2066 Quartz Lane
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 4589
PHONE: 454-8100
BUILDING PERMIT ReceiPt #k 3t
To be used for Date 19
Site Address •+ ???xti 9 Li - Erect ? Occupancy
Lot Block " Sec/Sub. '_- Alter [3 Zoning
Parcel # Repair ? Fire Zone _
Enlar
e ? T
e of Const
g yp
.
W Name Move ? # Stories
Z Address _ ?? •"• 1 4J?>' ?' ? '*•='
' Demolish ? Front ft.
? City ' 454'2160
Phone _ Grade ? Depth ft.
? N Approvals Fees
p ame _
F
?Q Address
?
?- ?:.--
Nome _
Address
Phone
Phone
Assessment _
Water & Sew
Police
Fire
Eng.
Planner _
Council _
Bldg. Off. _
APC
I hereby ocknowledge that I have reod this application and state that
the information is correct and agree to comply with ail applicoble
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee -
A Building Permit is issued to:
all work shall be done in acco
Building Officiol
Permit
Surcharge
Plan check
SAC
Water Conn. _
Water Meter
Totol 10.00
_ on the express condition that
with all opplicable State of Minnesota Stotutes and City of Eacan Ordinanc=s.
Pamit # Date Inued PermMtN
Plumbing
Mechanical
INSPECTIONS DATE INSP.
Rough-In
Flnol
Footings Dote Insp. Date Irnp.
Foundation Plumbing
Frame / ins. Mechanitol
Final
Remarks:
CITY OF EAGAN Remarks
* Cedar Grove Acquisition
Addition CEDAR GROVE #4 Lot 27 Blk 5 Parcel 10 16703 270 05
OwnerL-LJ t (2 ti`t L Street 2066 Quartz I,3II@ State Eag?, MN 55122
/vc •-? ` ?'
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR,
GRADING
SAN SEW TRUNK
* SEWER LATERAL ( 1972 1,304.00 52.16 25
WATERMAIN
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-189
(612) 681-4675
SITE ADDRESS: }
?; f tis?l t ( IiNt
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
? Date Issued:
I h! i4 S 0110 t9 t3 APPLICANT:
? rf I.' 3, d? R• "" N r/ ?! i
4
A
+:??i????w?;
??.•r?, 1 1
PERMIT SUBTYPE: TYPE OF WORK:
;,I iI ?f /11l+iN
i+1 ',, i; I? i t??id . 11.11 W61[Itl()f't ti/4!1 NDI:1W`.
Permit No. Permit Holder Date 7elephone N
ELECTRIC
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBC
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ` F#"! Ho
3830 Pilot Knob Road Permit Number: soy')17
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS• • .;! {?, APPLICANT:
I :r t s3r
1 tiR'!i,
i?. !.. i •??!. l 7.?
100+%Jt 44
PERMIT SUBTYPE:
TYPE OF WORK:
REpAIP
DCSCRtpilCtN (RObFthi(l)
"i} C) f' 1 t+E Ie
Permk No. Permit Molder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Commenis
FOOTINGS
FOUND
FRAMING
ROOFING ?? ?, eQ?'
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLOG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
? CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 4589
' PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt # 8236
$1,300. ??
To be used for Garaee Addn_ Dote pT•-r0_ , 19
Site Address Erect 0 Occupancy
Lot a? Block -!Sr Sec/Sub. Alter [a Zoning
Parcel # ' Repair ? Fire Zone _
Enlarge ? Type of Const.
j3t:Address e L.? R No c s Move ? # Stories
2066 Qusrt2 456-2248 Demolish Front ft.
Eagan ? Phone 454-2160 Grode ? Depth ft.
? ame _ Approvals Fees
N
OE Address
r r-:....
Assessment -
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
IL" Name
Address Ci Phone
I hereby acknowledge that I have read this appiication and state that
the information is correct and agree to comply with oll applicable
Stote of Minnesota Stotutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: B. Ness
ail work shall be done in acAance ith 9H?c'?plicoble $tate pf Minne
Permit 9.00_-
Surcharge i , AQ
Plan check
SAC
Woter Conn.
Water Meter
Total 10.00
on the express condition that
Statutes and City of Eagan Ordinonces.
Buiiding Officicl
N° . .792
Eagan Township
Town Hall
Date _l--? --------- -------•
53ories l To Be Used For Front Depfh Height Est. Cosf Permi! Fee Remarks
U LOCATION
Slreel, Road os other . Description of Location 1 Lo! Flock _ Addition or Tract
3
.3'
This permit- daes not auihoriae the useof slreets, roads, alleys or sidewalks nor does it give the owner or his ageni
the right to creaie any situation which is a nuisance or which presents, a hazard #o the health, safefy, convenience and
general welfare to anyone in the community.
THIS. PERMTT MUST BE KEPON THE PR MISE WHILE THE WORK IS FN PROGR£S . ? •
This is to certify, that__...... _---------------------- ____has perm;ssion to eaecf 2-1 ------------------------ __._.._____.__;-upon
the above descri pre ' subjeci #o the isions of the Building Ordinance for Eaaan Township dop4ed April 11,
1955. , - ..
_.:.
-••---------- -------------------------------------------- •---- -.._....--•------------ Per .....---•--,-............... -------- (L ----------?
--,------ --? - - -?- -
- - - - - - -? --
Chairman of Tnwn Board.. Building, Inspector ,
?
i
EAGAN TOWNSHIP
BUILDING PERMIT
owne: ......?..... .............. -.....=---..h.---?---------?---------
Address (Preseni) ........ ?7 .
..-• - • -•-•....._.: -•-••--••-•---•-•
Buildes ......... Al"t-Y . .....................
Address .....................................
DESCRIPTION
N° 2430
Eagan Township Town Hall
Date ...`' ?`3/
.........................
5iories To Be Used For Front Dep2h Heighi Esi. Cos! ' Permi! Fee Remarks
,
'Z?
U U LOCATION
Street, Road or other Descripiion of Location I Lo! Block Addition os Trac!
This permit does not suihorise the use of slreeis, roads, alleys or sidewalks nor does it give the owner or his agent
the right fo create any situation which is a nuisance or which presents a hazard to the heallh, safety, convenience aad
general welfare fo anyone in the community.
THIS PERMIT MUST BE EP O? THE PREMISE WHILE THE WORK IS IN PROGRESS.
: ?
This is !o ceriifp, lhat ... .:...... .... h_':'°:?' ............................. has permission !o erecf a!?. ?_.............Tf ................... .._ on
the above described premise subject to the provisions of the Buildiag Ordinance for Eagan Township adopled April 11,
1955.°....---. Per ............
/t-J?.?' .N_..`-'•"" ? :.....?........ ........ ..... .........
..h• ?...._.......... ...............•
......... . _...
.
.
_ Iaspector .........................
Ca?rman of ._ Tnwn .. 8oard . .?°j ....... . Building ..
:4•y} y?,?...?..??ij:3i{:y'.?:i ??y:?J?i.{:);:.i{-`?.?i{Y-•`..%:??.%?!)ji.•k:?3?i'? J?'.:i1i'J;:?':?{)f•.i?+`?
:r.,,:.Y.?.?,.h??•. ? F• , ,? , ,
•rt? 4..?_ !::'.., •.?;.? .
.... ' 'i ?.a? ?...Y9 a! I'•?.
?..•?::??"?.i.?».?''?,? r., rET4M.CNii{... Ni.:t 355
DA'Y'E;. s_)9lf:i.:;. ..: ; rl l'?'i°?' i 'T?::Ml:"„ W500
J .Ct .;
N1 ;-) r?E:--, R
,.i,.?. . ?. ? .C)?.?l.a:. 2066 ?, .y... i:??..?f'li"?.r f_ .r i...i?t! ? 87.25
::N::.i.!..? n.? c'c: 900i . ....., • ???
.
c?...??., c?[7!°:t:, t:?i.1r^tli'i f. !..! .r.°.•i?? ...
i
....o.t.,._i.t .. ,...._ ? ???.?:_?..:F:S,.r,•k ,, , ,_t,;tf.l?,.!Ft•?° 89.25
t1Ft;i.1i3050t:}
?;•?? ?
