4449 Cinnamon Ridge CirCITY OF EAGAN
3795 Pilot Knob Roed Eogon, MN 55122 " • PHON[: 454-8100 -• j -Xc, ?
BUILDING PERMIT
Ta Ir wNl inr 1/ .? "L'T-Pl,r'.Si it ?i.?:
I Site Addi
Lot Blkl Sej/s?'¢• _....?...,,.. _._ _
Pnrcel .#
.?u.....uucaa. aavaucca ? i?a1..
oc Nome
Z Addre 7760 Mitche 1 Road
9 _ Lc?en rairia -
o Nome _
?
v? Address
? r?•.,
Name _
Address
I hereby ocknowledge thot I hove read this opplication and stote thot
the inlormation Is correct ond agree to comply with oll opplicoble
Stote of Minnesota Stntutes ond Ciry of Eogon Ordinnnces.
Sipnnture of Pertnittee
A Building Permif is issued to:
all work shall be done in occordonce with
_? .
Receipt #
$ 51
Erect b Occuponcy n-_3
Alter ? Zoning
Repoir ? Fire Zone
Enlarge ? Type of Const.
Move ? # Storie„f
Demolish ? Length
F
D
Grode p epth Sq.
t.
Approvab Fees
Assessment
Water & Sew.
pol ice
Fire
Enfl.
Planner
Council
Bldg. Off.
APC
Permit
_? . _i?_r
Surchorye
i
Plan check
SAC
Water Conn. 451)• 0`'
n r• ?
Woter Meter , ,'
Road Unit
Totol ? " ? ? "
on the exprest condltion thrn
and City of Eagon Ordinances.
8ufldinq Official
Permit No. Permit Holder Misc. Permit No. Holder
P 3"7?j ?'?Z ? ? 'r6?3
-I, t ? W eq •l-' L ` ?O ??
Electric A 11 D 11
Inspection Oate (nsp. Other
Footings ,y
Foundation
Framing a
Rau9h PIb9. ?-
o •/9• /? 3 . ,
Rough HVAG ? ¦ '
Insulation °
Final PI6g
Final HVAC
Final , J
Water Describe Location:
YYell
Sewar
Pr. ?iap.
Receipt PLUMBING PERMIT Permit No. ?
CITY OF EAGAN ?
Fee
FiII rn numbered spaces S/C '
Type or Print /egib/y Tot. ?
1. Date 2. Installation Cost
3. Job Address LotBlk. 4 Tract
?
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
,
8. Building Type: Residential Commercial ? Institutional ?
9. Work Description: New `Cl Add O Alter 0 Repair O
I 10. Describe
I 11.
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Welt
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this tYpe of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt MECHANICAL PERMIT Permit Na.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print legibly Tot.
.J '
1. Date " 2. Installation Cost •
3. Job Address Lot - Bik. ` Tract •
4. Owner
5. Contractor Phone ,
6. Address '
7. City
impls.
SLBLB "
ZiP f)7
8. 6uilding Type: Residential CJ Commercial ? Institutional O
9. Work Description: New CI Add ? Alter ? Repair ?
10. Describe - ' Fuel Type
11.
No. Equioment 8TU - M. Ea.
Forced Air No. Equipment CFM
H
A
Mfg, ir
andling:
Boilers
Mfg.
Unit Heater MeCh. Exhaust
Mfg. O
h
Air Cond. er
t
Mfg,
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS•
' ;??I ?.# I.ilt?el
?+_ I ?;tlrtiM1?1?1 :r l1????: (: 1 i?
+ tirdl?f?uN i?. ! ui,l +1;1i
I PERMIT SUBTYPE:
f
n0 f l rrW:,
ON RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
.?
? tlrti{ i?
Ihl.'? tt`3A-9lH?l
TYPE OF WORK:
I f MAI
rI I i•I
ni? i4 iM41a
fb _' t. 4
wi /:,4)
? ?
wrmn Mo. Pennn Holde? oaM T.Npnone r
ELECTRIC
PLUMBING
HVAC
Inspectton Dah Insp. Comments
FOOTINGS
FOUND
FFiAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUI
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
?
DECK FlNAL
i[???7??7 i1:? .c_(• ?hcr? /LY
dt-p,nilr?7
slk6
CITY OF EAGAN Remarks 1?1`j ' 15 3 "?x v
Addition CINNAMUN RIDGE 3RD ADDN Lot pt Of 5 B1k
owner & !j :•.'J r',,- street 4449 CINNAMON RIDGE
MN 55122
;w c?? oso -
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ? 978-40 115-69 5 7$,40 C009$$5 11-13-84
STREET RESTOR.
GRAOING
SAN SEW TRUNK
SEWERLATERAL 414.02 C009885 11-13-84
WATERMAIN
WATERLATERAL x 352.75 C009885 11-13-84
WATER AREA 17 p i r originalA S 6
225.07 C009885 11-13-84
STORMSEW TRK 1979 Paid und r ori inal arce
STORM SEW LAT ? 1985 2 1 (?2].41 C009885 11-13-84
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 450.00 11
BUILDING PER.
SAC 575-00 11
PARK
Owner
OF EAGAN
? CINNAMON RIDGE 3RD
10-17402-050-04
Improvement Date Amount Annual Years Payment Rece' Date
STREET SURF.
STREET RESTOR,
GRADING
SAN SEW TRUNK 19 7 3 6.81 j 20.50 A013321 12-15-83
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1973 1 1 15 26.32 A013321 12-15-83
STORM SEW TRK 1979 381.6 9 19.08 267.21 A013321 12-15-83
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD I 500.00 37598ss 8-1-83
WATER CONN 900.00 it
BUILDIN R.
SA? ioso.ao of
JWNK
?
CiTY OF EAGAN WpTER SERVICE PERMR
3836 ?ila+? K nob Road ,, i' !! a.
P. O. Bo.. 21199 PERMIT NO.:
- -
a
5'
1 DA?:
???
Eagan, MN 5 1 up 1 er
Zo,yi?; No. of Unlts:
Zachman C 3
Owner.
fAdd`°s'' nnamon Rfd
4449 ge r L? C nnaman R ge rd
Site Addrcss:
6S Otl ' 3 v,
Plumber 45 0
Meter No.: ???i? ??:
ostt:
unt De
A
Size: p
coo ,. P',
'Reoder No.: Permit Fee: , ncl
1 qm to ooMrh? witii tM C'itr oi Eow¦ Surcharoe: 60.00 pcl raet er
Misc. Chorpes:
Totol:
B Dots Pnid:
y
' Dote of Irap.: l^mp^
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. o. Box 21199 PErtiwiT No.: 5005.
Eagan, MN 55121 DATE: 8-17-83
ln g: RZ No. of unirs: duplex
?r; Zachman HQnes
ro ?:
t
Addrcss: 4449 Ginnamon id
Plumber. Westanka S F W ge Cir L B4 G'nnamon R;dge:
AAeter No.: _3_ y 6 g/~f y? Con+xction Charqe: 450 _ 00 pd
51za: " R„4- Aocourrt Deposlr:
Reader No.: ogL- G 36 ?3 Permit Fee; _ 10.00 Ud
1osm eo oaeoy wnb the Cler ef 16040 Surcharge: • 5Q Pd
Ordiwseow. Miac. Choryes: 60_00 d mp e7
Totoi:
By Dots Paid:
Dote of Insp.: Irqp,;
CITY :AGAN SEWER SERVICE PERMR
3830 F ? Knob Road
P. U. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zordr+O: t` 2 No. of Unita: duplex
Owrnr• :'1?:'??::2?? ?i!):1E;S
Address:
Site Addi
Plumber.
3rc
1 pme te emoy wh6 Hw CiFr of agen Connection Charpa: 425, DO.,,,?ci r
Ordinamas. Acoount Deposlf:
Permit Fee: ? -
Surchow: '
Bv Mirc. Charpss:
Date of Insp.: Totol:
Insp.: Date Paid:
Ele ' al Contractor ICompany Name)
2 0tv c, r.L Contractor's License No.
d
Mailinp Address IContractor or Owner Making stailation)
?3? K? ? c,?,w ? , ?? ssy
Aut ized Signature (C tract Owner Making Installa ' n) Phone Numbe
MINNESOTA STAT BOARD OF ELECTRICITY
Griygs_Midway Bldg. - Room N-197
7821 University Ave., St. Paul, MN 66104
Phone I612) 297.2111
THIS INSPECTION REQUEST WILI NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
1z
ql' REQUEST FOR ELECTRICAL IN$PECTION ^ nonnt_na
See instructions Ior completing tMs form op back of yellow copy. ??
A 412A "X " BelOw Work Cnvnrpri hi. Th; ? aa.,..,,... ?
AAd
Rep. Type of Building
Home __ _, ...,., ....y.,?.,.
