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4340 Nicols RdCITY OF EAGAN 3795 Pilot Kwob Road Eogan, Minnesofa 55122 Phone: 454-8100 HEATING/A.C. Date: 10-13-78 PERMIT Site Address: "3?E0 Cedar Aveaue Lot 7 Block Sub/Sec. -CEC40 Y ro1'!Le 4- -- Name l' obert T.awZE!r .. ? Address '- 140 Ceda- n,verue City "la`;an Phone: Name F'a Wkirer Heatinc,, Cc;. . ? qddreu <637 Chicago So. S V c i tY :4 f17 Phone: This Permit is issued on the express condition thot oll work sholl be Minnesota Statutes and City of Eagon Ordinances. COM}3i1ST20N AIR RFQUIRED No. *" 1324 Receipt No.: Single Residentiol r: Multi Res., Comm./Ind. I New/Alter./Repafr Cost of Instollotion Permit Fee 5.00 SurtFarge Tota I done in occordance with oll applicuble State of Building Offlciol INSPECTI4N RECORD CITY 4F EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: 1„, : kit f APPLICANT: M1 fjllutn ! b 1.' 1 f; ti ti .' O6+, M1l11?i1Nt] A :' t+ 1 tt ! YN?f1N /?fh wii I rFim 13nf PERMIT SUBTYPE: TYPE OF WORK: 01 i 1 1 1 tsri ?•.I 11,1r,l, i'a i i t, 11MM' ?: PermR No. PKmk Holder Dsbe Telephone N ELECTRIC PLUMBING HVAC Insp"tion Dats Insp. Commeats FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING (3AS SVC TEST INSUL GYP BOARD FlREPLACE FlREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL - 414 ? r ;?? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: •???+ ir ? r?fj 3830 Pilot Knob Road Permit Number. E, I??+?. Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: I 11 PERMIT SUBTYPE: 1 NfiS ?t' i. ? 1,11 t , APPLICANT: RIi [!I, t ? nM TYPE OF WORK: It F 1NAt ? J Psrmh No. Permk Holder ? Data Telephone # ELECTRIC PLUMBING HVAC (nspecGon Date insp. Comments FOOTINC3S FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIH TEST FINAL PL9G FINAL HTG ORSAT TEST /??'/S?? BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG v ! S ? ??? DECK FINAL ?J CITY OF EAGAN Remarks * Cedar Grove ACcruisition Addition CEDp'R GROV #4 Lot 7 Bik 6 Parcel 10 16703 070 06 AVen ie Ea$an? MN 5_5122 - d Owner Street - 340 CeddY State ?--? sa<r. LL'?. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTDR. GRADING SAN SEW TRUNK * SEWERLATERAL 1972 1 304.00 52.16 25 Pi WATERMAIN * WATER LATERAL 1972 WATER AREA STORM 5EW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK EAGAN TOWNSHIP BUILDING PERMIT Omnax ......??.4.. r....---?..7.:...-'.C!.':C?.._'."C..---.._--- ? ?t ? Address (Presenf) -...._ ................._----'-........._....--------........_......-'----'- Buildex ------ ------- ?`??/-...-..?_.-?. ........................ .... Address ------------ '-..................................... ......-'--"---_.........._...------- DESCRIPTION N° 1555 Eagan Township Town Hall Dale ......... 