1280 Timbershore LaneRESIDENT J OWNER
Name:741+ 4.,ilr._- / 'i 62✓ /14'4G'c Phone:
50C--1 -
Address !City !Zip: �V
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L.
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: L
/ 7 -
Construction Cost /4) SI 7' M '- amity Building: (Yes a' ! No )
CONTRACTOR
Name, trt 1 . us01.47 l' .r License #: 6 7 q..,
_oz
Address: .. ;511 D ode-9 ($(/r 1-it City: t r , ArreaciA
��� , -557 4 (Z- 7z 3r- t - f...(
State : c3 y Ph ne:
y Zip:
_ 4-1
Contact: 73. £4- [.-t -- Email: 1 ' - _7nii4# vim, f'4
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 fora similar plan based on a master plan?
date and address of master plan:
_Yes
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 My to
conclude that they are trade secrets.
Jul 12 10 08:14a Gates General Contractors
41 City of Eapll
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675-5694
Appii s Printed Name
Applicant's Sig nature
(763) 498 -7710 p.5
For Office 7
Permit Fee:
Use BLUE or BLACK Ink
Date Received:
Staff:
J
r 2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: i(i i 0 Site Address: _.a1 Z80 '
Zera Suite #:
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. Iwww.copherstateonecali.org
hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances • • codes of the City of
Eagan• nderstand this is not a permit, but only an application for a permit, and wo . ' rP to start without a perm i hat the work will be in
acco = an.y' h the approved plan in th a e of work which requires a review and ap
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1
For Office Use
a a
s
e Permit#:
Permit Fee:
- \ ",a
Date Received: S -/k
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 /_ ,_ 1 ,
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 ��� Staff:
buildindinspections(ci)citvofeadan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION,
Date: Site Address: / e67 / /+ It
� e �/ Unit#:
�Name: Phone:
.���..�
Resident/ i
Owner Address/City/Zip:
Applicant is: Owner Contractor_
Type of Work
escription of workv
� G (11 Co �'lCvele 51r'�
Construction Cost:7`/ 2 I G D O — Multi-Family Building: (Yes /No
bt
v 'Cf�naee iCompany: v C ct: J
Address: 9 /3 6 � /a✓ 4/ a- /2e4ity:
/5/0 141
h5 d!�
Contractor
I State:MN Zip:k.1-2/J/ Phone: 9S) 3 ' Ei-K Pc77— 6i0e 7/,.5 56,G I, �Jr�
t ' License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
t Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression 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 ou rovide specific reasons that would ermit the Cit to conclude that the 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.citvofeaqan.com/subscribe.
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. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.aooherstateonecall.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 tans.
&V e�f A e -//'
Applicant'§-Printed Name J App icant's nature
L--- -
11/1
DO NOT WRITE BELOW THIS LINE . 6) l 1 k4"144 2n . /..;• -•, -7/ c -
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
lc 01 of q Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition Move Building Reroof _ Demolish Interior
1( 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 So1,fl� , -- Occupancy ✓p C ' 3 MCES System
Plan Review Code Edition YrWl 2-01 c SAC Units
(25%7C 100% ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction }r( Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
16° Footings tion.) S7-0D t�a 7q Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
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:_FootingsBackfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: / O /'n ; /4-1
7/7" , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Copies
TOTAL
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