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3241 Evergreen Dr?REQUEST FOR ELECTRICAL INSPECTION ' See instructions for completine this form on back ot yellow copy. A" :in ?I "X'" Below Work Covered by This Request Es-oooor-oa ' 7 7(09' Afid Rap. " i?yoq_ of euilding Appliances WireA Equipment WireA ? X? Home Range 7emporary Service Duplex Water Heater Lightiny Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Fumace Silo Unloader Industrial 81dg. Air Conditioner 8ulk Milk Tank Farm 02her Soec y OtherlSOecitvl ther SueciFY Other Other (,'ompute lnspection Fee 8elaw p Fee Service EntrenceSize h Fee feeders/5ubfaeder5 ? Fee Cir vits ' 1 72,00 0 ta200qms to30Ams Oto 30Ams Above 200 Amps' Vj . 0 1 to 1U0 Amps 31 to 700 q y Swimming Poal Above 100_Am s Above 100_AmPs TransformerS Irrigation Booms Partiai:'Other Fee Signs Special Inspection S 50 0 O OTAL Rerrerks . FEE , ut To wnhouse Proje flough-in ? - ? Dnte ? /-??7 ? ec ectriwelby ns P Itor, hel certily thxt the abova Final ?`? c specfion has Oeen matle. Thie repuesf voitl 18 monNS fmm ihis request vaid 18 months trom ( A 1 fl r,';d 1,21i 81t Coachw?°ih 4Vtklaa ds 3 8''I (c S' -t14' , sn Reques[ Daie Fire No. F equi Rough- ed in tnspeci?on r? Fea dy Now Q W ' N l l I nsp oHfy 9-21-Q3 ?Yes ?NO [or Whe nFe adv E] Lic2nsetl ElecViwl Contrac[or I hereby request inspection of abovg ? Owner electrical work installed at Sveet Address, Box or Houty No. C ity 3241 Evergreen Drive Eagan ecLgn o Township Name or No. Range No. County ? Dakota Occupertt (PqINT) Phone Np, Brutger Companies 612-252-6262 Power Supplier Address NSP Eiectrical CoMractor (COmpany Name) Contractor's License No. Tim's Electric, Inc. Mailing Address (ConVactor or Owner MakinP Instailation) 432 S. Wabasha St. Paul MN 55107 p.?jhprvzed Signamre (COntractodOwner Making Installationl / Phone Number 2 24-8293 MINNESOTA STqTE eOAN F ELECTflICITY THIS INSPECTION pEdUEST WILI NOT C+riBgs-Midway Bltlg. - Po N-191 gE ACGEPTED 8V THE STATE BOARD 1827 Univarsity Ave., 51. Paul, MN 55704 UNLESS PROPER 1ltlSPECiION FEE IS Phone 16121 297-2111 ENCLOSED. ^????? CITY OF EAGAN , Include 2 sets of plans, 1 site plan w/elevations & ?fBUILDING PERMIT APPLICATION 1 set of energy calculations. 2 i,3aQ • Zb-B2 Used P'Or 1 of 6 Plex ValUatlOn ?.488 ? 3 Qao Ddt2 July 13, 1983 0 S].te Adciz'2SS 3241. Evergreen Drive IAt 21_ B1oC.k 1 SeC_/SUb. Coachman -Parcel #: Highlands Own2T- Brutqer Companies, Inc. Add*'Pss: One Sunwood Drive, P.O. Box 399 Clty/Zip COde: St. Cloud, MN 56302 Phon2 #: (612) 252-6262 CORtrdCtor: Brutqer Companies, Inc. Addre55: One Sunwood Drive, P.O. Box 399 City/Zip Gode: St. Cloud, h]N 56302 Phone #: (612) 252-6262 Arc'1i./Eng.: $lumentals Architecture, Inc. AddresS: 6100 Summit Drive North C1'ty/ZlP COdC': _ Brooklyn Center, MN 55430 Ph011e #: (612) 571-5550 OFFICE USE.ONLY Erect ? Occupancy e? Alter Zoning Repair Fire Zone Enlarge _ Type of Const Nbve # Stories y Demolish Front ft. Grade Depth ft. APPROVALS FEES Assessrients Permit a=Zx= ?aater/Sewer Surcharge ,',U-- Police Plan Check /4(6 Fire SAC 16-ox.f Ehg. Water Conn. cL1-2 _ Planner Water Meter *6 0 Council Road Unit 3,r-O Bldg. Off. APC 'IC)7`AL ? ? Q I ?? l • Bldg. A-5 BUILDING PERMIT T. ? oe,a ?, lof 6 PLEX Site Addres Lot 21 Parcel # - CITY OF EAGAN 9795 Pilot Knob Rmd Eogen, MN 53122 PHONEs 434-6100 Drive $53,000 Btxk 1 Sec/SubCoachman Highlands c Name Brutger Companies, Inc. ? Addreu One Sunwood Dr., P.O. Box 399 ?-;.,$C• ClOlld 252-6262 p Name OWneY ??? Address t- Name Address I hereby ackrwwledge thot I hova read this application ond state thot the inbrmation is correcf ond agree to comply wifh oll opplicable Stafe of Minnemta $tatutes and City of Eagan Ordinnnces. $ipnofure of Pertnittee rutger Companies A Buildinq Permit Is issued to: oll work sholl be done in accordance with oll oppli ble Stme Building Offlciol A?OAI ?p 1 Erect )C$ Occupancy R-3 Alter ? Zoning R-3 Repoir ? Fire Zone NA Enlurge ? Type of Consf. V Move ? # Stories Z Demoliah ? Length_ Grode ? Depth Sq. Ft.- Aoorornb Faes Assessment _ Water 8 Sew. Police _ Firo Eng. Plonner _ Council _ Bldg. Off. _ APC Permit Lyz•VV Surcharge 26.50 Plan check 146.00 SAC 52$.00 Water Conn.450.00 Woter Meter 60.00 Road Unit 250.00 roral $1749.50 N° 8335 Receipf i}` 276-5-1 _ on the exryress condition Ihm ond City of Eagan Ordirwnces. ^????? CITY OF EAGAN , Include 2 sets of plans, 1 site plan w/elevations & ?fBUILDING PERMIT APPLICATION 1 set of energy calculations. 2 i,3aQ • Zb-B2 Used P'Or 1 of 6 Plex ValUatlOn ?.488 ? 3 Qao Ddt2 July 13, 1983 0 S].te Adciz'2SS 3241. Evergreen Drive IAt 21_ B1oC.k 1 SeC_/SUb. Coachman -Parcel #: Highlands Own2T- Brutqer Companies, Inc. Add*'Pss: One Sunwood Drive, P.O. Box 399 Clty/Zip COde: St. Cloud, MN 56302 Phon2 #: (612) 252-6262 CORtrdCtor: Brutqer Companies, Inc. Addre55: One Sunwood Drive, P.O. Box 399 City/Zip Gode: St. Cloud, h]N 56302 Phone #: (612) 252-6262 Arc'1i./Eng.: $lumentals Architecture, Inc. AddresS: 6100 Summit Drive North C1'ty/ZlP COdC': _ Brooklyn Center, MN 55430 Ph011e #: (612) 571-5550 OFFICE USE.ONLY Erect ? Occupancy e? Alter Zoning Repair Fire Zone Enlarge _ Type of Const Nbve # Stories y Demolish Front ft. Grade Depth ft. APPROVALS FEES Assessrients Permit a=Zx= ?aater/Sewer Surcharge ,',U-- Police Plan Check /4(6 Fire SAC 16-ox.f Ehg. Water Conn. cL1-2 _ Planner Water Meter *6 0 Council Road Unit 3,r-O Bldg. Off. APC 'IC)7`AL ? ? Q I ?? l • Bldg. A-5 BUILDING PERMIT T. ? oe,a ?, lof 6 PLEX Site Addres Lot 21 Parcel # - CITY OF EAGAN 9795 Pilot Knob Rmd Eogen, MN 53122 PHONEs 434-6100 Drive $53,000 Btxk 1 Sec/SubCoachman Highlands c Name Brutger Companies, Inc. ? Addreu One Sunwood Dr., P.O. Box 399 ?-;.,$C• ClOlld 252-6262 p Name OWneY ??? Address t- Name Address I hereby ackrwwledge thot I hova read this application ond state thot the inbrmation is correcf ond agree to comply wifh oll opplicable Stafe of Minnemta $tatutes and City of Eagan Ordinnnces. $ipnofure of Pertnittee rutger Companies A Buildinq Permit Is issued to: oll work sholl be done in accordance with oll oppli ble Stme Building Offlciol A?OAI ?p 1 Erect )C$ Occupancy R-3 Alter ? Zoning R-3 Repoir ? Fire Zone NA Enlurge ? Type of Consf. V Move ? # Stories Z Demoliah ? Length_ Grode ? Depth Sq. Ft.- Aoorornb Faes Assessment _ Water 8 Sew. Police _ Firo Eng. Plonner _ Council _ Bldg. Off. _ APC Permit Lyz•VV Surcharge 26.50 Plan check 146.00 SAC 52$.00 Water Conn.450.00 Woter Meter 60.00 Road Unit 250.00 roral $1749.50 N° 8335 Receipf i}` 276-5-1 _ on the exryress condition Ihm ond City of Eagan Ordirwnces. CITY OF EAGAN 3830 Pilot Kno6 Road WATER SERVICE PERMIT r? ?; f, r i PERMIT NO : P. O. Box 21199 . ? MN 55127 an E DATE: , ag i Z of Units: No on rg; . Ownar; Urutger Co Address: 3241 EvergrQan Dr L:.1 lil Coachnan :iighlands sib Aedreas: -- Hayes .on rac ars Plumber: 00 pd 450 Meter No.: Connection Charge: . Si AcCOUnt Deposit: ze: 00 10 Reader No.: Permit Fee: . ? ' n 1 aqne te oomphr wilh !IN City of E,oyan Surchorge: ' OrdinancM. Miac. Charges: 6 0. 00 pu Ti^ t el' Total: g Dats Paid: y Dote of (nsp : (nsP•: . CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road 6-04 j P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 pq''E; R-3?` 3 Zonirg: , No. of Units: Owner. b.rutger CO Address: Site Addi Plumbec 1 ayroe ta osmply with !he City of Esgen Connettlon Chanpe: 42S.00 I1c1 OrdinAnem AccOUnt Deposit: Perrnit Fae: 10, 00 pd Surcha?oe: .50 12d gy Misc. Chorpes: Date of Insp.: Total: I nsp.: Daft Pafd: PERMIT NO.: DATE: No. of Units: Connection Chcrge: Account Deposit: _ Permit Fee: Surcharge: Misc. Chorges: - Total: Dote Poid: No.. h aaaply wilh 1w Cihr sf Eeqes OF EAGAN Pilot Knob Road Box 21199 i, MN 55121 U SEVNER SERVICE PERMIT to eaaply wlth ehe Chy of EogoA Connectlon Charpe: Account Deposit: _ Permit Fee: Surdwrpe: Misc. Chorper. , Totcl: Doto Paid: CITY OF, EAGAN Remarks Nv'{' =1 Z I 1I; Addition COACtMAN HIGHLANDS Lot 21 131k 1 Parcel 14-18075-210-01 OwRer Street 3241 EYERGREEN DRIVE state EAGAN MN 55221 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 'L70 1975 p arcel 10 2750 Q10-03 STREET RESTOR. jg 1974 1f 1f ' GRADiNG 1007 1986 354.14 35.41 10 c?-/S 8S SAN SEW TRUNK 440 196$ Paid und r aTCel 10 275Q 010-03 SEWER LATERAL 1984 n li * WATERMAIN 1 7 1972 P$id Wld T 8rC01 10 Z750( -010-03 WATER LATERAL 2 1975 • WATER AREA 1972 n ?t WER TERAL 7-9 1975 ?' " STORM SEW TRK g 1975 it ' STORM SEW LAT CURB & GUTTER ' SIDEWALK STREET LIGHT 2SO.00 37651 8-2-83 WATER CONN. 00.00 BUILDING PER. RAXIS SAC ?e 11 PARK INSPECT'ION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: I (651) 681-4675 ? SITE ADDRESS: ' ' 110 i : •t t? ,??i ? r.? .:?. PERMIT SUBTYPE: APPLICANT: rtr a?.•;r F. ?,?.? Mi.?i??.a f TYPE OF WORK: fi1 1-t'R1F'X I+M V t- ty A r tt ja( 1•rr10 t ; r, I11 1 I INSPECTION „ , ,. i 1 fIf3F'n . :4 i'39„ 324 1 "Ih , A Nt -1 I ?.?. Permft Holder Date Telephone # SEWER/ WATER • PLUMBING HVAC Inspection Uete Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGN HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS coNOUCnvirr resr HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL Receipt ?-7 C' PLUMBING PERMIT Permit No. .3 U. CITY OF EAGAN Fee :;7"' Fill in numbered spaces 5/C Type or Print /egibly Tot 1. Date 2. Installation Cost A ", ?,1C'L 3. Job Address 3;?q t V'c Lot?_Bik. Tract 4. Owner k'l - '-? 5. Cnntractor Phone (i i 6. Address LN c 7. Citv -_ +_ ?:t 1 t r State /Vf /t," Zip > -,c 8. Building Type: Residential I? Commercial ? Institutional ? 9. Work Description: New L? Add ? Alter ? Repair ? 10. Describe 11. No. " Fixtures Water Closet No. Fixtures Cesspool/Drainfield .2 Bath tubs Septic Tank 2 Lavatory Softner Shower Well ? Kitchen Sink Urinal/Bidet Other ? Laundry Tray 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 all ordinances and codes governing this type of work. Signed : for Rough , Final Inspections: Date Insp. Date Insp. This is yourpermit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee _ Fill in numbered spaces S/C " Type or Prim legibly Tot. , 1. Date - 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor `t- /?''? ? ?. ., 6. Address 7. City State 2ip ?- 8. Building Type: Residential f? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. oescriee I?. ?"f`fLGIP X/c, Fuei Tvae 11. No, 'L' Equioment 8TU - M. Ea. Forced Air No. Equipment CFM Air H dli Mfg. an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other '/ Air Cond. Z r Mfg, Gas, Piping Outlets I 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 : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454,8100 `Bldg.