649 McFaddens TrCITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTIQN RECURD
PERMIT TYPE:
Permit Number:
Date Issued:
SITE ADDRESS: Cqt ; U
t-4 10 MtFA[1bEN x TR
I rkr i v r t't-i ?I{ A l L
PERMIT SUBTYPE:
•, r 101.1, '
Contral No. 134
E3Ui! O1NA
•wI "t.9
.t2/*1 /42
fit APPLICANT:
MILIER MOMES JOSEPH
(61: ) 164-4683
TYPE OF WORK:
MEu
F?t'NhRk`'i: Rf-[:F.7FrF # 5 16 41 C:EIMTRAi:y00 -- tlEMl••IZYAMI P1.D9
Pennk No. Wrmk Holdsr Dste Telephorro #
S/VY
ALUMBING
HVAC
ELECTRIC
ELECTRlC ?
InsPwtlon Do" kMp. Comernts
Faodngs I 2 •? pZ ?
Foundation ?/Fh (? G?r.?P/ f??l !! 9,? G??
F?ing 1-?g3 s
RooNng
R°,o Pbg.
PAYJO ft. ,
? ,
?8ul. ? .
?????
??l Mg.
orsatTest {t R
Ffnal Mg. F4b9- Irspector - NotllY Plwmber
ConeL Meter
EnprJPlsn
eias. Rnal Z ?23- ?3 tS
DeCk Ftg_
Deck Fnel
Well
Pr. oisp.
.•?
? ..
s
(Itr#tf trafe uf (Orr??aury
tttp of eagan
lomrtmritt af &dtding iwrrtum
Tkts Cerllfraate buedpursuant to Ihe reguinments ojSeclion 306 of the Unifornt Brrilding
CMe e"f*g thar ar rhe 11me of inua,soe rhls strucum wrrss In on,rrplianrx witle rhe mw0scs
ordirramoes of 11u Cily irgudating building cwrsduUioR or u= For tlie foUowiing:
UK Cb=T=*M SE' DWG ? N Nm 1859
00-P-7 TM R3/141 zesiag nwia RI t"e cmr VN
1'L.C rv w AUy7 14V1.LL . .. l•? ? DL, 1d9L?C.Y 1L' WiKw 1 1.
r
Dm a2/23/93
?.
POST IN A CONSPICUOUS PUCE
? CITY OF EAGAN PERMIT TYPE: N?3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
i ? 10 - 14 `?'?i3N-4f!pH• N
SITEADDRESS'' ??
' r r, r; tIt u c?.
:1iif+t 14: i r:
PERMIT SUBTYPE:
I I r71Nit
I I : ,:;sl
I ,S:?
APPLICANT:
TYPE OF WORK:
1I1 '.('k I I''t I (1W
1, i 1' A 1 V
! 1 P1 IIf1N/1(i1 )11 I`OUt
k t)tll 1 N1.
f'11f:Afl tA ttM t l t'. 14F'I+I1i1"11, f'01i I1W'/ 1 11:l.Ih 1f nl tl41i"I
?F-
L
?
J
Pertnit No. Permit Holder Date Telephone i
ELECTRIC
PLUMBING
HVAC
Inspection Date Msp. Commenu
FOOTI NGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
DRSAT
TEST
BLDG FINAL
7
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION RECQRD
CITY OF EAGAN PERMIT TYPE: """',
3830 Pilot Knob Road Permit Number: 1 `
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: ;,; , , ,; i,,, f APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION D. ..
. ; ? ,?•; , • , , , ? 1 , 4 ? 11 ?
?11 1 11 f! ?+ fJ 1 I P•I rl i
I1-
I L-
Permit No. Permit Holder Dete Telephone #
SNV
PLUMBING
HVAC
ELECTRI
ELECTRIC
Inapection dete Insp. Comments
Footings I .?3/y-?
Foundation
Framing
r I
Roofing 42 ?P
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Fnal Plbg. Plbg. InSpeCtor - Natify Plumber
Const. Meter
Engr./Plan
-
8klg. Final 127
/f? o7
Deck Fig. R Z.?! 3 ?
Dedc Final
weli
Pr. Disp.
M
REQUEST FOR ELECTRICAL INSPECTION
????? ? Seemslmctions ior complenng this lorm Dn beck ol yellow copy
"X;Be/ow Work Covered by This Request
EB-00001-08
3? 9c?
ew Atltl Rep. Typeot8uilding AppliancesWired EquipmentWiretl
Home Range • Temporary Service
Duplex Water Heater Electric Heating
Apt. Butldin9 oryer Load Managemern
Gomm./Industrial Fumace Other (Specily)
Farm Air Condiuoner
Otner (syeciN) Contrecmr's Remerks Compute Inspection Fee Below:
# Other Fee # ServiceEnvenceSize Fee # CiromislFeeders Fee
Swimming Poo1 0 to 200 Amps o to 100 Amps -
Transtormer5 Above200_Amps Above'100_Amps
Signs Inspedor5 Use Only TOTAL
Irriganon Booms QQ'?..c ? G y, ? ?
