1616 Johnny Cake Ridge LaQ2-0SS RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conskuction Reaui2menls RemodeUReaair Reouirements Offce Use Onlv
3 regisle2d site surveys showing sq. ry. of lol, sq. B. of house; and all roofed areas 2 copies of plan Cert of Survey Reoi _ Y_ N
(20°/a maximum lot coverage albwed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _ Y_ N
2 copies ot plan showing beam & window sizes; poured found design, etc. 1 site survey For additions & decks Tree Pres Reqd _ Y_ N
1 set o( Ene(gy CalculaUons Addttion - irMicate if on-s8e sepfic sysfem Oo-site Septic System _Y _ N
3 wpies of Tree Preservation Plan i( lot platted aNer 711193
Rim Jo'sf Defail Options seledion sheet (bldgs with 3 or less uniis
Date -?O-/ 14 / d) Constructian Cost 'Ka` 12 00 --
SiteAddress J.b 1?6 -)D 0 0 hjl v??.? Wt??(S ?? Unit/Ste #
L: ftDAp
Description of Work ` )'"1UJ6
Muiti-Family Bidg _ Y_ N Fireplace(s) _ 0 0_ 2
Property Owner Telephone # ( (,?1 '5?)36
Contractor t
Address 1ri, ?
?vJ"j
j)
City 61R")
State kvi Zip Telephone #( il'Z )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Cpde Category
• Residenlial Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Suhmitted
• Enerqy Envelope Calculations Submitted
Nave you previously constructed a
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
plan2 _ Y _ N If so, 25% plan review
Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
pernut; that the work will be in accordance with the approved lan in the c e f work which requires a review and
approval of plans.
,
? ,
Applicanl'S7Printed Name Applicant Signature
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone 4 651-675-5675 FAX # 651-675-5674
Please complere for: Single Family Dwellings
Townhomes and Condos when pemilts are required for each unit
a?-1
Date s , ?,4-a ?
site Address r) unit #
PropertyOwner??? ??,??LfJ Telephone#( `Q51)k5k 1?5J .)UEIJ_
Contractor
Address `,] t"t City
State Wl Zip Telephone #(1 15) ?.[? `CXL lCJ ?
The Applican[ is Owner \P- Contractor _ Other
Septic System New Refurbished Submit 2 sets of plans and MPC Iicense $ 100.00
Includes Counry fee. Additional consultant faes may apply.
AlteraHons To Existing Dwelling Unit, Including $ 50
00
_ Adding fxtures to lower levels or room additions, excluding water softener and water hea ter .
_ Abandonment of septic system
_ Water turnaround (+ 5!8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
? W
ater softener Water heater
$ 15.00
_ replacement additional J,??
=
t1'? ?? )
State Surcharge ?.i? $ .50
Total $ ?
I hereby apply for a Residenrial Plumbing Pemut and aclmowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and with the Plumbing Codes; that I understand this is not a
pemut, but only an application for a pernilt, 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 ?,
mL" ? `iz_ / U ?"K
Applicant's Printed Name App i anYs ' ure
?
Site address: Lot _ Block _ Subd.
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
? This structure: ig consWcted to meet minimum requirements of ihe Mn Energy Code, Chapter 7670
? OR
??7his structure: will be consWcted to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MOUEL BTU'S VENTING TYPE
Water Heater 144,mN yy??? ?6- ?5
Furnace ? L-,r:N1,j a C2 _al C- s dd?
?' ec
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YEs No
Kitchen kitchen
Bathroom 1 ,q
l?Ga?h -
LL4ScniC
EY-OSV6L
Qo
Bathroom 2 1 f 91D
Bathroom 3 S D ?
Bathroom 4
t
Other 7 1
VENTING
PIREPLACE 5 LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIRECT ATMOS
I hereby acknowledge that the above information is correct and agree to comply wiih the Minnesota Energy Code and City of Eagan
requirements.
Signature Date
Company ame
* This form is the responsibility of the General Contractor.
