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1074 Beatrice St0- ?^ 71- 2 6 4 C4] 7??9? LY This requesf void 18 monlhs from validation date printed in Ihis h?? 4-f- F? PLEASE PRINT OR TYPE Requesf Dote Rough-in inspection required2 ? N d ll h In:pecfion Other Thon Rough-In: ? Ready NowAWill Call D t R d the inspector w en re (You must ca a y) a e ea y: I, Mlicensed coniractor ? owner hereby request inspection of the above elecfrical work at: Job Addross (Street, 8ox, or Route No.) , 10'7 eCL-1 . Vrce- City 4'-_ C-&nl Zip Coda ?5 i 2- I Section No. Township Name or No. Range No. Fire No. County ?upa ?. hc rd Phone No. ? f 5_ ?-- ?- Power Supplier Address 2fiw l ? .onfraclor (Company Name) !i l??J?J lJ/v Confractor License No. t/'"VL?(?J f?--' -' Masta' Lic. No. (Plant Elad- Only) Moiling Addreu (Contrador or Owner Pedorrning InstallaKon) ''l'? Aufhoriz ?_ckot or wn P v xzi Phone No. 3 ? _ EB-OOOOlA-10 6/95 STATE BOARO COPY- SEE INSTRUCTIONSOH BACK OF YELLOW COPY 0 REQUEST FOR ELECTRICAL INSPECTION 40?- I IIII ?I II A'jllfli_L_?914 . Minnesota State Board of Electricity II?I 777??- ? - ? 1821 University Ave., Rm2$, St. Paul, MN 55104 -';? * Phone (612) 642-0800 F? e ;'? ' i9?r• . ,? Home Duplex Apt. Bldg,. er: . New Addn Commercial Indusfrial Farm Remod e air Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other: D er Ran e Elec. Heat Tem . Service "X° above fhe work covered by this request. Enter remarks in this spvice and on fhe back of the white copy only. Calculate lnspection Fee - This Inspecfion Request will not be accepfed without }he correct fee: Olher Fee # Service EMrance S"¢e Fee # Circuits/Feeders Fee Mo6ile Home Park Stail 0 to 200 Amps 0 to 100 Amps $treet Ltg./fraffic Sig. Above 200 Amps Above 00 Amps Transformer/C?ienerator INSPECTOR'S USE ONLY TOTAL Sign/Outline Ltg. Xfmr. ? • ? Alarm/Remote Control C;?O. 5o Swimming Pool I he,eb mrii that I int eded The eleckical insiallofion escribed herein on the dates slated Irrigation Boom Rough-In Dare ecipl Inspedion S p Investigative Fee Final ?, . ? " THIS INSTALLATION MAY BE OR DERED DISC NWCTED 1 NOT COMPLETED WITHIN 18 M S. CITY OF EAGAN Remarks Addition McKee Addition #l Lot 12 Bik 3 Percei 10 47700 120 03 Owner Street 1074 Reatrice St- StateFagan, MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. LA, STREET RESTOR.PBVlrig 1969 311.50 $31-15 GRADI.NG SAN 5EW TRUNK ?100.00 . * SEWER LATERAL 1968 20 WATERMAIN WATERLATERAL & SE 1968 850.00 42.50 20 PAID WATER AREA STORM SEW TRK 1984 403.00 26.87 15 403.00 C008651 10-15-83 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $200.00 676 3-11-68 BUILDING PER. sac 200.00 676 3-11-68 PARK INSPEC I "TION R ECC)RD . CITY 4F EAGAN PERIVIiT T"YPE: "01r Fr:r*6 3830 Pilot Knob Road ? Permit Number: ??? 719 Eagan, Minnespta 551 22-1897 Qate Issued: ?? ! ??? J ?? - (612) 681-4675 SITE ADDRESS. • 1 . N 0 , 4 t 1 0 - a 0, 0') APPLICANT• - 1014 14C, ?K kf ?? za.? `?c? C4, 74?' RERMIT SUBTYPE: TYRE OF WUAK: - ?;? ? ?? ?s?, ? '? ??t ?r?:??r??r? - ?????????? I ON ?'Har: S 60e11) INsut.) Parmft No. Permlt FtqlAor Date TeFephone # El.E-CTRlC PLUMB#NG HVAC 6- NopwoQn lim Wpa comFhada POOTENGS FQUND FRAMllkiG RaOFINf,a ROlfCit-t PLllMBING F'LBG ArR-tEsr HF3UQH HEATItdG GAS SVC 'fEST . ItdS4JL OYP 80ARD FIREPLACE FIf1EPLACE . AIR TEBT . FlNAL PLBG FINAL HTG ORSAT TES? BLDG FINAC BSMT R.I. BSMT FINAL pECK FfG DECK FINAL C.ITY of EAGAI _ Ownel' ..?? ./?..11r?cLAr.?.?