Loading...
1634 Oakbrooke DrRESIDENTIAL 6P- ll4N531 - ? 5 ?16. ?? BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 NewConstructian Renuirements RemudeltReoair Requirements ? ? . 3 registered site surveys Showing sq k. of lo( sq. k. of house; and all roofed ardas . 2 copies of plan (20°6 mazimum lot coverege allowed) . 1 set of Energy Calculations (or heated additions • 2 copies of pian shaxing 6eam 8 wmdow sizes; poured found design, etc ) • 1 sde surrey for extenor addinons & decks C61 I • lsetofEnergyCalculatlons 16,d 9'Zl0' • 3 copies of Tree Preservafion Plan if Iot platled after I11193 ? • Rim Joist DeWil OpUons selection sheet (61dgs with 3 or less units) DATE VALUATION (EXCLUDING LAND) I? 7l ?3-? JOB SITE ADDRESS I43'7? ??kA&DkE- IDl)lfe- IF MULTI-fAMILY PROPERTY OWNE TYPE OF WORK APPLICANT MANY UNITS? n l1G PIREPLACE(5) _?'YES _ NO PHONE # PAGER # CELL PHONE #( l.2-3 6q-l7a 1 FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLF Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 ? (check one) - Residential Ventilation Category 1 Worksheet Submitt - Energy Envelope Calculations Submitted -?/ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumhing Contractor: ?11`1511-?'8=0 W f4U- Phone Plumbing System Includes: Water Softener I.awn Sprinkler Fee: $90.00 ' Water HeaCer 41 No. of R.I. Baths 3 No. of Baths Mechanical Contractor: Pu?113ale ii7iccL'fln4- Nlcclianic+il Syslcin Includes: _ Air Gonditiomne _ Hcat Rccovery Sys'tem Sewer/Water Contractor: #cl ro GUne,/ci1 c5C{VEC_f.. Phone # $olf' Gd UJ?' Fee: $70.00 Phone # 96'3 -42?-1 -51 3X All above information must be su6mitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable Stote of Minnesota Statutes and City of Eagan Ordinances. ?? ??vl?c?lo?1L5?1Y??1 SignatureofApplicanf 5 Certificates of Survey Received Tree Preservation Plan Received _ Not Required _ S Updated 1I01 OFFICE USE ONLY ? Ot Foundation . 02 SF Dwelling ? 03 0 1 of _ plex ? 04 02-plex ? 05 43-plex ? 06 04-plex ,:?61 New ? 32 Addition ? 33 Alteration ? 34 Replacement ? 07 05-plex q 13 16-plex ? OS 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck ? 11 10-plex ? 19 LowerLeve! ? 12 12•plex Plbg_Y or i N ? 20 Pool ? 21 Porch (3-sea.) ? 22 PorchlAddn. (4•sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt • SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors 'Demolition (Entire Bldg only) - Give PCA handout to applicant ?, Valuation 1 S? ODU, pO Occupancy MC/ES System Census Code )G ( Zoning ? p City Water SAC Units 0_ Stories 2 Booster Pump Nbr. of Units Sq. Ft. PRV Nbr, of Bldgs ` Length S I Fire Sprinklered Type of Const ? Width 27 x Footmgs(new bldg) ? Foohngs(deck) Footings (addition) ? Foundation _ Dram Tile Roof Ice & Water Final x Framing ? Fireplace ? R.I. XAir Test '<- Final '1?