4523 Scott Tr
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Q Eaau Permit
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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-
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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
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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