? `i?::.,ti. .t...? ,? ; P'•,A•..:1
•..):: ... (: « s?
r . ,.
PERMIT
CI'TY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 030757
(612) 681-4675 Date Issued: 09/09/97
SITE ADDRESS:
2066 QUARTZ LANE
LpT: 27 BLqGKs 5
CEDAR GRqVE #4
P.I.N.: 10--16703-270-05
DESCRIPTION:
? (ROOFING)
??a ?. a. rt ??,P,;e r m i t T' y p e S F ( M I 5 C.)
irsg t ?i6TYPe REPAIR
le? 434 ALT. RESIDENTIAL
1r?4
? ?
- ?? ?
??
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
VALUATION
$87.25
$2.00
$89.25
$4,000
1 nm%.I vn. - Applicant - ST. LTG vvrl-4E-n.
pQTSETH, CHARLES 14923118 0006804 NESS LUTMER
26'820 LANGFORD WAY 2066 QUAR7Z LN
aoRDAN mN 55352 E+aGaN MN
(6-12) 492-3118 (612)454-2160
301JI1997
New Construction Reauirements
_-7M _ - - ?
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.) • 2 site surveys (exterior additions 8 dedcs)
? 1 energy calculations ? 1 energy caiculations for heated additions
? 3 copies of tree preservation plan if lot platted after 7N/93
required: _ Yes _ N
CD
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT ? BLOCK SUBD./P.I.D.
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
BUILDING PERMIT APPLICATiON (RESIDENTIAL) ? ?Qa ?CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675
Name: ? A)tSC' L Jpj Phone #: O?H^wbo
Street Address. ? n 661 dG,Q 4z LU
City: 5?70 G al? State: Zip:
Company: }?h?Nl Phone #: ki 2 1 13 ?1g
Street Address: ?C) g )-Gn ?OY? I?I.?JN1 License #: ?? aLl
61
---? „
City: .J my ? G'V\. State: Zip:
Company:
Name:
Phone #:
Registration #:
Street Address:
City:
State: Zip:
Sewer & water licer.ned plumber (new construction only): . Penalty applies when address change
and lot change are iequested once permit is issued.
I hereby acknowledge that I have read this application and state that the info ti s agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
._ ?
OFFICE USE ONLY
Certificates af Survey fteceived Yes No
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
0 02 SF Dweiling o 07 4-plex
0 03 SF Addition o 08 8-plex
a 04 SF Porch o 09 12-plex
0 05 SF Misc. ? 10 _-plex
WORK TYPE
0 31 New a 33 Alterations
? 32 Addition o 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
0 11 Apt./Lodging o
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory o
? 14 Fireplace ?
? 15 Deck
a 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Planning Building
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/VN Permit
S/V1l Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
L? T Ft? 1L ??S S
?
?
?
?
CE-6A-P,- Gkz,,)r-
i
ZS v
?
C? u4,YZ 'T? LX (v ?
t y' ur
MASTER CARD
?
LOCATION (J/ IJAA@T` L AI . a?Dz /. o? 7-,S-
OWNER ? s s , L
STRUCTURE
LAND USED ASD T Duli Y 4 A R
Permit
No.
Issued Issued To
Contractor Owner
BUILDING jo S 3• 7-/
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
NEATING
GAS INSTALLING
SANITARY SEWER •
OTHER
OTHER
Items
FOOTING
FOUNDATION
FRAMING
FINAI
ELECTRICAL
HEATING
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Approved
(Initial) Date Remarks
F?-
From Well
Distance
SEPTIC
CESSPOOL
TILE FIELD FT.
DEPTH
OF WELL
.- '.[ / ?
COMMENTS: 6
Violations Noted
on Back
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
9
PERMIT NO.
