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4464 Ches Mar Cir WATER SERVICE PERMIT CITY OF, EAGAN 3795 Pilot Knob Rood PERMIT NO.: Eagan, MN 55122 DATE: /7q Zoning: No. of Units: Owner: =,e Address: Site Address: s _ Plumber: j , Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: ^ + z 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: on ' f_ Total: ' BY Date Paid: Date of Insp.: I nsp.: CITY OF *EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, 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: Dote of Insp.: Total: Insp.:- Date Paid: CITY OF EAGAN 7 ` 3795 PEot Knob Read Eagan, MN 55122 ~ N2 4970 PHONE: 454.8100 BUILDING PERMIT Receipt # To be used for Est. Value Date 19 Site Address Erect ❑ Occupancy Lot Block Sec/Sub. lar 1st Alter ❑ Zoning Parcel # Repair ❑ Fire Zone Enlarge ❑ Type of Const. W Name Move ❑ # Stories 3 Address Demolish ❑ Front ft. City Phone Grade ❑ Depth ft. o Name Approvals Fees 01 Address Assessment / Permit _ ~ Ci Phone Water & Sew. Surcharge Police Plan check W Name - Fire SAC ~W Address Eng. Water Conn. <W city Phone Planner Water Meter Council I hereby acknowledge that I have read this application and state that Bldg. Off. -'/1--1/7'' the information is correct and agree to comply with all applicable 4 State of Minnesota Statutes and City of Eagan Ordinances. APC Total Signature of Permittee A Building Permit is issued to: on the express condition that oil work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official 7 9 Eel- -v-\ C ~'~~It(2 I~- 78 ~ervmwk Penult # Deft Issuml hneWoo Plumbing /oZS~ - ~(o ( Mechanical _ 3 3 p - 31- V) . r , b-KLC-"- C-0 4- 1 - 1~- pkjzl~ 4-1,C-,L-V- q-C At c t--~ 3 1-1 - a 7 P/C 19 C C-o INSPECTIONS DATE INsP. Rough-In Final Footings -ylData Insp. Date lrksp. Foundation Plumbing Frame/ins. Mechanical Final a' r I Remarks: 1.2 -13 • J S - Ljp~eu~ a + r T!/aa( 1 ^3a-)91 1_C/eye i CITY OF EAGAN Remarks Addition S'_HRS MAR 1-;t ADDTTTON Lot 2 Blk 2 Parcel 10 17100 020 02 Owner `1~"I % " Street 4464 Ches Mar Circle State Eagan, MN -5" Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK A007387 2-7-79 * SEWER LATERAL 19 Z4-- 19 7 7 445965 3567.72 A007387 2-7-79 WATERMAIN * WATER LATERAL 1977 * WATER AREA 1977 * STORM SEW TRK 1977 * STORM SEW LAT 1977 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 250.00 11643 9-13-78 BUILDING PER. SAC 500.00 11643 9-13-78 PARK CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 PERMIT No. 1337 Date: Receipt No., 446' CizC.~ Single Y. Site Address: Residential C,W Lot Block Sub/Sec. _ Multi Res., Comm./Ind. Name and LeItm.a__ ' New /Alter./ Repair 3 Address ".0. Box 1211 Cost of Installation C City t Ville Phone: ` - Tid6 Permit Fee Name .aV xi r.itc ?t. ` Surcharge Address f637 ('I11(_~s ;t? c 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 .Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EA"N 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 PLUVBINC PERMIT No. 12S2 Date: 10--26-73 Receipt No.: 12188 Single Site Address f+46 .ar Circle Residential X Lot 2 Block Sub/Sec. Multi Res., Comm./Ind. Name New/Alter./Repair. Address Cost of Installation ' ri.Ile 1:52--31~'2", 7t~.n l City _ Phone: Permit Fee Name Surcharge 43 Humhh?at- A-,-e, c„` g Address `r's 55431 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 \his request void 18 months from /3 c~,~ s R 52067 Date o s _Request G r, 9f79. I, as ~ Licensed Electri , Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at: n n Street Addressor Route No. T ~7A aLae1~1CG}i <~LGXG ,C~'ty ( - Section Township Range County Y~ (Llf~Id Which is occupied by (Name of Occupant) / Is a roughin inspection required on this job? No D Yes ❑ Ready Now P- Will Call ❑ Power Supplier _ Address n -3r~a Electrical Contractor co R 7S- Contractor's License No. Q pany N) Mailing Address CO {r1 t' Z /7 a t~>Ai A;, SS3 Adz ctrl l Cogtj9~t9r or Owner Making Thl, imtanation) Authorized Signature /c' iA [ r 1 Phone No~D (Electrical contractor -Tdl O ner a ing Tnlr+f~c s instanatlon) cl~U(~~ BOARD This inspection request will not be accepted by the State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity ,19+4 University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION R 52067 CFIECK BELOW WORK COVERED BY THIS REQUEST Typebf Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ ❑ Range ❑ Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Futures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ` Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace Silo Unloadet ❑ Industrial Bldg. ❑ ❑ ❑ Air Condi r Bulk Milk Tank ❑ Farm ❑ ❑ ❑ List List ethers Other ❑ ❑ ❑ Here COMPUTE INSPECTION FEE BELO Service Entrance Size: # Fee Feede Subfeeders: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Am res 0 to 30 Amperes 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes Above 200_Amps. Above 100 Amps. Above 100 Amps. =III Transformers Remote Control Circ. Partial or other fee Signs Special Ins ection Minimum fee $5.00 Remarks TOTAL FEE I, the Electrical Inspector, hereby certify that the above inspection has been made. (Rough-in) / r Date u • 5'~ (Final) j This request void 18 months from L4his request void 18 months from 25449 Datdof this Request I, ask Licensed Electrical Contractor El owner, do hereby request inspection of the above electri- cal wiring installed at: ~J Street Address or Route No. ~Y 146711 ~u.eJtbt ity Section Township o Range County Which is occupied by c~ * ~L 2~Gti7 rcG~r .J (Name of occupant) Is a roughin inspection required on this job? No D Yes K Ready Now El Will Call Power Supplier ~ion LtZil 259"L-Address Electrical Contracto/LGC/ Contractor's License No..0V ( ompany Name) Mailing Address d (F&E Ical tracto or Owner Making This Installation) Authorized Signature Phone No. (Electrical Contractor or r Owner Makin his Installation) RAM BOMB Of This inspection request will not accepted the RAM {l' ~f State Board unless proper inspection tee is enclosed. Minnesota State Board of Electricity 1954 University Ave., St. Paul, Minn. 55104-Phone 645.7703 !eZ 3~~ FOR ANCK EE OW WORK CO EREDTBYI THIS REQUEST'ON E~ 2544 9 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ Range ® Temporary Wiring ❑ Duplex ❑ ❑ Water Heater ❑ Lighting Fixtures 9 Apt. Bldg. ❑ ❑ ❑ Dryer 99 Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner Bulk Milk Tank ❑ Farm ❑ ❑ ❑ Lpis[ ppList Other ❑ ❑ ❑ Here Herers~ COMPUTE INSPECTION FEE BELO 11 Service Entrance Size: # Fee 11 Feed &S Circuits: # Fee 0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes 101 to 200 Amps. _ 31 to 100 Amperes 31 to 100 Am res Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Crrc. Partial or other fee Signs Special Inspection Minimum fee $5.00 s Remarks TOTALF O,p !f0 I, the Electrical Insipecior, hereby cert" at t b e inspection has been ma e. (Rough-in) Date 13 2~f (Final) Date This request void 18 months from This request void 18 months from Date of this Request P 9 4 0 6 0 I, asXLicensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wrong installed at: ( Ej Vt EO 111(yA.. ar. CQ.t1 . Street Address or Route No. / L City Section Township Range County 149w~ Which is occupied by VL (Name of occupant) Is a roughin inspection required on this job? No~ Yes ❑ Ready Now IX Will Call ❑ Power Supplier 162-414A14- Address Electrical Contract T'JL'r./st.r~J Contractor's License No. (Company Name) _p Mailing Address p ~/X`Elect I - JL1 i b { (Electr Contra r or owner Nlakln9 This Inataliatlon) Authorized Signature Phone No. l0 9 3,P 7r (Flat rlcal Contractor or Owner Makl his Installation) U VE NG{j S 2D Copy( S i s inspection request will not he accepted by the txtate