3312 River Bluff DrGity otkau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
33/e/j/ i/ "i 0i �--
Use BLUE or BLACK Ink
For Office Use
Permit #: g'r70? I
Permit Fee: 139 9 ri5
Date Received: L�._ 2/4
Staff:
z
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1-(' c? p • 070// Site Address: 331,E t� r VP,/ 61 Lt D
Unit #:
RESIDENT /
OWNER
Name: ny or
Address / City / Zip:
l4 r acterrtrtrl-I—/
Applicant is: Owner
)( Contractor
Phone: 76.3 - Y99 -9/op
TYPE OF WORK
Description of work: Re, --(290-P
Construction Cost'2/, 5,13. �J
CONTRACTOR
Multi -Family Building: (Yes )( / No )
Company:,, Co n ols.e. kn_mood de/CS) SC_ Contact:
of P 0-7-)
Address: Sri7 .4, City: .S-} Po ct
State: M N Zip: 551/o Phone: 65/ - 7601 - 90745
License #: a p j5/ g Lead Certificate #: NAT- q .33 —o
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 may be 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 CaII at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. Nww.gopnerstateonecall.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 1 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 app . va1
x �So�l
PO-te,0011
Applicant's Printed Name A
's Signature
Page 1 of 3
No. .3`
CITY OF EA"N
3795 Pilot Knob Road
Eagan, Minnesota $5122
Phone: 454-8100
PERMIT
Sac, C? sc.>
??- ka-+r? z
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Date: Receipt No.:
Single
Site Address: Residential
Lot Block Sub/Sec.
Name
`
c Address address
S
City Phone:
Nome ?, ;.;t?t?2
Address
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Eagan Ordinances.
1d7bb
New/Alter./Repair
Cost of Installation
Permit Fee
Surcharge
Total
done in accordance with all applicable State of
Building Official
CITY OF EAGAN
3795 Pilot Knob Roea
Eagan, Minnesota 55122
Phone: 454-8100
-',ATER rOF i'E; a" _ PERMIT
)[?kert ka-r4'7-- /241-
No
20, 19;
)ril
Date: Receipt No.:
Single I
Site Address- , .r' f Residentiol
Lot Block Sub/Sec. _ Multi Res., Comm./Ind.
Name New/Alter
/Re
air
.
p
Address Cost of Installation
City _ Phone: Permit Fee
Name Surcharge
Address
V
City Phone: Total
This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EA"N
3795 Pilot Knob Rood
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT
Date:
1{?-1$-78
Site Address: 3316 P.iver_ Bluff Drive
Lot Block Sub/Sec.
Name ',.,art Cott-
3 Address
City Phone:
ilkSA? . 2` Cli2t'. A?1.
Name
g Address 15 Cedar Ave. Vin.
s
0
V -
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Eagan Ordinances.
No.
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind.
New/Alter./Repair. Cost of Installation
Permit Fee
Surcharge
Toto I
done in accordance with all applicable State of
Building Official
EAGAN TOWNSHIP
BUILDING PERMIT
4(?a^"`.-'v.... ...._--.... .... ..........-----._....-..-.
Owner .... .
,.:.. ---...
Address (present) iE!i ?-'"--
Builder ........ ..------------------------------ ..................... --...-.
Address ............................... -........'-°--°°°..............----_-_.............---'
N°
a
Eagan Township
Town Hall
L/
2916
Dale ...d ...°Z?? ? L
Stories To Be Used For Front Depth Heigh! Est. Cost i Permit Fee Remarks
/s B w'N" A,o43
oeg Sa
xo77 CpJ ?`C Gy Eau w.2
, •
X12 r I
s
This permit does not authorise the use of streets, roads, alleys or sidewalks not does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE,r4EPPT ON THF, PREMISE WHILE THE WORK IS IN PROGRESS.
--------------••has permission to erect O.^._ ..................._u on
P
This is to certify. that ----- .Yf...!.. ...... COLc
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955.
..--------. C.:----ll ....... ..:....... Y --'.'-..,.J ... Per ---.........------.c........ . ............-...............-........:.......-..........
43 Chetrman-v rrB w& tf'= _ Building Inspector It
jai/so ? °°
6 0
U 4
/
Request Date Fire No. Rough-in In probb n
Re?qwired?
? Ready Now 3 Will Notity Inspector
1
8-30-90 iYes ? No
When Ready?
14licensed contractor Downer hereby request inspection of above electrical work at:
Job Address (Street, Box or Route No.) City
3320 Riverbluff Dr Eagan
Section No. Township Neme or No. Range No. County
Dakota
Occupant (PRINT) Phone No.
