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802 Eagan Oaks Lane Use BLUE or BLACK Ink F----------------- Foy C~f11ce Use 1 f j Permit l- I City o Eap I Permit Fee: I I 3830 Pilot Knob Road Eagan MN 55122 j Date Received: Phone: (651) 675-5675 1 I Fax: (651) 675-5694 1 Staff: 1..- 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit M Name: e~~rL Qo.kS "'l; %A0v►kavyle. 4S54 Phone: 16 L7-- LLB-014 39 RESIDENT / OWNER Address / City / Zip: 807-r lgoq.' E)&6 ~~wa✓6 Oaks 14 J Applicant is: Owner _.t< Contractor TYPE OF WORK Description of work: nae o-(-c r y- r'mo-F Construction Cost: 0 000 _g Multi-Family Building: {Yes / No ) Company: ~J Rw_h-_rS LLG. Contact: &'Q'eL Aajot~ k-6- CONTRACTOR Address: tI$ t 4 /VF, City: A[ov State: IYJA Zip: 4'5"`l34( Phone: 6 1 'z"LZ.1--Oct0 License To 1.3 6 t 9a Lead Certificate Does this project require Lead Remediation? ❑ Yes V9 No (see Page 3 for additional information) If no, please explain: 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: 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.got) herstateonecall.ora 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. x vt b.✓t i41L_,a kt x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type: Plumbing 3830 Pilot Knob Rd Permit Number: EA091140 Eagan, MN 55122 . Date Issued: 09/14/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 802 Eagan Oaks Lane Lot: 7 Block: 01 Addition: Eagan Oaks 2nd PID 10-22461-070-01 Use Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Kris Oien 3670 Dodd Rd Eagan, mn 55123 Fee Summary: PL - Permit Fee (WS &/or WH) $50.00 0801.4087 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Champion Plumbing Prabhjit S Gujral 3670 Dodd Rd., #100 802 Eagan Oaks Lane Eagan MN 55123 Eagan MN 55123 (651) 365-1340 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature i , CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 SITE ADDRESS: 1 A:,AI r,r1 iin? sJ, PERMIT SUBTYPE: :CORD PERMIT TYPE: r 1 I? plr, Permit Number: Date Issued: It 1 r, / t APPLICANT: TYPE OF WORK: •, ill ,11y 1 1 •. P N R INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE S I T . I A14 kf:1/ I I I:1! 11 Ily UAYt+if 11I1 1 1 1. 11 111 liblill W 1 I.1 IIM1I I h11i 5142 9.3 Permit Holder Date Telephone # SEWER/ WATER PLUMBING hAl 9 D HVAC 3 Jr Inspection Date 1 Comments FOOTINGS '11 ? !! FOUND FRAMING qAOMQ ROOFING ROUGH PLUMBING •/ PLBG AIR TEST ROUGH HEATING y GAS SVC TEST 3 ?C INSUL 5 S GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECT ION RECORD CITY OF EAGAN PERMIT TYPE: 1; 3830 Pilot Knob Road Permit Number: 4 1 Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: APPLICANT: f M " i rt FlA . A I PERMIT SUBTYPE: TYPE OF WORK: - ?? J tIP4 r I i INSPECTION TYPE .DATE INSPTR. PE DATE INSPTR. t; r'. 1 I ' ? ? ? • i I AN Rf VIFtJI ti HY UA';01t MI I I rR Ld P1.IIMRfk I'. i'I IIMPINf• '4 14VIf V i I NI'I"I? I [?I j IIF1I f 846.' h 1t0" f A 6 A N IIA'. ", I At4f 3 oZ 9 / Permit Holder Date Telephone S SEWER/ WATER PLUMBING CJ HVAC Inspection Date In Comments FOOTINGS FOUND FRAMING jj&*A yqf OAc- ROOFING ROUGH PLUMBING PLBG AIR TEST r ?cr e? j Sy ROUGH HEATING GAS SVC TEST /ax INSUL /a GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: " `A Eagan, Minnesota 55122-1897 Date Issued: " I /of.. /94# (651) 681-4675 SITE ADDRESS: ,IIr:N IIAF . PERMIT SUBTYPE: ,t1 (11 f . APPLICANT: ' S I. 1 i 7. GI 'I S'1'lir? TYPE OF WORK: ,'. i 1 I I .i4 f 3 IIN I I INSPECTION DATE INSPTR INSPECTION TYPE DATE INSPTR. . 1II• ' I N 1 OF R PIt("NV tf 7A0 '?N'l 1 ANI J iFlk. c: Fit AN R VIIWII I;'i IIAYNF MtIIFp. n IJ f' I tIMItI is I-, I' I IIMfi I NO,$ `.f` I?v I c f (lF 1.IN i 1 `. ! 11414 !• HOh If A6AN IIAN 3 V-2,1 2_ permit Holder Date Telephone N SEWER/ WATER PLUMBING ...? HVAC 3 *s .' Inspection Date k4Rsp. Comments FOOTINGS FOUND 3,fr a FRAMING YM?t i?? ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST _3 i INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 2007 RESIDENTIAL MECHANICAL PERMIT APPLICATION ?? City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for single family dwellings & townhomesicondos when permits are required for each unit f Date ? ?_ / ` / b]_ 1 Site Address bo"1 n ?q ?Qn unit# Property Owner _cd -t 1 A 1 on Telephone # ( (0I U1 IS- Contractor A IR MECHANICAL I G Street Address 16411 Aberdeen Street NE H L k City State aiti a e, MN 053()4 Zi 7 !to-J `I 2 T i h # J L) "-7-7`7 -7 p ) . e ep one ( Bond Expires: The Applicant is Owner Contractor Other Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelling unit $ 50.00 furnace Additi l R l t N - ona ep acemen _ ew air exchanger air conditioner heat pump other :51(a 2JYU 0 State Surcharge $ .50 D) I J Total _ DEC 1 1 200 $ `Jd I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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 appro?yed plan in the casg of work which requires a review and approval of plans; C' r-0 n, 6c( ?1 u X L?/ ??iP1lR ` lU u aM Q L Applicant's Printed Name Applicant's Signature j 7 u ? u o ? /7 L C2 0 Gd ? ? ? W-'0 0 [!3' ?0 ? r ? ? /p ? [B ? ? 3-11?0 ? ? u- 'o Q---? ? ? &'o PROPERTYLEGAL: n DATE OF SURVEY: LATEST REVISION: DOCUMENT STANDARDS Registered Land Surveyor signature and company Building Permit Applicant Legal description Address North arrow and scale House type (rambler, walkout, split w/o, split entry, lookout, etc.) Directional drainage arrows with slope/gradient % Proposed/existing sewer and water services & invert elevation Street name Driveway ELEVATIONS Existing Sewer service (or Proposed) Property corners Top of curb at the driveway Elevations of any existing adjacent homes Proposed ?'? ? ET, ? ? gr--?? ? ? 0--'? ?l-?? ? e7 ?? ? ?? ? ? 11, ? ? d ? ? C'I' ? e" ? ? ? B" ? of ? ? e' ? ? 2? ? ? ? 2-,? Garage floor First floor Lowest exposed elevation (walkout/window) Property corners Front and rear of home at the foundation PONDING AREA (if applicable) • Easement line • NWL • HWL • Pond # designation • Emergency Overflow Elevation DIMENSIONS • Lot lines/Bearings & dimensions • Right-of-way and street width (to back of curb) • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (.e. all structures requiring permanent footings) • Show all easements of record and any City utilities within those easements • Setbacks of proposed structure and sideyard setback of adjacent existing structures • Retaining wall requirements, i4ny Reviewed: A January 1998 CRAIG19MISLDGPRMT FM LOT SURVEY CHECKLIST FOR RESIDENTIAL CITY OF EAGAN CASHIER: S TERMINAL NO: 861 DATE: 01/05/99 TIME: 15102:15 ID: NAME: LANG BLDRS INC 2256 9001 802 EAGAN OAFS 47208.74 2256 9001 806 EAGAN OAFS 47208.74 2256 9001 804 EAGAN OAFS 37491.79 Total Receipt Amount: 117909.27 CRi01673 USER ID: NANCY 3 CITY OF EAGAN 3830. Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMIT PERMIT TYPE: B U I L D I N G Permit Number: 0 3 4 2 9 2 Date Issued: 01 /06 /919 SITE ADDRESS: P.T.N.: 10-22461-070-01 802 EAGAN OAKS LANE LOT- 7 BLOCK: 1 EAGAN OAKS 2NC1 DESCRIPTION: 1 Of° 3 l)NITj Bu'i1d+no,LPermit Type Vuildi.nci ab,rk Tvpe ?08C Occupanc'v' Construction Tv'De Zonino Building Length > Building Width "?. BuildiaG stories - - rf re Feet: ? . ? - G MULTI. (ADO'L NEW R--::3. U -- I VN R-3 32 56 1 1.602 102 1. - FAN. ATIAcH V REMARKS: PI AN REVIEW?0 BY WAYNE !,III I EF2. S & W PLUMBER IS PLUMBING SERVICE CENTER PHONE #780--9091. 1 OF 3 UNITS: 804 N 306 EAGAN OAKS LAME FEE SUMMARY: VALUATION 186.000 Base Fee 1.89S..7S M:[3C. FEES $1..637.50 Plan Review $582-.24 COPIES _ ` Ii Surcharge 1,43. 00 Total Fee $4.,'.08.74 SAC $1.050.00 SAC % 100 SAC Units _ 1 Subtotal $2„570.99 CONTRACTOR: - Applicant - :T. L I C LANG BUILDERS INC 17809090 0002651. 6202 CIVIC HEIGHTS OR 100 CIRCLE PINES MN 55014 (?u12) 720-9090 OWNER: LANG BUILDERS 620 CIVIC CIRCLE PINES ffi121780-9@5@ HEIDI-ITS DR MN 55014 I herebv acknowledge that I have read this intormation is correct and agree to compiv Stetutes and Citv of Eacan Ordinances. L "I APPLICANT/PERMITEE SIGNATURE application and state that the with all applicable State of Mr. UED BY. SIGNATURE I off.