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4203 Malmo PlCITY OF EAGAN Remarks '-,44dition 6Jilderness Run 5th Addition Loc 12 etk 5 Parcel 10 84354 120 OS Owne?j??f aJ. L? tl '_. ('t. 1W,Street A-403. $ W5 Malino Place stace Eagan, MN 55123 04- _ „ . i . 1;& L-LC , - _ 1 _ _ c Dunle v Improvement Date Amount Annuai Years Payment Receipt Date STREET SURF. STREET RESTOR, GRADING SAN SEW TRUNK 1973 132 .60 6.63 20 =,'? SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 1977 10.66 15 ? 7 ( STORM SEW TRK ^ 1 6-2-80 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit WATER CONN. BUILDING PER. SAC PARK • - • CITY OF EAGAN ? 3795 Pilot Kaob Rosd Eagan, MN 55122 N2 5874 PHONE: 454,8100 ? BUILDING PERMIT 11a03 S??OSN• I?ec'eipt .# Te `e Nud ier , Fer Vnllw , f]nta 19 Site ^ddress Lot Block Sec/Sub. Parce! .# W I Name 3 Address o _ ac i oE ? V ? Nome _ Address Name _ Address Erect p Occupancy Alter ? Zoning Repoir ? Fire Zone Eniarge ? Type of Const. Move ? # Srories Demolish Q Front ft. Grade ? Depth ft. Auorova II Feea Assessment Water & Sew. Police Fire Eng. Planner Council Permit Surchorge - Plan check _ SAC Water Conn. Water Meter Road UniY _ I hereby acknowledge thot I have read this application ond state thot Bldg. Off. the infomnation is correct and agree to comply with all applicoble APC Totoi State of Minnesoto Statutes and City of Eagan Ordirances. Signoture of Permittee A 8uilding Permit is lssued to: on the express condition tiwt all work shall be done in accordance with oll applicoble Stnte of Minnesoto Statutes and City of Eagan Ordinonces. Bullding Officiol f yjo? ?9 9c? ? ??,/ ?o / . r' PonnM # OeFe Nt??d FaMitfM Plumbing 2, j p0 t •?/?. Mechanicol / C INSPECTIONS ATE INSP. Rouqh-In Final FOOtings Date Incp. Date Irap. Foundation Plumbing Fromelins. Mechanicol Finol I Remorks: 'o/iCrCrp ?- . CITY OF EAGAN ? 3795 Pilot Knob Rood Eaqan, MinnesoM 55122 No. Phow: 454-8100 PERMIT Date: Site Address: Lot Block Sub/Sec. Phone: Nome Address INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single Residential Multi Res., Comm./Ind. I New/Alter./Repair. Cost of Installotion Permit Fee Surcharge "?71 `:14- l-1 tiVe. T'3111, la. . , . _ , I City Phone: Totol This Permit is issued on the express condition that ull work shall be done in actordonce with oll applicable State of Minnesota Stotutes and City of Eogan Ordinonces. Building Officiul A . - No. ? :?atir.s' Date: 7-11-80 cinr oF EAGAN 3795 Pilot Kno6 Road Eegen, Minnesota $5122 Phem: 454-8100 PERMIT Site Addreu: Lot Block Sub/5ec. Nomr . ; Address O City Phone: Nome . g ?;0 ':dh3te F.:(:.'^_ g Address e 0 ? City Phone: This Permit is issued on the express condition that all work sholl be Minnesoto Statutes ond City of Eagan Ordinonces. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS 1. ?, . . . Receipt No.: Single I Residential Multi Res., Comm./Ind. I New/Alter./Repair ' Cost of Instollotion Permit Fee r, Surcharge Tofnl done in accordance with oll applicable Stote of Building Official . . .. Mo. CITY OF EAGAN 3795 Pilot Knob Road Ea9en, Minnesoea 55122 INSPECTOR NOTIFICATION Phwne: 454-8100 R E Q U I R E D B Y LAW PERMIT FOR ALL INSPECTIONS Date: Receipt No.: Singie Site /lddreu: Residential lot Block Sub/Sec. Ncme ? r?• "'. New //11ter. / Repoir . ; Address Cost of Installation O City Phone: Permit Fee Name _.;Ab? Surchorge . ? Address 71;r7 nVr , ? City Phone: T 5?' ITotnl This Permit is issued on ihe express tondition ihat cll work shpll be done in atcordante with oll cpplitoble Stote of Minnesoto Stututes ond City of Eogan Ordinances. Building Official -x _ -- No. -) ` cinr oF EAGAN 3795 Pilot Knob Roed Eagan, Minnesofe 55122 Phone: 454-6100 PERMIT INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Date: Receipt No.: Single I Site Address• 4 30r' ? IVi-' 10 - Residenfial Lot Block Sub/Sec. Muiti Res., Comm./Ind. I . ? ? ? ? 0 Nome L'annen Coiistruct3on ?O. New/Alter./Repulr Address City Cost of Installotion Permit fee Phone: Nome ,al]VI`ti£1-. ;-'.t,._ . ISurcharge Address ;'= AVP.. V I I City Phone; I Totol This Permit is issued on the express condition that oll work sholl be done in accordante with all opplicable State of Minnesota Statutes and City of Eogon Ordinonces. Building Offlciol -5 0 C'TY OF EAGAN W95 Pilot Knob Reed Lagan, MN 55122 oning: ner: dress: Pite Address: ? Plumber: eter No.: Connedion Charge: ize: Account Deposit: eader No.: Permit Fee: egree to eamply with !fie City of Eagan Surcharge: dinoncea. Misc. Charges: 1 Total: gy Date Puid: ote of Insp.: InsP•: CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 Zoning: Owner: Address: Site Address: PI umber: 1 s9rce to tomply with Nro Citr of Eegon Ordinanoat. WATER SERVICE PERMIT PERMIT NO.: OATE: . No. of Units: SEWER SERVICE PERMIT PERMIT NO.: DATE: No, of Units: By Date of Insp.: Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: - Totol: ki rlf OF EAGAN .95 Pllot Knob Road oan, MN 53122 _oning: 0Owner: Address: Site Address: Plumber: SEWER SERVICE PERMIT NO.: DATE: No. of Units: PERMIT agree to eomplp with the City oF Eugon Connection Charge: inanCeS. Account Deposit: Permit Fee: Surcharge: Misc Chor es: . g e of Insp.: Total: SP•• Dote Poid: ClTY Of EAC,AN " 745 Pilot Knob Road gon, MN 55122 _oning: Owner. .4ddress: $ite Address: ? Plumber: Meter No.: Size: Render No.: Iagree to oomply with the City of Ea9an Ordteanaea. By Date of Insp.: WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: Connection Chorge: Account Deposit: Permit Fee: Surchorge: Misc. Chorges: ' Totol: Date Poid: Insp.,_ This reyuest void P_ 1 t monti',s from Date o this Request -1I Z, I SSU Fire No, S (2U74 I, aI.icensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cai n g installed at: Street Address or Route No Section Township Which is occupied by ?3 ??R?ri? P+.?c? ? ?y i Range County? Is a roughin inspection required on this job? No ? YesX_ Ready Now ? Will Cg< PowerSupplier ? Address Electrical Contractor ?e???Contractor's License Nd.'??sl ? ompany Name) Mailing Address c, Ct- fF p I -? ( ical Contractor or Ownar Making This Installatlon) ?j?