7/ ................... S2ories To Be Used For Fron! Depih Heighi Esi. Cos3 Parmit Fee Remarks 7 v LOCATION 5ireei, Road or ofher Deseripfion of Loeafion I Lo! I Elack I Atld3i9on or Tiac! . T'his permit does not auihoriza the use of slreels, roads, slleys os sidewalks nor does it give the owner os his agenS the xigh! !o ezeate aap sifuation which is a nuisanee or which preseals a hasard !o the health, safefy, convenieace and genaxal welfare !o anyone in the communily. THIS PERMIT MUST BE PT ON THE AEMISE WHILE THE WORK IS IN PROGRE? . This is fo cerlifp, lha2-_?= :°'s-`-.`-e°---......... -------- has permissioa fo ereei a...... .--° ----- ---°.- -. ?---...-°---°-°-..upon the above described premise subjeei fo the provisions of the Building Ordinance for E an Taw hip adopled April 11. 1955. ....................... ....._?:....?./.`' ..-C p?- - ? ._7='::.'•:"-------.. Per ---- .................°?.-............"-__.?.?..-f.. ...:...._...."'---'-- Chairmalf ot Tnwn Board Building Inapector G' -/3 - CtTY of EAGAN BUILDING PERMIT own.: ....... ??....--- ..0 .?..a.......P"'...`?':".` ................. ....... Addreu (prasen! ? ) ........... ........ Bulldes Addresa DESCRIPTION . ,. N° 3285 3795 PiloY Knob Road Eagan Mieuiesofa 55122 454-8100 a.:. ....S.. ..... i3.-? ? .. ... ................ Btoxiec To Be Uaed For Fron1 Depih Heighf Esi. Cos! Pesmi! Fae Remarks ?a-'P? ? f ?%?d•"% ?° ? , ,St+ LOCATION Sfzeet, Road or oiher Descxipfion ot Locaf9on I Lo! 81ock Addifion os Tsaet I 7 6 /-,-, This permif does aot aulhorue the use of streais, roads, alleys or sidewalks nor does it gfve the ownes or h[a ageat the ri4ht So create any situation which is a nuisance or which presenls a hazard fo the health, safelp, contreniente and general welfare !o anpona in the community. THIS P£RMIT MUST B£EP?T/ ON THE PREMISE WHILE THE WORK IS IN PROGRES. This is !o ce:tify. 2hal.---" -- . ^up? ..:.......... ..............................-.----has permisaion !o erec! _............................... the above described premi subjecY !o the provisions of all applica6le Ordinances for fhe Cilp of Eagan. ...... -----------................ ? Per ....---------------- . ............_..----...-??e_+r-??......._..........._.._... Ma or ?' Suilding Inayeelor ,Kg . EAGAN TOWNSHIP BUILDING PERMIT Ownex ..._.-...?E?..:_..?C./......... Address (present) ..."4 ......... '/? ---......... N: 1179 Eagan Township Town Hall Builder ....... ............ .----- .. - . _................. ... ?/ ._.... 7 ? f _. _._.._....._...._..__......_' .... _ .... ............_.. __."__....__...._...._.......... _..... __.._.". Dafe .... L/ Address ? DESCRIPTION 5fories! To Be Used For Fronf Depih Fieig ht Esi. Cos!_ ?Permi! Fee Remarks _ ?? ?a2-C??. _-_ ' _ - ____ 'e?? • _----_ LOCATION Slreel, Road or ofher Descripiion of Localion Lo! Elock Addiiion or Teacf -? / 'A? ----1 ad? ZZZ 7. ? -- -_?L^'?-a •_-' _?'L_P-e-f?_-?`yc. rJ ....u •? i i_ ? c.c..c..c.<_ /K-?t? This permii does no2 auihorise the use of slreefs, roads, alleys or sidewalks nor does it give the owner or his agenf the righf io creaie any siluation which is a nuisance or which presenis a hazard to the health, safety, convenience and general welfare So anyone in ihe community. TFIIS P£RMIT MUST BE KEPT OIQ, THE PREMISE WHILE THE WOAK IS tN PROGRESS. , This is fo terlify, fhaiZt.? .....haspermission !o erecl a._/?. . __' . . . ........ . . . .upon the above descri6ed nremise subjecf 2o the pzovisioes of the Building Ord?nance for Eagan wnship adopied pril 11, 1955. ......... Per ..._....1"_ t.t ?•.r-?"'x ?^-.?G./5?.? ............._.... ..... ........... . ... ... ... ........... Chairman of Tnwn Board4 •? Buildrng Inspeefor Tlvs request void 18 months from 7_ > " ?f? r C_'?13850 Date of t' Request LP a? , 17 7? I, as ?censed Electrical Contractor OOwner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. Section Township Which is occupied by Is a rougliin inspection required on this job? No ? Yes ? Ready Now ?Will Call ? Power Supplier Address Electrical Contractor Contractor's License No.'16J7? p (COmp}?'y Name) ?/Q MailingAddress /L' '14Lh, zz-/z ?yL• s7.Sg7L EI <trf al ontra r o f . Owner Making Thls Installation) Authorized Signature ,Lf / Phone No. - Z d IElectrical Cont?acto? or O ner Maklna This Installatlanl ((??ll ?(!5 (? ???[??j? fj'/?.??? This inspeeUOp request will nat 6e accepted hy the e°^J ? ?,q(?y ?,Et1JU' State Board unless proper inspection fee is endosed. ? A4innesotd State Board of Electricity 1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 RE'QUEST FOR ELECTRICAL INSPECTION CHbfK BEGOW WORK COVERED BY THIS REOUEST 'R 13850 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired Foi Hume Duplex Apt. Bldg. Commercial Bldg. ? ? ? ? ? ? ? ? ? ? 0 ? Range ? W eater ? D x ?'1' F 44 Temporary Wiring ? Lighung Putures ? Electric Heating ? Silo Unloader ? Industrial Bldg. ? ? ? . A' Con List ) Bulk Milk Tank ? List ! O her ? ? ? p } Hehers7 p } Heiels! COMPUTE INSPECTION FEE BELOW Service Envance Size: x Fee Feeders&Su6feeders: n Fee C'vcuits: # Fee 0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eies 101 m 200 Amps. 31 to 100 Am eres 31 to 100 Am eres Above 200_Amps. Above 100 Amps. Above 100 Amps. Tiansformers RemoteControlCire. - Partialoiotherfee S' ns Special lns ection Minimum fee $5.00 Remazks .. TOTAL FEE y o-? I, the Electrical Inspector, hereby certify that (Final) L•c?, ? ?. _. .. . This request void 18 months from has been made. ,S ? 3 ? ? I RESIDENTIAI. BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New ConaweUon Reauiramenn . 3 registered sde surveys slqvrirg sq. ft. of lot, sq. R. of house; and all roofed areas (20% maximum lat coverage allowed) • 2 copies o6plan showing beam & window sizes; poured found Cesgn, etc J • 1 set of Energy CalculaGore . 