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3290 Dodd LaneMar. 9. 2010 9:19AM Crest Exteriors 651-463-8095 P. 2 411°' C!tyofEalall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675.5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink 1. 'For Office Used Pal mit 9: 9396-3_ Permit Fee; _rage(' 66 - Date Received: Staff: J 2010 RESIDENTIAL BUILDING PERMIT APPLICATION (-2l-/%(d 3� - Date: 3/3/// / [/ Site Address: 3 ?67 /Z? Gan e Tenant: Suite #: RESIDENT / OWNER Name: d % : e ►/ t Phone: /" /• i !',5 —,9 L Address / City / Zip: % %- Ada/ L Ze9e- gip, i _675-42/ � Applicant is: Owner Contractor TYPE OF WORK WRi(A. Aa'11 ' RiEpAi Description of work: CC d f } Construction Cost: g(% Multi -Family Building: (Yes" / No,) CONTRACTOR IVama:C%`e,�'��,1CP� T! Ls' License #: S Address: a O - e.."5„.)7,0.40,44_ City_ /414/272/./1/51 Stale:///// ip: 0 ca4 Phone: 6,67— 6.'e)-- ev:/(// Conla Email: COMPLETE In the last 12 months. has _Yes ,No If yes, Licensed Plumber: THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan Issued a permit for a similar plan based on a master plan? dale and address of master plan: Phone: Mechanical Contractor: Phone: Sewer S 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 they are trade secrets. CALL BEFORE YOU DIG. CaII Gopher State One CaII at (851) 454-0002 for protection against underground utility damage. CaII 40 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.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 permll; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plan: Applicant's Printed Name [DECE,M1 1-1 11 MAR 1 e 2010 x Applicant's SignD E © E MAR 1J2010 e 1 of 2 pro DO NOT WRITE BELOW THIS LINE 36 :45 'S SUB TYPES Foundation Single Family Multi 01 of l{ Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Fireplace Garage Deck Lower Level Porch (3 -Season) _ Porch (4 -Season) Interior Improvement Move Building Fire Repair Repair DESCRIPTION Valuation 9az, si?— Plan Review (25% 100% Census Code 4/31./ #of Units /of<[. # of Buildings / Type of Construction Q Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water Final AFraming Fireplace: _Rough In Air Test Final Insulation Meter Size: Reviewed By: Siding Reroof Windows Egress Window *Demolition of entire ,,tpt97 a-3 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior _ Demolish Foundation 3 Water Damage building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required Final / No C.O. Required HVAC Other: Pool: _Footings Air/Gas Tests __Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings Backfill Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL /7? 1/5 fi Page 2 of 3 VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO • Eagan, MN,55122 DATE: Zoning: No. of Units• Owner• Address • Site Address• Plumber • Meter No.: Connection Charge• Size: Account Deposit• Reader No.: Permit Fee• I agree to comply with the Village of Eagan Surcharge• Ordinances. Misc. Charges• Total: By Date Paid• Date of Insp • Insp • VILLAGE OF EAGAN SEWER SERVICE PERMIT 3795 Pilot+t:nob Road PERMIT NO • Eagan,,14N 55122 DATE• ZoniTl4b: No. of Units• Owner• Address • Site Address• Plumber I agree to comply with the Village of Eagan Connection Charge• Ordinances. Account Deposit Permit Fee• Surcharge • By: Misc. Charges• Date of Insp.: Total• Insp • Date Paid•