1521 Covington LaneA- (RESIDEN IAL
. BUILDING PERMIT APPLICATION
. CITY OF EAGAN lry)
830 PILOT KNOB RD - 55122
651-681-4675 0 P ? g-?--? 4 q o ?
NewConstructionReauirements ` ' ' lbetifodeVReoairReauirements
• 3 regislered sile surveys showing sq. fl. of lot, sq. ft of house; an?ll roo ed areas • 2 copies of plan
(20%ma)imum lot coverage albwed) . 1 selof Energy Calculations for heated ad ihons? ? g a?
. 2 mpies of plan showing baam 8 window sizes; poured found desgn, etc.) . 1 site survey for e?Aerior addi0ons 8 decks
• 1 set of Energy Calculations . Indicate if home served by septicsystem foraddihons
• 3 cop(es of Tree Preservafion Plan it IM platted a(ter 7/1193
• Rim Joist Detail Options selecUon sheet (hldgs wilh 3 or less units) l - `D-`1 b y
DATE
JOB SITE
IF MULTI-FAMILY BUILDING, HOW MANY
PROPERTY OWN
TYPE OP
ADDRESS .
PAGER # CELL PHONE #
FAX # 954 73-
i. 1-k- [a lo; , 1 rl ?
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RUI.ES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor: ,JL_ _ .?[.1?nj Phone #: 9_5 2- V(-9a
Plumhing System Includes: _ Water Softener _ I.awn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Balhs
No. of Baths
_
J'rZ "
r-
Mechanical Contractor: Phone #% J
Mechanical System Includes: _ Air Conditioning Fcc: $70.00
Heat Recovery System
Sewer/Water Contractor: y/y
i
' ? ?pnt
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the info n i ?fctg?e to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinanc . •
SignatureafApplicant
Certificates of Survey Received -:so_ Tree Preservation Plan Received Not Required _
Updated 1J01
Q?-2_ S-ev v0.?t-i o ?, -?
FIREPLACE(S) _ 0 1 _ 2
PHONE# I
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
A 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AIt - Multi
O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
O 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
?.? ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
V
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/E
S
t
a
ua
on Occupancy ys
em
C
S
Census Code
Zoning
City Water ?
Y/k's
SAC Units Stories ? Booster Pump
Nbr. of Units Sq. Ft. PRV V/ ?
Nbr. of Bldgs ? Length 7 ! Fire Sprinklered
.?
Type of Const ?j_ Width q
(n / /
? REQUIRED INSPECTIONS
Footings (new bldg)
_ Footings(deck) FinaUNo C.O.
Footings (addition) Pl
? Foundation HVAC
Drain Tile
RooF Ice & Water Final Other
Framing-
1C Fireplace ?{, R.I. S AuTest _Final
? Insulation
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
5&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Pool Ftgs _ Au/Gas Tests _ Final
? Siding ? Stucco _ Stone
_ Windows (new/replacement)
??
9?/ q`?S?
4s,3?
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,
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333
FinaUC.O.
_ umbing
i
? Permd#: V?C ?/ I
I Permit Fee:
I
? Date Received: ?
I I
I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: W3 OI Qq Site Address: IS a? co U, ny-?pn Lv? _
Tenant: Jo?r, (`On?? ISLh Suite
RESIDENT I OWNER Name: JO?v\ Ponat+sC k Phone:
Address/City/2ip: Ln EziqaY1 SS?? °Z
Applicant is: _ Owner -Z-Contractor
TYPEOFWORK Description of work: Q-e ' foCT +-0e-Src12 p+v ?fe1/a7lor,
?
Construction Cost: ? S t O d U Multi-Family Building: (Yes _ I No Vl")
CONTRACTOR Name: C rP O- Ek }C ?lcf S License #:
Address. ?a?21 a ??;??h4atf Yh/'f- SO '
City: PA( Mf rS?Vn State: Zip: 540
bO'6 (g I C
Ph
t Lo r
P
one:
erson:
ontact
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 7 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheef • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 72 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 sbpportrny,documents thatiyou submrt aie
considered to?be, paBho informatfon??` Portions oP
?
