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4523 Scott Tr F For Office Use h I n ~d4 Q Eaau Permit I City I Permit Fee: !P /210 - 3830 Pilot Knob Road Eagan MN 55122 Date Recei e g~ - I Phone: (651) 675-5675 I I or I Staff: I Fax: (651) 675-5694 C 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: b J fl`I Site Address: q513 'SCc L C ,"a, SS 1 22- ~Ij Tenant: J U-. L Suite RESIDENT / OWNER Name: rti L Phone: (0s 1 (096 9 J _Q_ TO 0-S Address/City /Zip: HCp2_S c rc L In SS/2 2 Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: I'S®®` Multi-Family Building: (Yes. / No m CONTRACTOR fsojj License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (I submission type) • Energy Envelope Calculations Submitted 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 maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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 Printed Name A s Signature Page 1 of 3 DO 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 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) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC 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 Meter Size: Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee n 6ac2 Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 MA If f 1 RS tAD SN tri - clolo 00, .4> d t w.6 o-d ¦ ti#a 1 . - 1 . NO >►Mt SSia N z r r No (AVM"' _ k t 1, aajslar. yes _ )' . . _ '. _ ' : _ Si* ( a �� T,9 . A r St Paid U'ti f -ice' z�., • 1 Iii .. AMC:" ■ Totals �Y i mss✓ DOW' P a , ``of A fT� �{: ;;....__ Ind►.•, i O sikritair PERMIT 140-' s..1MW$1122 DATE: , 1,T' /1 i Zonire: T`T,T No. of unit 1,1 tlr?^ Pu (Xenon 7- 1C1 - u „ h Site :. r*,? cptt sa 11 7 5 T ? (1r Plumber: i't P.n a 1 T?f 10/14/80 21343 -- 400 00 x 1 *'►110,1111° Deposit: ; � Ilora+nt Permit Fee: SilithONVO: 1 iaC t 1 • r it BY = "`a�it PO PERMIT City of Eagan Permit Type:Building Permit Number:EA113750 Date Issued:09/09/2013 Permit Category:ePermit Site Address: 4523 Scott Tr Lot:052 Block: 02 Addition: Cedar Cliff 3rd PID:10-16602-02-052 Use: Description: Sub Type:Reroof Work Type:Replace Description: 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 . Laura Gillespie 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 - Jeanne L Tousignant 4523 Scott Tr Eagan MN 55122 Able Restoration Group Inc. 17316 Kenyon Avenue, Suite 103 Lakeville MN 55044 (952) 378-5000 Applicant/Permitee: Signature Issued By: Signature