1269 Vildmark Dr CITY OF EAGAN Remarks
Addition Wilderness Run 3rd Addition Lot 17 Rik 1 Parcel 10 84352 170 Ol
Owr,er Lc('i ~r ~'111U~.';1Y, ',,,street 1269 Vildmaz'k Dr. State Eagan, MN 55123
Improvement Date Amount Annual Years i~ Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK ~ 1973 S175.00 $8.75 20 PAID
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA p th w ter onnection 6 7
STORM SEW TRK "I (5 1983 417 . 96 27 . 86 15 3 0(-. 5-~L eollq6-11 _ 6
STORM SEW TRK ~ifl
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREETLIGHT 1981 107.94 21.59 S
SEW CONN 1974 2 0.00 . PAID
WATER CONN. $300.00 5854 - -
13UILDING PER,
sac 6 2-1-73
PARK
f,
Rep'ipt MECHANICAL PERMIT Psrmit No.
CITY OF EAGAN
Fse
Fill in numberod waces S/C
~ rYPe or Print legfbly Tot
1. Date ~ ~ Z, Installation Cost
. . .
3. Job Address f 1 ? ~ . _ ~ - i 1
LotBlk. Trsct
i
4. Owner
5. Conuactor Phone. ?4l~
6. Addmas
7. City 4 $tdtB i e l/?t ZI~~ ~ ~ ~ ~ j
8. BuitdingType: Residential ~Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter Repair ?
;
10. Describe,_ .:-L fue Type Z-~
11. No. Equap=nt BTU - M. Ea. No, Evuiament CFM
Forced Air r'r' Air Handling:
Mfg. . . , -
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. : Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and f aqree to
oomply with all ordinances end Codes governing this type of work.
Signed : - %s_ -
for
nal
Rouyh 4nsp.
Inspections: Date Insp. Date This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
t, _
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
1 u I ~ r kt t t f. ~
, I f1MA1?K f?R ,~+V F „ti ~r~ii~l 11'li~
PERIVIIT SUBTYPE: TYPE OF WORK:
INSPECTION .
1
~
~ s J
PermR No. Permft Holder Date Telephone t
ELECTRIC
PLUMBING
HVAC
Intpectlon Dste Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING 711' '
AOUGH
PLUMBING
PLBG
AIR TEST
FiOUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
/7-/ w-~-3
CI7Y Or EAC~kN
3795 Pilot Khob P,oad
EGga-a, Mi.nnesota 55122
PERMLT NO.: 652
I'he City of Ea.gan hereby grants to 8eascnal Control, Znc.
pf 7620 Lyndale Ava. So.
a 1°,/C Permit for: (Owner) T-eonard Simon
at 1269 nildmark Drive , pursuant to application dated 3/12/75
Fee Paid: $5.00 dated this 24 day of MarCh ,19 75 +
..Osc
• Building Inspector
Mechanical Permits:
Bid Total:
~
.
s~ ,r,~ . , S ~ , a ~ - . - _ -
.~iti ~ p~+{r~• ~ c,.~t:'~~,~.f4' ~+~F -~e' ' ' ~j ~s~
tr•
.s~`7'.~72~' ~iP V , ' a:.'~~X'y, , _ . . . , . ~ . ~a4' .,t ' ^ 4 w~~ s+~.. . . . .
. , . _ . . . ~ . _ •Y . ' . '
110-
POR P6
. ,
~
b
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74 G ~
/1-1(il ViLP Ijjfi,C-- b-A-.
w~ 3
Wild OF EAGAId
3795 Pilot Kiiob i:oad
Eagan, Minnesata 55121
PEItMIT N0. 252
The Board o£ Supervisors hereby grants to wmasai PlymbW 6 HMtW Ii1C*
o f ss192
e p:st,~ T~ Pernait for: (Owner) Ve
nM¦sd? Cc?4ststtetioa
at IA7 Yiid~s Am III , pursuant to application dated
~1.3L~L22 •
Fee Paid: J20.pp Dated this lbtb day of 1972 .
.SO s/c
Building Inspector
• EAGAN TOWNSHtP
BUILDING PERMIT N° 2'741
wnex Eagan Township
Addreu (Presen!) 4- - Towa Hall
'lder _....~1~4 . . . . . .
na:e ---G..-~./..7...z
Addrese
DESCRIPTION
Storias To Be Uaed For Fron! Depih Heigh! Esi. Cos! Permi! Fee Remarke
I ~!G •3 a ~3~v oo: /%7•1719 0 c~ / ~u
.
~Y LOCATION 1 • x-e
Streel, Roed or oi6er Descriplion of Loealion I Lo! Block Addilioa or Tracf
/ ~ l 2u,~^-"`-~ ?L"^.' 3 ~
This pesmil does not aufhoriae ihe use of atreefs, roeds, alleps or sidewalka nos does it give the owaer or his ageaY
the righito creaie anp siluarion which is a nuisence or which presenls a hazerd !o the healfh, safely, eonvenience and
gaqe:al weliare !o anpone in the communifp.