/? Authorized Signature Phone No. 9-(? '"5?0 5, VIM o(DQRM) QOff Thisimpectionrequastwillnoibeacceptedbythe State Board unless proper inspectian fee is enclosed. - - minne5ota State i50artl oT Electriclty Griggs Midway 81dg. - Noom N791 1821 University Ave., St. Paul, Minn. 55104 - Phone 297-2171 FifQUEST FOR ELECTRICAL INSPECTION CH KK BELOW WORK COVERED BY THIS REQUEST 0117 E-B_ooooi_oz S 72074 Type oP 8uilding New Add. Aep. Check Appliances Wired For Check Equipmen[ Wired Foi Homc ? ? ? Range Temporary W'uing ? Ddplex 1IL F ? ? Water Hextet Lighting Fixmies ? Apt. Bldg. ? ? Dryer ? ElecVic Heating ? Commercia] Bldg. ? ? ? rrr yyy,,, Fumace ? Sdo UNoader ? Industrial Bldg. ? ? ? A'v CondiBonet Bulk Milk Tank ? Fazm List List Othei ? ? ? p Heie?s? /'-+'. p Hehersj COMPUTE INSPECTION FEE BELOW JL--? Service Ent[ance Size: # Fee Feedets8Su6 dets• ' F Ci[cuita: # Fce 0 to400 Am s. 0 to 30 Am eres O;.io 30 Am eres 10I to 200 Amps. 31 [0 100 Ampexes 3ljto 100 Am eTes 104 Above 200 Amps. Above 100 Amps. ? A ove 100 Amps. Transformers Remo[eControlCiro. Partialorothe[fee Signs S ecial [nspection Minimum tee $5 Remaiks TOTALFE 3?,00 ,/ 30,7 I, the Electrical [nspector, hereby certify that (Final) This request void 18 months from above ins ection has been ma?de--? r Date 7'/; -}e7 mimresoca acace noara or tiectticny Griggs Midway 61dg. - Room N191 1821 University Ave., St. Paul, Minn. 55104 - Phone 297-2711 ? ' ^VEST FOR ELECTRICAL INSPECTION C??!FCn-nc'OAK COVERED BY THIS REQUEST EB-00001-02 72075 ype of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired Foi Home ? ? Rangc 7emporazy Witing ? Duplex ? ? Wa[eiHeater ? Ligh[ingFiaWres Apt. Bldg. ? ? D7Yer ? F,lecttic Hea[ing ? Commcfcial Btdg. ? ? Q Fuanace Silo Unloader ? Industrial Bldg. ? ? ? Au Condition Bulk Milk Tank ? Farm List ) List ) Oiher ? ? ? p Hehers} ) - ) Hehers} COMPUTE INSPECTION FEE BELOW Secvice Entnnce Size: # Fee FeedersdSu6feeders: Circuits: # Fee 0 to 100 Am s. to 30 Am eres 0 to 30 Am eres 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am ies Above 200_Amps. 1 1 Above 100 Amps. Above 100 Amps. Transfarmexs 1 1 RemoteControlCitc. Pactialoio[Hexfee Signs Special inspechon Mmimum fee $ Remazks ? TOTAL F ? . ? / J I, the Electrical Inspector, hereby certify tl}?t?? abc?ir?,,Ct?p@,Wbeen m? (Roueh-in) ?? Date ? 7kv (Final) This request void 18 months from ?o?a L(?c bS w, ?`17 w°7 `c Date this Request I 2 1 0b Firc No. 7207i `, I, aLicensed Electrical Contractor OOwner, do hereby request inspection of the above electri- cal w?nng installed at: Street tCddress or Route No. Uo? ??? Rizw-? City a,560 Section Township Range County I*Aa Which is occupied by Is a roughin inspection required on this job? No ? Ye? Ready Now ? Will Cal? Power Supplier 1'?N Address Electncal Contractor eL C16 Contractor's License N (??rtl7any pName?) Mailing Address ?4? ? L?/?/ Authorized or owner naakinq rnIs instauation) CS n 5',t' Phone No. `l?'U,??pV ?OQ?D ????V Thisinspecdonrequestwillnotheecceptedhythe r` ?^?? State 6oard unless prapar inspectian fee is enclosed. minnesoca acaie uoara or tiecmciry Griggs Midway Bldg. - Hoom N791 ' 7827 University Ave., St. Paul, Minn. 55104 - Phone 297-2111 ? ' " RE'tlUEST FOR ELECTRICAL INSPECTION aI ?? CHECK 9ELOW WORK COVERED BY THIS REQUEST EB-00001-02 60494 Type of Building New Add. Aep. Check Appliances Wired For Check Fquipment Wired Por Home . ? ? ? Range ? Temporary Wiring ? Duplex ? ? Water Heater Lighllng Fixtuces ? Apt. Bidg. ? ? ? Dryec `.Z Electric Heating ? Commercial Bldg. ? ? ? Furnace ? Silo Unloadei ? Industrial Bldg. ? ? ? A'u Conditioner ? Bulk Milk Tank ? Farm ? ? 0 List )?_ List Other ? ? ? p Reiers} ) Oehets? A f COMPUTEINSPECTION FEE BFLOW Service Entnnce Size: # Fee Fcedeia h # ee Ciccuita: u Fee 0 to 300 Am s. 0 to 30 res,, 3= 0 to 30 Am eres 47 d0 101 to 200 Amps. 31 to IOOsAm 4ei 31 to 100 Am res Above 200 Amps. A6ove 10 _Amps. Above 100 Am s. 1'ransformers RemoteControlCiic. Partialor othertee Si ns Special Ins ection Minimum fee 55.00 0 , Rema.ks 'fOTAL FE g• ? o ?• ?r I, the Electrical Inspector, hereby certify that the above inspection has been made. (Final) This request voiQ 18 months from Date - P?ie ? - 9p -,?r/ ?s W` Tlus request void L 1P( P 1 amontJig from d+ ( ? Date o this Request 0 F;re No. S 6 0 4 9 4 I, as Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 4/,2 o s¢'/z a S 097-7 d.& -- Section Township Range CountyZaja;n? Which is occupied by 64f Q.&ec/ ''?f -??Qe Ds.3 (Name of occupant) Is a roughin inspection required on this job? Nrye Yes ? Ready Nowk Will Call ? Powet Supplie???a[,.• Co . ?,c"t??.Address ? ' Electrical Contractor??? Contractor's Lice?N? (CompanY Name) Mailing Address 12 51el' ? /Jj^j.c?/?,? 7 (Electri Contr ctor or Qwner Making This Installatlon) Authorized Signature ep Phone Nu.?QO?• 4pr5??( (Elettrital Contractol oI OwnefMdking Thls InstailaLion) This inspectian request will not he accepted 6y the ? L3 fnl ll State Board unlas proper inspection fee is enclosed. CITY OF EAGAN Inclixle 2 sets of plans, ? 1 site plan w/elevations & ?, ' BUILDINGPE1CT APPLICATION 1 set of energy calculations. p ? ?To Be Used For Valuation- 79, p D d Date -/ y, -& Site Prlclress A/j0 3?y.,?. IAt /?- Elocat 5--sec./sub. Fxact Parcel #: t2? Alter ? ILepair Oaner: Eh1arJe - Nbve Address: .,f? ?, c- P: <o?,/?d?D?8 ?D . Demlish City/Zip Code: x! Grade Phone #: Contractor: 'rlSG.J Address: sed- as /PTNik6e/J g n City/Zip Code: F-46 yyiJ SS/ ?)- 2? Pnone #: u.,r U- ) 3 p-5? Arch./EnS.. Adclress: OFFICE USE ONLY occupancy _d 3 Zoning Fire Zone Zype of Const. # Stories Front ? y ft. Depth ?ft. APPROVAIS FEES , - Assessments ML Permit /7,2 ?Vater/Seaer Surcharge Police Plan Check Fire SACVeA`Sas IDS"o ? g1q, ??f cs Water Conn: Llv Planner z.tGa Water Meter /ao AM Council 2>li16ROdC1 UTLit Sldg. Off. AFC ' City/Zip Cade: Phone # : TOTAL ' ? CITY OF EAGAN 3795 Pilo! Knob Roud Eogan. MN 55722 N2 5874 PHONE: 454-8100 I 93 `? g BUILDING PERMIT Receipt APPLICATION # To 6e used Fo. Dbl.Bungalow Est. Value 72,000.00 pate June 13, 19$0 Site Address??3 O Pl Erect [A Octupancy R3 Lot 12 Bfock 5 Sec/Sub. Wi1d.Run 5Eh Alter ? Zonin9 R2 Parcel # I(L?i ?SLi ? ?0 OS Repoir ? Fire Zone III Enlorge ? Type of Canst. V w Nome Walter V. Nelson Move ? # Storie5 w D Address /y.205 Pi lo+ Knnh RA Demolish ? FronT ?$ ft. i-?... Fam.?.. F5'1 77 / F/ 100F Grode n DCDtft R. ? Zu F°- f Name _ Address Name _ Addreu Assessment Woter & Sew. Police Fire Eng. Planner CounCil I hereby ackrwwledga that I have reod this application and stote that gldg pF{, 6 12 g0 the information is corred and ogree to comply with all ap lic le AP? State of Minnesota Statutes and Cit of gan Ordinanc Signoture of Pertnittee A Buildin9 Permit is issued to: WalteP N21SOI1 all work shall be done in oaordance with oll ap ' ble State of/ Ainneso Building Official /J Feea Permit i r ?• ?" Surcharge 36.00 Plan check gb • 25 SAC 1050.00 Water Conn. 610.00 WaterMeter 120•?0 Road UniT 370.00 TotQi 2.444.75 on the express condition that Statutes and City of Eagan Ordinonces. 5C? ? S Z? MECHANICAL (RESIDENTIAL) Permit Application - City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX 4 651-675-5674 Please complete for: Single Farnily Dwellings Townhomes and Condos when pertni[s are required for each unit 3o?5a Date n (n_ //Q / 03 Site Address 42? 3 ? ?i? ? I Unit # 55 12- 3 - 1 lo--5 Property Owner 7tci?, Q h? ? v k \,so Y\ Telephone # ( (X6! ) 4541- / 3?'i' -5 Contractor + stn S[reetAddress 2 (erj -541S4-W •, ?. U, ?C?( 95, City ? State K\Vj Zip Telephone # (6 ?J' ( ) 32-2 ^89 Z ? `r3 0 The App?icant is _ Owner X Contractor _ Other Add-on, modiGcation or alteration to existing dwelling unit $ 30.00 fumace replacement air exchanger Z? airconditioner other U ? State Surcharge JUN 1 2 Z??' ', ? ? $ 50 ? ? t l T C) $ o a ? I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will he in conformance with the ord'mances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a peimit, but only an application for a perndt, and work is not to start without a pemvt; that the work will be in accordance with the approved plan in the case of work which requires a review and approva] of plans. ?, 1 ? 1 -4-:' (V\ . )'(-?r \.A L), ?t , ApplicanYs Printed Name ? Applicant's Signature ? .. , ; . I \? .` - - ? 3 ? ? a - y - ? ° p ? , - - o a ? . ? I i .?6) o ' -- C/? ? - - --- - - - - ? _ -_ ? B T - E, MINNESOTA EXTERIOR ENVELOPE AVERIIGE "U" COMPUTRTION OWNER 1&) b4 I 7-GR SO ? SITE ADDRESS l-OT $*F/2 X//r Ug?f 1J?Sf' RV f? CONTRACTOR .$ DA'PE?4'0 PHONE Determine working square footage of ea ch. 1. Tot al exposed wall area . ..... -liza__sq,ft. x .185 =E2M 5- 2. Total roof/ceiling area . .....-- A1?/ sq.ft. x .04 =C1112 r Total exposed wall area above Eloor = a. Total wall window are a .................... .... sq. ft b. Total door area ...... ..................... .... , sq, ft c. Total sliding glass d oor area ............. .... sq, ft d. Total fireplace wall area ................. .... -- sq. ft e. Total wall framing ar ea (averaqe 1050)..... ... " sq. ft f. Total net wall area a bove floor ........... : .. JAV ft g. Total rim joist area . ..................... ... sq, ft Total exposed foundation area ft. h. Total foundation wind ow area.............. . ... sq. ft i. Total net foundation area abovc arade..... ??- .... (, sq, ft Determine "U" value of cach wall segment. Area X "U" Value = Tota "U" a. ITJ. F'? s X" U, ft _ q. ? . . b- -4U. 01 sq. ft. X "U" ? I• c._ tole sq. r? ft. X„U" L d. sq. ft. X "U" ...e _ ? e• ?&, ? sq. ft. X??U?? a f/ i? _ 1 ? f. I-41?2.?/ (?sq. ft. X 'lUll .6/'?'+.r? = Fy,?J•1? q ) 0 " X" ft a 41 . sq. • U ? . - _ . V h. sq. ft. X 'lUll ,41?iT _ 714 i . ? sq, ft. X"U" ,021 =IL?.? 3 ......................................... TOTAL = ? If item #3 is the same as, or less than item #1, you have met the intent of SBC 6006(c)2. I ? . Total exposed roof/ceiling area = sq, ft. Total gross roof/ceiling area =sq, ft. j. Total skylight area ..................... ? sq. ft. k. Total roof/ceiling framing area......... sq. ft. 1. Total net insulated roof/ceiling area... sq, ft. DETERMZNE "U" VALUE FOR EACH ROOF/CEILING SEGMENT. j. sq, ft. X "U" = Total "U" k. sq, ft. X "U" ? 1(09-- _ ? 1 Total "U" 1. 1& IZ Wsq, ft. X "U" Total "U" 4 ................................... TOTAL = i--6i?? If total of #4 is the same as, or less than #2, you have met the intent of SBC 6006(c)1. To utilized the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2. ITEM #1 0_ + ITEM #2 ITEM #3 --*/? + ITEM #4 ? Total envelope DOES DOES NOT meet SBC. Checked By Date -/ DAKOTA COUNTY NAME / DESCRIPTION AN PARCEL IDENTIPICATiON SG11001 OIST PLAT LOT BLK SVBOIVISION: pqO(;{ D DELINaUENT r,ax n PPOPERTV OESCR tGunu VTION secIo. JVOGwEN! VEAF E 5 A OIi ON 10 A4?54 t20 1 AUN WILDE9NESS H THAN SFEHOATE" "TRANSFFAM LASTGPANTEE LZ S 10 9 79 crv 1 7 gobert S. Tilsen et al WD -- 84 462 6 9 30 ter V. & Delores A. Nelson WD i :J 770 !1 LJ C?,fI P/CJ f1c, . ? ,.:7- -.3 -a-K PERMIT City of Eagan Permit Type:Building Permit Number:EA127847 Date Issued:10/16/2014 Permit Category:ePermit Site Address: 4203 Malmo Pl Lot:12 Block: 5 Addition: Wilderness Run 5th PID:10-84354-05-120 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Kathy Espelien Valuation: 4,000.00 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 - Krista Nelson 4796 Eriks Blvd Eagan MN 55122 All Sons Exteriors Inc P.O. Box 146 Lakeville MN 55044 (952) 469-5221 Applicant/Permitee: Signature Issued By: Signature � Use BLUE or BLACK Ink �� r—————————————————+ I For Office Use � ' � /����� � C�b� Ol L���11 � Permit#: � � � � Permit Fee: - J � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 � � Fax: (651)675-5694 I Staff: � I I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION � `'��,Z, �nn,� Date: Site Address: `� ✓ �'�'F7���� 'e-� Unit#: � t 'A n� ,, ` t�� � ����i b Name: `I��X.�-�J�\ Phone. ���#BC�� = ��� z� .' Address/City/Zip: M� � �� � � � . �ti- � � ,s: = Applicant is: Owner Contractor �. ����� � Description of work: � ` '� ��� �. � � � � �� ,�✓l � y� �� Construction Cost: �?� �N✓c1 � Multi-Family Building: (Yes� /No_) Company: �� eContact: � � ��� Address: � �v� City: ������� ;� r ; State: Zip:� Phone: EmaiL ` � License#: 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�similar plan based on a master plan? �,r'" Yes No If yes, date and address of mast��ian: .t Licensed Plumber:_ ✓'��� Phone: ,� Mechanical Contractor: �^ Phone: Sewer&Water Contr or: Phone: Fire Suppression Contractor: Phone: ' ��TE P�5 at��J:��t'�r���O��e��t,y�3�il;���a��8�`e��(�ri b� �� the��r����i r�a�y b���a��l�ra����'�r"���ra��;�+�c�''���r����'���Co� �. �� ; < •, �- :�.��� �.:i�, ���`t��. s..�-�,w r�� ���` � � _ ... , �,�` _. . � � 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.g,.opherstateonecall.orp 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 perm' issuance II ��� x _...,. x Ap IicanYs Printe Name ApplicanYs Signature Page 1 of 3 �fd�� 1'�l�}l�'�-�' �I, DO NOT WRITE BELOW THIS LINE ������ SUB TYPES _ Foundation _ Fireplace _ Porch(3Season) _ Exterior Alteration(Single Family) _ Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration(Multi) _ Multi _ Deck _ Porch (ScreeNGazebo/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 HVAC Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls � Fire Suppression:_Rough In_Final Braced Walls Erosion Control Other: Reviewed By: �1 l�.t-� �- , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S8�W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3