/..1.+..: . -•-•. .f.''C... -?!Iv..--•--.... . .... ..... Addresa' (Pseseni) ... ..?t2.7.... ....:.. ,? . .. ... ..............••••. ' - , .. . Huilder ....................... 11??••-............. ...................:..... ?. Address • ..............................:.:......::...........::.....•--............::.................: ' ' DESCAfPTi?N .; ;. N2 4100 3795 Pilot Knob Road Eagan. Minnesota 55182 454=8100 ' Dale ? ? Blories . To Be Used Foz 1 : r ? ,_front • Q• Depth ? Height Eql. Coat ?v? Pssmi! Fea AF? ? Aemaslu . , , U .. - . - LOCATIDN Street, Road or other Dascription of; Localion I Lo! Slock Addition os Tract 4?? - - ? ? /,#,Z ??? _ w, z- Thl'LB permit dols • ao! sufhorize !he use of streets, roads, alleps or sidewalks aos doea?i! give !he ownes os his agpni !he right to create anp situation which is a nnisance or whieh presents a hasard !o the heallh, safety, eoavenience ead geaeral ;welfere to anyone ia !he community.' THIS PERMIT MUST B?E K,?PT TH PREMISE W II:E THE WORK IS IN PAO R .' ? This is io certifq. thal. ?e??_..... ??c . :•--.. . .. ....... hes pera?ission to erect a ' .... . --- .. ..... • .... .......................... _apogat, e ---•ee •• 4 the above described premise subject to provisions of all applica unanc for f e o agaa. . =- . . .. . ....... ........ . •---:..... ••- -- - •,?•• =` ?:, .............. ........ Per ..... ..: . .....---•-.... .. .._ f'??..... . ................... May .Huildin9 .. Iospeclos PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: s uIL0 7[ tv 6 Eagan, Minnesota 55122-1897 Permit Number: 027719 (612) 681-4675 Date Issued: 0 6/06/g 6 , SITE ADDRESS: . , 1074 8EA"CRICE ST . LO"f: 12 BI.qCKs 3 MGKEE P.I.N.: 10-47750-120-03 DESCRIPTION:, (MAC SOUNR IIVSUL) permit Type SF (MISC. ). l"ype ALTEfZATIqP! 434 ALT. RESZDEN7IflL dotV ?..: .. ant ? ? ft REMARKS: ? FEE SUMMARY: vaLuaTzoN . $19,000 Base Fee $274.75 Plan Revxew $137.38 Surcharge $9'.50 La.a. Search Fee $5.610 Total Fee $426.63 . CONTRACTOR: - Applicant - 5T. LzC.OWNER: . SQGON CQMST INC 17845910 00918934 SCHUCH FYIGHARD ? 9901 XY.LITE ST NE .:1974; BEATRICE 5T BLAINE P9N 55449 EAGAN MN 55121 (612) 784-6910 % ?.(612)452-1241 SSUE BY: IGN URE ClTY OF EAGAN qlg 3830 PIL4T KMOB RD - 55122 1996 BUILDING PEaMIT APPLICATIC]N (RESIDENTIAL) oiq 681-4675 ? ? ? ? 3 ragistered site surveys 2 copies of plans (include 6e2m & windaw sizes; poured fid. design; etc.) t energy cak:ulations 3 copies af lree preservation plan if lat platted aftsr 711193 requfred: _Yes _ No DATE: 3 " ??1G• o WA d .:??-- 3? t 2 oopies of plan i 2 site surveys (exteriar additions & dedss) ? 1 energy calcWations for heaied addit6ons CONSTRUCTIQN COST: 4 +s yc CD DESCRIPTION OF WORK: LSOI-VQCI 00 STREET ADDRESS: =?t ( C -C)1 &A) LiDT ? BLOCK 3SUSD./P.i.D. #: PROPERTY Name:Sh ? \C L-Pc?m` C-1Ca . Phone #: W,3a- ?aLAI owNER . LM. `""T Street Address• ? -1 City: State: M EJ Zip: 55 CONTRACTOR. Company: Phone #: ...,.- Street Address: ?1 1 License #:U-.?Ck3LI Ci#y: 1 ? State: Z+p: 55LiLD ARCHITECT/ Company: cc? Phone #:_ ENGINEER Name: Registratian #: Street Address- t?b'? City: State: Mo...? Zip: 5514 5D Sewer 8 water licensed piumber: Penalty appties when address change and lat change are requested once permit is issued. i hereby ackntjwledge that i have read this application and state that the information is correct and agree Eo compiy with ail epplicable State af Minnesota Statu#es and City of Eagan Ordinances. 