? • Cj o
Special Inspec[ion V L
Alarm/Communicahon THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MON7 (
I, the Electrical tnspector, hereby Rough,m
certify that the above insPection has
heen made.
Final (
/
Date + 5;
OFFICE USE ONLY
TM1is reQUest vatl 18 months irom ? "
?
647?
Repuest Oefe
1! 1 l?l ?
? ?• ire No Raugh-In Inpsac4on Requiretl
(YOU mu t call ?nspectq w?en reaGy) I? nspeqian Other Than Fougt?-In
qeatly Now Will Nolily Inspecta
r
Ves ? N. Dale qea
1 C licensed contractor , owner hereby request inspectionof above electrical work aC .
Job Atltlress (SVeel Box or Poute No ) City
Secbon N. Township Name or Na Range No County
Ocapant?PRWT) PhoneNO
XYM ??OW
wot v1-s9s2
Power Supplrer Atltlress
Elecmcal Conttactor(Company Name) Conlrector5 Laense No
?
Maning qtltlress (Comraztor or Owner Making Installa[ion)
Authonze onlaclonOwner Installationj PhonB Numbar
? 0ii, yy-?
MINNESOTA STATE BOARO OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT
GrIgge-MlOway Bltlg. - Room 5-173 BE ACCEPTED BY THE STATE BOARO
1821 UnivenRy Ave, St Paul, MN 55104 UNLESS PFOPER INSPEGTION FEE IS
Plwne (612) 642-08W ENCLOSED
/'? ??? REQUEST FOR ELECTRICAL INSPECTION r°"``{'?« egy-?'pppm
? See insvuMions for completing ihis form an back of yellow copy ??? „?El JQ?O GJ?
? -
_2 5?.2 "x" Below Work Covered by This Request •?`?? ` JQ o
ew Atltl Rep TypeofBmldinq ApplrencesWireE EquipmeniWired
Home .Range Temporary Service
Duplex Water Heater Electric Heating
Apt Building Dryer Other-(Specify)
Comm./Industrial Furnace
Farm Air Contlitioner
O[her(syeciiy) ConVaclor's Remarks.
Compute Inspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuns/Feeders Fee
/ Swimming Pool ? 0 to 200 Amps 1 0 to 700 Amps ?$
Transformers Above 200 _ Amps A6ove 100 _ Amps
Signs Inspecbr§ Use Only TOTAI
trngauon Booms 7- a 7 7.50
Special Inspechon
Alarm/Communication TNIS INSTALLATION MAY B DERED D CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 S. ?
I, the Electrical Inspector, hereby
ceridy that ihe above inspection has
been made R°ugn-,n ,
F,,,ai
ece ?, Y Z
OFFIGE USE ONLY
This reQUest voitl 18 months imm
1
2
?
Requ st Date Fire N Rough-in Inspetlion
12110192
I
Reqwre09
? Reatly Now f7.?MiM1JO4N Inspector
,-?9s ? No When RBaQy?
Iiiii-tfcensed contractor p owner hereby request inspection of above electrical work at:
Job AGtlress ISbeet Boa or FoNe No I City
49 P1c!¢ddeaa 72aii Eag¢n
SecLOn No, Township Neme or No Rarge No Counry
Dakot¢
Ocapant(PRINT)
aoz 1 fComee Phone No
454-4663
Power Supplier Atltlress . .
/]¢kof¢ fePii fanmington ,I7N 55024
Elecmcal Contracror ICompany Namel ConVactor5 Lkense No
Mi.dland E2ect4ic 04161D
Mailing Atltlress ICOnlractor or Owner Makmg Installation,
17854-8 aii Gla LakeUii2e,ON 55044
nlreclor/Ownar Makmg Installatrory Pnone Number
? "°"469-9444
MINNESOTA STATE D Of ELECTPICITY THIS INSPECTION REOUEST WILL NOT
Grigge-MlGway Bltlg. - om &173 BE ACCEPTED BV THE STATE BOARO
1831 Universily Ave.. SY. Paul, MN 55100 UNLESS PFOPER INSPECTION FEE IS
Plwne (612) 602-0B00 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
, See inshuqionsbr compleNng Ibis lorm on back of yellow copy -/ G
"X" Be/ow Work Covered by This Request
Ne Adtl Rep. Type of Buiiding Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwlding Dryer Load Management
Comm /Indushial Fumace Other (Speafy)
rm Air Conddioner
e1 p i ConVacroYS Remarks
Compute Inspection Fee Below:
# Other Fee # Service Entrance S¢e Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Transiormers Above 2D0-Amps Above 100 -Am s
Si nS inspector s Use OnW ?? OTAL ?
