794 Golden Meadow RdCITY OF EAGAN .
,..?-?"w ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?^ -
PHONE: 454-8100 G? j ?(? ?/
BUILDING PERMIT Receipttt -
To be used ?or SF Di+7G/C,F?R Est Value $69 0 000 Dare 3ULY 31 ?g +?b
site Address 794 GOLDEN A1G?OW RD
Lot_l._ Block ?? Sec/Sub. T. F. _ PR.
Parcel No.
w I Name WM AD'?l'?15
3 address 2976 BURA7SIDE
° ??ry .^'.AG.?1N Phone 454-4991
?
i o Name S?'?
? Q Address
? City Phone
?Q
F W Name
? ? Address
a W City 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.
Erect ? Occupancy K3
Remodel ? Zoning R?
Repair ? Type of Const {?
Addition ? No. Stories
Move ? length An
Demolish ? Depth-?D
Int. Impr. ? Sq. Ft
install ?
Aonrovals Fees
Assessment
water & Sew.
Police
Fire
Planner
Council
Bldg. Of
Permit Y """• ""
Surcharge 34.50
PlanReview b7U,00
snc 575000
WaterCOnn. ?d0aU0
Water Meter 63, 50
Road Unit 240.00
Tr. Pi. 156 a ??
Var. Date Copies
Signature of Permittee Total ?Z a?29 ° Q?
A Building Permit is issued to: ?? ???? on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
8uilding Official ,. -l ? ^=^? -i
?)
PormN No. PermN Hdder Date Telephone #
PluRbing ? S"') 7" 3/<6
N.V.A.C. 7.5 S / ? .' 7 '
e1eCtr'c C'. 53 7e
son"er
InspecHOn Date Insp. CommenU
Foodngst
Footlngell
Foundelbn
Framing .9?
Roofing
Nough Plbg.
Rough Htg. 9 ?
Insul. ?
Fireplace ?
Final Htg. b' 'a
Finel Pibg.
Bldg. Finel
Cerl. Occ.
ck Ftg.
k Frmg.
Deacribe Lxatlon:
CITY OF EAGAN
? r- 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N2 12383
BUILDING PERMIT PHONE:454-8100 Receipt # ?? / 2
To be used tor SF D:dG/GAR Est Value $6 9, 0 U 0 Date JULY 31 19 o b
SiteAddress 794 GOLDEN :-:i:ADOFJ RD Erect 17 Occupancy R 3
Lot1- Block 1 Sec/Sub. T-E.M- Remodel ? Zoning RI
Parcel No. Repair ? Type of Const. v=:r-
Addition ? No. Stories
°C Name 4 Pj)A:'1S Move ? Length d d
= Demolish ? Depth c a
3 Address 2976 BL)RNS Z DE Int Impr. ? 5q. Fr
° city -`?'AGA!1 Phone 454-4991 mstall ?
= a Name SMiE
0 ? Address
~ CiN Phone
?
F W Name
? ? Addre
z
i W City _
Assessment Permit ?
Water 8 Sew. Surcharge
Police Plan Revie
Fire
Planner
I hereby acknowledge that f have read this application and state that the gldg.
information is correct and agree to comply with all applicable State of
Minnesota Statutes end City of Eagan Ordinances. APC.
Var. [
Signature of Permittee
WaterCon n. -lmv.vv
Water Met er 63.50
Road Unit 290.00
Tr. Pl. 156.00
Parks
Copies
Total
12 9. 0 0
A Building Permit is issusd to: WM ADAMS on the express condition Mat
all work shall be done in accordance with all applicable State oi Minnesota Statutes and City of Eagan Ordinances.
Building
I I IPermM No. I Permu Hotder I Date I TNaphone M I
4
Comments
Plby.
Htp.
Dtsp.
, PLUMBING PERMIT RECEIPT #e?'?
CITY OF EAGAN I-
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: J ?r.? ?
-
-31
' CONTRACT PRICE: PHONE: 4544100
I Site Addresg-' ' ' Y ? • - BLDG. TYPE WORK DESCRIPTION
LotBlock Sec/Sub Y »
Res. New
? m Name ? .-' Mult Add-on
? Address ` Comm. Repair
c City Z !22 Phone Other
NO. FlXTURES TOTAL, ,.
? Nam - Water Closet - $3
00 -?
?
.
- .
. .r
? Address f ` Bath Tubs - $3.00 -? `
p City"4_-? ?? • ? Phone giL Lavatory - $3.00
Shower - $3.00
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDEIYTIAL F _ $1p_pp
- /IN FEE _ 20,pp
MINIMUM
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
? BEYOND $1,000.00) LKitchen Sink - $3.00
Urinal/Bidet -$3.00
,Z-Laundry Tray - $3.00
?Floor Drains - $1.50
?Water Heater -$1.50
Whiripool -$3.00
2-Gas Piping Outlets - $1.50 Sottener - $5.00
- S
L-
Well - $10
00
? -
,. ?
? J .
Private Disp. - $10.00
2_Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE
STATE S/C:
FOR: CfTY OF EAGAN GRAND TOTAL•
' MECHANICAL PERMIT Q
RECEIPT
CITY OF EAGAN #
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ?
CONTRACT PRICE PHONE,454-e100
Block Sec/Sub
m Name
? Addre:
c Cityt
c Add
p City
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
I M BTU
M BTU
M BTU
M BTU
CFM
?
FEE
S/C:
TOTAL•
BLDG. TYPE WORK DESCRIPTION
Res. X New _?-
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - 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)
1 . -. ,
SIGNATURE OF PERMITTEE
FOR CITY OF EAGAN
CITY'_ EAGAN WATBt SERVICE PERMIT ?
3PJ30 Pikol Krob Road
P. O. Box 21199 PERMIT NO.:
Eegan, MN 55121 ONTE:
Zonlrg: No. of Uni
Owrnr: ,
Addroas:
Site Addrea: ?? - ? . . . . .
Plumber. . ,
Me.r N..: a' z 7 ,?,
si?: s/?" 1?4pa6 ?? .
Reader No.: / ?E?? S 1f.
1esm te "mpy wi16 1Lt Cih w
ormanno... ?EQV?R • ? N .
, ,
By
Uafe of Insp.:
?,?L 2 ..SF
rMol:
Dote
TY OF EAGAN
30 Pilot Knotr Road VYATER SERVICE pERMIT
0. Box 91199 PERMIT NO.:
9an, MN 55121 DATE:
nirq: No. of Units:
Tur: ^ n
dross:
1 AddIQli:
No..
No..
h? saN* w'1!b 1w City of yW.
of Irnp..
Connection Chorys:
Acaount Depaalt: _ ;
,
Permit Fee:
Surcfiarpe:
Misc. Chorpm
Tatal: - 5 ?iUt' r r ? ??7
n, MN 55121 DATE=
,g; No. of Units: -
? .[sgJ
r. -
M N-rb wkb th• G!p of go"¦
of Insp.:
COn?MCNon Char'Det `' i
Aocour* Depak:
P'amAf Fee: -
SurcMarp?:
Misc. Chorom ?-
Totol:
Dob Paid:
DATE ls ' I -O 6
Rich:
Would you please let us know if Tl?. Addition
is ready for Sewer and Water Connection.
OK 5 igned L-
NOT OK Signed
Thanks,
Diane & Sue
BUILDING PERMIT
Receipt #
7obeusedfor SF DWG/GAR EstValue $69,000 Date JULY 31 ?y86
SiteAddress 794 GOLDEN MEADOW RD Erect C7 Occupancy R3
Lot 1 Block 1 Sec/Sub. T_ E_ M_ Remodel ? Zoning Ri
Parcel No Repair ? Type of Const vft
. Addition ? No. Stories
W Name WM ADAMS Move ? Length dd
z 2976 BURNSIDE
Address Demolish
I
I ?
? Depth?
Ft
S
a
city EAGAN phone 454-4991 nt
mpr.
mstan
? q.
.
a
o Name $A,]E APProvals
? a Address ASSeSSmeflt
w
• City Phone Water & Sew.
r?
F W
Name
x z5 Address
z
i w City Phone
I hereby acknowledge that I have read this application and state that the
iniormation is correct and agr e to comply with all applicable State of
Minnesota Statutes and City oagan Ordina ces/J
Signatuie of Permittee [.-??-? ^--?-
A Building Permit is issued to: WM ADAMS
all work shall be done in accordance with all applicable
Building Official ?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Boz 21-199, Eagan, MN 55121
PHONE: 454-8100
Police
Fire _
Planner
Council
Bldg. Oft. 7/30/81
APC
Ne 12383
/, S?3 7
Permit +' -'Y".""
