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1225 Carlson Lake Lane CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: S Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Dugan, MN 55122 DATE: Zoning: No. of Units: Owner: _ Address:. Site Address: ' Plumber: 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: BY - Misc. Charges: Date of Insp.: _ Total: Insp.: Date Paid: CITY OF EA"N _ 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 _ PERMIT No. ^ 57 Date: ~za^uaYV 10, 197x: Receipt No.: nH734 o7a Single Site Addre~arl son ? J Residential Lot Block ~ Sub/Sec. _ Multi Res., Comm./Ind. Name :,r :arses New/Alter./Repair Address 701 W. 110th St. Cost of Installation ~I 100m in gto City Phone: Permit Fee Name 'Ryan Surcharge Address 745 So. Robert Ti7i a e U City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN • 3795 Pilot Knob Road Eagan, Minnesota 55123 Phone: 454-8100 _ PERMIT No. 4 Dote: 7 1.977 Receipt No.: 03343 Single I r 1 S o r. T,a Residential Site Address: Lot Block Sub/Sec. Multi Res., Comm./Ind. I Name' -i F' t e r s New/Alter./Repair. Address Cost of Installation C City n 0 i n q tot : Phone: Permit Fee Name r'e iz-Rvan rjU'!''-,; p` Surcharge Address e 0 V City _ Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minne to Statutes and City of Eagan Ordinances. 17 Building Official CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N4 4570 PHONE: 454.8100 BUILDING Receipt # To be used for Date , 19 Site Address' Erect ❑ Occupancy Lot Block Sec/Sub. Alter ❑ Zoning Parcel # Repair ❑ Fire Zone _ Enlarge ❑ Type of Const. - Q~ Name Move ❑ # Stories W z Address - Demolish ❑ Front ft. 0 City Phone _ Grade ❑ Depth ft. Name Approvals Fees 0 o~ Address Assessment - Permit _ F City Phone Water & Sew. Surcharge Police Plan check uW Name ~u W Fire SAC u~ Address - Eng. Water Conn. aW Ci Phone Planner Water Meter Council I hereby acknowledge that I have read this application and state that Bldg. Off, the information is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official - Permit ~j Date Issued ~eewMht Plumbing r' 7 77 ' Mechanical /4 7 /-/0 7 e-+~J INSPECTIONS DATE INSP. Rough-In Final Footings -I Pate Insp. Date Insp. Foundation Plumbing Frame/ins. Mechanical Final Remarks: CITY OF EAGAN Remarks Addition Wilderness Park Lot 14 Blk 1 Parcel 10 84250 140 01 owner, T' , ' ) , J ) 6 k ' ✓(''J; tIj0 Street 1225 Carlson Take T-ane State Eagan.MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 197 176.05 8,8o 20 123.25 A005909 .5/4/98 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 977 V60, 10.66 15 ~138.~8 A005909 5/4/78 STORM SEW TRK w r, 221 09 14 - 73 1 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 230.00 8103 1-15-77 BUILDING PER. #4-S70 Rini 11-15-77 SAC 475.00 8103 1-15-77 PARK Tl is request void 18 months from C? Y o L - Date of this Request P 14 817 I, as h Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at: ,aa 5 Street Address or Route No. /4g C?`,y5e n 14 E k4-K e. City E ~ Section Township Range County n ~rt~ s-v P~A_~ . Co 5 -w Which is occupied by tie' r !E;-, r e rs + hr-re, (Name of Occupant) Is a roughin inspection required on this job? No ❑ Yes I( Ready Now ❑ Will Call sla Power Supplieal ort~{ FA" I. A-:55n. Address er /a.~,.rrc~..caG- A& ss~.2 Electrical Contractor 4,-n (e, 47 Contractor's License No34385 (Company Name) Mailing Address 8' C `r o 1 &*k (C}~ c- Z , . 1~ l c y (a (k K, Ss+('6>c} (Electrical Con~jcto r Owner Makin. Thls In allatlan)r - Authorized Signature -",.f2y, G 7 / ' a g Phone No. $S ~ ~tl" Zd igp 5r~(Ll E (l'ec rlcI~alcontractt& of owner akin This Installation) SL3 L'fi! DBAR® COPY Minnesota State Board of Electricity -,ov4 University Ave., St. Paul, Minn. 55104-Phone 645-7703 el s REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST 14 817 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ Range ® Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace X1 Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ Farm ❑ ❑ ❑ ooList ~f,51 4>d~h List Other ❑ ❑ ❑ Here s1 is s Hehers COMPUTE INSPECTION FEE BELOW ED A Service Entrance Size: # Fee Feeder u f Circuits: # Fee 0 to 100 Am s. 0 to 3 Am 0 to 30 Amperes 101 to 200 Am s. 31 to 100 Amperes 31 to 100 Amperes Above 200-Amps. Above 100 Amps. Above 100 Am s. Transformers Remote Control Circ. Partial or other fee S' s S ecial Ins ection Minimum fee $5.00 Remarks ~C~G ~n ~-Sr~ W t n TOTAL FE D 5 I, the Electrical Inspector, hereby certif h the ove inspection has been made. (Rough-in) Date rv`7 (Final) ? L-L Date _ a?o- This request void 18 months from 2oo6 RESIDENTLAL BUILDING PERMIT APPLICATION l~Y--\s N City Of Eagan / 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 f~rCa~mReo~k rAkoel~Oeb 3re90daelsile9mmets59 gsµQdld. sg.Qdbnne;asd~mdedateas 2copesof plien ®gtadrgs, banns, OZ CetdSuveyRecd -Y _N (71%cmdnem6t doh /x atEnewc storleatad aawxm TieslIm PfeaRard -Y _N 2apesdow I -gbeamd 5a~pmsedfaundd o,ek tsi6esonnytir INmSEdeds TreeilresRegoeed -Y -N I set of Energy Celcuel A*ftn-ir>I INambsi*ftI em 0mithSpto Syrian -Y -N 3 copies of Tree Presmation Plan if lot platted star 711193 Rlm Joist Detail options selection sheet (buildings with 3 of less units) Minnegasco mechanical ventilation form Date 0 / /S / Ur Construction Co 7 Site Address If-95'' L44RZ PJ 44,ke UniUste # Description of Work !`rhr- I~U16D Multi-Family Bldg OWED- j~ New AA -y~ Fireplace(s) - 0 - i - 2 Property Owner ILI- &AW1 f L Telephone # ( ) Contractor AILLtUST EXTOZIDI.3 INIC ACL 1AM,TSEMA Address 168~~tp , lm .WA jol E • City S'f• Mal- state om./ Zip Q~ Telephone # (&t) fJ7 - 9' Z Vo COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Cade Catagoay - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 td sum tYpei Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Submitted Submitted • 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? Y - N If yes, date and address of master plan: n Licensed Plumber FP_ (a E ~ W Elphone #f Mechanical Contractor 006T phone ) Sewer/Water Contractor 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 approval of plans. 