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713 Hay Lake Rd N Use BLUE or BLACK Ink - - - - - - - - - - - - - - - - - ;[.t I Permit C ity Eapn of /\l 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 j Date Received: Phone: (651) 675-5675 l I Fax: (651) 675-5694 l Staff. l 2010 , MECHANICAL PERMIT APPLICATION Date: Site Address: Tenant: Suite RESIDENT I OWNER Name: P e: LOW -L (x)w '1QjJW - I W Address I City / Zip: a CONTRACTOR Name: D`C~~ -U- Bunt aI_I~IGt (~C tense t'~ Address: -Boy V f'V I'll j"I j~~~ State: YM Zip:-- C~ Phone. Contact: Email: ' TYPE OF WORK New ~ Replacement Ad iti nal Alteration Demolition Description of work: L/ ry f_ I Oil MI PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace _ New Construction _ Interior Improvement 4- Air Conditioner Install Piping Processed T Air Exchanger Gas W_, Exterior HVAC Unit Heat Pump -Under/ Above ground Tanis L Install / _Remove) Other When instaliingfreroving tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL. FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) ~j ~j $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ c-J"'•~ . TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ X1% $50.50 Minimum (includes State Surcharge) If Permit F Permit Fee - ~ is less than $1,000, surcharge is $,50. - if ermi Fee is > $1,000, surcharge increases by $.50 for each Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a$1.00 surcharge). TOTAL FILE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www. onherstgQnecal[.ora I hereby acknowledge that this information is complete and accurate; that the work will be i conformance wit he ordinances and codes of the City of Eagan; that I understand this is not a pe it, but only an application for a permit, and work i t to start without ermit; tha the work will be in accordance with th p roved plan in t ~se of wpik which requires a review and approval of plans. X I, X A IN/ V IV *-01 Applica s Printed Name Appli an s Signature ral . a v # r; `"5~ .ia.< ~ L•,( r.":A s i. r~~ .x• _,.,,.F.'n~'x"t•... i r,F'-1{+ r ` (s ~~;.rv;, i.r 'E`: k•. , 4 t' r..: ~ ~5: ~ °7 t e ~u w ak to otia, pY!5,•'x ;.,,p~~.. i?b 1° t x'' f ' t ~t~ •<~';.y ( . ~t a,r CP y. ~ v~tr~^s:.t• s ' ~ x<-..~.•.. 2 . ~ca~ t.c~, ~.,c. bt~r '>r`•'f, ors txi~ ~ r n6 st.. i'#~ ~ t`'yi~,r~~•,`D=•.~ Y ' ri`"• ci Reg4CeC.iceittt7sr.rtx t, i i , T.K :g~a w YciF=,; "r7 ~~Z{, ~s "J rm;. s.. li ~ ,"ir+S •:~essli~~=~ an •5~N=~.rx~;.,~r`,.'~,,'5,::;XEs:%~:-., eV`a. .4 !sW^y~:,eR ..kx i. 'r$it~t.~x~~~dt~'~L~'. i S yx.(. ~ yf M~` E t „ Tn•' ~'y~4 1` ••~'y;k•.. t,..t^ 1 < °Yr ~ ~ s. ~:t... J SY.t-, tut 4} N~~• Y A3 . x`"• ~ fi ~~"tN•a:~•;sa`!M''L,v{` "..~Si.'.~ j`::: `.S CITY OF EAGAN 3830 Piloi Knob Road, P.O. Box 21-199, Eagan, MN 55121 Poliee Fire Eng. Planner " PHONE: 454-8 100 BUILDING PEIRMIT Receipt # Tobeusedtor z'??'? y- --+ Escvalue Date JUNE 26 1986 SiteAddress 713 N0 ;IAY LAKF :D Erect CK Occupancy K3 OV£RHILL FARM Lot 2 Block 4 Sec/Sub Remodel ? Zoning kl . Parcel No. ZND A17U IT ION Repair ? Type ot Const yn Addition ? No. Stories ¢ GRAND Of?TtS DEVELOPMENT CO N Move ? Length 54 = ame 1831 ?UNi?ISG CT Demolish ? Depth S2 o Addreas Int. Impr. ? Sq. Ft City EAGAii Phone 4 5 2- f3 93 4 Install ? = o Name SAi iE Approv; ? ¢ Address Assessment _ i'- Citv Phone Water & Sew. Phone 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. Signature ot Permittee A Building Permit is issued to: all work shall be done in accordance with all applicable Bldg. NQ _ iZ17$ Permit V i J • ' Surcharge Plan Review Water Conn. Water Meter Road Unit Tr. PI. Var. Date I Copies Total V5 -00 ELOPALENT CO on the expreas condition that Statutes and City of Eagan Ordinances. II IPwm„ No. I wm,n How." I Dau I T~a,. ? I 041, Wsp. ------•..,? BUILDING Site Address - Lot 2 Block Parcel No. W Name- 3 Address _ 0 -- - Z ? Name_ CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 123,18 ; PHONE: 454-8100 MIT " Receipt # ? UWG/GAR Esc veiue $SQ,OUO natp JULY 28 6 ,a Erect n Occupancy - Remodel ? Zoning R Repair ? Type of Const v Demolish LJ Del L SUNRISS CT Int.lmpr. ? Sq. Phone 452-8934 Install ? Approvats ? ° U? Address Assessment Permit y ?' ' '' • "" 00 City Phone Water 8 Sew. Surcharge . 