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1803 Carnelian Lanecinr oF EAC.AN 3795 Pilot Knob Road Eogan, MN S5122 N! 6326 PHONE: 454-8100 BUILDING PERMIT Receipt _- To 6e aed far Est. Value Date , 19 Site Addrcss Erect [Q Occupancy Lot Q ? Block `i Sec/Sub. • -? Alter ? Zoning parcel # Repcir ? Fire Zone Enlorge ? Type of Const. oWC Nome Move ? # Stories Z Address • Demolish ? Front ff. ? Ci Phone Grnde p Depth h. m Name APProvab Feea o . ? Address Assessment ? ~ Ci p?o,? Woter & Sew. ? Police ? Name W Fire ?? Address Eng. <"?' Ci Phone Plonner Council Permit Surtharge Plan check SAC Water Conn. Water Meter Road Unit I hereby acknowledge that I have reod this epplicotion and stote that gld9. p{f. the information is correct nnd agree to comply with all applicable APC Totol Stote of Minnesoto Stotutes and City of Eugan Ordinances. Signature of Permittee A Building Permit is issued to: on the express rnndition thot oll work sholl be done in accordance with all applicable Stote of Minnesota Stetutes and City of Eagon Ordinonces. Building Officicl Pwwlt # Dah Im? hrmitFN Plumbing Mechanical INSPECTIONS DATE INSP. Raph-I n Finol Footing5 Q- ? Dote Imp. Date Irnp. Foundotion Plumbing Frome/ins. Mechonical Final Remarks• 1117 IgC C?f c?e ?.fiiA?? S/rre' C I ? CITY OF EAGAN Remarks Addition CEIaAR GRO VE #7 Lot 21 Blk 9 Parcel 11 16600 210 09 Owner A-, - ^? 4') Street 1803 CarneliaA I,ane State Eag?? MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1970 58.1$ 2.08 28 Paid * SEWER LATERAL 1971 20 WATERMAIN * WATER LATERAL Z 1971 1,615.00 $0.75 20 Paid WATER AREA • STORM SEW TRK 1971 20 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 260.00 3477 4-28-71 BUILDING PER. sAC 200.00 3477 4-28-71 PARK INSPECTI CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: ` PERNIIT SUBTYPE: ? I I !"m I IV ON RECORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: ?c.l. ! • ? 1) i.?. 'i TYPE 4F WORK: i , , 1. i i , F 1 N A I ?I W. rn' N ? lJ 1 F WF F', 1 AN(O 1'Nt3 ) Permit No. PermR Holder Date Talephone A ELECTRIC PLUMBING HVAC InspecUon Dete Insp. Comments FOOTINGS FOUND FRAMINQ ROOFING ROUGH PLUMBING PIBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FiREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ' CITY OF EAGAN z 3795 Pile! Knob Raad Eagan, MN 55122 N2 6326 PHONE; 454-8700 BUILDING PERMIT APPLICATION Receiut # To 6e used fer CHIMNEY Est. Value 1,300 Dme 10-27 1980 Site Address 180 Carnelian Lri. Erect ? Occuponcy Lot-2 1 Block Sec/Sub. C- ?' ? Alter ? Zoning _ Parcel # I? . ?? I??F?0C9 21j0 dO ` Repair ? FlreZone _ E l T f C t n arge ? ons ype o . w Name ROnald J8CkE1S Move ? # Stories z o Address 1$03 Carnelian Ln. Demoiish j] Front ft. ci Eagan, NECI. Phane 454-6237 Grode ? Depth ft. ? 0 Narrve Wlll7.8IIL B11M Approrob Fees ?u Address Assessment Permit 5-(1(1 Apple ZIa112y, ?Tl ?' Woter & Sew. SurcFarge - 5(1 o?e Ci Police Plon check luw Neme F?„ Fire SAC 2 ? Address Eng. Water Conn. aW Ci Phone Plonner WaterMeter Council Road Unit I hereby acknowledge that I have read this application and state thot Bldg. Off. the information is torreci and agree to comply wlth all cpplicable AP? Total 5.50 State of Minnewta Statutes nd?City Eag an O rd i na nces. ? ? ?? j ? ? a ' Signature of Permittee ?