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4552 Villa Dr , ~ M'EM03tA.NDU1kI- TO: DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR #S DALE WEGLEITNER, FII2E MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MII{E RIDLEY, SEPTIOR PLANNER PAUL HEUER, SYSTENIS AIVALYST SCOTT PETERSON, BUII.DING INSPECTOR TOM COLBERT, DIItECTOR OF PUBLIC WORKS TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SEHIOR INSPECTOR DATE: SEPTEMBER 10, 2003 RE: PLA1V REVIEW FOR EAGAN CEDAR FAMILY AOUSING (CDA) LOT 1 BLOCK 1 CEDAR VII.LAS 2172 CEDAR L?uYE 2180 CEDAR LANE 4551 VILLA PKWY 2175 CEDAR LANE C4552 VII.LA DRIVE ~ 2176 CEDAR PASS 4558 VII.LA DRIVE The plans are in our plan review section for your review and comment. Please return this form to mv attention with your signed comments and the date of review within seven days. If you have any concerns with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please fill out the proper "hold° request form. Comments• Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No landscape security required Z O N I N G? ? Yes ? No water quality dedication METER SIZE ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No PRV Required ~ e-7-/5> - c' -3 Signature Date RESIDENTIAL MECHANICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complete for: Single Family Dwellings & Townhomes and Condos when permits are requireA for each unit Date/0 /D't_ / Site Address Zf/' Unit # ~ l/ Property Owner e61• S 7 Telephone tf 9J.;? Contractor ~cv7 StreetAddress ~JO ~'r l~ ~~/l oZ~ G~ City i~ State ~h Zip Telephone # (763 &5G Bond Eapires: The Applicant is _ Owner /zr Conuactor _ Other Add-on, modification or alterarion to eaisting dwelling unit $ 30.00 fumace replacement _ air exchanger ~ / _ air conditioner ~ rvew _ Replacement other State Surcharge .50 Totel O C T 2 1 2003 $ a g o. B I hereby apply for a Residenrial Mechanical Permit and acknowledge that the informarion is complete and aceurate; that the work will be in conformance wit6 the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand tlus is not a permit, but only an appGcaaon for a permit, and work is not to start without a pe that the work will be in acwrdance with the approved plan in the case of work wluch requires a review and approval of plans. 6/ , 7S ciL, ApplicanYs Prin d Name Applicant's Si e COMMERCIAL MECHANICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please comple[e for. cocmnerciaVindus[rial buildings multi-family buildings when scparate permits are not required for each dwelling uni[ Date Site Street Address Unit # Tenant Name (if applicable) Previous Teuant Name Property Owuer Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond Espires: The Applicant is _ Owner _ Contractor _ Other Work Type _ New construction _Install _Remove Underground Tank _ Interior Improvement Schedule inspection during insWllaGon or removal of tank Processed Piping Nature ot Work: Permit Fee $50.50 Mircimum Fee (includes Sta[e Surcharge) Contract Value x 1% Permit Fee • If permit fee is $1,000 or less, add $.50 State Surcharge If pemat fee is over $1,000, add $.50 per $1,000 Pemut Fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and aclmowledge 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 with the Mechanical Codes; that I understand tlus is not a permit, but only an applicarion 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. ApplicanYs Printed Name Applicant's Signature Approved By: Inspector Date: PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit ~ Date~/~/~~ ~ SiteAddress_ Unit# ~ Property Owner &6-oi s7- Telephone # 7,c~ r6G1 d , Contractor , L- Ci'' Address / JT-:> d 7- ~ City -/)nzo~F- State) nZip-S~9 Telephone# -(7R~7, 74~fd ~ The Applicant is _ Owner Contractor _ Other Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 _ Adding