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3456 Ivy Ct     ñ      ù ÿÿþ   ÿÿþÿýþüÿ     û  ðúýï ú ÷ÿôö ë íì  ÷  ýüûúùø÷óå öàöüúùø ÷öúùø÷óå öôóåøÿð öøõü àüàîüøÿù Þ ýÝüÿöè ðøöáð  ðöÝüöðöÿûöðé ÿöóóøþÿ ö öÿð   øéàÿ ö ÿøÿ öÿÿé àÿöûðâöÿööÝüöûùÿó ÿðù ðé ÿèãïãéìéì öû  ýüö ÿöÿêÿüÿãïãéìéëì êÿüÿþé  õô ÷ óò øøÿ Üàÿöáöàöüýèöÿñö ìý ýì áùà ýé ÿüòôììí ÿÿòôììë çìäìì  öûùÿó ÿ  ÿáöÿ ÿøøÿÿÿ ÿ  öðÿööÿÿöðøùó ÿÿøøÿûýÿ  òÿýÿüÿàù  ÿÿîöÿé øøÿå öðýÿüö üùýÿüö ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesflta 55123 (612) 681-4675 SITE ADDRESS: ? , . 3 4si? II , , ; I rv??k i to .wr, PERMIT SUBTYPE: TION RECURD PERNIIT TYPE: Permit Number: Date Issued: APPLICANT: TYPE OF WORK: . , ? ? ,??• ?.• I ? 1+I ?IriRt; .ri* -,? S t,J 1>1 PtF; ii! Fli kYfaN F! 1si, ? Permit No. Permft Holder Date Telephone N S/W PLUMBING HVAC r , I? 9 di G 9?•- ?Q? ELECTR ELECTRIC L4 V a, Inspecdon Date Insp. Comments Footings I 7l / , F-, Foundation Framing i?f?q/, Roofing Rough Pibg. Rough Htg. L W lsul. Fireplace Final Htg. Orsat Test Rnal Plbg. ^?G gy / ?? Plbg. lnspeclor - Notity Plumber Const. Meter Engr./Plan Bldg. Flnal ? ?,?, Deck Ftg. Deck Final Well Pr. Disp. /1'/488 6 7'.?,1?..,? )1o.2v-?g ?J'0?'? ?quest Date - y/ /? CP ? ? Fre No. Rough-in InspecLOn Requiretl? es ? Na NOTICE: You Must Call Eleqnwl Inspector H A Faugh-In InspecLOn Is Required. ??Kcensed contractor ? owner hereby request inspection of above electriral work at Job AdtlreSS (S(reet, Box or Route No ) ? Ciry Section No Townstrp Name or No. Renge No. Coun Occupant(PRINT) A 1 Olf Phone No. PowerSu ???? Atltlress Elecincal Contactor (COmpany Namea / Co clorb L.cense NoLJ ,pitai x ? Madi Atltlress nVactor or Owner Meking InsWllahon) /3 AumonzeC S nature (COntreclodOwner aking Installatwn) Phone Number MINNESOTA STATE BOARD OF ELECTflICITY ? THIS INSPECTION FEOUEST WILL NOT GrIggsMidwey Bltlg. - Poom S-173 BE ACCEPTEO BV THE STATE BOARD 1821 Unlversity Ave., SI. Peul, MN 55104 IINLESS PROPER INSPECTION FEE IS Phane(612)662-0800 ENCLOSED ;/O" ? ? RE?UEST FOR EIECTRiCAL INSPECTION ?- M 48816 , See instrucbons for completmg ihrs form on back ot yellow wpy X" Below Work Covered by This Request e Add Re ?ypeotBuilding AppliancesWVed EquipmentWiretl Home Range Temporary Service Duplex Water Heater Electnc Heanng ? Apt 8udding Dryer Load Management COmm./IndUStriai FufnaCe Other (SpeCrfy) Farm Air Condnioner Other (speafy) Convaclor5 Remarks Compute Inspection Fee Below: # Other Fes # ServiceEntranceSrze Fee # Circurts/Feeders Fee Swimming Pool 0 to 200 Amps "- 0 to 100 Amps Transformers Above 200 _ Amps Above 100- Amps Sgns Inspecror's Use Only TOTAL ?"l Irrigacion Booms D • _.?--- SpeciallnspeCiion Alarm/Commurncation THIS INSTALLATION MAY BE OR ISCONNECTEO IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspecror, hereby Rou9h-in oare ??„ L_r, tWZ cer[ify that the above inspechon has been made. F,nai ? OFFICE USE ONLY This requesf voitl 18 months trom a 4 5 'HN [? ? ? 1? °? ? 8 Request D 1 3 F;n o Rough-in nspection NO ICE. Vou Musl Call Elecvmal Inspector Reqmre0? it A Rough-In InsP?tian R eqwretl ? Yes u No Is I lice ed tr ctor owner eb request inspection of above electrical work at, . Jo0 Ad ( (ree , or •- `/ ? /Y? 3 Q ?y Senion No Towns?ip Neme or No. Fange No Covnry Occupant (PFINT) Phone No Pawer S.u.Piie/r/ Atltlress ? h" ? /T ? ? <Cl'V Electncal nVacror (COmpany Name) Contrecbr License No Mailing Atltlress (COnVactor or Owner Making Inslallation) 762-76- kv c,--- Avthor e ignaWre (Contradai wner Makmg Inslalla Phone Nu ber MINNESOTA STATE BOAflD OF ELECTHICITY ? THIS INSPECTION REQUEST WILL NOT ? Grlggs-Mitlwey BIAg. - Foom 5-173 BE ACCEPTED BYTHE STATE BOARO 1821 Univar8iry Ava., SL Paul, MN 55100 UNLE55 PROPER INSPECTION PEE IS Phone (612) 642-0800 ENCLOSED V041-4 REQUEST FOR ELECTRICAL INSPECTION ? Sea insimctions br complebng iNS form on beck of yellow ?npy5 "x° Below Work Covered by This Request ' -E./37l EB-00001-OB ew ?J -ii Rep. - Typeofeuiltling AppiiancesWiretl EquipmentWired Home Range Temporary Service Duplex Water Heater Elecinc Heating Apt Building Dryer LoaO Management Comm./Industrial Furnace Other (Speafy) Farm Air Contlilioner Other (spe&ty) CoMrac[or's flamarks Compute lnspection Fee Below: # Other Fee # ServiceEntrance5rze Fee # Crtcuits/Feedere Fee Swimming Pool 0 to 200 Amps 0 ta 700 Amps Transtormers Above 200 _ Amps e-400 _ Amps Signs Inspecmr§ Use On1y ? TOTAL ?U Irngation BoOms Special Inspechon AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee ? COMPLETED WITHIN 18 MONTHS. I, the Electncal Inspecror, hereby th tif t th b i RougRin oere y cer a e a ove nspec6on has been made. Final oat OFFICE USE ONLY This request witl 18 monihs from Address 3456 IvY roURT Zip 55123 I.ot' ' io - Blk t Sub iHE Wuuoni.r+rros Noxni 2rm THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: /a f C? Yes No Inspector: f• Final grade (6" from siding) Z/ Permanent steps (garage) ? Permanent steps (main entry) ? Permanent driveway ? Permanent gas Sod/Seeded grass TraiUcurb damage Porch ? Basement finish Deck ? Please verify with the builder the removal of roof test caps from the plumbing syscem and the shut-off of water supply to the outside lawn fauce[ before freeze potential exists. Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 INSPECTION RECORD PERMIT TYPE: Permrt Number. Date Issued: BUIIDING 021869 @9/10/93 SITEADDRESS: Lor: Le BLOCK: 3456 IVY CT THE WOODLANDS NORTH 2ND PE?Wj RBTYPE: 1 APPLICANT: SIEKMANN CONST (612) 447-2424 TYPE OF WORK: NEW (1 OF 2 UNITS) DESCRIPTION INSPECTION FOO7ZNG .. . FRAMING D- INSULATION FINAL FIREPLACE REMARKS: S& W PLBR - GENZ-RYAN PLBG F - ? J L ?CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 ?. . PERMIT PERMIT TYPE: Permit Number: Date Issued: BUI DI15G? 021869 09/10/93 SITE ADDRESS: P.I.N.: 10-75891-100-01 3456 IVY CT LOT: 10 BLOCK: 1 THE WOODLANDS NORTH 2ND DESCRIPTION: (1 OF 2 UNITS) BJ1,-ild3rs'g? Permit Type DUPLEX 9uilding CJOrk Type NEW -UBC Occupan?Ey-" R-3 M-1 Canstruation Type V-N ,f 2on3ng L. PD ? Building Length ? 90 \ Building Width `-} 30 z ( 1 ? a- Q-1o-? ?_Y-?•,rr;? REMARKS: S& W PLBR - GENZ-RYAN PIBG FEE SUMMARY: Base Fee Plan Review Surcharge 5AC SAC ? SAC Units Subtotal VALUATION $744.50 $483.93 $65.00 $750.00 100 $2,043.43 $130,000 MISCELLANEOUS $1t744.50 Total Fee $3,787.93 SIVKPI7iN10T?ONST PP 114472424 0001436 CqUNTRYNOME BLDRS INC 6648 RUSTIC RD SE 6648 RUSTTC RD SE PRIOR LAKE MN 55372 PRIOR LAKE MN 55372 (612) 447-2424 (612)447-2424 I hereby acknowledge that F have reed this applicatinn and state that the informaYion is correct and agree to comply with all applicable State of Mn. ? Statutes and City of Eagan Ordinances. I \Y APPLICANT/PERMITEE SIGNATURE ISSUE BV: SIG RE REACTIVATE,_ [ECENED ITY OF EAGAN PERMIT # ' JUL 0 5 1993 1 93 BUILDING PERMIT APPLICATION 32 k7. z.a 681-4675 ?c??,, SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2} address is changed ar 3) lot change is requested once permit is issued. Date July ? 