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3215 Evergreen DrCASH RECEIPT C1TY OF EAGAN P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 . . . ( . DATE 19 RE EI EO OM AMOUNT $ I? OOLLARS J A .I 32 , 00 /? GASH tZCHEGK i . ,? Ly L FOR . . . . . ? . . 1 ..? . . ? . . ? FUND CODE AMOUNT ) J -714 I Thank You'" 4 F `,-,3 t, '7". .5'o ? z7.y? White-Payers Copy Yellow-Posting Copy Pink-File Copy 2006 RESIDENTIAL BUILDING rExMIT arrLrcnTiorr Ck ?. S?-Y3 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCfion RaQuirements RemodeUFieoair Reauiremenls ORceLse'.Ohlv 3 registered site surveys showing sq, h. of IoC sq. ft. of house; and all roofed areas 2 copies of plan shovnng footings, beams, joists Cert of SurJey ReaJ '-_ Y--- N (20% maximum bt coverage allowed) 1 set of Energy Calculafions (or heated additions Tree Pres Plap Recd Y_ N. 2 copies of plan stwwing beam & window sizes; poured found design, efc. 7 site survey for addi6ons & decks Trce Pres Reqwred Y_ N lsetofEnergyCalculations Addifion - indicateif rn-s8esepficsystem On-sifeSepficSystem '_Y _N 3 copies of Tree Pmservation Plan if loi pbtted after 711/93 Rim Jolst Detaii Options selection sheet (buildings with 3 or less uniLS) . Minnegasm mechanical ven6lation foim Date L_ % U? Construction Cost -P Zo ? M Site Address ?i 213 321S 3 Z 17, ;Z 1 y 3 2 Z I 3 Z 2 3 Unitlste # r 'v?2?n_ ?r T ? DescriptionoCWork NC1'w1[r1I ?In ?@+aS Multi-Family Bldg ? y _ N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner ?oAf_HmA? I4hW TP1+dr??omtS Telephone D Ir 0 5 ?006 Contractor Address 7351 ?ifQkilloo cQ tyi ? 13c? ?p / City /?IqnIL 6110vC State Zip 5531-q Telephone {! ( 'Y?3 ) (L3' DS?/y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilatlon Category 1 Worksheet • New Energy Code Worksheet (dsubmissiontype) Submitted Submitted • Energy Envelope CalalaGOns Submitted In the last 12 monihs, has the CiTy of Eagan issued a permit for a similar plon based on a master plan8 _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( ) Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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. Applicant's Printed Name Applicant's Signature i 2/84 CITY OF EAGAN ? A PPLICATION FOR PERMIT SEWER AND/OR SdATER CONNECTIODT (PLEASE PRINT) 1) PROPEEYPYADDRESS: ?r??? !?,{)?iP?(`tP?Pl7 ?I?:t7sF r.Fr?,L nESCRLE3TTcv: A_ (Lr?t/Block/Subclivision or Tax cel I.D. Niunber) ST',L'CI'L^:ZE, De?T'O G^ ORIGu1AL ;aiILCL;G F_ _.!I?r IcSZ:a,NCr': 'U5E: ? R-1 SD]GIW r^p= ? /,``( 2 DUPLE.Y (?RO W ZTS ) ? L3' R-3 ZCI^dVHC[;SE (TIIl2F"' + LP,VITS) ( UNITS) ? R-4 APAR7=^P/CCN?y7S'?iIIL^,I ( iNI:S) Q COP4MERCIAL/RESAII,/OFFICE ? INDL'STRIAL ? INSTITUTZO:VAL/GOU='ZhIIIVT ? 2) AppLICAN'T ? (PLEASE PRINi) ??: ? )IC?fT CiQr, C ADDRESS: 1- S U l)i e1,20rI CITY, STATE, ZIP: ?? '?" od- PHO-NE: 3) pLTJeffiM PLEASE PRINT) FOR CITY USE ONLY NkME: ? awnREss: PLUMBERS LICENSE: , Attive CITY, STATE, ZIP: Z-t-.'?? 