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;-
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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
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CONTRACTOR Name: 4Li-~,LZS HI4-,n,'p' NW ~llatH~yl! License* Address:
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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
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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
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Total:
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hermit foe: ' __ 10. GO p
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3830 P�iof Knob Road ;
Eagan RAN 55122 � Date Receroe�d: j
Phone:(651)675-5675 � �
Fax:(651 j 6T5-5694 1 Staff: t
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2014 RESIDENTIAL BUIL.�31NG PERMIT APPLICATIBN
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Date:�'���'"j� Site Addre.ss: L['��/�'" � �/ 7 �� �iG Ci,r/��` ElnFt#'
� tVame: ��/�i1� �-r�'�� t t�t,.�r��?�+�r� �Phone:
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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��'
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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
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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. '
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Applir.anf's P�r�ted Name anY's Signature
Pi�f of 3