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1770 Crestridge Lane BUILD'rNG PERMIT CITY OF EAGAN N• ? 7924 3795 Pilot Knob Road Eegan, MN 53112 PHONF: 454-8100 GARAGE & PORCH Ed, yal,x $16, 000 ReceiPt # 2 ;7?, DateApril 13 _ ly83 Site Address 1770 Crestridge Lane Lot 6 Block 3 See/Sub. Ridge View Acres parm] # 10 64000 060 03 oc Name DOllg Wi11S W ? nddress 1770 Crestridge Lane r-,...Eaean 55122 eL_- 454-3787 Z? °u§ 1- Name _ Address Noma _ Address 1 hereby ockrrowledge that I hove read this applicotion and state that the intormation is correct nnd ogree fo Wmply with all applicable State of Minnewta Statutes ond Cify of Eagon Ordirances. Slpnofure of Permittea A Building Pertnit is iuued to: Doug ali work :hall be done in acwrdance with oll Erect ? Occupanty-?? Alter ? Zoning Repair ? Fire Zone NA* Enlarge ? Type of Const. V Mova El # Stories Demolish ? Length22 Grade ? Depth-a8---Sq. Ft.- Approvols Fees Assessmenf _ Water & Sew. Pollce _ Fire Enp. Plonner _ Coundl - Bldg. Off. _ APC _ Permit tto.jv Surthorge 8.00 Plon check 58.25 SAC Water Conn. Woter Meter Road Unir Torol $182.75 _ on the axpreu tondition thni and City of Ea9an Ordinances. Building Offitlol CITY OF EAGAN 8795 Pllot Itnob R+oad Eagaw, MN SSl?4 r r> .? N ? ??? 2)? PHONE: 4544100 BUILDING PERMIT Receipt ?t •?' ?? ??/" Te Muted for GARAGT & FOkCH Est. Value $16, 000 DateA._Pr11 13 ?q 83 Site Address- 1770 CrestridQe Lane Erect ? p«„pancy R-3 Lot 6 Block 3 Sec/Sub. ;'?1d.ge Vy' ew Acres _. Alrer p Zoning R~x Porcel # 10 64000 -)GO 03 Repair ? Fire Zone vA* Enlorge ?. Type of Const. V oWe hlame Doug tdills Move ? # Stories = Address 1770 Cr.estridPa Lane ? Demolish ? Length_22 ei I'.a?ar. 55122 phane 454-3787 Grode p Depth_333-Sq. Ft. ?Jwner o Nam@ ADProrals Fees o? Address Assessment 50 Permit 116. u? Cit Phone Woter 8? Sew. 5urcharge $•`?`? Police Plon check 58• 25 ? ? FZ N°^1Q Fire SAC y? ?reu Eng. Woter Conn. i W Gi pho.,e Planner Water Meter Council Rood Unit I hereby ocknowiedge that I heve read this application ond stote that gldg. Off. the intormotion is correct and ogree to comply with all epplicable APC Totnl ?182.75 State of Minnesote Statutes ond City of Eogan Ordinonces. Sipnoture of Permittee A Building Pertnif is issued M: DQU; ; k'ills on the express condition that oll work shatl be done in accordonte with oll a icable 5tate gf.'-Minrre sSro-Stotutes ond Ciry of Eaqon drdinances. Buftdinq Officiol ? -? ' • ? Permit No. Permit Holder Mist. Permit No. Holder Plumbing H.V.A.C. Well Water Disp. Sewer Electric Inspection Date Insp. Other Footings r?? ow Foundation Framinq a Rough Ping. Rough HVAC Insulation Final Plbg. Final HVAC Final De3eri6e Location: Waur YYell Savuer ? Pr. Qisp. CITY OF EAGAN Remarks Addition Ridge View Acres Lot 6 Bik 3 Parcel 10 64000 060 03 OwneZb??)F.C 'v 5treet 1770 Crestridge Lane state Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. -3 5 1977 1484.05 148.40 10 STREET RESTOR. GRADING SAN SEW TRUNK y 1968 $100. 00 $3. 