-. A-5 cirir oF E?cAN 3795 Pilet Knob Raod Eeyen, MN 5512= PHONEs 454-8100 BUILDING PERMIT Tw " ....a m,.. lof 6 PLEY, Sit! /,ddflSS '??'?a a+voa?c,LCCU aiLyYa Lot 21 elxk 1 Sec/SubCoachman Highlaz Porcel # /0 "i80 75 - a 2- /0- O / oc Name ? Addro! G Nome _ u? Address F f'irv Nome _ Address 1 hereby acknowledfle that I hove read this oppiication ond state that thB inlormation is COrrect nnd ogree to tomply wifh all applicoble State of Minnesota Statutes ond City of Eo9an Ordinonces. Slqnature of Pertnittee rutP ger Compa*iiies, A 8ullding Permif Is issued to: oll work sholl be done in occordonce with oll opplioobla Stote ? Buildinq Offltiol ?`?YE-? 8335 Receipt # ? ^ Erect Occupor?cy R-3 Alter p Zoning R-3 Repair ? Fire Zone P7A Enlorpe p Type of Const. Move p # Stories 2 Demolish Q Length Grade p Depth Sq. Ft. Appro vals Fees Assessment Water & Sew. Pol ice Firo Enfl. Plunner Council Bldp. Off. APC Permit ?7[..uu $urcharge 26-50 Plan check 146.04 SAC 525.00 ware. con?,.450 - 0) Woter Meter F:fl _ f10 Rood Unit 4' 72 • ?i Totol $1749.50 on the ezpress tondition thni and City of Eapan Ordinances. Permit No. Permit Holder Misc. Permit No. Holder Plumbing 0 H.V.A.C. 3173 ?.l {?l/l?C1r L '27'0 w.u wace? Disp. Sevwr E??,? 55q -t?•?,?s ?1?. ?-z3-? Inspsction Data Insp. Other Footingr Foundstion Fnminq . Roud? Plbp. i -S3 L Rouph HVA Inwlation ? Final Piby. Final HVAC Final Wour Dsscribe Location: YYell Sowrr Pr. Disp. • RESIDENT / OWNER Name: G6 1 441 61-1 LAAJD5" T i1/LISPhone: Address / City / Zip: Sik. d LJ r j P D Applicant is: Owner X Contractor TYPE OF WORK Description of work: RE R Construction Cost / � OC) Multi - Family Building: (Yes x / No ) CONTRACTOR Name: ROD F ) i- c,P41,1r N4 -t-/✓C . License #: a ° l 7� l . 5-3 Address: S Q CJA-44 j /-U A- City: S7' G'4 /e./-/A- L State: /4/-J Zip: SS2 7 / Phone: 76 3 - S 0 - d Y Yy Contact: (�5- 2R' Y Email: ��1%/ Y� © o a MA o Cosh COMPLETE In the last 12 months, has 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: _Yes 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. *' City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Tenant: 141.E • x . cam, x 0-z41 Applicant's Signature App cant's Printed Name r Permit #: 94(0.7 3 Permit Fee: , 2S' (P12.5"//0 Date Received: Staff: Use BLUE or BLACK Ink 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: - . 2 .S - /0 Site Address: Dr Ji �,� � R. gu /L Df�G / t.t i S2J43 3'v-45 32 uite #: 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.org 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. Page 1 of 2 r . �3� , 3� 3�, �3� ��� 3� �3; 3aUS; �� `� l Use BLUE or BLACK ink .------------------ � For Office Use � I ',� l.�'� ��G I I Cit of �� a� ; P�,�#: � � ; � � i Permit Fee: � �S � 3830 Pilot Knob Road � � l�� � I Eagan MN 55122 � Date Received: � Phone:(651)675-5675 � � Fax:(651)675-5694 i Staff: � V_���������������J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: � I�� Site Address: �� 4�-b'��� �V�-�`-l>1w�.� �J�—�V�— Unit#:�7' �.�� Name: Phone: Resident! +�wner Add�e�i c��y i zp:��.37—3���1 �U"t���� 1�1,11�. Applicant is: Owner � Contra�tor Description of work: �� ` �"� Type of wor� ,� Construction Cost: � 15���� Multi-Famity Building:(Yes /No� Company: �W� �• �� • �1'��.. Contact:��y P�1�1�1G Cantra�tor 1� Address:'J.�� �(.�.