4345 Livingston DrA
BUILDING PERMIT
To be
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Est. value $841,000
Site Address 4345 LIVINGS'lY)N DR
Lot S Block 1 Sec/Sub. LB7CINCTON POI ?1
Parcel No. _
W Name WiL[.IAM HU1"[IiER
o Address 960 idATESPORD DR FT
City EAG?N Phone 452-3088
o Name 5AME
?¢ Address
`- City Phone
Name _
Address
Phone
I hereby acknowlege that I have read this appiication and state that the
information is correct and agree to comply with ail applicable Slate of
Minnesota Statutes and City of Eagan Ordinaoces._, Signature of Permitee .-A euilding Permit is issued ro: WI LI.IAl"J xU'f?liSR
on the express condition that all work shalt be done in accordance with all
applica6le State of Minnesota Statutes and City of Eagan Ordinances.
Building Ofticial
OFFICE USE ONLY
Occupancy R-3 ?1 FEFS
Zoning PD R=1
(Aclual) Const V-N 81dg. Permit 568 • 00
?
(Allowable) V?
Sumharge 42• 00
# of Slories
?1
PlanReview 369.00
Length
Depth
48?
SAC,Ciry .?
1?•? j
S.F. To1al -
SAQ MCWCC ?
6?•?
S.F. Footprints -
On Site Sewage _ water Conn 62 5.00
On Site Well
Waler Meter ?
90•00
MWCCSystem ? i
A
D 30.00
City Water
xx
cct.
epos
t ?
PRV Required S/W Permit 30•00
Boosler Pump - S/W Surcharge • ? ?
Treatment PI 252.
? I
APPROVALS RoadUnit 3ss.? 7
Planner
nGl
C
-
Park Ded. ?
ou
BIdg.Off. _ Copies ?
Variance - TOTAI 39061.?0 j
J
42 17543
Receipt # '
Date FEE 23 , 19-9n--
Permit No. Permk Molder Date Telephone #
WATER :??F ? . (.L?Lc<r' ?.;?.c.?? ?,?'?S'?SD
SEWER
PLUMBING '3 O
H.V.A.C.
ELECTRIC h D,l`,3g5 S/ /?O ?
Inspeelion Date Insp. Comments
Footings I - ? L U
Foundation
Framing
Roofing
Fiough Plbg. 7 Q
Rough Ht9. U ?
Isul.
'j ?
7
Fireplace y? QU G(J
Final Htg.
Fnal Plbg.
ConsL Meter Plbg. Inspector - Notify Plumber
Eryr.IPlan
Bldg. Final
? J
Deck Ftg.
Deck Final
Well
Pr. Oisp.
e;v- ?
• MECHANICAL PERMIT PERMIT #
CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122
VTRACT PRICE: PHONE: 454-8100 DATE: '
I Site Add[ass
? Lot ? Block. '--;r Secl$4b -
? Name
? Address
c Ciry ^ Phone
,
Name r ..
?
4 3 Address
p City Phone
TYPE OF WORK
Forced Air
it Heater
Cond.
? Gas Piping Outlets iY
M BTU
M BTU
M BTU
M BTU
CFM
PERMIT FEE:
S/C:
TOTAL:
BLDG. TYPE WORK DE3CNIPTION
Res. New ?
Mult Add-on
Comm. Repair
Other
FEES ?
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
50 EA
" GAS OUTLETS (MINIMUM -1 PEH PERMITI -
COYMIIND FEE -1% OF CONTRACT FEE
APT. BLDGS. - COMM. AATE APPLIES 1.
.
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
REMODELS - 12.00
MINIMUM COMMERCIAL FEE -
STATE SURC1iARGE PER PERMIT - ?
20.00
50
(ADD $.50 S1C PER EACH $1000.00 OF PERMIT FEE) .
3 ?
?
`
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
. . , . . . . . . ,- . .. . . . . . 9 . . .. .
PLUMBING PERMIT
r ? For Officq Uyu
y
CITY OF EAGAN PERMIT # ?' ?
??
CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT ?
1
PRICE PHONE4548100 ?
DATE: 14 So
SRe AddresS L-"L'/Of7 J/, BLDG. TYP, E/ WORK DES?RIPTION
Lot S- lock
Seq/?b ?s. V New
, Muft. Add-on
Name { ??? q n. tlS Comm. Fiepair
?
Address Other
?
- City Phone `I 3 3-373 RFS. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES
J TOTAL
? Jv
Water Closet - $3.00 $
Name ! gath Tubs - $3
00 •? ° ?
`
c Address .
} Lavatory - $3.00 ? • ?O
? Cit Phone
y Shower - $3.00
-
?
? Kitchen Sink - $3.00 00
1
l/Bid
3
00
U
i
FEES et - $
.
_
r
na
/ Laundry Tray - $3.00
- 3.oa
COMM./IND. FEE - 1% OF CONTRACT FEE T Floor Drains -$1.50
APT. BLDGS. - COMM. RATE APPLIES T Water Heater -$1.50
TOWNHOUSE & CONDO - RES. RATE APLLIES Whirlpool -$3.00
MINIMUM - RESIDENTIAL FEE $12.00 1 Gas Piping Outlets -$1.50 ?--o
MINIMUM - COMM.IND./FEE $20.00 (MINIMUM -1 PER PERMIT)
STATE SURCHARGE PER PERMIT .50 Softener -$5.00
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) _ Well -$10.00
i PrivateDisp. -$10.00
Rough Openings - $1.50
U
G
Sprinkler System - $12
00
SIGNATURE OF RMITTEE .
.
.
PERMIT FEE:
STATES SIC: 50
FOR: CITY OF EAGAN ?
GRAND TOTAL: a i?? 1
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE ?
METER # :V-3 74 749 7 pERMIT DATE-" 2 o% 90
CHIP#CJ&-? dO??g PERMIT# 11746
METER SIZE B.P. RECEIPT # C 6504
ISSUE DATE B.P. RECEIPT DATE02/23/90
- PRV - BOOSTER PUMP
SffE ADDRESS C't. L' i,
LOT ?BLOCK --L--SEC/SUB - • •', N yf?= ` ; `' '?
APPLICANT:
ADDRESS: 7._ [1
CITY, STATE 21P PHONE:
PLUMBER:
ADDRESS: 15185 caxoirsEL wE:V
CITY, STATE ROSEi+iC`UNZ, M:N Zip 550(:8
PHONE: '{Z -? - - '?
OWNER: -
ADDRESS:_
CITY, STATE
PHONE: _
ZIP
PERMIT REQUESTED
X SEWER X WATER - TAPS
COMM/IND X RESIDENTIAL
-X NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
;-
x
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
.- ' CITY OF EAGAN N2 17543
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt # c' V"so
To be used for SF DWG/GAR Est. Value $84, 000 Date FEB 23 , 19 90
Site Address 4345 LIVINGSTON DR
Lot 5 Block I Sec/Sub. LEXINGTON POINTI
Parc el No. 4TI
W Name WILLIAM HUTTNER
Address 960 WATERFORD DR W
o City EAGAN Phone 452-3088
4164
o
Name -
SAMF.
Z
Q
O Address
U
Q
?
City
Phone
?
?W
Name
?? Address
a W City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply w' h all plicable State of
Minnesota Statutes and City ot Apan Ordina es 2 ?
Signature of Permilee ?
A euilding Permit is issued to: WILLIAM HUTTNER
on Ihe express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
8uilding Official
OFFICE USE ONLY
Occupancy R-3 -M--l FEFS
Zoning PD R=1
(AcWal) Const V=N Bldg. Permit 568.00
(Allowabie) V=N
Surcharge ?+2.00
# of Stories -
50'
Plan Review
369.00
Length
Depih 48' SAC, City 100.00
S.F. Total - SAC. MCWCC 600.00
S.F. Footprints -
on Site Sewage _ water Conn 625. 00
On Site Well - Water Meter 90.00
MWCC System Y-X 30
00
City Water 'XX Acct. Deposit .
PRV Required - SIW Permil 30.00
Boosler Pump - S/yy Surcharge • 50
Treatment PI 252.00
APPROVALS Road Unit 35 S_ 00
Planner - park Ded.
Council
BIdg.Off. _ Copies
Variance - TOTAL 32061.5
0
?_ 90. 06
(?3 S?3c
I F-----------------
j Pet#:y?.:.(J?f?a I
? Permit Fee: A?l, C,I ? ? I
j Date peceived: ?^ ?
I I
I Staff: ?
V __________J
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: s d SiteAddress: Li5 A (1oglt)-}Cjl ??..
Tenant:
Suite #:
RESIDENT/OWNER Name: Tiw Vc) Phone: (05-1951'}(f
Address / City ! Zip:
Applicant is: _ Owner -X Contractor
TYPE OF WORK Description of work: J pC?r cqf?- ?-t ?cp
Construction Cost: S:n `7 9 Qo Muit'r-Family Building: (Yes / No >G )
CONTRACTOR Name: ? License#: d??c?s?-IZ7v1
Address: M&orfai Avp City: _ &Tf I '('f - State: 1 r'? Zip:
Phone: l0 JI "q9)I-q3x Contact Person: K[x;ren
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submined Submitled
(4 submissiort type) • Energy Envelope Calculations Submitled
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 Piumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOFE Plans.8ttaf suppor,??ng ?tt7ct(t?e7Xs ihe?kou sdGr?{rit a?e cldncnd??ec?#+?i ??' ?ru?i?Yc'frtYor?iatro?a ?a??qr?;pf ;
#he irrfvrmat?orx rr?ysbe aC?ss+fYt??"vr?T??i?r#y'a?
€l??lt+? . ? ?..,,_rB
*66
I hereby acknowledge that this information is complete and accurate; that Ihe work will be in coniorrnance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application ior 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.
x f?tCt'IO?? (?c<1fCCA'? ?y-
ApphcanYs Prmied Name ? ApplicanPs gnatu e?
Page 1 of 3
RESIDENTIAL
_5p(?5q BUILDINC PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-881-4675 ?
NewConstructionReauirements RertadeUReoairReauiremanb
• 3 registered site surveys showing sq. ft. of lot, sq. R. of house; and ?II roofed areas • 2 copies ot plan
(20% maximum lot coverage allowed) . 1 set of Energy Calwlations for heated addiGons
• 2 copies of plan showing heam 8 window sizes; poured found desgn, etc.) • 1 sde survey for extenor additions & decks
• 1 set of Energy CalculaGOns • Indicate if home served by septic system for additions
a 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Delail Options selecUOn sheet (bldgs with 3 or less units)
DATE t 5 lz.?lc a
VALUATION
SITE ADDRESS ?I3t"? ? l-? ?( j i_%0?0h -Dr MULTI-FAMILY BLDG _Y _ N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
Eals,
APPLICANT
STREETADDRESS -b 95-2,_-, U PPp'r __1ZO?a CITY ?c, tl STATE_P)3.zZIP ?6rzf?fo
TELEPHONE #?15a-yy? 9901 CELL PHONE # C-sd ZZSo°Z `?y 1 PAX #f5t`1"S`(95
CG? 51J
PROPERTYOWNER 1 71 Vo TELEPHONE# JG& U
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOT:1 RULES 7670 CATEGORY 1 ?
(J submission type) • Residentlal VenGlation Category 1 Worksheet Submitted •
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing system inclades:
Mechanical Contractor. _
Mechanical system includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Phone #
Phone #
MAY 2 3 2002
Fee: $90.00
Fee: $70.00
----------------- •-----°-----------------°------------------------------•-----------------------------------------°....
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
---------- ----------------- ------ -------- __------ _._..-------_...
OFFICE USE ONLY
_ Water Softener _
_ Water Heater _
1Vo. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS SEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For:
Site Address
n
5? ? 4 F---W / Valuation
`f3w L?v/? F
Lot ? Block _/
f E C?
Parcel/Sub LL°-?ttnfc,?
Owner
Address
City/Zip Code
Phone
Contractor
Address
City/Zip Code
?
Phone '(57L?3v 7z 3- LF/ h l
Arch./Engr.
Address
City/Zip Code
LEL 2 t' RECO
Date : ?^ Zd -/ 0
OFFICE USE ONLY
$y,aoa,
Occupancy
I R-3 m' (
Zoning pp pl- 1
Actual Const 'V-N
Allowable v-N
# of stories
Length 50'
I, Depth ?
!S.F. Total
?Footprint S.F.
On site sewage_
On site well
i MWCC System Ie
'City water ?
PRV _
Booster Pump _
AYPROVALS
Planner
Council
Bldg. Off, 2/7?i
Variance
FEES
Bldg. Permit 568, a0
Surcharge 142,00
Plan Review 69, DD
SAC, City J('O1 C?O
SAC, MWCC P,1Q, OC7
Water Conn
Water Meter °f0,00
Acct. Deposit p,
S/W Permit AD.?
S/W Surcharge Ib
Treatment P1. 262,0
O
Road Unit 355,Da
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL ,??1I •
1S ? pl
Phone #
GARA{.,1F
?x22= ?o x
?--- ,
.. , ,..?•. 3 %?
IS-= eobop
?SmT,
a?X4o = (oLl0
?S x ? ? 32
I 2 ?/a = 12,0
?-?
11?1? x 14 = 166??
H
?
?X7 r- ?LI
I Zo (o )( -_?
8 ?8
.. ,
?,.
?•
? .
1
(Fo:m Dcvcloped by the Sca:e of Y,innesota i,uile:119 Coec i)ivisio:z)
TO EE 5U9:SITTED T,'I73i IIUILDIt:C PFPSfIT AI'PLIC,ITIO1
FiTE?;IOR F:JVELOPE AVERACP "U" C(1?3UTATION _
M'tiER:
S?TE ADDRESS: 4,f S
:ia7(__
CANTRACrOR: Cv WL #U 7( ? ? DATE: 7 -?-0-) d PFIONE: ?S?'3o ?' ?
Determine vorking square faotage of each
1. Total exposed wall area......... z d/ z- sq.ft. a' ?( o Z ,32
2. Total roof/ceiling area......... sq.ft. x?? 3l98
3.• Total exposed wall area calculations:
Total exposed wall area above floor
a. Total wall raindow-area ..............................
b:' 2ota1 door area .................................. ?7_
c. Total sliding g2ass door area ....................... ~
d. Total fireplace wall area ........................... -
' e. Total wall framing area (average 107.) ............... 1 f: Total net wall area above floor ..................... 1367
g. Total rin joist area ................................ //O
Total exposed foundation area m lv 5,
h. Total foundation windoca area ........................ -
i. Total net foundatioa area above grade ............... ic
Determine "U" value of each wall segment
a 1 tF2 x "u"
. • •, .
:
b. S ? x „U.,
C. - x „u„ ---
d
. - X $fu,l
. e.
19 /
X
,tU,l .?? _
I 31 37
f. I 3? 7 X „Ul. ,
g. l/o x ,tU„
g $sU"
X nUn
' ???•:. .
30 • TOTAI. . • "??
If item 03 is the same as, or less than item 01, you havc met the intent of
SIIC 6006(c)20
'
A I
' _ ?r,.. •,
Total exposed roof/cclling calculations:
Total e:cposed roof/cailing area 2-3 d
';^, J. Total skylight area ...................................
k.'Total roof/ceiling framing area (averaPe 107.)......... /13
1. Total net insulated roof/ceiling area................. /f0 7
Deternine "II" value for each roof/ceiling segaent
J. ?- . X uIIu .
k. ? z 3R„u„
y-
1. x „U„ , ?.
4. 'TOTAL 0
If total of A is the same as, or•less than G2, you have net the intent
of SBC 6006(c)1.
Alternate Building Envelope Aesign
'°•i', . •- , . . . .
To utilize the total envelope system method, the values establislied by -•
the sum of items #3 and 34 shall not be greater than the sum of items O1
and 02.
1. + 2. `
3. + 4. ? •
. . • : '?
C E R T I F I C A T I O H
------------
I hereby certify that I bave calculated the "U" factors and R values
hereia and that the building hera described meeta or exceeds the State of
• Minnesota Energy Conservation Act. . •
• ? , _
?
. ? (Signature). . Z-zv - 5'0
. (Aate) '
? . "
TRI-LAND C4.
SURVEYING
SERVICES
EAGAN, MINNESOTA 55126
LOT 5
LEGAL DESCRIPTION: LOT 5113LOCKJ-, LEXINGTON POINTE 4thADD.
ACCORDING TO THE RECORDED PLAT
, r THEREOF DAKOTA COUNTY,MINNESOTA
i. ,
SCALE: I11=30'
LOT 4
DR ?PSEN
W ? ?\
Lo co\
ap ,j:
? N ?
?- ?
N ?
IN-?\qX
o N .
00
cn
CERTIFICATE OF SURVEY F4R:
HUTTNER CONSTRUCTION
q01
y a5
qg w
S?9?44
LOT 6
LEGEND
o DENOTES IRON MONUMENT
a DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES ORAINAGE DIRECTION
I hereby certify ihat this survey, pian or
report wcs prepared by me or under my
direct supervision and thot I am a duly
Reqistered Land Surveyor undsr ths
Laws of the State of Minnesota.
?
98/r. 0?1'
74 s ? q?1p??e 1'
n- v D L
23.?? ? ??a ?C?? ?
p
i qo
, ? 11 O
s. ?
i s' tD
lp
a A `' •O ?t1 q86.a?
w 5 ?
9o.92
16t 68 m
wk ? ??. .
ByF EAGR'N
FRopoS6i7 SPLIT 6NTRy - No vJauCoUT
INVERT ELEVLITION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION = q89 k
PROPOSED FIRST FLOOR ELEVATION = 989 z
PROPOSED BASEMENT FLOOR = 985.'
ELEVATION
NOTE * VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
-'?/;
Bradley J. S,w)nson, Mn. Req. No. 15235
oare :
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA129189
Date Issued:01/20/2015
Permit Category:ePermit
Site Address: 4345 Livingston Dr
Lot:5 Block: 1 Addition: Lexington Pointe 4th
PID:10-45073-01-050
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.
Applicant: Craig Angell
12253 Nicollet Ave. S.
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Khanh K Nguyen
4345 Livingston Dr
Eagan MN 55123
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746-5200
Applicant/Permitee: Signature Issued By: Signature
1
For Office Use
4+� � � �� :::
,,, E AG A N
:
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@cityofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7,4/i Site Address: +9515'2-h/1417.49 atT1,.e Unit#:
(
Name ��l.� G
® Phone: .-oa , S.31—ell ?�C.)
Resident/ ���s
Owner Address/city/zip: /t/!a- Icbj „e"-ii/0
Applicant is: Owner Contractor
Type of Work Description of work: We ( cD
Construction Cost: 8-49Multi-Family Building: (Yes /Nc) ( )
Company: i41/ 4rpec/r .,&;&-kce!f%eJ Contact: b7- ,„aQ/J'7i ~G
Contractor Address: 93/5 i%/41/4 040/4/ !� 'I City: C.-",44-111rI,U
State: NZip: M/` Phone: 3 62.c.) 91-Z-Eimail: d.1415 7)� e A-1,14). ea.* i
License#: 13e 45'a Dal Lead Certificate#: /v11-i Z eJ
If the project is exempt from lead certification, please explain why:
g@-( b4) /1/0 %ai r/bec oiet
yel
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.
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.citvofeaaan.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 co • ance with the ordinances and ••es of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and wo s no to start with. •i as' the work will be in
accordance w'th the a proved pl in the case of work which requires a review and approval • plan /
x ( dx
Applicari's Prin ed Name ) Applic. - Signature