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3217 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 ? ? z/a4 ; CZTY OF EAGAN ? APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTIODT (PLEASE PRINT) 1) PROPERPI' ADDRESS: r•Frar• DESCRIpTIC:1: ?23 .?L? p (Lot/Elock/Subclivision or Tax Parcei I.D. Nluciber) i: t'YIS=':_:C STRC''CP?2E, DaT--; OL' ORIGii1AL .'-,iiILPI:iG ?=T ISSZ:?%CJ: ? PR7JL-;r- ? t'2'-1 SLVGI-E C_tl-_NiT,Y 2 DUPIE{ ('ILN'0 Wi ITS ) V 3 TC'lA7NII3CYISE (Tf?2 EE + [InTITS) ( UN7T5) ? R-4 ApAR'IY'E?:T/CG-mC??LL1TILn1 ( INITS) ? COMMEEtCIAL/REPAII,/OFFICE p MCSTRIAL Q INSTITUTIONP,L/GCV??]'P (PLEASE PftI4T) Z) APPLICt'?V'T ` NAI1E: ? 'SV'TC? C? S' PonREss: _1? ??,??c????n?) 1??. CITY, STATE, ZIr: a}. CIlhcgd ImL] ' PHONE: 3) pLUjiBEFZ (P1LnEASE PRINi) FOR CITY USE ONLY Pl?: ? fol?A, T? N ?ib A°°RESS' 1 I? l?f? ,; ` V P?lyUyBERS LICE4SE: 0 C L ] Active 1?.,? CITY, STATE, ZIP: " ker II V)o ??82 Q Expired PHOiVE: r' 1 -1 ?SIt? ? ?"I I ? 0 Not of Record 7d ^ ?_ PLUMBER LICENSE # / arr nitia g) QCC[JpAN'I`??,7NEy ?? t YLt0.?tYHINIJ : ADDRE55: Q? -- a CITY, STATE, ZIP: PHONE_ 5) INDICAT'E WHICH PERMIT IS BEING REQUESTID: ON 'Ib CZTY SD7ER C0.]NEK.TION TO CITY WATER ? dI'EM (PLFA.SE DESCRIBE) 6) L'vDIC;!?.;: 0:-.: ? PI,FASE HOID APPRC7VF1D PEFiMIT FOR PICi:-UP BY ONE OF ABOVE °LEASE titAIL APPRCJVID Pg= TU l, 2, 3? 4 ABOVE (Circle one) 71 SI='IL":2E: DATE: ? F 0 R C PERMZT !-` ISSUED T Y U S E O N L Y FEES: $ ?o ?-a $ tn .G'Q $ $ $ $ $ $ s1 > o . a-.?? S $ $ $ $ $E;^dER nEp?tTm !T`ICLi:DE .,'..'? u ar•, C ? ., ? ) WATER PER14IT (INCLIIDE SURCHARGE) WAT°R METEP./COPPERHORN/OUTSIDF. READER WATER TAP (ZNCLliDE CORPCRATZON STOP) SE:1E4 T*.n ACCOUNT DEPOSIT - SE-A:ER ACCOUNT DEPOSIT - WATER WAC SAC TRUiVK T.VATER ASSESSMEDIT TRliNK SEWER ASSESSIIENT LATERAL BENEFIT/TRUNR SE?VER LATERAL BENEFIT/TRUNI: WATER OTHER $ TOTAL ,G o . .r! 'a< G s f $ 98 9• -s"d ANiOL'NT PAID/RECEIPT ; g DOES UTILITY CONNECTION REQUIRE EXCAVATION I[V PUBLIC RIGaT OF WAY? ? YES IF YES, THEN A"PERMIT FOR WORK WITHIN ? PUBLZC ROADWAY" MUST BE ZSSUED SY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBSECT TO THE FOLL0:4ING CONDITIONS: APPROVED BY: TITLE:-,,/ DATE: 8? ? MGs" w?M NWW? WRAN OtWOe W-w R+ fa a ffle fia wf+ w.a R? sf VWr? ?04 W4=MW=se 0,:M wc_w PcW Wa WI:i+ 10 ? ' CITY OF EAGAN . N? ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 9153 PHONE: 454•8100 BUILDING PERMIT Receipt # T. be wad fer 1 OF 6 PLEX En,yalue $58,000 pate JUNE 11 19 84 SiteAddress 3217 EVERGREEN DR Erec t pX ccuponcy O Rl ct Lot 33 Block 1 Sec/Sub. COACHMAN HIGHLA•mqnta ? Z oning R3 Percel No. 10-18075-330-01 Repair ? Fire Zone N/A Enlarge ? Type of Const. V ? Name BROTGER COMPANIES INC Move ? # Stories Z Address 1 SUNWOOD DR., P.O. BOX 399 ?rtfOlish ? 'yy Length_ (l ? City ST CLOUD phone 252-6262 Gmde ? t Depth 3?? Sq. Ft.- ? AME Approvab Feas ,o Name F ?? Address r City Phone ?W I Name BLUMENTALS ARCHITECTURE INC i? Address 6100 SUMMIT DR NO sZ,. City BRKLYN CTRphone 571-5550 Assessment _ Water & Sew. Police - Fire Erg. Planner - Council _ 1 here6y ocknowled9e thot I have read fhis apDlicotion ond state that gldg. Off. fhe intormotion is correct and ogree to comply with oll opplicable APC - $tofe of Minnewto Statutes ond City of Eugan Ordinances. $i0noturo of Permittee Permit 07•00 Surcharge 29 • 00 Plon check 153.50 SAC 525.00 Water Conn. 470.00 Woter Meter _6L3.:00 Road Unit 25n-00 Total $1,807.50 A Building Permit Is Issued ro: BRUTGER COMPANIES INC on the express condirlon thnt all work shall be done in accordonce with a}f ?ppliwbJe "o of Minnewto Statutes ard Ciry of Eagan Ordinances. Building Officiol E)U I L D! N U'A2 '? CITY OF EAGAN Include 2 sets of plans, I?jF (o S?-? 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. Zb Be Used For Townhouse Site Ptldress 32?? Everqreen Drive Iot 33 Bloclc 1 Sec./Sub. Coachman PaYCel #: /0 10 )S -, 230 _ H?qhlands Owner: Brutqer Companies Inc. ACkli'255: One Sunwood Drive, P.O. Box 399 Clty/Zlp COCle: St. Cloud, MN 56302 PhOite #: (612) 252-6262 COritYdCtpr: Brutqer Companies Inc AddL'2S5: One Sunwood Drive, P.O. Box 399 City/Zip Cod2: St. Cloud, MN 56302 Phone #: (612) 252-6262 Arch•/E'19.: Blumer.tals Architecture, Inc. AddLLe55: 6100 Sucunit Drive North City/Zip Code: _ grooklvn Center MN 55430 PllOne #: (612) 571-555n Valuation $}5°° Date Mav 24, 1984 OFFICE USE ONLY Erect Oc,cupancy ?- ? Alter zoning R. 3 Repair Fire Zone Enlarge _ Type of Const. ? mve # Stories Dgnolish Fmnt ft, Grade _ Depth ft. Hssess-ments Permit ?aater/Scaer Surcharge Police Plan Check_ Fire SAC En3• Water Conn. Planner Water Meter Council Rnad Unit Bldg. Off. - APC Zl7I'AL 4, 5 3 7 • ,:3 O CITY OF EAGAN Remarks Addition JC011iCtMAN HIGH.ANDS Lot 33 Bik 1 Parcel 10-18075-330-01 Oiemer ' Street 3217 EYER6REEN DRIVB State EAGAN MA1 55121 Improvement Date Amount Annual Years Payment Receipt Oate STREET SUFiF. 7 . STREET RESTOR. $ ? it of of GRADING 1007 1986 354.14 35.41 10 -/0 /0 - `- . 5AN SEW TRUNK SEWER LATERAL 1994 ft t? 1? • WATERMAIN I( 1972 P d und r mrcel 1 Z7 WATER LATERAL ?, 1975 ?t nn n * WATER AREA 1972 11 tr u ? 2- 1975 It tt 11 STORM SEW TRK 'Zg 1 7S STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT $260.00 #44004 6-12-84 WATER CONN, 470.00 BUILDING PER. SAC PARK CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P.O. Box'21199 PERMIT NO.: Eagan, MN 55121 D/?TE: 7- 11 -'' Zonin9: p„ `, .+ ?. • No. of Units: ? OMI/1lf: 13 ???I 1ggrM !o oomPly with tba City of Easan o.rtscoe... Yn?-L # 0-n ?,, -,-?, _ CITY 3830 P. O. 'Posit: 1.5 AOpd lII no Pd 2es; 61 _ nn Fj OF EAGAN SEWER SERVICE PERMIT Pilot Knob Road .3r. F,?'):) u Box 21199 PERMIT NO.: 7-31 MN 551'? DATE: ' " Zonfnp; ru ger No. of Units: ? Owrwr: Address: .5219 ergreen vttve oac man g i-irxc 9 Site Address: !'- Plumber: ? Iph 9 P b? (1-127-64 W714 • 1 yres to eanvh? whb t`e G1p of Eaonm Connection aorge: 425.00 pd .00 Ordtnenea. AccourK Deposlt: p Permit Ae: 10.00 p Surcharye: _ ' P By Misc. Chot'pes: Date of Insp.: Totol: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Roed ' 5615 P. O. 60:: 21159 PERMIT NO.: 7_ 31- S4 EurZoning: n, MN 55121 DNTE: ?a"U J No. of Units: o f F' gwner: BT.'llt??GS3: lllk ?7 S I Addrcss: ?r: -rRi??? R ?- C. ' -? 470.0o vd r No.: R`. u?cri?, aor?: 15 00 1 -) a Stze: " ?'c''? •r " -- Reade No.: Q.1 L 8' D 1 y ---- 1 nyne eo eawpll? willi Nw Ciry of Eagow Ordi"nees. BY Dote of I nsp.: nt Deposit: lo. oo ,: _ Permit Fee: 5U po Surcharge: Misc. Cha,ges: 63 00 pd mecer Toto1: Date Paid: - MN 55121 DATE: ? No. of Units: Conrnttlon Clwrpe: Account Deposit: _ Sur+chorpe: - M(sc. Cho?yes: By Date of Insp.: Total: Insp.: Date PoW: Receipt PLUMBING PERMIT • Permit No. ?- • CITY OF EAGAN • Fee fill in numbered spaces S/C I Type or Prini /egibly Tot 1. Date '• -"i 2. Installation Cost 3. Job Address , ? ? ? vCC'?r- r •J.ot Blk. ? Tract . ; 4. Owner I , A,%.c, p r ' ? 5. Contractor i , ?-, ! `;h, Phone 0 6. Address ,-f?h' 1'?•_ = .: ?? r - --- -- 7. City State Zip - 8. Building Type: Residential -0' Commercial ? Institutional ? 9. Work Description: New-B- Add ? Alter ? Repair O 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other ? ? Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : !._ 41 . 0- ' -#or Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt -1 'l L J' kL PERMIT EAGAN Permit No. Fee ? `c- ? ? s/c ? r ; Tot. 2.0• 3 c.• i i 1. Date 2. Installation Cost 'Lur L-? ,I. fl' ?. 3. Job Address Blk. _i ?ra(`7 ct ? 4. Owner /? ?-?- .-•.?., 5. Contractor Phone 1- 3 ?% w y 6. Address 7. City State 2ip 8. Building Type: Residential Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe \ Fuel Type 11. No, ' Enuinment BTU - M. Ea. Forced Air .?? No. Equiament CFM Ai ndli : H Mfg. r a ng 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 comply with all ordinances and codes governing this type of work. Signed: ??t.•r..??.-r=for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 lr C 9153 PHONE: 454-8100 , BUILDING PERMIT Receipt # Ta L. rrA iw. 1 OF b PLEX c- \/-1- $58, cV U .,_,_ JUbIE I1 ... 84 Site Address Lot 3 3 Parcel No. _ IV8f71C Dr<., P.O. sox 399 A?reiA City Phone flW ? Gi?l City $RKLYN CTF phone 571-5550 I hereby acknowledge thnt 1 have reod fhis opplication and siote that the intormotion is wrred and ogree to tomply with oll opplicable Stota of Minnesotu tatutes and Ciry of Eagon Ordinonces. Sipneturo of Permittee ATRUTCE'F Cn1?4PANIFS Erott Occupancy J"' '?r ? Zoning R Repoir Q Flre Zone , E? Enlarpa O TYPe of Const. v Move ? # Stories Demollsh p Length /'7 ' y" Ft. Asuument Water & Sew. Police Firo Enp. Pianner Council Bidy. Off. /1PC Permit '"' I • v v Surchcrge 29.00 Plon check5 3•50 SAC 525.00 Water Conn. 470.00 Woter JNetar 63.00 Road Unit 4'- G 0. U 0 Torol , . 