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2030 Flint Lanef CITY OF EAGAN Remarks Ced Addition Cedar Grove #3 Improvement Oate Amount Annual Years Payment Receipt Date 3TREET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK # SEWER LATERAL 1972 130.QQ 52.16- 2 938.88 A 06241 6 30 78 WATERMAIN ? # WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT . WATER CONN. BUILDING PER. SAC PAR K ? EAGAN TOWNSHIP BUILDING PERMIT Owne: ..... lre-e'avY-.'C/'/(.f'Arw.1....t:d:x?._.. ?...,..... ..... . Address (PresenS) .,14-.. .d?.'..(f.-01.u°l• ._ .__........_..... Builder ..__ . ......... ...... ........ _. ...... ........... _._. ... Address ... .._ ..... ........ . ........ ... . ......... DESCRIPTION IM ] 144 EaI an Township Town Hall - 5fories To Be Used For Froni Depih- - Heighf -- Esi. Cost Permii Fee Remarks _ - ? -- - - / - ------ - ,/u-rYU t-c ? / ---- -- - ---- - ??r- ", ?Pl?`-- ?J _ ? - ------ ` / , - I l_ p ' LOCATION _?" ,ireei, iloaC or oiner uescripi1on oi 4ocaxnon I? Gl; ck Addiii?Tract _ B ? ? 6? /3x « - ,-- ? 3t 1•1- Z 7 " .s .? ? 3 ? e ? 0?2.?z -?3?1 . Tl 3 This permii does nof authorize the use of sireeSs, zoads, alleys or sidewalks nor does if give the owner or his agenf the righf !o create any sifuation which is a nuisanae or whieh presenls a hazard fo the healSh, safety, aonvenience and general welfare to anyone in the community, THIS PEAMIT MIIST BE KEPT O THEPAEMISEWHILE THE WOAK IS IN PROGGRESS. : . This is fo eerlify, thaf..d??.RS....:_.G.r?..e....?fi._.......has permission So arecf a_.a _l4e.... .?4..?c±?. the abooe described premise svbjeci fo the provisions of fhe 8uilding Ordinanee for Eagan?nship adop dGApril 11, 1955. ?• _ / / . ....... . . .... . ....?F:'T.?l.i-4-f.J...._?C`?':3'?......_. Per . ......... _? ...... Chairman of Tnwn Hoard Building Inspector 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) - CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681•4675 Remodel/Reoair Reauiremenh D 3 reglstered sHe surveys showing tq. ff. of bt, sq. ft, o( house and QJI roofed oreas (20% maximum lot coveraae allowed) D 2 copiea of Dians (show beam a window slzes; poured ind. design; etc.) D 1 se1 ot energy calculaHons D 3 copies of hee preservallon plan B lot platled aNer 7/1/93 DATE: ?s "z)-q "rj DESCRIPTION OF WORK: ?K42IC4 D 1'?CCcr\- l a??Km k-C1nk01QA- I I - / STREET ADDRESS: ?? I? I IN ? C-N LOT: U BLOCK: (P SUBD./P.I.D. #: QkA L Y U?-e ? 3 Name: ?-VA?' 100- l/IQ Phone#: CoS?-`?S`+ •SCvZ.O PROPERTY last flrst OWNER • Street Address: Z?? ?- ? I til I L+- City ?,G?j State: Zip: Company: Sia- Lcp'-P? Phone #: o I Z qcil- z2-l LP (area code) CONTRACTOR ? Sfreet Address: (-Ad5 LJ ucense # ZU I a 2ZR? Exp. • ?1 MC.O Ci}y ,l,DIA. State: VY1 Ai Iip: •5 5/ Z? ARCHITECT/ ENGINEER Company: Name: Telephone C area code ( ) Sheet Address: RegisfraNon #: City State: Sewer R water Ilcensed plumber (reauhed for new construcNon onlv): PenaNy applles when address change and b1 change Is requested once permM h Iszued. Zip: I hereby acknowledge that I hrne read thia appllcalion, siate fhal lhe InformaFion Is conect, and agree to eomply wMh all applicabi State of Minnesota Statufes and City of Eagan Ordinances. ^ Signature of Applicant .ni t '1 /LL? OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ 2 eopies of plan i sef ot energy calculaNona for heafed addXlons 1 sBe wrvey tor exteAor addMions i dec W CONSTRIICTION COST: J? ao? .6 + Yes _ No Yes _ No - Not Required