5ignature af Applicant: OFFICE USE OMLY ? a Certificates of Sunrey Received Yes Na M 2 3 1996 ° Tree Preservation Plan Received Yes No - - - -- - - - - - ? - - - BUlLDING PERNIIT TYPE ? 01 Foundation o OB Dupiex ? 02 SF Dwelling a 07 4-plex 0 03 SF Addition o 08 8-plex 0 04 SF Porch 0 09 12-plex ?05 SF Misc. 0 10 _.7plex 1NORK TYPE 0 31 New ?!,i3 Alterativns 0 32 Additian o 34 Repair GENERAL INFORIMAT[C)N OFFICE USE ONLY 0 11 Apt./Lodging o 0 12 Multi RepairlRem. ? o 13 Garage/Accessory o ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demalition Const. (Actual) Basement sq. ft. (Allvwable) Main level sq. ft. UBC Occupancy sq. #t. Zoning sq. ft. # af Stories sq. ft. Lengfh sq. ft. Depth Footprint sq. ft. APPROVALS Planning Building 16 Basemen# Finish 17 Swim Pvol 20 Public Faciiity 21 Miscellaneous MC1WS System Ci#y Wafer Fire Sprinklered PRV Booster Pump Census Code. SAC Cvde Census Bfdg Census Unit Engineering 7k- Variance o? d Permit Fee Surcharge Plan Review License MG/WS SAC City SAC Water Cann. Water Meter Acct. t3eposit SJW Permit S/W Surcharge Treatment PI. Raad Unit Park Ded. Trails Ded. Other Copies Tvtal:. Valuation: $ % SAC 5AC Units CITY USE ONLY L ? BL °? RECEfPT # SUB ? DATE. '7 ?6p 1996 MECHANICAL PERMIT (RESIDENTtAL) ?He 7 y? cmr oF EAGaw 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 689-4675 Please complete for: ? single family dwellings ? townhomes and condos when permb are required for each unit New canstruction ? Add-on furrace _-)I, Add-on air canditioning Add-on air exchanger, i.e. Vanee system, +etc. Date: ?-- ? S ?110 0 ? Minimum Fee: Add-oNRemodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required a $3.00 each) ? ? State Surcharge -50 TOTAL CAO-sz SITE 0 7, C OWNER NAME: ?l ehcxcl S0- h u-o, h PHONE INSTALLER STREET ADDRESS' CIIY: IA/L STATE: _ ZIP: ??-- PHONE #: ( 6 12) -,v.3 4s4j ? L CITY USE ONLY L ,_ BL RECEIPT #: SUBD. DATE: ? 1996 MECHANICAL PERMIT (COMMERCIAL) • CITY OF EAGAN 3830 PtLOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for. ? all commerc.iaUndustrial buildings. ? muiti-family buildings when separate permits are nM required for each dwelling unit. - Dfi-TE: CONTRAi:7 FRICE: W4RK NPE: NEW CONSTRUCTION INTERlOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ?$25.00 minimum fee gr 1% of conbact price, whichever is greater. ? Processed piping - $25.00 > State surcharge of $.50 per $1,000 of pmd fee due on all permits. CONTRACT PRICE x 1 % PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRE55: OWNER NAME: TEI.EPHONE #: TENANT NAME: (IMPROVEMENTS ONLI) INSTALLER: ADDRESS: cinr: 'w PHONE #: STATE: ZIP:, SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR BAGAIiT TOWNSHIP 3795 Pilot Kaab P.oad St. Pau1, Minnesota 55111 Telephon.e 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: b7ar. 12. 