0- Police Plan Reviewo? Q ? = ame Fire SAC ' N Q= Address Eng. Water Conn. 5 . 00 ' ? W Gity Phone Planner Water Meter50 ' Council Road Unit ?W00 ' I hereby acknowledge that I have read this application and state thatthe Bldg. Off. 7 2 9 6 Tr. PI. 15? 00 information is correct and agree to comply with all applicable State oi Minnesota Statutes and City pf Eagan?Ord inances. APC Parks Signature oi Permittee Var. Date Copie . 00 ' , A Building Permit7s issued to: GRAN D OAKS DEVF.L CU Total th o diti th t I all work shall be cJone in accordance with all app?able State of Minnesota Statµtes and City of " n e express con on a Eagan Ordinances. 6uilding Official f " ? 11 % I PomN NO. I PermM Ho1dN I Data I TNWphaM N 1 .? Plby. occ. - 61.1" .,14 11Z+ Ftq. CONTRACT PRICE: Site Address c. ?' L?, I( c Lot Block 1Su ?- m Name to Address c City ?Urc?c :?. Phone Name 3 Address p City ? f ?--• Phone FEES COMM/IND FEE - 196 OF CONTRACT FEE MINIMJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) -- SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN PERMIT # PLUMBING PERMIT RECEIPT # (z) -7 ?a CITY OF EAGAN /? 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: /???-?? PHONE: 454-87 00 ? ?- BLDG. TYPE WORK DESCRIPTION / -i Res. New ? Muit Add-on Comm. Repair Other NO_ FIXTURES TQ7'AL ? Water Closet - $3.00 ?Bath Tubs - $3.00 Lavatory - $3.00 t ? ?Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 -T-Laundry Tray - $3.00 ? Floor Drains - $1.50 T-Water Heater - $1.50 ' Whirlpool - $3.00 ? Gas Piping Outlets - $1.50 ' Softener - $5.00 Well - $10.00 _.,_Private Disp. - $10.00 ? Rough Openings - $1.50 FEE STATE S/C: -' GRAND TOTAL• •? ? S ? PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, E11GAN, MN 55121 DATE 1- % 0 s CONTRACT PRICE r' - T RHONE 454-8100 I Site Address ti• ? BLDG. TYPE WORK DESCRIPTION ? Lot ? Block Sec/Suq N ew es. ? Name ` M ult Add-on ao Address '-? ' • J ?:- Gomm. Repair c City Phone ` a " Other ? . Name FEES { ; Address r t , RES. HVAC 0-100 M BTU -$24.00 p City F•? q' Phone`L ADDITIONAL 50 M BTU - 6.00 ADD-ON A1R COND. 0-24 6TU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 196 OF CONTRACT FEE ; Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SU,RCHARGE PER PERMIT . - .50 ' Vent CFM ? (ADD $.50 S!C IF PERMIT PRICE GOES BEYOND $1,000.00) Gas Piping Outlets # ; Other • FEE . S/C: .!?u SIGNATURE OF PERMITTEE TOTAL• FOR: CITY OF EAGAN CITY OF EA6AN SEWN swtvxx PLVR 3830 Pilot Knob Raad P. O. Rox 21199 pERAMT Np.: Eagan, MN 55121 pA.T.E. Zoring' Na of Units; Owner. Address: Stte Address: •' 13 : ?i t , - Plu?r+be.: lley i• 1 . I NFw !r aeeo/llr wa !IN C*Y ei Lwn OfdlMape, By Date of Inap.: C.cnnocllan Chorpe; - - IRCOOUnt DepoWf: P~ Fea: Surchorpe: Misc. Cho,+pes; Totoi: DoM Pbid: CITY OF E AGAN 3830 Pilot Knub Roar1 Wp? S?yiC E pERMn P. O. Bax 21199 PERMIT NO : Eagan, MN 55121 . Zontnp: _ p^TE; OwrKr: No. of Unlh: /1ddrom Stb /lddrrss: - Plur+ber: Metsr No.: Connedion Chorps: Size: AcoouM Depostt: Reoder No.: Permit Fee: I "MM b euvhr wm 1M Cihr ei go", Surchorps: orsMmem Mlsc. Chorges; BY Totai: Dote Pbid: Dote of Irap.: -'- CITY OF EAGAN 1NATER SERVi CE PERNIIT 3830 PilGt Knob Road , P. O. Box 21199 PERMIT NO.: MN 55121 DATE Eagsn, : Zaninp: _ No. of Units: Owrnr . Add rem Mdnas: 21 t umber . t?r No. Zl: " 76 ck' Reodoi No.: ()_?