16L-LULe'l5~/j2¢'l Applicanfs Printed Name App cant's Signature DO NOT WRITE BELOW THIS LINE Sub Twee ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 AccessoryBfdg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 EM. Aft - Mufti ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 PordVAddn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex 19 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ as 041Ax ❑ 12 12-pler ❑ 25 Miscellaneous Work Trees R 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building" ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *08molidon IEntire Bldg) - Give PCA handout to applicant Description: water oamage _ Yes Valuation C) . Occupancy 3 MCES System Plan Review 100% or 25% Census Code Zoning ( City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length / y Fire Sprinklered Type of Const Y r Width 2D REQUIRED INSPECTIONS _ Footings (new bldg) _ Sheetrock Footings (deck) _ Final/C.O. Footings (addition) -c Final/No C.O. _ Foundation _ IiVAC _ Drain Tile Other Roof _ le e& Water _ Final - Pool _ Ftgs _ Air/Gas Tests _ Final Framing - Siding _ Stucco Lath _ Stone Lath -Brick - Fireplace _ R.I. _Air Test -Final _ Windows - Insulation _ Retaining Wall Approved By: -f/k/ Building Inspector Base Fee - Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ✓enci Fetersor. 3 gi:;~>r.irgton. Mn. DELMAR H. SCHWANZ LAND SURVEYOR Reglstefed Unoer Laws of The Stale of Minnesota 14515 SOUTH ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE l2 ~-tl 'i i v , 0 T i , SOO L , Drainage `L u't 2:.ty .11 2g„IV A, b~ 8405` `eP O 1 / LO I3a0 yOI I O / Y) ~qqy 1 11y OW N /C ~ Q I Grp / '7 6 I ~ ~7Clyl' oep CAl:i: Nyg d ~y~ \~V Jp O0 2Si ~ p I'fly I :1 v / / `0 T he-,~ty CCT_'t: I*` tha this f~ 3 and t' T••~t rE'('i e:it''3i 1~,i i'"1 •j r• Lot 14. Filock 14-1 " tK A-;-.T i., j>: accr;rt l nc 1-0 i v1- N Cr'rf'P(3 ~~D`T1..~.~ "AF, _ plat therm f, Dakota C'j1Lnty, Also r the. Itjc2Li.~ ifn of a ;:rnp0?f-C 'n-tli e a3 Staked thr r.aOr- Dated: October / MINNESOTA REGISTRATION NO. 8625 i CITY USE ONLY PERMIT C[ RECEIPT DATE: 8008 RESIDENTIAL MECHANICAL PERMIT APPLICATION crrYor EAeAN S$SO PILOT KNOB SD EAGAN INN 551 EE 651-661-4675 Please complete for: ➢ single family dwellings t~ownnhhomes and condos when permits are required for each unit Date: 2 lO f -L / G SITE ADDRESS: 122-5 C a_ \_~Ja-r\ I oAcsl- Lj\j OWNER NAME: TELEPHONE INSTALLER NAME: TELEPHONE* lDS I-L3/ZLZC$GZS~ STREET ADDRESS: CITY: ~ F-t" STATE: ! ' Vv ZIP: lr:~eZ'; CJ G ~ Place a check mark next to the permit work type _ Add-on, modificatio to existing dwelling unit $ 30.00 urnace replaceme irex nger • air conditioner • other 1 Nature of work: [T \f L ( ?C Z State Surcharge y $ .50 C Total = $ Q, SIGNATURE OF PERMITTEE 1/02 CITY OF EAGAN 46 3795 Pilot Knob Road Eagan, MN 55122 N? 4570 PHONE: 454-8100 BUILDING PERMIT APPLICATION $751000. Receipt # _8103 To be used for Sine. Fam Durle. d Gare. Date Nov. 15, 19 77 122 Carlson LakeLn Site Address - Erect [I Occupancy --j---4jjj@Njjp~-- Lot 14 Block 1 Sec/Sub. Wilderness ParkAlter ❑ Zoning Rzt. Parcel # 10 84250 140 Ol Repair ❑ Fire Zone 3 Enlarge ❑ Type of Const. V W Name Svend Petersen Co. Move ❑ # Stories - 2 Address 4701 W. 110th St. Demolish C3 Front 45 ft. P s 884-5144 City Phone Grade ❑ Depth 48 ft. rx ADDfDY013 Fees Name O _t,7 on OV Address Assessment Permit t7 t' Ci Phone Water & Sew. Surcharge -3,-.