196$ OWNEI?: Wi ll-1_am J =ot?E3ek pLLMERAl].. State P1.bfL IdUNtBER 126 . Addxess ldZ4 Beatrice ? TYFE OF PIPE caat iron T3ESCRIPTION OF BUILUTIVG Industrial l Comercial` Residential ] Mu7.tipl.e 33wellimg i Ncs. of units x Location of Connectiotls: connectivn crsarge 200o Pd. 3/12/68 Fermit Fee 7,50 " SCreet Repairs ToCa 1.._ ? _20?.90 - - Ir Inspected bys Date Remarks: By Chief Inypector In considerativn of the issue and delivery tv me af the atsave gQS-=3.t, i hereby agree tio do the propased work irc aceordance wi.th tha rules and regulations of Eagaxt Tot•nship, Dakota Coutlty, Mixtne9ota gy ? ? FI.?,agP r.oti£y -.7ksea ready for inspectian and coxmection ar,d before an3* pQrtyon cs'r' thy wcrk is ccnrered. Aate : -;? a ??? _ -yo? lb BUILDING PERMIT P.,PPLICATION r,or _ f ?Z szACc ADDTT=oN e PARCEL & SLCTION DNP-MER IF UYdPLATTED ADDRESa OF ?,OivITdG ?N e rJa u, ?- .., L OCCUPAPICY ,Q: na?1?ra.2,, /_ J- USE /n ,r 1 L" E STTNIATED COST MTI-TEP, N r f( ? ?:? ?. ?L 4.. TELEPxorE No. xDnxEss C0NTRACTOR TELEPHONE VO . S i-l wc t? c? q kJ AIJDRESS S r Note° xnolude aite plan, building plans, and energy calculati.ons with this application Signed - I OE'FICE USE VALU2?TIOid ?90? ? SAC WATER. C0101ECTTO11 GIATER 14ETEF2 BUILDING PERRIT FEE 5URCHARGE FEE PIAt1 CFM'CK FEE PARK DEDTCATIOil FL'E OTHER TOTAL* u ? ?. APPROVALS: ASSESSMEI?,,T CLERK BUILDING DEPT. POLICE DEPT. WATER & SEVJER DEPT. FIRE DEPT. PARTC DEPT. EAGAN 210WNSHIP 3795 Pilot Knob Rosd St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: March 12. 1968 Number: 73 Bflliag Name: William Janousek Site Address: 1074 Beatrice awner: above Billing Address Plumber: All State r1bg. Location of Connectian Building is a: Resideace X Multiple Ao. Units Commercial Industrial 4ther MeCer Size Connectioa Chg. 200.00 Pd 3/12/68 ,.___..._?..._ Meter No.Permit Fee 7•50 _ t, Nieter Reading ( Meter Dep. 15.00 tt Meter Sealed: Yes fAdd'1 Chg. NO ! Total Chg. 222.50 a G Tnspected by Da te Remarks: BY: Chief Inspector In cansideration of the isaue and deli.aery to me of the above permf.t, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. Al By: . ? z.-,----- Please notify the above office when ready fer inspection and connection. MASTER CARD , , LOCATION rl.d P a -.3 - OWNER j o. nD STRUCTURE AND LAND USED AS 4 x?"" SI I !/?? /? de 41,t4 X/? I I Issued To Permit No. Issued I Contractor Owner BUILDING i? ? PLUMBING I CESSPOOL - SEPTIC TANK WELL EIECTRICAL H EATI NG GAS INSTALLING SANITARY SEWER OTHER OTHER i Approved Items (Initial) FOOTING FOUNDA710N FRAMING FINAL ELECTRICAL HEATING GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER COMMENTS: Date Remarks Distance From Well SEPTIC ? ? CESSPOOL `- !#? TILE FIELD FT. DEPTH OF WELL Violations Noted on Back COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. a ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. DATE OF INSPECTION ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: 11 NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. a COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REIPlSPECTION REQUIRED REINSPECTION REVEALED DATE OF REINSPEC'iION CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that 1 have reported herein all significant conditions observed to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. F ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR CONIMENTS: DATE QD> 23 o u N T Y c ENVIRONMENTAL MANAGEMENT DEPAR'fMEIdT GROUNDWATER PROTECTION SECTION 14955 Galaxie Avenue • Apple Valley, MN 55124 952.891.7557 • Fax 952.881.7588 • www.co.dakata.mn.us ?,; (?,??O ?- 1/ (J_l ` ' (?f(?J,4?,p . ?