-
°th ma
e ?nio?tion may be cla§srfied as`non public rf yoa provide speci lc reasons fhat, woutd permrt the Cify to 3p
'
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and wdes of the City of
Eagaq that I understand this is not a permit, but only an apphcation 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.
X1 n , t4 a." X4!l %da?
Appl n's Printed Name Applicant' Si ature Page 1 of 3
5G? G? L! C1 RESIDENTIAL BUII.DING
< < Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
A NEW BUILDING
New Consiruction Reauirements RemodeVReoair Requi2ments OHice llse OnW
3 registered sde surveys showirg sq. ft of lot sq. fl. of house; and all rooted areas 2 copies of plan Cert of Suney Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copias of plan showing beam & window sizes; poured found design, etc. 7 stte survey foraddi6ons & decks Tree Pres Not Reqd
7 set of Energy Calculations Addition - indicate if on-sde septic system _ Onsde SepUc System
3 copies of Tree Preservalion Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bldgswilli 3 or less unifs
Date -?,-/ _/3 / ca-
Site Address 15-a ( (n1! Air TU M1l Construction Cost /,24
I
L(}/J ? UniUSte #
Description of Work oi-w
Multi-Family Bldg _ YY
N
Fireplace(s) _ 0 41 _ 2
Property Owner Of{A} d. Rd pj! A1 Telephone #(6?
Contractor
Address
State City
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRtI
Energy Code Category Minnesota Rules 7670 Categorv 1
• Residential Ventilation Category 1 Worksheet
(J submission type) Submitted ?'?
• Energy Envelope Calculations I diFe ?
C?
Licensed Plumber
?.
Mechanical Contractor
Sewer/Water Contractor
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone # (
#(
$'70.00
eA Z" , ? I /.? ?e?
Telephone # ( J
I hereby apply for a Residential Building 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 the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
0offis ?.onlGr?cf¢
Applicant's Printed Name plic t's SignaYUre
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 D2-plex
? 05 03-plex
? 06 04-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Repiacement
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 OS-plex 5Y 18
` Deck
? 11 10-plex ?
19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screenlgazebo)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/DOOrs
'Demolition (Entire Bldg) - Give PCA handout to appiicant
Valuation )„b / ? Occupancy
Census Code L/ Zoning
SAC Units Stories
Nbr. of Units Sq. Ft.
Nbr. of Bldgs Length
Type of Const ? Width
Foorings(new bldg)
Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water Final
_ Framing
_ Fueplace _ R.I. _ Air Test Final
Insulation
&, -7 - 14 f,
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIREDINSPECTIONS
Final/C.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ AidGas Tests
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By TZ , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
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NINChOCk COMPLIANCE REPORT
Minnesota Energy Code
hINcheck Software Version 3.0
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 1-2-2002
DATE OF PLPNS: 01-02-02
TITLE: John Rongitsch & Robin Rooney Residence
PROJECT INFORMATION:
1521 Covington Lane
Eagan, NIIQ
Stonecliffe
COMPANY INFORMATION:
Lundgren Bros. Construction
NOTES:
Kenton "E"
9' Basement Walls
Side Lookout & Walkout
Double Say @ Nook
Angled Bay @ Master Bedroom
COMPLIANCE: PASSES
Required UA = 763
Your Home = 634
16.9t Better Than Code
Permit #
Checked by/Date
Area or Cavity Cont. Glazing/DOOr
Perimeter R-Value R-Va1ue U-Value UA
---------------------------------------
CEILINGS -----
1903 --------
38.0 ------
0. ----
0 ------------ -----
57
WALLS: Wood Frame, 16" O.C. 653 19.0 2. 0 37
WALLS: Wood Frame, 16" O.C. 1565 19.0 2. 0 88
WALLS: Wood Frame, 16" O.C. 1352 19.0 2. 0 76
WALLS: Wood Frame, 16" O.C. 201 12.0 2. 0 15
WALLS: Wood Frame, 16" O.C. 200 12.0 2. 0 15
BSMT: Conc. 9.0' ht/8.5' bg/9.0' insul 1156 10.0 0. 0 71
GLAZING: Windows or poors, Above Grade 78 0.350 27
GLAZING: Windows or poors, Above Grade 379 0.350 133
GLAZING: Windows or poors, Above Grade 256 0.350 90
DOORS 56 0.350 20
FLOORS: Over Unconditioned Space 114 30.0 0. 0 4
FLOORS: Over Outside Air 23 30.0 0. 0 1
HVAC EQUIPMENT: Furnace, 90.0 AFUE
- -------------------------------- --
COMPLIANCE STATEMENT: The proposed building
design
described
here is
consistent with the building plans, specificationa, and other calculations
submitted with the permit application. The proposed building has been
designed to meet requirements of the Min nesota Energy Code .