RECENED MAY U 5 1999 BY: L , BL CITY USE ONLY suso. CfdUf RECEIPT #: RECEIPT DATE: PERMIT # ? F L'1 b I 2000 PLUMSING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT EQIOB RD EAGPN, tM1 55122 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinklersystem FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee DeSCribB: R¢o6cinn U)aAC.r JAea:lt¢r $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet * minimum - t 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tra 3.00 x = $ Lavatory 3.00 x = $ Septic System newlrefurbished " requires MPC Ilc. 75.00 x = $ Septic System abandonment 30.00 x = $ RPZ new installadon/repaidrebuild 30.00 X = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground sprinkler if dwelling is under consVUCtion 3.00 = $ Underground sprinkler if existing dwelling 30.00 = $ Water closet 3.00 x+,,, _ $ Water heater 3.0 x" ? ?nr„ _ $ Water softener If dwelling under construction 5. • x -" = $ Water softener if existing dwelling 30.00 $ Water turnaround 30.00 x $ State Surcharge .50 -> --> ---> $ p .50 Total -' --' ---' ?? $ Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. ------------? ----------------•------•-------• ---, s--tate ----that -•-- the i---nfortna------tion ---is cortect--------,and -----agree-•----to -•---comply---- w--it-h--all ---------applicable---Cit y ---of--Eagan--•---ord----- inan-ce--•s .- I hereby acknowiedge that I have read this application It is tha applicant's responsibility to notiTy the property owner that the City of Eagan assumes no 6ability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City propertylright-ot-way/easement. SITE ADDRESS: Q030 1: 1Lh ,?0.?0.r E m? ss I aa OWNERNAME:: Q v+cl L=-rb TELEPHONE(0S1 y$'q -Sitao l ? ?6 (AREA COOE) ? A ? ? /_n a?? !? u,?C,? j vrG? [, cat INSTALLERNAME: I?1arV S c??ow TELEPHONE#: 50?1 3W-i -to11ll (aRe,?, cooe? STREET ADDRESS: ? q-?gR 1?`I 6?' $"V W CIIY: STA : ZIP: .6-(0 06 SIGNATURE OF P RMITTEE 2006 "SIDF.NTjAi, BUTI.DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construcbon Reauirements 3 registered sde surveys shoxing sq. iL of bC sq. R of house, and all roofed areas (20 % maximum lot coverage allowed) 2 copies of plan showing beam 8 windmv s¢es; poured found design, etc. 1 set oi Energy Calculations 3 copies of Tree Preserva6on Plan d IM platted after 7/1193 Rim Joist Detail Options selecfion sheet (bwldings with 3 a less units) Mmnegasco mcchanical ventilation fortn RemcdeVReoair Reuwrements Office Use Onlv 2 copies of plan showing footings, beams, joists Cert of Survey Recd _ Y_ N t set of Energy Calcula6ons (a healed addi6ons Tree Pres Plan Recd _ Y_ N. 1 site survey for additions & decks Tree Pres Required Y_ N AddiNon-indicaferfon-sResepficsystem On-siteSep4cSyatem _Y _N zi N ti C t ?) c? Uc C t Date / / ons ruc on os SiteAddress UnidSte # 9 Qescription of Work /L71 Multi-Family Bldg _ Y / N Fireplace(s) ? 0 _ 1 _ 2 PropertyOwner Qui ? lo _ - ?'?e;?e?o #?t 2-0 `? LS Contractor. W J 1 6r) I W4'Q!ej e4& q F p % 5 2006 Address ? - ' ?.I W?!]VI?Y?,' ??'l •?. City S[ate Zip JJ? 3 14 Telephone #?aj COMPLETE TFIIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Ca[eeorv 1 _ Minneso[a Rules 7672 Enefgy Code Category , Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet (4 submission type) Submitted Submitted . Energy Envelope Calculations Submitted In the last 12 mon}hs, has ihe 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 Residential Building Permit and acknowledge thal the information is complete and accurate; tha[ 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 re uires a review and approval of plans. ^ -4,? / 1/ L9 rv c?-, ,/-i l, r ' Applicant's Pried Name D C 2006 RESIDENTIAL MECIIANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single famity dwellings & townhomeslcondos when permits are required for each unit Date 1 2- /" Q:1 Site Address "10 Unit 4 PropertyOwner \'S`• \1?? ??`J Telephone#((,Lfj-? )?5U-J?(o2Q ? Contractor Street Address Z c?b? City State Zip Telephone # (Co5l Bond Expires: The Applicant is _ Owner ?Contractor _ Other Add-on or alteration to existing dwelling unit $ 30.00 furnace _Additional _Replacement _ New air exchanger air conditioner heat pump other State Surcharge $ .50 Total a? 5 (_P l-117) ? $ -'-?-? I hereby apply for a Residential Mechanical Permit and acknowledge 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 Mechanical Codes; 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. ?S, ? ? - Q fv-,' ? Applicant's Printed Name Applicant's Signature ? Use BLUE or BLACK Ink - For Office Use • I /~t -7 City of EI Permit , 1 , Permit Fee: ~?C/6 6/- 0 1 3830 Pilot Knob Road I Eagan MN 55122 y i Date Received: I Phone: (651) 675-5675 1 I staff- Fax: (651) 675-5694 I - - - - 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Cq~l ~j - Date: Site Address: cX3U le/W l.A) unit Name: Phone: RESIDENT / OWNER Address 1 City / Zip: c2cbc) Fii-r 1'1'1•t/ 65 /a Applicant is: Owner Contractor TYPE OF WORK Description of work: 1_j 1C I ScttBcrn~ Construction Cost: pC4119-71 Multi-Family Building: (Yes t No J<J Company: ? taffAi" Uh kio,W ZEr. Contact: 'Po. ]i!F CONTRACTOR Address: .2.11 ~1 5A a, A- City: ~`L~e~ ~ State: ~'1/ Zip: SS5 Phone: _/`ra~" ?7'c5I~> License* d0S36(X Lead Certificate V4T-10007-, If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-M2 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.oro 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 Of perm' issuance. x x Applicant's Printed Name Applicant's Signature Page 1 of 3 O r:~ r16- NOT WRITE BELOW THIS LINE SUB TYPES - Foundation - Fireplace _ Porch (3-Season) - Storm Damage _ Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Single Family) - Multi _ Deck - Porch (Screen/Gazebo/Pergola) - Exterior Alteration (Multi) _ 01 of Plex Lower Level Pool _ Miscellaneous - 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 ~!--,yO 7 SAC Units 25% 100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers 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 Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In Air Test -Final Windows Insulation Retaining Wall: ` Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge / y l / a '9 / S&W Permit & Surcharge ` Treatment Plant Copies TOTAL Page 2 of 3 f! 4c 'r w r r c 94 fc J 74c Use BLUE or BLACK Ink r-----------------I I For Office Use r Permit - Y' City of EaI I Permit Fee: 3830 Pilot Knob Road I t L Eagan MN 55122 Date Received: cjj) -L I I I Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: I - - - - - - - - - - 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: '6-31-13 Site Address: o?030 f4/A(1 ! LIV Unit M Name: L'. /A) 49#9 &Z /-S Phone: Resident/ Owner Address / City / Zip: ;kO,31) F[. CAI T L-A) 6QA .J A IA_) b'.'j/a oZ Applicant is: Owner X Contractor Type of Work Description of work: J2~ - ROOD L60 Multi-Family Building: (Yes ` / No 'oe ) Construction Cost: Ze Company: *'A -)7'04 t5k) G0A .