Irrigation Booms ?? ? ,?`??
Special Ins ection
Alarm/Communication THIS INSTALLATION MAY B D DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 16 MONTHS.
I, the Elechtcal Inspector, hereby POU9h-in Date
certify that the above inspection has
been made. Fin01 pa?e C?
OFFICE USE ONLY •
This repuest voitl 18 monlns Irom
?'o? t " .
&
?. 4io4,V
? O/ 9s425 1
"?
5 '
Repuest Oat
S ul ??//( Flre No floogh-In I ecuun Requnetl Inspeclion Other Than Rou
(YOU must call pector wnen ready) ? Ready Now AI Notlty Inspecror
7 / V es ? No Oate Reod
I icensed contractor 0 owner hereby request inspecnon of above electrical work at
Job Atltlress (SVeet Bor or RoWe No?
/'?c ??' I"/L CM1y
L--.?G'.-?
Sectwn No Townsnip Name or N. qange N.
?
Occupant(PRINT)
?d IL` TC 2SO? Phone o
?
Pawer SUppLer AQtlress
Elecmcat Contracror (Gompany Name) ?/
= LlECme C.Q Conlrecto?r's 4cens?e No.
C
M g Atldress (COntra r or Owner Mak? Installation)
O .U
Authonzetl 9gnaNr (C ractorlOw ab q IoSutllaiion) Phone Nomber
771l'tr
MINNESOTA STpTE BOARD OF ECT I THIS INSPECTION AEQUEST WIIL NOT
GrIggs-MiEway BIEg. - floom 5-1 8 I BE PGGEPTED BV THE STATE BOARD
1821 University Ave., SL Paul, MN 5510 II II ? I III II I I I I I I I II UNLE55 PROPER INSPECTION FEE I$
Phone (612) 642-0800 ? ENCLOSEO
Address 649 rxYaMats rnan. Zip 5512_3
Lot 5 Blk 2 Sub LAKEVIF.W I?tAIL
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: 02/23/93 Yes No Inspector:
Final gnde (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas ?
Sod/Seeded grass
TraiUcurb damage LI/
Porch ?
Basement finish ?
Deck
Please verify wi[6 the builder the removal of roof test caps from the plumbing system and Ihe shutoff of water supply to
the outside lawp faucet before freeze potential exists.
Contac[ engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White • Cily Copy Ycllow - Resident Copy Pink - Contraclor Copy
?----------------I
? 09(,'.'$?D.fljcevlESe ?
? Permit#:
I Permit Fee: 0 •
? Date Received:
I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ? 3? 0 1? Site Address:
Tenant:
(?y9 xi) G s TT
Suite #:
RESIDENT / OWNER Name: SCU' f??C L,C?C Phone: ???F7
Address / City / Zip: 6'/ ? mG
Applicant is: _ Owner rContractor
TYPEOFWORK
/?-?l•r?? ?.?U?
Description of work:
Construction Cost: lo-775' Multi-Family Building: (Yes _! K(ZX
?a?7?33
'
044
CONTRACTOR License#:
Name: tfbMe ZI
OilPM
Address: ?Z 1?
S-2
City: /e ?-?''I State: Xk'?7 Zip:
ze llvl-rs
t
t P
Ph
C
on
ac
erson:
one:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
CatBgory Submitted Submitted
(4 submiSSion type) • Energy Envelope Calculations SubmiNed
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 8. Water Contractor: Phone:
NOTE: Plans and supporiing documenfs fhaf"yousub?rtrf_are considered,to be pubtic, informatior?. :Portrons os
City to
may be classifed as `non putilic i{yau proyidesp°ecifrc reasons that would permit fhe
` fhe information
?
j
concJode?thaf Yhe are trade secrets. - - ? ?-tt-
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 ork is not to start without a permd; that the work will be in
plans.
accdr ance with the approved plan in the case of work which requires a review and approv of IL
x I?A en'/M 2P.GVc'Tj X
Applicaqi' PriUted Name Applican ig ture
Page 1 of 3
INSPECTION RECORD
CITY OF EAGAN PERMITTYPE: euzLoxNe
3830 Pilot Knob Road Permit Number: 021143
Eagan, Minnesota 55123 Date Issued. 06 / 1 B J 9 3
(612) 687-4675
SITEADDRESS: Lp7: 5 BLOCK: Z APPLICANT:
6q9 MCFADDENS TR PETERSON EDWARp
LAKEVIEW TRAIL (612) 947-5952
PERMIT SUBTYPE: TYPE OF WORK:
SF PORCH NEW
DESCRIPTION 3-5EA5UN
INSPECTION
FDOTING .. .
FRAMZNG ..
INSULATION FINAL
?
?- - . . - - - - - - -?
;?CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
3F PORCH
NEW
R-3
C? g?l? S
PERMIT TYPE:
Permit Number:
Date Issued:
BUILOING
021143
06/10/93
SITE ADDRESS:
P.I.N.: 10-44390-050-02
16
12
DESCRIPTIOPI:
@
?'?.. 3-SEASpN
8rfi ldftt`4_ Permit Type
??tildiYag WYa,rk Type
r SC bEoupahcv,-
1'`•BuiEditrq Lengt.
'k€t;
Qu1ld%EY9 W4dth t_.
l ?
?
i
1` I
PERMIT
649 MCFADDENS 7R
L07: 5 BLQCK: 2
LAKEVIEW TRAIL
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
VALUATION
$108.@0
$9.50
$112.59
CONTRACTOR:
$9.600
OWNER: - APplicant -
PETERSON EDWARD
649 MCFAUDENS TR
ERGAN MN 55123
(612)347-5952
I herehy acknawledge ehaC I havs read' th3s epplaaratiorr arl=d, state tha? the trtParmatlort is correEt anzi agrGe to cturnAly yxith a31 appl3.ca.ble 8;tatre srf plirt.
- Statutea anc} Cfty f Eagan Ardinantses.
AP_? ?m?
PLICANT/PE MITEE SIGNATURE I SUED B SI NATUR?
°EALTIYATE _
rERMIT, #,
F '
ne 17 m°?0M
W l T Vt tACaA1V
1993 BUILDING PERMIT APPLICATION t) I?, ?j'0
681-4675
Cf.i'd,d, t? •1
? ?.
SINGLE 8 MULT -f sets of plans, 3 registered site surveys, 1 copy of energy
?%3
4
alcs.
HA
L?
C hJKE.2CIA6======= sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: i) when permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date S / 2? Yaluation of work
Site Address: 6el? ,41GFAO.05v -7A?
STREET SUITE Y
Tenant Name: (commercial only)
IAT 1) BIACK ? SUBD. - ,{ P.I.D. M
Descri tion of work: 3 S ?tl?crF
The applicant is: Owner ? Cantractor ? Other (Deseribe)
2 i/n ?/S2- ?
Name /`c?E,?.Scy./ FAu•?G? Phone wk sv7-?'
Property LAST F=R5T
Owner Address /y/GFi?.orrs? ?zz
STREET STE M
City State Zip S`?IZ3
Compan,y Phone
Contractor Address / License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration M
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State af Minnesota Statutes and City of
Eagan Ordinances. ?
??
Siqnature of Applicant: ??
?'
BUILDING PERMIT TYPE
? OI Foundation
? 02 5f Dwg.
? 03 5F Addition
;664 SF Porch
? 05 Sf Misc.
WORK TYPE
? 31 New
? 32 Additian
OFFICE USE ONLY
? 06 Duplex
? 07 4-Plex
? 08 8-P1ex
? 09 12-Plex
? 10 Multi. Add'1
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
?i:• r ? ?rrl?.
c
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
p 35 Tenant Finish
? 36 Move
?
? 16 Basement Finish
? 17 Swim Pool
? 18 Comn./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 31 Demolish
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy _T__1 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length T? On-site well Census Code
Depth iz, On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REDUIRED INSPECTIONS
? Site
? Wallboard
M Footing
14 final
ET Framing
? Draintile
22YE
/
0
6 Insulation
O Fireplace
Permit fee
Surcharge
Plan Review
License
MWLC 5AC
City 5AC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
108.00 I V.L?tim: s`l o00 !
?F, .SD
I12,Sn
I (-xjz? I a2x tis? 6 6yo
SAC % '
5AC Units -
.?£ # %?
4
* PIdNEEp LAND SUflVEY0R5 • CINL ENGINEE
* engineering LANO ALANNERS • lANOSChPE Af7C111
* ? *
?
2422 Enlerprisr. I]rive
Mendota Ilciylils, MN 55120
612) 681-1914•Fox 681_9480
625 Highway 10 Northr.ost
Blaine, MN 55434
612) 783-1080•fax 783-1883
Certificate of Survey for: J05Epr1 M Miller Constructi
House Address: 649 McFaddens Trail Eagan. MN
Modei Name: Brunswick
\ •
\
\
?
\ 939.U
qa
?
r H t ?
N
/-740.7.9'40? `v
•? ?? /
? 3 se??,? ?ry
4
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I> Jrv
?
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q4!
? /g4a¢
?"q r
?
6 9:3C s so
69 3sSS..
i ?
i ?
.
N i ?
i ?
rv I
// / o 933 S / s
?'? ?
?
??
/i
\
9z0,3..,.
297V
. \
i?
? ? ?3 aRpp *soo7S, ? qs
6
?4i.S?nP , j
i
?
C°" °
INSPECTION RECORD "° ?? ?g
CITY OF EAGAN PERMIT TYPE: Bu zLo i N G
3830 Pilot Knob Road Permit Number: 0 0 18 5 9
Eagan, Minnesota 55123 Date Issued: 1 2/ 01 ( 9 2
(612) 681-4675
SITE ADDRESS: LOr: s 81.. o r K: L APPLICANT:
699 MCFADDENS 7R MILLER HOMES .70SEPH
LAKFVIEW TRAIL (612) 454-4663 1
PERMIT SUBTYPE:
SF QWG
TYPE OF WORK:
NEW
INSPECTION
F00'1'1:N0 .. .
FRf4M.1:NG .A
'[NSULAT,T,ON FINIIL
F7REPLFlCF
REMARKS: RECEIPT #
?
g& W CI1N7"RAC'i'OR - GENZ-RVAN PLFJG
?
PERMIT
? C1TY OF EAGAN
- 3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Datelssued:
F3UILD:CNG
001859
L?/01/92
SITE ADDRESS:
649 mcFAoueNs ra
Lor: s sLocK: z
LAKEVIEW TRRIL
DESCRIPTION:
"Building Perrnit Type SF OWG
0ui.ld!rtr?'?Work T"yPe IVEbJ
UBC Occupar're.y R-3 h-1
Consi:ructian lype V--n
Zoning . F2-1
Building Langth ,
Bui.l.ding Width
<
58
38
?r ? U { ) 1 I?? ??
REMARKS:
EeEcrzPr # Ct bal g(r?
FEE SUMMARY:
Base Fee
Plan ftev3.ew
Surcharge
SAG
SAC 4
SHC UriiYs
Subtptal
5& W CONTRACTOR - GENZ-RYAN PLBG
VF1l.UATT(JN
$751.50
$988e48
$66. a0
$700 .00
1.Vi0
$2,005. 98
$132, 000
MISCELLANEOUS $1,618.50
1`otal Fee $3:.616.45
CONTRACTOR: - n a p 1 i u a n c- s'7 .Lz COWNER:
MILLER HOMES JOSEPH 14544663 0002431 JOk: MILLER i-IOmES
75133 CEUAFi AVE S 19133 CFORR AVE 5
FARMINGT6N MN 55024 FARhILNGTOA! MN 55024
(612) 454-4663 (612)454-4663
I hereby acknowledge that I have read this application and state L'hat the
i.nformati.on t, GorrecC and aGree tp camply with aJl applS.cabls Stata af Mn.
Statutp-s and City of Eagan Ordinances.
APPLIC NT/PERMITEE SIGNATUFE ISSUED Y: IGN UR
Control No. 1349
PERMIT M
REACTIVATE _
CITY OF EAGAN 13,??GA
1992 BUILDING PERMIT APPLICATION
681-4675 MOY M 4, RW
a„r -r
? .. ;, 1 ,.i
INGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date
s
g
of
Valuation of work
oO
4
Site Address: Jit.a?
STREET SUITE M
Tenant Name: (comnercial only)
IAT 5 BIACK 2 SUBD. P.I.D. N
Oescri tion of work:
The applicant is: ? Owner CKContractor ? Other (Deseribe)
Name Phone
Property LAsT FIRST
Owner
Address
STREET STE !
C1ty State Zip
Company
Phone yS?-S?G
Jo
?
Contractor Address 18133CEDARAYE.SO. License # Exp.3-
City N0002431 State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 3 water licensed plumber - t . Processing time for
sewer 8 water permits is two days.once ea has been approved.
i hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable 5tate of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
v
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
Jg 02 SF Dwg. O 07 4-Plex O 12 Multi. Misc.
? 03 5F Addition ? OS 8-Plex O 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 fireplace
? OS SF Misc. ? 10 Multi. Add'1. O 15 Deck
WORK TYPE
9 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Mave
GENERAL INFORMATION
Const. (Actual)
SAllowable)
UBC ccupancy
Zoning
9 of Stories
Length
Depth
APPROVALS
V- N Basement sq. ft.
lst F1. sq. ft.
?I 2nd F1, sq. ft.
R-I Sq. Ft. total
Footprint Sq. ft.
ST On-site well
? On-site sewage
Planning Building
Engineering Yariance
REGIUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
? Framing
? Draintile
? Insulation
? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Nater Conn.
Water Meter
Acct. Deposit
S/W Permit
S/Y1 Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % 100
SAC Units I_
vetumcia,: g 137-10A0 '7
32. X2Y=r) 6$ s:
GA RA,6 E.? y x 3 = Iz)
__..----
BgnaTf '132 x IG =
22X?t ?CR2
3 K ?? c /'i.
IST ?c..?a. 9 (c 1! IS ?'
f MsAAT= 9q6 x 53 =
h
+O B em-ent
? 17 Swim Poo
? 18 Comn./In
O 19 Comm./Ind
O 20 Public F
? 21 Miscella
O 37 Demolish
Finish
1
d.
. Misc.
acility
neous
MWCC System y urw
City Water yES
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code ?
Assessments
II1712.
/4? 94a
52, 7 88
? x Nl 2 50
2-6x 2G, = 676
IKI2r
I '?2 t?l o!'? % t??
984u 53= ?,
,-tt <9
?* **
* PIONEER LAND SURVEYORS •
* engmeering ----LAND PLANNERS • LAN
* 4( * *
7422 Enlr.rprisc Drive
Mendoto liciglils, MN 55120
612) 681-1914•Fox 681-9488
625 Highway 10 IJorlhcost
Bloine, MN 55434
(612) 783-1880•Fax 783-1883
Certificate of Survey for: JOSEph M Miller COn5t1"UCtIOn CO.
House Address: 649 McFaddens Trail Eagan. MN
Model Name: Brunswick
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EAGAN ING%YdERRIIdG DEPT
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. 900.0 Denotes Existing Elevation PROPOSED HOUSE,_ELEVATION
. eoa.o Denotes Proposed Elevation Lowest Floor Elevation:933.55
-- Denotes Drainage & Utility Eosement Top of Block Elevation:942.36
- Denotes Drainage Flow Direction Garage Siab Elevation:941.33
---o-- Denotes Monument ----
-9- Denotes Offset Hub Bearings shown are assumed
LOT 5, BLOCK 2 LAKEVIEW TRAIL ADD.
? OAKOTA COUNTY, MINNESOTA -- - ?
I hereby cerUly that lhis survey, plan or report was p.epareA by me r under my Jirect supervieion and thal I am duly Regislered Land Surveyor
under che laws ol ihe State ol Minnesota. Dared d+is 14 day of r'?ovf' A.D. 19q Z.1•
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INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
aurLoxNG
025571
05/11/95
$ITEADDRE$$:P•I•N.: 10-44330-050-02
LOTa 5 BLOCK:
649 MCFADDENS TR
LAKEVIEW TRAIL
PERMIT SUBTYPE:
GARAGE/ACCESSORY
r-
?
z
APPLICANT:
DAVIS SYSTEMS, PAUL
(612) 954-9702
TYPE OF WORK:
DESCRIPTION
REPAIR
FIRE DAMAGE TO ROOF
?
REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
-i..
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
649 MCFADDENS TR
LO7: 5 BLOCK: 2
LAKEVIEW TRAIL
P.I.N.: 10-44330-050-02
DESCRIPTION:
FIRE DAMAGE 70 ROOF
Building P,ermit 7ype GARA6E/ACCES30RY
?u3lding Wo'rk,7ype REPAIR
-f
?.
t
?
k
cp'4o0
BUILDIN6
025571
05/11/95
. . ;{..?. " .._ .:t ` ....?%tP. . Cf
REMARKS:
A SEPARATE PERMIT SS REQUTRED FOR FiNY ELEC7RICHL WORK
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Total Fee
$252.00
$12.50
$264.50
$25,000
CONTRACTOR: - Applicant - 57. LIC. OWNER:
DAVIS SYSTEMS, PAUL 14549702 0008324 PETERSON EDWARD
2535 PILOT KNOB RD 118 649 MCFADDENS TR
MENDOTA NEIGHTS MN 55120 EAfaAN MN 55123
(612) 454-9702 (612)452-8035
?
I hereby aaknawledge that I have read this application and staCe tMat the
information i,s correct and agrae ta comply with ali applioabi•e State of Mn,
9tatutes and City of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATURE
t
f?ED By.' S1 NAT R
CITY OF EAGAN ,? I t 4 F
3830 PILOT KNOB RD - 55122
Mil 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
? 3 registered sfte surveys ? 2 copiea M pian
? 2 copies of plans (indude beam & window sizes; poured fid. design; etc.) ? 2 ske surveys (eMerior addkione & decks)
? 7 energy calwlations ? t energy calculaUons tor heated eddklona
? 3 copfe5 of trea preservatfon plan if lot platted after 7/1/93 ---
requlred: _ Yes _ No ?--
DATE: CONSTRUCTION C ST::
n ?--A-1- -?
DESCRIPTION OF WORK: ? ' -
STREET ADDRESS: _CS?TaMG.?-?
LOT BLOCK ? SUBD./P.I.D. #: ?,('tdRLNO1PY '1,C?i,(?`.
PROPERTY Name: ?-1-ra_r?17s'1 I?A ca »,Y4 Phone #:
OWNER `"°T
Street Address_C2A?Q?.1?
City: State: zI.aL_ Zip:
CONTRACTOR Companyl? %ilt u<<5.????IS???1Phone #: 4r?70z
Street Address: License #:
ef ?r+e I f? 66 I.Z?
City : Al1.?mr4r??-n State: ?_ Zip: ?
