1626 Marina Lane6186L I C?P 654-42 ?s/ 9. 1
? ?' ?
`/\? ??SIDENTIAL BUILDING PERNIIT APPLICATION 6544d /Tt' S-o
City Of Eagan IpP 6 5 V-? 9 90. S-p
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
-
New Construction Reouirements RemodeUReoair Reauirements ce' se'?
3 registered site surveys showing sq. ft oi bt, sq. ft of house; and au roo(ed areas 2 coples of plan
(20% mauimum lot caverage albwed) 1 set of Energy CalculaGons for heated addiUons
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tn?R?g-,?k
t set oi Ene ?JY Calculatlons AddiGon - indicate if on-site sePtic sYSfem On? ,
_ ?Y? ?-,?.? h? ? ..
3 copies of Tree Preservation Plan if lot platted after 717193 I 1
Rim Joist Detail Optlons selection sheet (bidgs with 3 or less units w . ?S f
Date, /q
Site Address / 0'-'t"" Construction Cost c:? 05, CJoo' M
UniUSte #
Description of Work
Multi-Family Bldg _ Y? N Fireplace(s) _ 0x 1 _ 2
Property Owner Telephone #(0-51 )c) 09" -7 C? L5
Coutractor ?xn
Address ? ? ?
State 1 r ?? • City Qn
Zip?Telephone #?j?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate2orv 1 Minnesota Rules 7672
Enefgy Code Category . ResidenGal Ventilatlon Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calcuiations Submitted
Have you previously constructed a building in Eagan with a similar plan? Y'-- Y _ N If so, 25% plan review
fee applies.
Licensed Plumber, ' he r L° um ?t 1'1
Mechanical Contractor Lofn Y ?-?
Sewer/Water Contractor '-S?
Telephone #V
??
Telephone "r(oo
Telephone
I hereby apply for a Residential Building Permit and aclrnowledge that the informa i?&4A9 rate;
that the work will be in conformance with the ordinances and codes of the City o agan and the State o MN
Statutes; I understand this is not a permit, but only an application for a pernut, and wit out 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.
MrGhe ( l& PAC-" ??-E?-
Applicanfs Printed Name Applicant's Signature
OFFICE USE ONLY ' ?-
?
Sub Types
? 01 Foundation ? 07 05-plex O 13 16-plex O 20 Pool ? 30 Accessory Bldg
02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03. 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) 0 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Mufti Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? OB 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
x 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
0 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* 0 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolitlon (EnUre Bldg) - Give PCA handout to applicant
Valuation Occupancy /? - 3 MCES System -
Census Code Zoning n_ City Water -
SAC Units - Stories / Booster Pump - --
# of Units - Sq. Ft. l11 ?PRV _?-
# of Bldgs Length Fire Sprinklered
Type of Const ? Width 3G
? Footings (new bldg)
_ Footings (deck)
Footings (addition)
? Foundation
Drain Tile
Roof ? Ice & Water ?C Final
Framing
Fireplace *t- R.I. -_,*AirTest yFinal
? Insulation
Approved By:
Base Fee "
Surcharge
Plan Review-
S'" 'LiL A.
MC/ES SAC A-41'1
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUI RED INSPECTIONS
FinallC.O.
_ Final/No C.O.
_ Plumbing
_ HVAC
Other
_ Pool Ftgs Air/Gas Tests
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Building Inspector
n ?-/-=------
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: ?-,c?f' (!>,?L.OCKI C??UT?n/VUJ?
. --?
.
DATE OF SURVEY:
m
LATEST REVISION:
?
e
m
r
U
?
0
Z 'II
a
DOCUMENT STANDARDS
? 0 ? • Registered Land Surveyor signature and company
? ? • Building Permit Applicant
? 0 D • Legal description
f? ? ? • Address
? 0 0 • North arrow and scale
,e. 0 ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? ? • Directional drainage arrows with slope(gradient %
? D 0 • Proposed/existing sewer and water services & invert elevaiion
? ? 0 • Street name
,a ? ? • Driveway (grade & width - in R/W and back of curb
22' max
)
X 13 ? ,
.
• Lot Square Footage
,2r 0 ? • Lot Coverage
ELEVATIONS
Ew.stinq
? 0 ? • Sewer service (or Proposed)
? 0 ? • Property comers
? ? 0 • Top of curb at the driveway and property line extensions
? ? ? • Elevations of any existing adjacent homes
'0
- ? ? • Adequate footing depth of structures due to adjacent utility trenches
'J;? D ? • Waterways (pond, stream, etc.)
Prooosed
?l ? 0 . Garage floor
? ? ? • Basement floor
-ff D 0 • Lowest exposed elevation (walkouUwindow)
? ? • Property comers
f8 ?? . Front and rear of home at the foundation
PONDING AREA (if applicabie)
11 2f 0 • Easement line
D ? • NWl
0 fd" ? • HWL
D ? • Pond # designation
0 ,0 ? • Emergency Overflow Elevation
? J"d ? • PondlWetland buffer delineation
DIMENSIONS
-T D ? • Lot lines/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 permanent footings)
,8` ?? • Show all easements of record and City utiiities within those easements
"z- 0 ? • Setbacks of proposed structure d si eyard setback of adjacent existing structures
? • Retaining wall requirements, if ny
Reviewed: s-
N me Date
G:/FORMSlBuilding Permit Application Rev. 12-16-03
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
4 -7(D
'l
New Construction Reauirements RemodeVReoair Reauirements Office Use Onlv
3 registered sife surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Ced of Survey Recd ` Y_ N
(20°k maximum lot cover8ge allowed) 1 set oi Energy Calculations for heated additions Tree Pres Plan Recd , _ Y_ N.
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y_ N
1 set of Energy Calculations Addftion - indicate ifon-site septic system On-site SepGc System _ Y_ N
3 copies of Tree Preservation Plan ii lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date (y / Z- Construction Cost
Site Address /[Q 2-eP /, 4?f_1 ri? h a?? UniUSte #
Description of Work
Muiti-Family Bldg _ Y 'N Fireplace(s) _ 0 _ 1 _ 2
Property Owner 6IA-At-? jl?o t . C&_'3,5-?--- Telephone # ( )
?
I,?nw `
G
Contractor °O ?y 2' V
Address n_? ?
`"_7 City ?
State -Iffy-czzl A-2s Zip Telephone # (G? 1 ) 2AM`7 771
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv I Minnesota Rules 7672
Energy Code Category
• Residential Ventilation Category t Worksheet • New Energy Code Worksheet
(-Isubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitled
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #( ?
Telephone # (
a
?
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the wark 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 th"ase of work which requires a review and
approval of plans.
Applicant's Printed Name
Applicant's ?ignature
OFFICE USE ONLY
Sub Types
? 01 Foundation
O 02; SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05. 03-plex
? 06: 04-plex
Work Types
D 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
O 31 New ? 35
?? 32 Addition ? 36
33 Alteration ? 37
? 34 Replacement
Valuation ?r0& 0
Census Code ?
SAC Units
# of Units
# of Bldgs
Type of Const _If_
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screen/gazebo)
? 24 Storm Damage
? 25 Miscellaneous
,. A
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Int Improvement ? 38 Demolish Interior ? 44 Siding
Move Building ? 42 Demolish Foundation ? 45 Fire Repair
Demolish Building* ? 43 Reroof ? 46 Windows/Doors
"Demolition (EnGre Bldg) - Give PCA handout to applicant
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. a , PRV
Length ° Fire Sprinklered
Width
Footings (new bldg)
?C Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final
Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
Final/C.O.
?C Final/No C.O.
_ Plumbing
HVAC
Other
Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
W indows
Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Capies
Other
Total
-^? 0
l
\ 9
2nCktMAr-IL; \? \
?
\ / \ PROPOSED
Y / r urr•BENCH MARK HOUSE
TOP OF SPIKE
' ELEV.= 959.67 ?.9 957.9 I
9 --
?
INST 959.2
B? OR soo
? ? S89'410 " 110.429? 60.
