2070 Quartz LaneCITY OF EAGAN Remarks * Cedar Grove Acauasition
Addition CEDAR GROVE #4 Lot_ 26 Blk 5 Parcel 10 16703 260 05
Owner Jf w'?GhYI F<<'l, eet 2070 Quartz Iane State Eagan, NN 55122
? l,k k" L! ttl l f )
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
3795 Pllot Knob Road Eagan, MN 55122
PHONE: 454-8100
BUILDING PERMIT
Site Address 2070 Wjarr 7 t,.
Lot 26 Block 5 Sec/Sub. CG 4
Porcel #
$6*`J0, Receipt #
Ol d Fvmc&lue Dote May 22 ,
W Name Huhert Echneidar
Z Address 2070 OuartZ Ln
0
?:.., A;z -.1 DM.,..e 454•3343
0
zX
oQ
U a,
?
Name NorthCountrv PeelA
Address
C'ty -
Name _
Address
Erect Occupancy ?.--
Alter ? Zoning n •
Repair ? Fire Zone 3 _
Enlorge ? Type of Const. ?r
Move ? # Stories
Demolish ? Front 16 ft.
Grade ? Depth 32
ft.
Approvak Fees
Assessment -
Woter & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. _
APC
I hereby acknowledge that I have reod this application ond stote that
the information is correct and agree to comply with all applicable
State of Minnesota Statutes and-City of Eagqn Ordinances.
Signature of Permittee ??-
A Building Permit is issued to:
all work shall be done in accordance with all applicable State of Minne
78
Permit 24•00 _
Surcharge 3• 50
Plan check
SAC
Water Conn.
Water Meter
Total 27.50
on the express condition that
and City of Eagan Ordinonces.
N2 4808
10051
Building Official
Permk # I Daf* Issuad
INSPECTIONS DATE INSF• Rou9h-In Finol
Footings Dote Inso• Date I lnsD
Foundation Plumbino
Remarks:
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ?leti?7.??--- • .• -- - -------,. . --••- •-•• ---•---•----••-
Address (P:eseni) .2,U?.L?...... --•--•--"•-•--...
Builder ..-•-•-••-••---sJ_?!`".f_.__ ..-•-••---••--•••---•--?--•--•••--••--•-•-••----•--?---
Address ••---.-•._...._....-••••--•'•••-•--••-•--••----••-••-•-••---•-••-•-••••••-•-•-••---•--•-••---
DESCRIPTION
AtOS 2'783
Eagan Township
Town Hall
Da:e --- i_l?..?'
5tories To Be Used For Fron! Depth Height Est. Cos! Perm; Fee Remarks
? ?'? G?a?? ° 3c?a s?
? ? y s°
r ?
LOCATION
Street, Road or ofher Description of Location I Lot I Block I Addition oz Trac!
:,?r o 70 /,/ 4Zg 1 ? ? l??rLr
This permii does noi suthorfae the use of streels, roads, alleys or sidewalks nor does i3 give the owner or his agent
the right to create any si2uaYion which is a nuisance or which presents a hazard fo the health, safely, coavenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE K ?PT? ?N ?T? PR$? S`E WFiILE THE WORK IS IN PROG E
This is 3o certify, tha}lk:??'s?.Zil.`7?. %. ?!---•----....has permissioa to erect a__..-..................................... _upon
the above descri ed premise ubj ct 20 the provisions of the Building Ordinance for Eagan T s ip adopYed April 11,
1955.
--?- •--.. ..... -••---..-•-••-•-•-. Per ---C.--. a ..?_. ...??. ._ .... ..................
....._-- ° ..•-••-•-•--•---• -•°--
. -... - -- •-- -- - .. , _... ...--
Chairman of Tnwn Board Building Iaspecfor
CITY OF EAGAN
8795 Pilot Knob Road Eogan, MN 55122 No 4808
? - ' PHONE: 454-8100
BUILDING PERMIT APPLICATION $6,500. ReceiPt # 10061
To be used for Swimming Pool d Fet.cMalue Dote May 22, , 19 78
Site Address 2.-070 n,•^+-*z T^ Erect [R Occupancy
Lot 26 Block 5 Sec/Sub. CG 4 Alter p Zoning
Parcei .#
s Name Httbp*'t $C.h1Leidgr
3 Address 2070 Quartz Ln
° :... Eagan DM....e 454- 3343
r
'x Name Nox'thCoLntry nol g
,o
ol Address
Nome
Address
Repair ? Fire Zone 3
Enlarge ? Type of Const. V
Move Q .# Stories
Demolish ? Front 16 ft.