ARCHITECTI Company: PhOne #,
ENGINEER
Name: Registration #•
Street Address-
City: State: Zip:
Sewer & water licensed plumber:
change are requested once pertnit is issued.
1 hereby acknowledge that I have read this application and state that the
applicable State of Minnesota Statutes and City of Eagan Ordinances. /
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
_ Yes _ No
Penalty applies when address change and lot
with all
Tree Preservation Plan Received - Yes - No
BUILDING PERMIT TYPE
? 01 Foundation o 06 Duplex
0 02 SF Dweliing ? 07 4-plex
n 03 SF Addition ? 08 8-plex
0 04 SF Porch o 09 12-plex
0 05 SF Misc. 0 10 _ plex
F?2L DsMAyE
WORK TYPE
0 31 New ? 33 Aiterations
0 32 Addition ezc34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
OFFICE USE ONLY
0 11 Apt./Lodging o
? 12 Multi Repair/Rem. o
? 13 Garage/Accessory ?
14 Fireplace o
? 15 Deck
0 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq.ft.
Building
i a?..
... « .? ., ?""y.
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code. ?W
SAC Code oi
Census Bidg _L
Census Unit a
Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S/W 5urcharge
Treatment PI.
Road Unit
Park Ded.
Treils Ded.
Other
Copies
Total:
Valuation: $ 2 s1:2oL' ?
°h SAC
SAC Units
L? eL CITY OF EAGAN CITY USE ONLY
PLUMBING PERHIT
SIIBD.LLiICLVIeGt? (612) 681-4675 RECEIPT #
DATE
?
&ESIDENTIAL
PLEASE COMPLETE IIPPER PO&TION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH IINIT.
---------------------------------------
GTORK DESCRIPTION
NEW CONST ?
ADD ON
REPAIR _
pwNER NAME; JOE MILLER CONSTRUCTION C0. INC.
SITE ADDRESS:42 i/ lY/?ddP%IS /YQl I
INSTALLER: GENZ-RYAN PLUMBING
ADDRESS: 14745 South Robert Trail
CITY: Rosemount ZIP:
55068
N0. . FIXTIJRES U. TOTAI.
REPAIR/ADD ON 15.00
SHOWER 3.00
? WATER CIASET 3.00
? BATH TITB 3.00 6, OD
? IAVATORY 3.00
? KITCHEN SINK 3.00 ?
I IAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
? WATER HEATER 3.00
? F7AOiL DRA£N 3.00
GAS PIPjNG OUT.
I (MINIMUM - 1) 3.00
? ROUGH OPENINGS 1.50
_ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. T[JRNAROUND 15.00
S,TATE SURCHARGE .50
TOTAL: ?S /•//(J
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
SUITE $: _
INSTALI.ER: _
ADDRESS:
CITY:
'PHONE #:
FOR:
ZIP:
COMPLETE THE FOLIAWING:
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE $
TOTAL:
( SIGNATIJRE )
$
CITY OF EAGAN
PHONE #: 423-1144
CTTY OF EAGAN
L,?_ B 4 MECHANICAL PERMIT
SiTBD. -C C (612) 681-4675
xECEIEPr # tlv s ?ov
DATE r- °
'i RESIDEN'I7AL
PLEASE COMPI,EfE UPPER PORTION ONLY FOR SINGLE FAMQ.Y DWELLINGS. ALSO, COMPLETE FOR
TOR'NHOMES/CONDOS R'HEN SEPARATE PERMITS ARE REQUIRID FOR EACH DR'II.LING UNIT.
OWNER'.,e ? ?? ' FEES
S ADDRFS : ADD ON/REMODII. (EJIISTING $ I5.00
?j ? A W ? Y' CONSTRUCl'ION ONLI)
INSTALLER: ? C HVAC: 9-100 M BTU 24.00
PHONE #: O ADD11'IONAL 50 M BTU 6.00
ADDRFaS: vAS 017T'..a^TS - ?.IINIM:TAt t @ $=. I'r4. ? ? j (DO
CITY: ZIP: SURCHARGE $ .50
SIGNA ? Cl- TOTAL: $ ?1Q ?\
?
COMMERCIAL
PLEASE COMPLEl'E THIS PORTION FOR ALL COMMERCWJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR
APARTIYfENT BUILDINGS OR OTHER MULT[-FAMILY BUILDINGS R'HEN SEPARATE PIItMTfS ARE NOT REQUIRED FOR
EACH DWELLING UNTT.
R'ORK DFSCRIPTION:
CONTRACf PRICE: I FEES
1% OF CONTRACl' FEE. I
STATE SURCFL4RGE IS $.50 FOR EACH r
$1,000 OF PERMTT FEE. ?$
PROCFSSED PIPING • $25.00
MUM FEE • S25•00
MIINI Fs
`77b1z-7
, 2006 RESIDENTIAL BUILDING rERMIT arrLrcnTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
New Constructron Reouirements
3 regislered site surveys showing sq. R W lot, sq. H. oi house; and all roofed areas
(20°h maximum lot coverage albwed)
1 Soils Report if proposed buiiding is to be placed on disWr6ed soil
2 copies of plan showing beam 8 window sizes, poured found design, etc.