/'
?? 19.54 ?. sss.7 ?(?t(4oo) 61.67 gs?.a (? ??'O?
t 959.8 ? ?, ? u) l4? 960.8
O ? ---
`O? r_ ?-_ 9 0. ' p9 1 9F 20
?? 0 f °oi ? S. 959.2 35. o y2.00a 0°4 ?? a o asz.s
? ?- c?vi = o DECK't? I?' w O seo.s
U
?oa x o _ 21 -?3- ---?^
seo.z? 2S o` i' ? a 12.00 s s e. ??? ?
7 / 960.0 9 5 W Q 960.9
14.67 9.50 °? m
960.2? ?2 co) 0 ? a N ? .
o ? ? ¢
PROP OSED o/ w/ o
/
S DRIVEWAY ? Q
N Ly N ? ?
7 0 ? a . ? 956.
61. ...? 20
:2?4
? 45.6 s o. ?°i 61.67 (Ci 5'ISJ 957.0' X ?
1961.0 S89'41'00"W _^ Jr 136.56 o,? 96,., I
$ENCH MARK ?63.1 9fi4.1 958?4 ? Irl)
TOP OF SPIKE . I
ELEV.= 960.89 /? I
PROPOSED
\ 962.4 / ? I ..
,?962.4
?
W
O
0
?
LO
OPOSED RETAINING
WALL BY OTHERS
3
0
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r
--
r i?HOUSE TYPE= LOOK-OUT (9')
i4* SAN. SEWER INVERT= 950.1 PLAN
VIEWED
By (
. Date ? Ss1GNED: PIONEER
EAGAN ENGIIVEEWNG DEPT. ? Q? A???,
P.A.
1
Aut 24 04 09;06a Lofgrer Hts & RlC 6514601208 p.l
s+te.'aoress /G7)Z ,/11 ;l 12 'NC, V-jCkV`S-- _ot t y'aet / suaa (f ea•ft'n!!J,a I R: dg C
;r, .apfil 15, ?.O(Kl tAe Mmnesota Eneigy (:nde, Catgory I 8uiding Requirements ftx !nsulahosl orotei.:ft-1n. ir.
trghL'ess. dnd tenfih4d+. ettas edo¢ted. A5 a msug.lhe Ctiy o! Eagsn es requitir!g IIta1 !he taMowing snftxma!ic•r N.
?ubi7iHed prror to issu?cs ol a Gertificale of Occupancy
41'.IS SUiiCEU/B 15 CoRSUb'G:ix; FG mjfl1 mr,rnnU!c rcrawli'('1Cr.i5 ot IhC h1q L11e19y l:tlUe. !:D'6tilef iC fl
dP
i his stroctws wfll ba: onst;ucte0 lo nppl muf4 !esjncRve reauiremer.ts u! Chaplers'6'2 n.'6?»
_. .. . .?_._ ._. .. . . .. . - - r -. .. . . _ . . ... ..... . ... ... . .. .
LANLE . ...?GAS EiFG ? ?MiAGT17ftR _.. ._.. .,..... ___....?CJOEI__._._' 9TfJ'S ? YEN7iiVtiITPE
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?ur+.ce ? t?.a?r o•? ?7='/???`At??4??)?//? ?c#G??`l C/??
? ?. -- -- . '?-?._- --? ' ?'• - _ . ? _ L f
' orye ?t 41G
f .
----T-- _T ? V-ENTEC
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EIWAUSi SYSTEM ? lOCI?71[H?i ? TYPE i?DEi CFllt'a _fyES
_.. .. ___ . ?.?. . _--
? _
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Kdchu
?--??_..._... ?,i?__.??,__..? . . ? ?.. _ ... .... ? ? . .. __ .._.??.. .?. ._._ ( ?_ ... .
' 6a?staatn' j
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` NtJIKE-UPAYd _ MODEL- - NPE CfM's
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; nCrebr acknewiedqa ma? Me aflovr mtomtiatar. n wrrecl aW agrae to complr ?ft mmesota Energy Csr,le arrci Ctly u! =agar
+ewrBr.wts
o
S;?iure ?