Surcharge 34.50
Plan Review 170.00
SAC 575.00
Water Con n. 5 0 0. 0 0
Water Meter 63.50
Road Unit 290.00
Tr. PI. 156. 00
Var. Date I Copies
Total $2.129.00
- on the express condition that
of Eagan Ordinances.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
? 851-681-4675
New ConaVuctlon Beaulrementa
• 3 registered sAe surveys showing sq. fl. of Wt, sq. fl. of trouse; arW aII roofetl areas
(2U°k maximum bt coverage albwee)
• 2 coples af plan shaxing heam & window size& Poured foaM deslyn, atc.)
• 1 set ol Energy Cabulatbns
• 3 copies oi Tree Preservetron Plan it bt plattetl afler 711198
• RM Jolst Detail Optbns selectbn sheei (bltlgs wiM 3 or less units)
DATE S II (' i () a`
BamadeVNenair Heaulremanis
• 2 capies of plan I 1'3 `? -rj
. t setM Energy Cakulationsfor heated additions
• 1sAe6uneytorexteriDrad4AionsBdBCkS
• Indipte H home serve0 6y septlc system for atlditions
VALUATION Y6O 0 ` ' '
SITE ADDRESS MULTI-FAMILY BIDG _ Y )"N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPUCANT N v`fiz v-'A"` ISRo 5. Co ns?,z ? c#,'o r?
STREET ADDRESS 1 ST CITY Pf±'?3 "L' S ti-°'"STATE ZIP 55' 11'8
TELEPHONE#?'`>>"?Z?'-olab' CELLPHONE# ! oS I'a35' 3y'7`? FAX# - ??5
PROPERTY OWNER L) I YUJ N G TELEPHONE#
-------- °-------------°------------°------------------------------°----
COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNESOTA RULFS 7690 CATEGORY 1 MYE ?I6fl
(d submission type) • Rasidential Ventilation Category 1 Worksheet Submitted • o h?i
• Energy Envelope Calculations Submitted MAY 1 6 2002
Plumbing Contracfor. Phone #
Plumbing system includes: _ Water Softener ? I,awn Spruikler ee: 9?
_ Water Heater _ No. of A.I. Baths
_ No. of Baths
Mechanlcal Confmcfor: Phone #
Mechanical system includes: u Air Condiiioning Fee: $70.00
- Heat Recovery 5ystem
Sewer/Wafer ConMactor: Phone #
--° °° °---°--°------°----°-----------------°---°°---°--°--^-------------------------------°-------°---------
I hereby acknowledge that ! have repd thls application, staFe that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
SignatureotApplicanf
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
1986 BOILDIHG PERMIIT 9PPLIC9TIOH - CITY OF SAGAN
HOYS: ALL COATRACTORS M[TST BE LICSNSSD HITH T$S CITY OF EAGAN
SINGLfi FAFIILY Di1ELI.INGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCIILATIONS
MOLTIPLS DflELLIAGS ? HESIDENTIAI ? RENTAL DNITS F08 SALE UWITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SDRYSY - CHECB WITH BLDG. DSPT.9
1 SET OF SNERGY CALCULATIONS
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFTCATIONS AND 7 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND 00
.
To Be Used For: flit5jo/a w/ j p L Valuatio Date:
Site Address7
Lot ? Block ?
Parcel/Sub
Owner 4J?
Address Z A S+/?
City/Zip Code ?q a q y/
Phone
Contractor 10ky 491040 iryd-
Address z9J ie 00de-yox x
City/Zip Code C9 a7 Q y
Phone
Areh./Engr.
O
Erect tt Oeeupancy
Remodel Zoning
Repair Type of Const
Addition # oF Stories
Move ? Length ?
Demolish Depth
_
Int.Impr. Sq Ft
Install
APPROVAIS FSES
Assessments Permit ?
Water/Sewer Surcharge
Police Plan Review
Fire SAC J??
Engr
Water Conn VrJ
Planner Water Meter ?
