Building Permit Application RESIDENTIAL PERMIT APPLICATION
CITY OF CHANHASSEN BUILD ZONE
7700 MARKET BLVD•PO BOX 147 ♦ CHANHASSEN,MN 55317
Phone: 952-227-1180 Fax: 952-227-1190
E-Mail: bldgsupport@ci.chanhassen.mn.us Web: www.ci.chanhassen.mn.us
A GENERAL INFORMATION
Site Address: 7 T e/ Frba,tt r r fir&; / CJ ch I,.a c s Ti
Property Owner: /9 Z. . LLC Phone: 61 2 2r/ a rag
Address 5- 4J 'r T,,e, pCity ('1,�t �. r j s ..,� State H N Zip S-.f-3/ '
If different than site address
Lot: o/v Block: p ,q Subdivision:
Parcel Identification Number: .2 S 05-0 036'0 Zoning District:
***RENOVATION,REMODEL,RESIDE,REROOF AND WINDOW REPLACEMENT:***
Year Structure Was Built: t,cp Licensee Lead Certificate Number:
Variance required: Yes filNo 0 Planning Dept.Case Number:
Is there a water feature within 75'of any property lines? Yes l!!l No 0
Is the property in a floodplain? Yes 0 No If YES,Complete Certificate of Compliance for Authorized Floodplain Development.
Sewer Available: Yes 11,, No 0 City Water Available: Yes ca( No 0
B ONE &TWO FAMILY DWELLINGS-NEW CONSTRUCTION ONLY
Basement 1st Level lnd Level 3rd Level Total
Finished Finished Finished Finished Finished
Unfinished Unfinished Unfinished Unfinished Unfinished
Garage Square Footage: Attached Detached Tuck Under
HVAC System: Oil O Gas 0 Electric 0 Forced Air 0 Hot Water 0 A/C 0 Mechanical Ventilation 0
Number of Baths: Full '/. '/z Number of Bedrooms Number Future Bedrooms
Number of Fireplaces: Masonry Manufactured Other
Dwelling Square Footage: Deck-Sq. Footage 3 Season Porch-Sq. Footage Screen Porch-Sq.Footage
Value of Dwelling EXCLUDING Land:
C OTHER IMPROVEMENTS-EXISTING DWELLINGS
Addition ❑ Basement Finish ❑ Deck 0 Demolition ❑ Fence ❑ Fireplace ❑ Pool ❑ Remodel ❑
Repair❑ Reroof❑ Reside 0 Shed 0 UST Installation/Removal Cit Other 0 Year home was built /8 c G
Explain: 10e4 "�/u vt O Y c 0. -c— rte., ]'raa. f'� eL a ra t' $re _
Square Footage: 7L c L.1 Dimensions: 'X 2 g- S Value of Improvement: p o c)
D APPLICANT'S INFORMATION
THIS IS AN APPLICATION FOR A PERMIT. IT IS NOT THE ACTUAL PERMIT.
THE UNDERSIGNED STATES THE INFORMATION PROVIDED IS ACCURATE AND AGREES TO DO ALL WORK IN ACCORDANCE
WITH THE CHANHASSEN CITY CODE AND THE MINNESOTA STATE LAWS REGULATING BUILDING CONSTRUCTION.
CONTRACTOR/APPLICANT: i f/ AL,v s LI.C.
CONTACT PERSON: q.1 L l-J' E-MAIL: Af Qv(./..,S1 ESQ t-/-/4/4 . Lc1
ADDRESS: S 43 7 t 5`-�(�ti.�-f CITY(�,�4k r 5f ` k STATE:PIA-ZIP:
PHONES(W) (C) 6l 2 — 7 5T 1 - o YP( (F)
License Number: - Type: Expiration Date:
SIGNATURE." DATE:
SIGNER MU OME ER, C TDR, CONTRACTOR'S AGENT OR EMPLOYEE
CITY OF CHANHASSEN
HARDCOVER CALCULATION WORKSHEET
EXISTING AND PROPOSED HARDCOVER
Property Address: 7 7v ) r 4 St ., rf"S s S"31
A. House a g_ X 2 6. 1 = 74G ..37S.F.
/ 4_3 X //.. = , 5 3. ,, S.F.
6 X i2.r) = 9 L. da S.F.
X = S.F.
X = S.F.
B. Garage /V d X 2s. / = 3 t 3 . „pg. S.F.
X 3. = k . (ted S.F.
C. Driveway X = S.F.
X = S.F.
D. Sidewalks X = S.F.
X = S.F.
E. Patio/Deck X = S.F.
X = S.F.
F. Other X = S.F.
(i.e. shed, etc.) X = S.F.
TOTAL HARDCOVER: /, 37, sz S.F.
TOTAL LOT SIZE: y, q No S.F.
HARDCOVER PERCENTAGE: /6_ 3 %
MAXIMUM % ALLOWABLE:
Prepared by: ,' / ,;,/t Y Date: 6/ l 2 a„z
Signatt. 2.1iik
Reviewed by: Date:
Comments:
G:\PLAN\Forms\Hardcover Calculation Worksheet.xis