4665 Aspen Ridge Cir
Address 4665 Aspen Ridge Cirrla Zip 5512_2
Lot 6 Blk I Sub Oaknointe of Eagan 2nd Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEC110N.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish
Deck \
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
I L BL CITY USE ONLY RECEIPT#: 4 q9 1 16 0 -'Jo 10
SUED. Qt0 YI n~ RECEIPT DATE: i a r
y PERMIT # O
8000 PLumain PERmrr (REsmENTUL)
CITY OF $ABAB
3930 PILOT KNOB RD
EAISAN, UN 55122
651-6$1-4675
Please complete for: > single family dwellings
➢ townhomes and condos when permits are required for each unit
D backfiow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x - $
Floor drain 3.00 x = $
Gas piping outlet ` minimum - 1 3.00 x 3 = $ b~
Hot tub/spa 3.00 x = $ EO
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $ CR7
Septic System new/refurbished 'requires MPC fic. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installadon/reairlrebuild 30.00 x = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground srinkler if dwelling is under concoction 3.00 x = $
Under rounds rinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener If existing dwelling 30.00 x = $
Water turnaround 30.00 x = $
State Surcharge 50 > > > $ 50
> $
Total
(oo• SO
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
1. Oa
-
- - - - -
I hereby acknowledge that-I-have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances.
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activifies to the facilities constructed under this permit within City propertylrightof-wayleasement.
SITE ADDRESS: L S /4 P, 6 Q ~
OWNER NAME:: vat/~sf t orrs ?uc .st TELEPHONE#: S D•7 -33L/- 6034
(AREA CODE)
INSTALLER NAME: /J umG/n r 1t hKa~»a TELEPHONE S/ 7 r{i -,I m n
(AREA CODE)
STREET ADDRESS: l l J)]y/~ ~+o c~i j I L
CITY: IlaC~1 fart S/TA~TTE: 6~~n ZIP: .S-S~d4
SIGNATURE OF PERMITTEE
CITY USE ONLY n t ?
LOT ~ I, BL 1 PERMIT gOh37-
SUBD. Oakp01 i4r.. n r r ;4 RECEIPT ~~g 5
RECEIPT DATE:
2000 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN NN 55122
Date: 651-681-4675
N 1 Z(a lO O
Complete this section only if you are installing HVAC in a single family dwelling, townhome or condo 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 Q $3.00 ea.) 3 -O 0
State Surcharge .50
Total $ 33,5-6
Complete this section only if you are remodeling, adding to, or repairing an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New _ Alteration _ Repair _ Other
- Furnace Air conditioning
- Air exchanger Other
Fee $ 30.00
State Surcharge .50
Total $ 30.50
Reminder: Call for inspections
SITE ADDRESS: , NIOIf S ' $ -y C I r~ LJ
7 CCU j
OWNER NAME: V C( ~V"~GIJ~YIS ~YL1 !G dY(~ PHONE 501
INSTALLER NAME: Y f Piet ~ ~ ✓1 Yf.CF.1-h p4 ~ G PHONE 5 1DE)
p 7y,~ / (AREA CODE)
STREET ADDRESS: 3('160 XtiytU be c ) T
CITY: G STATE: MA/ ZIP: 5512 Z
&AJ
SIGNATURE OF PERMIT -tE
,
CITY O EAGAN
;T<~SiNAL NC Oi4
CA~TE:R~ .s
°D•ATE. OV22/00 TIME: 0.240.4
NAB? JG$EPW VARLEY CCNSTRUC'riCN sNC
' 2252 9820 44ES ASPN RDG C ,`p8
.3210 9009 46rs5 ASPN Rt?G G
1,2 .93-
3866, 93"'9 4665 ASPN RDC C +pp';00
34.Gr'l i - - n
3rK}i 46045 ASPN Pic c si7 C2
i ASPN RING C i•, 089x,00
227'5 9220 4'E u
s
344E 9001 44~ r~r,
21 a` 009 4 i A l i C t97.$p
37'43 92f0 466 ASPN FDC C
sG.dn
'155 9001 4661 ASPN REIG C 73.'50
3868 9220 •t66" AS-?N RDG C 492, Ctl
:CR1248i.7 )4 f,O.NTiNUF_'
US'E'R ID7 JAY ~ ~k4{ C~lhkT7NUE
Y
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
LJ r 0 O 3830 PILOT KNOB RD • 55122
Li 851.881-4875
New Construction RemiremeMs
3 regfsfered slle surveys showing sq. M. of lot, sq. R. of house 2 copies of plan