Torchwood Management 452-4884
Power Supplier Address
Dakota Electric Farmington
Electrical Contractor (Company Name) Gontracwr5 License No.
Hilite Electric Inc. 040445
Mailing Address (Contractor or Owner Making Installation)
1953 Shaw ee Rd Eagan, MN 55122
Authorized Signature con1 a caner Making Install Lion)
? 7Z ??? C 1
Phone Number
562-8886
MINNESOTA STATE BOARD OF ELEc1`RICITV THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612)(I42-l)M ENCLOSED.
?1400
2 46051
REQUEST FOR ELECTRICAL INSPECTION
?.See instructions for complet.ng this form on back of yellow copy.
X" Below Work Covered by This Request
E&00001-07
9 P1_
New .e Typeof Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance size Fee Circuits/Feeders Fee
Swimming Pool 1 0 to 200 Amps 10 a o 100 Amps 24.
Transformers Above 200 Amps 1 Amps
Signs inspectors use Only:
?? OTAL
Irrigation Booms ?f 39.50
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical inspector, hereby
certify that the above inspection has
been made. Rough-in
Final /1 /
Date w
OFFICE USE ONLY tw `" -' e 4
This request void 18 months from #2618
gss/:?
2007 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
x*. 50
Please complete for modifications to existing residential dwellings. Do not combine inside and outside
plumbing on the same application; separate applications and permits are re wired.
Date 1( / lI,-) f or-l
7
Site Street Address A 3 211 VAcct ??
Jt
Unit #
Property Owner r
Q Telephone # ("j 1) j SS- 1?7 I
Champion
Contractor 651-365. Telephone # ( )
Address 3670 Rd. #100 State
ciity Zip
The Applicant is: - Owner & Occupant ,
Licensed Plumbing Contractor
Septic System - New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
This fee applies when extensive plumbing repairs are made to a building.
Alterations to existing dwelling $ 50.00
- Add plumbing fixtures to main level _ lower level. This fee includes
installation of a water softener and/or water heater at the same time. if you are
installing only a water softener and/or wafer heater, do not complete this section,
move to the next section and place a checkmark next to the appliance(s) you are
installing.
U/ iC 5 LP W/
-Septic System Abandonment I
n
)
?
i
f
-Water Turnaround (add $136.00 if a 5/8" meter is required) Q C T 3 1 200 U
Other:
_ Water Softener ?ate r Heater $ 15.00
new replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge .50
$
T
t
l r{
$
o
a
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 permit and work will be in accordance with the approved plan in the event
a plan is required to be reviewed and approved.
V- C)f(5iP &"&= -
Applicant's Printed Name Applicant's signature
arIN
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date
Site Address ue r uu Unit #
O
P
t
Eecorc Telephone # 4c> l) `1,5 >' `
l
wner
roper
y
Contractor
STANDARD HEATING a :aIR CONDITIONING
Street Address 410 WFAT LAKE STREET City
MINNEAPOLIS, MN 55408-299
State 612 824-2ggg Zip Telephone # ( )
The Applicant is Owner Contractor Other
Add-on, modification or alteration to existing dwelling unit $ 30.00
t
X f
l
acemen
urnace rep
?y air exchanger
?\ air conditioner
other
State Surcharge $ 50
l
T
t $
o
a
I hereby apply for a Residential Mechanical 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 with the Mechanical Codes that I understand this is not a
permit, but only an application for a permit, and work is not to start witho p t; that or t be in accordance with the
approved plan in the case of work which requires a review and approval o laps. n
Applicant's Printed Name Applicant's 7c U LS l-to IS IJ
U p
AUG 1 31003 U
MECHANICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone #
( )
The Applicant is Owner Contractor Other
Work Type
- New construction Underground Tank -Install -Remove
- Interior Improvement Call for inspection during installation/removal of tank
Processed Piping
Nature of Work:
Permit Fee S50.50 Minimum Fee (includes State Surcharge)
Contract Value $ x 1% _ $ Permit Fee
• I f permit fee is $1,000 or less, add $.50 $ State Surcharge
If permit fee is over $1,000, add $.50 per
$1,000 Permit Fee
$ Total Fee
t hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; that 1 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
Applicant's Signature
Approved By: Inspector Date:
41300 ROBERT KARATZ
RIVER BLUFF DRIVE
Condo
Unit #
3300/ 10 41300 073 05 73
3302/ 074 05 74
3304/ 075 05 75
3306/ 076 05 76
3308/ 077 05 77
3310 078 05 78
3312/ 10 41300 079 05 79
3314/ 080 05 80
3316/ 08105 81
3318/ 082 05 82
33202 _ - 083 05 - 83. 7
3322 084 05 84
3313/ 10 41300 120 05 120
3315/ 119 05 119
3317/ 118 05 118
3319/ 117 05 117
3321/ 116 05 116
3323 115 05 115
(6-plex - Cedar Bluff Townhomes)
(6-plex - Cedar Bluff Townhomes)
(6-plex - Cedar Bluff Townhomes)
3325 10 41300 120 01 (office/storage - Cedar Bluff Townhomes)
16
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date:4/25/73 (12/29/72) Number: 1173
Billing Name:Rj-yprva.4illa Bldg. 3 Site Address: - - River Bluff Dr.
