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
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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
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