-7 339az fNTIAL) ,34 ?i -1998 BUILDING PERMIT APPLICATION (REgIlp CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-4675 New Construction Requirements RemodeVReoair Requirements G ef ??D ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks' ? 1 energy calculations ? 1 energy calculation?, tr heated additions ? 3 copies of tree preservation plan if lot platted after 711/93 C C 15 , required: _ Yes _ No DATE: I -?- a CS CONSTRUCTION COST; Za V b_' DESCRIPTION OF WORK: STREET ADDRESS: LOT: BLOCK: SUBD./P.I.D. * ?; n o KS L "?- PROPERTY OWNER CONTRACTOR Name: S'7? 45 l vEt Phone #: Last First Street Address: City Company: Street Address: city & Phone#: 61;? - / tyD`(?0 lL License", 26S 1 State: Mn Zip: ? 14 bf ARCHITECT/ ENGINEER Company: Name:` Street Address: City Phone #: -75-40 ZI J 2- Registration #: 1n 9 / State: / / // / Zip: J S LA Sewer & water licensed plumber (new construction only): Penalty applies when address chant. R and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applica'c State of Minnesota Statutes and City of Eagan Ordinances. RECEIVED Signature of Applicant: DEC 2 3 199 BY: OFFICE USE Y U/rUG? / /71? State: Zip: Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. V 10 _-plex ? 15 Deck WORK TYPE A 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFOR MATION A- Const. (Actual) V w Basement sq. ft. 106-2 MC/WS System -per (Allowable) dN Main leve l sq. ft. 11,62 City Water UBC Occupancy fl,;1/1 R sq. ft. A/*0 Fire Sprinklered Zoning 0?3_ sq. ft. PRV # of Stories I sq. ft. Booster Pump Length 3 2 sq. ft. Census Code. X02 Depth 66 Footprint sq. ft. 160 SAC Code "g) Census Bldg e9i Census Unit / APPROVALS Planning Building kt t_ Engineering Variance Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total % SAC SAC Units Valuation: $ ?r C, I DOa 43-0[7 F?Es FRon,11 prAMiT338001 rio ryi r?? a ?'y BascNlailt { 8p t00?}r15, = l:!rb30 1, U SZu , p ? ?tol$axSN=6s,s?8 V"i Sc ?O•b? 6?R,I?Dx1& = 6720 ( ,? O a.-7 CITY OF EAGAN CASHIER: S TERMINAL NO: 961 DATE", 01/05/99 TIME: 15:04:36 ID: NAME: LANG DLDRS INC 2256 9001 904 EAGAN OAKS 765.05 2256 9001 804 EAGAN OAKS 0.10 Total Receipt Amount: 765.15 CRi01674 USER ID: NANCY MTTTMMMMTTTTTTTMMTTTTT'ITTMTTMTTTTTMMTMM CITY OF EAGAN CASHIER S TERMINAL NO: 861 DATE,. 01/05/99 TIME; 15;02:10 ID NAME. LANG BL.DRS INC 2256 9001 802 EAGAN OAKS 42208.74 2256 9001 806 EAGAN OAKS 422OO.74 2256 9001 804 EAGAN OAKS 3.491..79 Total Receipt Amount 112909.27 CR iOi.6'?3 USER I.I.I. NANCY n ?%!KYF?X?yF7kk?yK7p?K7kW?kYF?>K%(>X7KW ?N(YF%K>K1C9nV($fHC?k ?(7kh??K%? ?2F . CITY OF EAGAN I030 MIN Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 SITE ADDRESS: P.T.N.: 10-22'461-060-01 $823,75 MISC. FEES $1.637.60 $600.44 COPIES $.25 $43.00 Total Fee $4,.256.94 $1.,050.00 100 --._-.52.619.1.9 PERMIT PERMIT TYPE: BU11_DTKG Permit Number: - 0 8 4 2 9 1 Date Issued: 0 -1 ( 0 5( 9 5 FAGAN OAKS I-ANL 6 BLOCK. 1 OAKS 2ND DESCRIPTION: 1 OF 3 UNITS 8u_1 d ri'tr ermit: Type E'uilding Wtrrk Tvpe rl1BG Occupanap` Construction foe Zonino Building Length Building Width ? Buildinj stories S; Li,^ara Feet MULTI. (ADD'[- NEW R-3.U-1 VN R-3 32 66 7- 1.f>22 102 1 -- FAN. ATTACH 'J REMARKS: PI- Ap! IREVIFWFO BY AAVrdc hi R. S & W PLUMBER Tti' PLUMBING IiER'VICF CFINTER PHONE #780-57071. 1 OF 3 IJNITS:. 802 & 806 EAGAN OAKS LANE FEE SUMMARY- VALUATION $90,000 Base Fee Plan Review Surcharqe SAC SAC % SAC Unite Subtotal CP.NTRACTOR: LrSNG BUILDER'S INC 6202 civic GIVRCLE PINES (612) 780-9050 804 LOT; CA GAN Applicant -- 1/1809090 HLTGHTS OR 7.00 MN 55014 sr. 11C°OWNER: 0002657. LANG BUILDERS 620 CIVIC CIRCLE PINES (6:12) 780-9090 HEIGHTS DR MN 5501.4 I her-eby acknowledge that 1 have read this information is c.oi-rest and agree to cumoly Statutes and City of Eacian Ordinance,. L J I/ APPLICANT/PERMIT E SIGNATURE application and Mate that the with all applicable State of Pon. IS9t1ED BY: SIGNATURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) 3 y a °? II?? 3830 PILOT KNOB RD 55122 CITY OF EAGAN 681_4675 C CgcC " r 00,& New Construction Requirements Remodel/Repair Requirements C7 ? 3 registered site surveys • 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ? t energy calculations ? 1 energy calculations for heated additions n • 3 copies of tree preservation plan if lot platted after 711193 0 (1s required: _Yes _ No C(?14-X.,X- KS DATE: )? -?3 5C CONSTRUCTION`` COST; `wa?? DESCRIPTION OF WORK: `fMSUUYI _ 1?m1 t F ?cMyC STREET ADDRESS: LOT: 6 BLOCK: SUBD./P.I.D. #: Name: i?A? &I-604-x2 Phone PROPERTY Last First OWNER Street Address: City State: Zip: ^/?,1 ' QQe C?,?? c Company: C, C, ?y 11PJ ? S Phone #: CONTRACTOR Street Address: tP ?I ew tC _ ? ? Z ` License # 210S;1 City ('ail ?e V'AES State: ?1y Zip: ; /! )ARCHITECT/ I \? ?-"' ' ENGINEER Company: ?I Alz Phone 9: ?G?(?-?7? Name: r 5!`x_"1 Registration #: L / Street City State: W n Zip: ss*( ; Sewer & water licensed plumber (new construction only): Penalty applies when address chant and lot change is requested once permit is issued. -Igo - qo°+ I hereby acknowledge that I have read this application and state that the $.late Pf sainn si a Slat utes and City of Eagan Ordinances- ? ;u>3 DEC-2 BY:[) I OFFICE USE ON Y Certificates of Survey Received _ Yes Tree Preservation Plan Received Yes is corr@ct and agree to comply with all applicat Signature of Applicant:( /FIYI (??uriwv(?? No V U No Not Required OFFICE USE ONLY p BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. JN 10 :?_-plex ? 15 Deck WORK TYPE A 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) l) 0 Basement sq. ft. 1202 MC/WS System X (Allowable) l _ Main level sq. ft. 1 a?z City Water X UBC Occupancy R3? 112 6AR sq. ft. /42O Fire Sprinklered Zoning R.3 sq. ft. PRV # of Stories sq. ft. Booster Pump Length 3 d, sq. ft. Census Code. 102 Depth AS Footprint sq. ft. /14;z A SAC Code o/ Census Bldg of Census Unit 0_ APPROVALS v k Planning Building Engineering Variance -;?3 -T S Permit Fee 5 ] s? Valuation: $ t0, oo0 Surcharge fS.U ?tES yRo" p6fiMlToo 3380 Plan Review License IA02 X _ /y030 MCNVS SAC L 9 e 6 ! U SU . C) City SAC FiIDkpds Mal??? ?gN =6y 1709 Water Conn. 9a.G-D Water Meter m i Sc Acct. Deposit 69 _ 7AO SAN Permit S/W Surcharge -,? `d 9 l Treatment PI. Park Ded. Trails Ded. Other Copies q ?{ S? Total: % SAC SAC Units CITY OF EAGAN CASHIER: S TERMINAL NO: 861 DATE: 01/05/99 TIME: 15;02:20 ID: NAME: LANG BURS INC 2256 9001 802 EAGAN OAKS 47208.74 2256 9001 806 EAGAN OAKS 47208,74 2256 9001. 804 EAGAN OAKS 31491.79 Total Receipt Amount. 1.17909,27 CR101.673 USER ID: NANCY 7%%? ? ? %? %e ?X?k k e * %t %e r? Xe ?C 4 ? ? Ae 1e # ?X %e Xc ?C ? nk X? ?k ?# ?k ?k * ?X ?X %t ?C Xe k e CITY OF EAGAN 3830 Pilof Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 SITE ADDRESS: P.I.N.: 10-22461--050-01 DESCRIPTION: Buildinq Width Buildinq stories q.uare Feet. Ci'Ihquq, Code- ' PERMIT PERMIT TYPE: BUILDING Permit Number: 0 3 42 9 3 Date Issued: 01 / 0 5 / 9 9 806 EAGAN OAKS LANE LOT: 5 BLOCK: 1 EAGAN OAKS 2ND 1 OF 3 UNITS BU'iidintI Permit Tvpe BUiidinq W.tork Tvoe ,UBC Occupancy' Construction Tdp,e Zoning Buildinq Length ) f ? MULTI.. (ADD'[..) NEW R--3 , U-1 VN R--3 32 66 1 L. 602 102 1 - FAM. ATTACH REMARKS: PLAN REVIELJEO BY WAYNE MILLER. S & W PLUMBER IS PLUMBING SERVICE CENTER PHONE #780-9091I OF 3 UNITSx 802 & 804 EAGAN OAKS LANE FEE SUMMARY: VALUATION $06.000 Base Fee $895.75 MISC. FEES $1.,637.50 Plan Review $582.24 COPIES $.25 Surcharge $43.00 Tot:el Fes: $4.208.74 SAC $1,050-00 SAC K 100 SAC Units 1 Subtotal $2,570.99 CONTRACTOR: - Applicant _ ST. LIC. OWNER: LANG BUILDERS INC 17809090 0002651 LANG BUILDERS 62,02 CIVIC HEIGHTS DR 1.00 620 CIVIC HEIGHTS OR CIRCLE PINES IN 55014 CIRCLE PINES MN 55014 (612) 780-9090 (6).21780-9090 i C hereby acknowledge that I have read this intormation is correct and agree to comply Statutes and City of Eagan Ordinances. ` APPLICANT/PERMITEE SIGNATURE application and state that the. with all applicable State of IHn. ISO!TD BY: SIGNATUR 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) c mo d' CITY OF EAGAN Sa? 0,D- D6 t ?