Grade ? Depth 32 ft.
Approvais Fees
Assessment
Water & Sew.
Pol ice
Fire
Eng.
Pianner
Council
Bldg. Off.
APG
Permit 24.00 _
Surcharge 3.50
Plan check
SAC
Water Gonn.
Water Meter
I hereby acknowledge thut I have read this appiication and state that
the information is correct and agree to comply with a pplicable
State of Minnesota Statutes an o Eag r i ce .
Signature of Permittee
A Building Permit is iss ed to:
all work shall be done in uccordance wi1011 a plicable! te of Minne
Torol 27.50
on the express condition thot
and City of Eagan Ordinapces.
Building Officiol
EAGAN. TOV1l`N.SHIP
BUILDING PERMIT
Ownez __!.?-R??--?tf?°"`,-`?`---??----•-?--?------••-----•-••-- ,
Address (Presenf) ••••• ..............•-----------......•••-=-........._.....••••--•---••---...:.
Builder ........................ .------ -•----------------- ----••-...----.•_._...:._..._..._..._...--- --
Address ---- ----•-•------------------------- •---- --------------....--------•-•-•-----.••-•---=-- '
DESCRIPTION
N° 806
Eagan Township
Town Hall
?
Date ------ ----- ------°---------.--..........
5tories To - Be Used For Fron3 Depth H Est. Cosi Permi2- Fee Remarks
/ LOCATION
Street, Road or oiher Descripiion of Locaiion Lot Block Addition or Traci
?-o? /d - ?7- /?? ! `? - ?. c? ?- G I ? ???i • ?' f
This permit does not suthoriae 3he use of streets, roads, alleps or sidewalks nor does it give the owner or his agenf
ihe right io create any si2uation which is a nuisance or which presents a hazazd to !he heallh, safeYy, convenience and
general weifare to anyone in the community.
THIS PERMIT MUST BEn KE_PT ONg? THE PREMISE WHILE THE WORK IS IN PROG2RESS. r
This is; to ceriify, thai--C?-?-?:?-?--5%+?-y?:?-•.? '••-•--..... :.has permission 3o ereci a--•!P---- d!!??-..•••--• - -----•----_--•---upon
!he sbove describremis subjeei ihe provisions of 2he Building Ordinance for Eagan Towns p4ed April 11,
195.5.
?c t
.. -???
.......... Per .---.-............. --•-
- ..: •--• .•••-: • -•---•-•?--•-• -••-- - -----• - • - •/ -----
Chain? ? l _.: ?...
?- of `Ph
wn Board ? Building Inspector
Minnesota State Board of Electricity
? 1954J,lniversity Ave., St. Paul, Minn. 55104-Phone 645-7703
"- REQl1EST FOR ELECTRICAL INSPECTION
CHIECK BELOW WORK COVERED BY THIS REQUEST
lo //4
P 56057
Type of Bµilding New Add. Rep. Check Appliances Wired For 1 1 Check Equipment Wired For
Home ? ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Wat
er ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dry Electric Heating
Commercial Bldg. ? 0 ? Fur J
f Silo Unloader
Industrial Bldg.
?
?
?
Air er
n
-
A
Bulk Milk Tank
?
Farm ?
List List
Ottier
?
?
? pth
Here Others
Here
COMPUTE INSPECTIO N FEE B ELOW
Se ice Entrance Size: # Fee Feeders& Subfeeders: # Fee Cirwits: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres „?-
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers Remote Control Circ. Partial or other fee
Signs Special Inspection a& Minimum fee $5.00
Remarks
_..._ s TOTAL FEE
I, the Electrical Inspector, hereby
(Final)
This request void 18 months from
irfspection has been m de (a , p?
Date
2, .4NDate "? ga ~ 2r
This request void 18 months from
P 56057
AonnCt Date of this ftequest I, as ? Licensed Elecctor C Owner, , do hereby request inspection of the above electri-
cal wiring installed at: CL[..?
Street Address or Route No.
;90 11.4&
Section Township Range_
Whidh is occupied by
[ ' (Name of CYc<
Is a roughin inspection required on this job? No ? Yesp
Power Supplier ////.
. f
Electrical Contractor_
Mailing Address ?
Authorized Signature _
(E
.STATE . l
County
Ready Now ? Will Call ?
