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 """"-'------
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LOT NAME SIZE
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BLDCK A RE55 VALVE
lc 4340 1100
=
ADD'N. AREA TYPE
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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: ?
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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
??
?
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Lf? /D A,1, ? 6) ls 62d
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- - - - - - - - - - - - - - ?/
?- - - - - - -? ?--??-- -------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
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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. ,
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Applicant's Printed Name Ap nt's na re
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