33 30 PAID dcSEWER LATERAL & Stub 1972 20 WATERMAIN *WATEFi LATERAL & Stub 1972 ZO WATER AREA Pjai d w nnectinn + ? _ STORM SEW TRK 1983 561.00 37.40 15 *STORMSEWLAT & Stu 1972 3175.99 158.80 20 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $320.00 9294 10-23-73 BUILOING PER. sAC 5375.00 8744 8-10-73 PARK IX EAGAN TOWNSHtP BUILDING PERMIT Ownen "'-° ---'-°- °-------" •-:..................................... / ° -- - ......Address (psesen!) 3 9`?..`. ?'"`? , ................ °°°'.................................. ._----`--- Builder .._............?`.'!?? .................. Address ......... 61;? .`f o ......_. ...-?0?'^'_!'? DESCAIPTION N° 3100 Eagan Township Town Hall ?3 Date ...... --3 Siories To Se Used For Front Dep1h Heigh! Esl. Cos! Pezmi! Fee Remarks ? _- __ / . ?u 3d` 33 ??(o ? s v?v to sAG 3c" '-'? or LOCATION I 7 7 O This permit does not aulhorize the use of sieeefc, roads, alleps or sidewalke nor does it give the owner or Lis agent the righ! !o creale any silualion which is a nuisaaee or which presen2s a hezazd fo the heallh, safeiy, convenience aad genesal weliare !o anpone in the communilp. THIS PERMIT MUST BE K?PT ON THE PREMISE WHILE THE WORK dS IN PROGRE S. This is !o certifp. lhat...._/C!/:..???.--_.-._--.--..-._--..has permission !o e:eet a...._-----_......--- °............ --upon ' the above deacribed premisa subjeci fo the provisiona of the Buildiag Ordinanae for Eagan Townshi adopied April 11, 1855. .................. . n_....•.".'.D.`.-?'? "`"''-_-.. ,-?..,.,.?.-..".".?.""v" ??_/? O?-?? . . . u' ? - - - Per .._................................................ ...p...--..-...-.---........._°- ........_C?hairman_ .: of 1Xwn Soard " Buildin Im eclor g VILLAGE OF` NAGAN 379$ Pilot Knob N.oad' Eagan, Piinnesota 55122 PERMIT N0, als The Village of Eagan hereby grants to *,,,„Ql AQ wilia ? of ni.,nnw.r nriaa a pLMIRZM Permit for: (Owner) gQgo nmQlas W111s at _3770 CrgatvjA Cjg T„ o ? pursuant to application dated 12/21/73 Fee Pai.d: 6=0 nn dated this _21?t day of 1,9 73 - .50 s/c Building In:pector Niechanical Permits: Bid Total; , 63 Zd?eui?J VILLAGE OF EAGAN 3795 Pilot Knob Hoad Eagan, Mimlesota 55122 PERtqIT NO.: 437 The Village of Eagan hereby grants to Suburban Heating Co. of 2050 White Beu Avenne, ,3t. Paul 55109 a raQamzxc. Permit £or: (Owner) F7ouglas Willa at 1770 =s*r{dqg Lano .pursuant to application dated 11/21/73 Fee Paid: S2e.o0 dated this lbth day.of Non. ? 79 73 .50 s/c Building Inspector Mechanical Permits: Bid Tocale CITY of EAGAN BUILDING PERMIT ../. Ownes .... C.2.51 7 ..........4?{/.s-.f•.?.5 .......................................... Addseu (Precenf) ..... !••.7.2-6 .----- Builder .....................CJ-7e.14 ................ ................................ .... Addreu ........................•--................................................................... DESCAIPTION A iy N4 3495 3795 Pilo! Knob Road Eagaa, Minaesola 55122 454-8100 Dale ..l?.:.??...?.? ................. / 6fosiea To He Uaed % Fronf Dapih Hetgh! Esl. Coe! , efflmit5reev _ Remarlct ? 6?+ or LOCATION C? This permit does not aulhorise the use of slseelc, roade, alleys or sidawalks aos ddes it give the dwner or his agen! the righ! !o create eny aituafion which is a nu3senee or which presents a hasard !o ffia heallh, eafelp, eoaveaieace end genezal welfare to anpone in the communi2p. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS. This is !o cerSifp, ihal .................. .°--......................................... has permission !o arect a......................... ..................... ......... _.._upon the above describe?J remise subjeci fo the provisions of all applicable ' nces for ihe of Eagan ..'---•" '-L....'?_...l..? .............................. . -... Per .....- -....--.--..-?...--?" ' .......................................... MaY or Buildinq Inspecfor `?i ` G??C?Zy' cz? oF ?c,Arr . . BUILDING PERN'ILT APPLIC ' ? ` rlu se vsed Fbr 6r ALEI3 SEi41: AaWuation Site Address ??? e?Q Es 7?a IOc- Iot _V(Oslock 16 ?; sec./sub. Rt0iEUjFi,dJW&t - Parcel #: Jb V(000 OCeO 03 Alter ormer: 00 d 6 GvI[ &-J Address: n? o LRe: 7WroA.F City/Zip Code: 0,46 AM`7N Pnone #: YfY? S7d7 Contractor: Address: City/Zip Code: Phone # : Arch./Eng.: A / H -7V O/ Address: City/zip Code: Phone #: Include 2 sets of plans, 1 site plan w/elevations & ATION 1 set of enerqy calculations. a/ Date y.?/ 3^if ? ? OFFICE USE ONLY ?--- occupancy 3 zonin?g Rapair Fire Zone Enlarge? 'itlpe of Const. Move # Stories Deirolish Fxont o24. ft. Grade Depth ft. APPI.'OVAIS FEES Assess[rnnts Pexmit / fdater/Sewer Surcharge ? - ?? Police Plan Check ,5'S" Fire ? zw_ gig, Water Conn. plynner Water Meter Council Rnad Unit Bldg. Off. APc _ 9 76 un'-? TOTAL ? ? a2 ? vuLAne cf tnaaN SEWER SERVICE PERMIT 3795 Pilot Kno6 Road PERMIT NO.: -? 132 _ Eogon, MN 55122 Dp'PF;: 12?21/73 'Loning: A-1_ No. of Uni[s: -I - Owner:.-_p0ygl3s-Wi11s --, Add " ress: -- Site Address: ?1.770-SSEBtLld9P T'anQ " Plumber: sdme _ 1 ogree to comply wifh tha Villaqa of Eagon Connection Charge375.00 pd 8 10, Ordinances. Accoun[ Deposit: Permit F'ee: _I ^ n--.....nn-?-- Surcharge: --..50_pd n gy_ Misc. Charges: ?-?.? bate of Ins? 'Cotal: Insp.: Dare Paid WATER SERVICE PERMIT VILLAGE OF EAGRN 3795 Pilot Knob Road PERMIT NO.: 1383 Eagan,MN 55122 DATE: 12?21/73 Zoning R-1 : -- No. of Units: 1 7A4 wi 7 7 D s "- a19. Owner: Address: Site Address; -1270Crnatri dS}€ T'^° - amP b er: S Plum Meter No.: -?2988985 Connection Charge: 320.00 Pd Size: 5/8 Roek Account Uepositr Reader No.: 482674 _ permit Fee: 10.00 pd , 50 pd3Y9H 1 ogrea fo comply with tha Village of Eagon Surcharge: Ordinonces. Misc. Chazges: To[al: _ g Date Paid: y Da[e of Insp Insp.: REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os , Seeinstructions br complating thls form on back ot yellow copy. ~^ / 2 L? 37191 "X"' Selow Work Covered by 7his Reques! Add Nep. Type of Bulldin0 AODliancns Wiretl EquiVC,enl Wired Hume Range Temporary Service Ouplex Water Heater Llyhtiny Fixtures Apt. Buflding Dryer Electric Heaun Commerci.al Bldy. Fumace Silo Unloadnr Industrial HIAg. qir Conditioner Bulk Milk Tnnk Farm otne, 5oecirv Oiner ?sneclryl [ha? VbcViy Othpr 011-cr C.wnpu[C i/!SU@CflOq f?P tlP.IOW p Fee ServicefnVencaSize Ffee feetlers tt Fee Circults 0 to 200 qmps s 0 to 30 Am s A6ove 200_qm>s nps 31 to 100 q SwimminG Pool = Am?s Above 100_P.m Trans iofiners om5 Pdrtial Signs ection $ Remarks TO A E e?O w Rooeh-in Date r 1, th ctrical InsDector, hereby Final certily ihat the above I . ? inspection has bean ? made. i nis reQuesi vaia ie momre nem This req uest voitl 18 nwnths from J C 37191 ? /'[ ? 