C Contractor's Licef?se NOY yll 16
G""- V V ! • fzj? `
( lectrical C =!? ner Making This Installation)
Phone No.??7 3-9,oz-
al Contractor or Owner Mak g This Installatlon)
is inspection request will not 6e accepted.by the,
State Board unless proper inspection fee isvnclosed. :;
This` reqti5i` void 18 months from
.
Datt this Request 5-/Z C, ?77 _ P 63521
I, as YWJLlcensed Electrical Contractor O Owner, do hereby request inspection of the above electn-
caY w ring installed at: ? a b 6s c(,'j q
Street Address or Route No. Z? ?? ??? (AA&ECity
Section Township Range County
D?
Which is occupied by t`t-l.Jl,rQ C?E.A J? t* (\) lkz?-1
(Name of Occupant)
Is a roughin inspection required on this job? No ? Yes ? Ready Now ? Will Call ?
. rt
Power Supplier Address ?a 1J ( N?-
t?tt 34 7 7
Electrical ContractorContractor's License No.
(Company Name)
Mailing Address
Authorized Signature ..,??????'???lJ? ._.-...' . ... Phone No `?'' `? ?5??
fI yoo (Electrfcal Contractor or Owner Makfng This Installation)
( {?
This inspection requestwill. not be accepted by the
STA'IwE A:Cppy .. Stiate Board unless proper inspection fee is enclosed.
r Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
'REQUEST FOR ELECTRICAL INSPECTION
CHECK: bELOW WORK COVERED BY THIS REQUEST
10?/7
P 63521
Type of Building New Add. Rep. Check Applian ces Wited For Check Equipment Wired For
Home ? ? Range ? Temporary Wiring ?
Duplex ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dr Electric Heating ?
Commercial Bldg. ? ? ? Fu c
0. Silo Unloader ?
Industrial Bldg. ? ? ? A' z' ? ' it' - ? Bulk Milk Tank ?
Farm ? ? ? Lis." List
Other ? ? ? Herers? Hehers?
COMPUTE INSPEGTION FEE BELOW
Service Entrance Size: # Fee FeedersBcSubfeeders: # Fee Circuits: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers Remote Control Circ. Partial or other fee
Signs Special Inspection Minimum fe
Remarks
AL 7,C
.?,CL
TOTAL F gO
I, the Electrical Inspector, hereby cer the abov inspection has been made. Ir-k-20. y0
(Rough-in) tify t r Date
(Final) # Date
This request void 18 months from
SO ? .? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20°/a maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 7/1193
. Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE ?5_-aZ q""0.;-
MINNESOTA RULES 7670 CATEGORY 1
• Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
SITE ADDRESS aU 7C? 6tkati-2- MULTI-FAMILY BLDG
TYPE OF WORK k!L ::-? ? FIREPLACE(S) _
APPLICANT (gi
STREET ADDRESS 15?25_ E_, /hV v • /c3 CITY 23 (/ ST
TELEPHONE #qS -97" CELL PHONE # FAX #_
TJ`?'???3
PROPERTYOWNER ???-,?T rS'?? ?Xc?-J TELEPHONE# ?SI -
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category
(4 submission type)
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Phone #
Phone #
_Y _N
0 _ 1 _ 2
Fee: $70.00
--------------------------------------------------------------------------------- ---------------------------------------
I hereby acknowledge that I have read this application, state th he ' orm tion is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eaga ces.
Signature of Appli t
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
Water Softener
? Water Heater
No. of Baths
P 3-7
VALUATION 7 `70 ' "`)
Phone #
Lawn Sprinkler
No. of R.I. Baths
RemodellReaair Requirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• 1 site survey for exterior additions & decks
• Indicate if home served by septic system for additions
?
as
?- ?
?
/
irgy-Code Worksheet
MAY 2 9 2002
Fee: $90.00
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
0 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & W ater _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
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
Building Inspector
i
r. '
•
' ?v V
Y
nATE
BtSILD2TdG PERMIT APPLTCATIbN
Include 2 sets of plans, i site pian w/elevations arid 1 set of energy calculations.
To be used for Valuation
Site Address;,
Lot Block Sec. Sub.
?-
Owner ./
Asdclress e)
-?? -
Contpietgr
Addres
Arch.jEnq.
Address
Erect ?
Alter
Repair
Enlarge
Move
Der,oli:sh
Grade
OFFICE USE
Date of Approval & Tnitial
Assessment
watex/Sewer
Palice
Fire
Eng.