1-??- 3a (3 I o ct ? ??-- uj 157?-63 8P- ?'a5
RESIDENTIAL
, BUILDING PERMIT APPLICATION
• CITY OF EAGAN P n- s? c- a'1
3830 PiLOT KNOB RD, EAGAN MN 55122
651-681-4675 ?
Yew Construction Reauirementa
• 7: egistereo sde surveys showing sq. A. of IoL sq. ft. of house; and all roofed areas
(20 % mwimum lot cove2ge allcwed)
. ? r,opies of pian snowing beam 3 window srzes: poured found tlesign, etcJ
1 fE
oa ,?
?-1 ?.??
RemadeURaaairRecuirements
. 2 coDies of plan
• I set of Eneryy Calculations for heated additions
• 1 site survey lor ex[enor additions & decks 9" a? •
• set o nergy Calculauons . Indicate if Mme served by septic system for additions
• 3 copies of Tree Preservalion Plan if lot platted a%er 7I7193 ? ????
• Rim Joist Detail OpUOns selection sheet (bidgs with 3 or less uni4s) K
DATE 11 i -]!a-t- VALUATION
SITE ADDRES
TYPE Of WO
tULTI-FAMILY BLDG _ Y ?C N
FIREPLACE(S) _ 0 X1 _ 2
APPLIGANT? !d/tC /yoji
STREET ADDRESS 9/S NordwLd- /.E CITYAzadA- STATE '1?ZIP-G3-09?
TELEPHONE # CELL PHON #? FAX #?7 99?`??7
PROPERTY OWNER
TELEPHONE#
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINVESOTA IiliL.ES 7670C:\"Ct:GORY ! [I'NNCS0"f:1 RCLES 7672
(d submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submittetl
• Energy Envelope Calculations Submitted
Plumbin
ntr
a?L ? W
C
t ?l #
Ph `fR 2-
g
.-
o
ac
or:
?---
' one
PlumUing system includes: Vat?
l- er Softener Lawn Sprinkler Pee: $90.00
-- Water Hca[er No. of R.I. Baths
--
No. of 13aths
Mechanical Contractor. eU/?CS? id!L n,% Phone
1VIcctlsmical systctn includes: __ Air Cot iuouin- I'cc: 570.00
EieaL Rccovcn' Systcm
Sewer/Water Contraetor: ?i? C.?Srtt_ Phone #
--°-------------------°----------------•-----._...----------------------°-------------- - -- - ----
I1? ? ? ? ? I II
I hereby acknowledge that I have read this application, state that ihe information is a,o?rect, and a ree o o ply
with ali applicabie State of Minnesota Statutes and City of Eagan Ordinances.
Slgnature of Applicant
OFFICE USE ONLY
Certificates of Survev Received -'Qla- Tree Preservation Plan Received Not Reauired
Updated 4102
OFFICE USE ONLY
? Ot Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg
x 02 SF Dwelling ? 08 06-plex ? 76 Fireplace O 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ezt. Alt - SF
? 04 02•plex ? 70 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 tp-plex ? 19 LowerLevel ? 24 StormDamage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
J?z 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof 0 40" WindowslDoors
? 34 Replacement •Demolition (Entire B ldg only) - Give PCA handout to applicant
/,!5F3 OC,5r'
l
V R
3
a
uation Occupancy " MC/ES System
Census Code /O/ Zoning P O City Water
SAC Units e,-1 Stories ? Booster Pump
Nbr. of Units 0/ Sq. Ft. ?12 31L PRV ILI"
Nbr. of Bldgs ? length 33 Fire Sprinklered
Type of Const UA)
?- Width -70
REQUIRED IN SPECTIONS
Footings (new bld.g) ? FinaUC.O.
_ Foo[ings (deck) _ FinaVNo C.O.
Foonngs (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Othzr
Roof -4 Ice & W'azer ? Final _ Pool _ Ftgs _AiriGas Tzscs _ Final
? Framing Siding Stucco Srone
_
?L Fireplace R.I.