50 INC A Bullding Pertnit Is luued to: ' ? on the express condition ihnt all work sholl be done in accordance wlth o11 opplicabFb StoEe of Minnesoto Statutes and City of Eaqon Ordinonces. Buildirq Officiol ?r 11 - P.E ( `. - -- _ !. ' r . - Pwmit No. Permit HoltMr Mise. Permit No. Holder Plumbing k / CJFy H.V.A.C. We11 Water Disp. Sower Electric A o Q q 4 o a Intpection Date Insp• Other Footings Foundation Freminy fG U Rouph Plbq. Rouph HVA Inwlation Final Plba Finel HVAC Final Water Dex?ibe Locati t Well Sewsr 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 4bl. For Office Use Gni. of u� Permit# > 7 £ 17 Permit Fee: `/ 5 1 3830 Pilot Knob Road Eagan MN 55122 D Date Received: Phone:(651)875-5675 buiidinginspections&cityofeastan.com Seo 1 g 1017 staff 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: fir,- t,:y- . t-tKs-i:t+y C.� .C.A,N kA� -`C't I? .14,C- ;_, , r 1 11/4' c4..--�:�i� -- 3=S").4, Name: zPhone: `3 Resident/ Otter Address/City/Zip:3 a 17 -v-42rrckrs r, 1)r k•f2j -a._:�3 Yu i i•-) '. i ) Applicant is: Owner 'X Contractor Type of Work Description of work � �-:..1 k , "`- '"es`1' '''A- '':.'-`_fit- Construction Cost Multi-Family Building:(Yes Y /No ) Company: 5'7'* tA,-s ( , .rt5A-4-.A-I\. :-u,"tc Contact VW.`.1L,a S-zb:, contractor Address: Z- Vic: ? =t t `a$s^ . City: I 51.:e.v— State:l'ij--, Zip: 5S`; 7---Phone:+i t 3 3-c333 Email: 5-2\Ee*°"..'54'.a. k\--,e --ri.a:‘ , License#: 6C_t3�3-I1 ci Lead Certificate#: I-% 14 If the project is exempt from lead certification,please explain why: c-; Vii::..;- 1 i,,-.acam, c-:-i1= -st-i-�ac ---.4 "s-cie_14- t {1Lb 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: NOT&Pians and supporting documents that you submit are considered to be publicinfOnnation. Pylons tithe information:may be classified as nonpublic,b`you provide specific reasons that wouldpermit the CUy to conclude t they 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.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. Can 48 hours before you intend to dig to receive locates of underground ailkkits. uwuw.aopherstateonecail.ora 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 pemnit,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. „., •_'..-1---.' _:-x 112......_'N\-1-.L.,' % 5-:-../ya-, Ps-z‘--d -41 i--- „i °,'... _,.,- ,-,,e7,...."°.- e-*.--......',....**"'' '- Applicants Printed Name Applicant's Signatu Page 1 of 3 6,4-6-/t. Ow. r go/7 r1� DO NOT WRITE BELOW THIS LINE lg.g -7g SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi X 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 y Replace — Repair _ Egress Window _ Water Damage 1 Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 94212 Occupancy MCES System Plan Review Code Edition , : , /r" SAC Units (25% 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: X" Footings(Deck) Final/C.O. Required Footings (Addition) X Final/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 A / a Base Fee Surcharge ,, m Plan Review MCES SAC City SAC Utility Connection Charge (/� S&W Permit&Surcharge V Pv Treatment Plant 01' 492, /2, 0 C-22 Copies TOTAL Page 2 of 3