-7 5nrt police Plan check vw Name Fire SAC 475.00 _'I Address Eng. Water Conn. b0 <w Ci Phone Planner Water Meter Council I hereby acknowledge that I have read thisgo ion and state that Bldg. Off. the information is correct and agree 't}s afl~ppal' ble APC Total ~State of Minnesota Sto utes and Cit Ordi a e Signature of Permitt Sven Pete rsen Co uction A Building Permit is issued to: _ on the express condition that all work shall be done in occordan { with 11 ap le State of Minnesota Statutes and City of Eagan Ordinances. Building Official . DATE BUILDS PERMIT APPLICATION Include 2 sets of plans 1 site plan /elevYtions and 1 set of a orgy calculations. To be used for ~C- S/OE n i / /a Valuation Jr O ~rz Site Address : ~~cR s s ~'iv~ rc Lot /`f Block / Sec./Sub. Parcel Number /C `oy is 1`~~ n~ 71 Owner S'dc z) PZ=;c~-k S ✓ C'Un/~ Telephone Address 41701 Gv i 10T" s M~'~> 55 Y3~ Contractor Telephone Address Arch./Eng. Telephone Address / OFFICE US.E~ Erect Occupancy i- - Alter Zoning Repair Fire Zone Enlarge Type of Const. Move # of Stories Demolish Front Grade Depth OFFICE USE Date of Approval & Initial FEES Assessment 7, ,U. Permit -4e Water/Sewer Surcharge Police Plan Check Fire SAC 7S ° Eng- Water Conn. Planner Water Meter /=D • to Council I° A LR' Bldg. Off. I AL 40* A.P.C. P 1,41 qu Zertif icate for: ?Q :)vend Peterson ' ik "s 4' 31 West 11 ^th Street `y Bloomington, 'stn. ))437 I - DELMAR H. SCHWANZ LANDSURVEYOR Registered Under Laws of The State of Minnesota 14515 SOUTH ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 612 423-1760 SURVEYOR'S CERTIFICATE L 0 71 '1 I OO ?a, s~ a3 Nse0 3 Drainage & ut t: L ty easement AZ A~ .3I p PI 0 LOT o C o h 14 yIy ° 4 C ry /10 c r { /2 Q! i I {P O / 4 SCAI.r : 1 inch 40 feet O t_ ~ J T ~s O i O / 13 „ 4`' 3p I hereby certify that this is a t7-ae and correct representation of Lot 14, Block 1, WILDERNESS PARK ADDI".'7_?'. acc-)rding to the recorded plat thereof, Dakota County, Minnesota. Also showing the local' Dated: October 7, 1` MINNESOTA REGISTRATION NO. 8625 For Office Use Cit y of EaKd~ r~ D LOIN Permit 1 I 3830 Pilot Knob Road I I Permit Fee: i I Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: I //2008 RESIDENTIAL PLUMBING P RMIT APPLICATION Dater C~ Site Address: ~a k- /67 Tenant: Suite RESIDENT ! OWNER Name: fit/ vf~- l~J 7 Phoned"/ 9/ - 6~246 Address / City / Zip: 151 CONTRACTOR Name: License 99 7~ Address:/ eA OA City: `1 ~ 1 d-ni on Slate: 0Zip: 5"4(60 Phone:2/5 j-80b&7 Contact Person: TYPE OF WORK _ New 7X Replacement _ Repair _ Rebuild- Modify Space Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater T-Water Softener Lawn:Jrrigetiori Add Plumbing Fixtures M C- RPZ PVB) Main Lower Level) _ Septic System Water Turnaround -New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ L u~d I hereby acknowledge that this information 'i's 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 fora permit, and work is not to start without a permit; that the work will be in accordance with the approved plan imthe case of work which requires a review and approval of plans. X X Applicant's Prt ted Name = Applica 's ture FOR OFFICE USE Reviewed By: Date: Required Inspections: `Under Ground --Rough-in -Air Test -Gas Test -Final PERMIT City of Eagan Permit Type:Building Permit Number:EA116799 Date Issued:10/11/2013 Permit Category:ePermit Site Address: 1225 Carlson Lake Lane Lot:014 Block: 001 Addition: Wilderness Park PID:10-84250-01-140 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Michael Sirek Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Emily M Ferche 1225 Carlson Lake Lane Eagan MN 55123 (612) 845-0302 House Partners 14145 266th Pl Isle MN 56342 (651) 329-7552 Applicant/Permitee: Signature Issued By: Signature JP 0100C 1 8' td 407 cn",r 8" rf p.W',SFE Q005 h fo C�oS WALKINR MMUS MUTER THAN 30" ABOVE ARM ilELQiW REQUIRE GYAP, MAILS MINIMUM 36" IN `` - " 'T AND DESIGNED SUCH 7 -IAT TER SPHERE MAY tuOT Ptw.4 t-1HOUGH /0' DA IN A1_G/2 *0 MOUNTED -�N 34 TO 3$" ABOVE TREAD REQUIRED ON AT LEAST ONE biuc ut 1 HE STAIRS. EV RIEWED /)^1, SIG wisPEcnOiis mum 1 1 1 i ,f)6 \i,Pxot)JF,Nodo),(4,,e, 1") DECKS ALL NOT BE SUPPORTED BY CANTIL ERED I -JOIST HOUSE FRAMING WITHOU SPECIFIC ENGINEERING. 2Xrof. 1 t tlitt le f , � � Use BLUE or BLACK Ink �----------------- � For Office Use � ' �EC�,'V G►� j Permit#: / ��T/� j Clt� of ��a� � � �� .� � ��ll �'� `�� Permit Fee: � 3830 Pilot Knob Road �� /^ Eagan MN 55122 � Date Received: �-[�� c I Phone:(651)675-5675 I /]o.,� � Fax:(651)675-5694 I Staff: 1� I I `��______ J . 2014 RESIDENTIAL BUILDING PERMIT APPLICATION �� Date: � " Z- ZO�'-1 Site Address: � Z.ZS C.ip.+Z.t s 0 ti �-��C I �.?r!� Unit#: `�� t �_.�� ,� a�q��.�� ,��-� ��a.a�. ��e��,,�-�.. .q��,�u.��.�. � �`� � Name: �I�l(��'t�� Nt� 1� �'<-VL.c..k e- Phone: G 5 I Z'j 1 - q I.�L � ` Residentl � Owner � addressiCityizip: 6 ZL5 �-g�-isovs 4�.Ke..- La�c,• � t � � � Applicant is.m,,,,,p—tlOwner �Contractor M��yv,.,.�,�p,. �__.._..�,�,� ,,��. .�n,. r,.,tt,�� ` Type�Of WOPk � Description of work:RY�7►�Z.a�'w� IZQ-Kn,at�P i io � � Construction Cost: ��D� Multi-Family Building: (Yes_/No�_) , �Company. ��.��.� , Pr`��Zr-w�.�vs �r.�� ,..��„�m„�..Contact:p ,WM�` k.c, ��,��,K �,.,v,,..,� � ` � ' § � Address: (�1 �i S 2(�(�"� �I City: �S�G � Contractor � � # State:�_Zip: `3k t Phone:L�n l �L�i°1�SZEmail: l�nu�G• PJrs2.'rht.�� CI�c_�,j`. �GT ; pWew �VovW ; � ' � License# 3C Z�-d$5 1� Lead Certificate# �'L 1$�J c5�- l b` �O�tro ( L�' �� .,v�.. ,.�,,�_� .,,.,�„�,��.�...,..,��,,,�. ,.v .�, ,.�„wd.. ,�.<��,. �..�.�.., .��.,,��,�,,,, �,�.�,.,,,� E If the ro'ect is exem t from lead certification, lease ex lain wh see Pa e 3 for additional information L p 1 p P p Y� � 9 ) � � I , , � � ,��aas�� v.,,,.,:: .,�,�.,:::. ..W...... .. .. .:.r��a�v�.�.. „_,�,Kw,,, ,�.r..,,, , kr.�.._.�,��..n "„�::�...�.... . ...,.��u .,.w., �,�.,� ,,,,rn .N�..,�,�� 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: g � i ; Licensed Plumber: Phone: ; Mechanical Contractor: Phone: �`= Sewer&Water Contractor: Phone: A�� ,�..��.��.� .s �,, o,o.� .,�,� .�� ,,�� a..�.�,,,,��„� �a ,..�� NOTE Plans and supportmg documents that you submit are considered to be public information. Porfions of �_ the information may be classified as non-public if you provide specific reasons thatwould 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.aotaherstateonecali.ora 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 780 days of permit issuance. X I��,�G.2.