3460 Highlander DrJun. 8. 2011 2:49PM SELA ROOFING
41111'City atEta
Date:
3830 Pilot Knob Road
Eagan MN 56122
Phone: (651) 675-5675
Fax: (651) 675-5694
No. 6530 P. 32
Use BLUE or BLACK Ink
For_Otfi ,U.
Permit #:
Permit Fee:
Date Received:
Staff,
2011 RESIDENTIAL BUILDING PERMIT APPLICATION�
Site Address' �f Llf �` "4` 1 `-` 8.t n :
RESIDENT I
OWNER
Name;s, G'L itko ') Phone: /501--W)-- 667 4
��
Address I City 1 zip: — AO tel ,�, . tiar
Applicant is: Owner .i(/ Contractor
TYPE OF WORK
,
Description of work:` 11U 01 /t_ U3 I C[' i��' (y__,
,
li
Construction Cost: (I( l - (1 0 0.4 - f Mufti -Family Building: (Yes) I No )
dig
CONTRACTOR
Company:cSaf izeo i 1'•a Contact 61412,4 lar V 1(?J
Address: clop -67,e A7,04- &VA- City: . .It P/ —
1LAO
State: Zip: (554 I(9 Phone: f 1- / %61?
License* OM/ 060 Lead Certificate it: Alm-- A 6634 -1
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
_Yes _No If
Licensed Plumber:
Mechanical Contractor
Sewer & Water Contractor:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Phone:
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 City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Can 45 hours before you intend to dig to receive locates of underground utilities. www.000herstateonecall.oro
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 y; lans.
x (54 -Ln vi4A1v 1M -La
Applicant's Printed Name
x
App icant's Signature
Page 1 of 3
CITY OF CAGAN Remarks
Addition SURREY HEIGHTS 7TH ADDN. Lot 1 Rlk 8 Parcel 10 73006 01 fl [1R
Ownerl, i _ street 3460 Highlander Drive state Eagan, NIN 55122
? GARAGE
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWERLATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
9UILOING PER.
SAC
CITY OF EAGAN
Ownerfl?Q;Ct? a1'? Street
Blk 7 Parcel 10 73006 060 f17. Drive stete Eagan, 14Ai 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWERLATERAL 738.01 A004083 5-19-77
WATERMAIN
* WATER LATERAL 1975
WATER AREA 1973 Assessed der 02'1 1111 3.T el
* STORMSEW 1975
STORM SEW LAT
CUFi6 & GUTTER
? SIDEWALK
STREET LIGHT
I
WATER CONN. Z$O.OO IZ$ Q 9-27-78
BUIIDING PER. #4981
SAC
PARK
CITY OF EAGAN
3795 Pilof Knob Roed
Ea9en, Minnesofa 55122
P6one: 454-8100
iEATING
Dote:
9-28-?8
PERMIT
S;te Addreu: 460 Highlander Drive
?
Lor Block Sub/Sec
SH 7th
Nome ??• Fl• CUStSfso-'
? Address SOOi N. 80th St:eet
City m 1 S. Phone:
Name ". L` iT'u.12 i fr Sr??
.
jrAddress 120 E. Butier Ave.
S IA. _ y . t . P8U1 . Phone: This Permit is issued on the express condition thot all work sholl be
Minnesota Statutes and City of Eugun prdinances.
Combustion Air Required
No1 ;03
.
Reteipt No.:
Single (
Residential
t.n,., ( X
Multi Res., Comm./Ind.
New/Alter./Repoir
Cost of Instcllation _
Permit Fee 2 t? . 0 0
- r,
Surchorge
done in accordonce wlth all opplicable Stete of
Building Officiol
- CITY OF EAGAN
3795 Pilaf Kwob Raod
Eagaw, Mlnneaata 55122
Phone: 454-8100
- PERMIT
Date: 9- Z 9- 7 S
it:ighla;l ? -? rriv(
Site Addreu:
Lot ' Block ? Sub/Sec. _-
?t
Name • •
? Address }(11 .
City Phone: ame ` .7UJBCC PIlll:ll) ;
I `
I ?3 Fltiinboldt .?ve
j ?
Address
` o
V -. ?..y. -
CitY Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes ond City of Eogon Ordinonces.
No. -!:?l 2 24
Receipt No.: 1 ?
Single
Residentiol
Multi Res., Comm./Ind. x
New/Alter. / Repair
Cost of Installotion
Permit Fee y Surcho?ge
Tota I done in accordonce with oll appliwble State of
SH 7th
Building Official
00 0
? ? .
CITY OF EAGAN
8795 Pilot Knob Road Eogan, MN as» N°_ 4980
PHOMEs 454-8100
BUILDING PERMIT ReceiPt .#
Ts 6? u?ed fer •' ) Unit Of 4's'F?'?+??/?I„P n.,*.. ??•'t• ? 1 19 7`i
Site Addf@SS - e :- ':! .thi endC'ir--Dr.
Lot BIoCI?? i SeC/Sub. 1:+1rrgy? ilahta ?
Pcrcel #
oc Name _
3 Address
0
" Name
,o
?? Addre
?- r?..,
Address
I hereby acknowledge that i hove reod this opplication cnd stote that
the informotion is correct ond agree to comply with all opplicoble
State of Minnewta 5tatutes and Ciry of Eagan Ordinonces.
Siynature of Permittee
/1 Building Permit is issued to: all work sholl be done in accordonce with all oppli
Building Official
Erect ? X Occupancy
Alter Q Zoning '' 4
Repair ? Fire Zone 3
Enlarge ? Type of Const. w
Move ? ¢# Stories
Demolish ? Front
Grade fl Denth ft.
Assessment -
Water & Sew.
Police
Firo
Eng.
Planner
Council
Bldg. Off. _
APC
Permit _
Surchorge '
Plon check
SAC
Water Conn.
Woter Meter "")• 40
Totai 925.00
I
Gcz) d i'?ri :, ? ; ..,
on the expreu condition thot
Stote of Minnesoto Stotutes ond City of Eogan Ordinances.
PerAM # oafe Imred ?aIffM
Plumbing "I ? rL C?'+-
Mechanicol ( •30 j - 1 ? -7
INSPECTIONS DATE INSP. Rouph-In Find
Footings Date Insp. Dote Innp.
Foundotion Plumbing j ;J) l6
Frame/ins. Methanicnl ?
Final
Remorks:
? CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
, PHONE: 454-8100
BUILDING PERMIT
Receipt # _
To be used for SCREEIED PORCA Est. Value =3 ,000 Date Apit 2 s
Site Address 3"0 tliGNt.AMEN DR
Lot 6_ Block _L SeGSub. SUR1tLY l1TS 2TN OFFICE USE ONLY
PSfCeI NO. Occupancy FEE S
Zoning
W
? Name ELISE YEN
Address 3460 l1IGHI.AIDBR D1l (Adual) Const -
(lulowable) Bldg. Permit 14?-OD
o C? ??
ty Phone 454-7329 -
# of scwie5 _ Surcharge
Pl
R
i
Length an
ev
ew
_? Name t?RRY-?E NONE RLlAIR Depth - SAC, ciry
?¢ Address -- g?1.gt08 tVD S.F. Total _
? City 3? IDUIS tI(Phone 927..7755 S.F. Footprints _ SAC, Mcwcc
?¢ On Site Sewage _ Water Conn
? W Name On Site Well - Water Meter
oi,
<W Address
Cit
Ph Mwcc syscem _
Cit
Wat
Aect• DePosit
y
one er _
y
PRV Required _ S/W Permit
I hereby acknowlege that I have read this application and state that the
t
i Booscer Pump - gryN Surcharge
n
ormation is correcl and agree to comply with all applicable State of
Minnesota Stalutes and City of Eagan Ordinances. Treatment PI
Signature of Permitee • ''""^
i APPROVALS Road Unit
A Building Permil is issued to: wmn-?m sm SOAZR Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. gld9 pff. _ Copies
Building Ofticial ? Variance - TOTAL gs' ?
r
Permit No. Permit Holder Date Tekphone N
WATER
SEW=F
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundalion
Framing
Roofing
Rough PIb9• 4,10 QlLG` 4 ?. L•!?G -12
Rough Hlg. D rt1G".'' ,./Lt
ISUI. .-
Fireplace
Final Htg.
Orstat Tesl
Final Plbg. Plbg.lnspector - NotifyPlumber
m
CITY OF EAGAN
3795 Pilot Knob RoaA
Eagon, MN 55122
Zoning: -- -
f
Owner: -
Address: --.--
Site Address:
Plumber. - -- -
?1 ogree to eanPly with Nhe Cify of Eagan
Ordinanees.
By
Date of insp.:
I nsp..-
SEWER SERVICE PERMIT
PERMIT NO.: - -
DATE:
No. of Units:
Connection Charge: ?