),?Air Tzst /Final
Windows (new%replace _
menq
? Insulation ? Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
. -al<
-
Building Inspector
y?5 ?5 c i??
q??a
/-/7,1- 7oG
Total
i i n i v.,?vy yp: ? .. • . ,
?Y'
, rt }??r?ic COMPLTArfC? ???k'L? '
P+'?? i,?rk softw&r?';Ve, bio7L .3 ?'tl
i:
fi'zt: Dakota ?? ?
Mznneaota; `
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P?,fCT'tbrr `TXPE:= siagl.'e' Pam31y
c-7.2-2000'
r?? ;?r'? i?IAMONP SN/PdRCHrn,.2
.,, ; I14FORP7P.TIbIQ:: -.
Ufi a 526
•ss
F.M.'R7
_ p'?' eYh1 t -F--..
Checke by Da-a
409
''^`tsir Thari Cofla
Azea or cavity Cont. Olaaing/Door
Perimet:G;• R-Va1ua R-value iJ-VaZua
-_ ?•,_.---__• _---___ ---------------__
-'- 1887 64.0 0.0 ---- -----__--
??, t?saood Frame; 16" O.C. 1875 19.0 2.0 t
y7indowsboora; Abova dra9e 279 0.350
38 0.350
AJI:'S P'z,OQRS: LTnhggted, 42.0" incul, 206 1.0.0
L
RV:•?: EqUIPMENTi. VurnAce, 92.0 AFUE
_'_..'_"-'_? -__".."___'^-_..'-'_""'--
Cc7N?LI7?NC? STATMNTe T,he Proyoosed buildiny deai?escribed?hmrm ipv -
canslgtent with 'C"1* 1'6.ing:.pZans,`speaif'icaGsane,. nd other, aalCUlaCions
aur,mi.tted w1,th'"th???. ."^appl ?patioh ?;!.', The propos8d bsuil-ding has been
designgd to me?t??'?e' trten?a b?'.a?'He:M4nnasotA ?i'?im?i°mt:?''![?nAe :.?
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, LOT SURVEY CHECKLIST FOR RESIDENTIAL
' BUILDING PERMIT APPLICATION
PROPERTYLEGAL: Lof / lJqK?/da& G7i?I
DATE OF SURVEY: 9 /2'? 2
? LATEST REVISION:
c
m
t
c? DOCUMENTSTANDARDS
0
o z °ai
V50 ? • Registered Land Surveyor signature and company
dA ? • Building Permit Applicant
[a?,o o • Legal description
E7 ? • Address
1( ? ? . North arrow and scale
? ? • House type (rambler, walkou[, split w/o, split entry, lookout, etc.)
? ? . Directional drainage arrows with slopelgradient %
? ? . Proposed/existing sewer and water services & invert elevatron
? • Sfreet name
GY ? ? • Driveway
? 0
? 0 . Lot Square Footage
? ? . Lot Coverage
ELEVATIONS
? Existina
? ? • Sewer seroice (or Proposed)
? ? • Property comers
[Y ? y" ? • Top of curb at the driveway and properly line extensions
? P?,? • Elevations of any existing adjacent homes
L 6?,? . Adequate footing depth of structures due to adjacenT utility trenches
C ? ? . Waterways (pond, stream, eta)
Prooosed
g??l ? . Garage floor
????? ? • Basement floor
• Lowest exposed elevation (walkoutlwindow)
? • Property comers
? u . Front and rear of home at the foundation
PONDING AREA (if aoolicable)
? zi/0 • Easement line
? [i/? • NWl
? Cd/ ? • HWL
? 0?/ ? . Pond # designation
? ?l ? • Emergency Overflow Elevation
3' y7
?
?
?
u
?
L
?
DIMENSIONS
• Lot Iines/Bearings & dimensions
• Right-of-way and street width (to back of curb)
. Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring pertnanent footings)
• Show all easements of record and any City utilities within those easements
• Setbacks of proposed sVucture and sideyard setback of adjacent ebsting struchrres
• Retaining wall requireme ' '"
Reviewed:
Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lot 32. Block 1, OAKBROOKE 6TH ADDITION, City of Eogan, Minnesota and reserving
easements of record.
SEP 17 REC`0
? ??
R
??E
6?? ?
J?? E LANE 93?2 ;s _a 20 ?? ,
0 ? ,4o E NGI?EPT.
D } '
R193?.0 930? ?
? 932.3
C? p0 f_
\e s°932D??`?'
35.7 -vACaNr_
a33? O1 ?ti? 's AO
0
a ? ry/ s
? O °6 a? o ?1 9rr
93 Cl ? Qo<° ss
k61 1? <?, 9O
0d S? OO
435. , 1eC3°? y0
7V e ? ?pc' ?
.Q Gr ??a
0O Y8 ? )J Q?
/
l9
A?., y0 9\6 ' 43v5
a
-vacnNr- 933. ?
Q\J
O
j l L'f' 9 ?
?E ruGC ? ?
Nc?
L 0 T SQ. F00 TA GE = 3,960 3t4 ?'TM"" ?e
or Fletaining yyan yyl,
HSE SQ. F00 TA GE = 2, 36 7 Be Required
L O T CO 1/ERA GE = 6 07o
PANo
ll u ? 1 7,
?
# 17951
PROPOSED ELEV?710N S
BENCHMARK,
Top of Foundation =q34.o
Goro Floor
9e
=433.b ca N soia TMH
EL= 831.79
Basement Floor =q2c?,o
Aprox. Sewer Service =a22.ot
Proposed Elev. MIN. SETBACK REQUIREMENTS
Existing Elev. =
Drainage Directions
= Front - House Side -
Denotes Offset Stake = .
SCALE: 1 inch =
30 feet.,?,wut?na.". Rear - Garage Side-
HEDLUND I HEREBY CERTIFY TFiA7
OF THE BOUNDARIES OF
BY ME OR UNDER MY DII
PLANNING B'NGINh'ERJNC SURV6'YINC SHOW IMPROVEMENTS OR
2005 Pin Oak Drive
Eagan, MN 55122 D/+Te
Phone: (651) 405-6600
Fox: (651) aos-ssos
SURVEYED
PORT TO
CAD FILE:
Sl/RVEYOR
: 14376 Oakbrooke 5
N0:
02R-597
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA104827
Date Issued: 06/12/2012
of E(~ (IR Permit Category: ePermit
Site Address: 1616 Johnny Cake Ridge La
Lot: 32 Block: 1 Addition: Oakbrooke 6th
PID: 10-53765-01-320
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protect)on inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $4K $103.25 0801.4085
Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195
Total: $105.25
Contractor: - Applicant - Owner:
Krech Exteriors Inc Terry L Rowan
5866 Blackshire Path 1616 Johnny Cake Ridge La
Inver Grove Heights MN 55076 Eagan MN 55122
(651) 688-6368
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127684
Date Issued:10/10/2014
Permit Category:ePermit
Site Address: 1616 Johnny Cake Ridge La
Lot:32 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-320
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Terry L Rowan
1616 Johnny Cake Ridge La
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA128124
Date Issued:10/27/2014
Permit Category:ePermit
Site Address: 1616 Johnny Cake Ridge La
Lot:32 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-320
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 .
Lisa Nyberg
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 -
Terry L Rowan
1616 Johnny Cake Ridge La
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
Use BLU�or BLACK Ink
--------------,
� Far Office Use �
I �
' i Permit#:��,�,� �
��� 1ll l����� � i
� Permit Fee: I
383Q Pilot Knob Road i � �� l �
Eagan MN 55122 I Date Receiued. �
Phone: (657j 675-56T5 AUG 12 2015 ; star�Q_ ;
Fax: (651)675-5694 �_________—_____�
20�RESIDENTIAL PLUMBING PERMIT APP�ICATION
Date: L- � Site Address: '� �*�� � '^ ' �
Tenant: t , �v'4'�� Suite#:
� _ Name: �'�-'� � vl r`�VVv�f 1 ����� �
� ����,���� � Phane:
� � Address/City I Zip: I � -I�
� Name:�°1 U�1����7� �U�'� I 1 �v1 If?�-(—� License#:���1 �
� �
����i�' � Address: ; � Irs City: ���1 �
� S#ate: {�_Zip: Phone: ���] �(? ��Q� �
� � c �
� Contact: �t� � _'�1.'f' Email: � � � 1.�C �
� �
` � _New �Replacement _Repair _Rebuild _Modity Space _,Work in R.O.W. �
� ,, ������ � �
�
Description af woric:
� RESIDENTIAL ;
� � -
� = Water Heater �
� � � �Water Softener
Lawn Irrigation(_RPZ/_PVB) � ,
� ������ � Add Plumbing Fi�ttures�AAain/_Lower Level)
� � Septic System _
�" _ � Water Turnaround
_New � �
� �Abandonment �
� RESIDENTIAL FEES: w�
� $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) �
$6Q.Q0 Lawn Irrigafion (includes State Surcharge)
�
$60.00 Add Ptumbing Fixtures, Septic System Abandonment,Water Turnaround*{includes State Surcharge) �
� "Water Turnaround(add$210.00 if a 5!8"meter is required) �
�� $115.00 SeptiC Svstem New{includes County fee and State Surcharge) � �
TOTAL FEES$_� �
CALL BEFORE YOU DIG. Calt Gopher State One Call at(651)45�4-OOQ2 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive tocates af underground utilities. ww�i.ctc�phersfiate�r�ecali.ores
I hereby acknawledge that this information is complete and accurate;that the work will be in conformance with the ardinances and cades of the City of
Eagan; that t understand this is not a permit, but onty an application for a permit, and work is not to start without a permit;tt�at the work wiN be in
accardance with the approved plan in the case of wrork which requires a review and approval of plans.
� �
X��.r�� �����►� X ��t�
App6cant's Printed Name Appfic� 's Signature
�'������� � ��f�l�ti�� � ;�`�,�:,,
��'�#��C@i���1��;�'S ,...,.,h.,,;,.����Ti�t�' : ��C�1{���1i°i �i��S� �..._.:._,..�'i.r��#k�-" '�"� :
For Office Use
• ♦ ♦ i Permit#:
E AG N
Permit Fee:
�►1
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(a�cityofeagan.com
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
7l3?
Date:ritacen l( plc( Site Address: i(AIG 3c I nn Coke R.• Unit#:
Name: 12f('u, Rv1 Phone: fj5 1(
Resident/ E
Owner Address/City/Zip: I to (0 leak Ltzt JZ e k;.k e I n 6 ,cy 4►'\l WI TO 5 c
Applicant is: Owner Contractor
Description of work: kepi ace W
•
Type of Work 1&rr
Construction Cost: 15)041`0 o Multi-Family Building: (Yes /No )
Com•.• • 0 1aG ` „n, - 3 S,di, • C.. _ . o r goe Iter
Contractor
Address: 1 36; C City: Y \* l• ,e\ e J?
State:rnN Zip: 5 # - "_ Phone:5c1"Li ' N3S Email: s: Ot:lr 0, AveD c i
License(#(1C- (p 0 0 •a 3 7 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:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be
classified as non-public if youlrovide specific reasons that would permit the C'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.citvofeagan.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.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 pla .
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Applicant's Print d Name Applicant's Signat e
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159594
Date Issued:01/02/2020
Permit Category:ePermit
Site Address: 1616 Johnny Cake Ridge La
Lot:32 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-320
Use:
Description:
Sub Type:Residential
Work Type:New
Description:Garage Heater
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Terry L Rowan
1616 Johnny Cake Ridge La
Eagan MN 55122
(952) 288-3594
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature