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1771 Talon Tr04/2112014 12:19 Les Jones Roofing, Inc. 4101§. City of kall 3830 Pilot Knob Road Eagan MN 55122 Phone: (661) 676.5675 Fax: (661) 675-8694 (FAX)9528817009 P.0071011 Use BLUE or BLACK Ink For Office Bee /� Permit#: i1"/ Permit Fee: 1 6 1 '1 Date Received: Staff: J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Z52v/9 Date: 404P// f Site Address: /7//- l7 7 S-117 9'-/7fJ 7¢i Lo4' 7Z4 -c_ Unit #: Name: �a fa0►°i2?1' /Nc. Phone: WI- 5)1i- ?f 419 Address I City / Zip: f o Box 2/ z5- /A/1-2022_1, - ALlem kW 5-52)74 Applicant is: Owner X Contractor Description of Work: ��/k0�/� ,��: fh�E t i✓6 �S Construction Cost: $ ,./41210.L7._ Multi -Family Building: (Yee / No _____) Company:. Lr5 3 4 ES-cFaNt'fi 1 NIC- Contact: C4t42.tS 1DSR-Sot Address: 941 W' get STIZIEer City:..--e1.t c Lt.Altrn,A) State: I -,N Zip: 5-S-4'7-0 Phone: `iS 2 ,22241 License #: (p5G O Lead Certificate #: Nil-"- '40372=1 / If the protect 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: • ;\,ic(V' a ntarr� k/TOYti!i9:e.g1:;i 1/reap>;r CALL BEFORE YOU DIG. Cell 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 utll Ues. yuww poaherstateonecaN.oro 1 hereby acknowledge (hat this information Ie complete and accurate; that the work will be In conformance with the ordinances and codas of the City of Eagan: that 1 understand this Is not a permit, but only an application for a permit, and work le not to alert 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 plane. Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 180 days of permit laeuance. / Applicant's Printed Name Ap Ilcant's Signature Page 1 of 3 Address: 1771 Talon Tr Zip: 55122 Lot: 5 Block: 1 Subdivision: Greyhawk 2nd /p,?n //1? ? THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON I gd! `/ -t7-f7-?9 Yes No Comments Final grade - 6" from siding Permanent steps - garage Permanent steps - main entry X Permanent driveway Permanent as Retaining Wall or 3:1 Max Slope Sod/Seeded lawn Trail/curb damage Porch Lower level finish Deck Fireplace • Verify with your builder that roof test caps from the plumbing system have been removed. • Turn off water supply to the outside lawn faucets before freeze potential exists. • Call the City's Fngineering Department at 651-675-5646 prior to working in right-of-way or installing irrigation system. V BUILDING INSPECTOR: C®' CONTRACTOR: MW Johnson Construction 17645 Juniper Path #100 Lakeville MN 55044 Site address: 1-7 2l [ .'° '(* Lot_ Block_ Subd. On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater K k,& ,M - y„ G-( %?-t r , ry - 4IJ A'* Furnace fc q-0- c ??ra TvpoG.4y3t 6" S L if." Dryer K0-4.ww ? &, EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES NO Kitchen kitchen +^^ 7i?- 1.4 _LPV LZJ e Bathroom 1 `? ?? 3 iG8 &F S o ?( Bathroom2 42 ?? 1 r6ddG S• Bathroom 3 L# n.„) 1 ? pa r S? p( Bathroom 4 Other FIREPLACES LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DIRECT ATMOS d 4/V 5e- H-- x I hereby acknowledge that the a ove information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. Signatures 6 Date r e Sany Name This form is the responsibility of the General Contractor. r Lo S fS mk +c? C, z__7 o ) RESIDENTIAL BUILDING -Lp -t,21p4(P-$44 (0.18 mP - (02 (oil ) - -70-5-0 Permit Application q City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Jr 4100 (• (9 Telephone # 651-675-5675 FAX # 651-675-5694 L,,(*-.+wa. 12-f2-03 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Can of Survey Recd JYL Y _N (20% maximum lot coverage allowed) 1 set of Energy Calculations for healed 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 Reqd ' _ Y ,14f1 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 7/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units - •l,. II-17 03 Date , ` / I lb / 03st-y? • Construction Cost l ao t o© Site Address 1-7-71 0r-f, --rra I t Unit/Ste # Description of Work S i r1q i e, -?a m, i v ?}b m e Multi-Family Bldg x Y _ N Fireplace(s) ?/_ 0 _ 1 _ 2 '' I Property Owner ?'l W J V ' 11? Sb Telephone #A _I ?I,- 77 w Contractor it UU 0"in hr t Address !???1rS : ?Uyl,l State T?!` f ^ I apy--1 (1 City LOL?y ?_A t Zip 1? Telephone#q5? a a ?7 ?7 ?d COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 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 Have you previously constructed a building in Eagan with a similar plan? Y _ N If so, 25% plan review fee applies. p Licensed Plumber `Q,?' ,(? Telephone # I_+? $q a 6 4'I g Mechanical Contractor ah?``"-?-?' ?`A r Telephone #,L5. Sewer/Water Contractor I a nZPl J ,&QofCa) Telephone#0 ? 1 uu It / hereby apply for a Residential Building Permit and acknowledge that the informatio ?s complefe and Yn that the work will be in conformance with the ordinances and codes of the City of E e to 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. 0.rnrny cav-?ey /' Applicant's Printe Name Applicant's Signa e OFFICE USE ONLY Approved By 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 J? 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 Demdlish (Foundation) ?' 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation av Occupancy MC/ES System Census Code Zoning City Water " SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. // 92 PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) _ FinaUNo C.O. _ Footings (addition) Plumbing Foundation _ _ HVAC _ Drain Tile Other Roof _*_ Ice & Water -.;K F inal 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 S,m•a5 ,.n,,, MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector ------ - - - --------------- - - ------ - -------------- LC/ ?4??r J?LO?iA 79? 00 ff" yo2?G? 8-,5 6V /7 rt, //D ?s??' G ?6 ltc MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version Permit # Checked by/Date COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Multifamily DATE: 5-21-2004 DATE OF PLANS: 01/02/03 PROJECT INFORMATION: Greyhawk End Units Daylight Eagan, MN COMPANY INFORMATION: MW Johnson Construction Inc. 17645 Juniper Path #100 Lakeville, MN 55044 COMPLIANCE: PASSES Required UA = 485 Your Home = 351 27.6% Better Than Code ? wi l et i v, 'l? 1 1 l t TG.?Ov? 71 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS 980 44.0 0.0 26 WALLS: Wood Frame, 16" O.C. 2874 19.0 2.0 161 BSMT: Conc. 8.0' ht/4.0' bg/4.0' insul 464 10.0 0.0 74 GLAZING: Windows or Doors, Above Grade 139 0.480 67 DOORS 38 0.350 13 FLOORS: Over Unconditioned Space 290 30.0 0.0 10 HVAC EQUIPMENT: Furnace, 80.0 AFUE ------------------------------------------------------------------------ COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet th it nts of the Minnesota Energy Code. Builder/Designer ?? Date 0 S LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION / LDfS 2- ??c</G J ??e Gtacv?c zy? 7?? PRO PERTY LEGAL: ? DATE OF SURVEY: ??- -0 LATEST REVISION: m rT c m r U O ' a 2 Q DOCUMENT STANDARDS .? ? • Registered Land Surveyor signature and company ? ? • Building Permit Applicant ? -*- • Legal description 0 .K1 • Address ? ? • North arrow and scale ? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.) Directional drainage arrows with slope/ radient %(4640-31' 1 > 4TG? g ? ? . Proposedlexisting sewer and water services & invert elevation ?CKtiQ S dOls H '* rm'eet ? ? ? 13 • Street name D i 07® M 2 ? ? • • veway r Lot Square Footage p?I"n'IV I ?? .54e ? ,g, ? • Lot Coverage ELEVATIONS Existin ?K ? ? • Sewer service (or Proposed) ? ? • Property comers ? ? • Top of curb at the driveway and property line extensions ? A ? • Elevations of any existing adjacent homes ? ? • Adequate footing depth of structures due to adjacent utility trenches ? ? • Waterways (pond, stream, etc.) Proposed ? ? • Garage floor X ? ? ?? .+. • • Basement floor Lowest exposed elevation (walkou 'ndow) D3? ? X ? ? ;B • . Property comers v? F i Front and rear of home at the foundation e . c PONDING AREA (if applicable) ? 0 ? • Easement line ? ?r ? • NWL ? $J ? • HWL ? ? • Pond # designation ? fQ ? • Emergency Overflow Elevation ? ? . Pond/wetland buffer delineation ? ? • Lot lines/Bearings & dimensions ?( ? ? . Right-of-way and street width (to back of curb) ? . . Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) J ? 4 • Show all easements of record and any City utilities within those easements Cs hoc 1 pips n West sr?Qe) 7? ? ? • Setbacks of proposed structure and sideyard setback of adjacent existing structures ? ? . Retaining wall requirements, if any 14 Reviewed: 11-26-0-3 G:/FORMS/Building Permit Application CERTIFICA TE OF SU I n QO ivy ic9 ? 0002¢ 1 n t` W M BASIN 0 J DRIVEWAY 9.]x 20.33 GARAGE ? ; 5 ?-j n TWO N ROPOSEDB/LO N TWO 1P?! LO STORY F 95a3 20.00 930x9 z1 PATH S 89°35' 18" E 164.31 R ROAD ?Arr_ hil ?1t1? QECT-'FEROPERTY DESCRIPTION: COND ADDITION, LOTS CITY 2 OF EAGAN, THRU 5 DAKOTA 1. REMINNESOTA DEC 0 9 f2EC`D M9-1118-03 30.0' B-B TALON RiVEY jog V• TRAIL: C. S 89035'32" E 51.08 se R-.158 _ IOU 19 1724 x4 MDO i-te 80 48, I 37•• DRIVEWAY III DRIVER AY 3.0E _ I W n fi`?^m 1R.1 I 1 ,21 t + L.. x 2 93622 ° 20.33 n GARAGE 20.33 n GARAGE ,d IZ 93 " I ° 5.50 2 3 3 s.6T 35 9 ?n I m ar m ? I to 93120 ?jzt I I PROPOSED TWO PROPOSED TWO m STORY FB/LO STORY FB/LO 20. Q 25.84 26.00 ¢ j I I DECK oDECK u 9 x g ? 932x1 1o.D o.o 0 r W SIN y CATCH M. T JOHNSON CONSTR UCTION ?"3? X47 S A 9 ? sr9??'??v ,yry \ tc9 ? o 3 93420 933x6 1 933x3 It 3 % 932.9 a BLOCK 933.6 R=84.00 NOTE: ALL DIMENSIONS ARE TO OUTSIDE FOUNDATION Bohlen Surveying & Engineering 31462 Foliage Avenue 4735 123 tl Street W. 55378 N.,tnii((m. Wt 55057 •'??ayy( t 2 89 559259 PFo ? (500)695--]7998 PFoc (952)) 9 he00DxO DENOTES HUB ELEVATION DENOTES SERVICE LOCATION 000x0 DENOTES PROPOSED ELEVATION DENOTES PROPOSED DRAINAGE DIRECTION 000x0 DENOTES EXISTING ELEVATION ® DENOTES WOOD HUB • DENOTES FOUND IRON PIPE MONUMENT I HEREBY CERTIFY THAT THIS SURVEY WAS PREPARED BY ME OR UNDER RECT AND TH SUPERVISIO REGIS[T SURVIEYOR UNDER THENLAWS OFATHEASTATE OF MINNESOTA. LAND DATE- 11-6-03 ?Xa?d SURVEYOR REVISED 12-09-03 LI ROY K LICENSE , LANNO-10795 FILENAME IOtS2-5blkiceft2390 1 LOT 2 PROPOSED GARAGE FLOOR ELEV =938.4 PROPOSED TOP OF BLOCK ELEV.=938.7 PROPOSED LOWEST FLOOR ELEV.=930.7 LOT AREA.= 7768 SQ.FT. BUILDING AREA= 1195 SQ.FT. SEWER SVC INV=926.0 LOT 3 PROPOSED GARAGE FLOOR ELEV =938.4 PROPOSED TOP OF BLOCK ELEV.=938.7 PROPOSED LOWEST FLOOR ELEV: 930.7 LOT AREA= 3213 SQFT. BUILDING AREA= 1195 SQFT. SEWER SVC (NV.=925.() 51f. I' PLOT 4 ROPOSED GARAGE FLOOR ELEV.=938.4 MCC-PROPOSED TOP OF BLOCK ELEV.=938.7 f " PROPOSED LOWEST FLOOR ELEV.=930.7 LOT AREA.- 3207 SQ. FT. 1-p .'0 BUILDING AREA= 1195 SQ.FT. II II II SEWER SVC INV.=925.0 ci O LOT 5 W op PROPOSED GARAGE FLOOR ELEV=938.4 PROPOSED TOP OF BLOCK ELEV.=938.7 p PROPOSED LOWEST FLOOR ELEV.=930.7 co LOT AREA .= 9902 SQFT. BUILDING AREA= 1195 SQFT. SEWER SVC INV.=924-0 32 EP ? V 95M1Y9 p?52 3.1 M&Arnu slopes1 ?, Releining WWI Be Required 111 =30' 7374s 2006 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. O'd) 1 0 ro Date ! ?j _ Site Street Address f FLU// 4i L- Unit # Property Owner Ch?S v\l? c uMd Telephone # (63'1) 33s =- yS Z? off q5? _Z cZ2 ---753? Contractor /??? Telephone# 113-SZ Address-5q !Lfi°a/??/r? City Pr??fl?l?P Stateo/i// Zip-E5 The Applicant is: _ Owner _ Contractor -Other Septic System - New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterat' s to existing dwelling $ 50.00 =Add plumbing fixtures. 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 check the appliance(s) you are installing. -Septic System Abandonment -Water Turnaround (add $130.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 _ new _ replacement Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 State Surcharge $ .50 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 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 it,we nd a proved. ApplicanIs Printed Name plicant's ignatur -13?52, 2006 RESIDENTIAL BUILDING PERMIT APPLICATION S-q&,&0 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered side surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas (20% 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 Blot platted after 711193 Rim Joist Detail Options selection sheet (buildings wdh 3 or less units) Minnegasco mechanical ventilation form /RemodellReoair Requirements - '-Us _ V 2 copies of plan showing footings, beams, joists Cert nt~SUrvey'Recd - Y' 11 1 set of Energy Calculations for heated additions Th "-res Plan Recd ` ?Y - N. 1 site survey for additions& decks Free Prey Regmt'$d! azt?? Y '.. Addition - indicate don-site septic system On-sde-SeptidSyp1em,?-. Y",` N Date (0 Construction Cost ?r 0 a D - Site Address 1721 Ti} co `J Unit/Ste # G,q &" Description of Work r? %S lgSM I W J jprTl?2o oM Multi-Family Bldg Y - N Fireplace(s) ?0 _ 1 - 2 Property Owner C WCs rV1 C i-J%-^I ) _ 3 3S' y SZ Telephone # (6 5 1 Contractor LAr CAI'4 C t.ISTN 1 9-r- f'lt ps"Vc 1 Cow `2s+u TIJV Address ( 7164.`- rTVNSPt+e {0rTtl 3)o city k??Stl? State d" Ir' Zip Telephone # ((?/2) 2 ?2 7 gS S- Lrc # zoyl-7365- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ mimes Energy Code Category . Residential Ventilation Category 1 Worksheet New (J submission type) Submitted Subr Energy Envelope Calculations Submitted f In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master; Y _ N If yes, date and address of master plan: r? Licensed Plumber Telephone #( Mechanical Contractor Telephone # ( Sewer/Water Contractor t r1 _ A- VJUN 0 3 ZOO- I U 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 woA which requires a review and approval of plans. Applicant's Printed Name DO NOT WRITE BELOW THIS LINE Sub Types ' + Y; y ? 01 Foundation ? 07 05-plex ? 13 16 plex " b z20 ?'obl °= i ? 30 AccessoryBldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace "?%,21 Prrrah'{3 sea) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage '0 22 P6rch/&d.'(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 '141, 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Types ? 31.New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding 4 2 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage_ Yes Valuation a'OGg 0 Occupancy 9-13 MCES System Plan Review 100% or _ 25% Census Code _ Zoning City Water SAC Units Stories Booster Pump # of Units / Sq. Ft. PRV # of Bldgs I Length Fire Sprinklered Type of Const R Width REQUIRED INSPECTIONS - Footings (new bldg) _ Sheetrock - Footings (deck) Final/C.O. _ Footings (addition) Y Final/No C.O. Foundation HVAC Drain Tile Other Roof - Ice & Water Final 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: Jr 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 08/26/2014 06:51 Les Jones Roofing,Inc. ffAX�9528817009 P.005l006 Use BI�U�or BI.ACK Ink � ForOfflceUaa----,—/--`—� C��' j Permlt#: � `� ,/�� ^_ ��b�� Pertnit Fee: �/�� I 3830 Pllot Knob Road Eagan MN 55722 j Dale Recelved: j phone:(661)675-6676 I I Fax:{651)675•5694 j S�ff• I ��J 2014 RESIDENTIAL BUILDING PERIVII7 APPLICATION nate, cY�2.x�Ly Site Address:/�7/-/175-/779-��783 7�-oit/ 7.��4'1�.. Unit#: Name:l�o P,�vP�r� �,A�2� __Phone:_��- S��u� �19�f9 Resident/ owner Address/City!Zip: Po [�nx .��.�s /�vv� r�o� l�i��. �l�r �'s'b7� Applicent le: Owner x Contractor Type of Wo�k Description ofwortc:�U_1�E,4aVD ��AE.f S�DINLr - �ttGL �9GK- 5/�E bF I.��CT' Constructlon Coet: �� G� Multi-Family Building:(Yes�C /No� Company:�.S 7p►JF5 Kr�[�Fll�r� I n�L Contacti��tQ►S f+NDE2So�1 Contractor /�ddrees: �y I �b�' STR�T` City: �31�M.��L�D�J Stete:�Z(p: �J Z� Phone:�5�-�/a7-Z8I7 Email: W�►"�SGt �!�e6inn�S l u�r��,e LoM Llcense#: �e5(o0 �.ead Certlficate#: N�4T �037Z—/ If the project is exempt from lead certtflcatlon, please explain why: (see Page 3 for additional informaEion) COMpLEYE THIS AREA ONLY 1� CONSTRUCTING A NEW BUIL.DINO In the last 12 months,hes the Clty ot Eagan leaued a permlt for a sfmllar plan based on a master plan9 Yes _No If yes,date and address of master plan; Llcensed Plumber: Phone: Mechanlcal Contractor: Phone: � Sewer 8�Water Contractor: Phone: NOTE:P/ans and supporting documenfs�tl�at you subm/t are considered to be publlc lnformat/on, Portions of the informat/on may be classlfled as non-publlc�f you provlde specific reasons that would permit.fhe C;ty to conclude that the are frade secrets. CALL��FORE YOU DIG. Call Gopher Stata Ona Cell at(681)4S4•0002 tor protectlon agalnst under�round utlllty demage. CaN 46 houre betolb y0u Intend to dlg to recalve locates af underground ulIllGes, www.poohetsta e necall.ora I hereby acknowledge that thls InFortnatlon Is complele and accurafe;lhat the woAc wtll b0 In ConfomlanCe wlth(he ordlnances and codes of the Clly of Eagan; lhal I understarxl lhls Is nol a partnll, bul only an appllcatlon for a permlt, and work le not to etaR wlthoul a parmlt; thal Ihe wotk wlll be In eccordenCe wllh Ihe approved plan In the case of work whlch requlres e reWew and approvel of plane. Exterlor work authorizsd by a bullding permlt Issued In accordanca wlth the MInn69ot8 State Sullding Coda muat ba complatoA wlthln 180 daye of parmlt Issuance. x G�`��S .4it/D�:��.SO/Y x Appllcant's Printed Name Applicant's Slgnature Page 1 ot 3 City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: 4- Use BLUE or BLACK Ink For Office Use Permit #: / / 90, Permit Fee: 00 • OO Date Received: Staff: L 10 2016 RESIDENTIAL PLUMBING PERMIT APPLICATION Site Address: Tenant: ............................ Resident/Owner Contractor type of Work Pe mit Type Suite #: J •� r Name: �•{?t t ot_i✓e u Phone: c1 L�'�(0t"I_1 Address / City / Zip: ` 11'.4e• c ! Name: 14\ v,) l � Address: -G‘ 0 iNlt41^.. r>n ASL tJ j License #: `— 5o 14 City: Akt`tAp�\r State: AM3 Zip: Phone: 60---}(0)--;02,c1, Contact: c Email: i t : �a a i,A.3;r ©' k- New Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation (_ RPZ / _ PVB) Septic System Water Softener Add Plumbing Fixtures ( Main / Lower Level) Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge) *Water Turnaround (add $280.00 if a 3/4" meter is required) $115.00 Septic System New (includes County fee and State Surcharge) TOTAL FEES $ (-)(2 CALL BEFORE YOU DIG. Cali 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. 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. x Hu-AAI'AACe t6s Applicant's Printed Name Ap •• <'cant's Signature FOR OFFICE USE Required Inspections:' Meter Related Items: