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3243 Evergreen Dr
REQUEST FOR ELECTRICAL INSPECTION ' ee-oouoi-oa , See instructions for complecinB this torm on back oi yellow copy, ?4?1 ?? '"X'" Below Work Covered by This Request 7j $'7 (p g Nee AAd flBp. TVPe of Building APOliunces Wiretl EquipmBnt Wiretl 7{ Home Range Temporary Service Duplex Water Heater Lighiiny Fixhures Building Dryer Hectnc Heatin erCial Bidg. Furnace Silo Unloader trial Bldg. I Air Condi[ioner Bulk Milk Tank Otner pen y iner sneclfyl r tSUecify Other Otner ComUUte lnspectiai Fee Below M Fee * Service EntranceSiza fl Fee Faxders/SUbfaeders N Fee Cirouits - 1 2. 0 to 200 Am s 3 13 z 0 to 30 qm s 0 to 30 Am s Above 200 qm??s 1 5. 0 37 to 100 Amps 31 to 700 Am s ' Swimming Pool Above 100_Am s Above 100_Amps Tranytormers Irrigation Booms • Part ial%Other Fee Signs Special Inspec[ion - S? ` ' Re rks . j 0 . 00 TA FEE ?. /?? .?I'7 , 1VWL11IVUJG 11'V GI.L -Vi V- Rough-in ? Dnte L AI nsPector, herabv ? certity thet the above Final d D:te - p nspection has been ?da. Thls noue6t voiC 18 montOS from This repuest void Q -Z5 18 rtqnffis fmm A 1 n„a LROi S(i Coa"nlan 3 g7(10 g 14%1kland3 q4 . So HFxques[ Date ' Fire No. Rough-in Inspec[ion ReQOired? [NReadY Now Q Will Notily InsPec- 9-? 1 -83 ?]?es ?Na ?ur When Reatly 9 Licensed Elec[rical Contrac[or I haraby reauest insvection ot above^ Owner elechicel work installed eY 5[reet Atldress. Boz or Route No. Ciry 3243 Evergreen Drive Eagan ectian o. Township Name or No. RanAr, No. County Dakota OccvpantlPRINTI Phone No. , Brutger Companies 612-252-6262 Power Suuulier Address . NSP Electrical ConVactor (Company Name) Coniroclor"s Licen?e No. Tim's Electric, Inc. Mailing AdJress IConvactor or Owner Making Instailationl . ` 432 S. Wabasha, St. Paul, MN 55107 horized Sienature ICOnvactor Owner Makinp Installalionl Phone Number ? 224-8293 MINNESOTp STATE AFD OF ELECTRICITY TNIS INSPECTION qEQUEST WILL NOT Griggs•Mitlwav 01dg. Poom N491 BE ACCEPTED BV THE STATE BOARD 7821 University Ave., $t. Paul, MN 56104 UNLESS PNOPEN INSPECTION FEE IS Phone 1812) 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ' ee-oouoi-oa , See instructions for complecinB this torm on back oi yellow copy, ?4?1 ?? '"X'" Below Work Covered by This Request 7j $'7 (p g Nee AAd flBp. TVPe of Building APOliunces Wiretl EquipmBnt Wiretl 7{ Home Range Temporary Service Duplex Water Heater Lighiiny Fixhures Building Dryer Hectnc Heatin erCial Bidg. Furnace Silo Unloader trial Bldg. I Air Condi[ioner Bulk Milk Tank Otner pen y iner sneclfyl r tSUecify Other Otner ComUUte lnspectiai Fee Below M Fee * Service EntranceSiza fl Fee Faxders/SUbfaeders N Fee Cirouits - 1 2. 0 to 200 Am s 3 13 z 0 to 30 qm s 0 to 30 Am s Above 200 qm??s 1 5. 0 37 to 100 Amps 31 to 700 Am s ' Swimming Pool Above 100_Am s Above 100_Amps Tranytormers Irrigation Booms • Part ial%Other Fee Signs Special Inspec[ion - S? ` ' Re rks . j 0 . 00 TA FEE ?. /?? .?I'7 , 1VWL11IVUJG 11'V GI.L -Vi V- Rough-in ? Dnte L AI nsPector, herabv ? certity thet the above Final d D:te - p nspection has been ?da. Thls noue6t voiC 18 montOS from This repuest void Q -Z5 18 rtqnffis fmm A 1 n„a LROi S(i Coa"nlan 3 g7(10 g 14%1kland3 q4 . So HFxques[ Date ' Fire No. Rough-in Inspec[ion ReQOired? [NReadY Now Q Will Notily InsPec- 9-? 1 -83 ?]?es ?Na ?ur When Reatly 9 Licensed Elec[rical Contrac[or I haraby reauest insvection ot above^ Owner elechicel work installed eY 5[reet Atldress. Boz or Route No. Ciry 3243 Evergreen Drive Eagan ectian o. Township Name or No. RanAr, No. County Dakota OccvpantlPRINTI Phone No. , Brutger Companies 612-252-6262 Power Suuulier Address . NSP Electrical ConVactor (Company Name) Coniroclor"s Licen?e No. Tim's Electric, Inc. Mailing AdJress IConvactor or Owner Making Instailationl . ` 432 S. Wabasha, St. Paul, MN 55107 horized Sienature ICOnvactor Owner Makinp Installalionl Phone Number ? 224-8293 MINNESOTp STATE AFD OF ELECTRICITY TNIS INSPECTION qEQUEST WILL NOT Griggs•Mitlwav 01dg. Poom N491 BE ACCEPTED BV THE STATE BOARD 7821 University Ave., $t. Paul, MN 56104 UNLESS PNOPEN INSPECTION FEE IS Phone 1812) 297-2111 ENCLOSED. CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevatians & BUILDING PERMIT APPLICATION 1 set of energy calculations. To•Be Used For 1 of 6 Plex Valuation 00 0 Date July 13, 1983 Site PddYOSS 3243 Evergreen Drive IAt 2 0_ Block 1 SeC./Stah. Coachman PaYCel #: Highlands OWl'1P-Y: Brutqer Companies, Inc. Addr255: One Sunwood Drive, P.O. Box 399 City/Zip Code: St. Cloud, P7N 56302 Phone #: (612) 252-6262 CAntYdCtAL: Brutqer Companies, Inc_ Address: One Sunwood Drive, P.O. Box 399 City/Zip Code: St. Cloud, Mta7 56302 Phone #: (612) 252-6262 AZ'Ch./E'lg-: Blumentals Architecture, Inc. Address: 6100 Summit Drive North City/Zip Cocle: Brooklyn Center, MN 55430 Phone #: (512) 571-555o OFEICE USE ONLY ? Erect . OccuPancY Alter Zoning ? Repair Fire Zone 4 Enlarge Type of Const Move # Stories y Dsmlish Front ft. Grade Depth ft. APPEtOVAIS FEES Assessnients Permit y yZ ?Vater/Sciaer Surcharge Z 6 - Police Plan Check IS/6 Fire SIC Sas- Fhq. Water Conn. ? Planner Water Meter 6a Council Road Unit y s-o Bldg. Off. APC ?C7PAL ? ? 1 ? So cirr oF Er?cAN N° 8336 Bldg. ?1-$ 9793 Pilo! Knob Rmd Eagan, MN 55721 ' PNONEs 4548100 BUILDING FERMIT Receipt # To be vaed 1or 1 of 6 PLEX Est. Vaiue $53,000 pate Aupust 1 , 1983 Sire Address 1 3243 EverQreen ?rive Erecr gg Occuponcy R-3 Lor 20 B lock 1 Sec/Su6Coachman HiQhlands qlrer ? Zoning R-3 Repoir ? Fire Zone NA Parcel # E l T f C V n arge ? ype o onsL c Name Brutger Companies, Inc. Move ? # Srories 2 I ; Address One Sunwood Dr., P.O. Box 399 DemoHsh ? Length_ ° ci St. Cloud phone 252-6262 Grade ? Depth Sq. Ft.- ? Name OWner Approvala Fees o0 u V? Address Name _ Address 1 hereby atknowledge that I hove read this opplicotion ond stote that the informotion Is wrrect ond agree to comply with nll op0licuble Stofe of Minnesota Stotutes and City of Eogan Ordinonces. Signoture of Pertnilfee ru ger ompanies, nc. A Bullding Pertnit Is issued to: oll work shall be done in accordonce with oll oooNmble Sta f Mlni Assessment _ Water & $ew. Police _ Fi.e Erp. Plonner _ Council _ Bidg. Off. - APC - Permit °J°•"? Surchorge 26.50 Plon check 146.00 SAC 525.00 Water Conn. 450.00 Water Meter 60.00 Rood Unit 250.00 1oral $1749.50 on the express conditlon Ihnt $totutes end City of Eogan Ordirwnces. Buildinq Officiol CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevatians & BUILDING PERMIT APPLICATION 1 set of energy calculations. To•Be Used For 1 of 6 Plex