-i:.f r IVIUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION DATE: November 3, 2004 TU: Tom Co6bert/Wayne Schwanz (EM) RE: Well Permit #: 04-1-1230021 Manicipality: Eagan Fax #: (651) 675-5694 Well Type: Domestic Environmental Specialist: Olsen The Water and Land Management Section of the Dakota County Environmental Managennent Department has received the following permit application for the wel] described. If you require further review of the application or if you have any questions or eoncerns about it, contact the Environmentai Specialast listed above or our office at (952) 891-7557. If there is no response fram your office within 24 H4URS (excluding weekends and holidays), we will asswme that you have no objections to the issuance of the permit. Please note tliat permit issuance is always conditioned on the peemit applicant's observance of and compliance with all applieabie state, county, and municipal laws and codes. Well Cantractor: Date Application Received: Anticipated Drilling Date: Anticipated Grouting Date: Froperty Owner: Well Owner: WELL LOCATION: Thein Wefl Company 11 /2/2004 Richard P Schuch Richard 1' Schuch Time: Time: PLS Coordinates: 1/4, SW 1/4, NW 114, SW 1/4, Sec 02 Town 027 Ra.nge 23 Street Address: 1074 Beatrice ST PIN Number: 104775412003 WELL INFURMATION: Diameter: Casing Depth: TotaE Depth: Static W ater Level: Aquifer: COMMENTS: ?? ? ??? ?? ?pO???s tielp ????? _ 0 ? KEr?METx,I°r F (? *11 : g,I ;; ?eCti?? I comrn?? I Eagan ?U.Nding . ? E?? loprr?ent Percnits O?er ? Eagan . Assess5ohn I Eagan Prtpecty ? ? Zonk Parml 1D 1164n5012003 Addtess 1M BEA1'Rt?? ST t?wner 1 S04UEH RiGHARD P 1074 BEATRICE ST _ EAGAN MN 55121 e, ? Owner 2 . a. Owner 3 ? Owner 4 ; ?? .. .. ?? Farvel dda wdated August 27, ? c.A?rch Hnnen 1074 BEA'?a ST tz,, 3� ` EAC!'N TOWNSHIP 3 795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone PERMIT FORMA BR SERVICE CONNECTION Number: Dater 1968 \ 10'l4 FSe -...1 ea Site Address: _�._ =NA/ Billing Name: Willia Ja:a ouaak \ Billing Address show Owner: Plumber Al State Ylb 200.00 Yd x/12/68 Connection Chg•! —' Meter Size_________ Connection Connection 50 Location of i ! S8 g � Permi t Fee Meter No•' a Meter Reading_. Meter Dep..— N Meter Sealed: Yea__ Add'1 Chg.,---- 0��1�Yl�d NO_____ Total Chg.�" [S J Inspected by r �t g Date 3 / , y 3 Remarks: , 12.- �j�, d �/u CEV • Building is a: �I y �( Residence I Multiple No. Units C e ctor Bp: Chief Insp Industrial Other __________- t I delivery to me of the above permit, In co ree nsideration to do the proposed of the issue HAd ork in accordance with the rules and a hereby g of Sagan Township, Dakota County, Minnesota. By: Please notify the above office when ready for inspection and connection. 41101/ City of Eaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use �� Permit #: / g�J(UC ` Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: /ea' `7 /3 P +r- . Unit #: �r e% � Name: -S err ,,,,i Phone: t--) fi Z . /02 Address / City / Zip: /6, 1711 a_em1"/) "r- r e_. -, ---- el,e, Applicant is: Owner Contractor rk; Description of work: :_,,,,. �, '!- -4- re_ - r-c,c Construction Cost: °(, 600, °'i Multi -Family Building: (Ye / No ) ry Company: 0 norw-e.ra-e /C as rc:�:..