Couneil Road Unit O
Bldg OffJ p Treatment P1 -Z_
APC Parks
Varianee Copies
Address
City/23p Code
Phone #
TOTAI,
NOTE: ADDHESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNfiR MDST DESIGHATE NHICH ADDRESS
IS DESIRED. NO CHANGFS WILL BE ALLOiIED ONCE BOILDING PHRMIT IS ISSUED.
Certificate For:
Mr. Hill Adams
l Q`l
? 117Q0
?
3
M
?
?
r}'
1 \
Y\
h
?
0
O
/it
DELMAR H. SCHWANZ
wo KOwroPt. wc.
? IbrM?w? IIYV l? M 7M Mwr M IlwrsV
i11TT11Al 11p!lYOUNT,YINKEiOTAS'30U 914123-/7M
fIN1YEt011'8 CERTIFICATE
a
?
?
a
?
105/32
Scale: 1 inch = 40 feet
Found iron at property
corner
? = Set wood hub
/00h0 = Existing elevation on an
assumed datum
I herebycertify that this is a true and
correct representation of the following
described tract of land:
Lot 1, Block 1, T.E.M. ADDITION, according to
recorded plat thereof, Dakota County, Minn.
Also showinq the location of a proposed house
as staked thereon.
July 30, 1986
137. '71-, S 1 9-zs a'7G
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*KYn: PAYMF.Nr OF FM AT TIME pF
arp.xcmorr noES rOr ooNSTITUM
APPRbVAL OF PERNIIT.
irrsrncriorr oF sBM nrro/Ox vuM
Tr1cTAr.ranONS Wa,i, IVDT HE ?EED-
UI.ID UNiM PIItMIT HAS BM
APPROVID.
P eas Print
? 1) PROPERTY ADDRESS: ? yf
LEGAI, DESCRIPTION: Lpy" / _ TeI? vision or
IF EXISTING STRCCiTIRE, DATE OF ORIGINAL BtJILDING PERMiT ISSI:ANCE: ". -
PRFSENf ZONING/pROPOSID C'SE: It7on Year
[? CQMMEf2CIAL/RETAIL/OFFICE
? INIDC'STRIAL
? INSTIZ[;TZONAL/GOVERNMENT
2) ?
ADDRESS:
CITY, STATE, ZIP:
: PHONE:
NJ R-1 SINGLE FAMILY
? R-2 DL'PLEX (ltno Onits)
R-3 10WbMUSE (Three + Units) ( t?nits)
Q R-4 APARTMENT/COAIDOMINILTI ( Units)
• 3) • u?: ?• NAh1E. SGI 1rs +G d For City Use ..
-- Plumbers License:
ADDRESS: ActiVe
CITY. STATE, 2IP: Explred
i Not recorded
PHONE: MASTER LZCENS ?
St Initlal
4) ??r • i?+•
? NAME: So a*s
_ P,DDRFSS: CITY. STATE, ZIP:
PFIONE: .
.5) ? v t a• ? ?• : ? -aO - o-+
? coNruxCriorr zo ciTSr sEWER ? wNrmcrioN zu ciTY wATm Q arHEa_.
6) ? v•? r ? PLF.ASE HOLD APPROVID PIItbffT FOR PICK-CTP BY ONE OF ABOVE ---- -
PLF.ASE MAIL APPROVEU PERMIT TO 1. 2. 3, 4, ABOVE .
(Circle one)
7) r r u ? ??? - ?6
'1 • R'??
FOR CITY USE ONLY - -
PERMIT # ISSLED
7 7
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLODE SORCHARGE)
$ $ WATER PERMIT (INCLUDE SDRCHARGE) ..
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ ? S•??b $ ACCODNT DEPOSIT - SEWER
$ $ ACCOL'NT DEPOSIT - WATER
$ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRLNK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ T
_ OTAL
3 7
RECEIPT RECEIPT
DOES DTILITY CONNE CTION REQLIRE EXCAVATION IN P[JBLIC RIGHT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSLED BY THE ENGINEERING
Q
NO DIVISION. LIST AS A CONDITION.
SU BJECT TO THE FOL LOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: __ ? f ? ?
-
- AAA?eSS 04
VICINITY MAP TE M. ADDITIDN
,tnow za, rwr. n, Ree.as
? ;.w .";
?.
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m ?r?e pbr. ???
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fIV aOUlll liM 0I IM NI f ol 51[Iron 25. T.I. 27. RqI. 13
r!
+ssure re Nn A nAniq a, xo.m 89 eeqren B...una q sa
o O?nolss 3j1 ?A"n ey 16 ?Mn r an pip ?pW?nr s.r iyrx.
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• OInal.f lrM /rq YMUMnI fOW
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cv:.r'$ET TN:RL' 1 <?^ I
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MEAOpW 1 pOAO' S A
F. (V1? ?jJ ? ?M1jy:7
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; ?A,'. ? ?,?: ?• ?, r?!, = ?'192?
,
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?s.. '.. ., .. ? .. ...._.. . ....,. R...,------
Bl- Li-3 '
? s?oMw
suavsnno
saavices
This ruquest void C?'/?5/?-?
18 months iwm
C 53701 t--I, a z, s??. -r, F.vti
?' 65.00
Ne,qu Date y Fire No. Roueh- in Inspaction
R ? red?
CReady Nuw06 ill Nmity InsPec-
( Yes ?No tor When Ready
Licanse ElecVical ConVaclor I hereb
y reyueat inspaction ot ebove
? Owner electrical work imcelled av
Street Address, Box or Route fya.
? r4 _ 1 J
CD/ ///tif'?01<% G •
? City
y
C.
?
ecLOn o. wns
Tohip Name or No. Range No. Co.
?
Occupdnt IPAINTI
J " C'
?L Phone No.
ixn ov?
?,S
Power Su plier
77?- lsc. Address r•?„?
Elecvical ?C/o 'va tor ?COm?^ y Name`l / Contrar, r's License No.
ff?/y,•,,?y,?1 ?lf.?c4, CC p L
Mailing Address IContractor or wner akine Inst I tion)
,z
6v
?'
.
-
AuM SiB ature Con or? n/er? M-akin-B Installationl Phon N b
MIryNESOTA STqTE BOARD OF ELECTRICITY TMIS INSVECTION PEQUEST WILI NOT
Griqps•Midway BIdB• -Room N•791 BE ACCEPTED eY THE STATE BOARO
1821 Ilniveraitv Ave.. St. Peul, MN 55104 UNLESS PNOPEN INSPECTION FEE IS
Phnnw 19121 662-11BOO ENCLOSEO.
?/?? nEQUEST FOR ELECTRICAL INSPECTION ee-aooai-os
//FJ? 0 See instructians tor comoleti.g Uis torm on beck of vallow copy.
-?` 51701 X" Below Work Covered by This Request
Ad Rep. Typa oi BuilCina / Aooliances Wired r Eouinment Wiretl I
Water
Mi
p Fea SarviceEntrenca5ize p Fae Feedars/Subfeedees N Fee Circuits
0 to200Ams ? 0 to30qms Oto 30Am
Above 200 qmpy 31 to 700 Amps 31 to 100 A rnps
Swinxnin Pool Above 700_Amps Above 100?Am
Transformers Irngation Boorr?s Partia6"Other Fee
Signs Speciallnspec[ion
I, the E aal
InSpector, pereCy
certify [hat the abova
lnspectian has been
mede.
1(3V1 Use BLUE or BLACK Ink
For Office Use -
City of Eaaall P: ee113
:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
V J
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11 Site Address: - OpV1tCV) r aitiOV v R Unit#:
Name: POCAVl OVIV1 Phone: 1951' 152.' OSti
Resident/
Owner Address/City/Zip: 1 V ()MCI() Me1AC1OW P-d 1 of iVi , M I�1 SSIZ�
Applicant is: Owner X Contractor
Type;Of Work ' Description of work: Re. Roo-F--
Construction Cost cUc Multi-Family Building:(Yes /NoX )
Company: IISr•e` ifl (k)MtilitChIN1 CO lVlL; Contact:`Jot H�{�E
Contractor
Address: l2OD Ceitrc Pc'ivrtir, C � 11S City: `A 1GItil
u51. �5� ep ever9r-eev. c
) o`'SSfiYu& W'
State:I"`N Zip:FJ5 t 2-� Phone: 0 Co"I Email: IMt1I 01'ci po i)' • ►'✓r
License#: 5412100 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 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.
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.gooherstateonecall.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.ne.
Applicant's Printed Name Ap ant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ 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
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_100%_) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction 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:_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
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
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