(( 3830 PILOT KNOB RD - 55122 • )t4 ?7 -13 681-4675 -?41© &ic? or,?S New Construction Requirements RemodeUReoair Requirements _ (fir ? 3 registered site surveys ? 2 copies of plan r 1 ? 2 copies of plans (include beam & window sizes: poured fnd, design: etc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations for heated adnd?itions? ? 3 copies of tree preservation plan if lot platted after 7/1193 C_ l a-' R required: _Yes - No DATE: I a 737 9IR DESCRIPTION OF WORK: STREET ADDRESS: CONSTRUCTION COST;] 1 LOT: BLOCK: SUBD./P.I.D. #: PROPERTY OWNER First Street City State: Zip: 4, 1 J) _0 Company: ( IY 1U ill ys aijiC --Phone #: ZSt ° ?D9 CONTRACTOR D 11)IC 1 (G? 1? License# as1 Street Adddress / City &6-t 9 ty\es State: MY) Zip: ssbl4 ARCHITECT! phone!(: ENGINEER Company: [\ I tT? / (i Name: Registration #: 6k4D Street Address: City L,WY? ` 7C'LJ State: M V_? Zip: q Sewer & water licensed plumber (new construction only )3 Penalty applies when address chani and lot change is requested once permit is issued. acknowledge that I have read this application and state that the informati n is correct and agree to comply with all applicat Minnesotatit tes and City of Eagan Ordinances. A r 4 DEC r 3 iC 3Y: I fi I OFFICE USE ONLY Certificates of Survey Received `? Yes Tree Preservation Plan Received Yes Signature of Applicant: P/l/t No No ?! Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Acce ssory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. 10 ?-plex ? 15 Deck WORK TYPE '2( 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) P Basement sq. ft. ir,702 MCANS System _ C (Allowable) ) N - Main level sq. ft. // y ? City Water X UBC Occupancy X 11 sq. ft. 4120 Fire Sprinklered Zoning sq. ft. PRV # of Stories 1 sq. ft. Booster Pump Length sq. ft. Census Code. Depth 66 Footprint sq. ft. /bog SAC Code Census Bldg Census Unit d Z APPROVALS Planning Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Buildings Engineering Variance _ s`i 5,-15 Q' ? 5 Valuation: $ ??o Lt3 o 0 FRor1 d E/,gMiTlt 338d? Bas?M? ?s?"'1ouo.d ?(?a2 y/S - / 5030 IIS5?x5H=G3?S? rniSC- IS?ra.? lt0 N2 OXi6 - 6 1-{ aUS,-7q ------------------------- I nn I ? I % SAC SAC Units CITY USE ONLY p L '?/O BL ? -I RECEIPT #: SUBD. ? RECEIPT DATE: -Pj--46 ?,7t. 1999 PLUMBING PERMIT (RESIDENTIAL) CITY of EAGAN 3 "?/ O 2 3890 PILOT KNOB RD EAGAN, MN 55122 (651) 681-4675 Please complete for: > single family dwellings > townhomes and condos when permits are required for each unit > backflow, preventer for underground sprinkler system Alterations to existin residence 30.00 = Water Turn Around 30.00 = Private Disposal System MPC lic. 75.00 = (new and refurbished systems) Private Disposal Systems Abandonment 30.00 = RPZ (new installation/repair) 30.00 = FIXTURES EACH # TOTAL Shower 3.00 x Water Closet 3.00 x = Bath Tub 3.00 x - 3. Lavatory 3.00 x = 0C) q Kitchen Sink 3.00 x i = - ,OO Laundry Tray 3.00 x T = 3, OD Hot Tub/Spa 3.00 x = Water Heater 3.00 x _ 5.00 Floor Drain 3.00 x = 3,06 Gas Piping Outlet • minimum - 1 3.00 x = 3 Rough Openings 1.50 x = 4F Water Softener for dwellings under construction 5.00 X = U.G. Sprinkler for dwelling under const. 3.00 = STATE SURCHARGE .50 Reminder: Call 681.4675 for inspections of water heaters, water softeners, alterations, etc. J3g 90 TOT AL , --- -- ------------------------------ I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: ( 2" 1?-' 0-'2 (2/41K S OWNER NAME: INSTALLER NAME: P (r V' l SelvrL Ge6l f e iiTELEPHONE #,( (a) e,,,5' 10"v( STREET ADDRESS: 9)x01 l?7 ki L,y /yC ' CITY: I???