2089 Quartz LaneCITY OF EAGAN
3795 Pilot Knob Reud
No Eogon, Minnesota 95122
Phone: 454-8100
PERMIT
Date:
June 9, 1980
Site Addreu:
I 1 "?
Lot Block C Sub/Sec. L-2
Nome thrynYe a c o cir
.
°e Address
?
City Phone: ? -`V-?7 5;:
Nome
.
? Address ? e E }. `
QC ? f ?
V ..< .
City Phone: -
This Permit is issued on the express condition that oli work shall be
Minnesoto Stotutes and City of Eagan Ordinonces.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residentiol
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of Installotion
Permit Fee
Surcharge
I TOt01
done in accordance with all opplicable Stote of
Building Official
CITY OF EAGAN Remarks * Cedar Grove Acquisition
Additio-n?? CIDAR GROVE #4 Lot 12 Blk 4 Parcel 10 16703 120 04
Owner •? ? n ? e- ? JU =) r', , '' ? Street 2089 Quartz Lane State Eagan, M 55122
l? u W(lA
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWERLATERAL 1972 1,304.00 52.16 25
WATERMAIN
WATER LATERAL 19 2
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
RESIDENTIAL
BUILDING PERMIT APPLICATION
? --, --? ? -? OTY OF EAGAN
3830 PILOT KNOB RD - 55122
', 651-681-4675 0 I b ' 1 ? -0 ?
New Construction Requirements RemodeURepairRequirements
• 3 registered site suroeys showing sq. ft. of lot, sq. ft. of house; anc?ll roofed areas • 2 copies of plan
(20% maximum lot coverage albwed) ? • 1 set of Energy Calculations for heated additions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) ? • 1 site survey for extenor addi6ons & decks
• 1 set of Energy Calculations • Indicate if home served by septic system for additions
• 3 copies of Tree Preservation Plan if lot platted after 7/1/93 I
• Rim Joist Detail Opfions selection sheet (bldgs with 3 or less units) ?
-}'
DATE ' VALUXION
JOB SITE ADDRESS 2c?ROUQY'f-I., yll??
IF MULTI-FAMILY BUILDING, HQW MANY UNITS?
PROPERTY OWN
TYPE OF WO
T 1UU -D
RE
APPLICANT -PHONE# (PSI' `fa7I V
ADDRESS 0-d? Q ?? i? Z ?/l`? ZIPCODE 5 51 Z'Z
PAGER #
CELL PHONE #
FAX #
NEW RESIDENTIAL BUILDING ONLY- Fill OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Reside;ntial Ventilation Category 1 Worksheet Submitted
- Energy; Envelope Calculations Submitted
11
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone #:
Plttmbing System Includes: vVater Softener La.tivn Sprinl:ler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Batlis
Mechanical Contractor: Phone #
Mcchuiical Systein Includes: 2kir Conditioninb Pee:' I'70,00
?
Heat Recov,ery System
' C)c?v? _06
Sewer/Water Contractor: Phon,e #
All above information must be submitted 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 State of Minnesota Statutes and 'City of Eagan Of"" in nces.
f ,
? Signatur'e of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
' Updated 1/01
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) 0 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 Mu{ti
? 05 03-plex ? 11 10-plex A 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Yor)? N ? 25 Miscellaneous
? 31 New ? 35 Int improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
\9?' 33 Alteration ? 37 Demolish (Bidg)* ? 43 Reroof ? 46 Windows/Doors
0 34 Replacement "Demolition (Erttire Bldg only) - Give PCA handout to appiicant
.??
Valuation e?
Occupancy
9` 3
MC/ES System
Census Code Zoning /2 ?l City Water
SAG Units _if Stories Booster Pump
Nbr. of Units -10/ Sq. Ft. PRV
Nbr. of Bldgs G? Length Fire Sprinklered
Type of Const Width
_ Footings (new bldg)
_ Footings (deck)
_ Foorings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Other
` Pool Ftgs Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
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
r?
.?2 .-?'
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
, Plumbing
HVAC
Building Inspector
?? _ ??
EAGAN TOV1/N S H I P
. BUILDING PERMIT
Owner ---- •-? , . ------
(present) . `3?"'/-..??.------?r -?•-- ?-••?=•?..? ?"'• 'Uu"'`'?
Builder .- -•-----=•-----•-•-•------ ----••------------ ?-.................. .........................
--•
Address ...... .---------------- •............. ..........................
DESCR2PTTAN
N° 826
Eagan Township
Town Hall
Date 2-
52ories To Be Used For Front Depth Height Est. Cost " Permi3 Fee Remarks
.