� � . S 1 1�GI�, X ApplicanYs Printed Name Applicant's Signa e Page 1 of 3 � . t T ��4� / CG�Y�^�it/s9"�/! ✓m�'� `/YV�Y DO NOT WRITE BELOW THIS LINE �� -� SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) � Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior � Alteration Fire Repair Windows Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation '�� Occupancy ��_ MCES System Plan Review Code Edition (at,F� SAC Units (25%_ 100%�) Zoning _�� City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction _�� Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) � Final/No C.O. Required Foundation � HVAC_Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick �Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: I G.� , Building Inspector RESIDENTIAL FEES Base Fee Surcharge 't-,u�� " l ��,. Plan Review ��V" ' MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge � � Treatment Plant � � �� , �j(�� Copies ` � TOTAL Page 2 of 3 Use BLUE or BLACK Ink �-----------------, � For Office Use � • � ' � �� I ��t� o� �a�� o ' I Permit#: I � I � Permit Fee: o� I 3830 Pilot Knob Road i i Eagan MN 55122 I Date Received: � Phone: (651)675-5675 � i � Staff: Fax: (651)675-5694 i_________ _______! 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: �O- ►S-l`f Site Address:��-S C`�'�a� `��'^e- �-�c"1�- r��n , N�� SS��3 Tenant: Suite#: 4 ; : s ` Resident/Owner � Name:_M0.�\t� �"�-'��-�� Phone: � �a-' $�� a � ; ` � Address/City/Zip ��S �ur�S Z1n �o.� �� S,S� ,�.3 ;;�d. .,��. �� a,�� ...�. - ��,��.��.� ,�, �� ti�K � .�, m�.,� ,�,� . . m_.__ � .�.��,�� Name: License#: � Contractor E Address: City: # � 3 State: Zip: Phone: � � � � Contact Email _.�.,,� w. .,,.��„, .,,.,.. W...,...,� �.,,,�„�,� _,.,,,��..... .. ... ....�,,,�. �,,,_�..��.�u,�.,,...... �r,�_ .�,�.,.�.�,»�„��,M,,,�, ,,,�,.,,�.�....,,�,v,�,�.� Type of Work � —New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. � ' Description of work: ��p I�ct {��4,T'1'N G S(n1�5 . F4-vc�i'�. 'Tbi)e-T . T�g Sl�Onl e,` �.., ,,,,... ._.,� ,,,,,��,,,�.,��r. �,�..�.�,,�,�,�.0,,m��...�«,. „�,�,..�m.._�, �.�,��.�w,�� ,�� „�.,�,,� � RESIDENTIAL � � Water Heater � Water Softener � � � Lawn Irrigation(_RPZ/_PVB) � PePlTllt Typ@ Add Plumbing Fixtures(_Main/_Lower Level) Septic System � � New ' Water Turnaround — � � � '� ; � Abandonment ` _ ,..,��. __.,. .,��.....-. ., _.. �,a ,� w�,� ..-�� .,�. „� .. ..��,�,M��u .�a�- . �,:.,. ��,,,� ..�.��a rt � RESIDENTIAL FEES. s $60.00 Water Heater, Water Softener, or Water Heater and Softener(inctudes$5.00 State Surcharge) � $60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge) � � $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes$5.00 State Surcharge) ? *Water Tumaround (add$200.00 if a 5/8"meter is required) � � $115.00 Septic System New($10.00 per as built)(includes County fee and $5.00 State Surcharge) � � TOTAL FEES$ e � � 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.qapherstat�oneca6f.arq 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 Mor}I,e.��u�c� X��c�. � � ApplicanYs Printed Name Applica Ys SignatWre FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-}n` Air Test Gas Test Finat Meter Related Items: Meter Size Radio Read Staff: