Loading...
2029 Jade LaneCITY OF EAGAN Addition Cedaa -1 L, ZV,,., ? I Z?' I Lot 16 Blk State Eagan,MN 55122 Improyement , i Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK # SEW ER LATERAL . 2.1 2 paid WATERMAIN iE WATER LATERAL 1972 WATER AREA STORM 5EW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN, BUILDING PER. SAC PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: , 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: Control No. 0481 806607 06121192 (612) 681-4675 SITE ADDRESS: Lo t x 16 fi L f)C K: 4 APPLICANT: , 2029 3AQE tRN[ T4,?TN GZTY 37'OitM SASlt Ga , CEp14R GRUVf 3{RO (61:?) 646-81 6li PERNY'st?PA.?P?tU s TYPE OF WORK: RErAIa REMARl?S : RECUIPT #L l I 7? t.,. 0 SASNES, 'YRI11' SOFFITS. FACIA. OlitTFF?3 & S7tJNM ? Permlt No. Permlt Holdar Date Telephone k SNV PLUMBING HVAC ELECTRIC ELECTRIC inspection Date hssp. Commenta Footings I Foundetion Framing Aoafmg Rough Plbg. Rough Fltg. Isul. FiTeplece Fnal Htg. Orsat Test Fnal Pibg. Ptbg. IraspecEOr- Notify Plumber Consl. Meter Engr./Plan ._- eldg. Final Deck Ftg. Oedc Final Well Pc Disp. EAGAN TOWNSHIP BUILDING PERMIT owae: --..... _. ..r.:.-._..-? ......L ........-------..._..........-- - - - - ?? . p- ...._........._... Addxess (Preseni) --.. .er?c.- _._.....-- -. ' '-'----'-'-'--- Builder ....;.SW??.------------------- ..........._'---..............-°'----........._.. Aaa:ess DESCRIPTION N° i'78'7 Eagan Township Town Hall naze 7ories To Be Used For FronS Depih Heighf Est. Cos! Permit Fee Remazks - // ?.s?.. or LOCATION iw1 -V I e- ?? This pesmif does nof aulhoriae the use of siseels, roads, alleps ox sidewalks nor does if give the owner or hSs agen! the zigh!!o creafe anp sifuaiion whieh is a nuisance or which presenfs a hezard fo the healih, safetp, conveaienee and genesal welfare 2o anpone in the commuaify. THIS PERMIT MUST BE (K?EPT ON TFIE PAEMIS£ WHILE THE WORK IS IN PROGRESS. This is !o cerlifY, lhai."-'?`_ ..... .........._-----~.........--------..has permission fo ereet a---_'-' ---'--"--'- -"' '---- -............."_..._upon the above described premise s' jecS !o the pronisions of the Building Ordinanae tor E? gan T nship adopfed April 11, 1955. ...........'---"'-?"'- ."'.....'-'------. Per 4114 'c' A`eCc -' _ ......._ '. . .......__._ --------------- ..._........"""..'.g...fnsp..................................... Chairm of Tnwn Baard Buildin Iecloz 4 - ? EAGAN TOWNSHIP BUILDING PERMIT N° 13'79 Eagaa Township Town Hall Dafe ...J.?(..?.`f?G.d_?...__.__:.._....... ? ? - LOCATIOI3. ? SYreei, Road or ofher Deseripiion ot LocaSion , Lo! Slock Addition or Tracf i --- -=- -- - -- --- ---------- --__ This permit does not aulhorize the use of sYZee2s, zoads, alleps or sidewalks nor does i3 give the owner or his ageni the righ! 2o create any sifuaiion which is a nuisance os which presenis a hazard Yo the healih, saYeip, coavenience and general welfare !o anyone in ihe eommunify. . . TIiIS PERMIT MUST HE KEPT Oli THE P,IREMISE WHILE THE WORK IS IN PROG(H/"E SS. This is fo certify; ihat...______has permission 3o erect a.....A...??f_...??,: :^7',?.,..vpon fhe a6ove deseribed premise subjec! !o lhaprovisions af the Building Ordinanee for Eagan wnship adopied??April 11, 1955. ///? ?J p .--------- _.'_......._..