3 ?1: 6y Renuest Date ` Q y'/ y' Fire No. floapM1-in InspecHOn Neq ireA? E]Readv Nuw P(Will Notity Inspec- Wh ? :• O Q ?Yes No mr en PeadV L Licensed Elec[ric al Cminractor I hereby request insoaction ot above wner O electrical work ins<alled et Sveet Address, eoxbr Poute No. e ?' i G ` City S ? ?o r rr ? ecuon o. Township Name or No. Range No. Countv/? Occupant (PRINT) 1)ru` fa5 L. Wi (ls Phone Ne. Power Su?? pl?ier ? ' Address ?/Z r? Elecviral Fon[rac?or (Company ('L?? ?J? Contra?c/tor"s/ License No. 7 MailinA .4tl?J7r/es?s ICyontracm/r/-o?r?Owner Maki(n?pnstailationl (/'J/?? / (/? ?1?,. i /!? ? ?/ ? ?s r """ /?(?? Authprizetl Siynawte IConhact ?Owner Making installaVOnl ? Phone Numbcr 5c 7 - ? 1? 3 - !6 . ,1-?IiYY MINNESOTA STATE 80AHD OF ELYCTflICITV THIS INSPECTION flEpUEST ryILL NOT Griggs-Midwey 91dg. - Noom N-191 BE ACGEPTED 9Y THE STATE BOARD 1821 Universi<y qve..S<. Paol. MN 55104 UNLESS PROPEN INSPECTIpN FEE IS Phone(612)fi42-08D6i-- ENCLOSEO. REOUEST FOR ELECTRICAL INSPECTION ee-ooom-oe ? See insimceans lor compieting this farm an back oi yellow copy. y,yLL_.:i al S 'X" Below Work Covered by This Request ew Add Rep. Type of Building AppliancesWiretl EquipmanlWired Home Range Temporary Service Duplex Water Heater Electric Healing Apt Building Dryer Load Management Comm./Indusirial Fumace Other (SpeCily) Farm Air Conditioner Olher ispeatyl Gomraztark RemarksD•'??ea V Compute Inspectian Fee Below: # Other Fee # Service Entrance Size Fee # CircuitsiFeeders Fee Swimminq Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 - Amps Above 700 _ Amps Si9n5 Inspeclar's Use Only. TOT/?L f ? Irrigation Booms ? D Special Inspection Aiarm/COmmunication THIS INSTALLATION MAV 8E ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby AO09n"n Date ' Y certi(y that Ihe above inspection has been made. Final oa?e r OFFICE USE ONLV This request voitl 18 monfirs irom 44 170 mclion Repuire d / Ins eclion Ot?er Tna?o?9 '?^ all inspeclor han rea0y) ? Ready Now?W ill NotM Inspec?or Yes No Oa R dy??? IEl licensed contractor 0?wner hereby request inspectioa of above electrical work at Ciry Job Ahtleress (StreeL Bo/tp/O A-aute Nq.) /? ' 0 C?ih ? ? e -I(?r s1-I l.:f e C N Senion N0. T - ? Townshi0 Name 0r N4. J Rdng2 No. )LtuoanllPRINT; 'ower Supplier Jacmcal Gomracior iGOmperry Nama) ??+eo W n e-o'- MaiLng A?ss ?COnVaclor o, Ownar Mening X Irsstalla?ion) Autn tl7gnaw?e i? nU IDn?w^e? Making Inra?ielio L ? MINNESOTA STAT OARD OF ELECTHICITY Grig9s-Ml0way el g. - Aoam S-n3 teSl Unlversity Ave.. St. Paul. MN 55106 Phone (612) 15,12-0800 No. THIS INSPEGTION FWUEST WILL NOT BE ACGEPTEO BV THE STATE BOARD UNLESS PROPER INSPEQION FEE IS ENCLOSEO. 