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