/1L7-2 o /I_-yxtul? m -- 1 NrM to eoneohr wNb tiw Cthr ef 460"fl mrmarge: ? .,... nG 7otal. gy Dor. Patd: Date of Insp.: Insp.: N2 12178 i G n 3830 Pilot Knob Road P.O. Box 2 1 9, Eagan, M - N 55121 PHONE: 454-8100 ? l BUILDING PERMIT Receipt# To be used for FOUNDATION EsL Value Date JUNE 26 ?? 6 site Address 713 NO HAY LAKE RD Erect 13 Occupancy R3 Lot 2 Block 4 OVERHILL FARM Remodel ? Sec/Sub. Zoning 1?I 2ND ADDITION Repair ? Parcel No Type of Const Vn . Addition ? No.Storie5 GRAND OAKS DEVELOPMENT CO Move ? Length 54 : W Name Demolish ? 1881 SUNRISE CT Depth5.?2 3 nddress Int.?m? Pr Sq. Ft. ° c;ryEAGAN phone 452-8934 Install ? i ? a ame Address a ? City Phone r w Name ? ? Address < w SA14E Approvals Fees o N Ciry Phone I hereby acknowledge that I have read th is application and state that the information is correct and agree to comply with all applicable Siate of Minnesofa Statutes and Citv ol Eaaaf110rdinances! Signature of A Building Permit is issued to: 41: v?ry all work shall be done in accordance with all aoolicable State of Building Assessment_ Water & Sew. Police Fire Eng. Planner- Council - Bldg. Off. 6) Var. Date Permit $ 15.00 Surcharge Plan Review SAC Water Conn. Water Meter Road Unit Tr. PI. Parks Copies--T--I5 -.Dp ENT CO on the express condition that and City of Eagan Ordinances. 1;W-P i _. ? CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2: 12338 PHONE: 454-8100 BUILDING PERMIT ' Receiptri To be uaed for SF:DWG/GAR Est. Value $$ 0r0 0 0 Date JULY 28 Ig86 SiteAddress 713 NO HAY LAKE RD Erect ? Occupancy R3 Lot 2 elock 4 Sec/5ub. OVERHILL FARMS pemodel ? Zoning - Rl Parcel No. ZND Repair ? Type of Consl V Addition ? No. Stories a Name GRAND OAKS DEVEL CO Move ? Length = 18$1 SLINRTSR CT Demolish ? Depth 52 o Address - - - Int. Impr. ? Sq. Ft c;ry FACAN phone 452-8934 Insiall ? =o Name- SAME Approv: $ a Address AsseSSment _ Ciry Phone Water & Sew. F W Name ? ? Address i W Ciry ' Phone I hereby acknowledge that I have read this application and state that the information is correct and agree to compyl y?ith all applicable State of Minnesota Statutes and Cib'2f Eaaangdi6ances. _ ? Signature of Permittee,,i A Building Permit is issued all. work shall be done in an 8uilding OHicial Police - Fire Eng. Planner Council BIdg.Off. 7/29/86 var. Permit + Surcharge 40.00 Plan Review 186.50 SAC 575.00 Water Conn. 5 0 0. 0 0 Water Meter 63 . 50 Road Unit 290.00 Tr. pi. 156.00 Parks Copie r,...,? $2 19-4-. 0 0 GRAND OPrR DE L CO on the ezpress condition Mat with all appble ? of Mi esot tatytesgnd City of Eagan Ordinances. REQUEST FOR ELECTRICAL INSPECTION EB-00001-04 ' See instructions for completin9 this brm on beck o/ yellow copy. C/u/ Q *c L? 2 5 5 "'X"' 8elow Work Covered by This Request vJ ?/? t Fdd Heo. -T4!1p ol BuilCine P.COlionroa Wired EquiVment Wired ome Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Buiiding Dryer Electnc Heatin Commercial Bldy. Fumace Silo Unloader Industrial BIAg. Air Conditioner Bulk Mflk Tenk Farm Otner oe6 v riller ISVec,ty1 t er Suqafv the, Oiher Compute lnspection Fee Below - - N Fee ServiceEntranceSize tt Fee Fexdens/Subfaeders # fee Circuits U to 200 qm s 0 to 30 Am s c3 ?b 0 ta 30 Am s Above 200 qm??y 31 to 700 qmps 31 to 100 A s Swimming Pool Above 100-Amps Above 100_AmFri Transformers Irrigation Boorr?s ? Partial-'Other Fee $igns Speciallnspection $ TOT Nerrarks S SC? A EF,? LI/ Nough-in the lecbi r d?(? insaec a.eey certily that the ebove Finel D%}?e p ins0ection hes been [>%?) Y?I Thin requnl voiA 18 month6lrom ortwnthsfrom?? a -2 -U?f'? Llq / c ? 27255 LQ-15 „ Request Ua ?` I? Fire Np. Rouph-in InsUer,tion Reqwred7 ?Ready Now ?11 No?ity_ Inspec- 'h ,? ?NO en fleatly K icensed Electrical CoMrector 1 bereb y requeat inspection of above ? Owner l M1i i e ec cel work nstalled at Sireet Address, Box or Rout No. ?^r ?