TFIIS PERMIT MUST BE REPT ON THE PREMISE WHILE THE WOAK IS IN PROGA SS.
TLts is !o eeslifp, -r..-..~c.-..~w._.~._~....:c°i~haa pezmission !o ereet a_... _ . . .f.. - upon
the above described premise subject to ffie provisions o! the Buildiag Ordinance for Eaga Top adop2ed April 11,
1955.
. ,n O,
.
Per .........................L~'_......~.................
Chairman of Tnwn Board Suildin4 InsPeefoz g$
~
MASTER CARD
dl 7-/
• IoCATIoN ?,&mRRK pp--L~ 61 G~/de?ness A
OWNER imnh _ h avd.
STRUCTURE AND LAND USED AS x sa ~8V .?yx? y
~ Issued To
Permit No. Issued Contrador ~ Owner
BUILDING
PLUMBING q 5 ~ ~ ,Jn~ ~
CESSPOOI - SEPTIC TANK -7
WELL ~
ELECTRICAL
H EATI NG
GAS INSTAILING .
SANITARY SEWER
~ OTHER DI~ I
OTHER
• Approved
Items (Initial) Date Remarks Distance From Well
F60TING SEPTIC _
FOUNDATION CESSPOOL
FRAMING TILE FIEID FT.
FINAL i
ELECTRICAL
DEPTH
HEATING o~~ zl
OF WELL
GAS WSTALLATION
SEPTIC TANK
CESSGOOL
DRAINFlELD
PLUMBING
WELL
SANITARY SEWER ~ /h • 1~• 7 y
-
- ®r G~~
• Violatio s Noted
on Batk
COMMENTS: •
F
~
COMPLIANCE INSPECTION REPORTS
TO BE USEO ONLY IN EVENT OF OBSERVED VIOLATIONS
•
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
~ ACCEPTABIE SUBSTITl1TION5 OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY GONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
I7EMIZFD AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION •
REINSPECTION REVEALED
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to 6e 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
BUILOING INSPECTOR OATE
COMMENTS:
~
PERMIT CA&5`1"
4, CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Min nesota 55122-1897 Permit Number: 0 2 8 9 9 6
(612) 681 •4675 Date Issued: 10 /0 4/ 9 6
SITE ADDRESS:
1269 VILDMARK pR
LOT: 17 BLOCK: 1
WILDERNE55 RUN 3RD
P.I.N.: 10-84352-170-01
DESCRIPTION: R e R o o F
BVi~~aT'iFg~Permit Type 5F (MSSC.)
Bb .~t t f r l n,t~~UoAr k T y p e R E P A I R
n,,su,g. C pdi 484 ALT. RESIDENTZAL
Alk~
,
o ~
~
~Q" CC~i~~µ~~~~~kp~
REMARKS:
FEESUMMARY: vALuaTroN $5,0e0
Base Fee $99.75
Surcharge $2.50
Tota1 Fee $192.25
CONTRACTOR: - Applicant - 5T. t-zc. pWNER:
HORIZON ROOFING 18903900 20012795 SIMON LEN
1333 LARC INDUSTRIHL BIVD 1269 VILDMARK DR
BURNSVILLE MN 55337 EAGAN MN
(612) 896-3900 (612)454-1934
, G .
acknowl'edge thaxt`°~ Mav~e a0ad tthas appiA,Ca'ti'~tn 664 sta.te th*t .t'he`
I heY'aby r
` 1nf6rma5ian 3.s.carr"t aHd., agrb s, Ca aisrnply t~3t#t, ~a.ll, appli'cabi~e 6Cate bf Mn. ;
~
,
Statutes and ~Uty at JEagah a64rr~ncass
. x
APPL7GAN7/PERMITEE SIGNA7URE ISSUED BY: S ATURE
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 ltf~-
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construdion Reaulroments ' RemodeVReoair Reaufremenb
? 3 registered elle aurveya ? 2 coDies of plan
? 2 copies oi plans (indude beam 8 wlndcow sizes; poured fid. design; ete.) ? 2 ske surveys (eMerior add8ions & decks)
? 1 energy eelculatbna ? 1 energy oalaletlons for heated add'Rions
? 3 copiea ot tree pieeenaHon plan H bt platted eRer 7/1/93
requirod: _ Yea _ No
DATE: CONSTRUCTION COST: CK3
DESCRIPTION OF WORK: 7 e C, - 2f~
STREET ADDRESS: 6 9 Ojai) ~ ~~'~XQ/u} 2Del
LOT ~ BLOCK ~ SUBD.IP.I.D. 3
PROPERTY Name: Phone
OVYNER •
Street Address•
City: L 4~Qrl State: ZIp• SJ~~3
CONTRACTOR Company: ~7a~P~ZO~I 6o~i ~G Phone 396U
Street Address: /3,33 Z-194?: Z5Z?Q/License
City: 6Uel;5~~A State: 7~~ Zip• f375337
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address-
City: State: Zip:
Sewer & water licensed plumber: Penaity applies when address change and lot
change are requested once permit is Issued.