and gll roofed areas (20% maximum lot coverage allowed) 1 set of energy calculations for heated additions
D 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) 1 site survey for exterior additions & decks
y 1 set of energy calculations
D 3 copies of tree preservallon plan it lot platted after 7/1/93
DATE: 0/0,9 1 CONSTRUCTION COST: j7 00
/C/~L~l
DESCRIPTION OF WORK:
STREET ADDRESS: /new e )
LOT: BLOCK: SUBD./P.I.D. _ d AID' Fyo/.u rc-
/o 3-377 olo0 0
Name: C Phone C Po I ` U l a7
PROPERTY Last Q First
OWNER 0 ~ C7 % L f iU 1) ~L~ ~v i T7a /d / 4f
Street Address: ~ )
city I!Y n o.~ i0 6 T o ? State: X4 Zip: .rS174a'Cp
Company:;lfaS'Ea'4~ P Phone 9: ,o ;7 _
(area code)
CONTRACTOR Street Address: / t3 S'
l lEZ I~/GL 4ense it 0 Exp. 3
city U L7 State: zipd~~
ARCHITECT/
ENGINEER Company: Name:
Telephone ((os I ) / 4t S- L4 I C7
Street Address: T7 \4G' U R Registration rr
city C' T state: ZydZ2) - zip: J d
Sewerlwater licensed plumber (if installing sewer/water): Phone
te
1 hereby acknowledge that I have read this application, state that theiMort77777
of Minneso
ta Sfal(des and City of Eagan Ordinances. Signature of Applicant.
OFFICE USE ONLY
Certificates of Survey Received p-~gvYes No
Tree Preservation Plan Received Yes No Not Required
~ r
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 21 Porch (3-sea.) ❑ 31 Ext. Aft - Mufti
❑ 02 SF Dwelling ❑ 08 06-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Aft - SF
❑ 03 01 of _ plex ❑ 09 07-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi
❑ 04 02-plex ❑ 10 08-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 05 03-plex ❑ 11 10-plex Plbg _Yor_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 01 # of Stories 2 sq. ft.
No. of Units I Length 4 g.u sq. ft.
No. of Buildings I Widt4q,0 Footprint sq. ft.
Const. (Actual) ni Basement sq. ft. Census Code i u l
(Allowable) Main level sq. ft. H z Z. MC/ES System
UBC Occupancy Q-Vu-i 2-d It„I sq. ft. ssr-7 City Water
Zoning 6.•-,~ sq. ft. u2r. Booster Pump
PRV ~L s
Fire Sprinkiered
MISCELLANEOUS INSPECTIONS
❑ Stucco/Stone
APPROVALS
Planning Building CS G Engineering Variance
Permit Fee Valuation: $ N~ 100
Surcharge
Plan Review
License Lo.-4r le,.`I :~:r4e Ot ~K i z 06
MC/ES SAC 3vrzo iv+v fzs ~~S 25U
City SAC q k? I
s l v o G"` S
Water Conn. JA
Water Meter 'mod 3iv>IS zvXzO L-1 Z6 r(6 Cg-
Acct. Deposit h , h zX 13
S/W Permit
S/W Surcharge go Vi
n
Treatment Pl. 44;r I W z z s Ll
Park Ded. saX Iz
Trails Ded. 1 k
Other 2 k 12
^d Cloo✓
Copies
1Sr,S r1K•5 ~n
Total: q 9 X3.9 7 t3,5kz~ 57X54 316FY
SAC Units
% SAC
+
.4
CITY OF EAGAN
EXTERIOR ENVELOPE AVERAGE 'U' COMPUTATION
OWNER: Or -P HOMES OAKPo(NTE FWASE_ Tr
SITE ADDRESS: pg~4 gl G12GL1 LOT gLOCIt~
CONTRACTOR: DATE:' PHONE: 6i2'S~( D~~7
Determine working square footage of each: o
1. Total exposed wall area 3-190, sq. ft. x .11 = D
2. Total roof/ceiling area j 9 sq. ft. x .026 = ~3_
Total exposed wall area above floor = 3 O 1(O
a. Total wall window area
b. Total door area
c. Total sliding glass area 10
d. Total fireplace wall area
e. Total wall framing area (average 10%)
f. Total net wall area above floor -1'z
g. Total rim joist area 1!3 6
Total exposed foundation area = O O
h. Total foundation window area
1. Total net foundation area above grade 9LQ0
Determine 'U' value of each wall segment:
a. ~eZO x 'U' 143
b. ? g x 'u'
c. IdLO x 'u'
d. x 'U'
e• 3r,l x'u' .097 : ~l
f. 1 7 x ' u' . o gs
9. 1 .4
0 Z2
h. X 'U'
I . ~QO X 'U' 07G = 15
.ASS
3 Total = 341
If item f3 is the same as or less than item !1, you have met the intent of SHC
6006(c)2.