fiMures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system _ Water turnaround 5/8" meter if needed -$121.00) Other: _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system _ Water softener _ Water heater $ 15.00 _ replacement _ additional StateSurcharge OCT 1 7 2003 $ .50 Tocel BY 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 with the Plumbing Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; tha[ the work will'be in accordance with the approved plan in the case of work which requires a review and approval of plans. ~ ApplicanYs rinted Name ~ Applicant's 3 a ure PLUMBING (RESIDENTIAL) . Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 \ Please complete for: Single Family Dwellings Townhomes and Condos wben permits aze required for each unit Date _T/ /0-1/ Site Address •-~:NIG~ Park i.i1,,,A R, ldL,4 .4 Unit # ~-y Property Owner fq G d' So/IS Telephone if ( ) Contractor VaOGj Address 9W aJHk~~ A?G • City~dej°,- State Zip Telephone# (9Q) yy~ ai~l The Applicant is _ Owner -t Contractor _ Other Septic System ~ New Refurbish0d Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Eaisting Dwelling Unit, Including $ 50.00 _ Adding fixtures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system _ Water turnaround 5/8" meter if needed -$121.00) Other: _ RPZ _ new installaGon _ repair _ rebuild $ 30.00 _ Lawn irrigation system _ Water softener _ Water heater $ 15.00 _ replacement _ additional State Surcharge I D ~ .50 ~ 2 2003 ~ c, a c) 7 Total J $ 0 I hereby apply for a Residential Plwnbing Permit and aclmowledge that the '~'y~nation is_cotnpletea!~~ curate; that the work will be in conformance with the ordinances and codes of the City of Eagan and wifti the Plam~'IiingZodes; that I understand this is not a pemrit, but only an applica6en 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. , )DShr/4 ~--GIIy +?j Applicant's Printed Name A plicant's Signature RESIDENTIAL MECHANICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complete for. Single Faznily Dwellings & Tovmhomes and Condos when permits are required for each unit Date 112 / / /J Site Address Unit # Property Owner ~ ? Telephone # (~~oL ) ~asJ ~~~CJ Contractor w..~wi~~unc:a:~r~u •s uiir. Stree[ Address E: :01'kcts.c~h AvC. SO City A1111c:drV.aIYII 55420 State (952) 881'9WO Zip Telephone # ( ) Bond Eapires: The AppGcant is _ Owner ? Conhactor _ Other Add-on, modification or alteration to existing dwelling unit $ 30.00 furnace replacement air exchanger air conditioner _ New _ Replacement other /Y J State Surcharge .50 ln Total SC!: ,J8 _,;03 g I J ~ l ~°Y- I hereby apply for a Residential Mechanical Pernilt and acknowledge that the informarion is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pemut, 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 wluch requires a review and approval of plans. SEDBWICK MG. b AIR COND. CO Applicant's Printed Name Applicant's Signature COMMERCIAL MECHANICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complcte for: commerciaUindustrial buildings multi-family buildings when sepazate pemvts are not required for each dwelling unit Date 1 / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # { ) Contractor Street Address City State Zip Telephone # ( ) Bond Eapires: The Applicant is Owner Conhactor Other Work Type _ Newconstruction _Install _Remove Underground Tank _ Intefi0r ImpfoV@Rlent Schedule inspection during installation or removal of tank Processed Piping Nature of Work: Permit Fee $50.50 Minimum Fee (includes Sffite Surcharge) Contract Value x 1% _ $ Pernut Fee • If permit fee is $1,000 or tess, add $.50 =:1 $ State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Permit Fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinauces and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand tlus is not a permit, but only an applicarion for a permit, and work is not to start without a pemut, tLat the work will be in accordance with the approved plan in the case of work wluch requues a review and approval of plans. Applicant's Printed Name ApplicanPs Signature Approved By: , Inspector Date: S-~-1141 Q~(~ g' ) c, o S4. k--3 COMMERCIAL 2002 BUILDINQ PERMIT APPLICATION ' CITY OF EAGAN I 651-681-4675 Foundation Onl New Construction Interiw Im rovement • Strucfu2l Plans (2) seb . AahitecW21 Plans (2) sefs . ArchiteGural Plans (2) sets • Civil Plans (2) . Strudural Plans (2) • Code Malysis (1) . CeAificateofSurvey (1) . Gvfl Plans (2) • ProjeciSpecs (1) . CodeMalysis (1)" . Landscapn9Plans Cll . KeyPian (1) . Pmjec4Specs (1) . CodeAnalysis (1) ~ • Master6dtPlan (1) • Spec. InaP. & Testing Schedule " . Certificale M SurveY (1) • Enwgy Calwlations (1) rwt always•` • SoflsReport (1) • Spac.lnsp.a TestingSchedule (1)" • EIec.Power&UghtlngFortn (1)rwtaiways" • Mefer elze must 6e eatablished • Meter size must be established • Meter size must be established - If applice6le • Pmieaspecs j 1 . EnergyCalalatlwts (1) 1 . Elec6icPowerBLightingFartn ! 1 . Master 6dt Plan ) 1 ? . Emergency Response SHe Ptan (1) 1 . SoilsReport (1) i • MCIEu SAC detenNnation letter • MGES SAC determination letler • MCIES SAC determinatlon lelfer call 657602-7000 cali 651-802-1000 calL&51f02-1000 Food 8 beverage or lodging fadlHles - submit plan to MN Department of Heatth. Call 651-215-0700 for detafls.' I Contact Building Inspedions forsample. PermRfw new buildings or addiHons will not be pracessed wiThout Emergency Response Site Plan. Ask Building Inspections for requirements. ,l~4~ ~od DATE: ~f /~2/ O 2 WO~TYP : ~ NEW REMODEL CONSTRUCTION Cns ;2 , l P-~~ „ SITE ADDRESS: ~ f/ J $ • TENANTNAME: Cedar Villas Housing SUITE#: FORMER TENANT NAME, IF APPLICFlBLE: DESCRIPTION OF WORK C;WGU/1 .1 C&D G77UI"'Ad Name; Cedar Villas, LLP. Phone#: 6( 12 ) 341-7800 PROPERI'I' Last Firat, OWNER StreetAddress: 900 Second Avenue South, Suite 880 City: Minneapolis gffite; MN -zlp; 55402 ~ ~~y. Frana and Sons, Inc. Phone#: 15,2i corrrxAcroR . ` t 2G02 U~ StreetAddress: 633 Second Avenue South, 1 n ;l~l 2 Cyty; Hopkins State: MN Zip: 55343 ~ ~`I AItCHI7'ECT/ ENGINEER Company: Elness Swenson Graham ArchitectsPhone#: ( 612 ) 339-5508 Name: David Graham Registration#: 14808 StreetAddress: 700 Third Street South City: Minneapolis State: MN Zip; 55415 _ Licensedplumberlnstallingnow sewerlwaterservlce: imperial Developers phone#: F( 51 ) 454-3330 i hereby adcrwvvledge that I have read tlds epplicatlon, state that the Irdortnaflon Is correct, an g e' all applicable State of Minnesota Sfatutes and City of Eagan Ordina~es. L~,, LI/ Slgnature of Applicard: Updated 7/02 OFFICE USE ONLY SUBTYPE O 01 Foundation ? 26 Public Facility 0 30 Accessory Bldg. ? 14 Apariments ? 27 CommerciaUindustrial ? 32 Ext Alt - Apts. ? 15 Lodging O 28 C,reenhousc ? 34 Eact Alt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF WORK TYPE ? 37 Nail Salon O 31 New ? 35 Tenant Impr ? 42 Demolish (Foundation) ? 46 Windows/Doors O 32 Addition ? 36 Move Bldg ? 43 Reroof ? 47 Repair ? 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization ? 34 Replacement ? 38 Demolish (Int) 0 45 Fire Repair GENERAL INFORMATION Census Code Zoning sq. ft. SAC Code # of Stories Sq. g, No. of Units Length sq, ft. No. ofBldgs. Width sq. R Consk (Acxual) Basement sq. ft. MGES System (Allowable) First Floor sq. & City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Gas Service Test O Heating O Insulation Q Plumbing ? Stucco/Stone APPROVALS PWmiDg Bu~lding Engineering Variance Pertnit Fee o~ S 3~J. 3 5' VALUATION $ ~ 7~a ~~1r'Zl Surchan9e ~ ~ Q • ~U ?lan Review VIC/E3 SAC % SAC ~ity SAC _ 4 ltU, c~, SAC Unfts Nater Supply & Storage _ ~ C~ aa Meter Size ' i/VN Pertnit J 6-1) - ~ 31W Surcharge lFreatrnent Plant ~ 5~-cu ~iorT• :nNsBeditation VBWFVairlt-y -#l?er :opies f " --rr.'.,~. ~-~u • Otai S--t- `,D iq I CONIMERCIAL BUILDING Permit Application ~ City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ~ ~I"5`i'`~ 1a, 5~0 71`3 Foundation Onl New Buildin Interior Im rovement • Structural Plans (2) sets . Architectural Plans (2) seLs • Architectural Plans (2) sets • Civil Plans . (2) . Structural Pians (2) . Code Analysis (1) • Certificate of Survey _ (1) . Civil Plans (2) . Project Specs (1) • CodeAnalysis, - (1) " • LandscapingPlans (2) . KeyPlan (1) - . ProjectSpecs - (1) . CodeAnalysis (1) . Master Exit Plan (1) .-Spec. insp. & Testing Schedule . Certificate of Survey (1) . Energy Calcula6ons . (1) not always** , • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " . Elec. Power & Lighting Form (1) not always" • Meter size must be esfablished . Meter size must 6e esta6lished . Meter size must be esfablished-if applicable , . . . . y - . ProjedSpecs (1) . 1 . EnergyCalculations. (i) • Electric Power & Lighting Form (1) " .y . 1 • MaSterExitPlan (i) y . .l . • Emergency Response Site Plan (1) • Soils Report (1) L - • SAC determination - call 651-602-1000 . SAC determination - call 651-602-1000 SAC determination - call 651-602-1000 Call MN Dept of Health at 651-215-0700 for details regarding food & beverage ar lodging faciliries. Contact Building InspecROns for sample and if required when it sntes'hot always". Permit for new building or addition will not be processed without Emergency Response Site Plan. Lj. i T Date R'. / 2 j n_4S5•2 Yi ~ 1a ~Y Construction Cost T SiteAddress Bldg # t5 Unit/Ste # Tenant Name Eaaan d r Former Tenant Name Description of Work ( 34 ) Townhomes and (1) office in 7 buildinas PropertyOwner D3kota Countv CDA Telephone#( 657) 675-4400 Contractor. ° Frana and Sons. Inc , Address 633 2nd Av nue gni,1-h City Hnnki nc State Minnesota Zip 53.Telephone.#(952 ) 935-8600 C~ Arch/Engr . (z G r 2 2003 IJ I1 ` Registration #1740 2 Address 250 Third- A enu~ 1 City Minneapolis State Minnesota =~.Z'tp__ " Telephone#f512 ) 338-2029 r - Licensed plumber installing new sewerlwater service: Phone U I hereby apply for a Commercial Building Perxnit 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 5tatutes; 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 wark will be in accordance with the approved p1an in the case of work which requires a review and approval ofplans. qtuart Rgstui .r~ Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? Ol Foundation ? 26 Public Faciliry 30 Accessory Bldg. 14 Apartznents ? 27 Commercial/Indusinal ? 32 Ext Alt - Apts. ? 15 Lodging ? 28 Crreenhouse ? 34 Ext Alt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF ? 37 Nail Salon Work Types 31 New li 35 Int Impravement ? 38 Demolish (Intenor) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg only) -Give PCA handout to applicant Valuation 3 D ODO ~ Occupancy X ' 7- MC/ES System ? Census Code ~ 6~ Zoning City Water ~ SAC Units 4- Stories Z- Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs ~ Length Fire Sprinklered ~ Type of Const v 8. Width REQLTIRED INSPECTIONS Footings (new bldg) FinaUC.O. Footings(deck) FinaUNo C.O. ' Footings (addition) ~ plumbing ? Foundation HVAC ~ Drain Tile Other / Roof ~ Ice & Watei Final Pool Ftgs Air/Gas Tests Final ? Framing _ Siding Stucco Stone Fueplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) ~ Insularion _ Retaining Wall Approved By (_~~F.'.{Yy[p^~ , Building Inspector l _C12 - ` Base Fee 2f. l7 , 7 S~ Surcharge / g~ volys~~~ Plan Review . ~_T~ MC/ES SAC ~,~7',~:-s'6 5 100 .C)~ I B~OG-. yu ,3 ) CitySAC ~o-~- ~ Water Supply & Storage S/W Permit ( oU ,O t7 S/W Surcharge • "5~ Treatment Plant • °'fl -3, C) Park Dedication Trails Dedication Water Quality Copies Other mj:, C>G Tatal ~ I , '--s- n (a p ,'kHi TO: DAVE BENNETT, UTILITY CONSTRUCTION INSPECTOR ttS DALE WEGLEITNER, FIRE MARSHAL ERIC MACBETH, WATER RESOURCES COORDINATOR GREGG HOVE, CITY FORESTER JOHN GORDER, ASSISTANT CITY ENGINEER KENT THERKELSEN, CHIEF OF POLICE MARK ANDERSON, ELECTRICAL INSPECTOR MIKE RIDLEY, SENIOR PLANNER PAUL HEUER, SYSTEMS ANALYST SCOTT PETERSON, BUII.DING INSPECTOR TOM COLBERT, DIRECTOR OF PUBLIC WORKS : TOM PEPPER, CHIEF FINANCIAL OFFICER FROM: CRAIG NOVACZYK, SENIOR INSPECTOR DATE: SEPTEMBER 10, 2003 RE: PLAN REVIEW FOR EAGAN CEDAR FAMILY HOUSING (CDA) LOT 1 BLOCK 1 CEDAR VII.LAS 2172 CEDAR LANE 2180 CEDAR LANE 4551 VILLA PKWY 2175 CEDAR LANE 4552 VII.LA DRIVE 2176 CEDAR PASS 4558 VILLA DRIVE The plans are in our plan review section for your review and comment. Please return this form to mv attention with your signed comments and the date of review within seven days. If you have any concems with these plans, please so indicate on this form and notify and resolve these issues with the affected parties. If you aze requesting that issuance of the building permit be held, please fill out the proper "hold" request form. Comments: Indicate any fees that are to be collected with the building permit: AMOUNT ? Yes ? No landscape security required Z O N I N G? ? Yes ? No water quality dedication METER SIZE ? Yes ? No park dedication ? Yes ? No trail dedication ? Yes ? No tree dedication ? Yes ? No PRV Required Signature Date To: Page 5 of 8 2014-09-26 13:33:42(GMT) 18772375198 From: Danielle Merritt _ l,1Se f3Ll.lE CtC B1,�4"a1C:{i9k i For off ce Us ` ^ 4 ► j Permit#: �� $� o�`�� j �:.��.�� , ��,�t��: , �$30 Piiat Knab Road � � Eagatt MN 55122 I C�ate�tece�ued:, ----,� x ; F?hpne:(651)675�5675 I f { Staff; _ � �a�x:��s��s7s�s�s� � _ � �_�.,�_�.__�.__��..��_�¢ 2f�14'�ESICyENT1Al� BUILC�IIw1�C''a PIE��IIT 1�PPLIC�TIt�� Date �r�� '''� °��` Si#�AcldreSS: ��x..w""� � 4'� t�� ^`'�' �� .;� '�= �'" llRlt#: �t �:� t�. '�F ��,�� €-r� . � ��' ? N ....... - ". .. -� � ... .�.,'. ' v Name: ��a ��GIi ��' � �._� �� Phone: t �-�. `� lG��6�� ?��f' �/` �� ` �� '. Adciress 1 City!�ip: }�� eyi /'�ie� �� _ pPp[ieant is; _�Owner �Cantractor . Descripkion afwa�rk: � � " ��1�'"3'� d�'✓�: �C �1 � � : l l �:J' Co�structian Cast: ��?`�`; �',`r , /,r l�ulti-Family BuElding:.�Yes�,.f No„�,.,J ' � , ,.( Comparty: r i�{ 1 l�t �s �� E�?�`� Gantact��„� �� t Address � � ..�� j�fi.`�,��J �t'��'C��"�City: � �G'� ' srate:�i��`z��,�� Fnon�:�a�!�'�v��'E��t: ��r�t r r`�L d�'i�i!�l �� 1�°S"�'��'' � ��° - � ��t� y� �../ �p �r � License#: f-��'",�, t ��t � Lead Gerti#icate t#: J� � "'�� "° lf the pc�jpct is exempt from lea.d certi�catfan,ptease e��fa�n:vuhy, (see Page 3 far additiana.i inf,�rrnat�on} CC}MP4.ET.�THIS AREA�M�Y 1�C4?N�TRIJCTING.A,NEIA1�UIL;[311�G tn tt�e last 42+nonths, has Ehe�ity af Eagan issuecl a permlt for a�imi[ar plan ba�ed on�mastar-p{an? Y�s fVQ If yes;date arid address of rttasYer plan: ` L6.censed Plumber: _ _ Phon�: M�chanica�l Conlcactor; : Phone; ;Se�nter&Water Ccntrac4+ar: , . _ _ Rhone: > , C�tLi.E3E�d]RE YQU D[.�a. Cali Gapher State C?ne Catl ai(859.)454-0OQ2 far proiec#ion against underground utilit��r damege. Cat!?l8 hnurs l?efote you intend t�ciig ta receive tpr,akes af und�rground utitities, u�nnnu.aoah�,r.stateonecatLo l-hareby�cknowladge tY�at this:infor.m2tion is comptete�nd acCUrate;that the wark w'rIP be in Confoemanc.e�+ith khe.:pr�{in�ncES and codes ot the�it�+�sf Fagan;that 1 under;tand this is nat a permit, but.oniy an appEication for a permii. and urock is nat ta sxar3 arithaut�parmiC�thak th�work�riq:;be��. �ccerrdancs vrith th�ap�sresve�-pia�n in the case of werk uv'nich requ"rr�s a review and approval of pfans. �sclerior work authorizesi py a build'rng permit issued in accprdanec with tha�Ainnesata State BuiEdln.g Code anusk be compt�ted within i6p '... k - .. 0'^".,.-' ' .. . days of.permit issuance,. _ �.,�.. x ��.�,�� '��fi � t . �� Appticant"s Printed t�ame Applicanx`�Signatur� : _. Pag�:'t of 3