- Insulation Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) Approved By Buiiding Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total REQUIRED INSPECTIONS ? FinaUC.O. FinaVNo C.O. x Plumbing k HVAC St pec ?(- a?oao ? .A?',A 1 I -)0 x S`I =? 3,1 s ? 12 l4f r 5'-I =A6 S, ??? Gu??Se. zzxzz = Y4Y ?/6 ???y`? LIt- e, c,? 1 ! 70 ,r !S 17, SSS x)56,2s I Address _ L: 3a naxr,RooKE D?t Zip 5512 3 Lot 2 Blk 4 Sub OAKBROOKE 4th THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECITON. Date: G-? Gi • Q 1 Yes No Inspector: Final grade (6" from siding) Pennanentsteps (garage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass Trail/curb damage Porch Basement finish Deck Please ve ' with the bw(der the removal of raof test caps from the plumbing system and the shuboff af water supply to the outside awn faucet before freeze potential exists. Contact engineering division et 681-4645 before working in rightof-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contracwr Copy ?----------------- I F_o'r'OfSice'1Jse ? ? Parmit#: ? O I I Permit Fee: / I ? ? Date Received. ? ? I ? StaR I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: y'I S'-d k_ Site Address: 1?1 3 S1 Ch? P7LCC21,P I/c& ' Tenant: Suite #: RESIDENT 1 OWNER Name: ?21 yk ¢ Ila nn &,9 J1 Phone: j?- fZV6 -S'I/-?4 Address / City / Zip: Applicant is _ Owner ? Contractor TYPE OF WORK Description ofwork arcc?? - & 5i2L , Construction Cost: te%/),seL . Cz)_ Multi-Family Building: (Yes No CONTRACTOR Name: 112G _ License #: 43l Address' City: ?4?a ((1/?!D State 1)?)A-) Zip: SSDq?, Phone: ?-J,S,2_ pW- Contad Person: 0_,n5gpk lY\Pcri t COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqory 1 Minnesota Rules 7672 ? Energy Code . Residential Ventilation Category t Worksheet • New Energy Code Worksheet Cafe9ofy Submitted Submitted (4 Submi551on 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 p1an: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: = NOTE: Plans and supporting documents that you submit a{e considered to 6e public informafion..: Portions of. the information may be classffed as no?r-publfc-if you,provide specific reasons that woald `permit the City to coFlClude thaYYhe a're trade secrefs., ° 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 oNy an application for a permit, and work is not to start without a permit; that the work will be in accordance with ihe approved plan in the case of work which requves a review and approval of plans. X Sei,rn?,.1? X ? ApplicanYs Printed Name Applic t's Signature Page 1 of 3 LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTYLEGAL. Z/'t ? 