Total exposed roof/ceiling area . q
J. Total skylight area O
k. Total roof/ceiling framing area (average 10%) 150
1. Total net insulated roof/ceiling area 24-6
OVER
Determine 'u' value for each roof/ceiling segment:
J. d x 'u,
k. cJC7 x out •
x,u, .~~a e 3Q
4 . Total = -3---
If total of 04 is the same as or less than 02, you have met the intent of SBC
6006(c)1..
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum
of Items 43 and 04 shall not be greater than the sum of Items #1 and p2.
1. 39:1 _ + 2. 3 / =
3. -+4. 3 = X75
3
i
i
i
2
Cities Digital Quality Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
Provide insulation baffles in every'
rafter space. RQOF I COIL{N(,
s (F-) Vr
iQ U1~jEtvio(t F~tR F(LI~ .61
~ ~ INSUtAlIoN ` ~.dc
. ro l
1 ® ExjC9W A1F FILM
• ~ ~ ~~--1 ~S-GILL,
T&TAL
U oast
WAIL
QQ 441-r-1o[- AIR FILM <T16-0
9 O 'h ` GYP.' W. , 45
1P~SULATlo~'Siz''1~~L3~
. Q Zs/ten g~i.7 KiT~ I-3~
• ~ ,r ~ ~ c~nt~ rZ 51~tr~ , S 1
a Ex ,=1a, Arit FILPj 0~7
TOTAL (R) =2~.'f3
c~=•09.5.
12{M
(7,) AvAu
07 111TEV-10F, AIR FIUI'
2 FIR- R11/1 '~D15T
Z515 7- 472~
1 tiv CE
l~fZ 5►p1rG :
O . eXT~tzloiz A1~ fitC1 • 17
o
~6 - TOW
. p fC1VDAT100
VALUC
9
QQ 1N IE17 Z AIR FILPI Ctz) .*6
IS o I;"15UL.ATIo y am- `
o. 4t Fem.
71
go'.
e r~ EXjcV-IDrz AIR FILM -l7
Floors ore, L)-•076
unheated spaces must have minim'
ua R-factor of R-20 (tuck-under garages).
Floors ov.r outdoor air (overhangs) must liave a mininum R-factor of R-33.
PwRESE E:~
xcpr
REM, te. uti.
(SEE ATTACHMENTS)
Development no,"() \ who ~1 QLty~
Lot Number 6 Block Number
Address LI 66"x` k o u, ti~4A! G mcG
Builder J Se V
C u
Tree Protection Requirements:
Y` Tree Fencing
Oak Tree Pruning (Seal wounds during April 15 to July 1)
Therapeutic Pruning
Retaining Wall
Other:
Replacement Trees:
Not Required
As Follows:
Attachments:
_ Yes
No
J~ Additional Notes: I J
C7 RU QhCYdQt1~w.4w~ i. Lu ZZE
DAVE
Tree Preservation Plan
Oakpointe of Eagan ~),u ~ AN - t T/
Lot (D-, Block (Site Plan Attached)
Address: L ' J`--e, Q I ~ Q
Owner: OCP Homes, Inc. Builder: Joseph P. Varley construction
8609 Lyndale Ave. So. #101B 16800 Shieldsville Blvd.
Bloomington, MN 55420 Faribault, MN 55021
881-0127 507-334-6034
Significant Trees on Lot:
None
_ Significant Trees: (Numbers Per Tree Survey)
# Type Size Retain or Remove
7y Lo o !o
w v 17 ! 7~o W v /O 2E1yf/al~
a]/ )L
,d 7 ( w 9 • l QE r'A~~
59 Q PE,J tt ETi9lN
2,B ~ c 1+c RR L~' 7 -X
/N
'-1417 ASPEK/ Z" ~02irt--Fi9LL -/1FOUEs
Protective Measures: 31B
30o Gyt2oev 9''' /~cn~ov~
X Tree Fencing X68 p ! y- /.2C jty//V - P~U e~E ~T°ORCr~
Oak Pruning (April 15 - July 15)
Retaining Wall
12 ~
Therapuetic Pruning ~E~~ piy STOP
Other.19`0
Q&S'/~/v To U lVE ~iU.U/~ J
~~~E er,~ /l G~
Re lac rnnt Trees:
Not Required
As Follows:
Notes:
~ I ti _4
--7
Q
, .
I;Z.D 14'; 33 5~ _ 13
Ilk
DEf-K
xI any T_-
t 8
x~n
ft~ /
Arjo
9 G'1:9~
--'""9 $ T Tic
~f
\ 1 iz
S
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: 0!JV 14ne
DATE OF SURVEY:
H
LATEST REVISION:
W
tY
DOCUMENT STANDARDS
Y g n°
a a
❑ Registered Land Surveyor signature and company
y //0 ❑ Building Permit Applicant
❑ Legal description
p/p ❑ Address
❑ North arrow and scale
p .0 . House type (rambler, walkout, split w/o, split entry, lookout, etc.)
❑ Directional drainage arrows with slopelgradient %
❑ Proposed/existing sewer and water services & invert elevation
y~ ❑ Street name
i~o ❑ - Driveway
V ❑ Lot Square Footage
a~ ❑ ❑ Lot Coverage
ELEVATIONS
Existing
211"❑ ❑ Sewer service (or Proposed)
2110 ❑ Property corners
gi~❑ ❑ Top of curb at the driveway
o ✓g9 Elevations of any existing adjacent homes
❑ c✓❑ Adequate footing depth of structures due to adjacent utility trenches
Proposed
21/0 ❑ Garage floor
k✓0 ❑ First floor
❑ Lowest exposed elevation (walkout&vindow)
m//❑ ❑ Property corners
d ❑ ❑ Front and rear of home at the foundation
PONDING AREA (if applicable)
❑ Easement line
❑ Y ❑ NWL
❑ ❑ HWL
❑ ❑ Pond # designation
❑ ❑ Emergency Overflow Elevation
DIMENSIONS
V ot/ ❑ Lot Iines/Beanngs & dimensions
m' ❑ ❑ Right-of-way and street width (to back of curb)
q~ ❑ ❑ Proposed home dimensions including any proposed decks, overhangs greater than 7, porches, etc.
/ (i.e. all structures requiring permanent footings)
4 ❑ ❑ Show all easements of record and any City utilities within those easements
❑ ❑ Setbacks of proposed structure and sideyard setback of adjacent existing structures
❑ U,/❑ - Retaining wall requirements, if any
Reviewed:
Name / Date
March 1968
CRAIGIBLWPRMr.FM
2422 Enterprise Drive c.;•
iL Mendota Heights, MN 55120 a e
* (651) 681-1914 FAX: 681-9488
nn
T`T~,` Ty7o r1W
* PIONEER L D sw~S • OML 04MO S E-mail: PIONEEROPRESSENTER.COM ~ ~ U~
* ell RB6P1179 LAra vLArvrvaa. w+ouACe W+aITECrs 625 Highway 10 N.E. Pat111ot1
* Blaine, MN 55434 -
* ~L ~h (612) 783-1880 FAX: 783-1883
E-mail: PIONEER2®PRESSENTER.COM
Certificate of Survey for: OCP HOMES, INC. BENCH MARK LOT AREA = 15,519 SO. FT.
HOUSE AREA = 1730 SO. FT.
TOP OF PIPE COVERAGE = 11.17
~Np 4665 ASPEN RIDGE CIRCLE 7 ELEV.=939.28 HOUSE TYPE= 2 STo~r moo'
Q q~ LS (VACANT) .