%?-"?'- tiN111i27R BllT1Z1 A Building Pertnit is issued t: on the expreu condition that oll work shall be done in a ordance Ith a>il app?li le S?ta.?te. of Minnesota Statutes and City of Eagan Ordinances. BuildingOfficial • ? CITY OF EFIGAN /?`include 2 sets of plans, 1 site plan w/elevatians & g[7ILDING PE13?LiT APPLICATION 1 set of energy calculafions• To Be Used For Valuation ?? 4 O Date ?Q -??-?? site Paaress 1 go3 0-0h-'?,LJ ?a?zzJ oFFicE usE oNLY ? Lot ? Block ? Sec./Sub. L, Fsect OccuPancy T A1teY Zoning Parcel #: Zone Fi Repair re Enlaxge - q'ype of Const. Owner: mve # Stpries Aaaress: /?4 3 8 A-/7-J Derolish Fzont City/Zip Code: ??r ?7"'?li?nm 5? /a ? Grade Depth Pnone #: Contractor: prldress: City/Zip Code: Phone #: Arch. /t1g • • _ pddress: City/Zip Code: Phone #: APPROVAiB pssessments Pernti.t ?, e 0 taater/Sewer St1Z'ch3Yg2 ti D Police Plan Check Fire . SAC ?X3 • Planner Council Bldg. Off. APC Water C,onn- Water Meter RAad Unit 'it7PAL 6- 6? d _A 9- 7 c, G , TOWN OF EAGAYJ 3795 Pilot Knob Road S t. Paul, I4inn. 55111 PEP.MIT N0. 103 The Board of Supervisors hereby grants to Cedar Grove Construetian Co, of 7363 Concord B1vd., So. St.Paul 55075 a HEATING Permit for; (Owner) Cedar Grove Gonatructionat 1803 Carne11&n, 3990 Cimabar, 1775 Carnelian, 1783 Carnalian,'779-^Carneliang 1807 Carnwl4an21-9*711-9-5s 14-9-7. , pursuant to application dated 16-9-7, 1.5-9-7f 22-9-7 APriJ 220 1971 Fee Paid: 4120.00 Dated this 28th day of Apiil , 1971 ^Building Inspector S di--9--7 C, G- TowN oF Eacaii 3795 Pilot i;nob Boad St. Paul, Minn. 55111 PERMIT R0. ' 109 The Board of Supervisors hereby grants to Cedas Grova Conetiaction Co of 7343 Concord Blvd. E. South St. Panl 55075 a pmmMnrxr. Permit for: (Owner) Cedar Grove ConstruCtioa at 1803 Carnalian, 39 ?ianaher, 1775 Casnelian, 1783 Carnelisu,.l'779 Caraelian; _?21-4-7? 1-9- y 14-9-7,Pursuant to application dated 16-9-7* 15-9-79 22-9-7 Apsil.22. 1971 Fee Paid: $1 n nn Dated this 8th day of $pril , 1971. _ Building Inspector J i - RESIDENTIAL 19H3-S ????? BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New ConstruGtion Reuuiremants • J:-gistered site surveys showing sq. fl. ol b( sq. fl. of house: an0 all roafed areas (20% mmimum lot coverage allowed) • ? cooies of plan showug heam 3 window sizes: poured lound desgn, etc.) • 1 3zt of Energy Calcuiations . 3 ropies of Tree Preservatbn Plan i( lot Dlatted afler 717J93 . Rim Joist Detail Opuons selection sheet (bldgs with 3 or less unds) DAiE g[ ? q/o;;k 1-'V1C. SITE ADDRE55 i $? 3 Ccw Yl P A i"t 1-r, . MULTI-FAMILY BLDG _ Y TYPE OF WORKR IL Si-'dc? lG IZq( 65F fiREPIACE(5) _ 0_ 1 APPLICANT JI,, N _ 2 STREET ADDRESS _ 1aa ?I -7' iV. cv`&f cirr 6ulhsu ??- STATE Of y_ZIP 5 S?3 TELEPHONE # C?'I S?) `?D`,? • ELL PHONE # FAX #d 5?8D Ff- 8$'q6 PROPERTYOWNER kocS cJ0.e_ket5 TELEPHONE# (ic-St)yS?