1?.?..PV. Ou' Expired MA?IER Pxo„e: yiq- ?r7xI pl,UMBER LICENSE N Not ofRecord C__? att nitia 4) OCCUPADIT/Cf.,ZIEP. NAME: (YLtAStPfllNT) ADDRESS: CITY, STATE, ZIP: PHO^]E: 5) INpICATE WHZCII PEP,MIT IS BEIPIG REQUESTID: eErCG.u"QECPION TO CITY SEWER 2T'CC.:NECI'ICN 'IO CITY WATER ? 0'I'EM (PLEASE DESCFtIBE) 7) SIGNAT[,'RE: PI,EASE F?OID APPROVID PERtitIT FOR PICi:-UP BY ONE OF ABOVE PLFlASE ?TAIL APPROVID PEi2ALT 'Ib 1, 2, 30 4 AEWE (.. . ) ? ? DA'I'E: aO Ms.s:sa?:^i??in?.e.r.?e::--, ?r?F?3r•-`-.=..Q F 0 R C I T Y U S E 0 N L Y PERMIT - ISSUEO FEES: $ SE;^iEn nt'??%[rm %I`ICLi:D? SU?Cu ^ ?r?.r'.s?) $ ie,Sa WATER PERr4IT (ItdCLL'DE SURCHARGE) $ G,?. ^-r WATER METER/COPPERHORN/OUTSIDE REAGER $ WATE?? TAP (I.ICiUDE CORPORATICN STOP) $ SE:1E4 ^:3n $ ACCOUNT DEPOSIT - SEAER $ ACCOUNT DEPOSIT - WATER $ WAC $ SAC $ TRUNi: T.QATER ASSESSP4Et`dT $ TRliNK SE[4ER ASSES5MENT $ LATERAL BENEFIT/TRUNR SEWER $ LATERr1L BENEFIT/TRUNK WATER $ ' OTHER $ TOTAL $ 969 •?o ANIOUNT PAID/RECEIPT iar .?a-o 3 ? , DOES UTILITY CONNE CTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES . IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ? NO EDIGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLO;^IING CONDITIONS: APPROVED BY: TITLE: DATE: 7 -,j,, -FSG .e aANMf? ???owing OcM Oa otw w_+? w??e ssf ws? Ra WcMwMilwpq wCa wk M so aw wun Rm ON wp+ wmm CITY OF EAGAN ? .. : 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 9y,52 PHONE: 454-8700 BUILDING PERMIT Receipt # ? O _ Te M uaed br 1 OF 6 PLEX EN,yal? $58,000 pate JUNE 11 , 1984 3215 EVERGREEN DR Site Addre¢s Erecf pX Occuponcy R1 1 Lat 'i4 slock cec/Sub. COACHMAN HIGHLAW61 ? Zoniny R3 Parcel No. 10-I8475-340-01 Repoir ? Fire Zone N/A Enlaroe ? Tvae of Const. V Name BRUTGER COMPANIES INC Address 1 SUNWOOD DR., P.O. BOX 399 City ST_ CLOUD phone 252-6262 p Name _ ?? Address f Citv Phone Gw Name BLUMENTALS ARCHITECTURE INC ri 6100 SUMMIT DR NO x? Address BRKLYN CTR 571-5550 <W City Phone Move ? # Stories Demolish ? Length -V u Grade ? Depthiy?tfSq. Ft.- Apvrovals Fees Assessment _ Water & Sew. Police - Fire Eng. Plonner ? Council _ 1 here6y acknowledge thof I have reod Ihis aDPlication ond slafe that gldg. Off. the inlormation is correct ond ogree to camply with all upplicable AP? _ $tate of MinnesoM Stotutes and City of Eogon Ordinances. Sipnoture of PermiHee Permit $ 107 00 SurcFwrge 29.00 Plnn check 153.50 SnC 525.00 Woter Cona 470 00 WaterMeter63- 00 Rood Unit 26 n-00 roral $1,807.50 A Building Permit Is issued ro: BRUTGER COMPANIES INC on the exprexi condition tha+ oll work sholl be done in accordont if I oDD?ica?6?Sf?e of_ Minneesota Statutes and City of Eagon Ordirwnces. i .?{-? Buildinp Official O?i..L?-? / ? OF (o ' CITY OF EAGAN Include 2 sets of plans, 1 site Alan w/elevations & BUILDING PERMIT P,PPLICATION 1 set of er.ergy ca].culations. 2b Be Used For Townhouse Valuation Date May 24, 1984 Site Address: 3215 ftewf±zrke--Br4ve ?!E{Z(a?2?,( pR. OFL'ICE USE ONLY Lot 34 Block 1 Sec./Sub. Coachman Highlands Parcel #: /D - «CC 7S` _ -?o` U/ Or7ri2r: Brutqer Companies, Inc. AddreSS: One Sunwood Drive, P.O. Box 399 City/Zip Cocle: st. cloua, MN 56302 Phone #: (612) 252-6262 r:iEC:t _X QCCl1pV1Cy F- -I Alter Zoning E-3 Repair Fire Zone N /16, Enlarge Type of Const. Nbve # Stories Demlish Front ft. Grade Depth ft. APPROVALS FEES CAntsactAr: -^u'_ger C-anies, Inc. P,ddress: C^e Sunwood Drive, P.O. Box 399 Gity/Zip Ccde: st. Cloua, Mta 56302 Phone #: (612) 252-6262 AYCh./IIlg.: Blumentals Architecture, Inc. Addr255: 6100 Summit Drive North City/Zip Code: Brooklyn Center, NAI 55430 PhOn2 #: (612) 571-5550 Assesssmnts Pezmit -?01 . =v Water/Sewer =>.:Surcharge 29.'- Police Plan CheckC5 5 Fire SAC ?25 •`° Eng. Water Conn. 4 -7D o? planner Water Meter 63 Council Road Unit Z(ob. ? Bldg. Off. APC nrrAL 7• ? v CITY OF EAGAN Remarks nl • 1 `? ? ? I ?' ? '-' _ Addition I C.OAC?M HIC1HLANDS Loi 34 Bik 1 Partel 10-18075-340-01 owner screec 3215 El/MREEN DRIVB state PAGAN AW SS121 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. Z D 1975 Paid una r arcei 10 2750 -010-03 STREET RESTOR. ,9 1974 of It ' GRAOiNG 1007 1986 354.14 35.41 10 3 ,// - Q 720 Q-/5 ff SAN SEW TRUNK 1968 Paid und arcel 10 2750 010-03 SEWER LATERAL 1984 to to WATERMAIN 1972 Paid udn arCe! 10 Z75O -a10-03 WATER LATERAL Z92- 1975 of of * WATER AREA 1972 is It wATFA LATERAL Z-%Z, I975 " STORM SEW TRK 1975 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT $260.00 #44004 6-12-84 WATER CONN. 470.00 BUILDING PER. SAC 525.00 PARK 'ITY OF EAGAN ?830 Pilot Knob Raad WATER SERVIC E eCRlIFri . T P. O. Box 2;,199 PERMIT NO.: Eegan, IiAN 55121 DATE: Zoning: ' No. of Units: 1 o i E? Owner: ? z u t g ^? F 53 ? Add?ess: ? '-'' te Address: !?flk14 B1 Cpachman 'r=i hl ar.cis lumber. ter No.: ??;.?. ..,?? ?;Z D ? . , . -• ionChorge: ct 470.0C pt'l r?.` SIZ@. &/J ? ? ! DCp6Sif: 15.00 P Reode No.: 0-3 ?- 32 7910 permit Fee: P 1 agra- !o somply with tha City of Eegan Su?che?ge: .50 P Ordinoaoss. M[sc. Chorges: '3 . 0 G n ci t 7otel: ? 8Y 2'`'''X Date Pcid: ' Date of Insp.: 4 4 4.a / Insa.: ..rw... - NEvi I.ITWu nvau P. O. gox 21199 6806 PERMIT NO.: Eagan, MN 55121 DATE: 7_31_,r,4 Zoning: r''!' No. of Units: ? of E Owner: "2'jtF•rx' Address: Site Addi Plum6er. I syroe M wmply wilh fhe C!!r of Eaya¦ Ordinenees. By Dote of Ir,sp.: 425.00 Coarkeaton Chorse: Account Depoait: 15.00 Permit Fee: Aki , 0 Surcharge: .50 p?t Misc. CFwrges: Total: Date Poid; -? Roceipt PLUMBING PERM17 Permit No. CITY OF EAGAN FN , i .- •?' Fill in numbered spacea S/C I Type w Print leyidfy Tot. * 1. Date 2. Installation Cost 3. Job Addrl Bik. Tract , 4. Owner 5. Contractbr ", , . Phone 6. Address 7. City State Zip 8. Building Type: Residential O Commercial ? Institutional D 9. Work Description: New ? Add?[] Alter ? Repair O 10. Oescribe ` ? • 11. No. Fixtures Water Closet No. Fixtures Ce l/D i fi ld Bath tubs sspoo ra n e Se tic T nk ? Lavatory p a Soft er Showrer n Well Kitchen Sink Urinal/Bidet Oth Laundry Tray er Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with afl ordinances and codes g vsrning this type of work. Signed : s: • . _foi " Rough f inal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt r PLUMBING PERMIT • Psrmit No. ??' ?• CITY OF EAGAN • Fse Fill in numbered;paces S/C Ty Type or Print /egib/y Tot. 1. Date 2. Installation Cost 3. Job Address. : ?. i? Lot - 'i Blk. ? Tract,'Lx . 4. Owner ?tr !'e t 5. Contractor A • i ?7?`? i + Phone 6. Address 7. City t_ct l. 'S State Zip 8. Building Type: Residential 0+ Commercial ? Institutional O 9. Work Description: New,El Add O Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs 5eptic Tank Lavatory Softner ? Shower Well _L Kitchen Sink Urinal/Bidet Other ? ? Laundry Tray ? Floor Drains Drinking Ftn. Stop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to oomply with all ordinances and codes governing this tYpe of work. , "Y' ? Signed: ' -;?"?' 1?`-- for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454,6100 Receipt L1 4A, MECHANICAL PERMIT Psrmit No. ? b1 1 ? CITY OF EAGAN 2_f, d a Fee ? ? Fill in numbered spaces S/C ' G Type or Print /egib/y Tot. %Y .Y U 1. Date C- Z y- S/ 2, Installation Cost rr 2 /` 3. Job Address 19i --`1_Blk. I ?ract 4. Owner • 5. Contractar Phone 6. Address 7. CitY 8. Building Type: Residential 'Er 9. Work Description: New 10. Describe 11. State Zip Commercial ? Institutional ? Add 0 Alter ? Repair ? Type No. ? Equinment BTU - M. Ea. Forced Air y v No. Equiament CFM Air Handlin : Mfg. ` g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg, Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to vern this type of work. comply with all ordinances and cod7?04 Signed : ?i •?-; ? ?f or -? Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464,8100 T _... .--?.?.-?-- r _.-•- _?. CITY OF EAGAIV N. ? 91 52 . •• 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MAi 55121 PH UN E: 454-8100 BUILDING PERMIT Receipt r.. L. ..." 9... 1 OF 6 PLEX Site Addre?a 321 Lot 'S? BIpcJ,c? Parcel No. 1 U ac Name `"`•"' " ""• ` ; Addres? • CLOUD n U b City Phone t Name SA"iE ?? Address ?- City Phone t. Vo,ue $58,000 Dote JUhF 11 1 q 84 Ht ? T G AI? 0 1 ?? -1 1 7 HI C HL ? ? R Repoir ? N/A Fire Zone S INC Enlcrya ? v Type of Corut. ?? . O. F30X 399 0 # Stories ?"10lish ? Length 5- 262 Grode p Depth Sq. Ft. Approrols Feos Name -?__w_._. ?. .......,??.,..?.,?.... ??... Addres? , ` 1. 571-5550 City ? Phone I hereby ackrww the intormorion Stata of Minnea Sipnaturo of P1 /1 Building Pertni oll work sholl be I have reod this application and state thot ond cgree to tomply with all applitable :s and Ciry of Eogan Ordinonces. Assessment Wafer 3 Sew. Police Flro Eno• Plonner Countil Bldy. Off. APC Permit $ 307.00 5urchorfle 29.00 Plan check 153.50 SAC 525. u0 Woter Conn. 470.00 Water Meter 63.00 Rood Unit 260.00 Totol $1,807 • 50 ??- BRtITGI:R CONPAN ES INC I Issued to: on the express conditian thrn ie in ocaordonce wit"ll opPiicobre Stgte of Mimesota Stotutes and City of Eeyan Ordinonces. Permit No. Parmit Holder Misc. Permit No. Holder Plum6ing [ H.V.A.C. e"r1 kS4 wen Water I Diap. 5owsr Eketric ? ?? a l? (!