1292 Deercliff Lane
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Use or BLACK ink
I
I For Office Use -
a its,
I I?ermil u C
ut of Eap ix"
:
t Permit Fee (s~ J
3830 Pilot Knob Road ?
Eagan MN 55122 Date Receved:
Phone: (651) 675.5675 q'7 ;
Fax: (651) 675-5684 staff: (
i
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 ~j Site Address:. x.90 -q Z 94-96 Z'Pfh4c-WZAQ e unit
Name: 1 Y Ta:~tJ AZG,j ,Phone: ~~t ! f-z
Resident/
Owner Address i City I Zip:. Q . Q2n~ at - -`Z 177 M.& j
Applicant is: Owner Contractor
Type of Work Description of work: ~~c? --P"a n
Construction Cost: f t ti Multi-Family Building: (Yes ~ f Na
Company: A bn ty'o Ao U!& k Contact: ! u c, n on)
Contractor Address; 9 2_0 CU e r1d 7rgy~ t ~ City: 0AG A.NL
State: - zip. 52. ~3 Phone: I~ 1 ?I -2-i G ) { (6 y
License Lead Certificate #:-A ) R 1
If the project is exempt from lead certification, please explain `,vhy: (see Page 3 for additional information)
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 R Water Contractor: Phone:
NOTE: Plants 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 speck reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-4002 for protection against underground utility damage. Call 48 hours
before you =nterid to dig to receive locates of underground utilities
I hereby ack mvledge that this inforrnat>on is complete and accurate, that the work will be in conformance with the ordinances and codes of the City of
f-.agan. ttvil I understand this is nol a pofmit, :rst only an appl!cation for a permit; and work is not to start wilhoul a permit. tnat the work twi; be in
accordance with the approved plan in the case of work which requires a review and approval of plans
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 184
days of permit Issuance.
Applicant's P ' ted Name Applicant's ignature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126825
Date Issued:09/11/2014
Permit Category:ePermit
Site Address: 1292 Deercliff Lane
Lot:007 Block: 003 Addition: Windcrest
PID:10-84460-03-070
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Joyce G Jackman
1292 Deercliff Lane
Eagan MN 55123
(214) 893-2070
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature
Use SLUE or BLACK Ink
1 For Use j
ditiii,tillipp,City of It• J p l 7r , ,
I : e r
i -Permit Fee. oN UI
3830 Pilot Knob Road I .
Eagan (651) s F .;. EIVE I Received: - --/
I i
Fax:(651)675.5694 I t�
JUN 21 2017 .!
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: (Qt LL 1 11 Site nam ) V.-?Z D eeY c....�.k c L N unit#.:
i4tte: i A Cv 0 w PJ}�-o oNe A s c vae<r :,Phone: 4 \ —`-?5 g 7�,
R i T .rt-�'} le-P,P F
� l Address tCdy i l P:t�. , -,)C` $`7 r.C4.." Cr.,q-�-t e fen P ni
Applicant is: Owner `( Cont P.D
-1
Typeotiffiork. mon of wok. Ste.fC C..e. L t b "i h+(.0 D ca o.
'1
Construction Cost:
Multi-Family Budding (Yes'( I No. )
I Company: Pi 100 -=A- - a � ca I a R t ,) I
! Sat5: Mp: tPhone: &t/ I ti t 1Rtppe -n,v ti
, i License#: {•"J t5 4 1i- + 6 Lead certtilcate#: ik, 1 — , " ` ` _ s
if the project is exempt from lead cortiticatiom please. plain.why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEIN MOLDING
In the last 12 mon 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:
ISewer&Water Contractor: Phone:
Fire Summon Contractor: Phone: .>.
of
t i ininatlon may he i i as h� S`�: " specifica rra l�*void pets* CIFpt
tf aiiap ads.
CAe.t.BEFOR -YOU DIG. Call Gopher She One Cali at(651)4644002 for prolecthm against urdemmurid utiity damage. Call 48 bows
before you intend to dig to receive locates of underground uta, www.gopheraWeecescallorq
I hereby acknowledge that this infcrmehon is complete and accurate;that the work will be in conformance with the tart and codes cf the:City of
Eagan;that I end is not a permit,but only an r�e parmft,arcraat worn +e not•o t'without;well the work w 'be in
accordance with the approved plan in the case of work which requires a review and approval of plans,
Exteri
work authorb rtd bye building permit issued in accordance with the Minnesota State Building Code must be
days of permit issuance. completed within 180
x p u 0 .0145 R l p p' fir-113.^.1 x
t fl)••fi"&;fr----".-
Applicant's Printed Name Cants Si imaul*
Paget of 3
DO NOT WRITE BELOW THIS LINE sg" I/ 7("(
SUB TYPES /.(2V\ O&& Fc(,- - 1-6.4%4
Foundation _ Fireplace — Porch (3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi tU 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
p Replace _ Repair Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation ,, 2/cet-- Occupancy ...-- ' MCES System
Plan Review Code Edition . /N1 0 2op i c SAC Units
(25% 100% )0 ) Zoning P. City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction v 5 Width
REQUIRED INSPECTIONS •
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings (Addition) _ )a Final/No C.O. Required
Foundation HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice &Water Final Pool:_Footings Air/Gas Tests _Final
Framing Drain Tile
Fireplace:_Rough In Air Test _Final Siding: Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
— Fire Walls Fire Suppression:_Rough In_Final
— Braced Walls Erosion Control
Other:
Reviewed By: T 1/'/1 Oil i )__t y 4-- , Building Inspector
tESIDENTIAL FEES
Base Fee /,D `yoc.
= it.c2) ,p• )4.71....f,
Surcharge _
Plan Review �0. > S` O Sy'' �-
MCES SAC
City SAC 4' l 2 -
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant yyr-r ; nn nn re,e__
Copies 1
TOTAL �`J ��
Page 2 of 3
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I hereby certify- that;thi 3 s tr,2 41.r,. earreet r; ; ''s s' r tat1.o n of
of the boundaries of Lots , 6, 7, ,and S# or. 3, x• t , t r the
1aeu tits of *11 exis tirig L,1.11.1.Ji : �, a ny, t�«�x°f�=c?:,� r 3 > „1.53
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