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4637 1_2 Penkwe Way - BL 90736 r----------------- I For Office Use I Permit City of Ea R Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: 2 . Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION 1jr Date: Site Address: Tenant: Suite RESIDENT/ OWNER Name: ~-/~~•'Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: "--z - Construction Cost: 4_ G y Multi-Family Building: (Yes / No 7 L 9 Y f / W( License C) 1 5 1 CONTRACTOR Name: k 0/~,,> Y-- `i Address: i Zr City: /'Z_ G?l1'L_ State: I7 C Zip: Phone: /j- ~0 1 Contact Person: 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 ('1 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 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. 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 pla s. l /1~~ x x 1'' Applicant's Printed Name 'Alp icant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace Porch (3-Season) Storm Damage Single Family Garage Porch (4-Season) Exterior Alteration (Single Family) Multi Y Deck Porch (Screen/Gazebo/Pergola) 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 Egress Window Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy T4 G- 3 MCES System Plan Review Code Edition Zoo2 SAC Units (25%_ 100% Zoning /7,2 City Water Census Code 3 Stories Booster Pump # of Units Square Feet e'er PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required -4 Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: _Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: _Rough In _Air Test -Final Windows Insulation Retaining Wall Meter Size: Radon Control Erosion Control Reviewed By: 49, , Building Inspector RESIDENTIAL EES Base Fee 30 Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 EAGAN REVIEWED ' d z w /,lam/, l'ii i rfa S 1 e7 f 3 TREATED WOOD MAY REQUIRE SPECIAL -ASTENERS, HANGERS, AND CONTACT YOUR LUMBER SUPPLIER FOR MURL INFURMAl ION. pX34. tx C. R. WINDEN & ASSOCIATES, INC. LAND SURVEYORS Tel 645.3646 For: 1381 EUSTIS ST., ST. PAUL, MINN. 55108 U. S. Home Corporation N Scale: 1" = 50' , / fag 7~t v:a; ~ i FRtivP-cr 1 ~ ~ tlk 5~ ` ~ ` 3 Z r~ 33,, N X2.93 c~ 0.7 2 N J~Dtn! C Q- F 11 )t~1ro, v p¢mP A4i :cc 44 c~ ~Z c \ N J I~A Note: As of this date Johnny Cake Ridge Third Addition has not been recorded. Lots 1 through 4 inclusive, Block 4, Johnny Cake Ridge Third Addition, Dakota County, Minnesota. WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. Doted this r I doy of -A. D. 1960 C. R. WINOEN & ASSOCIATES, INC. Surveyor, Minnesota Registration No.-2 92 G