3 copies of Tree Prese(vatbn Plan if lol pla@ed after 711193 . Rim Jast Delail Optiars selection sheet (61dgs wb 3 w less unils) DATE 7-Z3-'Y RemodallRaoair ReouiremaMs • 2 copies ot plan • 1 set of Energy CaIcWa6ons for heated additions • 1 site survey farexterior additions & decks • Indicate if home served by septic syslem For adtliGons VALUATION ('_? SITEAODRES&, 43?D N t w`-S ?? TYPE OF WORK I? IZ-ba i APPLICANT -_ CRoi X ? AU 4-t z X. a? !!LY BLDG _ Y )?,N FIREFLACE(S) _ 0 _ 1 _ 2 STREET ADDRE55 aT_fk H1Ct? 7 CITY STATE ILW ZIP ?f331 TELEPHONE #Q(Sa-L(1o-44U3 CELL PHONE # 6T_1 -7T4_--TZ`f 4 FAX # 4,s-z- y7o -q4 13 PROPERTYOWNER TELEPHONE# L9fI -??'QR?' 7 ........... ------------------------------------------- °----------°--------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNE501'A RUITS 7670 CATEGORY l MINNESOTA RULES 7672 (4 submission type) . Residential Ventilatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Su6mitted . Energy Envelope Calculatlons Submitted Plumbing Conhactor. Plumbing system includes: Mechanical Conhactor: Mechanical system includes: 11 Sewer/Water Contractor. Phone # Fee:_ ??00 -------°---.,. s-°--°----^-------------------------------°---------°---------°-------°------- °-• -°--------------- I hereby acknowledge thpT I have read this application, state that the information is correct, and agree to comply with all applicpble State of Minnesota Statutes and City of Eagan Or{?i ces. 11 Signature of Applica G?tiu??^-^?? OFFICE USE ONLY _ Water So&ener _ Water Heater _ No. of Baths _ Phone # Larvn SprinA No. of R.I. I _ Air Conditioning _ Heat Recovery System ? -•° ,--?? ' ?- 0.00 ?? 1t ?? 1 ?? 2?02 ? , Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: DESCRIPTION: PERMIT PERMIT TYPE: Permit Number: Date Issued: 4340 NICOLS RD LOT: 7 BLOCK: 6 CEpAR GROVE 4TH (SLIDING PATIO DOOR) 5F (MISC.) ALTERATION BUILDING 926187 08/08/95 ?`' ? ? 3S '•;rq,`? j ltf s r?(;` i-€'•;i??st r k':.?? ?ES?. ..,.? ,.. . _. ?. .. ._ ..? ( ?. _ ._ _. _ Buxlding''Permit Type Building Wo;r-?, Type `. ; . f. ?'.•`, E . .. R? "t n s 5.. REMARKS: FEE SUMMARY: VALUATION Base Fee Surcharge Lic. Search Total Fee $48.50 $.75 Fee $5.00 $54.25 $1,500 CONTRACTOR: OWNER: - Applicant - STORDAHL CONS7 CO 18664812 MCQUOID WILLIAM 6821 PENN AVE 4340 NICOLS RD RICHFIEI.D MN 55423 EAGAN MN 55122 (612)688-2055 I hergby acknv;wletlge that L have read thi information is correct and agree to comply Statutes and Gity of Eagan Ordinances. L ? APPLICA /PE MITEE SIGNATURE s application and state tnat the with all applicable 5tate of' Mn> (f ISSUED 81": SIGNA7URE ? CITY OF EAGAN p? 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) / 681-4675 New GonetrucGon Reauirements RemodeVReoair ReauiremeMs ? 3 registered site wrveys ? 2 copbs of plan ? 2 eopiea of ptens (indude beam & window eizas; poured fid. design; atc.) ? 2 eke surveys (exterior addRions & dedca) ? 7 snergy calwletions ? 1 energy eelculaUons for heateE additions ? 3 copbs oT tree prsservatlon plan iF Ipf pletted after 7/7/93 mqWred: _ Yea No ? DATE: ? ? ? ^ CONSTRUCTION COST: DESCRIPTION OF WORK: - V z l,d //I/ STREET ADDRESS: v434D IVICGI.f AQ,-Y-e LOT __;7 BLOCK -4L SUBD./P.I.D. #: ( ?Zwld ??a? &4 PROPERTY Name%X!L /?LD Gf/1 /W/W PhOne #: ? ?????Sy- OWNER Street Address- A4?L? City: , 7i ,% &W State:/?? Zip: , rL/ a L CoNTRACTOR Company:,Syi9/JniRd/1- CONS C'O/144 Phone #: Street Address: tl:?!