01 ? 93 Valuation of work Site Address: 3456 Ivy Court STREET SUITE * Tenant Name: (commercial only) IAT 10 I BLOCK 1 FUBD. Woodlands North J.D. p,M 2nd Addition Descri tion of work: 11a The applicant is: ? Owner 13 Contractor 11 Other (Deccribe) Name Phone Property LAST FIRST Owner Address SiREET STE M City State ZiP Company COUNTRYHOME BUILDERS, INC. Phone 447-2424 Contractor Address 6648 Rustic Road S E License # 8508 Exp.3/"il /95 City Prior Lake State Minn. Zip 55372 Company Phone Architect/ Engineer Name Registration # Address City State ZiP Sewer & water licensed plumber GENZ-RYAN . Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this a plication and state that the information is correct and agree to comp ith all applica le State of Minnesota Statutes and City of Eagan Ordinances. , Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 5F Addition ? OS 8-Plex ? 13 Garage/Accessory 0 04 Sf Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE ?,? ., .;, ,. : ?. Q 164Ba?ement??ij)ssh G 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. 0 20 Public Facility ? 21 Miscellaneous ff 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish 32 Addition ? 34 Repair 0 36 Move GENERAL INFORMATION Const. (Actual) All bl )J Basement sq. ft. l t F1 ft MWCC System Yc Cit Wate owa e) ( s . sq. . y r UBC Occupancy ?? ? 2nd F1. sq. ft. PRV Required Zaning pp Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length o On-site well Census Code /D Z Oepth 30, On-site sewage SAC Code 40/ APPROVALS ? ? ? Planning Building Assessments Engineering Variance REQUIRED IN SPECTIONS ? Site ? Wallboard ? Footing ? Final ? framing ? Draintile ? Insulation ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: ve?uacim: S13 ?1 DDa " G•4ez as-E; yyo x /6' _ 'laya r flla,,?. N Fi_-XR, !s zo x.SY: gzo to 2N? D=, 415x ?y= 337S`0 3?seasuw l??r?; J+iYK yS= 6r?! /ay 3s? r SAC % 100 SAC Units ? ? LOT BORVEY CBECRLI6T FOR RESID£:'::AL BOILDING.PERMIT APPLIfy'ATION? _ ul • ? ; PROYERTY LEGAL: / ?-?O.?rGL/?lZZ < r Date of Burveys 7!?749' Z J?OCUMENT STANDARD6 0-'0 0 • Registered Land Surveyor siqnature and company C?0 0 • Building Permit Applicant p • Leqal description ?' ? 0 • Address 0??1 ? • North arrow and bar scale Q' ? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.) 0 : Directional drainage arrows with slope/gzadient $. ? Proposed/existing sewer and water services P . 0 Street name ? . Driveway ELEVATION6 Existina ? ?0 • Sewer service 0 • Lot corners r?Ll • Top of eurb at the driveway Del? • Elevations of any existinq adjacent homes Yrocosed Q"?0 ? • Garage floor X? ?0 0 : First floor ? Lowest exposed elevation (walkout/window) 0 • Property corners ?? 