1544 Greenwood Ct N*'
City of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
Permit #: ` %7 S�
Permit Fee:
Date Received: 1?
Staff:
2009 MECHANICAL PERMIT APPLICATION
Date: ./%24- 0 Site Address: �i/ L%CGL C7
Tenant: 60(
Suite #:
RESIDENT / OWNER
Name:ai�///Jf'7 £ ���� 6. tP-
,�-
Address / City / Zip ,�'OY`' %�`�� �� .1e0
Phone:
CONTRACTOR
Nameal..s1)%E�i%� Cay , A%49eg— %'t ense #:
Address: 2e � _9
City: Cal �'/S' G State: Zip:
Zip:
Phone: &I` 7/T 173/ Contact Person: .,/7//e"---
TYPE OF WORK
New Replacement Additional )(Alteration Demolition
Description of work:46, 61710/?07--,,z41) /i -(e %,
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened, by City
Code. Please; contact the Mechanical inspector. for information orypermitted screening methods..''
PERMIT TYPE
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump1Du.
Other ` Q. -AV -604A
COMMERCIAL
New Construction Interior Improvement
Install Piping
Gas
Processed
Exterior HVAC Unit
Under / Above ground Tank ( Install / Remove)
**When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $
TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal
$50.50 Minimum (includes State Surcharge)
OR
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each
$1,000 Permit Fee (i.e. a $1,001-$2,000 Perrnit Fee requires a $1.00 surcharge).
Contract Value $ x 1%
$ Permit Fee
= $ Surcharge
TOTAL FEE
=$
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
Eag
w
this information is complete and accurate; that the work will be in confo
s is not a permit, but only an application for a permit, and wor
n the case of work which requires a review and approval of p
Applicant's Printed Name
d codes of the City of
ork will be in accordance
Applicant's
FOR OFFICE USE
Required inspections:
Reviewed By: !.
:e:
Teat _Gas Service Tes
:erior AC Screening Inspection,
RESIDENT OWNER
Name: rA,n. v3-� c s4 r'vc L..-�: 5QNwPhone: /2- ,t1 Z 770'1.
Address City Zip: -.54 Cr 3 vi QS yt f f9r/' sde i eel,-
CONTRACTOR
el e u 3r) LC i er'
Name: License 6GS p
Z
Address: 1 1/ Z 1+ S 1- ►.J
G
City: f IF° State: MV" Zip: SAS 3 71�
Phone: Cl) Gc '1 Contact Person: 1.
TYPE OF WORK
New eplacement Repair Rebuild Modify Space Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL Q� p 1.4c.e. w e
Water Heater Water Softener Q u '4 Fes.
Lawn Irrigation Add Plumbing Fixtures
RPZ PVB) Main Lower Level)
y jt'l
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $165.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 11 tk)v ?c9g5 Site Address: 1 S LI 9 Gr,rec.v.1 wrs) fUd
N UJ
Applicants Printed Name
x
Applicants Si Nature
or
Permit i O
Permit Fee:
Date Received:
Staff:
Use BLUE or BLACK Ink
Tenant: Suite
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.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 o .pJans.
FOR OFFICE USE
Required Inspections: Under Ground
Reviewed B
Rough -In
Tes
Gas Tes
Fin
RESIDENT OWNER
Phone:
Name: E. t J4EAT4
Address City Zip: ell Cam \,c.t.g)i) C* 14 1 EV4*. 1V)1-3.
Applicant is: Owner Contractor
55 i 2-2---
v
TYPE OF WORK
Description of work: fitik.4. aw)/ IitiLittd f AA 1/
I e6t la. s Dye
Construction Co Multi Family Building: (Yes No
CONTRACTOR
Name: e _P
Address: 31 (h, tSj-
j License 7-0403(p 303
f&
City: EA State: r t Zip: 551 2-7-'
Phone: (V l2- 1-1 8410 Contact Person: 2 7 0 Z7D
COMPLETE
In the last 12 months, has
If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_Yes _No
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit
the information may be classified as non-public if you
conclude that they
are considered to be public information. Portions of
provide specific reasons that would permit the City to
are trade secrets.
City otEap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x C-45P,
Applicants Printed Name
NOV 49
Staff:
x4A /0
Appl an
Use BLUE or BLACK Ink
For Office U e /F
Permit 0 5
Permit Fee: c 2
Date Receive._ 0
2009 RESIDENTIAL BUILDING PERMIT APPLICATION CP1q
Date: 1 Site Address: 51 1 1 \?-I)O1D £T t-
Tenant: Suite
CALL BEFORE YOU DIG. CaII 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.aooherstateonecaliorq
J
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 p1t; that the work will be in
accordance with the approved plan in the case of work which requires a review and approve
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
Fireplace
Garage
Deck
01 of Plex Lower Level
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit Surcharge
Treatment Plant
Copies
Interior Improvement
Move Building
Fire Repair
Repair
(25 100%
Census Code
#of Units
of Buildings
Type of Construction
Vr)
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice Water _Final
4 Framing
Fireplace: _Rough In Air Test
Insulation
Meter Size:
TOTAL
)5qq.. Cre
DO NOT WRITE BELOW THIS LINE
Porch (3- Season)
Porch (4- Season)
Porch (Screen /Gazebo /Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Reviewed By: `t
Siding
Reroof
Windows
Egress Window
ovor
r-
rtir eir
•r I
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
*Demolition of entire building give PCA handout to applicant
Sheetrock
Final C.O. Required
Final No C.O. Required
HVAC
Other:
Pool: _Footings Air /Gas Tests _Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: Footings Backfill Final
Radon Control
Erosion Control
Building Inspector
Page 2 of 3
Aug. 1. 2012 12:37PM Sella, Accounting No. 1661 P. 12
Date:
City of Evan
3830 Pilot Knob Road
Eagan MN 66122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit*
Permit Fee:
Date Recelved:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
'j I / 2- Site Address:153B,I940,1 SQ., r1Sq) „woo c+. (i unit#:
-A
RESIDENT /
OWNER
Name: jCrYYt y iA.e►J\k-s 1r�,:%l-.\w me a:.:60 G Phone: (15.-.I -&3 1 •H I a 3 a
i\�_LL.-k-stme r^
Address / City / Zip. G 3 ii Ll'L/ '3F'j1 QIA-‘.C__Yl /
c' [ 1
Applicant Is: Owner )( Contractor-��� n ptZ ��v-\ , �� . L L/
TYPE OF WORK
Description of work: re `coo F"
Construction Cost: I ? [ i S—, DC.) Multl-Family Building: (Yes X / No )
•
CONTRACTOR
Company: SalC1- f Z(O VI 4.WY) t' ct 1 tici Contact: Karl im
Address: ' -I t CO f xtr-C�1 St or g 1 V cl, City: 5t , LoLA ' s R I" k.
State: 7Y\Y\ Zip: 55,11G, Phone; C) CJ6,/-oi 15 - -7 ca.
License ff: C- 12• 001 U 5 U Lead Certificate #: A%A T.— - a J C) i l — 1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_No
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
NOM 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 protide 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 Witty damage. Call 48 hours
before you intend to dig to receive locates of Underground uliiilles, wvnv.00pherstateonecall.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 1 understand this Is not a permit, but only an appltcatlon 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.
xteriorwork authorized by a building permit iesued in accordance with the Minnesota State Building Code must be completed within 160
days of permit Issuance.
x �l \ r Ca. et -- f
Applicant's Printed Name
Applicant's Signature .
Page 1 of 3
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