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1755 Flamingo Dr For Office Use City of Ea 11 Permit Permit Fee: ~K1 I 3830 Pilot Knob Road r Eagan MN 55122 Date Received: Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 2009 RESIDENTIAL BUILDING PERMIT APPLICATION C) C r?"iell ti. t~t Date Site Address: ~'~F Tenant: Suite RESIDENT / OWNER Name: C ~G~x `~Cmrl Phone: 7Address / City / Zip: I7J`~J 06L011!20 Applicant is: Owner Contractor TYPE OF WORK Description of work: & rJ Lam' 1~{r? , Construction Cost: 1 >O Multi-Family Building: (Yes IV// 'No CONTRACTOR Name: L-ohre- lt^rn~ 4- tro,3,-_ Y7€xif License#: 2-00-16q,5- Address: 2295 R r± i•°ltt R.d. City: l yli l~ ?~r. L State: M N Zip: I1c) Phone: 6 , 6l 'Y70 I'16 Contact Person: t cin Lon e COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category I _ 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 wit ut a permit; that the work will be in accordance with the approved plan in the case of work which requires a review an val of plans. pp icant's Printed Name D is Signature Page 1 of 3 F1 JUL 14 2009 ~tI 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 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 4A Occupancy -7WG -3 MCES System Plan Review Code Edition _ L SAC Units (25%_ 100%--~ Zoning J?-3 City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction _ZZ Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final I 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 FEE Base Fee 9O- 1 I T rz~ Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 íü ÿþ ÿþþ ýëý ûþþüííô ÿ úè ÞÞ ÿþù ýüûúùø ÷ö ñ üúùø ÷ ô ø ø ñ üñ íüøù ðÿ ýïü üý þ ý ý ýë üþãõÞ ááåå î ççëåëå ôû ýü çëäëä èüë óïñí ùðö øø âñ ì ñ ñ ø ý ýÞîóÿ ýë üãõÞ ÿãõ àáßáåå ûù ÿ ì øø ê ó ÿ óøùøøû ý êã ýü ñùê ÿí ë øøö ó ýÿü ü ùýÿü VILLAGE OF EAGAN 3795 Pilot Knob d WATER SERVICE PERMIT Eagan, MN f PERMIT 1428 T MIT 1V0.: DATE: nits: Zoning Owner: 4 No. of U Address: Site Address: Plumber: i r ,: _l_t •o t i Meter No.: summit Plumbing Size: Account Deposit Connection Char 40. Reader No.: g� 00 d 12 31/E : 1 agree to comply with the Villa a Permit Fee: 10.00 pd 4 Ordinances. 9 of Eagan Surcharge: 4 ge: .50 pd 4/4 Misc. Charges: ]3Y Total; Date of Insp. _? '7" Date pfd; d I nsp. : DESCRIPTION OF BUILDIN Industrial Commercial Residential Multip 111111111111111111M „ Location of Connections; , 1 1 q Ir aX `Line ~tLUE or BLACK Ink For Office Use 1 i Permit City of Eap I Permit Fee: 3830 Pilot Knob Road I 1 I Eagan MN 55122 ► Date Received: 6U 2~ i Phone: (651) 675-5675 1 Staff 1 i (l3/ Fax: (651) 675-5694 1 I L----------------- 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 01411 175, 1,753 1755, l>57 1~5g UmtM .e..o._._. 1a a -i3 a Name: Phone: ; i Resident/ Owner Address / City / Zip: t I Applicant is: Owner K Contractor Description of work: i Type of Work I Construction Cost: Multi-Family Building: (Yes I No t i ~ Company: --1~ ""tr►v~~¢.)~e~...4'!`~ nsa~fc~,.-4i6~ Contact' Address City: t rte i~ Contractor 1 q ~t 1 State. M ti Zip: Phone: r st ` ` - ~ 4 q5 ad_ Lead Certificate* A i9-r - ~ O r o ? -1 License If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) v 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 & Water Contractor Phone p _ - MOTE: Plans and supporting documents that you submit are considered to be publlc information. Pardons of the information may be classified as non-public if you provide specific reasons that rwoutd permit the City to - -._.d. ALLOm conclude that the are trade secrets, _i CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage, Caf148 hours before you intend to dig to receive locates of underground utilities. I hereby acknowledge that this information is complete and accurate; that the w-0. 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 pemoet, wid 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Cade must be completed within 180 days of permit issuance. x~rat ~ ~Q C~L+" X ~ l .ltd Applicant's Printed Name Applicant's Signature Page 1 of 3