1265 Timbershore LaneCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1265 Timbershore Lane
Lot: 3 Block: 03 Addition: Timbershore 3rd
PID:10- 76502- 030 -03
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
Fee Summary:
Contractor:
Home Energy Center
2415 Annapolis Lane #170
Plymouth MN 55441
(651) 766 -6763
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
G Dean Goebel
1265 Timbershore Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA091571
10/13/2009
ePermit
'1\7E13 For Office Use hi
f �3�
f
f. Permit If:
` ` a< OCT 15 2019 ��/j
Permit Fee: ` 3--
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(65 1)675-5675(TDD: (651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspections ca cityofeaoan.com
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: ,m l Ucvr7 0 rat e-S Phone: 95,Z—a 3 9— 900 2.,
Resident/ k
Owner Address/City/Zip: / 2 6 3 ! 'm r'i-1'4 / e
Applicant is: Owner Contractor
Type of Work Description of work: (J c-.) S7,'S
Construction Cost: Multi-Family Building:(Yes /No )
Company: 6 cis fe Contact: V w^e, #0,'e
ca, / y�
Contractor Address: /& 3 �, /y/Cin Cit C/ /Ctxf City: _../3fuuyr p-75 7V
State:/ `4'.Zip: cc'/3 c hone: )�.7)742 3 9— :c2,,. C. • rP7
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License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:Plans and supporting documents that you submit are considered tole public Information. Portions of the information maybe
classified as non-public if you provide specific reasons that would permit the.011y to conclude that the are trade secrets.
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.citvofeanan.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. wvw.gopherstateonecalt 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 permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of p ns.
Applicant's Printed Name J Applicant's SS ature
DO NOT WRITE BELOW THIS LINE La ol- -C- ,—k-Dt(c r� (Jr..( 1 If-sp
.SUB TYPES C
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex _ Lower Level — Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition — Move Building _ Reroof _ Demolish Interior I
— Alteration — Fire Repair _ Windows _ Demolish Foundation 1
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
—
DESCRIPTION
Valuation 2tialq Occupancy ML, MCES System
Plan ReviewCode Edition SAC Units
(25%_ 100% X) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction W Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) Y Final/No C.O. Required
Foundation Foundation Before Backfill 1` 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: , Building Inspector
RESIDENTIAL FEES } �p �
Base Fee ' aue,„ frunir
Surcharge c-r-gls
Plan Review 01 f
MCES SAC
City SAC04
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant91 0 t 0
Radio Meter Read
Copies
TOTAL
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