0 • Front and rear of home at the foundation PONDZNC3 AREA9 (if applieablel 0 0 • Easement line O f 0 • NwL 0 CJ ? • HWL p ? ? • Pond # designation ? ? • Emergency overflow Elevation pIMEN8ION8 ? Lot lines v : ? Right-of-way and street width (to back of curb) • 0 Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e., all ` structures requirinq permanent foottngs) i 0 0 ? • Show all easements of record and any City n utilities with those easements - Qi'D 0 • Setbacks of propbsed structure and setback of adjacent ? 0?? • existing homr? Retaining yu ire ts, if any Reviewed: / OCtobe7r 1992 - --- -- -- - - - - . EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION owrveR: WOODLAND COUNTRYHOME,S, INC. SITEADDRESS: 3456 Ivy Court PHONE: 447-2424 CONTRACTOR: COUNTRYHOME BUILDERS, INC. DATE: July 1, 1993 DETERMINE WORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED WALL AREA .............. 1,804.00 sq ft x"U" 0.110 = 7 98.44 2. TOTAL ROOF/CEILING AREA :................ 1,435.00 sq ft x"U" 0.026 = 37.31 3. TOTAL EXPOSED WALL AREA CALCULATIONS: Total exposed wall area above floor........ 1,804.00 sq ft a) Total window area: Double glazed ........... ............. 134.00 sq ft x"U" 0.430 57.62 sq ft x "U" - 0.00 bi Total door area :.................................... 38.00 sq ft x"U" 0.070 = 2.66 c) Total sliding door area: Double glazed ........... ............. 80.00 sq ft x"U" 0.430 = 34.40 sq ft x "U" - 0.00 dl Total fireplace wall area :....................... NA sq ft x"U" 0.370 = 0.00 el Total wall freming area (AVERAGE 10%).......... 180.40 sq ft x"U" 0.095 = 17.14 f) Total net wall area above floor Iinsulatedl ........................... 1,279.60 sq ft x"U" 0.043 = 55.02 gl Total rim joist area :............................... 92.00 sq ft x"U" 0.034 = Total foundation area (exposed) ..............NA sq ft h) Total foundation window area .. ............. NA sq ft x"U" 0.430 = 0.00 i) Total net foundation area above grade..... 0.00 sq ft x"U" 0.045 = 0.00 3. Total a) thru i) 169.97 ? If item t/3 is the same as, or less than item #1 you have met the intent of 2 MCAR 1.16008 A and O. Page -1- ?S _' " • 4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed roof/ceiling area . ............. 1,435.00 sq ft jl Total skylight area ................................ 0.00 sq ft x"U" = 0.00 Total roof/ceiling framing area k) (Average 10% ............. 143.50 sq ft x"U" 0.039 = 5.60 d) Total net insulated roof/ceiling area .................................... 1,291.50 sq ft x"U" 0.024 37.00 4. Total a) thru il 36.59 If item #4 is the same as, or less than item It2 you have met the intent of 2 MCAR 1.16008 A and O. ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total evelope system method, the values established by the sum of Items #3 and Item #4 shall not be greater than the sum of Items tf1 and #2. 1. 198.44 + 2 3. 169.97 + 4 CERTIFICATI ON 37.31 = 235.75 36.59 = 206.56 I hereby certify that I have calculated the "U" factors and "R" values herein and that the 6uilding here in described meets or exceeds the state of Minnesota Energy Conservation Act. Julv 1, 1993 (nste) ?YXf/ ,s?wre) James Siekmann Page -2- PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTf. NO. FIXTURES EA-CH TO SHOWER WATER CIASET 3.00 3•00 j4?0) ? BATH TUB 3.00 v cn ? - LAVATORY 3•00 da ? , KITCHEN SINK 3•00 ? LAUNDRY TRAY 3.00 1306) HOT TUB/5PA 3.00 WATER HEATER 3.00 O ? FLOOR DRAIN 3.00 -7 a v GAS PIPING OLITLET • minimum • t 3.00 ROUGH OPENINGS 1.50 WATER SOFI'ENER 5•00 PRIVATE DISP. • neeay. uc. 15.00 U.G. SPRINKLER • nome uoder oonsi. 