----------------- Per _ ........... ....: ;t??-c........ _.. t'....."'.. . ..... .. Chairman of Tnwn Soard I Building Inspeetor 4 b, 2005 RESIDENTIAL BUIL.DING PERMiT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ?70 00 New Constmction Reauirements RemodeVReoair Reauiremenls O(fice Use OnIV 3 registered sRe surveys showing sq. fL of bt, sq, ft. of house; and all roofed areas 2 copies of plan Ced of Survey;Recd '- _ X_ N (20% maximum lot coverage allowed) 1 set of Energy Calculatlons for heated additions T(ee.Pres Plan Recd Y_ N. 2 copies of plan showing beam & windax sizes; poured found desgn, etc. 1 sAe survey for additlons & decks Tree Pres Required . _ Y_ N lsetofEnergyCalculations Addfion-lndicafeifon-sdesep6csystem On-s'deSepficSyslem _Y _N 3 copies o( Tree PreseNatan Plan if lot platted after 711193 Rim Jaist Oefail Options selectlon sheet (buildings wAh 3 or less uniGS) Date Construction Cost Site Address ZU Z? Sct c? e_ Lc,V-P_ Unit/Ste # Q '` ? , Descriptian af Work - B`? ? Multi-Family Bldg _ Y x N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner J'e K ?eQ aa s-Q Telephone #(6,TI ) C? ? I-(L( I v Contractor Address :S-C?Lw?S S` City State Zip Telephooe # ( `9SL ) ?' ??' ' ? 2 dn COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv l _ MinnesoYa Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( Mechanical Contractor Sewer/Water Contractor 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 work will be in accordance with the approved pian in the ca of ork which requires a review and a roval of plans. _?!i/' V\VV? Applicant's Printed Name Applicant's Signature PL PBImitAppliaEonI?) City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each un : 03 ? to ? -:J / Date / KRAUSE,JEFFREY Site Address 2029 JADE LANE Unit tf EAGAN, MN 55122 (651) 681-1410 Property Owner Telephone # ( ) Contractor ??BLOM P.?ING Co, (612) 82T?033 Address _ City e State ip Telephone # ( ) The Applicant is _ Owner ? Contractor _ Other _ Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes Counry fee. Additional consultant fees may apply. Alterations Ta Existing Dwelling Unit, Including $ 50 00 _ Adding fia4ures to lower levels or room additions, excluding water softener and water heater . Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed -$121.00) Other: _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system Water softener X Water heater $ 15.00 X replacement _ additional StateSurcharge OCr 2 9 20 3 50 Tots, $ 15. SCl BY 1 hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accura e; chat the work will be in conformance with the ordinances and codes of the City of Eagan and with tlie Plumbing Codes; that I understand this is not a pemut, but only an application for a pernut, and work is not to start without a pei7cut; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pians. J? I?oc-blU-"n Applicant's Printed Name Appll/aliVs IA WY OF EAGAN 3830 Pilot Knoh Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: DESCRIPTION: PERMIT 2029 JADE LANE LOT: 16 BLOCK: 4 CEOAR GROVE 9R0 Control No. 0481 PERMITTYPE: guiLozNG Permit Number: 000607 Date Issued: 05 / 21 / 9 2 Builiitng Permit Type PIT5CELLANEOU3 ?Bu3lding,.4ork 7ype REPAIR ? REMARKS: RECEIPT N FEE SUMMARY: Base Fee Surcharge Total Fes e,q54Z SASHE5, TRIM, SOFFITS. FACIA, GUTTERS & STORMS VALUATION $144.00 16.50 $150.58 CONTRACTOR: - Applicant - TWIN CITY STQRM SASH CO 15468166 10825 GREENBRIER RD POINNETONKA MN 55303 (612) 546-8160 E13,000 KRAIISE JEFfREY 2929 JADE LANE EAOAN MN (612)681-1410 i hereby acknowledgQ CMat I have read thfs applie8tiorr a:nd state tihat the information is correct and agree to comply aith ell applicable SCate af Mn. Statutes and City of Eagan Ordinanees. L- APPLICANT/PERMITEE SIGNATURE . L P&',Lx? " ISSUEO B . IGNATURE J 1992 BUILDING PERMIT APPLICATION ? , , ?,J'-? ?? • ? ?'? ? ? CITY OF EAGAN $EOUIREMENTS: SINGLE FAMILY 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET ENERGY CALCS. MULTIPLE DWELLINGS 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET.OF ENERGY CALCS. # OF UNITS RENTAL FOR SALE COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAI PLANS, 1 SET OF SPECIFICATIONS, 1 SET OF ENERGY CALCS. PENALTY APPLIES WHEN TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY OF MONTH IN WHICH FiEQUEST IS MADE DB LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTc: ADDRESSES FOR CORNER LOTS - Ct7NTRACTOR/HOMEOWNER MUST DcSIGNATE WHICFi ADDRESS tS DESIRED. NO CNANGES WILL BF ALLOWED QNCE BUtLDtNG PERMIT tS ISSUED. To Be Used For:,,? ,_f,,_r-n;, Valuation Date: Site Address Lot Li Block Parcel/Sub C-e-S Owner J P ?4? f Address a9U ? CttY/ZP UL u.?t ? Phone ; q - Corrtractor7MN? Address una?oi City/Tip Phone,? 4(,-- License Arch./Engr. _ Address City/Zip Code Phone # ? 6?L (iREENBRIER ROAD Occupancy Zoning Actual Const Aliowable # of stories Length Depth S.F. Total Footprint S.F. On•site sewage On-sRe well MWCC System City water PRV Booster Pump Planner Council Bldg. Off. Variance Bldg Permit Surcharge Plan Review License Fee SAC, City SAC, MWCC Water Conn. Water Meter ACCt. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park f3ed. Traif Det1. Copies SUBTOTAL Penalry Lot Change TOTAL W-41 Sewer/Water Licensed Contr. . Processing time for sewer/water, permits is two ays once area as been approv . agrees that all work shall be done in accordenos wfth ignature o ermtttee - -- - all applicable State of Minnesota Statutes and City of Eagan Ordinances. PEA?+IIT CITY OF EAGAN ? 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLf & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 topy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty appties when typing of permit is requested, but nat picked up by last working day of month in which re uest is.made ar lot chan e is re uested once ermit is issued. Date Yaluation of work Site Address: Lp,?Nlc STREET STE ¦ Tenant Name• ' LOT BLOCK SUBp. C.I.D. i' .. Descri tion of work: The applicant is: ? Owner ? Contractor ? Other coescrine) Name Phone Property . , LAST FIRST Owner " A''' Adaress STREET ' STE t City ' State Zip Company Phone COntl'BCtOf Address License # Exp. City State Zip Company Phone Architect/ Engineer Name Registration # Address City. State Zip Sewer 8 water licensed plumber . Processing time for sewer & 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 of Minnesota Statutes and City of Eagan Ordinances. Signature af Applicant: vrrw? u?G vi??r BUILDING PERMIT TYPE ? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish b7'02 SF Dwg. ? 06 6arage/Accessory ? 10 5wim Pool ? 03 Two family ? 07 Fireplace -0 11 Res. Add./Porch ? 04 Multi-fam. T.H. ? 08 Deck ? 12 Comm./Ind. ._ .., . ? 13 Public Fac. ? 14 Agricultural ? 15 Miscellaneous WORK TYPE ? 31 New ? 32 Addition ? 33 Alterations ?O 34 Repair ? 35 Tenant Finish ? 36 Move ? 37 Demolish ? 99 Undeflned GENERAL INFORMATION Lonst. (Actual) Basement sq. ft. MWCC System (AlTowable) lst F1. sq. ft. City Water. UBC Occupancy 2- 3 2nd F1. sq. ft. PRV Required Zoning Sq. ft. total Booster Pump ?Y of Stories Footprint 5q. ft. Fire Sprinkler Length On-site well Census Code .?- Depth On-site sewage SAC Code APPROVALS Planning Buildi.ng Assessments Engineering Variance REQUIRED INSPECTION S Rom,aRKS: ?'elisIpk PA-er.4 j G.u.7702S. 57Z)RM5 ? Site ? Footing D Framing ? Insulation 0 Wallboard ?ff Final ? Draint9le ? Fireplace Permit Fee 4 veiu.c;a,: s Surcharge , a Plao- eview 1 icens , . AC City SAC Mater Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units " l:ll'Y UDE V1VLY „ .?vr .. ..._.,. . . .: FieW , ? } . ^w.. `.? . . . I!L ..Fr 3? Y~• .? .' ? _ ?2996 DLAMON;?i3RIV? ;'? S'1'. YAUL, ivfIlv';vESQTA Pi-tOfvE .454_,}45,? 3t ' i T?T. qc?y?• :.M. + . ? ) z wy . , . 1r - ' , . ? c' `T•r .2 „' '. Z?W n .. ,?'. ?n. ? .. .. ? C e'? •aa ? I r •.tW',-e . a '+K?? :Sa y h1. W tYa 3V ?? ?Y r ?,??s , . . .• Z . dr {? •?' k > .a`? 1 *i av ? ' .. . ?; ? y. . ; "'°s° 'dn'«w.?tir? 4 •y?3d x " •i . . : - P n ?y Y * _ ?li ?kl .i'?+?? ?l.d+? =,?.r ?. . ?el R (: ? ( ?? ?Aj ?[? +G:. ? . .? A ` _'sr p? 4°.??K,l'W{, ?? ?G1S°'+??,:.. A ? •' ?`F( °l6? ?/.?T. a ? 7'.y 4 ? ?? 'i z f: s?? . -0 : r ?` @ v --L..? ? ? ? .+: ? z• 4 t ?Y .r ? ?????k? ?..? ? `? y+{ ?.Rf`?.c.? ?'s'?1 '• , .. ?[ . . r ?'.,?,'i ?y rs;il ? ?i.. -14 p r a, y? ??? '? Q? ??# bi,?U6Y'\ Y } a [ z ?'? M?l??$ { J.w] . ? r` ? C+A l.?'{?[°iq ?? T O x?P2 k "7"'nw F a -iw} i , . r Y S /? (.? j1 ?^ . a ? t f A? ? ?,;? x ,?a ? a st? ,,.` ?yg?k?' ?t't?? k...A .;'s a ? ? A ? _ r .?r x ?ti« N'l n?.?,a-f '7 ' ? ? & ka.? ?,,. v.n , i F? ? ?, _ '. ? "' ? 4 fTPtL '? i?' e?•' ?0*?11? Q ?i?.17,. An, : ' ??? ?+"°u ,ri?t? a J y? . ,? . ' ?+? i ? a-? 'S? ?r?Aq?, ?.?y.?a -? . IM-?'S t ?l1?4, .c,r?4r-A -rs tW ? yl?a?vv ? ?ru yt ? yy xy?,?? S?r ? ;., ?i?"l,?,i ., .. ' ? y •v.,h' i ? ' ? n i ; i•? ,'?gA ¢ ? k? "?. L ? Mr !?4 i +x'1 ?tr?u t? $+?i?.O r..F? w4 rasNt?, 1 ys. ? p n } t?H> ?r c e '? ,x} T"^ fyr?'iH??*b'r.??{ y ?'F`F U S tT "' Y 1 ? ?E i4 .' L !K G S i 3v ? w„cA'. ?,it t- ;a -a u. ?,aa„?? f.,t+E ??yr.?$ I ?,?? 2 tl,?, ? ? i ?`3 E „ n `? i ' c t;? ?, ??? $ er • ;' t xn ' 'a ': F Y . . Y4 I Date: PP ion 60 CO City of Iaall2�� ���Na�' /83. (pi 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: log Permit Fee: / D-3- `t 7 Date Received: 1 - Z Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Resident/ ?-02G\ ? II , I yy Owner Address / City / Zip: LU %L\ 10 ca \�1\,r11�, E('t t f ��I �I � �� 1,; Name: Site Address: U 'Z IX- e ga /,/ a 22 -Unit #: Phone: qSZ 9H Applicant is: Owner Contractor Type of Work Description of work: � U�1 Go: `(tY Construction Cost: 2_5 DC' V Multi -Family Building: (Yes / No Contractor Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) A/off' Mu c�.rFRi� ci�lZ��1 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 V No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water 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 secret.` CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gopherstateonecall.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. x J `�ae)h eJICLL .. x fy i q Applicant's Printed Name an'' tsigs S gnature G Amp Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition t- Alteration Replace Retaining Wall DO NOT WRITE BELOW THIS LINE Fireplace Garage Deck At Lower Level Interior Improvement Move Building Fire Repair Repair DESCRIPTION Valuation ,ZCe?J Plan Review (25%_ 100%_ Census Code Hak #of Units / # of Buildings I Type of Construction yh REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final Framing Fireplace: _Rough In _Air Test Insulation Sheathing Sheetrock Reviewed By: Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 73 1() % 7411 3C� Siding Reroof Windows Egress Window C Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant - oZ ao? It MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meteir Fnal / C.O. Final / NoSize: C.O.Required Required HVAC _ Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _ Siding: _Stucco Lath _Stone Lath Windows Retaining Wall: _ Footings _ Backfill Radon Control Erosion Control , Building Inspector Final Brick Final Page 2 of 3 CityofEaQan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 L Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: 0' CDC) Date Received: (- Z ) 3 Staff: (5. 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: \ (2-/ 1O\ Site Address: 2 7A Mt r N 65f 2 Tenant: Resident/Owner "a" Vii, €,Ev) Address / City / Zip: 20-2,-q i. : �C�\,' Contractor Suite #: Phone: qJ2-' `l D 2 `)/ Mrd/ 5S/U__ Name: License #: Address: City: State: Zip: Phone: Contact: Email: Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ 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.gopherstateonecall.org 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. Applicant's Prinited Name FOR OFFICE USE Required Inspec ound Rough -In Test Use BLUE or BLACK Ink r---------------- I For Office Use � ��� I --7 Cl6 Ol L� �11 j Permit#: � � l � � Y � � ��� a.�; � Permit Fee: 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 � Staff: I I I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: � Site Address: �-' 4 Unit#: Name: o D.� �ef��f �/� 1/11.� ,( Phone: ��� �-������ �B��d��� ^T ` �1Ni'��I' Address/City/Zip: ,�--(� � .�q p �P{� �a�� tvZ?rj � -�-.�f�� U - Applicant is: �Owner Contractor Description of work:_ �L�� Type ��Work ' Construction Cost: Multi-Family Building: (Yes /No� Company: Contact: ' Address: City: �Q�'1#1"�C'�Qt' 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 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: .N�C?i'�:Fla»s�rad;sc�ppor�in�r�locuc��e�#�tt�a�you;swb►�r`t are,.cor�ssiatered to b�p�r#��F�r�'vrr�a.��r�. P��or��vf ' t�ae in�orr�natipn rraay be classif�sd��raa�-p�blic►`f,�or��ro�l��pe�i�ic r�c��s t�#�vo�ld per�a���Gi�,y ta ' con��%►tl�tt�a��.: . �re tr�d�secret�; 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.qopherstateonecall.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. X Lc��.��-�1.�.�c�c X ` Applicant s r�n ed Name Ap cant' Signature Page 1 of 3