DATE Of INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
r-I NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
a ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REIPlSPECTION REQUIRED
REINSPECTION REVEALED
11 NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL. -
DATE OF REINSPECTION
is
CE RTI FICATI ON - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
F-I .ALL IMPROVEMENTS ACCEPTABLY COMPLETED
CONIMENTS:
BUILDING INSPECTOR
DATE
?
23
. . ?
?-fl4l ICI
nATE lz,,v Z'?-, /?77
BUILBING PERMIT APPLICATTON
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To be usecl for CAheA?C A-D-D?TOaN
Valuation '*%3 ov
Site Address; Z o(,6
Lot Block Sec. Sub
c?l
Osaner L ? ? f /? csS
Address
Pareel Number
Telephone Q54 -2 i 4 0 ?
Contractor 5 ELF
Address
Arch./Eng.
Address
Telephane
Telephone
OFFICE USE
Erect
Alter
Repair
Enlarge G,42ACiE
Move
nemolish
Grade
Occupancy
Zoning
Fire Zone
Type of Gonst.
## of Stories
Front
Depth
OFFICE USE
T3ate nf Approval & Initial
Assessment
waterJSewer
Police
Fire
Eng . ?
Planner
Council
Bldg. Off.
P..P.C.
FEES
Permit
Surcharge
PZan Check
SAC 1
Glater G:onn.
Ldater Nteter
TOTAI:
?
? y
._, \ .
?AQ ,-?----?1 I
,
,
,
?
?
`' - - + -
44 0
AW
2v b(c Q.-kAa-mt- LA-,,, r EA 'A-A) ??,u -r .
?O{ ~
. l-- OT
_ .e'n2Q:.C- N , 3LDO t $ 24- + ?--
?
q- ? C? ? T t 0 N(q AttAc,c?
Tb-T a L-
'? ? fl 4 Z ? Z(?, j,? ?--
b
?
?1
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:10 -B! If $ Site Address: ?2L&_6 Q)?+Z &°- L
Tenant:
Suite #:
RESIDENT / OWNER 1 Name: _L?_tk?e-e- N42-SS
Phone:
Address / City / Zip: ??o?l QtiJev7L- 'L
Applicant is: Owner ? Contractor
TYPE OF WORK Description of work: X<- '/G °c-
Construction Cost: ,? o'" ''IV Multi-Family Building: (Yes / No
CONTRACTOR ? Name:
Address:
License #: 9-640?8163
City: t-a,r M c ??i? State: ,?'I/l) Zip: S37 FY
Phone: Contact Person: X0? A%?,4 /.SO•^
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
SubmisSfon 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:
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 onty 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., ,4 ,
x /?o? X
ApplicanYs Printed Name A rica 's Signature
Page 1 of 3
NEW 2-2x4 POST
IN EXIST WALL
TOE SCREW TOP OF NEWi
BEAM TO JOISTS ABOVE Q I
WITH #10 x 4" WOOD m 12'6 " V.I.F.
/
SCREWS, EACH JOIST a.
12'-2" V.I.F. DC J
EXIST WALLS TO
'( Q BE REMOVED
FASTEN NEW BEAM TO SHOWN DASHED
POSTSWITH SIMPSON N
POST POST GAP N
wI NEW 2-2x8 DROP BEAM
NEW 2-2x4 POST—�? (NDN-LOAD BEARING)
/N\I '',,<,\....1`•—...: HUSG28-2
INSTALL SOLID BLOCKING HANGER
BETWEEN BOTTOM OF Q IF POST DOES NOT ALIGN WITH
EXIST FLUSH BEAM AND 2-2x JOIST BELOW, INSTALL
TOP OF NEW DROP BEAM tucP 2-2x6 BLOCKING SPANNING
A5 NEEDED i BETWEEN JOISTS, FASTEN TO
N ADJACENT JOISTS WITH
- HANGERS, TYP BOTH POSTS
• U-
x
N EXIST 2x6 CEILING JOISTS @ 16"
CV EXIST 2x6 CEILING JOISTS @ 16" OG AND 2x6 RAFTERS 24"
OG AND 2x6 RAFTERS @ 24" N OG, RAFTERS DO NOT BEAR ON
OG, RAFTERS DO NOT BEAR ON w CENTER WALL/BEAM
CENTER WALL/BEAM
EXIST HEADER
0 PARTIAL ROOF FRAM I NC PLAN
CI?