3•00 ALTERATIONS • to adsting 15•00 WATER TURN AROUND 15.00 STATE SURCHARGE .50 m?_v TOTAL: CTI'Y: 11?i?2O/YSTATE:9?G? ` PHONE #: ZIP CODES 1993 PLUMBING PERNIIT (RESIDEIV'I7AL) CITY OF EAGAN 3830 PII.OT KNOB RD EAGAN MN SS122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSU, FOR TOVJY'riOMrS AiNTD CONDOS WHEN PERMITS ARE REQUIItED FOR EACH UNTf. X NEW CONSTRUCfION ADD-ON A/C ADD-ON FURNACE DATE ) 1 L4 I q3 HVAC: 0-100 M BTU ADDITIONAL 50 M BTU FEES $ 24.00 6.00 GAS OLTTLETS (MINIMUM I@ S3.00 EACH) 3, Du ADD-Olv'/REMODEL (EXISTING CONS7RUGTION) $ 15.00 STATE SURCHARGE TOTAL SITE .50 2-7•J-b OWNER NAME: 1?00kXY ?3A?r_ 80,'l)-ev-5 TEi.EPxorrE#: 44-1 - 24 24 INSTALLER Vallai tr J..^ ADDRESS:_,71 i 1 Ltl I Zf ?L? 5 k CITY: ??o&c e- STATE: Yln IU ZIP CODE: I ?P TELEPHONE #:_zqv _ _43ra I I ATURE OF P MITTEE 1993 MECHANICAL PERMIT (RESIDENTIAL) CTTY OF EAGAN 3830 PII.OT KNOB RD EAGAN MN 55122 (612) 6814675      øùø    ú  ÿ þ ÿÿ þ ýüý     ûþþÿÿ úüíõì úï ø  õ÷ï äâ   ÿø  ýüûú ù  ëü÷  é÷  ÷ ø÷ú ù õ ô  ÷ùëü÷  é÷  ÷ Ùü  ÷ ÿ ÷ÿ  ÷ ù ÷ ÷ Üü÷   ïüû ÷  ó ÷ ÷ þý   ÷  ù ÷þêâç  ÿ  ó ÷ ë êñ ù  æåå ÷û  ýü÷ï ÷ÿ ëã æåâåâ  öõô ø óò ùù  ö ûó ÷  ù   õØäíìá     ÿ óõíí êìçäìììäìí ï ÷ û  ô ÿ ï ï á ÷ ï  ùù     ï ï ÷  ÷÷   ÿ÷  ù ôï  ùù û ý   ó  ý ü     ÿ à÷  å ùù è ÷  ü  ýÿ ü÷           úñ ÿ ÿþ  ÿ þýþýþþ     üÿÿ ûñöì ú ÿ ÷ ì í    ù  ýüûúù  ÿ ø ÿ  ÷ ö   ÿ ø ÿ õ  õ  õÿüóÿü ý ÿ÷üòû ñ ò ÷üòû  ýô à  â    ïíñ ÿ ÿþòì ïïå  òî ëýêé çææåí øü  ýü ÿ çææì Ûÿüÿåæ  ÷öõ ù ôó  ÿ ðÿò üòû ûõÿù ïíñæþÞåïãùð ÿ ÿõ÷ì ÿ ÿõ÷ììå ëïèïå  ûùÿö  ÿÿã  ÿ ÿ ÿÿ ÿ ÿ ó òÿ  ÿÿ ò ùöÿÿ ÿû ýÿ  óõ ÿýÿü ÿðùó ÿ ÿâ ÿ æ  ÿé ò ý ÿü  ü ùý ÿü PERMIT City of Eagan Permit Type:Building Permit Number:EA114683 Date Issued:09/18/2013 Permit Category:ePermit Site Address: 3456 Ivy Ct Lot:10 Block: 01 Addition: The Woodlands North 2nd PID:10-75891-01-100 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Albin Mayer 3456 Ivy Ct Eagan MN 55123--243 (651) 454-1873 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature Date: ty otEagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use _--_AC��y Permit #: / 2 7 73 Permit Fee: /0 - Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION 7- l 6 Site Address: 3 4f S. Resident/ Owner Type of Work Contractor 1v1 L� Unit #: Name: ` `}-1 MC Phone. 1"4►")krJG Address / City / Zip: -S J�a Cr --Mi-444.1 SS► 23 Applicant is: Owner i Contractor Description of work: Construction Cost: 6„, l �' Company: ikt- Address: SI f t S Multi -Family Building: (Yes y I No Contact: City: 7o Email: ct.k State: t'l Zip: 5$"35"9 Phone: 745'4177' License #: 6(---7C"'"4?3 Lead Certificate #:` i- I 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 pian? _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 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 CALL BEFORE YOU DIG, Cat Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locatesof 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. Exterior work authorized by a building permit issued in accordance with the Minnesota Stat B9itding Code must be completed within 180 days of permit issuance. Applicant's Printed Name / vl Applicant's Signature Page 1 of 3