2018 Shale LaneCITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199. Espn, MN 55121
PHONE: 4548100
BUILDING PERMIT
To be wed fer Rj-.GE
$2,200
Site Address 2018 S:iALL f,%'
Lot Block 1s ib. C.r',i ;I<<JV L
Parcel No.
Name
Address
City Phone
Name ';AME
Address
I- City Phone
G°L Name
W
13 Address
trz. City Phone
I hereby acknowledge that I have rood this app
the information is correct and agree to comp
State of Minnesota Statutes and City of Eagc
Signature of Pernittee
A Building Permit is issued to: BRT'(.
all work shall be done in accordance with all c
Building Offidol
and state that
all applicable
Receipt
Date
-
Erect ? Occupancy
Remodel ? Zoning
Repair ? Type of Const.
Enlarge ® No. Stories
Move ? Length
Demolish ? Depth
Grade ? Sq. Ft.
Install ?
Assessment
Water & Saw.
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Var. Date
State of Minna
Surcharge i
Plan Review
SAC
Water Conn.
Water Meter
Road Unit
Parks
Total '
an the express condition that
Statutes and City of Eagan Ordlrwnces.
Permit No. Permit Holder Dow Tole hone it
Plumbing
H.VA.C.
Electric
Softener
Inspection Date Insp. Other
Footings
6 w
Foundation
Framing
Roofing
Rough Plbg.
Rough HVAC
Insulation
Final Pibg.
Final HVAC
Final
Cwt/Ooc.
Water Describe Location:
Welt
Sewer
Pr. Disp.
CITY OF EAGAN Remarks * Cedar Grove Acquisition
Addition CEDAR GROVE Lot 2 Blk 2 Parcel l0 16703 020 02
Owner 1 L/ r) Street 2018 Shale Lane State Eagan, MN 55122
. v
Improvement ._..
Date . . 1 1 , 1
Amount
Annual
Years
Payment
Receipt
Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 1972 1 304.00 52.16 25 Paid
WATERMAIN
WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
r- r
1N SFEU ION REUORll
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: lilt APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
10 MARK 'is Pr ki)O F 011F '110 `i I (IPM 0AMA$I .r.4fi
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING 7-.
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLDG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ...... ....... .. ..... ................ .
Address (present)=?....0.1 ............... ......
Builder ......-•- ....... ...........................................
Address ....................................................................
DESCRIPTION
N° 1197
Eagan Township
Town Hall
Date
Stories To Be Used For Front Depth Height Est. Cost ermit Fee Remarks
l/ v LOCATION
Street, Road or other Description of Location Lot Block Addition or T
raact
i
?
This permit does not authorize the use of streets, roads, alleys or sidewalks nor 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 B?XEPT ON THE PRE SE WHILE THE WORK IS IN PROGRESS.
This is to certify, that .. ..................................................has permission to erect a............ ------.......... ,................upon
the above described premise subject to the provisions of the Building Ordinance for E Town ip adopted-- April 11,
1955. \
................. ........ Per ... ?. .............
hairman of Tnwn Board Building nspector ,
e.6
EAGAN TOWNSHIP No 977
BUILDING PERMIT
Owner -=... DD ..._ ray..---:..C?dDw..o.. ??`.j ?.?....._ - Eagan Township
Address (present) ... i0..+_- - -..../.C!.S+T.Z Town Hall
Builder ....... ....... - ... ?/7 10.3
.. Date ....... -
Address
DESCRIPTION
Stories To Be Used For Front Depth _Height gEsstt..r Cost Pergmit Fee Remark,
,5- /r i1 i, jV 3 afsfLOCATION
Street, Road or -other Description of Location Lot Block Addition or Tract
r 3='F= ¢-" -- -- -- ---
This permit does not authorise the use of streets, roads, alleys or sidewalks nor 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 KEPT O%THE PREMISE 3VHILE THE WORK IS IN PROGRESS. j
This is to certify, that...11 '. ?_40k! ....------ ..(.......has permission to erect a._.L4i_.._a...L.L..."u°`.. /..."?........_.__upon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955.
.............._....................._...-................_.. Per ....... _......_._...__. --.-'
`!--`'^'^?`Z'
Chairman of Tnwn Board / Building Inspector
Q. 'B.
?' - CITY of EAGAN
BUILDING PERMIT
Owner ...1..:.......::?.:`........ ?.?......:? ............
Address (Present) -`°.?..C? ........?
G
.
Address ... ........ J.........
.............................
DESCRIPTION
N9 3527
3795 Pilo! Knob Road
Eagan, Minnesota 55122
454.8100
Date ... ...7-5--
...........................
8iories To Be Used For Fton! Depth Heigh! Est. Cost l Permi! Fee l Remarks
LOCATION 1% L/• O-
Street. Road or other Description of Location I Lo! Block Addition or Tract
This permit does not authorize the use of streets, roads, alleys or sidewalks nor 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, safely, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT ON TH/ PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify. .............has permission to erect a_.^..'.? .........'.'::`.::._.._upon
the above described premise subject to the provisions of all applicable Ordinances for the City of Eagan.
n
........................L?.' __...'"`"'?' `.L....---..............._..... Per ----.....-... _............. ........................
..........................................
Mayo r ? Building Impactor
Is
N`_' I.-
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21.198, Eagan, MN 55121
BUILDING PERMIT PHONE: 454.8100 Receipt # ?5- / !{
T. 6. and I. GARAGE ADDITIgpvalue $2,200 Date MAY 20 , 19 85
Site Address 2018 SHALE LN
Lot 2 Black 2 ?ec/Sub. CEDAR GROVE
Parcel No.
W Name BRUCE HOCKENSMITH
Address SAME
City Phone 454-2847
Name SAME
?
s Address
City Phone
G
Name
z; Address
.C. City Phone
I hereby acknowledge that 1 have read this application and state that
the information is correct and agree to comply with oil applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Erect ? Occupancy
Remodel ? Zoning
Repair ? Type of Const.
Enlarge M No. Stories
Move ? Length
Demolish ? Depth
Grade ? Sq. Ft.
Install ?
Approvals Fees
Assessment
Water a Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Var. Date
Permit Y J V. J V
Surcharge 1.50
Plan Review
SAC
Water Conn.
Water Meter
Road Unit
Parks
Total -
Signature of Permittee I
A Building Permit is issued to: BRUCE HOCKENSMITH on the express condition that
oil work shall be done in accordance with a?Jgpplipoble of mprttaota Statutes and City of Eagan Ordinances.
Building Official ?/~(? _QP
qty of Satan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 6755675
Fax: (651) 6755694
Date: (0
Tenant:
2008 RESIDENTIAL BUILDING
F- ----------
j Permit #:
Permit Fee:
Date Received:
I Staff: I
-----------------
APPLICATION
Suite #:
RESIDENT iOWNER Name:. -?? u P
Address / City / Zip: 7w l U eS? Phone:
I
Applicant is: -Owner ?Contractor
TYPE OF WORK Description of work: ' ecvo
Construction Cost: Multi-Family Building: (Yes _ / No
CONTRACTOR Name: S License #: 9? 0 z_4
I 1
Addre Z - W
City: (kO (A) A/L
Phone: ?'(rz G? - 5 _ Contact Person!
State: Z?ipp::J'9V2!
?.F? "
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Res dential Ventilation Category 1 Worksheet
Category Submitted New Energy Code Worksheet
submitted
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:
Plans and supporting documents that you submit are considered to be public information. portions of
NOTE:
.
