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4565 Horizon CirCity of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Permit #: 9 7 Permit Fee: Date Received: / Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Chi /06/z of c, Site Address: 1 -1CeS" I Ci ( 0/10 Y141/1 �J 12. Ct Tenant: 114 Mick a U J V - e kasi //? � J x s G x Applicant's Printed Name Applicant's Signature !' Use BLUE or BLACK Ink Suite #: RESIDENT / OWNER TYPE OF WORK CONTRACTOR Name: V a. Lo J ce, v 2 fiC a_ id Phone: 12 rf 4 -(0 Address / City / Zip: S (- 5,. / CI � }2u4 0140' 5 23 Applicant is tr Owner Contractor Description of work: Construction Cost: 7 a P CAti y' t t a 1 GC.. Multi- Family Building: (Yes / No t/ ) Name: License #: Address: City: State: Zip: Phone: Contact: Email: 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: TE: Plans and supporting documents that you submit are considered to be public information. Portions o e Information may classified as non-public if you provide specific reasons that would permit the C ity to. conclude that they are trade secrets. 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 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. Page 1 of 2 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x t vlek K k h6.1d1 Applicant's Printbd Name e 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 06 /Z57 200 q Site Address: L/ 5 <5 flOY 3(7 4 Ci y Permit Fe Date Received: C4 Staff: 537 z 3 Tenant: Suite RESIDENT OWNER TYPE OF WORK CONTRACTOR Name:�xelnes(av c4nnrk I�wc. ft-e O ArtIce Phone: 61Z Geto Address City Zip: o 1 S 6 N om CC IA Applicant is: V Owner Contractor Description of work: Construction Cost: goo .Qx AS aM CA Multi Family Building: (Yes No Name: License Address: City: State: Zip: Phone: Contact Person: Energy Code Category (4 submission type) Mechanical Contractor: Sewer Water Contractor: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Submitted Submitted Energy Envelope Calculations Submitted 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: Phone: Phone: NOTE: Plans and supporting, documents that you submit are considered to be Public "information- the information maybe classified as non-public if you; provide specific reasons that would permit conclude that they are trade secrets. 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. x Applicant's Signa>Cure 1 4 Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25 100% Census Code of Units of Buildings Type of Construction Reviewed By: Fireplace Garage A Deck Lower Level Interior Improvement Move Building Fire Repair Repair 0 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice Water Final Framing Fireplace: _Rough In _Air Test _Final Insulation Meter Size: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S &W Permit Surcharge Treatment Plant Copies TOTAL -ry 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 Siding Reroof Windows Egress Window *Demolition of entire building give PCA handout to applicant u7 Sheetrock Final C.O. Required X Final No C.O. Required HVAC Other: Building Inspector Pool: Footings Siding: _Stucco Windows Retaining Wall Erosion Control 69-4' 4 2 g b rd€ Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Water Damage MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Air/Gas Tests Final Lath Stone Lath Brick 5/ 1 9 Page 2 of 3 PERMIT Permit Type: Building City of Eagan Permit Number: EA105002 Date Issued: 06/20/2012 Permit Category: ePermit Site Address: 4565 Horizon Cir Lot: 6 Block: 02 Addition: Ches Mar East 4th PID: 10-17153-02-060 Use: Description: Sub Type: e-Siding Construction Type: Work Type: Siding Description: House Census Code: 434 - Occupancy: Zoning: Square Feet: 0 When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure Comments: maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. BL - Base Fee $4K $103.25 0801.4085 Fee Summary: Surcharge - Based on Valuation $4K $2.00 9001.2195 Valuation: 4,000.00 Total: $105.25 Contractor: Owner: - Applicant - Vyacheslav Raykhfeld 4565 Horizon Cir Eagan MN 55123 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature Ci1"1 S:AfdAN ATER SERVICE PERMIT �t *nob Road PERMIT NO.: / - 41 Es ri4 to 55122 DATE: 7/17r Zoning: I?IZ No. of Units: 1- c'upl Owner: Joseph ?Miller Construction Address: Site Address: 4565 Morizoa. Circle L6 B2 CM East 4th Plumber: Mc('uire mechanical Meter No.: Connection Charge: 4 50 00 pd Size: Account Deposit: Reader No.: Permit Fee: 10.00 pd i agree to comply with the City of Eagan Surcharge: .50 pc' Ordinances. Misc. Charges: 60.00 pd meter Total: By •' Dote Paid: Date of I nsp.: 3 -3 ( 3 Insp.: CITY -ors EAGAN ��... .. _$(IV_ER_ PERMIT 3793,, Piet Oa Rood P RMIT NO.: 5 6- 3 Eases, MA 55122 `\ 4 \. D TE: - J .- z \. 3/17/83 : Zoning: P11 . of Units: 1 ditp1 c:X Owner: o ph mill ar i".pn tat - rtii ; t riiti-,r Address: A /1 Site Address: 4565 Horizon Cirlce 1.6 132 CM East 4th Plumber: McCtiri+. ianical 2/14/3 34380 f' ' 'N' 100.00 pd 1 agree to comply with the City of Eagan 4 Forigection Charge: 425.00 pd Ordinances. Account Deposit: Permit Fee: 10.00 pd Surcharge: . 50 pd By Misc. Charges: Date of Insp.. D 1 C N Total: Insp.: Dote Paid •