1747 Bluebill Dr
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Use BLUE or BLACK Ink
For t!#fic~Use 1 Permit
I
City of ~I I
Permit. Fee: oZ o7 I
3830 Pilot Knob Road I
1
Eagan MN 55122 Date Received: Z 1
I -10-~--~ I
Phone: (651) 675-5675 1 1
Fax: (651) 675-5694 I Staff
014j L-------------------
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 0 -;n-13 Site Address: 1-7 441 1 '7q3 1-7 q5, 17,4 -7 Unit
e
0
Phone:
{Name:
Resident/ i
Owner Address / City t Zip:
Applicant is: Owner Contractor
3
Type of WOrk Description of work: )e=g_ CaQ
I I Construction Cost: Multi-Family Building: (Yes l No )
Company: ~C ~'lofr~ ¢ ,e ~1" t V eion Contact: J 01 t✓ctr
1
Contractor i Address' ~~e f~ tr q ~t City:+ nne~k a
f State: mAJ Zip: Phone:
License ILL cJ 5 Lead Certificate A -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 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.
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 approvalof plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of pennit issuance.
X S- a,,, I --5Q c* 4t-r x ii,>--
Applicant's Printed Name Applicant's Si nature
Page 1 of 3
Use BLUE or BLACK ink
�-----------------,
� For Office Use �
, f���� �
(��} O� nn n n I Permit#: I
1� 1 M.�t ii 1 I �
l) b l.11.l�tlll � � L�' I
� Permit Fee: � �
3830 Pilot Knob Road � �J Zjl- �
Eagan MN 55122 I Date Received: � ✓1
I �
Phone: (651)675-5675 � Staff: �
Fax: (651) 675-5694 i_ �
------ _ I
2 1 -- - �� ���
0 4 RESIDENTIAL PLUMBING PERMIT APPLICATION � �
Date: �� qTdt� /�I Site Address: C 7 � ;T /�j L Lc. E,� i LC..- � /�Z , �'/fG-�� ��/ �-�-
Tenant: Suite#:
Resitlent/Owner
Name: �+�1 dL�D r.� S �-c�`,,°1". � Phone: �� Z-- ��� !�� Z- I
Address/City/Zip: f � �7 g L���f c� �� �S � �-�-
Name: License#:
COt1tGlCtOt' Address: City:
State: Zip: Phone:
Contact: Email:
Type of Work �New �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work: N�W f��- ��Tif /Z E�t/t-G� FKGL 13j;yj','�
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation�RPZ/_PVB)
Permit Type
Septic System Add Plumbing Fixtures�Main/_Lower Level)
New Water Tumaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround*(includes$5.00 State Surcharge)
"Water Turnaround (add$200.00 if a 5/8"meter is required)
$115.00 Septic System New($10.00 per as built)(includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.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.
X Im/j-It�,f/ sGDTT � X
ApplicanYs Printed Name Ap canYs ignature
FOR OFFICE USE Reviewed-By: Date:
Required lnspections: Under Ground Rough=ln Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Staff:
• Use BLUE or BLACK Ink
; r------------------�
I For Office Use I
I / �/ I
' � Permit#: /� 7 ��� �
City of �a�a� � ��5 � �
pCrclvE� � Permit Fee: ' I
3830 Pilot Knob Road «c'�'�''! I -����� I
Eagan MN 55122 � Date_Received:�_ �
Phone: (651)675-5675 �UN 1 9 �q�CEIVED
� ��° �
Fax: (651)675-5694 � Staff: 1 I'
f�� � � �� �----------------- �
2014 RESIDENTIAL BUILDING PERMIT APPLICATION �\�
Date: � _...)��t �� Site Address: � 7� � �L"i"� ���'"�` �2 , SS� � 'Z-- Unit#:
Name: ��!'d-'�v,�J .� C v i l ,� Phone: �C 2 �`��] (.� ��./
Residentl
Owner Address i City/Zip: � � �� S�-����t z !� i2 , �s�-G�`�; ��I Z �z--
Applicant is: �Owner � Co�fractor
1�! TU�€� ' ��tlrc'�� �-P'/o I`r17t� T
Description ofwork: L�W�- •����L �/i✓'r S�-�i'�A7� 3�D ��.����
Type of Work .
Construction Cost: Multi-Family Buildi�g: (Yes�/No�
Company: Contact:
C011#PaCtOP Address: City:
, State: Zip: Phone:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) '�'�
1ll�i L.!c�'�`��17 �o ni�.�i�c�7 v.r� .�4-N 1� �t(�J �J�< S T/�'lr- ��4-��..S rS��=��c �
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has Eagan issued a permit�for a similar plan based on a master plan?
_Yes _No If yes, date and address of master p
. Licensed Plumber: Phone: �
Mechanical Contractor: Phone: �
s
S�wer&Water Contractor`,,�` .� ' " " � Phone:
NOTE:Plans and supporting documents that you submit are c�nsidered i�o be public information. Portions of
the ir3formation may�ie c/a"ssifieal as n'b�-public if�yod provide specific reasons that would permit the City to
con�clude#hat the are tra e secrets.
� CALL B�FORE YOU DIGt Cal1 Gdpher State One Call at(651)4b4-OUO2 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities, www.qopherstateonecall.ora
.�
I her�by 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 a�plication 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.
Ex�erior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x � �:'Lf�"t—Dfr1 �C c�l� � x �''�'°- . _.
ApplicanYs Printed Name Ap icanYs Signature
Page 1 of 3
1�7�7 ���ti%�/ /��=- � �
DO NOT WRITE BELOW THIS LINE
/d s� .� }
SUB TYPES
_ 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
� Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
_ Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
�„ N
Valuation 1� � Occupancy G ^3 MCES System ""
Plan Review Code Edition C�? SAC Units --
(25%_ 100% ✓ ) Zoning �-3 City Water —
Census Code �3y Stories "-' Booster Pump �-
#of Units I Square Feet ^ PRV —
#of Buildings J Length �' Fire Sprinklers "�'�
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 � HVAC_Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final
� Framing Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
� Insulation �, Windows
Sheathing Retaining Wall: _ Footings_ Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES ,(,1► /'l+� �.?GI�Q i�/X�' �,��'vOp
o�Ct - `�6
Base Fee �- J �/� � �
Surcharge � ��'� � �'�'�� �.� ���
Plan Review 17•Z �-- M� „v ? ? �
MCES SAC �'� ��►/�. �3�I ''�Q �/� � �`
City SAC j�/ ��/�
< <
Utility Connection Charge lN��/Y,J�/h�s
S&W Permit& Surcharge � 1,,,,j ?3y �
Treatment Plant
Copies
TOTAL
Page 2 of 3
» , . �.
Use BLUE or BLACK Ink
�-----------------,
� For Office Use �
' ������ �
City of�a�a� ; Permit#: �
�
�� �
3830 Pilot Knob Road j Permit Fee: �
Ea an MN 55122 � �
g I Date Received: �
Phone: (651) 675-5675 � �
� Staff: �
Fax: (651)675-5694 �
�������������_���J
2015 RESIDENTIAL PL�IMBING PERMIT APPLICATION
Date: Site Address:
Tenant:
Suite#:
� : � �t,�n aO.�i��-�� �,��3�.3 7��3
�:�Resl.°.;ef1 0�� .:��. ; Name: i"IPhone: "
� Address/City/Zip: � f3i�� �1..� �
�:, ;r
} � Name: M�bert Cor�pany Inc dba Culligan Water �icense#: WC6413 76
��
� pntr c : Add�esS: 1801 50�' St East ��ty, Inver Grove Hgts., ,
State: Mn Z�p; 55077 Phone: 651-451-224� �'i
�-_ ;';
contact: William R Milbert
Email:
x ���� � �New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
r Vl/ater Heater
Lawn Irri ation �Water SoRener
.nil. _ 9 (._RPZ/_PVB)
� Septic System Add Plumbing Fixtures(,_Main/_Lower Level)
_New Water Tumaround
:�,d ,_Abandonmen� � � ��
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes$5.00 State Surcharge)
*Water Tumaround(add$200.00 if a 5/8"meter is required)
$175.00 Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge) /�
TOTAL FEES$ V D O
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.aopherstateonecall ora
I hereby acknowledge that this information is complete and axurate;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 permlt; 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 . ��//,�-�. � � d���----_ x �
' Applicant's Printed Name ApplicanYs Signature
� ��
i e ,; .
_ ��;la �::