PRO
P C,~~G 45~'~'~ a~>t ti
S83'4242° N~
E 24.07 935.3 AD- 0- i O.SO _ D
3.050 }O W 11
\ \ _
s~ 931.8 2.55 937.1 I o wFW-v CO
~r,Jla --k-7- 934.4 /32.8 53.26 m J WZ r ,r-:.". J .:LL}.P'• j
2.3 x .O :x2/00 A 6 2' 53.93 3.93 0~
J L"PG'A of r 17'S,
SERV. 0 PROPOSED HOUSE ELEVATION
mw 9 W
y 937.6 s m
tOs ",a- oRl°F°wAV~LEV.=924.0
LOWEST FLOOR ELEVATION: 933 _ o
~m X 52.3 O
I _ S2, 3>o9 28.5 m1930.3 934 - MAIN FLOOR ELEVATION:
.311n 01 T 1 2f 2. 2
r W . N
59.51 -I GARAGE SLAB ELEVATION: 3
Y I TOB 0 LOOKOUT ELEVATION:
O 516 2$4I \ PROPOSED, P ;D ~ r
~o t
_ m
921-3 2,3360 0,50 _ M 1T1 X 000.00 DENOTES EXISTING ELEVATION
L 000.00) DENOTES PROPOSED ELEVATION
Y1 ,L1»~ - - DENOTES DRAINAGE AND UTILITY EASEMENT
? Na1~0o'
O DENOTES DRAINAGE FLOW DIRECTION
N DENOTES MONUMENT
BENCH MARK a DENOTES OFFSET HUB
(VACANT) TOP OF PIPE
ELEV.=933.40
NOTE: PROPOSED GRADES SHOWN PER GRADING PLAN BY: PIONEER
WE HEREBY CERTIFY TO OCP HOMES, INC. THAT THIS 15 A TRUE AND CORRECT REPRESENTATION OF A NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAL AND VERTICAL LOCATION
SURVEY OF THE BOUNDARIES OF: OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND
FOUNDATION DIMENSIONS.
LOT 6, BLOCK 1, OAKPOINTE OF EAGAN 2ND ADDITION NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE
DAKOTA COUNTY, MINNESOTA SURVEYOR. THE SUITABIUTY OF SOILS TO SUPPORT THE SPECIFIC HOUSE
PROPOSED IS NOT THE RESPONSIBILITY OF THE SURVEYOR.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS"OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR NOTE: THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS
OTHER THAN
UNDER MY DIRECT SUPERVISION THIS 6TH DAY OF MARCH, 2000. S THOSE SHOWN ON THE RECORDED PLAT.
I PIONEER ENGINEE G, P.A.
SCALE : 1 INCH = 40 FEET NOTE: CONTRACTOR MUST VERIFY DRIVEWAY DESIGN.
RECEIVED MAR 1 3 20001 BNOTE: BEARINGS SHOWN ARE BASED ON AN ASSUMED DATUM
2541 99546.03 BAT C. Larson, L.S. Reg. No. 19828
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA106570
Date Issued: 08/28/2012
Permit Category: ePermit
Site Address: 4665 Aspen Ridge Cir
Lot: 6 Block: 1 Addition: Oakpointe of Eagan 2nd
PID: 10-53776-O1-060
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace Description: House & Garage
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are
not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL -Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195
Valuation: 4,000.00 Total: $105.25
Contractor: -Applicant - Owner:
Exteriors Plus LLC Philip M Kor Tste 12481 Rhode Island Avenue 4665 Aspen Ridge Cir
Savage MN 55378 Eagan MN 55122
(952) 345-3408
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.
ApplicanvFermltee: Nignature issued tiy: NIgnature
Date:
r
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
/05, 0 5 -
Date
Date Received: �'02(0 /3
Staff;
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Resident/
Owner
Type of Work
Name:
Site Address: 1 (C625 /" p ns t (A r C,I-c_ Unit #:
vv. '(\o kQ\ C31\C-kc'-e k (Phone: 952 —,gc/4 -S1'60-0
zkk s /q y-2 C�i vile z-7, 1 /VIA SS72
Applicant is: Owner (Contractor
Address / City / Zip:
Description of work:
Construction Cost: Z .1U
Multi -Family Building: (Yes / No V )
Contractor
Company: 511)-0 1".0 Contact: E'. Co y
Address: VC 7 Za4 Q A/ Q City: grot tilt
! ` f L
State: /0 Zip: 5.51 / Phone: (62 5f) 2 0 f 5 /731
License #: Lead Certificate #:
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 fora similar plan based on a master plan?
Yes No If 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 CaII 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.gopherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State uilding Code must be completed within 180
days of permit issuance.
x
Applica
nted-Namc
(Le K3-1/
r
ppticit's Signature
Page 1 of 3