/-CR 3 1- ----------------------------------------------------------------------- ------------------------ COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ y[IVNE:SO'l':1 RGLES 7670 G\"fF.GOI2Y I NII\\ISOT:\ RI'I.L:S itii`l (v submission rype) . Residential Ventilation Category 7 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbinn sys[em includes: Mechanical Contractor: Mcchanic>tl systcm includrs: Sewer/Water Confractor: -- Air Condilioning Heal Rccoven• Systcm Phone # Phone # $70.00 ------------------------------------------°---------------------------°----------•-------------------------•----...----- I hereby acknowledge that I have read this application, state that the information is correct, and agree to compiy with all applicable State of Minnesota Statutes and City of Eagan Ordinanc Signafure of Applicant DI(. ?l ---------- ------------- ------- __.------------------- ---__---- ____- ---- _----- ------- ----- --------------------------- OFFICE USE OtiLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 _ Watcr Softencr Water Heater vo. of Baths 14fa. -7S RemodellReoair Reouirements • 2 copies of plan . t sel of Eneigy Caiculatbns for heated additions • 1 sire survey far ezterior addi6ons 8 decks . Indicate if home served hy seplic system for addi6ons VALUATION Phone # Lawn Sprinkler No. oF R.I. Baths ? AU6 2 1 2002 ? CITAF EAGAN PERMIT 3830 Pilot Knob Road PERMITTYPE: BuzLozNG Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 6 3 5 (612) 681-4675 Date Issued: 0 3/ 2 5/ 9 7 SITE ADDRESS: 1803 CARNELTAN LANE LOT: 21 BLOCK: 9 CEDAR GROVE #7 P.I.N.: 10-16706-210-09 DESCRIPTION: ^.. (FREESTFlNDING), k3:6iLding--F'ermi.t Type FIREPLACE Buildi+ng Wb?k Type NEW f?Fensus Code 434 ALT. RESIDEN7SAL ? , . ?? ?. ? A '21. f J 2J C" ? ?' REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: - Applicant - OWNER: MASTER GAS FITTERS INC 17708691 JACKELS LOIS 2340 SHAWNEE DR 1803 CARNELZAN LN NjST PAUL MN 55109 EAGAN MN 55122 (612) 770-8691 (612)454-6237 I hereby acknowledge that Z have read this infor?matiarr4s cor.rect ansl. agrse ta_ comply Statutes and City of Eagan,Ordinances. ? . _ . APPLICANT/PERMITEE SIGNATURE application and state that the witM a11 a?-jppli.cable State of Mn. (RI74 D?! .? ? SUE B SI ATUR _I ? ? ? ( 19t CTTY OF EAGAN 4 ig 3830 PILOT KNOB RD - 55122 1997 FII2EPLACE PERMIT APPLICATION 681-4675 DATE: J - -?- I/ _ "i ) DESCRIPTION OF WORK: _ CONSTRUCT NEW FIREPLACE INSTALL GAS INSERT ONLY PERMIT FEE: $50.50 _ ALTERATIONS TO EXISTING INSTALL GAS LINE ONLY ? O'IT3ER: Fzf T ??-5 h.?VL?ce -t G?s wv2 4f STREETADDRESS: I gD, 3 ?/?2nJ£G/'*,? L-J - LOT -J?_ BLOCK ? SUBDJP.I.D. #: 0, UJ&,' ZMN A APPLICANT: (circle one onty) OWNER CONTRACTOR 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 5tatutes and City of Eagan Ordinances. PROPERTY Name: J f!cifEG 5 Lo i 5 Phone #: IOd 3 7 OWNER Signature: StreetAddress: City: ?,4y4.? State: "4,-- Zip: FIREPLACE Company: (o S -rnvc. Phone #: 720- 162/ INSTALLER Signature: ' StreetAddress: a?-?o .s Li/?-???f E De- License # : City: No State: M-v Zip: SS 1 Uf GAS LINE Company: 4-W P Phone #: INSTALLER Name: .S1gIIfltUiC: r r Street Address: City: `I State: Zip: CITY liSE ONLY ? 