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- 2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conslruction Reauirements
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all rooted areas
(20% maximum lot coverege allowed)
2 copies ot plan showing beam & window sizes; poured (ound design, etc.
1 set oi Energy Calculations
3 copies of Tree Preservalion Plan if lot platted a8er 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
RemodeURenair Requirements Office UseDnly
2 copies of plan CeA ot Stirvey Rectl Y _N
1 set of Energy Calculations ior heated adddions Tree Pres Plan Recd _ Y_ N
lsitesurveyforadditions&decks TreeP2s'Required _Y`N
Addition - indicate H on-site septic sysMm On-site Septic System '_ Y`_ N
/
Date d -)
Site Address i-/ 6 7 Z? YA??q (0 7 y r? au
Construction Cost
L t-° nJ u?0 L A? ? Unit/Ste #
Description of Work FS Q 00 ?
Multi-Family Bidg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Cl•`Ff- P S S C , Telephone #( 7a Q 12- 5,?2 (o
Contractor ? Uf?-,.i! L. ?°1Ai9tl6J 3 c ..J
Address 13t19 (o t-I: ?4." ? %N
State m n) City t4,4 $7-, ?7 S 1
zip 0 33 Telephone#((o/2) q j'-2 - 93
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations SubmiHed
Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # ( )
Telephone #
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
permit; that the wark will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
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Applicant's Printed Name Applicant's Sign e
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CITY SF EAGAN ( WATER SERVICE PERMIT
X795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner: —
Address: — Site Address: 46 7�
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.• Permit Fee:
agree to comply with the City of Eagan Surcharge:
Ordinances. , Misc. Charges: -
Total: te Paid: Date of Ins .• [ ‘ —g/ Insp.:
•
CITY. 6F EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Address -- — —
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
posit:
Permit Fee:
B Surcharge:
y -- Misc. Charges:
Dote of Insp.: Total:
Insp.: Date Paid: