1516 Oakbrooke LaneClty of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax:(651) 675-5694
2008 RESIDENTIAL BUI
Date: Site Address:
Tenant:
Suite #:
RESIDENT / OWNER Name: Phone:
/ Zi
:
Address / Cit
p
y
ApplicaN is: _ Owner _ Contractor
1"YPE OF WORK 6on ofwork:
ri
D
p
esc
Construction Cost: Multi-Family Building: (Yes _ I No
CONTRACTOR ,
Name: License #:
Address: 7
City: State: Zip:
Phone: 6onfac-f'Person: l Jh-11 / Lj
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheef
Cat@gOry Submitted Submitted
(4 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 8 Water Contractor: Phone:
NOTE: Plans and supporting documents ihat 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.
I hereby acknowledge that this information is complete and accurete; that the work will be inconformance with the ordinances ano co?es ui iile Oily v?
Eagan; that I understand this is not a pertnit, but only an application for a permft, and work is not to start withoul a pertnit; that the work wdl be in
accordance with the approved plan in the case of work which requires a review and
x )/?Te) „ r\ s O 6Aj
ApplicanYs Printed Name
'----------------i
I Fo_r Offoe Use I
? Permit#:
?
I PermitFee: 70?0 G7 I
I ?
i
? Date Received' ?
I ?
? Staff ?
I
------------------
G PERMIT APPLICATION
/
Site address: ??LiJ Lot ? Block -' Subd. C.
On April 15, 2000 the Minnesota Energy Code, 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 requirements of the Mn Energy Code, Chapter 7670
? OR
`-This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFAC URER MODEL BTU'S 4ENTING TYPE
Water Heater ? onl xqlOSZ .?
Fumace
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
rES NO
Kilchen kitchen 6E ---J-IJ3Z7X
Bathroom 1 16d ?5- '" [`?.S ?rQ v? ?
Bathreom2 v- QS v s-?
Bathroom3 u, gro? ?/-?_s0 SO
Bathroom 4 tca s v Sv
Other
LOCATION I GAS I WOOD
DIRECT ATMOS
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
, iz9o?
T (.? ??? !/Oh1G5 Date
CompanyName
' This form is the responsibility of the General Contractor.
??-- 1 1 6 I o 3??- TIAL?Yl 60 s°?a_9 I
SID?
0 ??Y BUIL ING PERMIT APPLICATION
' CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122 9 v?
651-681-4675
New Construction Reauirementa RemodeVReoalr ReauiremeMs
• 3 registered site surveys shaxing sq. %. of lot, sq. ft of house; aM all roofed areas • 2 wpies af plan ???? ' I I
(20%maximumlotcoverageallowed) . 1setotEnargyCalculalionsfoi(ie`aYBCkaCditians
• 2 copies oi plan showinp 6eam & window s¢es; poured found design, etc.) • 7 sRe survey for ezteriar additions & decks /?
• 1 set of Energy Calculations Indicale'rf home served by seplic system for additiore -7-
• 3 copies of Tree Preservatbn Plan 9 lot platled after 711193 e30-2-s'
. Rim J
oisl Detail Options seledion sheet (61dgs with 3 or less uniLS) DATE I'& 'OZ. VALUATION O/50,DOU
SITEADDRESS ???? ?LG Zx...lP MULTI-FAMILYBLDG _Y CN
TYPE OF WORK )1ICeJ Aonr. 0?+_,Sz",t FIREPLACE(S) DZ 0_ 1_ 2
APPLICANT
STREET ADDRESS 01,7 /VOP"rha,Je.S-e /
CELL PHONE # &1Z_)36I'17ZZ
PROPERTY
e!j4c, ---STATEA62ZIP
CJ
TELEPHONE #
-----------------------------------------------------------------------------------------°----
COMPLETE THIS SECTION FOR NNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNI:SOTA RUI.CS 7670 CATEGORY l _L/MINNF.SOTA RULES 7672
(J submission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envalope Calculations Submitted
Plumbing Contractor. _ Aki- Phone # ? Z/.? / __
Plumbing syslem includes: _ Water '"ener _ Lawn Sprinklcr Fee: $90.00
/ WaLer Heatcr ? No. of R.I. Baths
.3 No. of Baths
Mechanical Contractor: oz(??G llN? Ph OF:l 8y? ?c <
Mechanical system includes: L Air Co oning Fee: $70.00
_ Hcat Recovery Sys Ll
F.? "I ', ?? "I
_n
Sewer/Water Contractor:
-----------------------------------------------------°-------._-------------------°----------
I hereby acknowledge that I have read ihis application, state that the information is conect, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan nces.
Signature of Applicant ?
OFFICE USE ONLY
Certifcates of Survey Received ? Tree Preservation Plan Received _ Not Required ?
Updated 4/02
?
? 01 Foundation
A 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex'
? OS 03-plex
? 06 04-plex
? 07 05-plex
? 08 O6-plex
? 09 07-plex
? 10 08-plex
? 11 10-plex
? 12 12-plex
OFFICE USE ONLY
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 78 Deck
? 19 LowerLevel
Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
A 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration O 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation 6 7av Occupancy -3 MC/ES System
Census Code IOl Zoning 1:2- D City Water
SAC Units C7T' Stories ? Booster Pump
Nbr. of Units Sq. Ft. ce,2 PRV
Nbr. of Bidgs Length ?f9 Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
? Footings (new bldg) FinallC.O.
_ Footings(deck) FinaUNo C.O.
Footings (addition) _ Plumbing
? Foundation HVAC
X Drain Tile Other
Roof Ice & Water ? Final Pool Ftgs Air/Gas Tesu Final
x Framing Siding Stucco Stone
Fireplace R.I. Air Test _
Final Windows (new/replacement)
Insulation _ Retaining Wall
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
Approved By
? 30 Accessory
Bldg ?
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
Building Inspectar
9An,?J,a
jL ?w???
5!-
RESIDENTIAL
.?
. ' • ' ` BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New ConsWCtlon ReauiremeMe
• 3 registered site surveys shmMng sq. ft of IM, sq. R of house; and J ioofed areas
(20% maximiun lot coverage allowed)
. 2 copies of plan showing 6earn & windav saes; poured touml design, etc.)
• tsetofEneqyCalculaUons
• 3 copia W Trae Preservadon Plan'rf lot platted aRer 711/93
• Rim JoislOelaJ Options selection sheel (bldgs wiTh 3 w less unils)
DATE
JOB SITE AODRESS Oalt'?rot
IF MULiI-FAMILY BUIIDING, OW MANY UNITS?
PROPERTY OWNER?s??.. ?+'?
TYPE OF W? K N2W ?`?
APPLICANT `\IN\\,.a.
ADDRE55
PAGER #
CELL PHONE
_0K 1_2
W21° ? -q54 -uml
+v: ?
- FILL OUT
Energy Code Category
(check one)
Plumbing Confractor. ?
Plumbing System Includes:
Mechanical Contractor.
Mechanical System Inch
Sewer/Water Contractor.
_ MINNESOT RULE 670 CA'
- Reside I Ventilation C egory 1 1
_ Fnor Fmrolnna R.Irulnii e Cnhi
w"' MINPVESOTA RULES 7672
I -Ts
New Energy Code Worksheet Sub itted
Pnon #:?Z•- 4?t- Z\Z\
Water Softe _ Iawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
ti54m-4" P h o n e # ?`aL???y - Qm)?
_ Air Conditioning Fee: .00
_ Heak Recovery System
4CC ?f i?2Cc? Phone #??.,?
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state th he informati ' correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eaga ?nances.
?
Signature ot Applicant
Certificates of Survey Received '4- Tree Preservation Pian Received _ Not Required
?b ,?R ?,( ? Updated 2002
b?
RemodeURaoalr ReauiremaMS 9m
• 2 copies of plan c
• 1 set of Energy Cakulahons for healed add'rtbre
• 7sitesurveyforexlenaradditions8decks -
• Indicate'rf lame served by septic system for additiais ,
\l 0?
VALUATION
..?e.. L4 ? ? g 3, (h?uvlt? Co
` L ?h 63,
gL s5a?? 173on. 53
mE 5s a-? ? `+o . 5-°
'Pt Ssa? ? q13 . Sc7
CODE S'-' \ Zt
FAX #
OFFICE USE ONLY
.. . ;.
f•-• _..
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
x 02 SF Dwelling ? 08 OB-plex ? 16 Fireplace ? 21 porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. AR - SF
? 04 02-plex ? 10 08-plex ? 18 Dedc ? 23 Porch (screened) ? 36 Multi
? 05 03-plex p 11 10.plex ? 19 Lower Level ? 24 Starm Damage
? 06 04plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
X 31 New ? 35 Int Impravement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 38 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
0 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroaf ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation G11,Qo t'7 Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories ? Booster Pump
Nbr. of Units Sq. Ft. ? PRV VA:6
N6r. of Bidgs ? Length Fire Sprinklered
Type of Const -[ 1 Width G ?'^
?
?
?
Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
Fireplace $? R.I. "Vir Test XFinat
Insulation
_ Other
_ Pool Ftgs A'v/Gas Tesu _ Final
_ Siding Stucco Stone
Windows (new/replacement)
Approved By Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8, Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
? FinaVC.O.
FinaUNo C.O.
_ Plwnbing
_ HVAC
c??? X ?s - /D, 3?
('J/?'? k 2r =
A S--f = 71?? rs
X
/ `f 0/ 9-,-? o
MNr.hPr.k CnMPLIANCE REPnRT
MinnPSnta EnPmv CndP
MNr.har.k Snftwara VPrsion 30
i i
i 'PPrmit #
I Ghar.kpcl hv/DatP I" I I
1
CnUNTY: Daknta
STATE Minnesota
7_nNF' 7
CONSTRUCTION TYPE: Single Family
DATF7 1-11-2002
DATE OF PLANS:7/25/00
TITLE: Oakbrooke Sterling with Lookout
COMPLIANCE: PASSES
RanuirPd l1A = .ri3?
Ynur Home = 403
24201, RPttPr Than CnHe
Area nr Cavitv Cnnt GlaAnn/Dnor
PPrimetPr R-Value R-ValuP U-Value UA
------------------------------- --121 R 39.0 0.0 37
CEILINGS 2B73 19A 20 150
WALI S. Wnod FramP 1R° O-C. 61
BSMT? Cnnr.. 9.0' htlR_3' ha/9.0' insul 1(147 11 0.350 141
C?LAZIN(?: Winrinws or Dnnrs- ??hnvP rraclP 4n ?5o 13
Dn(]RS . ?
FLOORS7 Over OutsidP Air 49 38_0 00
HVAC EOUIPMFNT Fumar.e. 92-0 AFUF
COMPI IANCF STATEMFNT- The nrnnosed buildino dPSi°n dPSr.rihed here i5
cnnsistent with the huilrlinn nlans- snecificatinns. and other r.alr.ulatinn5
submitted with the nermit annlir.atinn. The mmnnsed huildino has heen
designed to meet the?eApirer,nts ohe?eso Energy Code. ?_ lj-
!
/'// // 77 7- DatE.
p
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: L U
DATE OF SURVEY:
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LATEST REVISION:
DOCUMENTSTANDARDS
W,•i-s,a-;
• Registered Land Surveyor signature and company
• Building PertnitApplicant
• Legaldescription
• Address
• NoRh arrow and scale
• House type (rambler, walkout, spiit w/o, split entry, lookout, etc.)
. Directional drainage artows with slope/gradient %
• Proposedlexisting sewer and water services & invert elevation
• SVeet name
• Driveway
• Lot Square Footage
• Lot Coverage
ELEVATIONS
-/ Existinst
?y ? ? • Sewer service (or Proposed)
? ? ? • Property comers
??/ ? • Top of curb at the driveway and property line exRensions
? H/? • Elevations of any existing adjacent homes
? a?/ G • Adequate footing depth of structures due to adjacent utility trenches
? rJ ? . Watenvays (pond, sUeam, etc.)
Pronosed
14' ? . Garage floor
? o ? • Basementfloor
va?;7 ? • Lowest exposed elevation (walkouUwindow)
i?4• G • Property comers
yt7 C • Front and rear of home at the foundation
PONDING AREA (if aoolicable)
u ? ? • Easement line
? ? . NWL
? C? ? • HW L
? W, ? • Pond # designaGon
? C? D • Emergency Overflow Elevation
C9' ?
?p
p?n
:?0
DIMENSIONS
• Lot Iines/Bearings & dimensions
. Rightof-way and sVeet width (to back of curb)
• Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent faatings)
• Show all easements of record and any City utilffies within those easements
• Setbacks of proposed structure and sideyard set6ack of adjacent existing sWCtures
• Retaining wall requirements, "
G
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G
r
Reviewed:
Surveyor's Certificate
SURVEY FOR
DESCR(BED AS
A 51 O00
oA0B A?E
94?•? ?
?
qq2 5
PULTE HOMES
:Lot 11, Biock 3, OAKBROOKE 6TH ADDITION, City of Eagan, Minnesota and reserving
eosements of record.
SEP 16 REC'D
940I
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Requlred
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N89°42'35"E 50.0
? =1
? <
` 4
M?i
? s L 0 T SQ. F00 TA GE
? o = 23, 877
HSE SQ. F00 TA GE
= 1, 789
? o
_____________? ° LOT COl/ERAGE ="-?77o
y 18232 N89°42'35"E 98.46 r
PROPOSED ELEVATIONS ??
?? a
BENCHMARK, ..??
Top of Foundation = aaa o ce ?4003
Garage Floor =aa3.o
i??
Ieo = 492?3
E
Basement Floor =q3c?.?
Aprox. Sewer Service =a32 os
Proposed Elev.
MIN. SETBACK REQUIREMENTS
Existinq Elev. _
Drainage Directions Front - House Side -
Denotes Offset Stake = • SCnLE: 1inc Uj,p?.ear - Garage Side-
n = ao r'i7
„
tV f- '•;:?y?
?
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> JOB N0:
•..
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: re?r?srE?E
I HEREBY CERlIFY THAT THIS IS?A TRUE ANDaCBRRECT REPRESENTATION
PROPERT`C"AS:SURVEYED
Of THE BOUNDARIES OF THE A9fZVEIDESCR19fD
02R-536
HEDLUNQ j
?
\
'AND DOES
NOT PoPORT TO
BY ME OR UNDER MY DIRECT SIYPERVI510N BOOK: PAGE:
SHOW IMPROVEMENTS OR ENC OACHMENTS, E?SCfFP?7 AS SHM-
PLANN/NC fiNG7N6BRINC SURVdYING
2005 Pin Oak Drive
Eagan, MN 55122 7?
DATE ?/4?/Q Z
CAD FILE:
Phone: (657) 405-6600
Fax: (651) 405-6606 dD?gJN,P6REN, LAN URVEYOR
MIN OTA LICENSE NUMB R 14376
OakbrOOke 6
vv? _
?ll?)q(6
. 4VV-?5?0
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date ,/42 I 3 / I 69S'-
Site Street Address el Unit #
Property Owner Telephone # (4:57) 991/-4?W7
Contractor ?M10/D/Q Telephone# (9s:?) -3?5u=222e
Address /QLa?? City LL State-2ML Zip'-?Z
The Applicant is: _ Owner Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes putting in a water softener andlor water
heater at the same time. ff you are insta!lina onlv a water soffener and/or water
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
,KWater Softener _ Water Heater $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
rotal $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand?this is not a permit, but only an application for a
permit, work is not to start without a„permitiand yvqrk will be in accordanc with the approved plan in
the event a plan is required to be reviewed and appII?Iove
??1 I,G'?? ? 2 1005 ?JI G?K
pA pli anYs Printed Name AAplicanYs Signature
i"•Y- -_? -_-__ -
?-----------------
? - `0ffi--?" ?
Permit#:
City of EaiaIl
I Pertnit Fee:
3830 Pilot Knob Road
Eagan MN 55122 ? Date Received:
Stan: ?
Phone: (651) 675-5675 Fax: (651) 675-5694 Q?_ UGy /1 ?j ?u 1
r c ?----------------J
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SiteAddress:
Tenant: Suite 619
?? //r
?k Ph
RESIDENTlOWNER one
Name: C!C
Address / CiTy! Zip: ISlo /M/fG Glc???
Applicant is_ Owner ? Contractor
TYPE OF WORK Descnption ofwork: /'/itJl?? /?GSc'??!'a.??
Construction Cost: e? e!z5a Multi-Family Building: (Yes _/ No
CONTRACTOR Name /1POO?-ifcy?+?e- ?Jy?p"r1,S License#
Address: ?L?LIY C?/? ?lr'h/f? 9/??L
Cdy ?? Q.J State: /"-'l/? Zip:
Phone 1,? - - 6"[S6oO Contact Person
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residenhal VenUlation Category 1 Worksheet • New Energy Cotle Worksheet
COtegory Submitted Submined
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contrector: Phone:
Sewer & Water Contrector: Phone:
NOTE: Plans and supporting documenu that you submit are considered to be public informafion. Portions of
the information may be classffied as non-public if you provide specific reasons that would permJt the City to
conclude that ihe are trade secrets.
I here6y acknowledge that Ihis information is complefe and accurate; that the work will be in confortnance vrith the ordinances antl codes of the City oT
Eagan; that I understand this is not a permit, but only an application for a permil, and work is nol lo start withoa?permit; that the work wnll be in
accordance with Ihe approved plan in the case of vrork which requires a review and approval of plans ?
x Qal7a( LG•.lSaJ
Applicant's Printed Name
Page 1 of 3
15 /U 6&4rwV.-& 1-Ajo----
DO NOT WRITE BELOW THIS LINE Fq-19-1 ?
SUB TYPES
_ Foundation _ Fireplace _ Porch (3Season) _ Storm Damage
_ Single Family _ Garage _ Porch (4•Season) _ Exterior Alteration (Single Family)
_ Multi Deck _ Porch (ScreenlGazebolPergola) _ 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 _ EgressWindow _ WaterDamage
Retaining Wall *Demolition of entire bu(Iding - give PCA handoutto applicant
DESCRIPTION Valuation T( V? Occupancy VV_J1-- MCES System
Plan Review Code Edition WN? 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
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
? Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Meter 5ize:
Sheetrock
Final / C.O. Required
,?)t Final ! No C.O. Required
_77? HVAC
Other:
Pool: _FOOtings _Air/Gas Tests _Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall
Erosion Control
Reviewed 8y: -r -L- , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
City of Eapn
3830 Pilot Knob Road
Eagan MN 55722
Phone: (651) 675-5675
Fax: (651) 675-5694
?------, - - - - - - - - - -
? ?oroftice`""?,Use ?
? Permit #:
I permil Fee:
I ?
? Date Received: I
I ?
i ?
I Staff. ?
L -----------------
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: '- .7 70 Site Addre,": ?S / h ? a K 81DO IC-P L/'-
Tenant:
Suite #:
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
CONTRACTOR Name: J/C°?///-? License #.
Address:
-
city: Pr 1lF ? State: -Z?'Izzip:
Phone:'?S 7'2 42- 7S3 I Contact Person: TOIM
TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild V Modify Space _ Work in R.O.W.
Descri tion of work:
PERMIT TYPE RESIDENTIAL
Water Heater _ Water SoRener
Lawn Irrigation Add Plumbing Fixtures
(_ RPZ /_ PVB) Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RESIDENTlAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 state Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
"Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $50 State Surcharge)
$90.50 Fife Repaif (replace burned out appliances, duclwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
i nereny acKnowieage tnat mis mrormanon is compie[e ann accurace; mac me worrc wm oa in conronnencn witil Lilu .,llu ......- .., ,- ...v -Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permd; that the work will be in
accordance with the approved plan in the case of work which requires a review and approva of plans , /'
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ApplicanYs Printed Name App ant's Signature
FOR'OFFICE USE =. _ Reviewed By:. Date:
Required Inspections _Under`Ground -_Rough-In _Air Test, , _Gas Test , _Final
Use BLUE or BLACK Ink
r________________---.
I For Office Use I
nnn Permit I 11q95
City of EaRd I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: U
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Oak b L Unit
I- . . &k-- Name: r FF~~arl Ak Phone:
Resident/
~JA V1 6512-
Owner Address / City / Zip: KZ(2 L11
Applicant is: Owner Contractor
Type of Work Description of work: e RP r®Qf ,~s'j( vii
Construction Cost: /YOpa Multi-Family Building: (Yes / No )
Company: Contact:
i
Contractor Address: City:
State: 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
i
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 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 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.gopherstateonecall.om
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 must be completed within 180
days of permit issuance.
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Applicants rin ed Name Applicant's Signature
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