Owner:
Plumber: Bexftiorst Plumbing Co.
Building is a:
Residence
Multiple x No, units 6
Commercial
Industrial
Other
Billing Address
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
Berghorst Plumbing Co.
Please notify the above office when ready for inspection and connection.
JOP 66
Meter
Meter No-O.APAIi N Permit Fee 16.00 pd 12/26/72
-r -pTTT//26/72 s/c
Meter Reading`- Meter Dep
Meter Sealed: Yea Add'l Chg. ?
NO Total Chg.
Inspected by
Date
Remarks; t`v'ZN FED-??qq
,ownho
QVRv?QEZ\-? .
By:
Chief Inspector
y0 I/ 3l 0 r
3
6
EAGAN TOWNSHIP /a/- 61/
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: 12/29/72 (4/25/73) NUMBER 1317
OWNER: Rivergate Villa-Bldg. 3 Address ?' ? River Bluff Drive
PLUMBER Berghosbt Plumbing Co. TYPE OF PIPE heavy cast iron
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
xc 6 (townhouses)
Location of Connections:
Connection Charge 1170.00 billed 4/25/73
-?' ?
_
Permit Fee 10.00 d 12426/72
J 0 pd 12/26/72
Street Repairs
Total
Inspected by:
Date
Remarks:
By.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
By
Please notify when ready for inspection and connection and before any portion
of the work is covered.
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
DATE OF INSPECTION
1:1 ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTIFICATION -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.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COMMENTS:
a.
/4/- -/
¢ 3 ,6("V Iraf
MASTER CARD
LOCATION /Ilutw./?r/???? (tJw 9312 -1q,
STRUCTURE AND
LAND USED AS
Permit
No.
Issued ssued To
Contractor Owner
BUILDING qq
H 7?p ?' 7 Z /w
PLUMBING ./
(? /feryl?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING D
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING f- /?' 73 SEPTIC
FOUNDATION It ').3 CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING
1-2 -3' DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
P41, 7P 1
PLUMBING ?y.
WELL
SANITARY SEWER r?!-z
Violations Noted
on Back
COMMENTS:
U o Ko PLUMBING (RESIDENTIAL)
Permit Application/s!
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
03 -
30
U
1
/
Date
PECORA, KARI
Site Address 3320 RIVER BLUFF DRIVE Unit #
EAGAN, MN 55121
(651)452.4082
Property Owner elephone # ( )
Contractor NORBLOM PLUMBING CO,
(612) 827-4033
Address City
•
ip Telephone # ( )
State MINNFA-POUS, MN
The Applicant is Owner Contractor Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
- Adding fixtures to lower levels or roam additions, excluding water softener and water heater
- Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed - $121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
- Lawn irrigation system
- Water softener X Water heater $ 15.00
X replacement _ additional
$ .50
State Surcharge
Total
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 with the Plumbing Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start without a pet& that the_work-will_hcj} accordance with the
approved plan in the case of work which requires a review and approval of plans.
Jlp--? ?oL)CUaw?
Applicant's Printed Name App, ant's Signature
`41300 ROBERT KARATZ
3300/ 10 41300 073 05
3302/ 074 05
3304/ 075 05
3306/ 076 05
3308/ 077 05
3310 078 05
RIVER BLUFF DRIVE
Condo
Unit #
73
74
75
76
77
78
3312/ 10 41300 079 05 79
3314/ 080 05 80
3316/ 08105 81
3318/ 082 05 82
3320/ 083 05 83
3322 084 05
3313/ 10 41300 120 05 120
3315/ 119 05 119
3317/ 118 05 118
3319/ 117 05 117
3321/ 116 05 116
3323 115 05 115
(6-plex - Cedar Bluff Townhomes)
(6-plex - Cedar Bluff Townhomes)
(6-plex - Cedar Bluff Townhomes)
3325 10 41300 120 01 (office/storage - Cedar Bluff Townhomes)
16
/3 52
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date 7 / ?_ l v?.0
Site Address Unit #
Property Owner4'? Telephone # (lp rSIJ'-?08 oZ
Contractor
?
Q
Address City
?d c Telephone #
C Zi
St
t
p
a
e
"h
er
The Applicant is Owner Contractor
Septic System _ New - Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
Adding fixtures to lower levels or room additions, excluding water softener and water heater
1
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed - $121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener - Water heater $ 15.00
replacement _ additional
$ .50
State Surcharge ` Itt I
n
7 ';?^ II I'•''1
l r '
I
? y '
?'
$
l"c
l
,
•
Tota
I hereby apply for a Residential Plumbing Permit and acknowlecia that the mtormanon is curjplu.e ulw dcculaLc,
be in conformance with the ordinances and codes of the City of agan and with the-PlurribingCodes; that I understand this is not a
ermit; th t the work wtrdance with the
permit, but only an application for a permit, and work is not to start without a p Zin
approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name Applicant's Signature
J?(131 )F-6& Dart AL ? 3J b -16
200 BUILDING PERMIT APPLICATION
City Of Eagan 04
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Plans are considered public information unless you state they are trade secret and why.
• Structural Plans (2) sets
• Civil Plans (2)
• Certificate of Survey (1)
• Code Analysis (1) "
• Project Specs (1)
• Spec Insp & Testing Schedule (1) "
• Soils Report (1)
• Meter size must be established
l
1
1
l
l
S
• SAC determination - call 651-602-1000
Dent of Health at 651-201.4500
& beverage or
• Architectural Plans (2) sets
• Code Analysis. (1)
• Project Specs (1)
• Key Plan (1)
• Master Exit Plan (1)
• Energy Calculations (1) not always"
• Elec. Pourer & Lighting Form (1) not always-
• Meter size must be established-if applicable
• SAC determination -call 651-602-1000
** Contact Building Inspections to see if it is required and for a sample.
*** Permit for new building or addition will not be processed without Emergency Response Site Plan.
Date (o-7 Construction Cost $ • 000 /
Site Address ?J 3l 2 Q ° V z/C 61 UF/-- D )e Unit/Ste #
Tenant Name Former Tenant Name
35iLl 3310 33
? 332 3322.
`
Description of Work G 1 e .)A Z) wS I ' o ?d0? s
Property Owner Telephone # ( )
Contractor
Applicant is: _ Owner Contact#: (?(a) ?v?/ ?33??
//
Contractor d w S- W rrN /
d c7 L,) e=
Address 2 ?3°I 111 ? •^? e e 6?_ City 1 G S
State rn/ Zip S 06 "` Telephone # ( lV -7a
Arch/Engr Registrati
Address City IN MAY 0
2007
State 7
Zip Telephone # ( )
Licensed plumber installing new sewer/water service: Phone #:
I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work wits 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 pemrit, 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 Applicant's,$fgt e
• Soils Report (1)
• Certificate of Survey (1)
• Structural Plans (2)
• Architectural Plans (2) sets
to HVAC units req'd. on bldg elev. ! site plan
Civil Plans (2)
Landscaping Plans (2)
• Code Analysis (1)"
• Energy Calculations (1) "
• Emergency Response Site Plan (1)
• Spec. Insp. & Testing Schedule (1) "
• Electric Power & Lighting Form (1) "
• Project Specs (1)
• Master Exit Plan (1)
• SAC determination - call 651-602-1 000
• Fire Stopping Submittals
• Fire Suppression/Alarm Form
• Meter size must be established
Aug 18 1510;55a Sunrise Remodelers 651-762-9395 p.5
i
Use BLUE or BLACK Ink
r�.__��—_�.____.__�.��
I For OffFce Us� 4
� t
. � Pertnil�k: ������ f
Clt� of�a��Il � PermitFee: ���-�i �
3630 Pitot Knob Road � �
EagaA MN 35122 � Date Recei�ed: i
Fhone:(651)67�-5675 �
' � Staff: I
Eax:{65'I)6?5-5694 � !