} K? ?L?. Zaaao ecbon o. Townshi0 Nama o No. RanBe No. Covnry pant IPRINTI ?cs Olq Phone Nn. sa-?93 r $upplipr Atldress ? E c ncal Convactor ( om ny Nam9 I CoMractor's Lirense No. _ ? ? S"?C'7Y ( L41925- 3 l 1 Mailing AdJress (COnvac or or Owner Makine Instailationl `7 b 75 AuMorizetl SiB re(Conh /Owner in Installation) P?e Nu?mbei? ?? MINNESOTA STATE BOARD OF ELECTflICITY THIS INSPECTION REQUEST WILL NOT Giriggs•Mitlwey Bidg. - flaom N•191 BE ACCEPTED BV TNE STATE BOABD 1827 Unive•sity Ave., St Paul. MN 65104. UNLESS PqOPEN INSPECTION FEE IS on....e 16121197_2111 ENClOSED. rvn cLek, imciaL irvartcI Iurv ofirw% ° . oee insUUCtions for comDletiig this form on beek oi vellow wpy. 31 "X" Below Wark Covered by 7his Request ?i vae o/8uiltlinn -Aoe4ianees Wired EquiUment Wiretl I Ik N e ServicaEntrenceSize fl fee Peeders/Subfeeders N Fox Circuits U to 200 qm s 0 to 30 qm s :0 to 30 Am Above 200 qmps 31 to 100 qmps . 31 to 700 Amps Swimmin Pool Above 100-Am s - Above 1.00_Ain ' Transiormers Irrigation Booms 0(?) _artial.Other F Signs Special InspectionS -,-rLq TOTAL fEE Remsrks I, the Electricel Inspeetor, hereby cartity that ihe above inspection has baen mede. _ „nontns f,om'° (c - -? 3 - b=(iri & -::? y (o S C 15531 _ ? v::) (-zi y (n?, j; ?cG_ 71J A,. -D 4 s (-:) -- Renuest Uate ?? Fire No. ouph-in In on Requi Notity In [3 Ready Nuw pec- ?? ?? f?l N. es ? Y ?or When Reatl nsed I [nca ontractor I herebV reQUest inspection oi above Owner electrical work installed at SVeet AAdress, eon or Fovte No. CitY ecU 1 o Town ip N me or Ranye No. Count Occupant (PRIKW 7 Phone Nn. E' Power SupDli Atldress Eleciri al C h " tor ICOmDany Name) C?rtttacmr's Lice e o. N ? Mailinp dd ess Contractor or O er Maki g In ailationl a ? J Gf Authorizetl Si0^ re IContr r or MakinB In I ion) Phone Number - MINNE ?BOAfl OF ELECTPI THIS INSPECTION XEQUEST WILL NOT STATE GrigBS- itlwav 91d9• - oom N-191 BE ACCEPTED BY TME STATE BOAND 1821 Universiiv Ave.. St. Paul. MN 55104 UNLESS PNOPER INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. .. .? ?, r?n?'-- ?j/??,? 7z ? r? ? 1986 BIIII.DIAG PERM APPLICATION - CITY OF EAG9N / NOYE: ALL CANTRACSOaS M(1ST BB LICENSSD iIITH THE CITY OF EAGAN 3IAGLE F9lIILY DiiEI,LIAG3 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, t SET OF ENERGY CALCULATIONS MOLTIPLE DTiiE[.LIHGS - RESIDSNTIAL REN?9L iINITS FOE SALE 0liITS INCLUDE 2 SETS OF PLANS, CSRTIFICATE OF SQRY6Y - CHECg iIITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COlAIERCI9L INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, / 1 SET OF SPECIFICATIONS AND 1 SET F ENERGY CALCULATIONS, $2, 000 LAN ? ??E?BOND D To He Used For: ? Valuation: Date: Site Address ///'J 7)???[.ck. OFFICE DSE ONLY -v-- Lot ? Block Erect ? Occupaney 3 Remodel Zoning Pareel/Sub Repair _ Type of Const Owner Addition II of Stories ? C%? > Move ? Length Demolish _ Depth ? Address Int.Impr. _ Sq Ft Install City/Zip Code Phone Address City/2ip Code Phone ? Areh./Engr. _ Address City/Zip Code APPROVALS FSES Assessments Permit Water/Sewer Surcharge Police Plan Revie Fire SAC Engr Water Conn Planner Water Mete Council Road Unit Bldg Off Treatment APC Parks Varianee Copies IY)TAL ?lS ? ? Phone U HOTEs ADDRESSES FOR CORNER LOYS - CONTRACTOR/HOMEOiiNER MIIST DfiSIGNATS BHICH ADDRESS IS DFSIRED. NO CHANGSS WILL Bfi ALLOiiBD ONCE BOILDING PERMiT IS ISSOED. ,-_•, MINNESOTA VALLEY SURVEYORS IP1C. 1331 LARC INDUSTRIAL BOULEVARD, BOX 1169, BURNSVILLE, MN 55337 612-890-7750 CERTBFICATE OF SURVEY N 89°58'37it E 85.00 - - - „ DRAINAGE 9 UTILITY A TT EASEb1ENT PER PLAT I ?, V I l?L ? I ? LOT 2 ? I •-- sl Is r:, N ?D b ID II ? ? 25.? (964.0) (9470) so.oo ,Ts.oo N ? . ? p ` .. l PM?OUSE? m y--' SCALE: 1"= 40' M N : a O " N ze.oo/ O Denotes Iron Monument t9 .0) 4•0 t947lDenotes Proposed Elev? ? Garage Floor Elevation=l94 N GA R. ? ? N 26. Lowest Floar Elevation = ? H /=433 00? ?= ? 7op of Btock Elevation = 947.7 . I? ? - - - - .79 ? m (947.07 n oJ o _ IM S 83°26?441, - 0 '`9a6 12.99 E ? 