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4464 Johnny Cake Ridge Rd - BL89670 For Office Use Permit lP / v Cif of Ea a~ - 30;&6, Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date ReceivedJUN 10 2009 Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: a 'i 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address:` Johnny Ci'A/e d~ Tenant: Suite RESIDENT / OWNER Name: Md ',owle Phone: C dq7 -P-0 ~4 Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: l / ? _ Construction Cost: Multi-Family Building: (Yes. k- No CONTRACTOR Name:` C d License i t 416 Address: Z O /7_ Di - JJ City: ' r ) or LaKe~ State: ! Zip: 6#e Vjj A-7 Phone: c ` 2 ontact Person: L t rc 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 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 may be classified as non-public if you provide specific reasons that would permit the City to conclude that they 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 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. AA, x Lt4VV. /'"ctci,'So l x tS2 a Applicant's P nted Name App ant's Si Lure Page 1 of 3 HL4&q chop clq (GI a DO NOT WRITE BELOW THIS LINE 9& l r' 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 _ 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 Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100%_) Zoning City Water Census Code 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 / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: _Ice & 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 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 C16 -7 1) CL oo o C\j PO OCP LO p DO co C, C, cr) 4 00 rTl~lf S.Y JbL~i4 T f C