11 ti LOT ? BL I RECEIPT #: ? I SUBD. CtLl'QIr [97YU?C? ?? RECEIPT DATE: ? I? 1q 1999 M£CHMICAI. PEiMIT (RESIDENTIRIa crrY oF eAeax 3830 Pu.or [crros gn eAs,ax MNssiYE (651) 661-4675 Da[e: Complete this section onfv if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U $ 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section on[v if you aze remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. _ New X Replacement _ Repair _ Other T? ? Fumace _ Air conditioning _ Air exchanger, i.e. Vanee system, etc. _ Other Remiuder: Ca11681-4675 for Inspectioxs. $ 30.00 State Surcharge: Total: $30.50 SI'tE ADDRESS: 1 D O ( QIr nehan L! J• ONVNER NAME: LoiS yoGkeIS PHONE #: W`,? -?15y -(na37 NSTALLER NAMEVOh(uS Sa&T/ )J i di- We1 ' PHONE #: "q31--70q-1 STREET ADDRESS: AVX/' CITY: Aff (X ?/(29? STATE: MK)_ ZIP: 5f)104 441 e, (il)ditl?'? SIGNATURE OF PERMITTEE JS. FOR.NS 8LD%MECH PERMIT (RES) - 1999 I . M EAGFN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERPaT POR WATER SCRVICE CONNECTION Date: Anril 22, 1971 Number: 586 - 21-9-7 Billing Name:Cedar Grove Const. Co. Site Address: 1803 Carnelian L•an Owner: Same Plumber: Stein, Inc, Meter 4/28/71 Meter No. IPermit Fee 10.00 pd 4/28/71 Meter Reading IMeter Dep. Meter Sealed: Yes_ lAdd'1 Chg. NO I Total Chg. Building is a: Residence XXX t4ultiple tio. Commercial Industrial Other Inspected hy Date Remarks: $25.00 Re-iNsPccTION ,",-I 170; units IP,9PROPLERL'( fi,ISIALLED Mj-iEPS. Billing rkldress 7343 Goncord Blvd. B. South St. Paul, Minn. 55075 In conaideration of the issue and delivery to me of the above permit, I hereby agree to do ttE proposed work in accordance witn the rules and regulations of Eagan Tocasiship, Dakota Countq, Minnesota. By: Chief Inspector By: CE?AR GROVE CONSTRUCTION COMPANY ? D O /Y7,CP/ C.. LJ ?i.012'_st Please notify the above office when ready for inspection aad connection. . ? ? EAGtiN TOSJNSHIP 3795 Pilot Knob Road St, Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATB: An ' 1 22. 7 OWNER;Cerlar Grove .onst_ .o. TYPE OF PIPE Cast Iron (Lot 21, Block 9, CedarGrove #7) AddreBS 1803 a n 1;an .an PLUMBER Stein. Inc. DESCRIPTION OF BUITA ING Industriall Coffiercial[ Residential I Multiple Dwelling I No, of unfCs Location of Connections: NOMBER 746 Connection Charge 200.00 4/28/71 Permit Fee 10.00 4/28/71 Street Repairs Total Inspected by: DaCe Remarka: By. Chief Inspector In consideration of the issue arnd deliverp to me of the above permit, I hereby agree to do tfie proposed work in accordance with the rules and regulations of Eagan Toirc?ship, Dakota CounCy, Nlianesota gy CEDAR Grove CONSTRUCTION COMPANY /,?l J f//1 rn i r? ?' Please notify whea ready for.inspection and connection and hefore any portion of the work is covered. EAGAN TOWNSHIP BUILDING PERMIT Ownei "".?y...?':'T:7?Q:.......L'.v..°.?:'r? Addrese (Pzeseni) ...f..'.b..----:?..