1? q ?'Ja1L?LirnoR'F' /1 OATEOFSURVEY: Z, LATEST REVISION: 3'/- D I ? ? ? DOCUMENTSTANDARDS ? ? • Registered Land Surveyor sgnature and company L? ? ? ? ? • • Budding PertnitApplicant n L l d ri ti ? ega esc p o E? ? ? • Address G? ? ? • North arrow and scale / 6X ? ? • House type (rambler, walkout, splft w/o, splR entry, bokout, etcJ f,2/ o ? • Directional drainage artows with sbpe/gradient % ? ? • Proposed/existing sewer and water services & invert eievation o ? • SVeet name C3'/ ? 0 • Drneway ? ? • Lot Squa2 Footage e' ? ? • Lot Coverage ELEVATIONS Existin ?/u ? • Sewer service (or Proposed) d jC ? • Property comers G? ?? • Top of curb at the driveway ??? • Elevations of any existing adjacent homes ?P( ? • Adequate footlng depth of structures due to adjacent utildy trenches Prooosed ? ? ? • Garage floor ? ? • Firstfloor ? ? • Lowesi exposed elevation (walkouUwindow) ? ? • Property comers I? ? p • Front and rear of home at the foundation PONDING AREA (if aoolicabie) ? ? • Easement line ? 9 ? • NWL ? ? ? • HWL ? U • Pond # designation rfl El ti E O ? GY ? • on mergency ve ow eva DIMENSIONS Lot lines/Bearings 8 dimensions / ?J ? u ? • Right-of-way and street width (to back of curb) orches etc reater than 2' h n s k i d ? ? • , . , p s, over a g g ng any proposed ec Proposed home dimensions mclud (i.e. all structures requiring pertnanent footings) u ? • Show all easements of record and any City utiikies wRhin those easemenls Ci/ i.-i • Satbacks of proposed structure and sideyard seffiack of adjacent existing structures i 1 ?3' u • Retaining wall requirements, rf any Rewewed: ? Name 1 uate March 1999 rwnm.mi nroararcra Surzeyor's Certificate SURVEY FOR :PULTE DESCRIBED AS ; Lot 2, 61ock 4, OAKBROOKE 47H A00111aN, City of Eogcn, Dokotc County, Minnsoto and resarving eaeomenta of record. I s icT FENcE lw : - LOT SQ. FOOTAGE NSE. SQ. FODTAGE LOT COVERAGE _ Plan p 18232 PROPOSED ELEVATIONS Top of Foundation = 947.e Garage Floor =qA74 Basement Floor =93g,g Aprox. Sewer Service =932.7= Proposed Elev, = U Existinq Elev. _ Drainage Oirections = - Denotes Offset Stake = . ,. ° ,? E,?y 4L ?(.V E D. -:. I-r BENCHMARK. TNHL0 !13 Eko. q45 oa scALM I mch - ao raec ? ; ? MIN. SETBACK REQUIREMENTS Front -25 House Side - Rear -15 Gcrage Side- JOB N0: yE????? I HERE9Y CERTIFY THAT Ti1S IS A 1RUE f?ND CORREC7 REPRESENTATION OOR-083 OF iME 80UNOARIES OF 1TIE a80vE DESCPoBED PROPpiN AS SURVEYED BY AtE OR UNDER 4Y DIRECT SUPERVI90N AND DOES NOT PURPORT TO BOOKt PAGE: PLANNING 6/VGINB6R)NC SURi'dYINC SMOW IMPROVEAIENTS OR EN OqCHMENTS, EKCEPT AS POYM. 2005 Pfn Oak Orlve Eogan, MN 55122 OA7E ?/.01 E . UNOC? utr uRYEYOR CAD flLE: Phone: (661) 405-6600 ` A UCFNSE,NUMB t4396 OAKBROOKE FaK: (651) 405-6606 Z'd 9619- 0 N N1833N19N3 0 N(110 3H Wb?041 IOOZ I 'IpW = 1D,697 = 9, 669 169' PULTE HOMES OF MINNESOTA CHANGE ORDER #3 DATE: 1/10/01 JOB NO: 0320-202-04 LOT: 2 LOCK: 4 UNIT: COMMUNITY: Oakbrooke Single Family ADDITION: PHASE 2 BUILDING ADDRESS 1634 OAKBROOKE DRIVE CITY: Eagan STATE: MN ZIP: ##?