Pl.anner
Gauncil
Aldg. Off.
A.P.C.
Parcel Number
-33 ?/-.3
Telephone Its
Te one
Telephone
dFFICE USE
Occupancy
zoning /
Fire Zone -S
Type of Const.
# of Stories
Front _-_---
Depth
FEES
Permit S. ?2? .y-°
surcharge
Plan Chack
SAC
iA?ater Conn .
t7atez A2eter
TOTAI.,
? A 0 70 42,14.q 7?- L- r? f
?
57- qot-e y
"5'-r,4 Y c 7 '.
LOCATION
MASTER CARD
O W N E R SrY 1-:? --
LAND USED ASD iy/- ,
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING •?Ji "' SEPTIC
FOUNDATION G3 _ ?i _ 7 CESSPOOL
-F--u--?
.
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WEIL
SANITARY SEWER
/'27-
COMMENTS:
Violations Noted
on Back
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
23
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
a NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
11 NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
F-I COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REIPlSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CERTI FICATION -1 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.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COMMENTS:
DATE
A
?W (D ?
PERMIT #:
RECEIPT DATE:
2002 U.SIDENTIAL MECHANICAL FERMIT APPLICATI0N
crrY oF EAsALx
sgso PaoT icivo$ itn
EA6A1v MN 55122
651-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: ?
SITE ADDRESS:
?_o "l b C
NER NAME: 1-L tl e1 "`'C TELEPHONE #:
OW
INSTALLER NAMJTANDARD HEATiNG & AIR CUNpl1"IONING C0.
MINNEAPOLIS, MN 55408-2998
STREET ADDRESS: 612-824-2656
CITY:
CTTY USE ONLY
STATE:
Place a check mark next to the permit work type
ZIP:
Add-on, modification or alteration to existin dwelling unit $ 30.00
• furnace replacement
• air exchanger
? air conditioner
• other
Nature of work:
State Surchar e $ .50
UN :a: '. ?? ? ? r?(?!'? II
T
t
l
$
o
a -' 1
'---?-----_? SI A RE OF P
1/02
TELEPHONE #:
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
2002 COMMERCIAL MECHANIC.AL, P E _? ?PPL,ICATIO1V
CITY OF EAfiA1V
3$30 PILOT K1VOB RD
EAFAN,MN 55122
65 Y -6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #: -
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESS:
CITY:
TELEPHONE #:
STATE:
ZIP:
WORK TYPE: New construction Install U.G. Tank
Interior Improvement Remove U.G. Tank
Processed Piping
Specify Nature of Work:
When installing/removing underground tank, call 651-681-4675 far inspection by Fire Marshal and
Plumbing inspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
Contract price: $ x 1% _$ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
,
SIGNATURE OF PERMITTEE
Updated 1/02
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA140012
Date Issued:11/18/2016
Permit Category:ePermit
Site Address: 2070 Quartz Lane
Lot:26 Block: 5 Addition: Cedar Grove 4th
PID:10-16703-05-260
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Hubert P Schneider
2070 Quartz Lane
Eagan MN 55122
(651) 454-3343
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
For Office Use
all /L/4-5-06:5C
� -06:5 C
Cit4* y of En�nl Permit#:
Ju a Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
buildinginspections(a.citvofeacian.com Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: civ Site Address: clO 0 Q U 1 Z Li`) 1\G N Unit#:
Name: L.\ th\e,A e_, a,2✓ Phone: 5-1- 3- 33'13
Resident/ (�
Owner Address/City/Zip: �(� ) Q tn.A&7\--2-. 1-1 ) E- A G 4^
Applicant is: Owner Contractor
Type of Work
Description of work: 10n1)1(7) I .Sfl\ 1
Construction Cost: 11 Multi-Family Building:(Yes /No )
p
•
Company: 1 V 2. (19,4\k \llt,Ptp LLjContact: '').set, ) aw
Address: 1 S U l I � i J A City: /Lt 2N,{ii) 1(
Contractor
State: I V l 13 Zip: S-3-33) Phone: Q3)- 101'/30 Email: /41/ 1,!✓I &9 I%ao
License#: C Loa L) 9 L 3 Lead Certificate#: /
If the project is exempt from lead certification, please explain why:
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:
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
ane 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.citvofeagan.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.qopherstateonecall.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.4
Applicant's Printed Name Ap igna ure
Page 1 of 3