O`- '
'7f/ r'V
;r-7"
_? 1(?/
This: permit does not suthorize' the use of streets, ioads, alleps or sidewalks nos does it give the owner or his agent
3he right. to creaie any siYualion which is a nuisance or which presents a hazard to the health, safeYp, convenience and
general welfare to angone in the community.
THIS PERMIT MUST $E KEP Ol? THE P?fEMISE WHILE THE WORK IS IN PROGRESS.
This is 3o certify, that.-?-`=--C?o----•..... = ---- --------------- has permission to erect a._.-?-• --
•-•
-•-- ••----•-------••--• op f-•• -
the gbone dFSCribed premise subject to the piovisions of the Buildiag Ordinance for Eag •--
an Townshi ade - - upon
d April 11,
195$ f
? . ,
._ ...:• •••-.. . , -•-- --;-•• ---........ -..................... -• Per ...................... L?"
•-• : -• • -----• •-••-
-•--- -.... ._ •••- -----• .............. ....
' Chairman,' Tnwn Board : --- ----_
• Building Inspecior
. A?
LOCATION
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
?
C7 2007 RESIDENTIAL BUILDING PERMIT APPLICATION
. City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements
3 registered site surveys showing sq. 8. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage aliowed)
1 Soils Report if proposed building is to be placetl on disturbed soil
2 copies of plan showing beam & window sizes; poured found design, etc:
1 set of Energy Calcula6ons
3 copies of Tree Preservation Plan if lot platted after 711/93
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Minnegasco mechanical ventilation form
RemodellReaair Reauirements
2 copies of plan showing footings, beams, joists
1 set of Energy Calculations for heated addi6ons
1 site survey for additions & decks
Addifion - indicate if on-site septic sysfem
Office Use Oniv
Cert of 5urvey Recd _ Y_ N
Soils RepoR _-Y _ N
Tree Pres Plan Recd - Y N
Tree Pres Required _Y _N
On-site SepUc System _ Y_ N
F'I.qilS f3YP ('.f7i']SIC'1P_rP_t1 mihiir infnrmntinn isnlP.qc vot, state thev are trade secret and the reason.
Date ?/-ja / d'7
Site Address ? gI Qe
p ?'A? l Z L Construction Cost &2, > 7(,
'tL Unit/Ste #
Description of Work O&Q e ei'V l17 ( AO t ?lCLe ?ZS
Multi-Family Bldg _ Y2<? Fireplace(s) 2
Property Owner t' 't v ? Telephone # ( &S [
Contractor ? 4 r' ?2rS
Address :
State 111,14 • 14u-) .. City
Zip 5s337 Telephone #( qs2 )?? ? 3 Cg oC?
COMPL.ETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- MinnesotaRules 7670 Categorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(?l submiSsion type) Submitted Submitted
• Energy Envelope Caiculations Submitted
I ln the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
' _ Y. _ N if yes, date and address of master plan:
Licensed Plumber
Mechanicpl Contractor
Sewer/Water Contractor
Telephone # ( )
Telephone # ( )
Telephone # ( )
1 hereby apply tor a Kesidential tiuiictmg Yermrt ana acknowieage tnat tne mrormanon is compiete ana accuraie;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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 iri accordance with the approved lan in the case of work which req `res a review and .
aPProval of plans. -
` Applicant's Printed Name plic nt's Si re °
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola ) ? 36 Multi Misc.
? 05 03-Qlex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex 0 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ' ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration I ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCement *Demolition (Entire Bldg) - G ive PCA handout to applicant
DeSCflptlOtl: Water Damage Yes
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length - Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
Footings (deck) _ Final/C.O. -
Footings (addition) FinaUNo C.O.
Foundation HVAC
Drain Tile Other
Ice & Water _ Final
Roof Pool Ftgs _ Air/Gas Tests _ Final
_
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation Retaining Wall
Approved By: , Building Inspector
- -- - ------------------------ - ---- - ---- - ------------------ - -----
---- - ----- - - - ----------------------------------- - ----- - ---- - - - - - - ----------
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC .
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies :
Other
Total _
? ? ?9_?
