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1582 Clemson Dr BRESIDENT / OWNER Name: 0L-1 ■g • • Sd Yl Phone: Address / City / Zip: i S CLC2- 41 SOY1 e V , U (1 if - EcLo an S S 1 a-, CONTRACTOR Name: LA( C ' 1 C(.5 #! 7 1I )A KC License #: Se • Gtr G Address: 1 ADO 1 T ' l C BI VG City: /11 State: / I In{ Zip: ,M0,7 Phone: 9 co\ —9,..3 - 1 O tIO Contact: h / /L.. Email: l! 1 I • S V ' 0 V # TYPE OF WORK _ New )( Replacement Repair Rebuild Modify Space Work in R.O.W. _ _ _ n 1 •' Description of work: JA.)( n_ ,/ J f A 1Q , jV 5- n5J Q PERMIT TYPE RESIDENTIAL Water Heater �( Water Softener Lawn Irrigation \ Add Plumbing Fixtures ( RPZ / PVB) (_— Main Lower Level) _ Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation $50.50 Add Plumbing *Water Turnaround $100.50 Septic System $90.50 Fire Repair (replace (includes $.50 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $.50 State Surcharge) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 50 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Applicant's Printed Name Tel 2010 x App ant's Signature Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: 5e0 ' ✓v Date Received: Staff: 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: O -I 1 -10 Site Address: (5 A Cl� fY\ , (Y\ Dv . U n `l Tenant: Suite #: CALL BEFORE YOU DIG. CaII 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.000herstateonecall.org 1 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 • is not tart wit out a perm' • that the work will be in accordance with the approved plan in the case of work which requires a review and approv FOR OFFICE USE Reviewed By: Date: Required Inspections: _ Under Ground Rough -In Air Test Gas Test Final CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road PERMIT NO.: P. O: Box 21199 Eagan, MN 55121 DATE: Zoning: _ No. of Units: Owner: - — Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with Hie City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: /� ` g/y Insp.. CITY OF -EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P. Q. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: B Misc. Charges: Date of Insp.• Total: Insp.• . Date Paid: s 0 I a Use BLUE or BLACK Ink I For office Use I I ' j Permit#: 1►°~_ 1 t of Evan I .sa 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 Date Received: 0 j Phone: (651) 675-5675 1 I Fax: (651) 675-5694 1 staff. 2013 RESIDENTIAL BUILDING PERMIT APPLICATION? Date: .16- 1(- 13 Site Address:6 1fga,q.) wig )58 ` ----Unit Name:.#~ ~ ~l _7.64J -AQLM_eS_-_Phone: -2- 72L S't2 L_ Resident;/ Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: Ale_MQ f Construction Cost Multi-Family Building: (Yes No Company: R C0/7 Contact: i Contractor Address:, 3a 1"1 t c?j7Gt,_-- _ City: Mf►fn> axz. State: M Al_ Zip: 5'S~lo Phone: - Z - 5406 - License S t^ - 1 ~ 10 6 Z- - Lead Certificate ~AT--:: 2 I 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: - 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoohenstateonecall.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 160 days of permit Issuance. r Applicant's Printed Name L~ Applica f s Signature Page 1 of 3 r For Office Use /�� D6o l * 1: Permit Fee: (� i I ti 1.0/17VO -/ Date Received: 1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810f (651)675-5675 I TDD: (651)4548535 FAX (651)675-5694 e1, ` ,'�, '' '*/ Staff: buildinginspections( ciNofeaaan.com 2019 RESIDENTIAL BUILDING APPLICATION Date: 4/ 7Z11 Site Address: /51(1 B £ p� Unit#: Name: D i� 'V 14-11,6 /074:74#14410 ate' Phone: Retildenti _" ownerAddress/City/Zip: _, Applicant is: Owner X _Contractor QQkeit- Type , r Description of work: £le444.'_ �a(t a'• � S7'J !0X/d ke Tay � '� "'� Construction Cost: Multi-Family Building: (Yes I No ) r A �/ y^ pre iPreIv r X-119 e•' „. Company:f� I ,ne.a4ne 7,AMC/ /Ttlyl'it Z ontact: "owl_ /Sr- lrJ7Jy r Gt�n Address: ITi/l2 Cft2,45ez,,� �'w City: #/! Lf Jf1Lz' State: V Zip: 6N7,41-/ Phone:4s a214-Wail:ilivr6v5;172,01-77:2W. 14IC 51 c> .., License#: Rt ,22 94 1Z Lead Certificate#: If the project is exempt from lead certification, please explain why: Att/ _Atitliel iteL49 ,' /7 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:litsz .'. C, ' ,.: ybe- s classified 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.comisubscribe. 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.aooherstateonecall.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 pe '; that the work will be in accordance with the approved plan in the case of work which requires a review and approval tans. x Lx di , Applicant's Printed Naar* Applicant's Signature DO NOT WRITE BELOW THIS LINE 15g a C ( fl'1s )4 b92. g / -6 .06.6 .SUB TYPES Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi )0 Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous p 01 of i' Plex _T Lower Level _ Pool _ Accessory Building WORK TYPES _ New — Interior Improvement. _ Siding _ Demolish Building* _ Addition — Move Building _ Reroof _ Demolish Interior _ Alteration — Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation Zi OW-- Occupancy G–3_ MCES System Plan Review Code Edition j77.1 20 1 c SAC Units (25%_100% )43) Zoning _b City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice &Water _Final Pool:_Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: Footings Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough_ In_Final — Braced Walls Erosion Control Shower Pan Other: Reviewed By: 7Cnei f//k/7i - , Building Inspector RESIDENTIAL FEES 1� , je/do i / &66 yy,f-r. Base Fee Surcharge /5:; 0 c 5 p. / 5" - Plan Review MCES SAC ;n;eV, dot o City SAC Utility Connection Charge X,fTe11 rga/ n V S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3