remarks Addition Section 29 Lot Blk Parcel 1 Owner ,`rl r-- Street 4280 Blackhawk Rd. State Ea an MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 3fir 4581.8-4 STREET RESTOR. GRADING SAN SEW TRUNK 3970 12 .00 251 Pa d$ SEWER LATERAL WATERMAIN 1985 9-8.28 15 1474.24 C009833 11- -841 WATER LATERAL WATER AREA A 197W 1 2Q, 00 1 1 Y,C3 STORM SEW TRK 1985 711.3 4 42 . 15 711.35 0009833 11-2-84 STORM SEW LAT 95.28 15 1429.18 Services sqv . 'ro - 05 I7 15A _" 4 , 8 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: Permit Number: Date Issued: 4280 BLACKHAWK RD LOT:BLOCK: C EARVIEW 1' n(' DESCRIPTION: PORCH Building Permit Type FOUNDATION Building Work Type NEW UBC Occupancy R-3 Zoning A Control No. 0712 BUILDING 000923 06/26/92 REMARKS: C ( BEAM GRADE FOOTING FOR ENCLOSED PATIO AT WALKOUT LEVEL AND 3-SEASON PORCH WITH DECK ABOVE FEE SUMMARY: VALUATION $2,000 Base Fee $45.00 Surcharge 1.00 Total Fee $46.00 CONTRACTOR: OWNER: - Applicant - QUADAY BILL 4280 BLACKHAWK RD EAGAN MN 55122 (612)456-7754 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. Statutes and City of Eagan Ordinances. r/, s ?(! APPLICANT/PERM! EE S NATURE I i IS UED Y: IGNATURE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: LOT: 3 BLOCK: 2 APPLICANT: 4280 BLACKHAWK RD QUADAY CLEARVIEW (612) 456-7754 PERMIT SUBTYPE: TYPE OF WORK: FOUNDATION DESCRIPTION Control No. BUILDING 000923 06/26/92 BILL NEW PORCH INSPECTION TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR. FOOTING FINAL REMARKS: BEAM GRADE FOOTING FOR ENCLOSED PATIO AT WALKOUT LEVEL AND 3-SEASON PORCH WITH DECK ABOVE L t PERMITj# REACTIVATE _ 913 CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets ofplans, 3 registered site surveys, ropy y far-fi=e? COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy caics. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or -lot change is requested once permit is issued. Date ?uN5 / /D / Valuation of work Site Address: '?02 P3O 4Q4ho.u)AL K0104h STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. lArl 2q jJ` P.I.D. /0 - O Z Oa ?. O Zo _ c)(. f,i ?,uC_1c?SE;a rsa ,4CGu Ac Kocc G ¢u?c. Description of work: E i f s r 7 J d ' AR C , StASOo The applicant is: Owner ? Contractor ? Other (Describe) Property Name _?Gtf i?LL Phone 46d-_-8660 LAST FI T Owner RS wvkk '966 -775? Address ILSo &1c'014w iCb STREET STE # City 5,4!2 mtj State Mil Zip $6/Z2 Company Phone Contractor Address License # Exp. City State Zip Company Phone Architect/ 0 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 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: ?4,(,? ? GL( ?u? tvd BUILDING PERMIT TYPE JE?01 Foundation ? 02 SF Dwg. ? 03 SF Addition ? 04 SF Porch ? 05 SF Misc. WORK TYPE R''31 New ? 32 Addition OFFICE USE ONLY ? 06 Duplex ? 07 4-Plex ? 08 8-Plex ? 09 12-Plex ? 10 Multi. Add'l. ? 33 Alterations ? 34 Repair GENERAL INFORMATION 1 LL I ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 11 Apt./Lodging ? 12 Multi.. Misc. ? 13 Garage/Accessory ? 14 Fireplace ? 15 Deck ? 35 Tenant Finish ? 36 Move Const. (Actual) Basement sq. ft. (Allowable) 1st Fl. sq. ft. UBC Occupancy, e_5 ,. 2nd Fl. sq. ft. Zoning' Sq. Ft. total ___ # of Stories Footprint Sq. ft. Length On-site well Depth On-site sewage APPROVALS ? 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS t Og.C-i '?c-c 1?C A-j"1 a ? Site 14 Footing ? Framing ? Insulation 0 Wallboard "Final ? Draintile ? -Fireplace Permit Fee &45,00 00 vettation: $ c o ' Surcharge -I t 057 Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: 0. SAC % SAC Units f N y5' N ti I LPN 07 ,,= 1%or QGU/UeJe ; i/ C G C Gli41}f?Gj IT EEG 5r13r'CE --- 0 ***********************************# * CITY O F E A G A MUTE: PAYMENT OF FM AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. APPLICATION FOR PERMIT INSPECTION OF SEWER AND/CR WATER s SEWER AND/OR WATER CONNECTION ?f PERMIT HAS HMN APPROVED. ************************************ (Please Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parcel ID #) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: f S (Month/Year)- PRESENT ZONING/PROPOSED USE: [J COMMERCIAL/RETAIL/OFFICE R-1 SINGLE FAMILY INDUSTRIAL R-2 DUPLEX (Two Units) INSTITUTIONAL/GOVERNMENT M R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2) M«: NAMES all G Gi ?