�. � J /.0_04" -,Contact: t k •-..0,-A-- .Address: Address: aZ 5 3 d /,1( h ,-1- City: 7--; u a.,- d r4rz,a_, State: h/ Zip: 5' o `� Phone: 10S i - I/ g54mail: L, l,2 License #: 6 ci2 f. Lead Certificate #: If the project is exempt from lead certification, please explain why: .F. c rJ L b-7 In the last 12 months, Yes No 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? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: NOiii /an nd sup • ®.ct are crsn "a i rn fion he in or ationm f e o I ® � �ea(n•n u.r oup ®� se- �c sore# at.w � cocde - t t'fty of f tY f� 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.aopherstateonecall.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. Applicant's Printed Name ant's ignature Page 1 of 3 EAGAN 3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 (651) 675-5675 ( TDD: (651) 454-85351 FAX: (651) 675-5694 buildinoi tsoectionsecitvofeaaan.com flECEVE SEP 2 5 2019 r For Office Use Permit #: Permit Fee: l 5Va3 Date Received: Staff: J jAe 2019 RESIDENTIAL BUILDIIW � Nft rPPLICATION ey 7'�� �� Date: i 12519--01 c'1 Site Address: / O ? y. ,+ e4 i✓ l C2. , Name: Lid (4 ta)(1."e Phone: 6 i L 4 Address / City / Zip: c 1/1( 4-X -1-_.-g la fC . t`-\ F r? Applicant is: Owner Contractor % Description of work: .121i NAT C-5 VC SS (/j/U- o-euw (t,.t 1-6(-• Multi -Family Building: (Yes / No ) Contact: City: V \A \ vq•c4_G ,k mail! Unit #: Resident/ Owner Type of Work Construction Cost: %.SU(} tfrika- Contr�r Company: k OLe.,t-...P- t/ "ICt (-(--c Address: 2.S W 41`iV1'k4 v Y\ f �('Q State: Zip: CC(L 4 OcPhone: 14 License #: tles If the project is exempt from lead certification, please explain why: Lead Certificate #: 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: Mechanical Contractor: Phone: 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 may be classified as non-public if you provide specific reasons that would permit the City to conclude that they 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.citvofeaaan.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. CaII Gopher State One Call at (651) 464.0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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. X C/c<, ) X ( Applicant Printed Name Applicant's Signature SUB TYPFS Foundation Single Family Multi 01 of� Plex WORK TYPES New _ interior Improvement X071 fkatrict Fireplace Garage Deck Lower Level Addition Alteration Replace Retaining Wall Move Building Fire Repair Repair Porch (3 -Season) Porch (4 -Season) _ Porch (Screen/Gazebo!Pergota) Pool DESCRIPTION Valuation Occupancy Plan Review Code Edition (25% 100% Zoning Census Code h(Sq Stories # of Units / Square Feet # of Buildings i Length Type of Construction 7)3 Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings.(Addition) Foundation Foundation Before Backfili Roof: Ice &.Water Anal Framing V30 Minutes 1 Hour Fireplace: Rough in Air Test , _Final Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Radio Meter Read Copies TOTAL 73 Siding Reroof Windows Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building _ Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building—give PCA handout to applicant i? —t MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Service Test Gas Line Air Test — Hood Pool: Footings Air/Gas Tests Final Drain Tile Siding: _Stucco Lath Stone Lath Brick _ EFIS Windows Retaining Wail: Footings — Backfill ` Final Radon Control Fire Suppression: _Rough In _Final Erosion Control Other: , Building inspector Page 2 of 3