2004 RESIDENTIAL BUII.DING PERNIIT APPLICATiON City Of Eagan 3830 Pilot Knoh Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 'A 7-) d.0 6 New ConsWcUon Reaui2menL5 RemodeUF2eoairReouiremems 3 registered site surveys showing sq. ft of lof, sq. S of house; and aA roofed areas 2 wpies of plan (20% mazimum bl coversge allvxed) 1 set of Energy CakwWtions for fieated addifrons 2 copies of plan sFwwing beam 8 window aizes; poured found Oesign, etc. 1 srte survey for additions 8 decks lsetofEnergyCakulatans Addition - 'vidicatelfon„ftesepticsystem . . ... 3 copies of Tree Preservalron Plan If bt pWtted afer 711193 Rim Joist Defail Options selecfion sheat (bldgs wiM 3 or less uniLs Date !0 / z7 / Oq ,gCoustrucUon Cost Site Address 17-?O CA?IAC UniUSte # ,, iS- Description of Work ?/" J/ IT/,( ?T?,? /?n- l/`?,SCJL/ MulH-Family Bldg _ Y X-N Fireplace(s) _ 0 K 1 - 2 PropertyOwner Telephone# (6-5h !/\`7- 3/-Y-7 Contractor Address State ?? ?•' /7w?7. ?3 /VVV Zfp ???37 City /3 V«a(' Telephone#(7f-Z) OFa o7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Tvlinnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy COde Category , Residential Ventilation Category t Worksheet . New Energy Code Worksheet (Jsubmissiontype) Submitted Su6mitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review fee appiies. Licensed Plumber Telephone #? ) Mechanical Contractor Sewer/Water Contractor U`' Telephone #( Telephone # ( I hereby apply for a Residenrial Buil 'Tt d acl wledge that the information is complete and accurate; that the work will be in conformance with the o and codes of the City of Eagan and the State of MN Statutes; I understand this is not a pernut, 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 wiplk which requires a review and approval of p"1011i . _ sc-f?j ? 0 ? ApplicanYs P' ted Naxne Applic Ys Signature LOT: ? BLOCK: ? SUBD./P.I.D #: 1{I Q a' ?V1I ? C Y Q S 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830PILOTKNOBRD-55122 651-681-4675 New Construction Requirements ? 3 registered sHe surveys showtng sq. R. of lot, sq. ff. of house and all roofed areas (20% maxlmum lot coveraqe allowed) Y 2 copies of plans (show 6eam 8 window stzes; poured fnd. design; etc.) ? 1 set of energy calculations ? 3 coptes of iree preservation plan ff lot plaMed affer 711/93 ? Rim Joist Detail Opfions selecHon sheet (bufldinas wNh 3 or less unBs) Remodel/Repair Reauirements Ca ?? 2 copies of plan 1 set of energy calculatlons tor heated additions 1 site survey for exterfor addifions 8 decks !2-ti -j HM DATE: l Z^ (.- D O CONSTRUCTION COST: CI d'D'D. ev ?G.-s D e c-K DESCRIPTION OF WORK: -<c ttegu -?ifmu(ti-family bldg., how many units? STREETADDRESS: I-i i o L2FS7-fLt D66-- t,nD Name: v 1[.4-.s f)oylrt-/a-S Phone #: 69l-41S?1-3 7? 7 PROPERTY Last Fint OWNER Street Addresr. 17'1 O C 2 EST2 #DGa 6. A/ • City E A G A r., State: M AJ Zip: Company: Phone #: (area code) CONTRACTOR Street City State: ARCHITECT/ ?? ENGINEER Company: Name: Telephone 8: { Sheet Address: Clly State: Sewerlwaterlicensedplumber(ifinstallingsewer/water): C//y Phone#: Zip: Zlp: I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applica , OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Requir ? DEC 0 6 2000 ?D Regisiration #: License # Exp. OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex 0 13 76-plex ? 