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3686 Willbrook Ct
Control INSPECTION RECORD I No. e ~ CITY OF EAGAN PERMIT TYPE: ~ux~.niN~ 3830 Pilot Knob Road Permit Number: eN1767 Eagan, Minnesota 55123 Date Issued: 11 J!6 197 (612) 681-4675 SITE ADDRESS: LOt : 13 141. (Icl, I APPLICANT: 36HC.• wtlLiRRO[iK rT SUNRZnBE NAMES IMC Wii.LBROOK (612) 6ee...6245 . PERMIT SUBTYPE: TYPE OF WORK: "r Ii1h, NEW INSPECTION .A • .A I QI) 11 Nii FRA14IN9 1:NSEII.AT IttM iiNAl fiRFPLACF RFMAhk'S: & W CfINTRAGI'OR I.AKkSiUE W18G ~ . . . . _ - _ . - y ii'~ r • ?tic~~r ~ z.`` . . - . . ~r -h"]c.H~~.'`~li'a ~~:L.~. t} q~ ? . . _ . •}a,. i' . 'k .1_.~'. era ~ , Rvcmlt Mo. PersMt Holder Date Teiepltong # S/W PLUMBING 700 Hvac ELECTRIC ELECTRIC Inspection Date Insp. Comments F°oti'p ' Foundation Framing Rooting Rough P16g. Rough Htg. Isul. Freplace ~~l Htg. o?sac Test Firral Plbg. Plbg. knspector - Not'r(y Plumber CT' Conat. Meter Engr./Pian 8'c'g.Fina' Deck Ftg. Dedc Final Well Pr. Disp. 3a~~ ~ J } *M:y .w. ~iY~r ' cate ~ ~ccu~anc~ • This Certi}`icate issued pursuQrrt to the reqeeiremeats of the Uniform Building Code certifying that at the time of issuance this stnrcture was in compliunce with the various orrtinances of the City regulating building constnrction nr use. For dze followtng: SF Df,1G 1752 Uae Classific.ation: Bldg. Pamit No. 0-4-Y TyPe 1_N.; - Z~ Discnct 7,y~e _1I]C~:Coost. 755 H , Owoer of Building Addms s~;wW nea= ~y L B, iJII1~CK ; 01/25/993 BaiWing official PUST IN A CONSPICCUOUS PLACE 5~08 ~9~ ~ . / ~O/ Request Det Flre No. Rough-in Inspection 1 qaq ? ? Reatly Npw ill Notiy Inspec~or es = No Whan n FeadyT I licensed contractor E:) owner hereby request inspection of above electrical work at: JW Aaaress (SVeet. Box or Route No.~ Giry SeMlon No. Township NamB or W. parvge No. Coun OcNp n~ IPRINT) Phane No. 1 ~ PifereNNIPPI, r Atltlress GtJwLJ Elec al Convector yCompany Namel - Can actorS ' nse No. C or Ow er Making Installalion Mailing Atltlress ICOnhactor_~ 4 Authonzee $ignaWre IConvacton ner Making Installalion) P o e b¢r , MINNESOTA STAiE BOA OF ELECTRICITY TMIS INSPECTION REOUEST WILL NOT Grigge-MWwey Bltlp. - Room S173 BE ACCEPTED BV THE STATE BOARD 1821 Unlvenity Ave., St. paul. MN 55104 UNLESS PROPEF INSPECTION iEE IS Phone (612) W24B00 ENCLOSED. I~4 REQUEST FOR ELECTRICAL INSPECTION es-o , ae 2 6 3• See insimctions lori`mpleling Ihis lorm on back of yellow copy, ~ 6i'~ ~ ~ "X" Below Work Covered by This Request ~ e Atld Rep. 7ypeofBuilding AppliancesWireU EquipmantWlred Home Range Temporary Service Duplex Water Heater Eleciric Heating Apt.Building Dryer Othec(Specify) CommJlndustrial Fumace Farm Air Conditioner OtnerlsVeciryl Co or e rk; Compute Inspection Fee Below: - # Other Fee # ServiceEniranceSize Fee 8 Circuits/Feeders Fee Swimminq Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Amps ' Signs Inspector5 Use Only: UO TOTAL ~ ' Irrigation Booms / I. Special Inspection ~y Alarm/Communication THI5 INSTALLATION MAY 8E ORD ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in ^ Det certity that ihe above inspection has Finei been made. - OFFICE USE'JNLY This rapuest voiE 18 monihs tmm Address 3686 wns.sPDox cam Zip 5512 3 Lot13 Blk I Sub WnLBROOK THESE ITEMS WERE / WERE NOT COMPLE'I'E AT THE TIME OF THE FINAL INSPECI'ION. Date: 01/25/93 Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway k' Permanent gas Sod/Seeded grass x TraiUcutb datnage flaer, N Dvy Porch x Basement finish x Deck Please verify with the builder the removal of roof tes[ caps from the plumbing system and the shuhoff of water supply to the outside lawn faucet before freue potential exists. Contac[ engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ~ White'- City Copy Yellow - Resident Copy Pink - Con[ractor Copy l PERMIT Co" o "o 1271 --C CITY OF EAGAN 3830 Pilot Knob Road PERMITTYPE: euzLosNe Eagan, Minnesota 55123 Permit Number: 001752 (612) 681-4675 Date Issued: 1.1 / 0 5/ 9 2 SITE ADDRESS: 3686 WTLLSROOK C`f L07: 1.3 BLOCK: 1 W:[LLBROpK DESCRIPTION: , ''Buildi`ng Permit Type SF DWG Building ,Woric Type NEW UBC Oecupano-y R-3 M-1 Conetruction 1~,ypr V-N / Zaning R-1 Buzl.tling Leng'Ch ~ 68 \ Building Width ~ 33 r. ~I j~~~~ REMARKS: C (j a I'~~~ 5& W CONTRflCTOR - LAKESIDE PLBG FEE SUMMARY: VALUATION $101,000 Base Fee $643.00 MISCELLANEOUS $1,610.50 Plan fteview $917.95 COPIES Surcharge $50.50 Total Fee $3,422.95 SAC $700.@0 SAC ~ 100 SAC Units 1 SubtoT.al ~ $1,811.45 CONTRACTOR: - Rpplicant - s7. L7cOWNER: SUNf2TDGG HOMES INC 16858245 0004962 SUNRTDGE HOMES INC 755 BRCOLE RIDGE RD 755 BftIOLE RIDGE RO EflGAN MN 55123 EAGAN MN 55123 (612) 68e-3205 (622)6e8-8245 I hereby acknowledge that I have read this application and state that the infiormation is correct and agree to comply with all applicable StaT.e oP hin. StatuTSS and City of Eagan Orclinances. L - -~.bqA &n.i1I m,~1 PPLI NT/PERMI7EE SIGNATURE ISSUED B: S NAT E INSPECTION RECORD C°n` ° 1271 CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Knob Road Permit Number: 0017S2 Eagan, Minnesota 55123 Date Issued: 11 / 0 5/92 (612) 681-4675 SITE ADDRESS: APPLICANT: LpT: 13 f3LOCKe 1 3686 WI4LBROOK CT SUNRIDGE MOMES INC WILLRft00K (612) 6$8-8246 PERMIT SUBTYPE: TYPE OF WORK: SF OWG NEW INSPECTION . FOOTING FRAMING TNSULflTT.ON FLNAL FIREPLACE REMARKS: S& W CONTRACTOR - LAKESIDE PLBG F - L PERMIT N CITY OF EAGAN REacrA14irE = 1992 BUILDING PERMIT APPLICATION 681-4675 ocr s RECo SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy.calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or lot chan e is re uested once ermit is issued. Date /.}d / Valuation of work zpep Site Address:3t~ e6 (,rJ, Aro'ik 6::)'C SiREET SUITE M Tenant Name: (commercial only) LOT ~ BLOCK / 1 SUBD. P.I.D. M W / !~J Descri tion of work: The applicant is: Owner ~ Contractor ? Other (Deaeribe) Name c. Phor~e.C~Fr-~a5'S Property LAS1 F,a T Owner pddress ~75s &I)le fi,~~,,p ~J SiREET STE R City YState lil Zip a;'/a~ Company ~i9ivr 2 Phone Contractor Address License #Exp. 13 ~2 City State Zip Company j~ Phone 8~S'5`7 '>O Archltect/ Engineer Name Registration # Address City State Zip Sewer 3 water licensed plumber ~S ~ . Processing time for sewer 8 water permits is two days once area as een approved. 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 Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~ OFFICE USE ONLY „ . . . _ BUILDtNG PERMIT TYPE O 01 Foundation O 06 Duplex ? 11 Apt./Lodging `00104f6 tas ent Finish J& 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool ? 03 SF Addition p 08 8-Plex ? 13 Garage/Accessory ? 18 Comn./Ind. ? 04 SF Porch ? 09 12-Plex ? 14 Flreplace ? 19 Comm./Ind. Misc. ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility ? 21 Miscellaneous WORK TYPE J!f 31 New ? 33 Alterations O 35 Tenant Finish ? 37 Demolish O 32 Addition O 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) Y- N Basement sq. ft. MWCC System yt'a (Allowable) = T Ist F1. sq. ft. City Water ~ UBC Occupancy R-1 M_ 1 2nd F1. sq. ft. PRV Required Zoning ~ Sq. Ft, total Booster Pump # of Stories Footprint Sq. ft. Fire Sprink ler Length On-site well Census Code Depth On-site sewage SAC Code ~ APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS O Site ? footing 0 Framing O Insulation O Mallboard O Final ? Draintile ? Fireplace Permit Fee v.a.cim: g f DI , 4 DO Surcharge ~sqRAGE; Q6KZa~ ~ I Plan Review K $ 32a MWCCnSAC City 5AC Nater Conn. 3 Z Nater Meter , k Y = Acct. Deposit ~SY ~Lc;d{zJzq?~ X l"r o S/N Permit ..r.~..~. S/M Surcharge $SMT~ ~y~~ Treatment P1. Road Unit 46~ 6q Park Ded. 1'l2 n1t ~ 16 Trails Ded. OtKers 13111 x 53~= 92~ 9 g r ~ Total: 164'3l SAC % O1, SAC Units NQV,04 1,92 68:11 TO 612 691 4612 FROM PROBE E1JGIhh7EERIN'a T-554 P.02 w>. . Sv~RIDbE ~"toMeS CONf111TINp !Mp~M !Rf E PtRNNEBi md LRNO fYBYlYONf ~ 5376. D/ 8K. 187 ..,~MAt#~IY, INt. 1000 9A6T 1481A BTRBBT. lNpN8Y1LL6, MIfdJESOTA 66337 PX 43203000 • CERTIFICATE OF SURVEY te al~ ~~Descrlption: LOT 13 BLOCKlo WIGLBkA~K A~/T/O~V, . , - Odf/nTd l~J1vJA/~ AA(~/A/FSaTd. - - DENOTES EXtSTINO ELEYATION 019.o ) DENOTES PROPOSED ELEVATION - r INDICATES DIRECTIOM OR 8URFACE DRAINAG44 9i9,33 = FINISHED GARAQE FLOOR ELEVATION /9 d, 3/ = BASEMENT FLOOR ELEVATION /9. 66 e 70P OF FOUNDATIOIJ ELEVA710N BCALC : 1' - 90' (110.b N 89° 30' 03" bc/ ' Cp~.~j ' ~i?o`~i 158.46 > U71GtTY C4SeNtEti/T LJ l ~-OT 13 ' I ~ ~ \0 a14 i "~p~• .~~~y `'w` C ~ . ~ \ ~,~~,oJ ~ ~rG~ ~ Q H o0 5 ~ 1'°~ ~$ay 9 / ~,/6,0~ ~ • ~ ~ q~ ~ '.L~6•~ ~~+l`~ { ' . . [.~~.z 40 pl~ d~ - A -~,96 o y2 _ '~~4~ SO,~ , •6a ~o ~ ~ ~ qh.e'~ ~ , .N f I ti WILLRI~AV~C $,AC3A11T IE1VGIAIEERIRIG DEPT COVRT ~ ~,~T. fRa.vr ~vitoi~vB • ' ~ 9ETOWCK LiNE .I•.uhereby aertiPy thab this is a true and correat representation oE_q , traat oY shown at?d desaribed hereon. 3?r grspaYed by ms this,4ay;;oE . , : "'%I%V. ? 19,it_ Minn. Reg. No. AV' • ~'"R=96% ` 612 432 3723 11-04-92 09:04AM P0021t2~~0~ fXTERiOR EtIYEIGPE AVERAGE l'W" COMPUTATfON~ ' . , . , . . ' oH~,E~: . ~ ~ i,;~~1~10' ?5~12~~ ~ ' S!'it'ADDRESS: LoT Tt_Oe,K I ; "wl a+rTru?To,R: ~ ;~Ircr-+oRS6-- 'LL~t.d~1F.~1'a?Te:' 10-2~•-q2 Pr~a1rE: : . ~ . . . nw~~ . . . ' . . ~ pETERMINE VOItKIfIG 54WW f00TAGE OF EACH: . : . . . , TOTAL EXPOSED,NALL AREA........ w ft J4 "Y" • II ~ ~'I •i5. ~ ~ , 7oTAL Roof/cEiL. rNC ARFA........ sa~ ti TOtA E4POS.EO 41ALL AREA CALCYL'ATIONSi . . ' , • , ~ ' 7otai exposed wall . , , . 1' r'. • ~ •fCi ibQV! f IOOf...... ~ i ,Ip 't • , . • . Total wall window srs,a: ' . , $q . f . • . ' ~ . : . ~ ~ . : . ` • . , • ~ • " gl~zed......' ~ ' • fq ft x ifun . „ , . ~ ~ . . : , . : , ' b), ToRel dogr area sq f t x"{I" .-5 ' . . . , ~ . . , . . . , , ~ c). 7psa1 tl idin9 91a:s doo' arsai . ~~,''r , , , . . ~ ~ glazad...:... ' • ~Q~ ` .,ia ft• x • ulia , 'J~^^ _ . ~w~ 1:: 2O • ~ . ;.iui...¦ .ii .~.~.~w~~. . • Alusd......• , . : f9 ft x d) Total firoplacs wall aroa .sq•ft x• "W' • ,'J~ • • ~ • • ~e) 'Tocal wail framing area • . , ' . : . . , f1. , , • ~ , (Averaga lOR) ('72.. ' iq ft x .uUn ' ' • Y~ • • a2. ..i.~..~~ ~ . ' • . . . . . . , . . f) Tota) rtat wali area abova , , ~ ~ . . . , . ' ~ • . ~ ' • floor (Insu;lated)......._ LSH~ sq fe x1.11.1" •.~`~3• R,~,~g~2.~S~, ~ 8), ~Total rim joist area......~._ (Cod sq ft x"Y" ~.D fs• 2 , • . . . . 7ota1 foundatton . • ' . • • • dfoa•(Exposad).......... 'Q5. ~ ;q.ft • . . . . ~ . . . ~ . , . . , , , , . . h) . Total fouadatfon , . ~ . ~ ' . Nindaw ~rea...~........•.. ~ . . sq,ft.x folln ...~..,t.+~~ ~ - • , 1) fiotal net foun~ation. " . . , , ~ . , . . 4+'ea above arade:....e., ~ iq ft x!'U" + ~~.rp_. ~ . . ~ . . . . .~.~~...r.~.,.lA~~•~ .TQTAI. a) t6~u'1} • • . . ~ ~ .4 . . ~ . - ' ~ ' ~ i ' , ~ ' . - : • , (f.~ltom 9; is the sane as, or lqss tha,n itoa N1~ yop.~have mat'thR,intad0.q.f . S.D.C,..Sact(on 6006 (c) 2. ; . , . . . ..1. 1~1 ~ ~ i N C'~ ' i~! ,-~l, •i'! •~,S'Mi. , . . . . . ' . . ~ 1 \ } , ~ r ..K . . . . , . . ~i. ~ ~ •i. ~ . , ~ . . . - ~ . . ~ . ' , . . . . ~ . . . . . ' • - 7GM PPOSED ROG:/CEILIYG ChICUTAI'IOtIS: ' . Total oxpased . . fq ft , • . , . Tots1• skyl ich: area..........;,.~..~..,~.fq ft ~ ' , . . . . ` i. • k~ Total roof/ccsilinq frsming • sq f t x~'Un .02 w 3 . 109:)...... ~ •rea U,varaaa 3~ ' 1) 7ota1 net insulatad .02'L' w 2?•2T> ' rcof%ceilino area........ 2 O. ~q ft x. . . . ' • , : , TOTAL thru 1 ~ If totil of t4 is the sar•e as, or tess xhan,r2,.yPU hava met ths intent o S. B. C. 5sct i,on 66Q6 (c) 1. . , . . • ti . . . . ' : • . . . ~ . , • • . . ..~.5_. ~..b.:~ ~ ~ 4.r'M j . : . :~1~.r~ . .e • , . . . ~ ~ . j , . ~ •i. . , . , ~ ~ ~ ! . ~ . ~ • . ' ' . ' ~ , ~ . . ~ ~ : ~ ' . • • . , , ~ . • ' • . . •-AL`TERtWTE 40; 40.INC,~ ~ PVELOPE OES I Gtl . ' _ . • • I, 7o utTlize thn totst envslope systam msthode~the valws establtshed by ths iw of itams 13 +u+d 44 ihall 'nOt bs $f4iNf RhM thp iWA Pf tsloi. and IZ. ~ ' ' 1.• t 2., ~ . . ~ • , . . • " I 3 ~ • b., . . . . . • , , i . . ' . ; ; ~ : . ' ~ ' , " • : 'i , • • . . . • ; . .i ~ ~ . . '.t.. . . . ~ . . ' • ~ . i . • • , ' ' . . . ' . . . . . . ~ • ~ ~ ; ~ . . . . , . . . . • ~ . . . • , ' CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD ' EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT ow DATE: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS b TOWNHOMES/CONDOS WHEN PERMITS AR.E REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLIAWING: ND. FIXTURES EA. TOTAL NEW CONST Y ADD-ON MINIMUM 15.00 ADD ON a2 SHOWER 3.00 .4.w REPAIR 3 WATER CLOSET 3.00 5.~ _L BATH TUB 3.00 .3 LAVATORY 3.00 OWNER NAME: hld///~NcR1."~ OGl~L~ l KITCHEN SINK 3.00 J :a / % LAUNDRY TRAY 3.00 Li ~ SITE ADDRESS: 31• p~ r e/l HOT TUB/SPA 3.00 1 / WATER HEATER 3.00 3. IAT:~ BLOCK L SUBD. ~m,,k 7 FLOOR DRAIN 3.00 GAS PIPING OUT. c). •u INSTALLER: 3 (MINIMOM - 1) 3.00 ROUGH OPENINGS 1.50 ADDRESS: ~~3~6/` „Zi,?/r.~.? ~~/G SU _ OTHER WATER SOFTENER 5.00 CITY: ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE rFSS~•~b~ yo~ •W SUBTOTAL $ ST. SURCHARGE .50 I ATURE OF ERMITTEE TOTAL: S yd ~tiMf~lEA~ZALfiNDO~~'&IAL:: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE s $.50 FOR SITE ADDRESS: EACH $1,000 OF YERMIT FEE. ZAT: BIACK _ SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 18 $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN CTI'Y OF EAGAN cITY USE ONLY L„[5- BMECHANICAL PERMIT RECEIPT # SUBD. . (612) 681-4675 DATE_L- RESIDENTIAL PLELSE COMPLEPE UPPER PORTION ONLY FOR SINGLE FAMIILY DWELIdNGS. AiSO, COMPLEfE FDR TOWNHOMES/CONDOS WHEN SEPARATE PERMTTS ARE REQUIRED FOR EACH DPVELLING UNTT. OWNER. ADD-ON A/C ADD-ON FURNACE? SITE ADDRFSS: ADD ON/REMODII. (EJIISTIIdG $ 15.00 CONSI'RUCfION ONM INSTALLER: CL J~-~ ~(o HVAC: 0.100 M BTU &We,> 24.00 PHONE 25c( - L-1ENP~ ADDITIONAL 50 M BTU 6.00 ADDRESS: 3' 7 GAS OU17.E15 - MINMUM 1@ $3 EA. g,da crrr: AloucLcie zm:5'~`3nC~ suxcHnxcE: $ so SIGNATURE. TOTAL: $ ~C NO PERMIT ?2EQUIRED FOR DUCTWORR ONLY! COMMERCIAI. PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAUINDUSTRLIL BUILDINGS. AISO COMPLETE FOR APARTMENT BUII,DINGS OR OTHER MULTI-FAMILY BUII.DING5 R'HEN SEPARATE PERMTfS ARE NOT REQUIItID FOR EACH DWELLING UNIT. R'ORK DESCRIPTION: CONTRACT PRICE FEES 196 OF CONTRACf FEE. STATE SURCAARGE IS $.50 FOR EACH $1,000 OF PERMIT FEE. $ PROCFSSED PIPING . $25.00 a rnxMuM FEE - $25.00 OWNER: TOTAL: $ SI1'E ADDRFSS: TENANT: SUITE , INSTAI.LER: ADDRESS: CY: ZIP: CI1'Y SIGNATURE: Use BLUE or BLACK Ink For Office Use111! 1"' �j ::::e:' City of Eaa� l O 5 3830 Pilot Knob Road Eagan MN 55122 JUL 17 017 Date Received: 7-1,2--17 Phone: (651)675-5675 Fax:(651)675-5694 Staff: 2017 RESIDENTIAL BUILDING' PERMIT APPLICATION �-7 Date: `-�9 1 7 Site Address: 0 0; '(J9r () k C1 Unit#: ,J t• a Name: /tut f dimly/ Soh` I Phone: Restd ty/Zi 61 6-c44121--- 41A1 r'23 Address/Ci --,/4 l ��w�er � � p: 1 fif/a Applicant is: Owner X` Contractor Description of work: =CtT�Il ker - j jJ.r',144�r Type ofi ork Construction Cost: / 2C Multi-Family Building:(Yes /No ) Company: !{,�} /� /r 1 k3/ni J 4A?C2 ll-( , Contact: it Address: s g LA447- City: Contra{ r 6 7-. C23 State:J/4 Zip: TZ=4 Phone: Email: re-Ad/et (� .44'4C License## ' -1.5"3/6) Lead Certificate#: If the project is exempt from lead certification, please explain why: 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: ': 'to bev'" blic information P ion. NO�Eptans and stp ng ® • s that ©u submit" ar :conse, t in ormati•n may ®e cla t t l as non#• lc If provide specific reasons that ® permit the C! ► ' wea"" conclude:t are.t'r, d ,,'ecr t, v; aM 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.00pherstateonecall.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 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. Applicant's Printed Name .pli•.nt's S'•na re Page 1 of 3 For Office Use ,, 4 : f : , Permit#: ,, E AGA N 0 RECEI S Permit Fee: MAY 3 0 2018 Date Received:-5-'- e IS 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 i FAX: (651)675-5694 Staff: buildinginspectionsacityofeagan.com L i _.. 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 30._/g Site Address: 14r - Cr Unit#: Name: /LX , , SG,fl4i 6.97-475-- Phone: `° 5 Zit RResident/ / * Owner Address/City/Zip: k48 oia-m'e .. G'`T 9(f/ ,49,1 X5723 Applicant is: Owner VContractor __. _ /S /A/1.4/A/1.4 ola“_'S Description of work: GJLn%iJe4�. 6tmw S' Z-( o '. f'/5.- Construction Cost: /0,0 0 .fid— Multi-Family Building: (Yes /No ) Company: / ,,ion jt-174:11 (r/kl/ /17 Contact: ,IC AI , /TEl#9 Contractor Address: Lra9 wilyCity: ” I State: 4lN Zip: Phone: 4S/-2X3'-X02- Email: j'414/e1 ../es License#: 575750 Lead Certificate#: If the project is exempt from lead certification, please explain why: i. / .. geeZdrAlc- .,g 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: I Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: I NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-•ublic if ou •rovide s•ecific reasons that would •ermit the Ci to conclude that the are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaqan.com/subscribe. 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. 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 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. i 4 Applicant's Printed Name App' s Si. atu