~5;WU67'1010 Contact: 86a Contractor Address: Vi A-091E 4NE Sy/7'E 6 City: -T. 40'WV4 State: NA,) Zip: ~EW7f- Phone: &5-1- 3YO -/'Tq/ License d(1383/7 Lead Certificate /VAST /01/779-/ If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: 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. 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.om 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 ' ce. , /vTG sL App icant's Printed Name Applicant's Signature Page 1 of 3 • 4/7/2015 1:23 PM FROM: Fax TO: 1-651-675-5694 PAGE: 002 OF 009 Use BLUE or BLACK Ink�� ---------------- � For Office Use � a . ' j Pertnit�I: / �� ;j � Clt Of�� Il � Permit Fee: �� `� � � � , , 3830 Pilot Knob Road c��i_l � Eagan MN 55122 i Date Received: � � Phone:(651)675-567S I Staff: � _ I Fax:(651)675-5694 � I �:r �..��__��_�J 2015 RESIDENTIAL BUILDING PERIUIIT APPLICATION Oate: �I�1 I�SJ Site Addres�: b.�� ;�� Ln Unit!�: Name: �%`IU�� G✓� Phone: Resident/ ' Owner nddress i c�ty i z�P'� a d 3b ��%/I-f lf'1 ��9A� �i�s��} Applicant is: I Owner 1� ConUactor � T e of Wo�k Description of work. �� /� ��1cs�� YP Construction Cost: ' �S�� Multi-Family Building:(Yes /No� Company:��[1�Gl� ��.�G�Cl/ COYI�YD� Contad:��K�V Contractor Address: �3 a� �r�� Ay�n City: �� State:�Zip: S. � Phone: �IO�'�� Email: I'vi,il�e�c,�a�itrdt,�,h�•1� License#: � C DD�S�� Lead Certificate#: �A'�'"��y�li'� __ If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) J.�f�/�'� �..� G�Y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the Ciry of Eagan issued a pemnit for a similar plan based on a master plan? _Yes _No If yes,date and address of master plan: Licensed Plumber: ' Phone: Mechanical Contracto�: Phone: Sewer 8 Water Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be c/assified as non-public if you provide specffic reasons that would permit the City to ' conclude that the are trade secrefs. CALL BEFORE YOU DIG. Catl Gopher State One Call al(651)45�-0002 for protection egainst underground utility damage, Cell a8 hours before you intend to dig to receive locates of underground utitities. www.00nherstateonecall.ora I horoby acknowledge that this inlormation is complete and axuratc;that the wo�k will bc in oonfortnance wilh the ordinancee and codes of tho City of Eagan; that I undersland 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 wilh fhe approved plan in the case of work which requires a review and approval of plans. Extertorwork authorized by a bullding permlt Issued in accordanee with the Mlnnesota State 8uilding Code must be complated within 180 days of permtt Issuance. x � x A� ��a�d'3 P�' �tccl Na��ti� App ica��t'� ignature �o�e �� -� �� o� �7 � . ` DO NOT WRIT BELOW HIS LINE SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family _ Garage _ Porch(4Season) _ Exterior Alteration(Multi) _ Multi _ Deck � Porch(Screen/Gazebo/Pergola) _ Miscelianeous 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 C -� MCES System "�- Plan Review Code Edition ,�pl�j SAC Units '"" (25%_100%� Zoning n-1 City Water " Census Code �1�'1 Stories — Booster Pump '' #of Units / Square Feet ` PRV ^ #of Buildings ! Length 'r' 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: , Building Inspector RESIDENTIAL FEES Base Fee /�„3�.. ,� Surcharge Plan Review ri �--- MCES SAC City SAC Utility Connection Charge S&W Permit�Surcharge Treatment Plant Copies TOTAL Page 2 of 3 �* Use BLUE or BLACK Ink r--------------��- i For Office Use � I ^ � C�t of �� Il ; Permit#: ��d�� j , 2�1 QQ � i Permd Fee:�V o�I • V- 1 � 3830 Pilot Knob Road � _ � I Eagan MN 55122 r�� r~� � Date Received: � 7'� � ��`�<��r h��,� � I Phone:(651)675-5675 � Fax:(651)6T5-5684 „ � Staf�: --_-__ t � ��7 � � ,�� I � � 2015 RESIDENTIAL B►UILDING PERMIT APPLICATION C�!