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870 Trails End RdCity of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 JUN 2 7 2011 Use BLUE or BLACK Ink r For Office U Permit #: Permit Fee: Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION C 6 - Date: Site Address: Unit #: RESIDENTI OWNER Name: Toril owt- Phone: 611 -7L) _.' j q Address /City /Zip: 5-4- g 70 7.-1)5 .�� l2 9) El® t 'A-� � l �ai � 1\ t � Applicant is: Owner t/ Contractor TYPE OF WORK Description of work: /ZenvoL? R /lGp/Q 1.e �1,44zl, 4,4- ti ), vet,/ 14 O'Gk 136 Construction Cost: 70 0.00 Multi -Family Building: (Yes IV/No ) CONTRACTOR Company: Nl t/—h. 4,41/71,1_, //C'1^ Contact: 6 67' ?l c6 97 6 Address: 9 e F-027, if L '' City: �j / �%�4 - ,. State: / ®ki Zip: �7 / 1 7 Phone: ‘4--/ --- q '» g License #: 01 0 6 0 pL G C Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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. 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 plans. x Ni-fo rP/- .r Applicant's Printed Name x Ap gnature Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition Alteration 1, Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% Ii) Census Code # of Units # of Buildings Type of Construction DO NOT WRITE BELOW THIS LINE X10 T7zti7S Ord Fireplace Porch (3 -Season) Garage Porch (4 -Season) 74, Deck Porch (Screen/Gazebo/Pergola) Lower Level Pool Interior Improvement Move Building Fire Repair Repair 9, OS 0 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) (-.�Va7, Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In Air Test Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant 19.04.0 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Gas Service Test Other: Gas Line Air Test Pool: Footings Air/Gas Tests Final Siding: Stucco Lath Stone Lath Brick Windows Retaining Wall: Footings — Backfill Final Radon Control Erosion Control Building Inspector 0$1#1 Page 2 of 3 446 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 70 Use BLUE or BLACK Ink Permit #: 49 Or Permit Fee 4�� Date Received: Staff: 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: g" Tenant: Suite #: RESIDENT / OWNER Name: /QO �77 Phone: / Address / City / Zip: /7-_,V—/40 CONTRACTOR % / Name: r R 12/9 )S [11/71 l�l6s T4 U License#: 6-..g b qtqn [11/7 Address: 0 g - e.—.."" l eLde`( L ci c City:14911' kqi2 /--y9,-- State: Pi Zip: �/! 0 Phone: 6, J/ — .-26 D -0 C Contact: Email: TYPE OF WORK New Replacement Repair Rebuild ModifyfySpace Work in R.O.W. _ _ Description of work: ` `� L) /9 s v a` - 7'6 - S/W PERMIT TYPE RESIDENTIAL Ott a (110 s'1'2- C- - Water Softener Water Heater Add Plumbing Fixtures ( Main / Lower Level) Lawn Irrigation (_ RPZ / PVB) _ Water Turnaround Septic System � �� g /(%lC/ New nfi\ Abandonment G RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) (includes $.50 State Surcharge) $.50 State Surcharge) $.50 State Surcharge) TOTAL FEES $'1 - $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* (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and bumed out appliances, ductwork, etc.) (includes 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 plans. x M r C n -a -Q Applicant's Printed Name QR OFF Applicant's Signatur City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: `"7 Permit Fee: �© Date Received: Staff: 2010 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES �U 666 EXISTING RESIDENTIAL PROPERTY /s Address: Property Owner: 7-cw - 7)/qi) Telephone #:/ Plumber: (. (2. %-s U. 7 1.1 i �; 5 fiG Date of Inquiry: Contact Name:�l (l �r •/ 56 er Service Sewe teral charge Sewer trun City SAC MCES SAC Receipt #: Septic abandonm Permit Fee State arge ER TOTAL: $ 100.00 $ 2,100.00 $ 50.00 50.00 $ 0. ter Service Wate : eral charge Water trunk Water supply sto Receipt #: , Treatment Plant Permit Fee State Surge *Plum. Permit Required - water meter to be a.. rrred with building permit $ 1,185.00 $ 735.00 $ 50.00 TOTAL: 0.50 EWER', WATER Sewer Service Water Service Sewer lateral charge @ $62.70/ff Water lateral charge @ $63.30/ff Sewer trunk @ $1,275/connection Water trunk @ $1,325/connection City SAC MCES SAC Receipt # 415/62-, Date -1/20745- Water supply & storage Receipt # 40/62 , Date -7/2e/f5' Treatment plant Septic abandonment Permit Fee State Surcharge Plumbing Permit Required - water meter to be acquired with building permit -0- - 0- $ #08:90- - $ x,1O0 00. TOTAL: 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 City o[Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: �6 9a 10/34- oc) Date R- eived: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Name: j 1Au( Address / City / Zip: Applicant is: `86Bc O Owner (Contractor Description of work: n e /2 «' 7 Construction Cost: ,0 !> ,C) _ O Phone: 7Ti i l ell./ (to Multi -Family Building: (Yes / No ) Company: j,/ T 6, 071, ., li V lA. G // [ Contact: Address: $ Fre-h--7 L City: State: /`7Zip: 54/j 7 Phone:6. License #: d 6 ? 6.2a2m c loll /O 7724/. Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) /b ST l7 <e/ c 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 V No If yes, date and address of master plan: Licensed Plumber: Phone: Phone: Phone: Mechanical Contractor: Sewer & Water Contractor: VOTE: Plans and supporting documents that you submit are considered to be public information Portions$,c the information may be classified as non-public if you provide specific reasons that would permit the - - 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. 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 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 pleted within 180 days of permit issuance. x Ni -to %I2Aij Applicant's Printed Name x Ap nature Page 1 of 3