( e STATE: ?'f// ZIP: 1-5- q cz!1 SIGNATURE OF CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 bll? CITY USE ONLY L BL RECEIPT #: ?Ov?38?a SUBD.? RECEIPT DATE: 3 ?Lw 1999 PLUM$INEc PERMIT (RESID RTIAL) CITY OF EAGAN 1 r 3$30 PILOT KNOB RD 3 7 $ S EAGAN, MN 55122 (651) 6$1-4675 Please complete for: > single family dwellings townhomes and condos when permits are required for each unit > backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Shower --3.00 x Water Closet -3.00 x Bath Tub -3.00 x 3. 00 Lavatory -3.00 x Kitchen Sink -3.00 x - pO Laundry Tray - 3.00 x T = 3.Oo Hot Tub/Spa 3.00 x = Water Heater _ 3.00 x = pV Floor Drain -3.00 x = TOO Gas Piping Outlet ' minimum -1 _3.00 x _ 'o-V Rough Openings _ 1.50 x Water Softener for dwellings under construction 5.00 x = Water Softener * for existing dwelling 30.00 x = U.G. Sprinkler for dwelling under cont. 3.00 = U.G. Sprinkler for existing dwelling 30.00 = Alterations * to existing residence 30.00 = Water Turn Around 30.00 = Private Disposal System MPC lic. 75.00 = (new and refurbished systems) Private Disposal Systems Abandonment 30.00 = RPZ (new installation/repair) 30.00 = STATE SURCHARGE .50 Reminder: Call 681-4675 for inspections of water heaters, water softeners, alterations, etc. 0 'j 4 TOTAL ' 3 --------------- ----------------------------------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: 0(=,?3`7 OWNER NAME: INSTALLER NAME- Cey! f Pl/` TELEPHONE #:(?Q) 7Z ga f STREET ADDRESS: A00 /0? 1- Al ITY: I i'y(g e STATE: ?^ ?° t yv ZIP: 6-5-vq AA SIGNATURE OF rERMITTEE CD/PERMIT FORMSlRPLBG PERMIT (RES) - 1999 / CITY USE ONLY BL RECEIPT #: / SUBD. (( ? 0A 4T RECEIPT DATE: 1999 PLUM$INfi'PERMIT (RESIDENTIAL) CITY OF £AGAN 3630 PILOT KNOB RD EAHAN, MN 55122 (651) 681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit backflow preventer for underground sprinkler system ------------------------------------------------------------- FIXTURES --------`--------- EACH ------- -----------' # Shower 3.00 x Water Closet ^ 3.00 x 'off - Bath Tub ^-? 3.00 x ? Lavatory - 3.00 x Kitchen Sink - 3.00 x Laundry Tray -- 3.00 x - Hot Tub/Spa 3.00 x »? Water Heater 3.00 x Floor Drain _ 3.00 x Gas Piping Outlet * minimum -1 3.00 x Rough Openings _1.50 x Water Softener for dwellings under construction 5.00 X Water Softener for existing dwelling 30.00 X U.G. Sprinkler for dwelling under const. 3.00 U.G. Sprinkler for existing dwelling 30.00 Alterations " to existing residence 30.00 Water Turn Around 30.00 Private Disposal System MPC lic. 75.00 (new and refurbished systems) Private Disposal Systems Abandonment 30.00 RPZ (new installation/repair) 30.00 Reminder: Call 681.4675 for inspections of water heaters, water softeners, alterations, etc. TOTAL 00 00 STATE SURCHARGE TOTAL X00 3.00 5.00 +50 .50 $6,00 - -------------- ----------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under thist permit within City property/right-of-way/easement. SITE ADDRESS: goe r=.(20n 04(5 9 t,N OWNER NAME: MI!' S INSTALLER NAME: 1 `UM6(VII ?t r TELEPHONE#: C6(;Q 7,50_g0gr STREET ADDRESS: Ot ?( v107 ? t,4 CITY: 73` z e- STATE: om q ZIP: Tl!?qg{ l SIGNATURE OF PERMITTEE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 -3 l/ CITY USE ONLY LOT / 131 RECEIPT #: SUDD.(?NA@p yam. d aRd C? RECEIPT DATE: 1999 MECHANICAL PERMIT (RESIDENTIAL) CITY of EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 I a tP09 (651) 681-4675 Date: Complete this section only if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U S 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @ $3.00 ea) C3.' 9.00 • State Surcharge: .50 • TOTAL: 39 -SO Complete this section orsly if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. X New - Replacement X Furnace Air exchanger, i.e. Vanee system, etc. Reminder: Call 681-4675 for inspections. - Repair _ Other Air conditioning Other $ 30.00 State Surcharge: .50 Total: $30.50 SITE ADDRESS: I ph 4J ' Lt URZ OWNER NAME: PHONE #: (bL ??O I tJ tNSTALLERNAME: ?4 fVIA(?n4 s?tre?D /1L PHONE #: u3LI--7jN1 STREET ADDRESS: CITY: STA' ZIP:G6 3 SIGNA 1S/FORMS nLDNECH PERMIT (RES) - 1999 CITY USE ONLY LOT BL SURD. Q Qom` Dai., C??