Board unless proper inspection fee is enclosed. mmnesota State hoard or mectnctty SG l 1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 RLQUEST FOR ELECTRICAL INSPECTION P 84060 CHECK BELOW WORK COVERED BY THIS REQUEST 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 ❑ Silo Unloader ❑ In4ustrial Bldg., ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ Farm ❑ ❑ ❑ List List Other C] E] ❑ Herersf Herers COMPUTE INSPECTION FEE BEL Service Entrance Size: rt Fee F r S e Wee Circuits; x Fee 0 to 100 Amps. 0 0 to 30 Amperes 101 to 200 Amps. 31 % 100 m e 31 to 100 Amperes Above 200 Amps. Above 100 Amps. Above 1-00-Amps . Transformers Remote Control Cvc. Partial or other fee Signs Special Inspection Minimum fee $ Remarks . TOTAL E ®O 5-D 1, the Electrical Inspector, hereby certify that the above ' spection has been ma ! (Rough-in) r Date (Final) Date z F ?d' This request void 18 months from CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55132 NO. 4970 PHONE% 454-8100 BUILDING PERMIT APPLICATION Receipt single family dwP~1' To be used for ® re a Ft.Vo%e $44,000 DateRept, - 11 19-7$- 4Q 9 Site Address 4464 Ches Mar Circle Erect ❑ Occupancy? Lot 2 Block 2 Sec/Sub. Ches Mar 1st Alter ❑ Zoning R-1 Parcel # Repair ❑ Fire Zone 3 Enlarge ❑ Type of Const. V w Name Grosz and Lehman Move ❑ # Stories z Address PO Box 1211 Demolish ❑ Front 46 ft. G Burnsville Phone- Grade ❑ Depth 49.5 ff. p Name same Approvals Fees Assessment 9/1 17R Permit 9..7 S_2 Sn_ uE Address I.( Cl Phone Water & Sew. Surcharge 22 - 00 Police Plan check Name Sppnr~p Rankpn ¢ire SAC 500-00 Address - Eng. Water Conn.250 - On City Plymouth Uth Phone - - Planner Water Meter 60.00 Council I hereby acknowledge that I have a e d - ' application and state that : Bldg. Off.U] 3/78 7R - the information is correct an agree to mply with all applica ble State of Minnesota Statutes nd City of o on Ordina a, APC Total;'- Signature of Per. ittee A Building Permit is issued to- on the express condition that all work shall be done in a w rdance with, It applicable Sto of Minnesota Statutes and City of Eagan Ordinances. Building Official C, mo=b 69E~, DATE ~i i~7,r BUILDING PERMIT APPLICATION Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations. eryyaso be used for „LCG Valuation To Site AddresE; Am 6,41 6/4a.2 Lot Block See./Sub, Parcel Number A a All . ~sy Owner y Telephone L/`,Z 9~ /r Address 19J. Contractor Telephone Address Arch./Eng. ~e Telephone Address w4ft, OFFICE USE Erect Occupancy - Alter Zoning At Repair Fire Zone Enlarge Type of Const. Move # of Stories nemolish Front yG_ Grade Depths s OFFICE USE Date of Approval & Initial FEES Assessment Permit Water/Sewer Surcharge Police Plan Check Fire SAC Eng. Water Conn. - Planner Water Meter Council Bldg. Off. A.P.C. TOTAL Certif?cate for: Grosz-Lehman DELMAR H. SCHWANZ LANDSURVEYOR Regisle,eC Untler Laws of The State of Minnesota 2978 - 145TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55069 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE 30 10 ft, Utility easement i 132.36 N89049'54"W 100.00 ~g± !33' 0 C) LOT W \ a 4v ~ O y~ o. ro Y~ „ t°o Cf. N 0 M ~ ~ O t0 ~ 5s' QON a~ o SCALE: 1 inch = 4J foot ° 13p0 m //.9 / X20/2 4/ I,y 8p' I :nereby certify that this is a true and correct representation of Lot Mock 2, CEFS MAR FIRST ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. Dated: J•ily 10, 1913 4~y /Y U MINNESOTA REGISTRATION NO. 8625 5 5 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan C~CI u{ ( ON. 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel(Reair Requirements Office Use OnN 3 registered site surveys showing sq. ft. of lot. sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Certof SurvetrRew (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions NA Soils Report _ y 77 1 Soils Report if proposed building is to be placed on disturbed soil 1 site survey for additions & decks ✓ Tree Ares plan Recd Y ;,!Fl 2 copies of plan showing beam & window sizes; poured found design, etc Addition - indicate if on-site septic system Tree Pres Required 1 set of Energy Calculations o"IteSeptic Sysferp', Y 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date /a / C>Z_ / 04 Construction Cost Rooo- SiteAddress 4q(e4 C k % Mar C,it^Cl-t-, Unit/Ste # 2 Description of Work p@ k l•culS{puallLsi), Multi-Family Bldg _ Y ZC N Fireplace(s) _ 0 k 1 - 2 Property Owner 5 4 ` ; Yr~ ~ls 1S. Telephone # (6t2) g - eSS 7 l2 - 9 Contractor Address Cif}k !~C r, State Zi Telephone Zip 06D l~y- COMPLETE THIS AREA ONLY IF CONSTRUCTING A N W BUILDING Minnesota Rules 7670 Cateeory 1 _ Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (+1 submission type) 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: Licensed Plumber Telephone J Mechanical Contractor Telephone J 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. S-hty' r\ kl cis . . Applicant's Printed Name A plicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of- plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex N 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level O 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding A 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building' ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage_Yes Valuation Occupancy MICES System Plan Review A, h 100% or _ 25% Census Code G/.3y Zoning / City Water SAC Units Stories Booster Pump - # of Units Sq. Ft. 3/G PRV - # of Bldgs - Length /Z~ Fire Sprinklered Type of Const_ Width ~G REQUIRED INSPECTIONS _ Footings (new bldg) _ Sheetrock Footings (deck) _ Final/C.O. Footings (addition) Final/No C.O. _ Foundation _ HVAC _ Drain Tile Other Roof - Ice & Water _ Final _ Pool _ Figs _ Air/Gas Tests Final Framing _ Siding _ Stucco Lath _ Stone Lath_ -Brick - Fireplace _ R.I. -Air Test -Final _ Windows - Insulation - Retaining Wall Approved By: Building Inspector Base Fee 2 Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total WW MEN" VA60f ~Lvj JWA D5 0) 0 bull r. CFI /ts Ms92 C-A 38 x.6,6 mac. kle : 5 . y`Fb'f Cher op. w o 0 N) (`'J t4 40 1 35o 401*73 lk N OF; 0 map 2007 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomeslcondos when permits are required for each unit Date -7 / Site Address !yq (oq Ch 40-5 NW C i rd's Unit # 2 Ea~elyl Property Owner 54fe JL.c1 Telephone # ( (o4L 38"S " gb ~O Contractor Street Address City State Zip Telephone# ( ) Bond Expires: The Applicant is Owner Contractor Other Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelling unit $ 50.00 furnace -Additional Replacement _ New air exchanger air conditioner heat pump other State Surcharge $ .50 Total $ ~fz_~ r I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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. 54<,1 e k 1-e..i s Applicant's Printed Name Applicant's Signature ' SMOKE DETf:i`iOit5 A" REQUIRED A VAPOR iARRIER, iIJIU~ € BE ON EVERY LEVEL OF THE HOUSE Aim tN _ EVERY SLEEPING INSTALLED ON THE WARM SIDE op ROOM AbM IN EVERY ALL WALLS AND ATTIC CEILINC,. HALLWAY LEADING TO A SLEEPING ROOM oz` I ALL SLF MIN. 5.7 SO. OPENABLE ARL I =MIN. 20" NET CLEAR A~/LE WIDTH 7 -MR !4e NET CLEAR _ OF86 BLE HEIGHT _ 44° FROM FLOOR TQ- H GHEST PORTION OF S1 LL ra f P10TEa HEIGHT OR WIDTH (CR 5CNI ) VALL BE GREATER TO as FL,3;, a _ 11&j-_- Qm V-4 I FIRESTOP SOFFITS AND ALL ud EAGAN R OTHER DEAD SPACES. f; REVIEWE- 1 D` 5 w New • a FOUNDATI ' WALL MOISTURE ~ r3ARRIER IS EQUIRED BETWEEN _ ~~oil rNSPECYiORIS ®INiSIOR1 INSULATION A FOUNDATION WALL ! FROM, f:I nf1R GRADE ~ , _ - _ EGRESS o lev ~i hM1 Maw <s i r S n'~/ bL V 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 9 651-675-5694 New Construction Requirements RemodeAReoair