/l-i'?? W +?{ ADDRESS : djea, rkc?_ CITY, STATE, ZIP: 141 A, PHONE:_ 'y 6"7 7 37 3) u ?: _• NAME• - = For City Use 77 Plumbers License: ADDRESS: Active CITY, STATE, ZIP: Expired Not recorded PHONE: MASTER LICENSE# Staff Initial 4) •a? • NAME:`" ADDRESS: CITY, STATE, ZIP: PHONE: •5) • v a: • a?• : a • a• - ?,• • CONNECTION TO CITY SEWER tg' CONNECTION TO CITY WATER OTHER 6) • _- • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) 7) P .: z4 FOR CITY USE ONLY PERMIT it ISSUED z Pd w/Bldg. Permit FEES: $ $ /7- 5-e) SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /5-h C' ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ $ WAC $ ,S T $ SAC $ $ TRUNK WATER ASSESSMENT - $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: S TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. Q SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: ! tiC?r- r ?d1 _? TITLE: DATE : c? f Zr 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER ^*"`?: - ION (PLEASE PRINT) 1) PROPERTY ADDRESS : ,? LEGAL DESCRIPTIC ---? (Lot/Block/Subdivision or Tax Parcel I.D/ umber) IF ISTI:G S'I UCTJRE, DATE OF ORIGINAL BUILDING P .'?IIT ISSUANCE: PRESr 'I' ?C IN /P POSED USE: R-1 SINGLE FAMILY ? R-2 DUPL. { ('IWO UNITS) ? R-3 TOT^WNHCUSE (-F-QS + UNITS) ( UNITS) ? R-4 APART-1 T/CCi ,I NILM ( UNITS) ? CQMIIERCIAL/RETAII..,/OFFICE ? INDUSTRIAL ? INSTITG'TIONAL/GOVERTP)M1T 2.) APPLICANT (PLEASE PRINT) _ ADDRESS: =K? , 1 CITY, STATE, (IP.'/ ? PHONE: 3) PLumE PLEASE PRINT) FOR CITY USE ONLY ADDRESS: PLUM ERS LICENSE: Active CITY, STATE, ZIP: Expired ?`MAS i E PHONE- 71 PLUMBER LICENSE f "1Gl f"r 0 Not of Rec rd a nitia 4) (X.C'UPANI'/GWNM trL?µat FKIN } --'a j ADDRESS : CITY, STATE, ZIP:' PHONE: 5) INDICATE WHICH PERMIT IS BEING REQUESTED: ?? 90 CTION = TO CITY SEWER GO IO TO CITY WATER ? =iER (PLEASE DESCRIBE) 6) INDICATE ONE : ? ?PLEASE HOLD APPROVED PER4IT FOR PICK-UP BY ONE OF ABOVE L,,,i,'/PLEASE MAIL APPROVED PER:,11T TO 1, 2 , 3 4 ABOVE (Circle one) 7) SIG:'IVRE: DATE : +•t ":aibitlfr.F oMOM Mtota J. WMltM" MMtaWZ0Vt 41W4.a VW "tarNMVWats ;.r.a.t lrttanti.tt?rtrati.firlna sat tar1?tisa ga a F O R C I T Y U S E O N L Y PERMIT S ISSUED FEES: $ f C1 $ SEWER PERMIT (INCLUDE -SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ?.000UNT _: OSIT - S?:,ER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER TOTAL AMOUNT PAID/RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? L 1 YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: •E WF:M attar wt r Ata WkM a._ a- arm a z_ at • - NB=ft ala aUW- W MR a}:.a a.: a* W V*o.: ,a Oil WELL RECORD Well Owne:c and Adds ess VILLAGE OF E AC:AN fs ? l e -- ?a? s ICJ a ion Lot Block T!S ?` O S'i,a--ce Licence No. Permit No. Date I C C Drilling Compar_y Address Teleppono V r, Size of WellInches Water Level 1 f c% Feet ? ?p Well Depth. Feet Draw Down . ? Feet at _c?MM U a Casing Depth Feet Capacity Gallons ?% l Per/TI(= Thickness Started Ended of Kind of Formation xon Color Depth Depth Formation Remarks Exterior Space Around Casing Sealed With: (3Cement Grout )Fuddled Clay 1 ,/t C! Other Disinfectant Used /oz/, .T, Hours Left in Well 4? ISSON'S ML & PUMP CO. 1955 Shawnee Rd. ra er s S na '. RETURN THIS RECORD AFTER COMPLETION PUBLIC WORKS COMMITTEE June 17, 2014 II. TRAIL ON BLACKHAWK ROAD (DIFFLEY ROAD TO HIGHLINE TRAIL) DIRECTION TO BE CONSIDERED: Provide a recommendation to the City Council for the bid award for Contract 14-13 regarding the Blackhawk Road trail segment in response to the concerns expressed by the resident at 4300 Blackhawk Road. BACKGROUND: • On May 20, 2014, the City Council considered the plans and specifications