1 set ot Energy Calculatbns
3 copies of Tree Preservation Plan R lot platted after 711193
Rim Jorst Detail Options selectron sheet (buildings wAh 3 or less units)
Minnegasco mechamral ventilation fortn
C90
c?s?•
RemodeVReoair Reauirements Office Use Onlv
2 copies of plan showing footings, beams, joists Cert of Survey Reo] Y N
1 set oi Energy Calculations for heated addNons Soils Report _ Y_ N
1 sRe survey for add'Aions & decks Tree Pres Plan Recd _Y _ N,
Addition-indicatei(on-sitesepGcsys[em TreePresRequired Y N
OnaiteSepticSystem _Y _N
"d 5 I q
Date ? / J / _017
Site Address Construction Cost
elc UnibSte #
Description of Work
Multi-Family Bldg _ YX N Fireplace(s) _ 0 _ 1 _ 2
Properry Owner Telephone # ( )
Contractor GIr- 77Y /`
Address
State City ?„hp'?tii?l
Zip ?S'qpTelephone # (j?yS')
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(q su6mission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residenrial 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 work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
t nz fioPq
Applicant's rinted Name
Applicant's Si ature
DO NOT WRITE BELOW THIS LINE
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (9-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex );;lf 18 Deck ? 23 Porch (screen/gazebolperola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
??,/ 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
y? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
0 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "DemoliUon (Entire Bldg) - Give PCA handout to applicant
D@SCrIptlOn: Water Damage _ Yes
Valuation OL9L) Occupancy MCES System
Plan Review ? 100% or _ 25%
Census Code _(. U_ Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const _v? Width
Footings (new bldg)
? Footings(deck)
_ Footings (addition)
Foundation
Drain Tile
Roof lce & Water Final
_ Framingi
_ Fireplace - R.I. _ Air Test _ Final
_ Insulation
REQUIRED INSPECTIONS
_ Sheetrock
FinaUC.O.
? FinaUNo C.O.
HVAC
Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
Windows
_ Retaining Wall
r-S
Approved By: 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
/J/'Ak?-
3l0UD
; ..? ? 2422 Entcrprtse. l]rive
, * Mendota Ilciyiils, MN 55120
(612) 681-1914•Fax 881-9488
L* P1OlVEER LAND SUflVE1'ORS • CINL ENCINEEkS _ _ ------ -'--- -
LANU t'LANNERS • LANOSCME ARQIIlEC15 , 625 Fllyhway 10 NorfhCas!
? engmeering Blaine, MN 55434
# -* * * (612) 783-1880•Fax 783-1883
Certificate of Survey for. JOSeJh M Miller Construc_tion CO.
House Address: 649 McFaddens Trail Eagan MN
Model Name: Brunswick
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA133273
Date Issued:10/02/2015
Permit Category:ePermit
Site Address: 649 Mcfaddens Tr
Lot:5 Block: 2 Addition: Lakeview Trail
PID:10-44330-02-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Scott P Roelke
649 Mcfaddens Tr
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA133405
Date Issued:10/12/2015
Permit Category:ePermit
Site Address: 649 Mcfaddens Tr
Lot:5 Block: 2 Addition: Lakeview Trail
PID:10-44330-02-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
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
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Scott P Roelke
649 Mcfaddens Tr
Eagan MN 55123
(612) 309-4923
Holmin Heating & Cooling Llc
3432 Denmark Avenue, #228
Eagan MN 55123
(651) 405-3853
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r
For Office Use
City
City of EaRan Permit#:
Permit Fee: /
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675
Fax: (651)675-5694 Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
f 11
Name: O /Foe 6 Ze— Phone: �c�-309' c 3
Resident/
Owner Address/City/Zip: by ' 1411 Y` s 4-3
Applicant is: Owner (ontractor
Description of work: 72irg(- 1 ✓ �JQ(�/
Type of Work
Construction Cost: RC1. 00 Multi-Family Building:(Yes /No' \ )
Company: U j 2 4 c , d wi ' Ji Arki "tj r Contact: /-'/ (/fr)
•
Address: `C
Contractor Z /e el/9P City: L'/4B T029
State:$?) Zip: Sl 7/7 Phone: 4; 85'767 Email:
License#: ecG—�3-75'-i9 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:plansandsupporting documents that you submit are considered:to be Public;information. Portions of
the information maybe 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 Minnesot State Building Code must be completed within 180
days of permit issuance.
x C U�jfdYl [��jlOtf� x 11
Applicant's Printed Name Applicant's(;iiOnatu e
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