' rhis 7ortn is the raspOnSbUty ot Ihe Generai Contraciro
Address: 1626 Marina Lane
55123
Lot: 6 Block: 1 Subdivision: Centennial Ridge
THE FOLLOWING ITEMS WERL+/WERE NOT COMPLETE AT FINAL INSPECTION ON
Yes No Comments
Final rade - 6" from siding • r
Permanent ste s- gara e J r ?'
Permanent ste s- main ent
Permanent driveway
Permanent as
Retaining Wall or 3:1 Maar Slope
Sod/Seeded lawn ?
TraiUcurb damage /
Porch
Lower level finish J?
Deck
Fire lace
• Verify with your builder that roof test caps &om the plumbing system have been removed.
• Turn off water supply to the outside lawn faucets before freeze potential exists.
• Call the City's Engineering Department ai 651-675-5646 prior to woricing in right-of-way or installing
irrigation system.
J ?/?.., 1BUILDING INSPECTOR:
f;
v
CONTRACTOR:
Manley Brothers Construction
2113 Cliff Drivc
Eagan MN 55122
1
*4 *
* PIONEEFt
? 9flg AB6rl
* * * *
Certificate of Survey for:
2422 Enterprise Drive
Mendota Heights, MN 55120
LAND Sl1R4EY0R5 • CINL ENdNEEqS (851) 681-1814 FAX:681-94BB
LWD PLwNERS• UNDSCA7E MCHIlECTS 625 Highwoy 10 N.E. 9
Blaine, MN 55434 ??k VV\arv-' 6
(763) 783-1880 FAX:783-1883
_MANLEY BROTHFR. 961.2
CONSTRI1c`TION
1626 MARINA LANE BUYER:
EAGAN, MINNESOTA
PROPOSED ?
H U V BENCH ?1ARK HWSE
PROPOSED LOT AREA = 6140 SO.FT. TOP OF SPIKE ? C
LOWEST FLOOR ELEVATION: S'$ / ELEV.= 959.67 9579
HOUSE AREA = 1448 SQ.FT. ? I
559
? n TOP OF BLOCK ELEVATION: GARAGE AREA= 508 SC.FT.
GARAGE SLAB ELEVATION: DRIVEWAY AREA = 620 SQ.FT, ? ?i'
?
TOB 0 LOOKOUT ELEVATION:
PORCH = 75 SQ.FT. 959•2
BUILDING COVERAGE = 33%
x 000.00 oENohs ewsnNc ELEvAnon IMPERVIOUS COVERAGE = 43% S89-41 110.42 I
( 000.00 ) DENOTES PROPOSED ELEVA110N ) ??51 ?+ ^ ?
.q
--- DENOTE$ DRAINAGE AND UTIUTY EASEA1ENT '116,19.54 I 959.7 I(q(Q0,0) 61.67 9574 ?q5s o?• saPd
o
-? OENOIES DRAINACE ROW pIREC710N i 959.8
N .. . ...... 2. .
-? DENOlES SPIKE
$ ` ry O? I? ul 960.8
OENOIES OFFSET HUB cr% ? 9.
oi 1'959.2 980.2957.8 0956.1 ? F a 20
)
? i ? 5. 35. 0 12.000 c°v I]a
-? O 962.6
/
DECK 0 sso.s
Ni ? o o o
9o
v a'O ? ° " 29.21 W o
4, 960./Rt??$ ? ?',O o ^ -- rY- --
M ol ? s ? 12.O0 958.(¢ ? !ccc?????r
NOTE: PROPOSD CRADES SHOWN PER qiADING PLAN BY: PIONEER ENqNEERING \ \ 4\?? ?O 960.2 / 960A 14.67 9.50. a? ?1 ? a? 960,9
NOtE: BUILDING OIMENSIONS SHOVM ARE FOR HORIZONTAL AND YERTICAL lOCA710N ?? p QI ? W ? F
OF STRUCNRES ONLY. SEE ARCHITECNAI PLANS FOR BUILDING AND PROPOSED p/ ?/ ? a ??•? I p ?W
FOUNDAiION OIMENSIONS. O?
isx
oRivEwav( c?r N a N
O
NOTE: NO SPECIFlC SpLS INVESTIGAl10N HAS BEEN COAIPLE7ED ON T!{IS LOT BY THE C N
J
SURVEYOR THE SUITA&UTY OF SqLS TO SUPPIXiT THE SPEqFlC HWSE \ 1? 0 </ 61 . I !?956\
PROPOSED IS NOT THE RESPONSIBNtt OF THE $UR4EYOR, ZO ?