Appliancea Wired
Equipment Wired
R
n
Duplex ge
a
Water Heater Temporary Service
Apt. Building
Dryer Lightin,y Fixtures
Com
mercial Bldg,
Furnace Electric Heatin
Industrial Bldg.
Air Condition
S
ilo Unloader
Farm er
Other pec? Buik Milk Tdnk
t r
Veci y /4 s
th Otier (Sncr,ify)
ompute Inspection Fee Belo
w er
?
Other
# Fee Service EntrenceSize #
200
0 fee Feeders/Su6feeders # FAB
C?«??ts
to
Am s
Above 200 0 to30Am s Oto 30Am
qm )s
Swimmin Pool 31 to 100 41 nps 31 to 100 q
S
Transformers Above 100
_Am s
I
Above 100_Am s
Signs rrigation
Boorns
S
•S artial- Other Fee
ma
rks
I GKf 14 A c
F T(
cJ? N pecial Inspection $
,S T L F E +
a
,
.
Rough-in
Date
? 1, th ectr'
-/- ns
Fi
nal ?
pector, hareby
certify thgt the above
?? e
inspection hea been
TFIIg 1BCU981 void 19 mnnlha I- made.
This request void 18 months from q-? 14)--? , 0 1 ,-,1 Gc f
CITY OF EAGAN
9795 Pilat Knob Road Eogan, MN 55711
- ' PHONE: 454•8100
BUILDING PERMIT Receipt #
Site Addrexs 4447 cinnamon xiaQe circle (A)
Lot 5 Block 4 Sec/SubCinnamon Ridge 3rd
Parcel # 10 17402 050 04
? Na, Zachman Homes, Inc.
3 qdclfess 7760 Mitchell Road
° .-:..Eden Prairie 937-9520
rc
?
0
u5
C
Name _
Address
Nome _
Address
1 hereby ackrwwledge fhat I have read this opDlicution ond state that
the information is correct and ogree fo comply with ali opplicable
$late of Minnesata Statutes ond City of Eagon Ordinances.
Signature of Pertnittee
Zach
A Building Permil is issued to:
nll work sholl be done in acrnrdance wirh
N° 8308
3zsyf
Erect $$ Occupancy R-3
Alter ? Zoning (PD) R-2
Repoir ? Fire Zone NA
Enlarge ? Type of Const. V
Move ? # Stories
Demolish p Length 24-1
Gmde ? Depth 42 Sq. FL-
Aoorovals Feea
Assessmenl _
Wof¢r 8 Sew.
Pollce
Fire
Eng.
Vlonner -
Council _
Bldg. Off. _
APC
Permit too.vu
Surcharga 25.50
Plan check 143.00
SAC 525.00
Water Conn. 450, 00
Water Meter 60.00
Rood Unit 250.00
7oral $1739.50
- on the express condition thnl
ond Ciry of Eagon Ordinances.
Building Official
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
4449
LOT: 51
CINNAMON
P.I.N.: 10-77402-051•-04
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
CINNAMON RSDGE CIR
BLQCK: A
RI[7Gr 3RD
cp, W ?I
BUILDING
026422
09f29J95
DESCRIPTION:
B:IJ=ild$n?le+yarmit Type DECK
0, u-i.].dirzg Wt?jx=1s? Typa NEW
?
d0.
?r
? L £u p a
$ ? d...°}? h •
? ? ;: ?!4• `.N!.s ffiiSnN.v
:}.°,.•••• .s i 2
.?+ ,;? a6;?,ev
s °i ? El
Sea ?s" +?" ?. ?? ,n'a`s:'s e`s;??€?°?, ??'?q • ?
i'
--.:? .('? ( ,?
x _
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge
Total Fee $30,50
CONTRACTOR: OWNER: _ qpplicarit -
EWAID KELLY
4449 CTNNAMON RIt1GE CIR
FAGAN MN 55122
(612)894-0057
?
hereby "ack?noiwliOdgle? tYiat --1 hrai.9 e•- i"0, ad. t4i1,6 ?ApP 1??.aa`-C,S-?aR sta tg tGjla? th"
?
fn for^m,at%ori reCt;.attd, 'comr{aly wlthr? e_ iri ate
Stata-ts.l 4'ritl: Gityr ta€ 8agart, qrd"i n?nce?,.
?
?.
APPLICANT/PERMITEE SIGNATURE
ISSUED B SI M'A R
r i
C A L, V9 P1 H. N E D L lC D ? 7726 MorOan Avsnua soufn
Richtisld,Minneaoto 35423
Land Surveyor Clvll Enpineer phone : 866-2523
SURVEY FOR: Zachman Homes Inc.
DESCRIBED AS:Lot 5, Block 4, CINNAMON RIDGE 3RD ADDITION, City of Eagan,
Dakota County, Minnesota, and reserving easements of record.
6
ol;V14
?TAKES
RlDC E C IRC L E
5=o SOSTAKES
rO
?
IN 1
CERTIFIZATE OF SURVEY
Y hereby certify that on 7/14 /133 I surveyed ihe property described above and thot
the above plot is o correct represeniotion of soid survey.
7<e?./? W. ?W-a?
Calvin H. Hedlund, Minn. Reg. No. 5942
9340
Z? .
s?
0
/ s
?
\'P?
Top of FounAetion = `?24•?
$asem?nt ?/cors cz'2¢.?
,rarw9e Floov= ?23.7
ProPosed El?vvz?ons
Existi.,y Elcvoz;vns --'?
Drain4ye 'Ditracticns
Dencrcos Lot Corner 0
CINNAMON
' CITY OF EAGAN
5830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New ConstruCion Reauirements R•rtmdaLR?enair Reauuemertts
? 3 registeied 8Be surveys ,? 2 topies ot plan
? T copias oi pfans (indude beam 8 windav slzes; pomed fid. design; etc.) ? 2 site surveys (extarior add'Rions & dedcs)
? t errergy eakulations ? t energy calwlations for heated additions
? 3 copies ot tree pressrvation plen ff bt platted after 717/93 required: _ Yea _ No '
no
DATE: CONSTRUCTION COST: 5-0a
DESCRIPTION OF WORK: 1249,?k-
STREETADDRESS: 14414? ? yNnAwa"J • ???.- Ca't[-PjL-,
L07 _ajL BLOCK SUBD./P.I.D. #: CJ4¢yhj4jMr?f ,?V'-)A
PROPERTY NamelaJ64 &uJ? ?AWLA Phone #:
OWNER '"" `"
Street Address• !4 4 4 `t cA +? ?? 9=j&4 fi- c - ^"Qa?
City: Art,) State: N'1'?J Zip: Y?5-12Z
coNrrtACTOtt Company: IUAr • L i's't y SzfPhone #:
Stseet Address: License #:
City:
State:
Zip•
ARCHITECT! Company: A) )4
ENGINEER
Name:
Phone #-
Registration #:
Street Address,
City: State: Zip:
Sewer & water licensed plumber: . Penalry applies when address change and lot
change are requested once permit is issued. "
I hereby acknowledge that I have read this application and state that the information is cortect and agree to comply with all
applicable State of Minnesota STatutes and City of Eagan Ordinances.
5ignature of Applicant
RSc a QVV Pu
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No SEP 15 1995
Tree Preservadon Pian Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex
0 02 SF Dwelling ? 07 4-plex
0 03 SF Addition o 08 8-plex
o 04 SF Porch o 09 12-plex
0 05 SF Misc. 0 10 _-plex
WORK TYPE
New ? 33 Alterations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actuai)
(Allowable)
UBC Occupanay
Zoning
# of Stories
Length
Depth
APPROVALS
0 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
0 13 Garage/Accessory ?
? 14 Fireplace ?
,,,4 ? 5 Deck
0 36 Move
0 37 Demolition
?
16 Basement Finish
17 Swim Poot
20 Public Facility
21 Miscellaneous
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Planning Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
SIW 5urcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
MC/WS System
City Water
Fire Sprinktered
PRV
Booster Pump
Census Code. YJY
SAC Code
Census Bldg _L
Census Unit °
_ Engineering Variance
9
Valuation: $
.i
% SAC
SAC Units
Sept. 16, 1995
The executive board of the Cinnamon Ridge Twinhome Ass'n
have approved the plans for a deck to be constructed by
Kelly Ewald at 4449 Cinnamon Ridge Circle.
?i
errrison, President
aN H. HEDLI?. D
eyor Clvll Enqineer
AMW
Siiieticilotoos Ceirtifitirate
7726 Morqan Avsnue South
RlchfleId,Mfnnoaoto 53423
Phone : 866-2523
JOB NO.
SURVEY FOR= Zachman Homes Inc.
DESCRtBED AS: LOt 5, Block 4, CINNAMON RIDGE 3RD ADDITION, City of Eagan.
Dakota County, Minnesota, and reserving easements of record.
? -'rj
tiy
yb
Afo ?
931. o
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dS ,
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.v?
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k
o
N 1
N
m
t
m 1 - ?
,V? icF+
gcP??Wop ZV !'? ?.
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/ `C? 4\ \ \ \4n \
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.. I 923G ?
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0 ^+ i
yzz•3_ o ?
?o
4= y; r•. .
. io- '9t2.3.
?g.. ?
CINNAMDN
RIDC E C IRC L E
_ r or
pv
. ?
y
4.
h A
5=a? SThKES
x0
F-
O?
3
CERTIFIZATE OF SURVEY
I hereby certify ihot on 7 114 / g3 I surveyed The property described obove and ihot
the obove plot is a correct representation of soid survey.
(' u4?? W. -Ake??
Colvin H. Hedlund, Minn. Reg. No. 5942
?y
\ 'CA
?
\
Top of FounQet:on
BaStlrrer9t 7:100I s
4r7er.se Floov= ") Z3.7
PtopoSd-d E71wVac,o»S
E%istinjq EleVcmvpnS ---^
Drninaye -Doracticns
Denotas Lot Corner, 0
? -- _ _ _ _ _ _ - __ _ ' ` _ -?
? Permit#:
? Permit Fee:
I ?
? Date Received: ?
I '
j Staff: ?
L -----------------?
2008 RESIDENTIAL PL.UMBING PERMIT APPLICATION
Date: Site Addrasc-
Andrew Ocoruior
i enant:
4451 Cinnamon Ridge Circle
Eagan, MN 55116
RESIDENT I OWNER Name:_ 9524127552
Address / G. ,
CONTRACTOR
TYPE OF WORK
PERMIT TYPE
Name:
Addres
Phone:
Suite #:
Cih': ? State: r" Zip: W 554OtT
Phonel l{i I!i 1 T[1(' TM-Contact Person: Je J S
_ New _ Replacement
REStDENTIAL
X Water Heater
Lawn Irrigation
(_ RPZ / _ PVB)
Septic System
New
Abandonment
RESIDENTIAL FEES:
_ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
_ Water Softener
Add Plumbing Fixtures
? Main _ Lower Level)
WaterTurnaround
$50.50 Minimum Water Heater, Water Softener,,or WGter Heater and Softener (includes $.50 SYate Surcharge)
$30.50 Lawn Irrigation (includes $.50 Stata Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandorment, Water Turnaround* (includes $.50 State Surcharge)
•Water Turnaround (2tld $136.00 i' a 5;8" meier is reyuired)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, duclwork, etc.) (includes $.50 State Surcharge) 50
' TOTAL FEES $ SD, r-
I hereby acknowledge that this information is complete and accurate; that the wor e i nformance wiUl the ordl
Eagan; that I understand ihis is not a permit, but only an application fnr a per it, an ork is not to start wlthout a
accordance wiffi the approved plan in the case of work whlch require:? a review nd app va pl
xk )efFY'-cU L. NloYbl awu X
ApplipanPs Prfnted me Ap Signa ure
Oct 18. 2013 9:01AM Crest Exteriors 651-463-8095 P. 24
Use BLUE or BLACK Ink
^__w---------------
For Office Use L~
j Permll
City of Eap I Penult Fee:
3830 Pilot Knob Road I I
Eagan MN 66122 j Dale Received: j
Phone: (661) 676-6676 Staff:
FaX:(661)676.6694
i 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1~ Site Address: Unit!!:
NameAV1 r 6L) Y /r Phone:
R
01 nYt~ L
Address / Ci / Zip...
~`~0 ner- ~ ty Applicant is; Owner V Contractor
,y e e Description of work;
Construction Cost: W Multi-Family Building: (Yes ^ t No
Compan
y_ Contact:
ms's;~• ~'~'r~ J ~a: .
.w. Address: Z I X11 -,4 fy,5 O( )j f e ity: no IS
o a or
ry1 Slate: m N - zip; Q Phone* 69 I L.:c~ i '22
License ESC -11 2 2 1 6 Lead Certificate
If the project Is exempt from lead certification, please explain why; (see Page 3 for additional information)
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 ZNo If yes, date and address of master plan:
Licensed Plumber; Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
0 /a s a d sup" ortin do o "c s d `e" fo i" Wile Info m tion. ) irfi ns.of.
nfo~ 0 e c rallffil n that tvolrt/tjge m rs
CALL BEFORE YOU PIG, Call Gopher State Ono Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locales of underground utilities, www ao0 tateteoneoell.oro
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 worts will be In
accordance wllh the approved plan In the case of work which requires a review and approval of plans.
Exterlor work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
X X
Applicant's Printed Name Applicant's Signature
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