(?. ?V Inspettion Date Insp. Other Footinys Found.tian Framin9 ? Rouph PI6g. Rouph HVAC ? Inwlation f ?g Final Plbg 1TW Final HVAC Final ?/f f Water Dsscribs Location: • Well . ? Sevwr Pr. Disp. . RESIDENT / OWNER Name: -DA -1 t 4t 1161 -1 LA-tub _5 7G/ ° f(/ 1 C:Phone: Address / City / Zip: _ 5 A- L 3 FL4 ( t Dia— Applicant is: Owner Y Contractor TYPE OF WORK Description of work: RF (200 i Construction Cost: // S' Multi - Family Building: (Yes x / No ) CONTRACTOR Name: Rco 3 /-t/ 4J/ 1)4 -ANC. . License #: 02 ° 1 r 7a i 53 Address: S Q (JAM /44 NE City: ST M /C. f,4- - L State: MX Zip: 53 ( Phone: 76 3 - 5- - C y c /CV Contact: R- (Z / Email: )D • /' _ +w L7 r0 0 '- co iii / . Coo\ COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor: 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. ** City of Evan Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Applicant's Printed Name 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Applicant's Signature Staff: Use BLUE or BLACK Ink Qr1e -'/ Permit #: /4(0 Permit Fee: 221 2s Date Received: l2 2 /a Date: Co /U Site Address: 32 I 1 El/ (,,BEEN N, go/l_6(A) 6 L 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 VIG.l 1 I? 17 '2-11 3223 Suite #: 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 wit be in accordance with the approved plan in the case of work which requires a review and approval of plans. Page 1 of 2 . - - , �� 3� :3 aI Sj 3:�- 17j � � ►�� -�1 , ��.3 Use BLUE or BLACK Ink ------------------ � For Office Use � ' j Permit#: '1 �W �� j Cit� of ��Il a� � Permit Fee: ��• I 3830Pilot Knob Road Eagan MN 55122 j Date Received: j Phone:(651)675-5675 I Staff: I Fax:(651)675-5694 � � �..�� -�_��J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: cJ �"1, �� t Site Addr�s: ��' �o��" J �U�.�� VF-LIJ� Unit#: �3"3�-3 Name: Phone: Residenti °� ^� ��1 J � �Wtt@1' Address/City/Zip: J��3 ^ �d��3 � � l✓� Applicant is: OHmer 1� Contractor �.�� Description of work: �� Construction Cost: � `� � � Multi-Family Building: (Yes�/No� ' Campany: i�V b'F �- 1�,� • l�� . Corrtact:�t�'�� 1��1�� C011#C'dC��l Address: ��j0� �Ilf�� 1/� • �L.. City: �� I��lG-Nl��.L ' st�te:�� z�p: �537b Phone:�D1.2-"1��"IP13� EmaiL��{�lr.l►'1C.FL��I'n1a1��CD ' License#: �� J Lead Certificate#: 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 moMhs,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 8 Water Contractor. Phone: NOTE:Plans and supporting docurr�ents that yau submit ar�e cot►sider�tl to be�ubltc�nfomratiart. Por�ns of #he ir�farmation may be ctassified'�s rwrr publtc if yc�u prQV�iale speci�c reasons#ha#wcruld�errre#t fhe Gity�cr cw»cJuc#e ti+at fhe are tr�ate secr�s, 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.c�opherstateonecalf.org I hereby acknowledge that this information is complete and aca�rate;that the work will be in conforrnance with the ordinances and codes of the City of Eagan;that I understand this is not a permit, but