? ' ------- 1 ?
NOTE: THIS CER11FlCATE DOES NOT PURPORT TO SHOW EASEMENTS O7HER THAN 1 1 ' ? X 6. ?
iHOSE SHOWN ON THE RECORDEO PLAT. 960.
Eii
,?' 96D.Sf?961.0 61.67 956
NOIE: CONTRACTOR ?IUST VERIFY DRIVEWAY DESIGN. ?
`
.5 a
S89'41'00"W _ ? J" 136.56 fc 95' °' x
NOTE: BEAPoNGS SHOWN ARE BASEO ON AN ASSUNED pANM ?
f T?O? 961.1 I
1 9609 BENCH MARK ?"ys3.
964.1
960.6 - TOP OF SPIKE I ?&4 ? Q51 ?
ELEV.= 960.89
r? r7 f '? •?'' ,-"? r ? n ?-?, .-, , ? -B.-B. .0 FT. ? ?`?•
PROPOS_ED? 7
U0 Uo L t:
-1 a ; I ?u:1 4?.?.; ?
R =o.-w. 32.o Fr.- \ 962.4 -
• f 962.4 WE HEREBY CERIIFY TO MANLEY BRDTHERS CONSTRUCTION THAi 7H15 IS A TRUE AND CORREC7 REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 6, BLOCK 1, CENTENNIAL RIDGE
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 7TH DAY OF JUNE, 2004.
SCALE : 1 INCH = 20 FEET
1
REVISED 06/28/04 BLDG STAKE
?ly 7/,
F' ?.I?;N,? A?!SPECT6QM? 7
EW? ?
By ,
Date ?1/17/o4-
Bed'aGNIa Cd40Y 'L? D11G?'4e
N0.
O
O
r-
IA
OPOSED RETAINING
WALL BY OTHERS
3
0
QI
C"
t0
o
r
%0?)
HOUSE T1PE= LOOK-OUT (9')
SAN. SEWER INVERT= 950.1 PLAN
P.A.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA108028
Date Issued:11/13/2012
Permit Category:ePermit
Site Address: 1626 Marina Lane
Lot:6 Block: 1 Addition: Centennial Ridge
PID:10-16950-01-060
Use:
Description:
Sub Type:e-Reroof
Work Type:Reroof
Description:House
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection 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 .
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 -
Mary M Nutt
1626 Marina Lane
Eagan MN 55122
Gates General Contractors, Inc
3500 Vicksburg Lane North, Suite 400-351
Plymouth MN 55447
(763) 550-0043
Applicant/Permitee: Signature Issued By: Signature
41111111111'
City of Ea�aII
3830 PilotKnobRoad
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
1
For Office UsePermit #:
�, A (
1
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: "1- 7 -/4 Site Address: /�
Tenant:
Suite #:
Name: /1).44:41 _.,o Phone: 611- 3 3'/ - 9 /79?
Address / City / Zip: / 6 od L Z td < -' . rl�-r� a Cap' -� 77?!L1 S"'.5"
Name: vet+ /(29- /t%,,.� License #: ' ? 30 3 ,'°A'l.
Address: City: if="-
State:
`
State: %11 /() Zip: S"fO R
Phone: C.57 - 3 - /2 a -5
Contact: /1/.// Sa u h e, Email:
_ New (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 Tumaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge)
*Water Tumaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Cali 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.gooherstateonecall.org
1 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.
1`1/ cot w is,eR
Applicant's Printed Name
x
Applicant's Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA167870
Date Issued:03/31/2021
Permit Category:ePermit
Site Address: 1626 Marina Lane
Lot:6 Block: 1 Addition: Centennial Ridge
PID:10-16950-01-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Mary M Nutt
1626 Marina Ln
Eagan MN 55122
(651) 334-9798
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
Applicant/Permitee: Signature Issued By: Signature