- RECEIPT #: RECEIPT DATE: ??? 7 1999 MECHANICAL PERMIT (RESIDENTIAL) crrY OF EA6AN 3630 PILOT KNOB RD EAGAN MN 55122 (651) 681-4675 Date: Complete this section only if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U $ 30.00 ADDITIONAL 50 N1 BTU 6.00 • Gas outlets (minimum of one required @ $3.00 ea.) • 00 • State Surcharge: .50 • TOTAL: :53' Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. Y New - Replacement - Repair - Other Furnace Air exchanger, i.e. Vanee system, etc. Air conditioning Other Reminder: Call 681-4675 for inspections. $ 30.00 State Surcharge: .50 Total: $30.50 SITE ADDRESS: 0_J tit Un \ ukl OWNER NAME: RU, jdjA:?? /? PHONE #: '/I ?D) ?V 7C?J/ INSTALLER NAME: 1? I?L° I Ql t,(0A_0 PHONE #: 03 `I 77 l STREET ADDRESS: CITY: 1S/FORMS BLD/MECH PERMIT (RES). 1999 STATE: 09_r?) ZIP: Saa0_ . CITY USE ONLY 7LOT ?V BL 6d ?f?// / J RECEIPT #: ID3Cp d y 10 SURD. r Oqr&._ (S akd C/J RECEIPT DATE: 1999 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAEiAN 3$30 PILOT KNOB RD EAG" MN 55122 (651) 681-4675 Date Complete this section only if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U $ 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @ 53.00 ea.) • LSD • State Surcharge: .50 • TOTAL: 3 JU Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. * New Replacement - Repair Other Furnace Air exchanger, i.e. Vanee system, etc. Reminder: Call 681-4675 for inspections. SITE ADDRESS: Air conditioning Other $ 30.00 State Surcharge: .50 Total: $30.50 OWNER NAME: INSTALLER NAME: PHONE#: / m-qo7 ) PHONE #: _q311-W612 l oQY?'SI STREET ADDRESS: ) dl 11 L CITY: 'i.Y[fu 1S/FORMS BLD/M ECH PERMIT (RES) - [999 CLAIM VOUCHER - REFUND REQUEST CITY OF EAGAN MAKE CHECK PAYABLE TO: AIR MECHANICAL INC ADDRESS: 16411 ABERDEEN ST HAM LAKE MN 55304 LOCATION: 804 EAGAN OAKS LANE P.I.D./LEGAL: L6, BI, EAGAN OAKS 2ND RECEIPT #/DATE: 103382/03-03-99 VALUATION: REASON FOR REFUND: DUPLICATE PERMIT PERMIT #: ORIGINAL PERMIT ISSUED 01/20/99 TYPE OF REFUND: 1 $ Electrical Permit 3211-900 Plumbing Permit 3212-9001 $ Mechanical Permit 3213-9001 $39.00 Building Permit Fee 3210-9001 $ Plan Review Fee 3422-9001 $ SAC (MC/WS) 2275-9220 $ SAC (City) 3866-9379 $ SAC (Admin) 3446-9001 $ Water Connection 3865-9220 $ Sewer Permit 3743-9220 $ Water Permit 3713-9220 $ Account Deposit 2252-9220 $ Water Meter 3716-9220 $ Water Treatment 3868-9220 $ Surcharge 2155-9001 $ Utility Acct Overpayment 2250-9220 $ Curb Box Deposit Refund 2253-9220 $ Construction Meter Dep Refund 2254-9220 $ Water Usage Charge 3711-9220 $ Other $ TOTAL $39.00 1 declare under the penalties of law that this account, claim, or de mand is just and that no part of it has been paid. ? March 8, 1999 SIGNATURE V / DATE CITY USE ONLY LOT cc_QQ BL RECEIPT SUB D. CS-Q Sala 02? RECEIPT DATE: 3??99 1999 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3$30 PILOT KNOB RD EAHAN MN 55122 (651) 681-4675 Date: Complete this section onl if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U S 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @ $3.00 ea.) 7.0U • State Surcharge: .50 • TOTAL: ?? 39 Complete this section o lvly if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. New _ Replacement Furnace Air exchanger, i.e. Vance system, etc. Reminder. Call 681-4675 for inspections. Repair _ Other Air conditioning Other $ 30.00 State Surcharge: .50 Total: $30.50 SITE ADDRESS: y ?jp n (? OWNER NAME: PHONE#: (()(Jr l"7?7C? INSTALLER NAME: _ +AttlU qq?? PHONE #: `i ?W ?I7y ? STREET ADDRESS: "7 ILoUI? tnpw-A- - CITY: 1 p1 pt a STATE: :.