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?-? 0
New Construction Requirements RemodeVReoair Reauirements Office Use'0nlv
3 registered site surveys showing sq. ft. of lot, sq. ft. oi house; and all roofed areas 2 copies of plan Cert of Survey Recd _'Y _ N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree PresPlan Recd _ Y_ N,
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y_ N
1 set of Energy Calculations Addition - indicate if on-site septic sysfem On-sife Septic System _ Y_ N
3 copies of Tree Preservation Plan 'rf lot platted after 7/1193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Date / I )-- / () 13-- Construction Cost 6Do
Site Address ZQPp LCm h c,° Unit/Ste #
Description of Work 46d-/ ",f,F 046e,
Multi-Family Bldg tk/ Y _ N Fireplace(s) _ 0 2
Property Owner Telephone # ( )
Contractor ? CO ? Ll C 01,X
Address FlOcGt S'j' ? k,' City CG0 h 6,G' j S
State i.°?O T 4, Zip S<( Telephone #( 70) N2- 7
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateizory 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar pian? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone # ( )
Mechanical Contractor Telephone #( )
Sewer/Water Contractor
Telephone # (
I hereby apply for a Residential Building 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 State of MN
Statutes; 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.
ci ?SS<- rrrS P/
Applicant's Printed Name
?
pplicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
0 06 04-plex
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-piex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 12 12-plex Plbg_Y or r , N ? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building O 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bld g) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Sooster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Final _
Ice & Water
Roof Pool _ Ftgs _ Air/Gas Tests Final
_
_ Framing _
_ Siding _ Stucco _ Stone _ Brick
Fireplace
R.I. Final _
Air Test Windows
_
_
Insulation _
! Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
??(--)4
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
?? O'jo
S? -
Please complete for. single family dwellings & townhomes/condos when pemuts are required far eact
Date
Site Address ( ) ar Z n ?
d8 ?
-- - - '
Property Owner v a! ?2- Mto TelePhone # (&61
)-L
Contractor
Street Addre i
ss C
ty
State ?k) Zip 5sa? O Telephone #( tpS? )?O?a " O?d2'(o
Bond #: Egpires:
The Applicant is Owner ?.Cuntractor Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace _Addifional ?,eplacement
air exchanger
air conditioner _New _ Replacement
other
State Surcharge $ .50
Total $ o30 ?CJ
I hereby apply for a Residential Mechanical Pernut 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 ' e echanical Codes; that I understand this is not a
but only an application for a permit, and work is not to start with e't; that the work will be in accordance with the
appro ed plan in the pa,sg of work w?rich rgquires a review and approval of lans. , ? /f A, /.
Applicarit's Printed Name Applicant's Signature
RESIDENTIAL BLTILDING
Permit Application
City Of Eagan
3830 Piiot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodeVReaair Reauirements Office Use Oniv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd Y N
(20°/a maximum lot coverage allowed) 1 set o6 Energy Calculations for heated additions Tree Pres Plan Recd Y N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd _ Y_ N
1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _ Y_ N
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date 7 / 53 / Construction Cost ? 2-(300
Site Address Z (f?)'Bq Unit/Ste #
z2 -Z?2Z
Description of Work W{'T4}
Multi-Family Bldg _ Y_ N Firepiace(s) _ 0 _ 1 _ 2
Property Owner ?d--PA ?-{'cTZ-tylAn'? Telephone # ( (pSo ) 4GZ " -1 -7
Contractor C)(,c_V__
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categor? _ Minnesota Rules 7672
Energy Code Category
• Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
vio• 60
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25%a pian review
fee appiies.
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
I hereby apply for a Residential Building 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 State of MN
Statutes; 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. -
. Applicant's Printed Name App icant's d-"
ature
OFFICE USE ONLY
Sub Types
0 01 Foundation
.W'02 SF Dweiling
? 03 01 of _ plex
? 04 02-plex
0 05 03-plex
O 06 04-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 07 05-piex
? 08 06-plex
? 09 07-plex
? 10 08-plex
? 11 10-plex
? 12 12-plex
? 35
? 36
? 37
Valuation `-?-
Census Code
saC units ?- b "-
Nbr. of Units d
Nbr. of Bldgs ?
Type of Const
? 13 16-plex ? 20 Pool
0 16 Fireplace ? 21 Porch (3-sea.)
0 17 Garage ? 22 Porch/Addn. (4-sea.)
? 18 Deck ? 23 Porch (screen/gazebo)
? 19 Lower Level ? 24 Storm Damage
Plbg_Y or _ N 0 25 Miscellaneous
Int Improvement ? 38 Demolish (Inte(or) ? 44
Move Bldg. ? 42 Demolish (Foundation) ? 45
Demolish (Bldg)* ? 43 Reroof oe 46
*Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MC/ES System
zoning R • ( City water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
_ Footings (new bldg)
_ Footings (deck)
_ Foorings (addition)
Foundarion
Drain Tile
Roof _ Ice & Water Final
? Framing
/Fireplace _ R.I. _ Air Test _ Final
J Insulation
REQUIRED INSPECTIONS
FinaUC.O.