Requirements Office Use OnN 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas chi if showing footings, beams, joists Cad of Survey Recd Y N (20% maximum lot coverage allowed) r ~ 12 i1 Calculations for heated additions Soils Report Y N 1 Soils Report if proposed building is to be placed on dishrrhed soil h l'o i= "1 si surve additions & docks Tree Pres Plan Recd _Y _N. 2 copies of plan showing beam & window sizes; poured found design) §ki. Addbm c a ifon-site septic system Tree Pres Required -Y -N 1 set of Energy Calculations ~~r~\U Q 2QU On site Septic System Y N ,}V~ 3 copies of Tree Preservation Plan lot platted after 7/1/93 Rim Joist Detail Options selection sheet (buildings with ith 3 3 or less units) Minnegasco mechanical ventilation form 4k e&Vk,- Plans are considered public information unless you state the are trade secret and the reason. Date Construction Cost Z a~ Site Address 44 &L( c v ez .a li O~ r C-1'e Unit/Ste # F-v ZA W4 s5`t z-3 Description of Work i-. N J S 1% f 0a fA4 s dl ubU>e.V f -c xe Multi-Family Bldg J Y N Fireplace(s) - 0 _A 1 - 2 Property Owner - -4<-Ven (~(2SS Telephone # ( h t2.) 395 -1&15 O Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) 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: Licensed Plumber Telephone ) Mechanical Contractor Telephone ) 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. Applicant's Printed Name Ap'plicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt- Multi ❑ 03 01 of - plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo/pergola) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex t4l 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair e 33 Alteration ❑ 37. Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage _ Yes 'i Valuation OO Occupeincy" MCESSystem Plan Review 100% or _ 25% Code Edition Census Code al!v Zoning City Water SAC Units _,~P Stories Booster'Pump, T # of Units Sq. Ft. PRV # of Bldgs / Length Fire Sprinklered Type of Const 8 Width REQUIRED INSPECTIONS Footings (new bldg) _ Sheetrock Footings (deck) _ Final/C.O. - Footings (addition) _ Final/No C.O. Foundation HVAC _ Drain Tile Other Roof - Ice & Water - Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco Lath _ Stone Lath ,Brick _ Fireplace _ R.I. -Air Test -Final _ Windows y Insulation _ Retaining Wall Approved By:: g>® 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 Use BLUE or BLACK Ink r-----------------� I For Office Use � • � �"3�3-1`-� � Clty of �� Permit#: � � � �� Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I 1 Fax: (651)675-5694 I Staff: I I I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name. .� �U� �� l� Phone: �C � � � Z ^ � �� ReSid�n#� �W�1�t ' Address/City/Zip: '��v rLC� s/� � � Applicant is: Owner Contractor Description of work: ('--�-— �� T�i�e Of WOrIC Construction Cost: Multi-Family Building: (Yes /No Company: ��'¢'�"`� �� /��G�f /��Contact: ��( �� Address: � �" � ��– � City: `�" ! " " ��'�� I' Contract�r � State�N Zip:�� Phone: ^ � Email: �:� License#:�� Lead Certificate#: If the project is exempt from lead certification, please explain why: 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 8�Water Contractor: Phone: Fire Suppression Contractor: Phone: Nt?T�:Ft�»s ar�d�u�apart,�n��f�cu�te��tt�at you�c��rnl�are c�r�ial�rad'#�be pu�s�'c ir�#orr�a�or�. Pr�r��vf t�e irr�'o'rr�atinn may be classi�'r�d as no�_pt�ibl�c;i�'y��prov��l��pe�i�i�c re�aso��tha#v�o�t�r�per��t the Ci�y to ; cor��uale tha�'�"� are tr�d+s;secre#s. 'i 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. wvuw.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. Ezterior work authorized by a building permit issued in accordance with the Minnesota State Bu' ing Co must be completed within 180 days of permit issuance. X��' r.�� C��C�� _. X Applicant's Printed Name A I' g ure Page 1 of 3