� S'� � Date: � �Z �� Site Address: �� S�fi L^'� Unit#: � Name: ��N�"� �r�' Phone: Resident/ Owner Address i city�zip: `�`�t� F'(�ti�` 1-� - Applicant is: Owner � Contractor '( Description of work: �r"'�c;� (,�J.q ��f c�'f" �-�r�c.�.� -v�;;,,.h (`�tvws �r s��v� �v:5 t�,� Typ►e of work $ ��.4�,� Construction Cost: �, �c� � Multi-Family Buiiding: (Yes /No� Company:��-4-� 1-A��aS � `"�°=� � S;�'""1 Contact: p�/k^� ►� _� Gontractor Aaaress: I�f�� C� (�X-� �t �ro� c��: , P�� A�<<�/ State:�,_Zip: S��L`� Phone: t�-�9 r'�� Email: �icense#:_�6 l?�r'2'�- Lead Certificate#: �� 2�2� �- ' Z 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 pian: Licensed Plumber: Phone: Mechanicai Contractor: Phone: Sewer S Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:PJans and supporting documents that you submit are considered to be public infonna�iom, Port�'ons af the information may be ctass�ed as non pubt�c if you provide speciffc reasons that wotrld germit the City to conclude that the are trade secrets. CALL BEFORE Y(3U DIG. Cali Gopher State One Call at(651)454-0002 for protection against underground utility damage. Ca1148 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecali.or4 I hereby acknowledge that this iriformation is complete and accurate;that the work wili be in conformance with the ordinances and codes of the City of Eagan; that I unde�stand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the worlc wili be in accordance with the approved pian in the case of work which requires a review and approval of pians. ' Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must t�compie�d within 180 days of permit issuance. x �i2�^�D��► �- V�,r I� � appiicant's Printed Name plican s ignature Page 1 of 3 ,• �Q� �%l(�.t,,in . Df3 NOT WRITE BELOW THIS LINE I ,'�� '� 'SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family _ Garage _ Porch(4-Season) _ Exteriar Alteration(Mu1ti) Multl Deck Porch(ScreeNGazebo/Pergola) _ Miscellaneous ` 01 of_Plex � Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Inte�ior Improvement _ Slding _ Demolish Bullding* Addition _ Move Building _ Reroof _ Demolish Interfor � Alteration _ Fire Repair _ Windaws _ Demoltsh Foundation _ Replace � Repair _ Egress Window � Water Damage _ Retaining Wall • *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation /�9,� Occupancy ./L./ MCES System -- Plan Review Code Edition -��rr,'� SAC Units "' (25%_ 100%� Zoning �^1 City Water -^ Census Code y3h� Stories ^ Booster Pump -� #of Units ! Square Feet '^ PRV � #of Buildings j Length "' Fire Suppression Required " Type of Construction �_ Width "''' REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Finai/C.O. Required Footings(Addition) � Final/No C.O. Required Foundation � HVAC_Gas Service Test Gas Line Air Test Roof:_fce&Water _Final Pooi:_Footings _AiNGas 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 Walis Erosion Control Other. Reviewed By: , Building Inspector RESIDENTIAL FEE �3$' ,f�'�,�,, rr�y � �'�� /p ,7f� �" Base Fee j�f� --- Surcharge Plan Review /�„�� MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Piant Copies TOTAL Page 2 of 3