79.30 - o d=2°24'41" R=l884.29 ? HAY ' LAKE------ - ROAD DESCRI PTION LOT 2, BLOGK 4,OVERHILL FARM SEGOND ADD1710N ? naraby certiry ihat ;nis survey, p7an, or report avas preOSreO Dy nw or urWer my Olreci DAKOT'?1 COUNTY MINNES?Tf1 5upervlsionantlmxtiamaaWyRagiateredlanASurvsYwunCertMiawsoltPeSteteot Minnesota. As o-F ?'h:s •?a?e• ? _____ c^ t' -- -?'' - --- -' 9z 9,3. ../.__. ._ AoO. No.. .. _ _ RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Naw Construelian Ranuiremenh • 3 reg"stered sile surveys showirg sq. %. of lot, sq. ft. of house; and atl roo(ed areas (20%max'unum lof coverage allowed) • 2 copies of plan showiig beam & window sizes; poured found design, etc.) • 1 set of Energy CalculaGOns • 3 copies of Tree Preservatlan Plan if lot platted after 7/1193 • Rim Joist DeGB Options selection sheet (bldgs wiN 3 or less unAS) DATE nI()?• 14, ?002-- W ?5 RemodaVReoalr Reuuirements ? 2 eopies of plan • 1 set of Energy Calculalions for heated additions • lsitesurvey(orezterioraddiUonsBdacks • Indicate H home served by se0tic system for additlons VALUATION ?a,aso.?o SITE ADDRESS rI /? /l I. ?AL/ L. a L° e IQ pl MULTI-FAMILY BLDG _ Y N TYPE OF WORK ?Ecc -e- FIREPLACE(S) _ 0 X 1 _ 2 APPLICANT c STREET ADDRESS 7LI- N, tZ a7 Lq G.G R d CITY ?Q? a k STATE ?JK/ ZIP ? TELEPHONE # 6Sl`105-a3S7 CELL PHONE # FAX # ,p S? ? PROPERTY OWNER TELEPHONE # 6s?? ?'' - 30 ?a ? COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNPSOTA RUI.L:S 7670 CA"CEGORY 1 MINNFSE)1i? RUL1:S 7672 (J submission type) . Residential Ventila6on Category 1 Worksheet Submitted • "New Energy.Code Workslieel Submifted • Energy Envelope Calculations Submitted j ? Plumbing Contractor: Plumbing system includes: Mechanical Contractor. Mechanical system includes: Sewer/Water Contractor: Air Conditioning Hcat Recovery Systcm Phone # Phone # Fee: $70.00 I hereby acknowledge that I have read this application, state that the information is correct, an agree to comply with all applicable State of Minnesota STatutes and City of Eagan Ordinan? Signature of Appllcan} OFFICE USE ONLY _ Water Softener _ Water Heater No. of Ba[hs _ Phone # _ Lawn Sprinkler " --- Fee: $90.00 No. oF R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4l02 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF ? 04 02-plex ? 10 OB-plex 0 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage O 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 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 Valuation Occupancy MC/ES System Census Code Zoning Ciry Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaVC.O. _ Footings (deck) FinaUNo C.O. _ Foorings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final _ Franiing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC Ciry SAC Water Supply & Storage 5&W Permit & Surcharge Treatment Piant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector . ? ? 6v CITYOF EAGAfV APPLlCATION FOR PERMIT SEWER AND/OR WATER CONNECTION Nb'1'F': PAYhIEW OF MM AT TIME OF AppLICAMorq m? ? ?? APPrZVAL oP PERKET. INSPELTION OF SEWEI2 APID/O2 FTATFI2 IIVSTALLATIONS WII.I, NCYP BE SCHED- ULID [7NP7S, PEE2MCT HAS SEEN APPROVID. 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: ' (^, Lot B ock ub ivision or Tax arce ID IF EXiSTING SiRCCI(.'RE, DATE OF ORIGINAL HL'ILDING PEf2MIT ISSL'ANCE:_ i n Year1 PRE'SE[JP 7ANING/PROPOSID OSE: (hb C) M"T+EtCIAL/RBTAIL/OFFICE Q IbIDCTSTRIAI, ZNSTI2L'TIONAL/GOVERN•MT ? R-1 SINGLE FAMILY ? R-2 DL'PLEX (Ttvv C?nits) ? R-3 1UWNHODSE (Three + Units) ( L?nits) R-4 AFARTTENT/coNIDOMID]IUM Units) 2) ? NAME: ADDRFSS: CITY, STATE, 2IP: PHONE: 3) 4' C7• NAhE: , ADDRESS: i CITY. STATE, ZIP: PHONE: A/ MASTII2 LICENSE# o?167 11t ?i 4) ?a• • e idNAME: ADDRFSS: CITY. SPATE, ZIP: PHONE: 1 Pltvnbers License: Active Expired Not recorded StaT -Initial •5) t ? r• ? d• • a?