I hereby acknowiedge that 1 have read this applicatlon 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
Certificates of Survey Received _ Yes No
Trce Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT T1fPE
? 01 Foundation ? 06 Dupiex ? 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dweiling ? 07 4-plex o 12 Multi RepaidRem. 0 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility
0 04 SF Porch o 09 12-plex o 14 Fireplace a 21 Miscellaneous
0 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
0 31 New o 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MClWS System
(Allowabie) Main level sq. ft. City Waier
UBC Occupancy sq. ft. Fire Sprinklered
2oning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Pianning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS 5AC
City SAC
Water Conn.
W3le• ?q:Eer - - ' .
Acct. Deposit
S/W Pertnit
S/W Surcharge
Treatment Pi.
Road Unk
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
657-681-4675
Nsw Conafiucilon Reaulrements Ramodel/Reoalr ReaWremeMs
? J registered qfe wrveys ahowing sq. ft ot bt, aq. ff. ol house Y coptes of plan
antl 11 roofed areaa (2096 maximum lot coveraae allowed) 1 sef of energy calcula8ons lor heatetl nddiflons
? 2 copies ot plans (show beam 8 window sizes; pouretl mtl. tleslgn; etc.) 1 site suney lor exterior atltllHons & tlecks
? 1 set of energy calculafions .
? 9 coplea ol hee preservaHon plan H lof plattetl aHer 7/1193
DATE: CONSTRUCTION COST: ~ I~OO
DESCRIPTION OF WORK: Q~~~. [,P _ n ~ GT'' .l~c!
SiREET ADDRESS: °I_~ ~ rY1~~ ~c ~ ~
LOT: BLOCK: SUBD./P.I.D. PU..V, 3 r~
Name: ~ 's Phone C t-i~ r,-X4
PROPERTY Wr flnt
OWNER
SheefAddress:__)~~o~
CItY F~ C4 a z::2) State: Zip:
CompanY: "'L Co hona Jf:
(area code)
CONTRACTOR
Sheet Addreu: p914L72 0t-J r License li 6:5,Exp.
CiN L2,Cz--,AP Stafe: ` Zip: 3 7 a-
ARCHITECT/
ENGINEER Company: Name:
~ Telephone ( ) .
Sheet Addreu: RegishaHon p:
~
CHy Sfate: Zlp:
Sewer/water licensed plumber (if installina sewerlwaterPhone L---)
I hereby acknowledge itwt I have read ihis applkaHon, atafe fhat Ihe intortrafion is covect, and agree fo compty wilh all applieable Sate
of Minneaota SfaNtes and Ciry of Eagan Ordinances. ~
Signaiure of Applieant ~
OFFICE USE ONLY
Certificates of Survey Received _ Yes ~ No
"free Preservation Plan Received _ Yes _~+lo ~Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) 0 37 Ext Alt - Muki
? 02 SF Dwelling O 08 06-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF
O 03 01 of _ plex ? 09 07-plex W-18 Deck ? 23 Porch (screened) ? 36 MuRi
? 04 02-plex O 10 08-plex ? 19 Lower Level ? 24 Stortn Damage
? 05 03-plex 0 11 10-plex plbe _v or_ N? 25 Miscellaneous
? 06 04-plex ? 12 12-plex O 20 Pool ? 30 Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bidg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bidg)' O 44 Siding
0 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code I # of Stories sq. ft.
No. of Units I_ Length sq. ft.
No. of Buildings U Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code 4 z 4
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLAN EOU5 INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building 6V Engineering Variance
Permit Fee 6' ~ SO Valuation: $ I .l 20 C)
Surcharge ~
Plan Review
License
MC/ES SAC 4
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies .~s
Total: go, 7
. SAC Units
% SAC
~
~
?
3b
6 ARA~ d N
a ~
b
M
a
'
/
r ~
S TI?~~ ~
1
f
~Pr ~ ? ~ '
74 D D
. . . ~s--
`
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephonc # 651-675-5675 FAX # 651-675-5694
Nex Nostruction R uirements RteoairRewirements Olficell5eOnN -
3 register ite surveys shwring sq. ft of U. . use; and all roofed areas 2 copies o( plan shovring footi~s, beams, jdsls CeRpf Siuv"ey;RabC "1'. N
(20%mazim btcoverageallowed ' s TreePresPlanReQi,
2 copies of plan sh ' beam ' av s¢es; poured found design, etc. 1 sile survey for additims 8 dedcs Tree'Pres R".eq~"ur~` _ Y~ N
isetofEnergyCalcul " Addfflron-irM'katei7on-sdesepficsystem On-siteSepticS}!s[em Y-=N .
3 copies W Tr eservation Plan ed afler 7l1A3
RimJ' tailOptionsselectionsheet(builm ~ 3alessunits)
mnegasco mechanical ventilation (ortn
~
Date ~ / %a Construction Cos[
Site Address / a~`j 42 K 69 ( Vt Unit/Ste #
a
Description of Work F11tA. !5YL/ G~) foG-4(mS G+rytd- Pp2t2Ll rVwt
Multi-Family Bldg _ YN Fireplace(s) _ 0 _ 1x 2 ~
91./
n
PropertyOwner ~(6 ~M 'r l'~ n~FL/~-GvIF /v(!~ i\b Telephone#(
~-l-
Contractor D O 69
Addre
~
State .iZip e ephone
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- nesota Rules 7670 Cate o 1 Minnesota Rules 7672
Enefgy Code CategOry in Residential Ventilation Category 1 Worksheet • New Energy Code Worksheel
(4 submission rype) Submittetl Submitted .
• Energy Envelope Calcul ns Submitl
In ihe lasi 12 m n has Th City of Eagan issue permii for a similar an based on a ma r plan?
_ Y N If es, te and addr ss of mazter plan:
Licensed Plu er Teleph ne
Mechanical niracto O"~ Tel hone )
SeweNwater Contract r ~ q(•T S 2006 Telephone )
[ hereby apply for a Residential Building Permit and ac nowledge that the infortnation 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
permil; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
T6 ~ o L
Applica::t's Printed Name ~p~lant's Signature
DO NOT WAITE LELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 6ct. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex 0 18 Deck ? 23 Porch (screen/gazebo/perola) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int improvement 0 38 Demolish Interior ? 44 Siding
? 32 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
DBSCriptloll: Water Damage _ Yes
Valuation Occupancy -3 MCES System
Plan Review 100% or 25%
Census Code Y 3Gl Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const v A?_ Width
- -REQUIRED INSPECTIONS -
_ Footings(new bldg) _ Sheetrock
Foorings(deck) FinaVC.O.
~ Footings (addition) ~ FinallNo C.O.
Foundarion HVAC
Drain Tile Other
Roof Ice & Water Final Dool Ftgs Air/Gas Tests Final
Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insularion _ Retaining Wall
Approved By~ "Inspector
-
Base Fee
Surcharge x 7
J
Plan Review
MC/ES SAC 01 z , ~
City SAC ~
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
OtJier „
Total
Duane Thorpe P.E. October 16, 2006
DeweyWorks
1512 W. 34'" St
Mpls, Mn. 55408
Re; Swctural review of
greenhouse addiUon at
1269 VIldmazk Drive
Eagan, Mn. 55123
To whom it may concem,
As requested, l have reviewed the snow load calculation for the greenhouse addi6on for the residence
mentioned above. I have increased the snow load to 42 psf based on a Ct = 12 (unheated sVUCture) and
found the addition to be structurally adequate.
I am available to visit Ute site, to aid in [he understanding of the strucdual design intent and ro help resolve
any structurel problems during construction.
Please call ifyou have any questions (612 825 5607).
Sincerely,
e Thorpe P.E. 11
I hereby certify that I am a duly licensed professional engineer under the laws of the state of Minnesota.
6C~ ~ ~
~ ~
~ ~ ~ ~ L eiz v; t~Js .S ~,~c
OL
OD
L4
a
fl, I~124wc(F.
.
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r ~
~
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s
~ . _ ~ . " .
~
r For Office Use
Permit#:
Permit Fee: /-.7 0 b
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections(a�cityofeagan.com
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/30/2019 site address: 1269 Vildmark Dr Eagan, MN 55123 Unit#:
Name: Brianna Hatton Phone: 612-481-9773
Resident/ 1269 Vildmark Dr Eagan, MN
Owner Address/City/Zip: /' �
Applicant is: / Owner Contractor +/ I It A i, ,0 5n /i i l- (_ t " j
Type of Work
Description of work: Full roof replacement
Construction Cost: Multi-Family Building: (Yes /No )
Company: Contact:
Contractor Address: City:
State: Zip: Phone: Email:
License#: 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:
NOTE: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 provide specific reasons that would permit the City_to conclude that they 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.citvofeaaan.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.nopherstateonecall.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.
DigignBrinn
xBrianna Hatton xBrianna Hatton Datitallye'201s9toed3oby131a7.3a0 Natton-0500'
Applicant's Printed Name Applicant's Signature