Valuation 00 0 Date July 13, 1983 Site PddYOSS 3243 Evergreen Drive IAt 2 0_ Block 1 SeC./Stah. Coachman PaYCel #: Highlands OWl'1P-Y: Brutqer Companies, Inc. Addr255: One Sunwood Drive, P.O. Box 399 City/Zip Code: St. Cloud, P7N 56302 Phone #: (612) 252-6262 CAntYdCtAL: Brutqer Companies, Inc_ Address: One Sunwood Drive, P.O. Box 399 City/Zip Code: St. Cloud, Mta7 56302 Phone #: (612) 252-6262 AZ'Ch./E'lg-: Blumentals Architecture, Inc. Address: 6100 Summit Drive North City/Zip Cocle: Brooklyn Center, MN 55430 Phone #: (512) 571-555o OFEICE USE ONLY ? Erect . OccuPancY Alter Zoning ? Repair Fire Zone 4 Enlarge Type of Const Move # Stories y Dsmlish Front ft. Grade Depth ft. APPEtOVAIS FEES Assessnients Permit y yZ ?Vater/Sciaer Surcharge Z 6 - Police Plan Check IS/6 Fire SIC Sas- Fhq. Water Conn. ? Planner Water Meter 6a Council Road Unit y s-o Bldg. Off. APC ?C7PAL ? ? 1 ? So cirr oF Er?cAN N° 8336 Bldg. ?1-$ 9793 Pilo! Knob Rmd Eagan, MN 55721 ' PNONEs 4548100 BUILDING FERMIT Receipt # To be vaed 1or 1 of 6 PLEX Est. Vaiue $53,000 pate Aupust 1 , 1983 Sire Address 1 3243 EverQreen ?rive Erecr gg Occuponcy R-3 Lor 20 B lock 1 Sec/Su6Coachman HiQhlands qlrer ? Zoning R-3 Repoir ? Fire Zone NA Parcel # E l T f C V n arge ? ype o onsL c Name Brutger Companies, Inc. Move ? # Srories 2 I ; Address One Sunwood Dr., P.O. Box 399 DemoHsh ? Length_ ° ci St. Cloud phone 252-6262 Grade ? Depth Sq. Ft.- ? Name OWner Approvala Fees o0 u V? Address Name _ Address 1 hereby atknowledge that I hove read this opplicotion ond stote that the informotion Is wrrect ond agree to comply with nll op0licuble Stofe of Minnesota Stotutes and City of Eogan Ordinonces. Signoture of Pertnilfee ru ger ompanies, nc. A Bullding Pertnit Is issued to: oll work shall be done in accordonce with oll oooNmble Sta f Mlni Assessment _ Water & $ew. Police _ Fi.e Erp. Plonner _ Council _ Bidg. Off. - APC - Permit °J°•"? Surchorge 26.50 Plon check 146.00 SAC 525.00 Water Conn. 450.00 Water Meter 60.00 Rood Unit 250.00 1oral $1749.50 on the express conditlon Ihnt $totutes end City of Eogan Ordirwnces. Buildinq Officiol CITY OF EAGAN 3830 Pflot Knob Road P. 0. Box 21199 Eagan, MN 55121 Zoninp: Owner. BTUt ¢ Addmss: Sfte Nddress: ? Pluxnb4r: nyeS Metar No.: No.. h omvly whh tiN CM7r of Eown WATER SERVICE PERMIT PERMIT NO.: DATE: ' . No. of Units: Connection Charge: Acoount Oeposit: _ Permit Fee: Surcharye: Misc. CJaryes: - Total: Dcte Paid: of Insp.. OFEAGAN Pilot Knob Road Box 21199 i, MN 55121 SEVVER SERVICE PERMIT PERMIT NO.: 6046 DATE: No. of Units: Address: M eomply wilh !IM Cihr of Bapn of Insp.: 42-5. 00 jxi Connactlon Charge: AccouM Deposif: Permk Fas: 10.00 pd Surcharpe: .50 Pd Misc. Chorpes: A/ • Total: WATER SERVICE PERMIT - - 4 JE? Jo.: Connedion Charge: Account Deposit: No.: Permit Fae: • , 1'c: to een?ply with tlw CilY of EaYon Surcfiarge: ?, ? ? mE ? tr Misc. Chorfles: TDtQl: Dote Peid: CITY OF fAGAN SEWER SERVICE PERMIT 3830 PilAt IChob Road P. O. Box 21'189 PERMIT NO.: Eagan, MN 55121 DATE: ?ing; No. of Units: ?r Esrut ^ ez Co Add mpm h ean* with the City of Engen of Insp.: TY UF EAGAN l30 Pilot Knob Road 0. Box 21199 kaen. MN 55121 Conrnctton Charge: 4[.).uu pa Acmunt P Fee: ?t: 10. oo pa Surcharne: . 5 0 1)d Misc. Choroes: Total: IL BY CITY OF.EAGAN Remarks Addition ????M HIGHUNDS Lot 20 Rlk 1 Parcel 10-18075-200-01 owrier Street 3243 EYERGREEN DRIVE state EAGAN MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1975 Paid und r 8TC@1 10 2750 010-03 STREET RESTOR. ? 1974 of 01 GRADING 1007 1986 354.14 35.41 10 3516, 4 /G-/S- SAN SEW TRUNK O 1 SEWER LATERAL of ol w WATERMAIN f -It L91 2L P WATER LATERAL Z -- 1? u • WATEF AREA L 11 ft STORM SEW TRK u ?t STORM SEW LAT CURB & GUTTER ' SIDEWALK STREET LIGHT 250.00 37 51 8-2-83 WATER CONN. 4SO. 00 BUILDING PER. SAC 1t n 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 ?L PLUMBING PERMI7 Permit No. CITY OF EAGAN • Fee Fill in numbered speces 5/C ' 7 V Type or Print legib/y Tot. 1. Date 2. Installation Cost 14? ? ? ?r ? ai? .'f'Pi1 [?. r"( 3. Job Address Lot 2-caIk. Tract 4. Owner /- 5. Contractor 6. Address _ 7. City 45'T Phone / Z ( - ? ? 7 j ' State -11124. Zip 5--) CJ ? Z- I S. Building Type: Residential V Commercial ? Institutional ? 9. Work Qescription: New N Add ? Alter ? Repair ? 1 10. Descri be 1 11. No. -7 L Fixtures Water Closet No. Fixtures Cesspool/Drainfield Z Bath tubs Septic Tank Z Lavatory Softner Shower Well ? Kitchen Sink _L Urinal/Bidet Laundry Tray Other Floor Orains Drinking Ftn. 51op Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply wit II ordinances a d 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$100 Receipt ` MECHANICAL PERMIT Permit No. CITY OF EAGAN ' . Fee Fill in numbered spaces S/C Type or Print /egibly . Tot. 1. Date • 2. Installation Cost 3. Job Address Lot ? Blk. Tract 4. Owner 5. Contractor ? Phone ' 6. Address 7. City =•/17? 11 State Zip 8. Building Type: Residential 9(- Commercial O Institutional ? 9. Work Description: New)5 Add ? Alter O Repair ? 10. DesCribe'' r' '/ - =f' Fuel Type ' r' . 11. No. Eauioment 8TU - M. Ea. Forced Air No. Equipment CFM Ai H ndli 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 : _ for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Bldg. A-S BUILDING PERMIT CITY OF EAGAN 3795 Pilot Knob Roed Ee9en, MN 55122 PHONEi 454-8100 PLEX Site /lddreu _ `-. ... ". b....... "` ?." Lot' 20 Bi«k 1 Sec/Sub Coachman Highlai Parcel # /0 '/8'O7?6_ -6r2oQQ--O/ K NOmB uau.bca vvuat.aua?o? aasa.. Z ^ddreu One Sunwoad Dr., P.O. Box 399 9 ,,._ -?t. cloua ? 252-6262 ? Name ,o Receipt # ?,?r8 13Co i 7e- {/ 1 .83 Erect )ff Occuponcy j`^ 3 Alter ? Zoning o_ Repoir ? Fire Zone Np' EnIarye p Type of Const. V -? Move Q # Stories 2 Demolish p Length Grode Q Depth Sq. Ft. Approvols Fees Su Addreu Nssessment - ~ Cit Pho e Water & Sew. n t? Nome Police ? W fire ?? Address Enp. i'z Ci Phone Plonner 1 hereby acknowiedge thot I hove read this uppiitotion and state thot Councfl 81dp. Off. _ the informotion is correct and agree to tomply with all applicoble State of Minnesoto Statufes and City of Eogon Ordinances. ^PC 5ipnoturc of Permittee BraegeT , • A Building Permit Is issued to: all work shall be done in accordance with afl aoolicable Statt of Minr Permit .] Surchorpe ? Plon check ?.?.0_ 5AC , j Woter Conn. ?r Water Mecer Rood Unit 50 Totol ??1749 ' on tha express condition 1Fat Stotutes and City of Eoflon Ordinances. Buildinp Officlal Permit No. Permit Holder Misc. Permit No. Holder Plumbiny 3j ?? ? _gS E H.V.A.C. w.u w?.? . DhP• S?vre? ENctNc 4055.3 -T,'rN'S ??• ?-73-g3 Infpection Date Insp. Other Footinyt - 3 ' Foundation Freminq Rough Plbp. Rou¢+ HVA inwlation ?5 Final Pltp. ? Finel HVAC Final ? Water Wseriba Location: YWII , Sewer 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 Use BLUE or BLACK Ink For Office Use 4 o1 Ua Permit# 7 s*CiC�I Permit Fee: q3' i 1 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone:(651)675-5675 buiidinainsoectionseicitvofeaoan.com SEP 1 9 2017 Staff 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit illi i Akti,, 7"3 til-8,AS'pby Name: C� �.�. _�,t,l�<� a cs. Phone:t 9 S G, 3113").'s, Resident! 1),,v-e_1 Owner Address/City/Zip:3��}3 v-2v-c� ,•, V r:J21 . 1 Applicant is: Owner )( Contractor Work" Description of work: e-rrr' - -rr, �-� �:,"4-11/41 Type of Construction Cost Multi-Family Building:(Yes )4 /No ) Company: A�a -;°(i;L =,,=,-t s.����,_:�, r.G Contact 4fi S.V-41- S'ab� Contractor Address: 7--1 City:' ) s y: 43-3z.13zA. v_' State:1-t`ej Zip: 5'`'''6`s Phone:Lt .-3 3 '3.L.3Email: 5'xLro '"4'`.. l' ',ei Hsa:!, r ws License* 13(1-1 3 ( 1 i Lead Certificate#: P ti 1 if the project is exempt from lead certification,please explain why: T.1>3'3'v- `S}f-s c�-� m ilk- k 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 suporting documents that yousubmit are considered to bepub�ar formation. Portions information maybe classified as non�c If yon provide specific reasons that would permit the City to conclude-that they are bade 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(851)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utiikies. www.000herstateonecail.ora I hereby acknowledge that this information is complete and accurate;that the work will be hi conformance with the ordinances and codes of the City of Eagan;that t 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 hi accordance with the approved plan in the case of work which requires a review and approval of plans. - 1:a ....... Applicant's Printed Name Applicant's Signatur Page 1 of 3 r v 1)4, - ...� L/ E u fir` IDO NOT WRITE BELOW THIS LINE /q,(001 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 Y Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation t _0_2.d Occupancy MCES System Plan Review Code Edition / • 0 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: 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 Base Fee 1,4 Surcharge `� Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge pi mi Treatment Plant #611i , 2/ 0 (2 2 Copies - f TOTAL Page 2 of 3 • Use BLUE or BLACK Ink For Office Use CityO1 �� �� Permit#: ( ` ?0 Permit Fee: 6 o •a • 3830 Pilot Knob Road Eagan MN 55122 Date Received:/�+ �"36 ' Phone: (651) 675-5675 Fax: (651 - 94 L Staff: 2017 SIDENTIAL PLUMBING PERMIT APPLICATION Date: �) l'' I ' Site Address: .33 . Z-eurvvL, /a l Tenant ‘,,,j- �'�` Suite#:. �/p c..- ....X '.'1/4::'4'11,01'4;" t,sy } a,1 Name: \ 1 � (fes'–15 g 0 1 VVV Phone: �ry R Address/City/�Z/i/p� .___ low y //' 41 iR�t�jF`Z°Yt�f�F'tsF� ( t. iUF �� W t/ P, II Name: l r +, � ir 4101441112t 44441'..- 1 C,1� License#: UOC L. ( __, I t1i ,. ,rs �'. , \ lel/ �� �/� ( ,, �Q ,;r t o frac-}• �``,- Address: l L -\ 4J)$+ City:�C Y (12ru `- 1 € y`f* 1 S I I I ,Y ) .1f \�1` 1,�.J I lJ 1, i}�4t State: Zip: Phone: ,e t)i I' 1Tt <)k i� 9 q�J, "l/I' •[' hi\ Itklit i ��oo li