• : ? • ?? _ ?e - (??CONNECTION Zl? CITY SEWIIR CONNECPION TO CITY WATER OR'HEF2 ' T" 6) ?• ?• PLF.,ASE HOLD APPROVID PERMIT FC1R PICK-C?P BY ONE OF ABOVE ? ? PLEPSE MAIL APPROVID PEE2MIT 1t? 1, 2, 3, 9, ?JyE ?% . - (Circle one) 7) r i. u. . c /bi 4?? 1C •4 7. .P'( o t?Y' , a ., . F(JR C11"V USE OIVLY ' PERMIT # ISSUED 7 d93` Pd w/Bldg. Permit FEES: - J $ $ SEWER PERMIT (INCLUDE SL'RCHARGE) $ WATER PERMIT (INCLUDE SL'RCHARGE) s $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLCDE CORPORATION STOP) $ $ SEWER TAP n ? $ ACCOLNT DEPOSIT - SEWER $ ??• C' o? $ ACCOL'NT DEPOSIT - WATER $ .-? C? • L? C> $ WAC $ ? ]S?rOC) $ SAC $ ' $ TRUNK WATER ASSESSMENT $ $ TR['NK SEWER ASSESSME[VT $ $ LATERAL SENEFIT/TRC!NK SEWER $ $ LATERAL BENEFIT/TRL'NK WATER $ D C) $ WATER TREATMENT PLANT SL'RCHARGE $ $ OTHER: $ TOTAL ? RECEIPT ?- RECEIPT - DOES UTILITY CONNECTION REQUIRE EXCAVATION IN P(!BLIC RIGHT OF WAY? ? YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUSLIC ? NO ROADWAY" MUST BE DIVISIO[V LIST ISSUED BY THE ENGINEERING AS CO ON . . A NDITI SUBJECT TO THE FOL LOWING CONDITIONS: APPROVED BY: TITLE: DATE : Z 7-16 o•oo + o-"oo .? 37a•oo + ao•oo + 186•50 + 575•00 + 500•00 + 63•50 + 290•00 + 156•00 + 2184•00 * Zjft N i5EL' /0 3 1986 BIIILDIIQG PSAmIT 1PPLICATIOH , CI7 . I BOTS: ALL CANTRACTORS MOST BE LIC&RSSD iIITH '!'SE CITY OF EAGSlI SINGLS FAMIILY DiIELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLE DHELLING3 - RSSIDENTIAL INCLUDE 2 SETS OF PLANS, Cfi8 1 SET OF ENERGY CALCULATIONS C0MKE6CTei- RENTAL ONITS FOB SALS QNITS OF SIIR9SY - CHECS i1ITH BLDG. DEPT. 9 INCLUDE 2 SETS OF ARCHITECTIIRAL & STFUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND ?G?o To Be Used For: Valuation?T?-/ 0"V Site Address 1`? ??, HA'(L4?'• V-D. Lot ? Block 2µP Parcel/Sub ` a Owner Address City/Zip Code Phone ,4?ptLJwkz Contraetor Address City/Zip Code ?j Phone F Areh./Engr. Address City/Zip Code Phone # Date: a-i i f OFFICB IISS ONLY Ereet Occupancy P-3 Remodel Zoning P11 Repair _ Type of Const T.Z_ Addition # of Stories _ Move = Length S ¢ Demolish _ Depth $ Z Int.impr. _ Sq Ft Install _ APPROYAI.S FEES Assessments Permit 77 ?3. Water/Sewer Sureharge 40, Police Plan Review I 8f, so Fire SAC S?S, Engr Water Conn Soo. Planner Water Meter Cn3. 5-° Couneil Road Unit 90. Bldg Off Treatment Pl I SCfl. APC Parks Variance Copies TOTAL ? NOTE: ADDBESSES FOR CORNER LOTS - CONTRACTOR/HOMEO{iNER MOST DESIGNATE iiHICH ADDRESS IS DBSIRBD. NO CHANGHS iiILL BE ALLOiIED ONCE BDILDING PERMIY 13 IS3UED. CITY USE ONLY L aZ BL d RECEIPT #: SUBD. DATE: t ?3 I? 7995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 6814675 Please complete for: ? single family dweilings ? townhomes and condos when permits are required for each unit New construction Add-on fumace _ Add-on air conditioning ? Fireplace conversion (to existing fireplace) Date: 6 - 23 - ?S ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge .50 TOTAL Z o, 5'd ------- - - - -- - - ------- SITE ADDRESS: / (3 i " q?? L+"` ,`d OWNER NAME: c"Yi v1 p( e l ) o ?i _ pHONE #: y/ INSTALLER NAME: ?CILV I'C' ?l Jc,,S Ph',46??l- r STREET ADDRESS: /2 ?di CITY: C, CGt7ro Y? ci?r9 iC? S STATE: / A /V ZIP: PHONE #: ( ) 7S S ? (? ?/b? ? ? R------ ?T? 7T ?l2_- l??l ?? ?c?•- ?/2??? ??,?" ? 2-2,? 9s `f?P? cirr usE oNLv L BL SUBD. RECEIPT #: DATE: 1995 MECHANICAL PERMIT (C:OMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. ? multi-family buildings when separate permits are not required for each dwelling unit. DATE: WORK TYPE: CONTRACT PRICE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ? $25.00 minimum fee Qr 1°/a of contract price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of r i fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER:. ADDRESS:_ CITY: PHONE #: SIGNATURE STATE: ZIP: SIGNATURE OF PERMITTEE CITY INSPECTOR PERMIT City of Eagan