-Y........... Suild,z .................... :.........Q??.............................................. .... Addrere .......................................................... .................................... DESCAIPTION N° 2425 Eagan Townahip Town Ha11 ne:e r ................... Siorie' To Be Uced For Froni Deplh Heigh! Eei. Cost P ermiY Fee Ramarka / ? I ?'J This permif does not au2horise the use of slreels, roeds, alleyt or eidewalks noz does if giva the awnes or hia agent the righffo ereate any sifuation which is a nuisanee or which presents a hazard !o the healih, sefety, eonveaience end genesal welfare !o anpone in the cammunify. . THIS PERMIT MUST BE KEPT ON TFIE PREMISE WHILE THE WOAK IS IN PROGRESS. T6is is !o eariifY, that.4S..rr,....c-?.....t.-¢...-..-?cC....... hespermission !o arect a...... +...:.------ - ._,:?C_ . ............._upon the above descri6ed pramise subjaci fo the provisions of the Building Ordinance for Eagawnship dopled April 11, 1955. ? ....................... ( . .. .... F/...^ ... ............. Per .................... ' ?......0:`.?Q : °?---?............................ l Chairn of Tvwn Baard ? Buildin Im ector MASTER CARD • LOCATION OWNER `CVA R G.ML ClfA/1? STRUCTURE AND LAND USED AS Permit No. I Issued Issued To Coniractor - , Owner BUILDING -I I I PLUMBING CESSPOOL - SEPTIC TANK N?ELL ELECTRICAL I HEATING ? V s . y?s ?7/ GAS INSTALLWG I SANITARY SEWER ? y 6 .- ? OTHER W OTHER ? I I • 7 ? Items ? Approved (Initial) ' Daie Remarks Distance From Well FGOTING y ??, ??II SEPTIC _ FOUNDATION FRAMING `• Y. CESSPOOL TILE FIELD FT. FINAL ELECTRICAI HEATING T? y ? DEPTH OF WELL GAS INSTALLATION SEPTIC TANK I CESSPOOL DRAINFlELD PWMBING jl op- WELL SANITARY SEWER d, -o Violations Noted on Back COMMENTS: ? 2005 RESIDENTIAL BUII.DING PERMIT APPLICATION ? City Of Eagan 3830 Pilot Knob Raad, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construdion Reouirements RemodeVReoair ReauiremenGa OFwe Use Onlv 3 2gisle2d sile surveys showing sq. IL of lot sq. fL of hause; and ail roofed areas 2 wpies of plan CeR of Survey Recd _Y _ N (2VI. maximum lot coverage allowed) 7 set of Eneyy Calculatbns for heeted addftians Tree Pres Pian Recd _Y _ N_ 2 copies of plan showing beam 8 window sizes; poured found design, etc. 7 sRe survey for additlons & decks Tree Pres Required" _ Y_ N lsetofEnergyCalculations Addition - indicateHOnsiTeseptksysfem On-siteSepficSystem _Y _N 3 copies of Tree Preservation Plan'rf IM DlaGed afler 7/1/93 Rim Joist DetalOptbns selearon sheet (buldings with 3 or less units) Date 7 / ?`?/ 6 S Co struction Cost l? , t!? R? '- Site Address Ip p 03 ??-e, (;0.YA QP I?_. Unit/Ste # S i Description of Work ?v_ =h? A Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner Tm s ' Telephone # ( ?5() KS?I ^ (P Renewal By Andersen Conaacror 1920 County Rd. "C" West Address Roseville, MN 55113 C?ty State 651-264-4777 _ Telephone # ( ) License #20130983 '' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Enefgy COde Category . Residentiai Ventilation Category 1 Worksheet • New Energy Code WoAcsheet (Jsubmissionlype) Submitted Submitted . Energy Envelope Calculetions Submitted Have you previously constrvcted a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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 appro al of plans. A plicant's Printed Name Applic t's Signature ? ?"•"•,"'•? ?uu ?c.ov rrin. roa o!1 440D L(?tSiTlll. BYkttUtSit7tSLY . re rune ?, zaal - . City of Eapn . 