'�Yr 1��.-ir / �._�_�._____�_.�����.7
� �s �• �1�l' K�`� L.�� Gf ��2.G+-�C.Y1 • C,a:Yy'
2o�s RESIDENTIA� BUILDING PERMIT APPLICATION
�-e c��Y' L�(iN+-� TC��v n h 4..� S-e�s
pats:�-��'I �'J Site Address: ���� �'1�V't�� �c.l�►- ��'��!2- ��131 t�nit#:
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{ � Name: � Phone: x
� Residentl
' Owner `, Address J Cily/Zip: ;
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� ; Applicant is: Owner �Contractor
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� '• Descri Uon nf work: ��� � � y
� Type of Work ' P �� �
' : Construction Cost: � 1�: Q U�'• M�Iti-Family B�lding:(Yes�/No_) :
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� � Corr�pany:�t,�Y� Y� %
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' = Address:� �''� �G? 't'1L' ��. �,.-�� 'V1-� City: S�'" � �"'�C�-� �
; Contractar ;
y S�ate: �JlV�Zip: � �/ /C� Phone: Email:,� � � �''" S�-�h�� ��z►�n uc-�-e.�e`s=
� f License#: � � �j � � Lead Certificabe#:���f�� �3�~ � �
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s if the project is exempt from lead certificadon,please explair�why: �
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' COMPLETE THIS AREA 4NLY IF CONSTRUCTING A NEW BU�LDING ;
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t In the last 12�onths, has the City of Eagan issued a pemiit for a similar plan based ort a rreaster plan?
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5 Yes No If yes,date and address ot master plan: �
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" Lieensed Plu�ber. PhQne:
; �
�' Mechanical Corriraetor. Phane: °
x
; Sewer�Water Cont�actor. Phorte: �
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: Fire Suppression Contractor. Phone:
j NQTE:Ptans and supporti►rg ducumenis tf�at yoa s�bmii are cansidered ta 6e publlc information. Porfions of ��a
' the infcrrmation rr�ay 6e c/assi�ied as non public if you provide spe�c r+easons that woufd permif#he Cfty to
..�._...�__� - - .,�,�,.._� - -conclude thaf the,�are trade secrefs,� �.���_,_,�,�,� --- - -
CALL BEFORE YOU DIG. Cali Gopher Sfats One Call at(651)454-Q002 for prateclion against unrierground utiNty damage. Call 46 hours
beEore you iMend to dig to receive locates of undergrourid utilRies. wvwv.aoaherstaieonecall.ora
I hereby eckrw�+Aedge ihat this informal�on is oomplete and accurate;thai the work will be in conformanoe wfth the ordinancea artd codes oi the City of
Eagan;that I understand Ihis is not a perm9t, but only an applieation for a permit, and vworlc is not to s1aA withoul a permil; thal the wodc will be �
accordance with the approved plan in ihe case of work which requires e rewew and approval of pians.
Exleriorwork authorized by a bullding permit�sued(n accordanee with the Minnesota State Building Code must be complebed wlEhin 180
days of psemit tssuance. ---•
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Applicant's Prie�bed Name A a s ignatc�re
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Use BLUE or BLACK Ink
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I For O�ce Use �
C' � Permit#: J � r �� � j
��� 0� ����� I Permit Fee: ���� � Y �
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone:(651)675-5675 I I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: Site Address:� �� ' ��`-�' �� � ��� ���d � Uni#
Name: Phone:
1��5it1#�t�l`/ .��% ,�
(����;� ; `i Address/City/Zip: �iVLR13l.u.�F .�IL . �g6�ir 7YIn�• SS/�3
�`: ���" � . ,�� Applicant is: Owner �Contractor
' Descriptionofwork: �G'Pt_.A�c� �sr�-R.�-crd �o���
T�e of 1A1at��C
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Construction Cost: � .3 Multi-Family Building: (Yes�/No�
Company.l.ff-M�/onJ VM.t.�w, �t,�Cn° �iz�� [.(,C� Contact: �7Fl���Dy�►'�srAJ
GQ��C���.�' Address:�57�0 91��` .A1.�. City: (_.i9�N.✓���LS
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State: 7nJ Zip: SSUO Phone: (cr5'/-<2y5-l�3�l Email: SJo1�n�Swu B Gy,�nwN✓,t-��r.y�i¢.4od� 25.t�„
` License#: IJ�� Lead Certificate#: 1�1��f}
If the project is exempt from lead certification, please explain why:
,1V0 L6� �R f t t,Nr�
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:
�1�T�.Pla��ar�,tl:sc�ppor�?�g c��c�t►r���its th�t yow�ubtr��#a�e co�r��"dered to tie�Sr�b�ic�i��irn�a��ri�,P'o�tions��' ;
the���'ort���"Qn r�ay ti��lass��'lea►as r�o�=�w�ic�f,you�ra��F�e s��,�rc re�asc�tha�#�o�fr��er►r��#�r3e ��f�r.ta�
co�c��?de th�t�e .are tr;�d�s�r`ets,
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.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.
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ApplicanYs Printed Name Appli ant's Signatu e
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