�'✓� 1 w� f�i� City: ��� ����l���. State:l��� Zip: S� Phone:��"�'�7��13� Email:(t1�� ��P1C.Qr���^�Y►'�tt �s� License#: � 6��� �� Lead Certiflcate#: 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 pertnit for a similar plan based on a master plan? Yes _No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanicat Contractor: Phone: Sewer 8�Water Corrtractor: Phone: NOTE:Plans and suppordng documerrts',#ha#you�ubm�t are consider+ed to be pubftc irrt'o►ma#ivn. Parl�or��of ' t�e information may be cJa�sifi�d as»anyaubiic if you provf�r sRecitic reasons t�at would pennit#�e Gity#� ; conc�ude that the` are trsde se.�rets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protedion against underground utility damage. Call 48 hours before you intend to dig to rec:eive loptes of underground utili6es. www.aopherstateonecall.orq I hereby adcnowledge that this iMormation is complete a►id acxurate;thffi 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 onty an application for a permit, and v�rk is not to start without a pertnit; that the work will be in accordance with the approved plan in the case of wo�ic which requires a review and approval of plans. Exterior work authorized by a building permit issued in accoMance with the Minn State Building Code must be completed within 180 days of permit issuance. X �R�-��� X Applicant's 'nted Name Applicant's ignature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA140940 Date Issued:02/01/2017 Permit Category:ePermit Site Address: 3241 Evergreen Dr Lot:21 Block: 01 Addition: Coachman Highlands PID:10-18075-01-210 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Paula M Snippes 3241 Evergreen Dr Eagan MN 55121 (612) 816-9931 St Paul Plumbing & Heating 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink For Office Use CityofEapaii :::: ° 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone:(651)675-5675 buiidinginspectionst citvofeacian.com Staff: SEP 1 9 7917 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit t-i4.4'r Name: }�r.�.�� ��i-�tat./\4� 1 �� _> c�1 '' Phone: 9 c, "' S) 3 Resident/ Owner Address/City/Zap: 3a` 1 _•\i,-.2...q-eveaa.r, r:�f2 .; v n �i.i S` i:7 Applicant is: Owner =X Contractor Type of;Work Description of work �r " ' -ki z<t uA 1)--- Construction Cost Multi-Family Building:(Yes )4 /No ) Company: \ :1� -.-C�-� Contacttm ;. Contractor.' Address: 7-'1 r � � '�t a� may: 1r- 2..1155- .v' state:;.,( j Dp; 5< Phone: t -- S 031.E Email: k Ucense#: t_ 3 1 ti Lead Certificate#: l"4, i if the project is exempt from lead certification,please explain why: +� "�r'Si i`S•Y.q�`3" Ls-: =fj C::+ 1°j*i' 'a.G---' �S-•�--Z14 i tt3 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 marina. a considered to be publictrdennation. Portions of the information may be classifiedas nonpublic providespeciffc reasons thetwouldpermit the Citytoconclude-Matthey are trade secn 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.citvofearfan.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(851)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. wuw.sopherstateonecai.oro 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 mil 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 Page 1 of 3 c--6-14L- 6 * -g, 1 g:, _ , DO NOT WRITE BELOW THIS LINE / 7 � -e) SUB TYPES Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi le 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 Valuation 0 Occupancy 3 MCES System Plan Review Code Edition f f „ 1 ` SAC Units (25%X 100% ) Zoning a 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/C.O. Required Footings(Addition) C 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 FEESA / 14/L, Base Fee '. r r . fi,' Surcharge Plan Review ' MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Thi Treatment Plant 2/ 0 c. -22 Copies rn/1 4"` TOTAL Page 2 of 3