Permit Type: Plumbing Eaaan, Permit Number: EA099086 Date Issued: 05/16/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 713 Hay Lake Rd N Lot: 2 Block: 4 Addition: Overhill Farm 2nd PID: 10-56151-04-020 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 Eaaan, mn 55123 651-365-1340 Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 Total: $55.00 Contractor: - Applicant - Owner: Champion Plumbing Toni C Jiang 3670 Dodd Rd., =100 713 Hai Lae Rd N Eagan MN 55123 Eagan MN 55122--302 (651) 365-1340 I hereby aeknowledae 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 Cite of Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA113488 Date Issued:09/05/2013 Permit Category:ePermit Site Address: 713 Hay Lake Rd N Lot:2 Block: 4 Addition: Overhill Farm 2nd PID:10-56151-04-020 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Randy Bradach Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: 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. Contractor:Owner:- Applicant - Tony C Jiang 713 Hay Lake Rd N Eagan MN 55122--302 Bradach Roofing, Siding & Seamless Gutters Inc 18267 Italy Ave Lakeville MN 55044 (952) 892-6015 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA141059 Date Issued:02/13/2017 Permit Category:ePermit Site Address: 713 Hay Lake Rd N Lot:2 Block: 4 Addition: Overhill Farm 2nd PID:10-56151-04-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: 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. Contractor:Owner:- Applicant - Bruce & Carolyn Lemke 713 Hay Lake Rd N Eagan MN 55123 (612) 306-2543 Prior Lake Heating & A/c 16584 Pebble Brook Ct Prior Lake MN 55372 (952) 447-8110 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK In k For Office Use ::::e: � Cs�� l/ 7�' / ../ /7 3830 Pilot Knob Road Eagan MN 55122 Date Received: la I I Phone:(651)675-5675 Fax:(651)675-5694 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION II Date: 'e, 1 2C1`9 Site Address: 7 l 3 Ni k c .k N -3 . H . Unit#: Name: c u c.G Phone: I , Resident/ Owner Address/City/Zip: I IV k ' Lc,if<e et' Applicant is: Owner k Contractor .res Description of work: r r n(4 ee_ - J.Lk P vs+ S 4 w .+t Ke w of ilVorkr(0xb pacts (2 " c„,+,\,55- 2"C/1e'p. ( Construction Cost: 1 5 c7 0 o e) Multi Family Building: (Yes /No k ) Company: C k pat C4c eea(. y LLC. Contact: Chi; s Contractor: Address:ti/ , , r �wc C' -. City: E'5ekri State: Mss Zip: ti (2 2 Phone:j i -2 3` ' ; :mail: -e p of t-ccs r e entry M n rr,c 1•c-a ens 35 License#: a C 6`( 't ;3 7 Lead Certificate#: N/A ... .......... 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: 1 Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: I 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 world permit t City to conclude that the' are trade secretsx • 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. wv'--.grapherstateonecall.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. qq x akr �S �e.chcvtJ €� x ✓ Applicant's Printed Name Applicant's Signature Page 1 of 3 '713 kin DO NOT WRITE BELOW THIS LINE 4 0.(3q3-a- . SUB TYPES Foundation — Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi 4 Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of Piex _ Lower Level Pool _ Accessory Building WORK TYPES New — Interior Improvement _ Siding _ Demolish Building* _ Addition — Move Building _ Reroof _ Demolish Interior AlterationT Fire Repair _ Windows _ Demolish Foundation 1, Replace _ Repair i Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation (1\i°CY° Occupancy C MCES System Plan Review Code Edition nNti\s" SAC Units (25%_100%f ) Zoning ilk- 1 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction 4 0 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:T Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: , Building Inspector RESIDENTIAL FEES t 5 I Base Fee Surcharge Plan Review n .0 LAk: 