1/4" = I'-O"
LTJ
WALL REMOVAL I hereby certify that this plan, 17284
specification,or report was prepared Pro).No.
by me or under my direct supervision
2066 QUARTZ LN and that I am a duly LicensedDote 5/12/2011
Professional Engineer under the laws moMattson Macdonald Young EASAN, MN 55122 of the State of Minnesota. Drawn By
structural engineers /__
1Bassett Creek Business Center y^f�� x
901 North 3rd Street,Suite 100
.-7 {!f1 I
Minneapolis,MN 55401 TOR OK EVAD
612-827-7825 voice
612-827-0805 fax Date: 5/12/11 License No: 5Og38
Use BLUE or BLACK Inkco
For Office Use
Cit (�s*P. -
ykJ Ea an Permit Fee: /Z-// "
3830 Pilot Knob Road 1
Eagan MN 55122 °(V Date Received: � _
_Jr
Phone: (651)675-5675
buildinginspectionsna..citvofeacian.com Staff: mat
UL 16 6 2617 L
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10 C 2.01-4- Site Address: ZO b Co 00(111--7__ Ll..Q Unit#:
Name: i n t wlc,i, 070 ePhone: '" e7o7` 0/
Resident/
Owner Address/City/Zip: 20(210 U rz_ E. A
Applicant is: %Owner Contractor
i
Type of Work • Description of work: emoc ( hI[�- ✓\/'�MAoc�E 5 -pcdoe , 'A he" ef
Construction Cost: g. Ods°' Multi-Family Building: (Yes_74/No ) cY`"�
d lw4L.
Company: Contact:
I
Contractor Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
I Sewer&Water Contractor: Phone:
Fire Suppression 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 they
are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on
the City's website at www.citvofeadan.com/subscribe.
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.
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.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 isnot 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.
XYjmeiL Loi c, x
Applicant's Printed Name Applicant's Signat e
Page 1 of 3
/YYl��i
DO NOT WRITE BELOW THIS LINE
SUB TYPES O f 7 ablq14.-Z- G--/-
Foundatipn Fireplace Porch (3-Season) Exterior Alteration (Single Family)
( Single Family Garage Porch (4-Season) _ Exterior Alteration (Multi)
Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
New e 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 Zero, -.=' Occupancy T'J2H.-- ) MCES System
Plan Review Code Edition ,7 SAC Units
(25% 100%6) Zoning ) `) City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) KJ_ Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice &Water _Final Pool: Footings Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In _Air Test Final Siding: _Stucco Lath Stone Lath Brick EFIS
io Insulation Windows
Sheathing Retaining Wall: _ Footings_ Backfill_ Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: i Oft , Building Inspector
RESIDENTIAL FEES
Base Fee G/
Surcharge / `L/ / 59 Ar
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Copies
TOTAL
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Use BLUE or BLACK Ink
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Cityof Eaaari iii .t �� 61017 Permit#:Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:- —
Phone: (651) 675-5675
Staff
Fax: (651) 675-5694 �
2017 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ® Site Address: 12-06C. OkUif(tr, ,
Tenant: Suite#:
Resident/Owner Name: 1��za�1. �prl,& Phone : 4/z T 6151
Address/City/Zip: 2-b6,P
Name: License#:
Contractor Address: City:
State: Zip: Phone:
Contact: Email:
Type of Work —New _Replacement _ jRepair _Rebuild _, Modify Space _Work in R.O.W.
Description of work: N O /i't(fI �►Jt k / I4i Mh1c t f Vr GWi'l
RESIDENTIAL J
Water Heater
Water Softener
Lawn Irrigation( RPZ/_PVB)
Permit Type Add Plumbing Fixtures( Main/_Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge)
*Water Turnaround (add $280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge)
TOTAL FEES$
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.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.
x '/�,uis''1..�/�/ �� '11 ' T � x
Appl cant's Prin -d Name, Appl' an 's Sigc 'ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff: