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.
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Applicant's P nted Name App ant's Si Lure
Page 1 of 3
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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
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