# MODEL NAME: Sterling MODEL# 18232 ELEVATION 1 GARAGE: LEFT BUYERS NAME: MARK & LeANN BUGNI CURRENT ADDRES 5644 28TH AVE S HOME PHONE: 612-7244170 SALES REPRESENTATIVE: JMM BUSINESS PHONE: CITY: MINNEAPOLISSTATE: MN BUSINESS PHONE: PHONE: ZIP: ###k 1 18232 Sterling $229,990 1 00000 Lot Premium $0 1 28053 42 UPPERS - BASE $335 1 31001 LAUNDRY CABINETS - BASE $250 1 14007 1 ST CARPET PAD UPGRADE $215 1 14084 1 ST CARPET UPGRADE $1,440 1 40026 LAMINATE KITCHEN/DINETTE $1,500 1 40027 LAMINATE FOYER AREA $1,025 1 17000 ADD'L ELECTRIC OUTLET $50 1 17002 FREEZER CIRCUIT $100 5 17024 CEILING ELECTRIC OPENING ALL BEDS, LOFT, FR $500 1 23007 3 TON AIR CONDITIONER $2,350 2 32012 T.V. JACK-CABLE READY MSTRBR, LOFT,BR2,FR $100 2 32020 ADD'L PHONE JACK MSTRBR, LOFT,BR2,FR $100 1 10055 SPACEMKR MICROWAVE $575 1 21020 GAS FIREPLACE - CERAMIC W/SH.ROCK $3,825 1 13021 BRASS TRIM BATH $325 1 16036 DECK ON GRADE 16'X 12' $4,700 $0 $0 $0 $0 TOTAL $247,380 THIS CONSTITUTES fyE6JJTWT BETWEEN THE SELLER$ND THE PUCHASEOfM TIjQ ?RQ?F{yEft APPROVED BY BUYER APPROVED BY BUYER APPROVED BY SUPERI APPROVED BY SA : Builders License # 0001371 I PULTE HOMES OF MINNESOTA I Zt CHANGE ORDER #4 DATE: 1117101 JOB NO: 0320-202-04 LOT: 2 BLOCK: 4 UNIT: 0 COMMUNITY: Oakbrooke Single Family ADDITION: PHASE 2 BUIi.DING ADDRESS: 1634 OAKBROOKE DRI CITY: Eagan STATE: MN MODEL NAME: STERLING MODEL#: 18232 ELEVATION02, GARAGE: 0 BUYERS NAME: MARK & LeANN BUGNI CURRENT ADDRESS: 5644 28TH AVE S CITY: MINNEAPOLIS STATE: MN ZIP: 55417 HOME PHONE: 952-884-0563 BUSINESS PHONE: 0 BUSINESS PHONE: 0 SALES REPRESENTATIV JMM PHONE:O TOTAL FROM PREVIOUS JIO OR CHANGE ORDER $247,380 1 19021 FULL VIEW ALUM COMB DOOR $150 1 17043 ELECTRIC PANEL-BASEMENT $295 1 32020 ADD'L PHONE JACK $50 -1 16036 DECK ON GRADE 16'X 12' ($4.700) -1 18015 ELEVATION #1 $0 1 18023 ELEVATION #2 $3,000 -1 40026 LAMINATE KITCHEN/DINETTE ($1,500) -1 40027 LAMINATE FOYER AREA ($1,025) 1 40036 WOOD FLOOR KITCH. & DINETTE $2,000 1 40037 WOOD FLOOR FOYER $1,450 ; 40039 WOOD FLOOR HALL $555 1 22002 3RD CAR GARAGE-ELEV#2 $7,215 1 22025 GARAGE DR OPENER/2 CONTRLS $400 1 26043 WOOD RAILING - 2ND FLOOR $540 $0 $0 $0 $0 LK , $0 _ .? ? . .. . _ .. . ,..... $0 $0 TOTAL $255,810 THIS CONSTITUTES A NT T BETWEE THE SELLER AND THE PUCHASER (S) FOR THE ABOVE ITEMS. APPROVED BY BUYER (S): APPROVED BY BUYER (S): APPROVED SUPERINTEND NT: APPROVED BY SALES: !'o ?i.n a 6A ,±f I1C? 0 Builders License # 0001371 ZIP: 55122 LEFT 7UL-27-2020 14:42 PULTE HOMES MNoheck COMFLIANCE REPpRT Minneaota Ensrgy Code hff4ch6ck Boftware versian 3.0 CPUNTY: Dakota STATE: Mianesota zoaE: z CON3TRUCT?GN TYEE: 9ingle Family DATE: 7-27-2000 DATE OF PLANS: 9/2E/00 TITLE: Oakbrooke Starlir_g with Lookout CO:MPLIANCE: PAS9ES P. P2./02 Pe--- y?T-- Chec1-ed by Date Rsquired UA = 532 Yvur Home m 443 24.2% Batter Thar. Code area ar Cavtty Cont. alazing/DOOr Berimecer R-Vaiue R-value u-value -------------------- - ------------------------------------^.