&'d? ? l'7?l /Y /f410Z License #: Ciry:41State j/O/W,/ ° Zip? ? 3, ARCHITECTI Company: Phone #• ENGINEER Name: Registration #- Street Address- City: State: Zip: Sewer & water Iicensed plumber: . Penalty applies when address change and Int change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the informa'on is corcect and agree to compry with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. ?, ?L'? Signature of Applicant: ` ? OFFICE USE ONLY R 2C 'VE ?[? Certificates of Survey Received _ Yes _ No AUG 0 Z 1995 _ ........ Tree Preservadon Plan Received _ Yes _ No _ ..... ? PERMIT 040 1,14 & & / CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: DESCRIPTION: 4348 NSCOLS RD LQT: 7 BLOCK: 6 CEDAR GROVE 4TH 136i1 ldin; "P.,ermiti Type 5uilding Wor'k,Type r t r ? ? PERMIT TYPE: Permit Number: Date Issued: DECK NEW BUILDING 026186 @8/08J95 M. REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee $30.00 $30.50 CONTRACTOR: OWNER: - Applicant - MCQUQID WILLIAM 4340 NICOLS RD EAGAN MM 55122 (612)688-2055 I hereby acknowledge that I have read this infor?tnatiata 1s cbrrect and'° egrea-to copTply Statutes and City of Eagan Ordinances. ? ? APPLICA / F I E SIGNATtf? application and state that the wiCh a:11 appliaabl.e State of Mn ? L?l ISSUED B IGNATU ? CITY OF EAGAN ? 3830 PILOT KNOB RD - 55122 s,5 ?,'? 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Conahurlion Reaufrmnents RemodeVReoair Reouirements ? 3 ropis0erod site surveYg ? 2 copies M plan ? 2 copies oi plans (indutle beem 8 window saea; poured fid. design; ete.) ? 2 sRe surveys (e)derbr additiona 8 decks) ? 1 enerpy ealalationa ? 1 energy calculatiorw for heatetl additions ? 3 copies of tree preservetion plen 'rf b! pletted after 7/1/93 required: _ Y _ No DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: /Ll?7M4 k17 C-L Y-0 vST STREET ADDRESS: 43-20 /Vl eOL XD 'D LOT .4- BLOCK -- SUBD./P.I.D. #: Name:M &D?O U i?4l10W Phone ,s z - u., . .m.. PROPERTY OWNER CONTRACTOR Street 'l? Gl' /f /69 City: State-/-Vl/W Zip: Company: ?TL /? Phone #: Street Address: City: State: -4 License #• Zip• ARCHITECT/ Company: ENGINEER Name: Phone #• Registration #* Street Address- City: Sewer 8 water licensed plumber: change are requested once permit is issued. State: Zip: Penalty applies when address change and lot I hereby acknowledge that I have read this applicatlon and state that the infortnation is correct and agree to comply with all applicable State ofMinnesota Statutes and City of Eagan Ordinances. =' ?`-?`?/ Signature of Applicant: zZ 2 OFFICE USE ONLY ???G?I?`sDD Certificates of Survey Received _ Yes _ No AUG ? 2 1995 Tree Preservation Plan Received Yes No """"-'------ , ?. w ? ? ? V ? ? \ N ? ? ? ? Z5 ? x , I '?c \ 1 ? ? .\ N 1 \ A ?\C?N .? ? . d'8 J??,d /S'-s-- ?-- 4 54. - 2S 4-O LOT NAME SIZE / L x ZZ. BLDCK A RE55 VALVE lc 4340 1100 = ADD'N. AREA TYPE C-ec%<1.e C?rzc?vc 4ria. Ge c, z%,r? vr?c7v? l=02 n- ? Q+ q uniz e vJiTu Nvc;?st- ?L N T C? F &aA R 4 G-?a 7?' == 7•r1 OZ 7 JCF?S'OM `?!