the infonnation may be ciassiSed as non-pubho if you provide specific masons that would permit the city to
conclude that the are bade 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 applicalion 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 rase of work which requires a review and approval of p
x D c x
Applicant's PNm Name me Ap icant's Signet re
Page 1 of 3
qakuL 500, 6-0
4ene
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY of LOAM p
UN MW Koo Rol O"M INN 35122
661.681.4476
3 till, e?edekeew+as 68aaaataal?anouse ra roaMaas saaWeaawm
(poxm +wmbteawtaotekeedl 1setaEne?pyCekadedanfaM?daddMOra
smpasapmano.i?goamawYaowwe?round+a?ntlohq? ekJ • tskaneytrwWorandidonsadedn
1addenergyCOWAMM . k*A%fhanaemedbye9*%4WfV4ddk a
9eAplasaihePftW0 OaP0rrefpWM4ftMM
FftMD"oPWM t, "N' V"0t*WM30r1MWft
DAZE V'R b
SITE ADDRESS
TYPE OF WORK
MULTI-FAMILY BLD,Q _ Y _ N
J FIREPLACE(S) _ 0 _ 1 _ Z
APPLICANT ra.?ll C/! 57C11t)e5?I6H
STREET ADDRESS _s2 01-? j;:LZXJ t k' V J' s qry <1 / TATE 43-? =IP
Lt 9 - 3??
TELEPHONE # CELL PHONE # FAX #. 9S- L
PROPERTYOWNER TELEPHONE#?` ^
COMPLETE THIS SECTION FOR eeM(ee RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA R US 7670 CATEGORY 1 _
(4 vAaft an aPe) • Paslft ekl Vadladon Cateymy 1 Wewksfant Submmd
• Energy DwaWm Qdmftdorw SuWnftd . 1 1
murnbiv CoriftWor: Phbne #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler
_ Water Heater No. of R.I. Baths
No, of Baths
Mechanical Contractor _
Mechanical system includes:
"wet/water Contractor:
_. Air Conditioning
Heat Recovery System
Phone #
Fee:
$70.00
R" #
.1-------------- ---r------- -------------- -------- -.......... --.... --.. --------------- ..--------------- -------- - ------
I hereby acknowledge that I have read this opplica im state that the information Is correct and agree corr4*
vftih all applicable State of Minnesota Statutes and City of Eagan Orc7fl ) y/?
SlgrrahaaeuAppticanf CAL
OFFICE USE ONLY
VALUATION -4, cro
Cerllficatea of Survey Received Tree Preservation Plan Received _ Not Required _
updated arcs
Fee: $90.00
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
g 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. Aft - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) O 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
x 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) • Give PCA handout to applicant
Valuation ?-7 Occupancy 9-3 MC/ES System
Census Code 43 Zoning 2 City Water
SAC Units 6 Stories Booster Pump
Nbr. of Units o Sq. Ft. PRV
Nbr. of Bldgs / Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ FinaVNo C.O.
Footings (addition) Plumbing
Foundation _ HVAC
_ Drain Tile _ Other W ?N? w
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final
- Framing _ Siding _ Stucco _ Stone
Fireplace _ R.I. -Air Test -Final Windows (new/replacement)
- Insulation _ Retaining Wall
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
Approved By
Building Inspector
Total
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 3 2 6 3 2
(612) 681-4675 Date Issued: 07/22/98
SITE ADDRESS:
P.I.N.: 10-16703-020-02
2018 SHALE LANE
LOT: 2 BLOCK: 2
CEDAR GROVE #4
DESCRIPTION:
STORM DAMAGE
REPAIR
434 ALT. RESIDENTIAL
;1 It ,
t
REROOF
4,uildir€g_Permit Type
Building Work Type
,'Census Code
I ?
REMARKS:
REROOF DUE TO STORM DAMAGE.
FEE SUMMARY.
CONTRACTOR:
OWNER: - Rppiicanc -
SINGH CARLTON
2018 SHALE LANE
EAGAN MN 55122
(651)456-9255
I
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 Mn.
Statutes and City of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATURE
ISSUED BY: SIGNATURE
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
a (? 3 CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675 Q
New Construction Requirements Remodel/Reoair Requirements D /
• 3 registered site surveys 4 2 copies of plan
? 2 copies of plans (include beam & window saes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks)
? 1 energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservation plan if lot platted after 7/1/93
required: _Yes _ No
DATE: 7-
DESCRIPTION OF WORK: AX
STREET ADDRESS:
a-
LOT: BLOCK:
PROPERTY
OWNER
CONTRACTOR
CONSTRUCTION COST; 7,1 / CO
-S?-o YVV1 &&v?
SUBD./P.I.D. M
Name: SEN(a I- C14 P- L T7) 1?4 Phone#: (/2) L/5G-92555
Last First
Street Address: Z0 ! 5L74, Z
?2 rl f
City State: H/? Zip: o?VZ7i
Company: Phone #:
Street
City
License #
Zip:
ARCHITECT/
ENGINEER Company: Phone #:
Name: '----
Registration #:
Street Address:
City State:
Sewer & water licensed plumber (new construction only):
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information
State of Minnesota Statutes and City of Eagan Ordinances. / / ,
Signature of Applicant: 12-P
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
State:
Zip:
Penalty applies when address chang
to comply with all applicabl
IG%
Tree Preservation Plan Received Yes No Not
l
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
R 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _ plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
rAJrT•r1,fflV
Planning
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
? 11 Apt./Lodging ? 16 Basement Finish
? 12 Multi Repair/Rem. ? 17 Swim Pool
? 13 Garage/Accessory ? 20 Public Facility
? 14 Fireplace ? 21 Miscellaneous
? 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
_ Footprint sq. ft.
Building Engineering
Valuation: $
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
% SAC
SAC Units
MASTER CARD
LOCATION C;i?a r? . •yC O /? - C,
'
OWNER YCP SM. L l
STRUCTURE AND
LAND USED AS
Permit
No.
Issued Issued To
Contractor Owner
BUILDING 7
3S2 *
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING - SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
i
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
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.
AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED
DATE OF REINSPECTION
REVEALED
CERTIFICATION -I certify that I have carefully inspected the above in which 1 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
z?
/40 41;
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
To Be Used For: d24rg$ 0401710. Valuation: ,2?00 DO Date: 5 e 8g-
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
Site Address: ?%o/r S.4ais "#jg, OFFICE USE ONLY
Lot: 2- Block 2 Sect/Sub Erect
Remodel
Parcel # Repair
Enlarge
Owner ?sRUCrr ??ocNrin? ?// Move
Demolish
Address
r,42Ig L,6,?&r Grade
City/Zip Code c?¢e?,9N /9 ~^j d-S'1,2
2
Phone ZIrlyr z/7
Contractor vS? LMT
Address
City/Zip Code
Phone
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
Arch./Engr.
Address
City/Zip Code
Phone 11
APPanvet c
Occupancy
Zoning
Type of Const
11 of Stories
_ Length
_ Depth
Sq Ft
Assessments Permit ?.?
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off Parks
APC Treatment P1
Variance
TOTAL qD. Q'
24
O - f a -La
'Ir
23
J' -
! : •_tl
L L4-
T ,t-
44
21
20
i 19
17
16
15
_
L
14 _
3 r
12
10 = __.
B
7
- 6
5
4
~ 3
2
:a
7
1 2 3 4 5 6 7 6 9 10 11
13 14 15 16 17 16
CITY USE ONLY
PERMIT #: 7 D 159 RECEIPT DATE: I I-+ S "O
RESWENTIAL MECHANICAL PERMIT APPLICATION
crrYor EmAN
3$30 PILOT KNOB §W
KAfi" MN 551 EE
651-661-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: /(-?Q-_O\
SITE ADDRESS:
OWNER NAME: l tt W? TELEPHONE M ? _ EA4_
" p (AREA CODE) ?/
INSTALLER NAME; TELEPHONE #:: zi X 1
? // ?l (AREA CODE)
STREET ADDRESS: G-7 A l ,r -Nf_6L d A
CITY: ,:tYT pCZr . Q STATE: ZIP
Place a check mark next to the nermit work tune
New residential dwelling unit under constructionand not owner/occupied $ 70.00
Add-on, modification or alteration to existing dwelling unit $ 50.00
r. furnace replacement
• air exchanger ?
r
n i5
r
air conditioner ?
.
• other
?i? o o
Nature of work: ab
L,
cony
_
State Surcharge $ .50
Total $q)?R_
Reminder: Call for inspecdons.
S? r
4OF P
Updated 1/01
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
COMMERCIAL MECEMICAL PERMIT APPLICATION
crrY OF Emm
3$30 PILOT KNOB RD
EAEL EN, MN 551 EE
651-681-4675
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 #:
(AREA CODE]
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
(AREA CODE)
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 for inspection by Fire Marshal and
Plumbing linspector.
Fees: 1 % of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removal/installation = minimum fee
Contract price: $ xl%=$ (Base Fee)
State surcharge calculate at $.SO for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/01
S/ f O l )J 16 RESIDENTIAL BUILDING
ty{, U Permit Application
o City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 4 651-675-5674
New Construction Recuiremenb Remodel/Repair Reouiremenls office Use Only
3 registered she surveys showing sq. ft of lot sq. ft of house; and all roofed areas 2 copies of plan - Can of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Red
2 copies of plan showing beam & window sizes; poured found design, eta 1 site survey for additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicate donsile septic system _ On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date
Site Address ?L U y? )t l l C ?-t ?i Construction Cost " ) J
q alb Unit/Ste #
Description of Work -'e to iq e-e M etUt Yy % Ndo KI
Multi-Family Bldg - Y _ N Fireplace(s) - 0 _ 1 _ 2
Property Owner --J050llf E led h e r Gl C?LV/
Telephone #('I* ,'.) / ?? / - ?/ ?
Contractor u1
Address • rr SJ St d iPf lP-
State Ullm e 0 fa- C
Zip ?J?? 5 S City U!L
Telephone # ( (,954 y 5U - 04F/N
16 7S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Telephone #(
Mechanical Contractor
Sewer/Water Contractor
MAY 0 9
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 ordinance) 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 wb' requires a review and
approval of plans.
Jan,ellc 0,.,360
,
Applicant's Printed Name /is Signature
OFFICE USE ONLY
Sub Types
? 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 (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 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 (Bidgp ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - 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 Width
REQUIRED INSPECTIONS
- Footings (new bldg) _ Final/C.O.
- Footings (deck) Final/No C.O.
_ Footings (addition) _
_ Plumbing
- Foundation IIVAC
_ Drain Tile _ Other
Roof - Ice & Water _ 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
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search"
Copies
Other
Total
in It,
Building Inspector
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
<1 15.C?b
Date eQ -V l ?0 l 6
y
V
Site Street Address
,;7z2 Unit #
(1) 3?LJ v2?r?r7
Property Owner Telephone #
Contractor W go ?0? 1 e--oMJ
Telephone #V. 6 h 346 -h? 4R
{o
Address _??L?D kq, -? 9e,4, city G State 9W4 Zip.J 3
The Applicant is: _ Owner t! Contractor -Other
Alterations to existing dwelling $ 50.00
-Add fixtures to rooms, excluding water softener and water heater
-Septic System Abandonment
-Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
_ Water Softener YWater Heater $ 15.00
11/ replacement _ additional
Lawn Irrigation System RPZ_ new _ repair -rebuild $ 30.00
State Surcharge $ .50
Total $ Jlr &0
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.
) S h J/d 4FPAct,
P
Applicant's Printed Name
y¢ we_ab.?
Applicant's Signature FRM4y 14 2004 ??
Use BLUE or BLACK Ink
For 41 1 Office Use ~O~Q 1
Permit b l
Cloy of Eq, I Permit Fee: 5 ads
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 i Staff: all
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: >O(g Qse// Unit
Name: 640el ' /yG Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
ZOA~J ap~~-de
Type of Work Description of work:
Construction Cost: llra 7:-~ / Multi-Family Building: (Yes / No
i Company: ontact:
Contractor Address: - City:
.1 t7
State: ,~VZip: J / Phone: -
s License de- (el 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
E 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.
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 Bui ding Code must be completed within 180
days of it issuance.
x~ e~ x
Applicant's Pr nted Name Applicant's Signature
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