onty an application fior a permit, and work is not to start without a pertnit; that the wro�ic will be in accordance with the approved plan in the case of work which requires a review and approval of plaru. Exterior work authorized by a building permit issued in accordance with the tabe Bui in Code must be completed within 180 days of permit issuance. x ^�� x ApplicanY Printed Name Applicant' ign ure Page 1 of 3 Use BLUE or BLACK Ink For Office Eatail Use 'It'll"clty Pe #: / ( ;:7q ), 0 rri# Penntt Fee: g3al 3830 Pilot Knob Road Eagan MN 55122 EL- a _.j Date Received: Phone:(651)675-5675 buiidinainspectionstatcitvofeas».com SEP 1 2017 staff 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: A-kt+T^ k.`y3 lrtis'ph7i } ii Phone:Name: Resident! Owner Address/City/Zip:3 (5 5v..'2-4r-q1-4 r, D r,\f2 -.z--a, k •.) G`i, .1 Applicant is: Owner X Contractor Type.of Work Description of work ►2, rve0,:-.t k ?.,...ti 1.A- st p�-_4, C'--k 1) \L.. Construction Cost Multi-Family Building:(Yes )4 i No ) Company: 54.->--.N :4, :_ ? 1-.Lc;}-V::-n, rte- Contact ti's`, S'aA):a Contractor Address: 2:1'-'•;c-' -1;c114 ,14 `5 r- City: 13-.:a�.)z'1 � ' State:l'i`,.3 Zip: 5c'`''`" Phone:L12-- ''''''S.)-3 g31.3 Email: `51lcr o;"s- �.�.c: > 'e it,a':` . ' ''n License#: B L 3 3_I 1`t Lead Certificate#: 12;14 if the project is exempt from lead certification,please explain why: c-�3'.,.. 'v-;?_, e,;1 'As-... .cit-'-A -_4 amu, i 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: l Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to bepub#cbNin atlon. Portions of the information may be classlfled as non-publiclic it you provide speciffc reasonsthat wouldpermitthe City tocot ciudethatthey 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.citvofeagan.comtsubscribe. Exterior work authorized by a building permit issued in accordance with the Mirmesota 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 utillies. www.gopherstateonecallora 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 permk;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 5-210.?pe.......k.\,.... ......,..2,4:?..-6, ,-,..,-Vc-....c...e....AA ..-r t1.14-,c_. 1/Z......_ x_... ......e.'"'e".*:_,....-----z- ":-,---' .,e,..:.-----,....,#' '--- Applicant's Printed Name Applicant's Signatu Page 1 of 3 3. 15'. giktg ' OT ITE+BELOW THIS LINE Jf57' 7 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi XDeck _ 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 /'� �1 Valuation ' La 0 O ° Occupancy i 3 MCES System Plan Review / t Code Edition 1 SAC Units (25%1( 100% ) Zoning 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 I C.O. Required Footings(Addition) X Final I No C.O. Required Foundation Foundation Before Backfill ! HVAC Gas Service Test Gas Line Air Test 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 �1� Base Fee l , Surcharge ` l a'" ,' ti Plan Review '' �` MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge PNI Treatment Plant (11,12Copies ` I ` TOTAL Page 2 of 3