-!fJ Wnl O?:. l-?. ?G?GF2 TG Lln?c OrJ -tfe.i 5 ri? +?/EWJAY t1C 51-lOWnf 4E.E UWNE,iN.1E?[rFY C.-4G.ATI E:nI L0M a eJ r ?r ? fl ? Mus-r 8? ?'1r ?-E?tsr g' 1 tJ f 1 ? vi rl ? Z ry -- F- .G' e7 N T - ? VAV AIR OUTLE'i ? TEST REPORT r''E ? ?g ??- ?? °- , ca I 5 SYSTEM OUTLETMANUFACTURER Z-1 nI /`t' TESTAPPARATUS , 01^??d I OUTLET MR%IMUN DESIGN MA%IMUM PRELtMINARY MAXIMUM FlNAL MINiMUN I . ocA SERVEG ? N0. TYPE SIZE AK FPU Imrs) CFM 11.51 I VEL AIRFIOW VEL. AIRFLOW ? DESiGN AIRfLOW I ACiUt. AIRCLOv: ? bc?i C E `? 0 A I a i , u LO ?? l! I I Z! ?I I, cr ', ! I i I I I I 'I I I I I I ? j ? I I I I , ? ? I J I I I ? i ? i I r2-` 2« ? i I ? j lD 1?8a ? I I I i I REMARKS: <?C ?L DI /Z-a S'I,E l TEST DATE 10'-501 06 REAOINGS BY -+ TI-..-?- '-?? A2fl NatiOnai Environmmtal Balencing Bureau ? PAGE -/- OF --L 7({g ll 8-91 Fapoa r+nt veilC uniess 5tampee.inn E.1 E ¢ GoMnon'. NE&5199t NEBB GanMi?atron Seai ?? ? ?? ?? ?? ??e(i Lf? /D A,1, ? 6) ls 62d G i?SGGt> ?W sY,,,,?- 'Z ¢o - - - - - - - - - - - - - - ?/ ?- - - - - - -? ?--??-- -------EXIT DISTANCE ? _ 45 FEET TO EXIT)ACCESS CORRIDOR J , ?12'-u?? O EXIT TAIR Y i rax F? PrxnnoN _ _ - - - - - ? - - - LL?!'l Y} D lC ?fDIV AP-( iCF ? ? rREF ?EXIT DISTANCE --? i NIC I I I i iii` 62 FEET TO EXIT TO GRADE ? L .??t1 q siNx na r----, I ? L-- -? r----? DEDICATED FI? D VERIFY EXIT DOOR I? QI/ QI?. O? n? I GFCIE48 SERVER AT GRADE I ? ?-- --JTAHLE ' 60 t9Q VER. COMPl? ?^I N9ICTIRS I ? _ ? 71 FE Iz 4 L ?° ? i ,?.? ?' a i O COLUMN G rr `h 1h ? ? SF-ALALL DUCT WORK r?' z TENANT ITE ? ;?? T I,?e a CHAIR4; ? ? I o ? N 1O i i 0 z H I, a?A ? ?- , II Ot'eICS coeeS {j W I a i O- I I NIC 6AIRS '" ? I N N a 04 ?----_ __--_? , j rrc i kii CHAI I J iNIC `___'_____'_1 I i i r?EVa-WED ? FIELD VERIFY / BY LIMITS OF CONSTRUCTION DATE ? ? ? - --.. L BUILDING INSPECTIONS DEPT, TENANT SUITE AREAS Uaeable Area = 946 af Basic Rentable Area = 946 x 1.14 = 1078 e£ Rentable Area = 1078 x 1.11 = 1197 s£ KEY TO ELECTRIGAL SYMBOLS +S` SWITCH ? DIIPLEX ? QUAD 4 COMBINATION TELEPHONE/DATA Use BLUE or BLACK Ink ' f l~~- I For Office Use 1 Permit y`''~ I /~d J I - City of Eap I Permit Fee: 3830 Pilot Knob Road I 1 Eagan MN 55122 I Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date ` 3Site Address: Unit Name: A d/l OX Phone: 6& , _ Resident/ Owner Address / City / Zip: L Lt,340 t y t C k S ` Applicant is: Owner Contractor Description of work: ~ ~ - 2-2 Type of Work r c~ Construction Cost ` Multi-Family Building: (Yes / No Company Contact ~~1►~ Address: L~ 9, ~a C T) CitY Contractor p` State: NAB Zip: Phone: License Lead Certificate 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: a-_. _ r._ . 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 aooherstateonecall.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 Min tat i[ding Code must be completed within 180 days of permit issuance. , x Z?tS )U\JWV Applicant's Printed Name Ap nt's na re Page 1 of 3