20 Pool O 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace 'W 21 Porch (3-sea.) ? 31 Ext. Alt - Muiti ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Parch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous p 31 New ? 35 Int Improvement ? 42 Demolish (Foundation) ? 45 Fire Repair ? 32 Addition ? 36 Move Bidg. ? 43 Reroof ? 46 Windows/Doars ? 33 Alteration • 0 37 Demolish (Bldg)' ? 44 Siding ? 34 Replacement ? 38 Demolish (Interior) ' Demolition (Entire Bldg only) permit - Give PCA handout to applicsnt VALUATION .S, dz?) a Occupancy MC/ES System - Census Code ? Y-? Zoning JQ' ? City Water SAC Units Stories - Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width INSPECTIONS REQUIRED _ Foorings: New Bldg Footings: Deck ?I Footings: Addition Foundation 7" Framing APPROVALS Planning Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Suppiy 8 Storage S&W Permit 8 Surcharge Treatment Plant Park Dedication Trails Dedication License Search Copies Other Total: Insulation _ Windows-new/replacemeut FinallC.O. _ Siding FinaUNo C.O. _ Srucco/Stone Fireplace: _ r.i. _ air test final Roof: _ ice & water _ final Pool: _ ftgs _ air/gas tests _ fmal Building ? Engineering Variance Sc`- ee/Z pp ??? ? ? t ? I r r , Lo7-? GLKS ?-3 1770 ?RFsi A'/fJ?E L,q v??0:5 k-, A MASTER CARD STRUCTURE AND r ? _ . LAND USED AS Sb X J? ?? ? ?sA Permii No.. .'Issued I Con}rac}or ??V u V Owner BUILDING 0 y? ? PLUMBWG 145 CESSPOOL - SEPiIC iANK -- VJELL ELECT2ICAL HEATING GAS INSTALLING SANITARY SEWER 9 ?3 "j. L OTHER /38 `f I 07HER ! I Items Approved (Initial) Date Remarks Distance From Well FOOTING ? SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL ? I HEATING I f ? ? y ?+ DEPTH OF WECL GAS INSTAILATION I SEPTIC TANK CESSPOOL DRAINFIELD PLUM8ING , • ? WELL SANIiARY SEWER Violations Nofed on Batk COMMENTS: ? . OWNER D,....- I_ . . / . /L ? 34 U4 rlL MASTER CARD OWNER STRUC7URE AND LAND USED AS Permit No. _ Issued Issued To Contractor I Owner 6UILDING PLUMBING -349T ? '. agw? CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER I OTHER ? I ' Items Approved (Initial) Date Remarks Distance From Well FOOTING ? SEPTIC FOUNDATION CESSPOOL FAAMING TILE FIELD fT. FINAL ELECTFICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINfIELD PLUMBING WELL SANITARY SEWER Viola}ions Noted on Back COMMENTS: -;P,3i ra 4- oT ?, GZ e y 1770 ulca - o? Z A N? ?? Use BLUE or BLACK Ink r For Office Use M01 Permit City of Ea I Permit Fee: • a 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ClaS T E' Unit Name: Phone: 11o -7 Resident/ Owner Address / City_r ip: C- Applicant is: Owner Contractor i Type of Work Description of work: Construction Cost: ©C Multi-Family Building: (Yes / NoK Company: Contact #?-yL~ .-G S / City: D Contractor Address: State: Zip: Phone: 8 J License G 6Q- :Z 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 _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. C 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.orn 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 x Applicant's Printed Name Applicant's Signature Page 1 of 3