Builder/Designer ??(N??/VllG Da te D
?
Address 7.1p 5512?
I.ot 1 Blk 1 Sub i -e -( t-
THESE ITEMS WERE / WEItE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: i9?p? Yes No Inspector: y?
Final grade (6" from siding)
Permanent steps (garage) C?
Permanent steps (main entry) ? .
Peananent driveway ?f°
Permanent gas ?
Sod/Seeded grass
TraiUcurb damage V
Porch
Basement finish
Deck
-?..
Please verify with the builder the removal of roof test caps from the plumbing system ana me snuL-oU
the outside lawn faucet 6efore fteeze potential exists.
Contact engineering division at 651-4645 before working in rightof-way or installing undecground sprinkler system. ?
White - City Capy Yellow - Resident Copy Pink - Contractor Copy
Co6' ?
t
(SEE ATTACHMENTS)
Development (? I o?
Lot Number 1 Block Number ?
Address ( T Z\ C O? i t?;t t l i?-' L l?l r`?t
Builder ???t?pf-,?y N RizrS ? c, k) SC
Tree Protection Requirements:
Tree Fencing
Oak Tree Pruning (Immediately seal wounds during April 1 to July 37)
Therapeutic Pruning
Retaining Wall
Other:
Reolacement Trees:
Not Required
?< As Follows: Z C-??,LcZ`C 13 "T??G?f
?-? -rc: s1 -1 e: e 1 T)
Attachments:
Yes 'No
Additional Notes:
8? -
s
H:\ghove\2000fi1e1treepres\Tree Preservation Plan Summ3ry-2000
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LEGEND
O DENOTESSANITARYMIWFpLE
Srj ? OENOTESNYDWWi
DENOTESCATCHfl4SIN
5 DENOTESShNITMYSEYJER
y! DENOTES WATEPM1LllN
ST OENOTESSTORMSEWER
? OENOTESSTORMMANHOLE
n OENOTESSTORMRPRON
ppppp DENOTES PROPoSEO BOULDER RETAINING WALL
SETBACKS
MIN FROMTYAftD5ET94CK=30'
MIN SIDEYARDSEf&4CK=5',15'BOTNSIDES
MIN REAR VARO SETBACK=15'
anOVOSED TOP OF FOUNpAT10N ELEVATIDN- 95635
PROPOSEOWRqGEFLOORELEVATON= 9550
PROPOSEO LOWEST FLOOR ELEVATION= 997 6
IllLOFiSETIHOrvSPREMEASURFD TOHUNDRFDTHS
OF A FOOT ANO CAN BE USEDAS BENCHMARKS.
O DFNOTESIRON
MONUMENT
X OOCQ DENOTESE%ISTING
ELEVATON
(OOO.O) DENOTESPROPQSED
EIEVATION
DENOTES DIRECTION
OF SURFACE DRAINAGE
925.0 °EFwFTEocAeUARY
LOi AREAr= 11.885 SF.
HWSE AREA = 2,446 SF.
L01 AREA % ° 16.68R
,;;.
DENOTES TREE
TO B?E ?REyMOVED
+Vr1n
CHE'.72
TREE SUMMARY
PROPOSED CONDITIONS
9GNIflCaNT TREES - t iREE
7REE5 RENOVEUS t TREE
PERCENTAGE Of
TREES REMOYED= 1 ?REE = 100X
ALLOWABLE
TREE$ REMOVAL = 20%
=
a
2
MUST MAIXTAIN MININUN Tb SLOPE GMDE TO ACCOMODAiE VOSfINE URAIN0.GE
a TrtLE OPINION WAS NOT FUftNI5HE0 T0 THE SURVEYOR
NOR WA$ A SPEGFIG TRLE SEARCH FORIHE EXISIENCE OR
NON-IXISTENCE OF RECOROED Oft UNRECOROED
EASEMENTS CONDUCTED BY THE SURVEYOR AS PMT OF
iris suavEv
I hereby ceitiy Nat Nis is a We antl cortect rep2senlahon
of a survey of the boundanes of:
LOT i, BLOCK 7, PINETREE PASS 6TH ADDITION
DAKOTA COUNiV, MINNESOTA
And the location of all builtlings,'rf any, thereon, antl all visible
encroachments, if any, hom oron Said land. As suneyed by
me ihis 4ih day oF January, 2002
Gary R Germond
Licensed Land Surveyor, Minn. Lw. No.24764
REVISIONS BY
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ASSHONM
JOB NO
5402-839
> LOT SURVEY CHECKLIST FOR RESIDENTIAL
. BUILDING PERMIT APPLICATION
PROPERTY LEGAL: L b? / .?3'I"Ii 7 ?nr,7?ee. PcIS ? G
DATE OF SURVEY: /- 7- D?
LATEST REVISION:
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U DOCUMENTSTANDARDS
Y ¢
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? • egistered Land Sunreyor signature and company
? ? • Building Pertnit Applicant
[v?o ? • Legal description
? ? • Address
? ? • North arrow and scale
? ? • House type (rambler, walkout, split w/o, split entry, bokout, etc.)
?? ? • Directional drainage arrows with slope/gradient %
? ? • Proposedlexisting sewer and water services 8 invert elevation
ta'/ ?
d/ ? ?
? •
. Street name
Driveway
Ca" ? ? • Lat Square Footage
?j? ? • Lot Coverage
LR? ? ? • Benchmark
ELEVATIONS
Existino
/? ? • Sewer service (or Proposed)
[3 ? ? . Property comers
?? • Top of curb at the driveway and property fine extensbns
0/0 . Elevatbns of any exisling adjacent homes
? ra?/ ? • Adequate footing depth of structures due to adjacent utility trenches
? d ? • Waterways (pond, stream, etc.)
/ Prooosed
m? ? • Garage floor
d/ ? ? • First floor
d/? ? • Lowest exposed elevation (walkouUwindow)
6Y/o ? • Property carners
?? • Front and rear of home at the foundation
/ PONDING AREA fif aooiicab?l
? r?'/ ? . Easement line
? d ? • NWL
? ? • HWL
? [?" j ? • Pond # desgnation
? B? ? • Emergency Overflow Elavation
/ DIMENSIONS
o? • Lot lines/Bearings & dimensions
? • Right-Of-way and sVeet width (to back of curb)
GY ?? • Proposed home dimensions including any proposed decks, overhangs greaterihan 2', porches, etc.