- Ato 1S/FORMS BLD/MECH PERMIT(RES) - 1999 SIGNATURE 07/22/1999 11:37 6128585818 KAY HAMILTON / 6128585818 MN HOME MTG Z JACOBSEN PAGE 01 805 Eagan Oaks Lane Eagan, MN 55123 July 22, 1999 Tim Lang Lang Builders, Inc. 620 Civic Heights Drive Suite 100 Circle Pines, MN 55014 Dear Tim: via facsimile hard copy to We want youu_to know that there is still standing water due to a di behindSunits 801-807. The water is standing so deep, the new s This situation has deprived lus of the use of our grounds and the our property, as it did last year. We are also concerned about V mosquitoes; which the standing water encourages. The lack of proper drainage has been an on-going problem for When it was addressed Iasi'{ year, drain tile was to be installed around both ends of units 8101-807. This was not completed a northwest end. This summer sod was laid without completion Further, the grade out to E2lgan Oaks Courtremains uphill, for pool behind our four-plex.-WVhen this was _b o ght to your atte painters was assigned to lift up the sod and place rocks under the standing water. This is not an acceptable solution. Your a incomplete and the lack of proper drainage still results in stanc We ask that you give this matter your immediate attention and discuss the steps you will take. Sincerely, Kay Hamilton Lani Jacobsen cc: Bill Adams, City of Eagan John Gorder, City oP Eagan Rus Matthys, City of Eagan Kay Sands, PersonO Touch linage problem d is floating. enjoyment of proliferation of ere than a year. find and nd the he tile. a the water to n, one of your Ith to alleviate ?npts have been I water. us to CERTIFICATE OF SURVEY PREPARED FOR: LANG BUILDERS INC. ?9, 6a .SOP / Q E-1 O O z w 90• i,L2 A ? °O .?OF 8g8 SOY 4 i i i 10 *00 t + b°V Op 6p. Opp X600 LEGEND 8 o Denotes Set Wood Hub and Nail o Denotes Sanitary Sewer and Water Se z 894.1 Denotes Existing Elevation X 94. Denotes Proposed Elevation Denotes Existing Curb BENCHM Top ARK Nut of Hydrant at NW Corner of Intersection Trai ls End Road & Eagan Oaks Court. Elevation= 888.15 LEGAL DESCRIPTION LOTS 5-7, BLACK 1, EAGAN OAKS 2ND ADDITION CITY OF EAGAN. DAKOTA COUNTY, MINNESOTA. ADDRESS OF SITE LOT 5 = 808 Eagan Oaks Lane, Eagan, MN LOT 8 = 804 Eagan Oaks Lane, Eagan, MN LOT 7 = 802 Eagan Oaks Lane, Eagan, MN CERTIFICATION I HEREBY CERTIFY THAT THIS SURVEY, PLAN OR REPORT WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION AND THAT I AM A DULY REGISTERED LAND SURVEYOR UNDER THE LAWS OF THE STATE OF MINNESOTA. o wzt-? DATED: 22 WALLACE R. HANSEN R.L.S. NO. 24330 C= ENVIROSCIENCE ENGINEERS •SCIENTISTS •LAND SURVEYORS 10200 VALLEY VIEW ROAD SURE 151A EDEN PRAIRIE. MINNESOTA 65344-3544 . (812) 9144455 000" po r,:, Op ?6p p0 6p'? 889. 42 ?s 9r` ?,Cf''' I9 6y T/C J P 892.55 A ^ 0 00 os? zo O SCALE: 1" = 20' P R T/C 89760 892.16 S `c_Yrs soot' ° ® $ pOpp p?' S? ?y0 G??EI??s 888.3? ?? ? 6 Op #<, 55 + a8 °o T/C Y 891.55 CCatch Basin °.a TOP = 890.90 ?e90 ? `fli 00 o `ms A 's 00 ? 't® Six 419 ev LINE OF OAKS 2ND ADD Z?z?_ Pte. BUILDING PERMIT APPLICANT Lang Builders Inc. 3702 Bunker Lake Blvd. N.E. Ham Lake, Minnesota 55304 4110/. City of Eau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit#: X36-54 Permit Fee: /06*- Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION 5/25/2016/^ Date: Site Address: 0 �— Ea « Com.v-a (� IC La,yL Unit #: J Resident/ Owner Type of Work Name: Eagan Oaks Town Home Assn/tiu �a.l Phone: 952-238-1121 Address / City / Zip: c/o Personal Touch PO Box 5233 Hopkins, MN 55343 Applicant is: Owner ✓ Contractor Description of work: Garage door replacement Construction Cost: $1 ,1 52.64 Multi -Family Building: (Yes ✓ / No Contractor Company: Custom Door Sales, Inc Contact: Amy Egan Address: 5005 Hillsboro Ave N City: New Hope state: MN zip: 55428 Phone: 763-535-0042 Email: aegan@customdoorsales.com License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: Fire Suppression Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classed as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Buildin . ust be completed within 180 days of permit issuance. x RY x 1 j Applicants dad Name ppli-a 's Sig ture Page 1 of 3