1013 Trillium Ct
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued: ~
(612) 681-4675 -
SITEADDRESS: APPLICANT:
t 140 ~ I C'i t 1 1•. f A1 It I 1:I. 1 t I ~iI I .
? I. I tl~, I 11I1 1 1~ 1 II I t I ir I'~ , i j
PERMIT SUBTYPE: TYPE OF WORK:
' i ..11i, 0; I i '
INSPECTION DA • DA
i W.111 A i I iiPI I 1 ~ I t I,1~ I
t.,111101 1 N }1 1,,
i I hlr~ I I~ I fi~r I I f~111
~•I 1~Ir~1;t I! 1'l till Ml 1.1t1WF11 f' Nl 1111
I ~
~
P~?mk No. Pormk Noldsr Dab Tebphane #
S/YV
PLUMBING ~
HVAC
ELECTRIgO,
ELECTRIC
kapectlon Qats huP. commsnts
Foofirw I J!` Qy
Foundetion ~y`i[~ , ~ ~ / •d •~d~'
Framirp
a°°m,9
v t y -
Rm* Plbg.
Rou9h Ht9. '
l5ui. '~y p
7
F~reptace
Final Htg.
Orsat Test
Final Pbg. Plb9• lrepecta - NofiN Ptumber
Conet. Meter
EngrJPlan
BIOp. Finel
Dedc Ftg.
-ftdkool ~ / JS
VY811 Wov rr /r JS 40eT/v xY
Pr. Dlep. ~/(/~j~. •
~
~ usE oz~..Y
$L ~~~EEPT
.
su$~~~'~,. nAIT v. . .
1994 PLUMBING PERMTf (RESIDENT7AL)
C1TY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTI'.
NO. FIXTURES EACH TOTAL
_L SHOWER 3.00 ~
-r'Z
WATER CLOSET 3.00 ~
_L BATH TUB 3.00 3
'Z LAVATORY 3.00 `-C
_L KITCHEN SINK 3.00 3
/ LAUNDRY TRAY 3.00 3
HOT TUB/SPA 3.00
~ WATER HEATER 3.00 3
_L FLOOR DRAIN 3.00 ~
~ GAS PIPING OUTLET • minimum - i 3.00
~3 ROUGH OPENINGS 1.50 , r
WATER SOFTENER 5.00
PRNATE DISP. • Dak.Cry. Im. 20.00
U.G. SPRINKI,ER ' home under const 3.00
ALTERATIONS • to oasting 20.00
WATER TURN AROUND 20.00
37. yo
STATE SURCHARGE .50
TOTAL:
SITE ADDRESS: O3
OWNER NAME:
INSTALLER:
ADDRESS: ~ z ~
CITY:_ ~~~~~'/o STAT'E: t ZIP CODE:
PHONE
A/z
SI ATURE OF ERMI EE
: N 29742
Repuesl Dale I I ne No. RouBhin Inpaonron RepwraC Inspetlbn Other Than Rougb-In
zg(YOU mu wll mspectar w N~ n reatly) ~ qeaEy No+ ? WiII Nolly In50ector
Ves 0 Dal¢ FeaE
I,X licensed contractor ? owner hereby request inspection of above electiical work at:
Job Atlmess (SVael Box or RoWe No.l Ciry
Ca C A/
Secuon no. rownsnip Name or No Range No Counry
OCLUp ~ PFI TI PM1OnB No Power SvopLBr ACtlress
70.?
EIecURal Conlraclar ICOmpdny Name) nlraqor'S L¢onsa No
U~'~tls'qu GEGi c Cxd A~Z
MdJing AOOress IGOnhaClor pr Owner Makin Ins1alWLOnI
Autnonze naWre IL :ratlorA.vner Maiing Ins:allatiory Phone Number
MINNESOTA STATE BOARD OF ELECTqICITV THIS INSPECTION REOUEST WILL NOT
Gnggs-Mbwey Bltlg. - Raom 5-110 BE ACCEPTEO BV THE STATE BOARD
1821 UnlversHy Rve., 51. Paul. MN 55104 UNLE$$ PFOPEF INSPECTION FEE IS
Phone (612) 601-OB00 ENCLOSEO
1,111f REQUEST FOR ELECTRICAL INSPECTION ia ee.p/o~om-os
~ Sae inslmctions lor completinq Ihrs lorm on Oack ol yellow copy 1'
_'~u_ Io! / v
C~ 29742 . '"X° Below Work Covered by This Request ~•~..~v'ew Atld R erl Typeof 6mltling AOPhancesWuetl EquipmentWiretl
~HOme Range Temporary Service
Duplez ]Water Heater Electric Heating
~ Apt Builtling Dryer Load Management
Com./Industnal Fumace Olher (SpeCiTy)
Farmm Av COnditioner
Otner apentyl Comracior5 Remerks,
Compute Inspection Fee Below:
# Other Fee # Servme Enlrance Sze Fee # Circmts/Feeders Fee
Swimming Pool 0 to 200 Amps 0 m 100 Ampsl::gr
Translormers Above 200 _ Amps Abov 00 _ Amps
Sig05 Inspector'sUSeOnly.
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALlATION MAY BE ORDERED DIS ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MON N. f
I, ihe Elecirical Inspector, hereby Rooqnm
certify that ihe above inspecuon has F,,,ai oa~ ~y
been made. a
OFFICE USE ONLv
Ths repuesi wiE 18 mamM1S Imm
PERMIT c"Aa
CITY OF EAGAN 10~jq'~
3830 Pilot Knob Road PERMIT TYPE: B u L N G
Eagan, Minnesota 55123 Permit Number; 024781
(612) 681-4675 Date Issued: 10 / 2 7/ 9 4
SITE ADDRESS:
1013 TRILLIUM CT
LOT: 9 BLOCK: 1
LEXINGTON POINTE 10TH
P.I.N.: 10-45094-090-01
DESCRIPTION:
Bilding`Permit Type SF OWG
Building Wo,rk Type NEW
,-UBC Occupancy\ R-3 M-1
Construction Type V-N
Zoning - , PD R-1
euilding Length ~ 45
~ Building Width J 51
Building stories 4
" ~5quare Feet 1,710
~
~
~
i
C~r,~~~::~1-
REMARKS:
S& W PLBR - MCDONALD PLBG
FEE SUMMARY:
VALUATIOIV $123,000
Base Fee $720.00 MTSCELLANEOUS $1i828.50
Plan Review $468.00 Total Fee $3,878.00
Surcharge $61.50
SAC $800.00
SAC % 100
5AC Units 1
Subtotal $2,049.50
CONTRACTOR: - Applicant - sT. Lrc. OWNER:
MITTELSTAEOT BROTHERS 14569125 0003443 MITTELS7AEDT BROS
785 SUNSET DR 785 SUNSET DR
EAGAN MN 55123 EAGAN MN 55123
(612) 456-9125 (612)456-9125
I hereby acknowledge that I have read this application and state that the
infiormation is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
I- J
APPLfCA 4 /PERMI ~4 ATURE ~t~Ul. ~.PAUA.II~I
` CITY OF EAGAN
2"W9 1994 BUILDING PERMIT APPLICATION
681-4675
~
SINGLE & MULTI-fAMILY 2 sets of plans, 3 registered site urveys, 1 copy of nergy
calcs. ~ i 2 4 1994
COMMERCIAL 2 sets of architectural & structura - 1-ans,-1_set 9,f_
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date XQ /~2 e,-7 Valuation of work
Site Address: 411 '3 72Zlc.c~/~xr
STREET SUITE k
Tenant Name: (commercial only)
LOT 47 BLOCK ~ SUBD p Z,D. #
/
Descri tion of work:
The applicant is: ? Owner ~Contractor ? Other (Describe)
Name Phone
Property LAST FIRST
Owner qddress
S7REET STE #
City State Zip
Company 7- , Phone `~SPs~i~ 5
Contractor Address License # 34/4=3 Exp.,9~
City State /WW Zip
Architect/ Company Phone
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has 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
BUILDING PERMIT TYPE i ~
s
? 01 Foundation O 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
JZ 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex O 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. 0 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
(0~31 New ? 33 Alterations ? 35 Tenant Finish O 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) ~ Basement sq. ft. 5-30 MWCC System K
(Allowable) lst F1. sq. ft. pRVyReWater
UBC Occupancy 92nd F1, sq. ft.
quired ~
2oning Q D/a a Sq. Ft. total Booster Pump
# of Stories yC~ucc fP~,r Footprint Sq. ft. „/1n°' Fire Sprinkler
Length y5' On-site well q,~ 6 .p Census Code
Depth r7 On-site sewage Iz, SAC Code 0/
Census Bldg
APPROVALS Census Unit i
Planning Building Assessments
Engineering Variance
REOUIRED INSPECTIONS
? .Site E~) Footing 2:-Framing .Q Insulation
? Wallboard E~-Final ? Draintile ? Fireplace
Permit Fee vetuaci«,: g ~Z~,aoo
Surcharge
Plan Review
License /Y/R1,
~ s...r
MWCC SAC
City SAC
Water Conn. Z& x ys
Water Meter Czx
Acct. Deposit zz~
S/W Permit
S/W Surcharge
Treatment Pl. yx z y " 9~ 7 950~
Road Unit = 7 l2
Park Ded. ~ n 7 ~Trails Ded. ~ ze yxsy= yzx Zo = y~l~
Copies ~p Zzg~
Other Co~r~«~°
Total : (oS~
2 4 x 2'1 - yL 8 x!6 `
5AC % , x 8 - Z y ,
SAC Units 7zo ^ 5yDb
~dr~-~ ~zz,~o~ _l
i`
, .
LOT SURVEYS COMPANY, lNC.
LANA SURVEYORS
_ At0291'FRyD UNAER L,ANS Ot' 9TA'I'E 0il MWfit9= .
7607-73.d Aw. No, ~ IM+OIGE NO. 38753
INDUSTRIAL - JUDICIAI. "AMAp0116, Minrr"pto 55119 F. S. NO. 680- ]
COMMERCtAI,-70POGRAPHICAI p~ SCALE 7'• 30
CITYLOTS-PUITTING p~12Y~1r~TLIrb ~,;.eI-}jfirjttv
0 - OENOTES.IqON
_MITTELSTAEOT BROS. COHSTRUCTION ~ .
Type of Building -
n Denotes Waod Ftub Set For Excavation Qnly,
Denotes Surface Draina9e '
non,a Denotes Proposed Elevation Proposed building informatiort
c~n,o Penates Existing Elevation must be checked vith approved
huilding plan hefore excavdtion
! and Gonstruction
Property AdAress
1013 Tril)ium Court '
9836 1((-
~4
~
~
/
~ ~ .
v r ~ o y
,i • +p . •V ~ ~•182.8 ~t I :cpt9)y co
_.5l
1j
-17 V 0 2 ~ \ Pid. 1~
t. v C p il e as,.o0~` .lY
By 01~1
D
9&2. ~99To S~~k. 0
~
]EAGAN ' IGII~EERING DEFT. 3
o S _ i J
N I _ r a qs'~g ~ c~l• \
9~n C~ Zs~ sy
Proposed Top of Rlock Pr os - arage F onr Prnposed Lowest Floor
98 3~~ 78 Z 9 75. 7
'~'rn«+bYarttrymuviau~au~~„d~~~~ Lot 9, Blnck 1, LEXINGTON POINT TEN7H
ua, er a surv.y ar sr» eoune~n~a w m• aoaw e..cne.e /J DDITION ~
1~nd and tn• locallon ol ~II bulldlnpa ¦na rislDl•
~^~ch~nta. If arry. Aom or on a4a 4n4 !Lt~i~1L_.G7L ~ o[-~~
SU•wr~a by „s mw 21sta,y 01 October ld 94 ga oad A .
Ptescli, Mian. Rag. Na 67s3
LOT SIIRVEY CHECRLIST FOR RESIDENTIAL
SIIILDZNG BERMIT APPLICATI
pROPERTY LEGALt
~ Dat• of 8urvey. ~
DOCIIMENT BTANDA 8 -
F 0 • Registered Lnnd Surveyor signature and company
~ • Building Permit Applicant
F0 • Legal description
m~ 13 • ]laaress
~ 0 • North arrow end bnr scale
IDi0 D • House type (rambler, walkout, split v/o, =plit entry,
lookout, etc.)
@~p 0 • Directional drainaqe arrows vith clope/grndient t.
0 Proposed/existing aewer and water cervices
d Q • Streat name
0 0 • Dzivevay
ELE9ATIONB
Exietinc
0 • Sewer serviee
) 0 • Lot corners
[Y~ 0 • Top of curb at the driveway
Id~ D 0 • Elevations of any existing adjacent homes
ProooaeQ
• Garage floor
~ 0 • First floor
~ 0 • Lowest exposed elevation (valkout/window)
D • Property eorners
D 0 • Front and rear of home at the foundation
PONDING 7?REAS (if aflnl3cab1e)
D 0 0 • ~ement line
D D D • HwL
D • pon9 i designation
D 0 • Fmergency Overllow Elevation
DIME108IO1t8
Er-A~ 0 • Lot lines
0 • Right-of-way and street vidth (to back of curb)
D D • Propoaed home dimensions includinq any propoaed decks,
overhanqs greater thnn 21, porches, etc. (i.e. all
structures reguiriag permanent lootings)
BID 13 • Show all easements of record and any City utilities within
those easements
6'D 13 • Setbacks of proposed ctructure and setback of adjacent
existing homes
13 D • Retainitsg wall zequirements, if any
AW,
Reviewed: er ~
Na e / ate
Ottober 1992
STA 4+45 I
sTA 4+77 1 W -r-, ; '
w-~1'f" y.i C~e
S-969.7 ss~0
'i 12
I(J 51.f l i ~ SF,'p
I 117.80
S TA
w y
' - STA 4+87 17_20\
(-1 w-979.ee 7NH ELEV.982,53 -970.0 47.30,
~ ~
fFF 8 fIY~~.~~
g ,ro' / 3p~ F~~U.Lr. I MH I -
; CL-52 S?!1 5+03-,-=- -
44.90
STA 4+82 46.60/
'.P.C .
Y r
~y ~-970.0
/ `•c ~ STA 4+55 ~
~J ,1~J~/=4f~(-1:C~-7~a'..o,-•~r:~
~ STA 4+7
~ 2
N!-97g.6
S-969.6 ~J
.n ~
" ~ .
il~ \
. . \
TRiLiui
NOTES:
AI_.'._ SF_RVICFS qF2E F.=.~'1F.NUEf` I,`i
t.. ~
GIi'1~
F-.~•i~l!'~/k~:V i~ l'.~..~. 1.~1~i:`~TIO1.5 LO'1- TO BE SFRVICFC`.
1"1 ``-fln, 11LL ldl1TE?t; ;c:l~`/ICE ; r~17F UF I. ~ YF
r~'~Y10.`~;•... . . - ~
' ~ A~ L...SrlJ~t~7,li~'r'..S.F'iV F~:.5~CF~.
J:. PUf~PQ;._.._ FR~/
UIarnFrFrt F•Vc: ~
IT SHOUL
, 1 t~1DICATr S S;1fdITAF?Y ~F'1JFR
' El_FVATIUPJ Q'[ ;''fiOFFRTI' LI!•!f",
" .U . Ih1DICa TES Ei_._vA-riori n;.i
,
:,nE 0` 1.. -Yz;~
_ nc=
•1-1....S:~~.lv-.-,.~_ .7t. :
. ;
kPl-TE-R ?~VC SDR-20-
!NDICaTFS i:1i4ITARY SE'JJER cz^R\/Ir.c
_E VaiION A''n0°ERTY LI;J=.
..W" InDICG,fiE-c E! EvaTioh 0; : -G- ; = cuR5 sTOM csox.
. . . .
.
p~-~~
-
.s . . .e K
_ . . . ° . : . . . - , . _ . . ~ ~ . .
5:,~ ~~S.S'~ ~
. . . ' J~ . :.J 1 vriY OF UTILI I'r
f-.:.'"~i~' r'1''710i~0. T{~15
PUR?OSES 0'':`t H;dD
Pr,:q:;'.:. , L:.~ING IT SHOUL THE
' r-.'~ITE.
Mn o
~TL =•c~°.~C ..,.9H 15
TC STA 2•2,; 9.33.OC ^;T., :
~ , -TC n' cl-i.B.b..... . . 9 77.03 T ` 4
7.5 1'r'. 7 7-i
540! LF 6" D.I.F?_ CL 52_
,
. .
.265 -70
PVC SDR O.GFi%..
~
INV -~c~Ei? 96e.54 : 224 LF 8" PVC SDR 35 @ 303a, w
: =
5TA 5•I6 (L) _ 3.05 ~ ~
96b:78 INV -014~ f
STA 2~50 lU :
. ,
INV 9oE
,
S_
~ .
i
r
OCF+26-'94 10:03 T0: 612 681 4612 P02
. .
" (30LiC6N1(1G lYI uJrrH
LC K PAsJOe'A ~ Ad 4.&?6~.
' I
' II
i
ZSi••• epTA F. t7 GY CQDF. - LTERNATZVE CabtPLIAHCE
'This torm is only appliceble Co detaChed one-and-two lamily dw011irige. Tha
sai[uiramente herein are basad on amanded section 502.2.1.7 in liau of the
ariCeriO sgeclliea in SscCions 502.2.1.1, ,2 and .3.
Building Address: ZOQ13 ?12.ie..c_/f~~rLlLT
Cantlractor or owner c I' +-g'i'e *4 r illimwgua 4-P-&2!0Xi--
Buildina Element "E" Valuas Area lsif tt1 g of Ext.Walls
Ceilinqs pesign Required 3.8
walls+ (exterior) Dasign 27-Aequired aQ 25o'L
(without lounziation)
Ploors+ Design,XAaquired 12
(overheatsd cAaces)
` Wlndovs** Desiqn3_1Required _I OL
Foundatlon Walls Deaig 1 iRequired 11
(when insulatinq Eull depth of Poundation aall)
' aesiqn.'Gaequired IQ
(Whan insulating only to frost depth a footings
extend belov)
81ab-On-grAde DesignJ O Requirad 8.83
Ploors
Daors Design 'Required _I
Eogtn9tei:
For the insulated cavity of opaque walls, floora, and rim jpists.
Maximum window area must nok exceed iz peraent of the area of
exterior walls, not including foundation valls.
CERTIFICATION
I haraby certify that I have comgleted ths above intormatloh and that it
complies wlth tsinnesota state Energy Code,
8iqnature ~Datet.
r
R=94°ti ..-..'10-26,94 10:03AM P002 #12
r~ usR Oa~~.Y
. .
~ : AL ~~EIPr*—~,.:
1994 MECHANICAL PERMTT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
X NEW CONSTRUCTION
ADD-ON AJC
ADD-ON FURNACE
FIREPLACE INSERT
DATE _ 1 Z` Q-q4
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00 1
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ~ oc) ~
ADD-ON/REMODEL (ExISTING CoNSTRUCI'ION) $ 20.00
STATE SURCHARGE .50
TOTAL 60 - ~
SITE ADDRESS: I O l3 -Cr~ U~ l~M ~A r-l--
OWNER NA1v1E: 0 II-~Z~°~~eC~~ 1R~lsklho,re TELEFHCNE _lfxO -q I4,~_)
INSTALLER:~'e..71j1xQ 4 m 1
ADDRESS:_
CITY: STATE: M ln . ZIP CODE: D7~&7g
TELEPHONE
SIG TURE OF E ITTEE
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1013 Trillium Ct
Lot: 9 Block: 1 Addition: Lexington Pointe 10th
PID:10- 45094- 090 -01
Use:
Description:
Sub Type: e- Siding & Windows/Doors
Work Type: Siding & Windows /doors
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 6,000.00
Contractor:
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $6K
Surcharge - Based on Valuation $6K
Construction Type:
Occupancy:
Permit closed without required inspection(s). Letter & correc
on notice sent to applicant on 8/5/09. (pf)
Expired Permit - Closed w/o Required Inspections. Letter sent to homeowner 1/15/09 pf
$132.75
$3.00
$135.75
Owner:
Soma B Narasimhulu
1013 Trillium Ct
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Building
EA082693
04/23/2008
ePermit
- Applicant -
Use BLUE or BLACK Ink
r-----------------I
I For Office Use /
City of Eap Permit ~ I a
I Permit Fee: ~V5
3830 Pilot Knob Road i
Eagan MN 55122 Date Received: l I
Phone: (651) 675.5675
i
Fax: (651) 675.5694 Staff:
L--------------
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~ Site Address: Z401 3 Unit
Name: 50oux. /~~✓~t5;,~1'K~r~ Phone: (~SI~ yOS = 6~~j
OV4i,aer Address/ City/ Zip:
Applicant is: Owner contractor
Description of work: /[itro R - /ao
of Work
11. -
IMP
Construction Cost: ~yS Multi-Family Building: (Yes / No,/ )
Company: 1 a5xoce-,,V Contact: dry
Address: 3340 1. A01.11., ~e .6w -City: -
State: Zip: Phone: 07a- ~ggo
License #,BGir~da6 ~ Lead Certificate N,+r- Yd 9-6 1 - f
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:
~~'t'~: Plans and'sttpgo~f da~:~rx t~at(~o~~~rtriaut arecn~t~red:t® be.pr~t~ic.t'rflf~er~~e~d. Par~ioi!as c~1P
the _rrffarmator~r be<clafied a rroa#,pb~fc>yorsr~e:sec rreastr .t tnatat .grnr the Cllr to
vo~o~de tt~t~>fh. ° ai?e ~sc~e ~eore#=s.
BALL BEFORE YOU DIG. Caii Gopher State One Caii at (651) 454-0002 for protection against underground utility damage.. Ca1148 hours
before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.ora
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
clays of permit Issuance.
x &(Op a.
Applicant's Printed Name Appli nt's gnatur
Page 1 of 3