3836 RiIuE Snob Road ' EAM MN 55122 To Whom It May Canoerrr. EIder Tones is aathodzed to ptM buildfilg pftmits forRenewal bY Andeasen. Please aIIow Eider Jones to pi+ovide this date bcyond 616101; Acrvicc forns in Eagan, 'ihia enthorizetien is valid Pvr any to theCity- watil a?'enanvaj bY Andcrsen manapt exPcessIY revokes it in wiiHng I rcqueat tGis authodzafion be ecc,epted-°xpeffidously. as to uot deIay in the . our bniidinS Pcnmiti anY fi?ez. Plcaic contacbed at 763-502-4746_ caII mc If tficm arc nnp qucstfona.. I?ng of , .. _ ?. Your imm9diats mttcntion to Wis metterls 111DtdargL 9 - Sincarely, 4XYm ond R &-Rau dstalIation Managor Ranowal bY Andcrsen CorPotativn C'r.: TCarn-F.IcIPr 7nnea . - . y oH o. !? ?? ? _ `°^??.?.? ? Y • , +Gluu Received Tihe Jun. ]. 1-07Pld ----------------- I Far?f.?tice Ils_e` ? ? Permit # j i Pertnit Fee: ? Date Received: ? I I ? Stafr: I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ? - 11 - Site Address. k60 Tenant: Suite #: RESIDENT! OWNER Name: L_ffl-? Phone: 411l-'l5H -46 Z51 Address / CRy / Zip: \b° 3 (c.r ( ?., ?.7c??1 i Applicant is: _ Owner _X Contractor TYPE OF WORK Description ofwork: 1cn+" cDW k te,c*r+? Ywu,a, ,A Avr+xqP. - Construction Cost: Zac7' Multi-Family Building: (Yes No ? CONTRACTOR Name: ? ah F}clin 44 License #: 7.017-b66a Address: ?q ?J 2,76 Sf• City: 5t • l..oA.?s i? State: N'LN Zip: 554Z-B Phone:46s'9z5, 1,156 ContactPerson:U? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Su6mitted Su6mitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan hased on a master plan7 _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contrector: Phone: Sewer & Water Contractor: Phone: NOTE,` Plans and supporting documents thaf you submit are considered. to be public information. Portions of > the information may be cfassified as `non-public if you provide specific reasons-that would permit the City fo conclude that the are irade secrets. . = I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance 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 permik 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 - ApplicanYs Printed Name canf", a Page 1 of 3 Use BLUE or BLACK Ink r For Office Use - I rP~ I l 31 City of Emu I Permit I b 1C I Permit Fee: I 3830 Pilot Knob Road I Eagan MN 55122 Date Received: 1 Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit t Name: Lk, S )iCcctakw, Phone: 3-7 Resident/ Owner Address / City I Zip: caf^eA[._~ Lot. _ our.. C.J Applicant is: Owner Contractor Description of work: Lotcf'' oR Type of Work Construction Cost: OC7 Multi-Family Building: (Yes / No Company: ~Y- Contact: Address: MP~A City:-15 Contractor State: Zip: .~.3 Phone: !7S 7_ " 7Z56( 5 (CD License BL (2 ~88o Lead Certificate m......j , If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: i 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.aor)herstateonecall.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 the approved plan in the case of work which requires a review and approval of plans. 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. x bC_ x Applicant's Printed Name Appli ant' n ure Page 1 of 3