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4649 1_2 Penkwe Way reftnc®se Permit City of Iia a~ Permit Fee: 3830 Pilot Knob Road - Eagan MN 55122 Date Received: Phone: (651) 675-5675 l Fax: 651 675-5694 1 Stets; ( 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 5 2( - Site Address: Tenant: Suite RESIDENT / OWNER Name: L-k tA r) Phone. )V;- C t ~.Z t~ E' i C~ 7l' Address/ City /Zip: -V 4"q Applicant is: Owner Contractor TYPE OF WORK Description of work: 1~. d d 6h N fah dc°_{ ~ J Construction Cost: Multi-Family Building: (Yes /No _J CONTRACTOR Name: 4Li-~,LZS HI4-,n,'p' NW ~llatH~yl! License* Address: J City: T -a y tn't ft.* o State: _ _/V Zip: r~ Phone: ~5~ Y' f Contact Person: h, 1~ li GJ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (I submission type) • 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? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone; NOTE: Plans and supporting documents that you submit are considered to be public Information. Portions of the Information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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 of to start without permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of ns. x- ~6'4 V1 1 r,i ~c YI X Appl cant's Printed /Name I~ r Ap s Sig Page 1 of 3 MAY 2 i~ 2009 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage _ Single Family _ Garage _ Porch (4-Season) ` Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) , Exterior Alteration (Multi) _ 01 of _ Plex Lower Level ` Pool _ Miscellaneous _ Accessory Building WORK TYPES T 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 S Occupancy --r-42 C- I MCES System Plan Review Code Edition WU1 2- 1 SAC Units (25%_ 100%___) Zoning City Water Census Code ~f3 Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final I C.O. Required Footings (Addition) j Final I No C.O. Required Foundation HVAC Drain Tile Other: Roof: _Tlce & Water Final Pool: Footings Air/Gas Tests -Final Framing Siding: Stucco Lath Stone Lath ^Brick Fireplace: Rough In Air Test Final Windows Insulation Retaining Wall Meter Size: Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review 1 - F " j , n c~, ? ,7 ' '1c) MCES SAC / / w t L City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 _ General Contractors 46491,4 Penkwe Way, Eagan, Minnesota 55122, (612) 688-8100 POD fl t'FG €`'O t# le ~sFAGAN / I; d ,f fY 7 / 10.0 I Z. o 10, 0 0 3Z . , 1 ' of L # tw 3 a .Prr Tbiotnipson " flra s 46 enh a Way 11 2 C tid y `III may,,. _ •� itigoefir : ' , Porm .Foe: 10.00 1)d 1'r, ir.110- OISO ` t lirr air 0. hew Sindsotos: . 50 Pd 60 U0 esdimmiess Misc. Charges: . , d meter Total: Ar. ..� Dab Pak': Date off 'E Insp.: - Uses& 1414 51122 DATE No. of (fr it": � 1 .iS. site + ddrsss: !" 'eT e • y r I. r 1 r C 1f r C �I plumber r n - . owes to se** Ilse My ell loges Connection Osage: 42 Onlitsioaces. Account EDroett• hermit foe: ' __ 10. GO p Surcharge: r ti Dote vfHr Mix. Charges: Insp.: - . 1 f Dots Pal* K - » :mot "c"e ""< ,,.�„` r x r.�.at ' xb �c��� '1� IP-�� ��,� ��� yc���, , �� , Use�LU�or BLAGK ink �'(r��s ��`I� �G,r� rCl•�F�o��u�---------.i • � ' � � � Z,��Z� r �� � � J � PermitE#: � � f���� � � � , � Permit Fee: ; ��. � 3830 P�iof Knob Road ; Eagan RAN 55122 � Date Receroe�d: j Phone:(651)675-5675 � � Fax:(651 j 6T5-5694 1 Staff: t I ( . . . . . . � . . .t���.�....... �.���.�.�..���J� 2014 RESIDENTIAL BUIL.�31NG PERMIT APPLICATIBN �-f 6��c -� yl � 'Z P� 11°�-P� �� � Date:�'���'"j� Site Addre.ss: L['��/�'" � �/ 7 �� �iG Ci,r/��` ElnFt#' � tVame: ��/�i1� �-r�'�� t t�t,.�r��?�+�r� �Phone: � �R£S1[�@fl#� � C1W1��F Address I City f�ip: ���"�' /��� , Applicant is: Owner � Gantractor Description of work: ��r�r �(�� �{ ��- ---J'�o�'/"�� TYt�+a of WoMC � Cons#ruction Cost:������ Mu�i-Family Building:(Yes�/No� Company;I VC�I��1°5� �r�Y11�v9�C.�U15 '� Cor�taact t l f� �G�tJ��' � Go�tra�t�r �daress:�5'��� �✓���`��ja�r- L,%�-y}x /� c;�,:���'� �f�t�l.�� �t . �r �� �,.���i_��", �r State_�Zip:� Phone: ` Emai1:��►rn�? t3v'L�_,;'..,..5'T��r�t�J`�✓�v�vv — trcense#: �J� �.r�S� �'1 7� -_�c. �_�-�. l.e�aa certif[cate#:!V�.t—.—r�i�1 t9 3 ~-� It the pro}ect is exempt from lead certi#°�cation, please exptain why: (see Page 3 for addition�it informatian) CflMPLETE THIS AREA ONLY IF CONSTRUCT'ING A NEW BUILDtNG )n the last 12 roont , a�the City of Eagan iss�d a�rmit€or a similar plan based on a ma�#er plan7 ` ^Yes _No if yes,date and addr master p[an: Ucensed Plumber: Phone: Mlechanicai Contractor: , Sewer 8 Water Con r; Phone: �OfE= �a�d syppof#in�'docu�n�nfs fl!rat yc�rt sutimit�r�caasideF�c!f4 L�e publhc in�rrn�#an ��rti�ns of �� � trtfQrmatiet�m��rb��la�si�ed&s nart pubiic ifyot�pr+ovid'e.spec�c r�s�trs�lr�t t�r�ittfd{�ei�►rtt:��G��,r#t> c��rcf�de#tr�=f�ie �r��ad�secc�ts. CAL�BEFORE YOU D1G. Cait GophrerSta�One Ca8 at(651}454-00pZ#arprotection agai�st undergrounci ut�lity damage. CaA 48 hours beiore you iRtend to dig to receive locate.s of underground utilities. ww�v.c�opherstateonecait.oru i hereby acknowledge that this irifarmation is t:ompiete ar�d ac�urate;that the vaork wlit be in t:onfwmance with the ordinan�ar�tl codes of it►e Giry of Eagan; #hat 1 uadersfand this is not a permit,but only an applic�tron#or a permit, and w�ork is not to start writhcwt a permit;that the work will be in accordance writh Ute appraved pfan in the rase oi u�rorlc wk►ich requires a review arxt approvat of plans. Exterior�nrork authairized by a building pemvit issued in acc�dance with the Minnesota State iiding Code must be compieted witt►in 180 days of}�rmit issuance. ' ���� �r x i/ ' � G - . ---""� x � , • Applir.anf's P�r�ted Name anY's Signature Pi�f of 3