? Final/No C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests
_ Siding Stucco Stone
_ Windows (new/replacement)
Retaining Wall
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
Windows/Doors
Final
Approved By 61?', Building Inspector
Base Fee
Surcharge '
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge Treatment Plant
License Search
Copies
Other
Total
?
r
?- -------------
? Far,?7ffrce:tlse ' ' I
j Permit #: t I v ?
Permit Fee: I
96,00
? Date Received: ? j
I Staff: ?
I ?
?----------------?
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: I I t/ -06 Site Address: Tenant: ? E?'a {'ZGA_11_ ? Suite #:
RESIDENT / OWNER Name: ??? ?t' ?a?VlO? rl Phone: C12,5 -
Address / City / Zip: ??? ?a?'?'2. L.n. ??• ??S/Zz
Applicant is: Owner Acontractor
TYPE OF WORK Description of work: 4"lt
F ofF ? tGSi
_r
Construction Cost: ??.3?d0ev' e>V Multi-Family Building: (Yes / No -xj
CONTRACTOR Name: s? 9?4?_!' License #: Z4D (268&5
'
Address: Iti/ 1-7-1
City: LerAtS State: /un• Zip: ?3zig
Phone: 952 - Contact Person: L?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateaory 1 Minnesota Rules 7672
Energy Code • Residentiaf Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category 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 & Water Contractor: Phone:
NOTE: Plans.and supporting documents that you submit are considered to'be puhtic 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 accurate; that the work wiil 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 plans.
X ? a? c
Applicant's Printed N e p icanYs ig r
Page 1 of 3
Use BLUE or BLACK Ink
I For Office Useff G I
Permit
I1 j
City of EaWin C2.~
Permit Fee. I 1
3830 Pilot Knob Road
Eagan MN 55122 Date Received: 9 lawo I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
I I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 946-(3 Site Address: dQS9 QOgCt-7_ L0 . Unit
Name: ~_Rt `(R _~z VIA q L'1 Phone: 65-1- 4t-,g - 7 (97
RESIDENT /
OWNER Address / City / Zip: o2U g ~ Qo g d-~-z.
Applicant is: Owner Contractor
Description of work: q6- e
TYPE OF WORK '
Construction Cost: , 06a Multi-Family Building: (Yes / No )
Company: UO" to Q Contact: e 6-)A,2~~e~
CONTRACTOR Address: -7ao+ ST (6l{- City: 55 e,Ui~L
of-
State: Zip: A_-V~ Phone: R6 a - 1~ 3'5 (
License QC I o2 (,8g0 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:
NOTE: Plans and supporting` documents that you submit are considered to be public information. Portions of
the information maybe 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.gopherstateonecall.org
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.
x le-clL ~"6ed x :AU-Ltn
Applicant's Printeld Name Applicant' Sign ture
Page 1 of 3
4(°
CityofEaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For OfficeUse
(/ I
Permit #: l�
Permit Fee: /®�'
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Description of work: f)0, - ,.MA
Construction Cost:
-Ylsrl 42- rvQ ' vp1 e e- d 3`g.&\,
Multi -Family Building: (Yes / No X)
Company: ,I_ CCk d 01-16n Contact: ( 1 eC c1
Address: i 7� I 1da11'1v')" C:'L City: G -\
State: r 41\Zip: 5516 o3 Phon S5l�4(00&-c1810 Email: b
License #: 6 3Y60 6 Lead Certificate #:
If the project is exempt from lead certification, please explain why:
ina(Ernitogiu/co i
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:
Phone:
Fire Suppression Contractor: Phone:
Sewer & Water Contractor:
meats.>.ti
as non -
.r l a
mit are cons,
you Prow tle
hey are trac
ec_.
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
1 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 BuildingtCode must be co pleted within 180
days of permit issuance.
&CX
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
c,?e gj�( Ln DO NOT WRITE BELOW THIS LINE
/3V -
SUB TYPES
Foundation Fireplace
Single Family
Multi
01 of _ Piex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%_)
Census Code
# of Units
# of Buildings
Type of Construction
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season) _
_ Porch (Screen/Gazebo/Pergola)
Pool
Interior Improvement
Move Building
Fire Repair
Repair
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: Ice & Water Final
Framing 30 Minutes 1 Hour
Fireplace: Rough In _Air Test /Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
t,((sl
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
_ Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: Footings _Air/Gas Tests Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Fire Suppression: Rough In _Final
Erosion Control
Other:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3