1294 Deercliff Lane0
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #: `_\ °�\\
Permit Fee: 4
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11-1 / 0 Site Address: J g 1/ L) e c e 4T Lan e.J 1
Tenant Suite #s
RESIDENT / OWNER
Name: C/ i 2 ct b -2+% SITI O IA S eJ5 965 d 3(
Phone:CJ
Address / City / Zip: 1 9U/ beeV- C1; f4 Lars e Ica ja
Applicant is: Owner 'Contractor
y p e---)7
Description of work: Te i Gl. 'LQ G 1J I n.C1 (A S) I o.-�-'10 Gt ci-i�' op e�
TYPE OF WORK
LJ p
Construction Cost: %� -/ O Multi -Family Building: (Yes / No ?S )
CONTRACTOR
Name: c� w�. r c 2 S License #: C) \ (o 3L1
\---
(
Address: l 9 Q Lori e Ockk RA I/ (L City: eaC..y
State: a". J`) Zip: E I D I Phone: tai'' I 9 0 b 01047.;
Contact: 1\-► 0.Y` C a Email:
COMPLETE
Ir the ast 12 months, has
_Yes 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:
_No
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer& Water Contractor:
Phone:
t�t�1 Plan grid sra carting docu i atyo rl f onsi �� v , of
t`he int rmatr to maybe clan ifi d s n n pubs f your prod
conclude, that they are trade. se' rets,
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against: underground utility damage.
Call 48 flours before vou intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq
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
accorda®ce with the approved plan in the case of work which requires a review and approval of plans.
X
,"oncti
Applic€nt's Printed Name
x
Applicant's Si
City of Eakan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
i For Office Use
: t
l Pormil ii 1 1_3 2'64
i V
I Permit Fee
Date Received: 9'3-13
Staff: A
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:CI 61 2--° 1 Site Address: 2CIO --9a - 9 -9 6 `beevci-vce- j4v-e unit #:
Residentl
Owner
Type of Work
Contractor
Name:
k
iat
Address i City Zip: P. P 0 t 6s7
Applicant is: Owner )< Contractor
Description of work: Re_ --Rq0C
Construction Cost:
Company:
Address:
F-A6icku,1
hone: (s, I 45z -scmo
Pl'on 1.rt T\Ao u
910 CU
Multi -Family Building: (Yes y 1 No )
Contact: DG R
City: IGAiL
State: ./\)\14 Zip: ss -12,3 Phone: ( t1--24 0 —1(,(0y
License #: 51 5 768 Lead Certificate #: 73, 1 911 — 1
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 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:
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.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651)464-0002 for protection against underground utility damage. Call 48 hours
bekre you :Wend to dig lo Grave locates ol undercround
I hereby acknowledge that this informat-on is complete and accurate that the work will be in conformance with the ordinances and codes of the City of
I
agan. that I understand this is nol a peimil hot only an applIcation for a permit, and work is not to start without a permit !nal the work will he 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 180
days of permit issuance.
R
x 4
Applicants Pribted Name
Applicant's ignature
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
CA L BEPOR'E YOU TING.
tocilia m
that tttes
beegr-Wr
/ DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace
Single Family _ Garage
Multi Deck
01 of _ Plex Lower Level
Porch (3 -Season)
_ Porch (4 -Season)
WORK TYPES
New _ Interior Improvement
Addition _ Move Building
Alteration _ Fire Repair
xReplace _ Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
_ Footings (Deck)
_ Footings (Addition)
Foundation
Porch (Screen/Gazebo/Pergola) _
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Roof: Ice & Water __Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
1
_ Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
_ Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
N1IY SAC Units
p1'
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: Footings Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3