1807 Walnut LaneDate:
I ; /41.45,1,"
'
Applicants Printed Name
City of Eaaall Add
3830 Pilot Knob Road S 'C)'
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
01O RESIDENTIAL BUILDING PERMIT APPLICATION CIt
6 " / V O Site Address: I S ° 7 14/u / 7' Lowe rok5a4, M/v / /
Tenant: - 5Acit4.'t
RESIDENT / OWNER
TYPE OF WORK
CONTRACTOR
Name: AAf 6/t Si44 d Phone: (J&g1s 7s7z
Address / City / Zip: JgO7 Ida /rte) Late_
Applicant is: Owner X Contractor
Description of work: '�r//, e/47t7 r W t/4 / 't bosemeA doe -10 Waiet- dok & e ,
Construction Cost: `7 ��, y
Multi- Family Building: (Yes / No _)
Name:
Address:
State:
Contact:
Q iA t'wn Aes 1 ■=470,1
105 5 31c s I to A ye. Sa
AM" Zip: 554.8
X /e Email:
Phone:
License #: / � 0-36.70$6 City: i'`t cniirt
67 x-366— /67
m;4-ch f. h„,. nik Off.4artLeM40,Ates, can
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:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
Phone:
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
Applicants Signature
Permit #:
Permit Fee:
Date Received:
Staff:
Use BLUE or BLACK Ink
Suite #:
Page 1 of 2
•
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100 %_)
Census Code
# of Units
# of Buildings
Type of Construction
lA)A1cci-
SUB TYPES
Foundation _ Fireplace
�( Single Family _ Garage
Multi _ Deck
01 of Plex Lower Level
_ Interior Improvement
Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
Fireplace: _ Rough In _Air Test _Final
4 , Insulation
Meter Size:
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
Copies
TOTAL
DO NOT WRITE BELOW THIS LINE
Porch (3- Season)
Porch (4- Season)
Porch (Screen /Gazebo /Pergola)
Pool
Siding
Reroof
Windows
Egress Window
i f( Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: _Footings _Air /Gas Tests _Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
(A
_ Demolish Building*
_ Demolish Interior
_ Demolish Foundation
S Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Storm Damage
_ Exterior Alteration (Single Family)
_ Exterior Alteration (Multi)
Miscellaneous
b/ o
Page 2 of 2
VILLA OF EAGAN WATER SERVICE PERMIT
37pot Knob Road PERMIT NO.: 1779
EaAie 55122 DATE: 7/21/75
Zoning: PM 4
No. of Units:
Owner: New Horizon - Woodgate II1
Address:
Site Addres 8 01 — O3 -05 -07 Walnut Lane
Plumber: Thom pson Plumbing co.
Meter No.: Connection Charge: Pd
Size: Account Deposit:
Reader No.: Permit Fee: 10.00 pd
1 agree to comply with the Village of Eagan Surcharge: .50 Pd
Ordinances. Misc. Charges:
Total:
Date Paid:
` Date of Insp.: r
Insp.:
VJLLAGE.OF EAGAN SEWER SERVICE PERMIT
3795 not Knob Road PERMIT NO.: 2540
Eagbn, MN 55122 DATE: 7l21175
Zoning: PUT) No. of Units: 4
Owner: New Rorizon — Woodgate 111
Address:
Site Address: 1801-03-05-07 Walnut Lane
Plumber: Thompson Plumbing Co.
Y
I agree to comply with the Village of Eagan Connection Chargel pd
Ordinances. Account Deposit:
Permit Fee: 10.00 pd
Surcharge: .50 Pd
By: Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
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