--------^-°---- CBILINGS 1218 38.0 0.0 1 4JA:Z9: Woad Frame, 1611 0. C. 2473 19 10 2.0 HSMT: ConC. 5.0' ht/9.3' bg;9.6' ineul 1047 11.0 0.0 GLAZING: Windows or Daors, Above Grade 402 0.350 1 DOQR9 38 0.350 FLCOFtS: OvOr OuGdide Air 48 38.0 0.0 FNAC EQJrPMENi : FL'rn8ce, 92.0 FLZ'UE ---'-^ " -----°---_- " '"--'-- - ----'----'---'----------"--'----_" -------- ^ '- eOMPLiANCB 9TATEMENT: The proposed building design described hexe is conelatent with the building plans, specifications, and other calculations eubmitted with the permit appllcaticn. 'I'he propoeed building ha9 been deeigned to m??c emaz??linnesota Bnergy Code. Builderibsa TOTfiL F.02 N 0 0 ? - - ..? TnP CHORD I cc t o ?I PQeN Z-PlY TNIS D{!u PRtPARED FR0le t0.NPUTEit (qPUT {L(1A?5 6 D9KNSIOhS] 5lIdNIliEO BY TRUSS NFq. x6 SPF 7650f-].SE BOT CHORD twB SP 22581-1,9f 2 Complete Trusses Reauired ? NEBS 1x4 SPF 43 :Vp YxA Spf #11#2:- NAlLIk6 SCHEDtlLE: (12d_iommon_nalis) SPECIRL GOADS TOP CHOAD: 1 ROp @,72^ p,c, o --•-•ILUNBfR OUR.FAC.=t.i5 / o1ATE DUR,FAC.=1.15) BOT CHQRD: 1 AON @ 9" o.c. I; TC • from 44 PLF at 0.00 to 94 pLF at 22 21 pE85 : 1 ROW @ 4• p,c, ° BC - From 20 PLF et 0.00 to 20 p1F . at 22 21 USE EDUAG SPACING BETNfEN pONS ANO SiAGGiq lIAILS ? o 8C - I191 LB Conc. Load al 2.E1, q.P], , 6,21 8 71 ]O qi IO FACH ROX TO A70111 SPLST7196. •°• = 112,E1, 19.21, 16.21, 18,21, 20.21 , . , . WISCJNS111 PLpTE APP804A1 $9704)53•N. 1J9' TO 3/B' K 708= Id9M22g ? N F ? ? N ? ? N T ? ? ti ? m N O .i O O 0 16d8HAiL5g t 168 O?C, SCA? ROAS ) fACH PL 11-1-4 BVTLDIAG TYPE; FNCIOSED ? WIfOD LOAO:fO PSF nlRi? _ ,.,nI, H6KB(Al)= 6?Ke?U?C, p yiv? DDUBLE 2S8 N 31-0' SCkB OA ONC SIDE 36d flAiLS ( 6' O.C. -3 ROHS ) CACH 4lY }?--5-7-71-?----5-5•q-----?-5-5-4- ?fE 5-7-13-? UPL(FT LONHFCTI9B REOUIRE0:397.16# EACH SUPVORT ? HISCO!(SiN PI.ATE APPROYpI 4970053-N. I ? ? IN L1FU OF RIG(0 CELLIUG USE %YRUWS; TD BAACE BC 0 24,00" OC DEFLEC710N MEETS L1240.00 LIUE AAO LJ180.00 TOThI LOAA. i0 1 W s P P ? N ? CjwewS Q 64 rd !r T r.Sf AV A1F'1mE?q inxred PraCucLq Ina Qy.MOtJMf SqCI A t. i-B Over- 2 Sapport.s RR7265 W-3,25° . ' 1P1290 W=3,25" niii,a CF-iiaria: iriu 18.2i3 TYrl MN - t ••- F S l m ` (A/! 1h fdAAlG.7101. NWIIAS? SI?IIY:11) . IN)IA?tt? Aq NNMIl I dRltClll), F1111l:?EY6Y ?nun our !uaamnwrtavxmuea W ?RUISOM \1 INlf I TC LL 40.0 PSf ca e .25 t. RCF R7225-70746 . . l- p SN!!Y MAt11[LS jeIOR 71 alaoulm ERBµ[ INPoARO, 101 ttlOtp 1LLQlm'IL PM(VIJL/ bTACNO NAVE t r%mKe+r .nr.xio xaio muMa. ?wioutaa ? ?[SIC C 1.0 VSF DATE ?05 J?1 02 MidImClYilµ{,{}IONIOXlqp10LIV115[?lIlC10.m IY?BNIpIpR Itl? ml. 1ilu,Ol4N% ?H E • ?RW NQ?1$p72?$ ???Z?0?0 l.3RI[Ai110 NRpO{1XGf y1M166. lfAlli G AhI IDI61 y{?N SoPUIMIt IRW%iWli 01 pq (MIIOE?t 01116l ? rolUt Anl IAIa µ C 0 0 PSF MO-ENG yp?AlNl h?I f11. RVIk[ aa?ocKV. jrcce, ?nErr?nnmro_ auIu.,cnma ra y?Y , f1? , e? wurm ex ime na?cx. roeiuu coaactla: om ??rsulm jOT ?. 51,0 PSf SEON - 338902 iFAA1M 1?014IU {q?qpp aF PIIM]LWIYI( [yGA q n IY6 AWtfiM0ISI0?WiWl mmn? mni w DUN FA . urrorrxat Is Qf ?fSWMltBI{Il! Of Id tU1110Yt OvLtMfP. Q1 . C SPACIHna , 1.]5 24.0^ FAON RJA . ti m \ 0 ? m Siteaddress: ?4 0 Lot -? Block! Subd. (& On April 15, 2000 the Minnesota Energy Cotle, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. _ This structure: is constructed to meet minimum reqwrements of the Mn Energy Code, Chapter 7670 OR ? This structure: will be constructed to meet more restric6ve requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater Furnace Q)-1C-(7- Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES No Kitchen kitchen Bathroom 1 ? ,f ?J ? 7l/? US ? ? 6 ` Bathroom 2 ? . . ? _ ? ?v- l/ U ? \ Bathroom 3 Bathroom 4 Other FIREPLACE 5 LOCATION GAS WOOU MANUFACTURER MODEL BTU'S VENTING DIRECT ATMOS 26A rr )? 0 `9 ') 0? 017 ob? MAKE-UP AIR MODEL TYPE CFM's ? ?i I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. qu?? ? sip,1at ? !/''??2??m Company Name 4 ti/61 Date This form is the responsibility of the General Contractor. City of Eau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use 1001 S' S. Permit #: Permit Fee: ` 1' `'J Date Received: - I0 I i3 Stas: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: LI- 8 - 1.3 Site Address: I %3'J Oii'eALODE C)/td lit✓ Unit #: f,ww.. Name: M ft -21G BO (oNI 1 Resident/ Owner Type of Work Contractor J L i D Phone: 6152-- 3 i3b - 0418 Address/City/Zip: f!(D3i7 O/`166/117d1`E/2/21!%C 1 EA. -6'04W, MN 59 az Applicant is: Owner X Contractor Description of work: kO D �%(p 1 5 cj et r 1 O 13f -s Construction Cost: # 1100 Multi -Family Building: (Yes / No X ) Company: CO (L(3�2 (-CA AN! ES , at Contact: TEFF / J i/A-1,f Address: SS 17 1'+5 TTM sr. ni City: Nu GO 1 State: M 14 Zip: S—So 3 7 Phone: 6 / L —' / 4 - 5-s "? Sr I License #: $C 63/ 7 ZI If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) I Lead Certificate #: 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: I 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 may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Cali 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.gopherstateonecall.orq 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 Minnesota State Building Code m be completed within 180 days of permit issuances. J Iv xV1/A CA Applicant's Pried Name Page 1 of 3 Borrower: MARK & LEANNE BUGNI Prrtv Address: 1634 OAKBROOKE DRIVE City. EAGAN Leynder:'PRIMESTAR MORTGAGE, MC C AteC. tl, ty Rpaz N"l#7A-2.8.10442