(i.e. all structures requiring pertnanent footings)
2/1 ? ? • Show all easements af record and any City utilifies within those easements
? • Setbacks of proposed sWCture and sideyard sethack of adjacent exisGng sWctures
e? ?? • Retaming wall requirements, ff any
Reviewed:
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94$36 9433
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? RETAINiNG
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LOT AREA = 14,685 S.F.
HOUSE AREA = 2,446 S.F
LOT AREA X = 16.65%
DENOTES TREE
TO BE REMOVED
?
CHE 12
TREE SUMMARY
• PROPOSED CONDITIONS
SIGNIFICANT TREES = 1 TREE
. TREES REMOVEO= 1 TREE
, PERCENTAGE OF
; TREES REMOVED= 1 TREE - 100%
ALLOWABIE
TREES REMOVAL = 20% _
30 15 0 75 30 60
SCALE IN FEET
LEGEND
QS DENOTES SANITARY MANHOLE
yLY? DENOTES ITYDRANT
? DENOTES CATCH BASIN
5 DENOTES SANITARY SEWER
W DENOTES WATERMAIN
ST DENOTES STORM SEWER
Q DENOTESSTORM MANHOLE
n DENOTES STORM APRON
" ppppp DENOTES PROPOSED BOULDER RETAINING WALL
SETBACKS
MIN. FRONT YARD SETBACK = 30'
MIN. SIDE YARD SETBACK= 5', 15' BOTH SIDES
MIN. REAR YARD SETBACK = 15'
PROPOSED TOP OF FOUNDATION ELEVATION= 95635
PROPOSED GARAGE FLOOR ELEVATION= 955.0
PROPOSED LOWEST FLOOR ELEVATION= 947.6
ALL OFFSET IRONS ARE MEASURED TO HUNDREDTHS
OF A FOOT AND CAN BE USED AS BENCHMARKS.
p DENOTESIRON
MONUMENT
X 000,0 DENOTES EXISTING
ELEVATION
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(OOO DENOTESPROPOSED
. ELEVATION
DENOTES DIRECTION
OF SURFACE DRAINAGE
JZS
O DENOTES SANITARY
. SEWER SERVICE ELEVATION
F
0
2
MUST MAINTAIN MINIMUM 2% SLOPE GRADE TO ACCOMODATE POSITIVE DRAINAGE
A TITLE OPINION WAS NOT FURNISHED TO THE SURVEYOR
NOR WAS A SPECIFIC TITLE SEARCH FOR THE EXISTENCE OR
NON-EXISTENCE OF RECORDED OR UNRECORDEO
EASEMENTS CONDUCTED BY THE SURVEYOR AS PART OF
THIS SURVEY.
I hereby certiTy that this is a true and correct representation
of a survey of the boundaries of.
LOT 1, BLOCK 1, PINETREE PASS 6TH ADDITION
DAKOTA COUNN, MINNESOTA
And the location of all buildings, if any, thereon, and all visible
encroachments, if any, from or on said land. As surveyed by
me this 4th day of January, 2002.
REVISIONS BY
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CHECKED
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DATE
117102
SCALE
AS SHOWN
JOB NO.
5402-839
Gary R. Germond
Licensed Land Surveyor, Minn. Lic. No. 24764
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
-S%'-23d
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Name: ACG W4AJ
Address / City / Zip: ! 5?/ C O 0/;t2 1043 "L -
Applicant is:
Owner D‹ Contractor
Phone: es'/ -'3 ''/VQ3
Description of work:
13 d
Construction Cost: - 48.
Multi -Family Building: (Yes / No )
Company:
goiGcigeaS
Address: /7795- %J 6ct ,L3r i i
Contact: C #40
City: -+'t Ae %'�OW"G-
05��
State:� zip: 5-"WPhone:(0(2/l-Email: C �iebo:Gd44s, 41-e
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: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public infon.___.
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.
Om:, Portions of.
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.gopherstateonecall.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 Building Code must be completed within 180
days of permit issuance.
X G' -,en/ ido
Applicant's Printed Name
Applicant's Signature
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