113 MCES SAC \ City SAC kri i ,i Utility Connection Charge ' t S&W Permit&Surcharge 05 Treatment Plant ")// Copies TOTAL * ,, (-„�` NPage 2 of 3 !f For Office Use Permit#: //q9 EAGANPermit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections(a�cityofeagan.com L c 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: �` 1 � ' Site Address:'113 )v C 1 �) L �1 � 1h Unit#: �- Name: B?LkLe C CY`-vl- Phone: V[2-336 • Su Resident/ 3 0 4-V1-t L E (2- E_NbA c� I2-;,� Owner Address/City/Zip: Applicant is: Owner Contractor Type of Work Description of work: t -�E ` --- P/%72--.11A-�- c � N C t Construction Cost: ':"Z 00 V Multi-Family Building: (Yes /No> ) Company:�UI� � s CW NST^ A��lJ!`�-Contact: 0 2-t C24(2-C Contractor Address: � p C/eNllec. Poit�� CL 2 �, ity: M,ENO T"1a State: ION Zip: �� Phone: Jb5!2-O '3 Email:5 �� (�e y veveeJ real/14_45m License#: ,5� -2_ ® 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: supporting documents that you submit are considered to NOTE:Plans and be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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. 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.000herstateonecall.org 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 • to start without .{hermit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of PI- # \ 1tfl �j x c� 1J...7 x Applicant's Printed Name Applicant's Signature For Office Use I 4-4 a s c rc 1V � Permit#: 0 JUN 26 2018 Permit Fee: �� ' b Date Received: kt9��u 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinginsoections(&cityofeacian.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 6-2-C=. 1 Site Address: 7 - 407 t-2001---e— R.d Unit#: ,44%'' Name: .,cvc o ®.^X v.-Ns l.._.e \' - Phone:Ccoi'2 aG— 2S L/3 Resident! - / + Owner Address/City/Zip: -7 ► \- e� 1_c� +z_ �d � S S 1 2 Xf Applicant is: Owner Contractor ,Jc7.i1 1�ao Description of work: tr- Smit .}11 e_ u 10.11_ .4`�'i es,y c't P1acn Sha w e Pca�n. Type of Work : Construction Cost: t.Sk 4 2- o Multi-Family Building:(Yes /No C.) Company: %-.\1 Contact: �ontr�t;tor� . Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 1 �1 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 a ortin docu p fe AP � rents thf you sub� re� clerad#o be ubl�c��ln rmation Portions o i :We*atioe%R 1be classified as non public if you provide specif c reasons that .ou permit tie wC rlo nclude that# + rade, ecrets *�� ;: You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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. 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.00pherstateonecall.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. jt,„.„ Applicant's Printed Name Applicant :ture At DO NOT WRITE BELOW THIS LINE '77 144 61 LB /6o,S y ,i SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family) to Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck Porch(Screen/Gazebo/Pergola) _ Miscellaneous — 01 of Plex Lower Level Pool Accessory Building — WORK TYPES _ New _ Interior Improvement _ Siding — Demolish Building* Addition _ Move Building — Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION ValuationD - "— Occupancy 1124- / MCES System Plan Review Code Edition 07r)2...15---- SAC Units (25%_100% 7d ) Zoning -i City Water Census Code Stories Booster Pump #of Units _ Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction (4 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) A Final/No C.O. Required Foundation Foundation Before Backfill >0 HVAC_Gas Service Test Gas Line Air Test Hood Roof: Ice &Water Final Pool: _Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In Air Test Final Siding: Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 1041 /l),JA1`t/4" , Building Inspector RESIDENTIAL FEES _ Base Fee ` /) �'mom'fi 7‘e�" Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3