for Contract 14- 13 (2014 Trail & Parking Lot Improvements) for the purpose of advertising for a bid opening to be held on Thursday, June 26, 2014 (the bid date has since been postponed to July 10). Contract 14-13 provides for the construction and maintenance overlay of bituminous trails and parking lots in a number of locations. • The construction of a new bituminous trail on the east side of Blackhawk Road, south of Diffley Road from Eagan Pointe Senior Living (currently under construction) to the Highline Trail, was included as part of the contract. • At the May 20 Council meeting, a concern about the construction of the trail segment was expressed by the resident at 4300 Blackhawk Road. The concern stated was regarding the impact of a trail on the slopes of the existing residential driveways. The resident stated the grading required for a new trail would make the driveways steeper than desired. • In response to the resident's concern, the Council authorized the advertising of the contract for bids with the Blackhawk Road trail segment separated as an alternate bid and directed staff to schedule a discussion of the Blackhawk Road trail for a future Public Works Committee meeting. • As a follow up to the Council direction, a staff review of all of the driveways along the proposed trail segment was performed. The review indicated that revisions to the slope of the driveway at 4300 Blackhawk Road would be only slight, well within an acceptable range, and limited to within the public right-of-way. However, two other residential driveways, which are already steeper than desirable, would become slightly more steep or require the acquisition of significant temporary construction easements to maintain the current grades. • The single family residential properties adjacent to the proposed trail are guided for high- density residential in the City's Comprehensive Guide Plan. • The proposed design of the trail does not provide widths for a standard boulevard due to the topography. As proposed, snow removal and storage could be challenging and may conflict with winter street maintenance efforts. • The Eagan Pointe Senior Living development includes the construction of a new trail with standard boulevard widths along its frontage with Blackhawk Road. Similar trail construction could be included with future redevelopment of the current single family residential properties as high-density residential. OPTIONS: • Include the Alternate Bid for the Blackhawk Road trail segment as part of the Contract 14- 13 bid award consideration on July 15, 2014. PUBLIC WORKS COMMITTEE June 17, 2014 • Remove the Alternate Bid for the Blackhawk Road trail segment as part of the Contract 14- 13 bid award consideration on July 15, 2014. ATTACHMENTS: • May 20, 2014 City Council Meeting Minutes, pages thru • Resident Letter, pages thru • Existing Driveway Cross-Sections, To Be Distributed at Meeting. ��.�,�,,e {'�2 C�o'�"`m,v-r�S �� �°� ����j o� �l�.i�►'�. fz� ��'f��� �,�'�� °� �6n�'-nf• �o r�✓��� � � �l�. ,� �OLt�n�1 � �5 � � C�?f��a�l tri� �( �i�S � �� � - � � " r`� � � For Office Use �t fi Permit#: 6/9 Ar'S EAGAN 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: buildinoinspectionsacityofeagan.com L 2018 RESIDENTIAL BUILDING PERMITr APPLICATION Date: Site Address: 1-12-Y° BLA > x P" Unit#: f kek- r,cis Name: oG✓`Y -''� iCObi Phone:6/2- Fi Resident/ ,,�..,��,�((� [� Owner Address/City/Zip: LI 2.-Y0 i Li1�f Y'1.141 )II 1 Applicant is: X Owner Contractor T e of Work Description of work: — • • yp • Construction Co :/1 r 6-7J Multi-Family Building: (Yes /No 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 Oity to conclude that the 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.citvofeagan.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.000herstateonecall.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 p�.A �/��JrA� xkd y--ir S D el x Applicant's Printed Name Applicant's Signature