Account Deposit:
Permit Fee:
Surcharge:
Misc. Chnrges:
Total:
WATER SERVICE PERMIT
cirY oF EnraN
3795 Pilof Knob Rood PERMIT NO.:
Eogan, MN 55122 DATE:
Zoning: No. of Units:
Owner: -
Address: .
?
Site Address: - ?-
Plumber: . .
Connection Chorge:
Meter No.:
Size: Account Deposit:
Reaaer No.: Permit Fee:
1 agree to oon+PlY wifh the City of Eagan Surcharge:
prdinances. Misc. Charges:
Total:
gY Date Paid:
Date of Insp.: Insp.:
I
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
°:ogan, MN 55122 DATE:
No. of Units:
Zoning:
Owner:
Address:
`??z?'.lan??Pr ?
"r
Site Address:
Plumber.
Connection Char9e:
Meter No.:
Account Deposit:
Size: Permit Fee: --
Reader No.:
1 agroe to oomPlY with th° Ca1' °f Eagan Surcharge: . ' ,
Misc. Charges:
Ordinances.
Total:
Date Paid:
BY
Dote of Insp.: Insp.:
P.7V--1Sla
?h est va 8 monffis from (,p- 7 0,s, 7 p L,d
D i
' y- nl 4583
Date of [his Request ?..1 j']8 . ? ]?Vj
I, as ?Licensed Electrical Contractor ? Owner, do hereby request in ection of the above electri-
cal wuing installed at:
Street Address or Route No. 3460 Fiim1'1lander City Eaaan
Section Township
Range County nalrnta
Which is occupied by n.H. l:v8},g f8nn
. (Name of Ot<upant)
Is a roughin inspection required on this job? No ? YesXXX Ready Now ? Will Call Cix
Power Supplier Dwkota Cty. Address EA?ingto++
Electncal Contractor O.B. Thompeon Eleotric Co. Contractor's License No AMS
(COmpany Name)
Mailing Address 12201 #tka Blvd. Mtka 5
(Ele< cal ontractor_ Ow e akingThlslnstallatlon)
Authorized Signature Phone No. 933-2521
(Electrical Cont r or Owner Making This Instal4tlon)
(? VA?j(? ?Gpy This inspection request will not be accepted 6y the
? ?J ? t? State Board unless proper inspection fee is endosed.
CITY OF EAGAN No 18963
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt # Li? Xl?S?
To be used for SCREENED PORCH Est. Value $3, 000 Date APR 25 ,?g 91
Site Address 3460 HI H AHDER DR
Lot 6_ Block 7- Sec/Sub. S iRR Y HT 7TH OFFICE USE ONLY
Parcel No. occuPency R-3 FEES
2oning _
m Name ELISE YEN (Actual) Consi Permit 54.0
0
Bldg
w
3
? Address 3460 HIGHLANDER DR (auowaeie) _
.
surcnarye 1.50
City EAGAN Phone 454-7329 a«otsrories _
Plan R
view
Length e
_
F Name WORRY-FREE HOME REPAIR oepm snGCi
} -
ry
$? Address EXCEL4IOR BLVD s.F.rotal _
Cit ST LOllT PARK
Y?_ Phone- 927-7755
S.F.FOOtprims SAC, MCWCC
_
W
? 622-0656 On Sile Sewage ater Conn
W Name on sae wen
?w - WalerMeter
?? AddleSS MWCCSystem _
a W City PhOne City Water _ Accl. Deposit
PRV Required _ S/W Permil
I hereby acknowlege that I have read this application and state lhat the Booster Pump - SNJ Surcharge
infortnation is correct antl a e to comply with all applicable State of
Minnesota StaWtes an
CitEagan Ordina e s. Trealment PI
Signature of Permitee -
; APPHOVALS Roatl Unit
? WORRY-FREE HOME REPAIR
A Building Permil i5 is
6dto:- Planner
- Park D ed.
on the express condition that all work shall be done in accordance with all Council _.
applicable State ot MinnJe?sota Sta
tutes and Ciry of Eagan Ordinances. Bmg. ott. _ Copies
p
I 11Sf A Il Yt, 1,
Building ONicial
?? 1IIJI
Variance
- 7pTqL 55.50
CITY OF EAGAN
t ?
U?y? 3795 Pibt Knob Rmd Eagan, MN 55122 N2 4980
PHONE: 4548700
BUILDING PERMIT APPLICATION $33,000. Receipt # -------?Cf?sA'/
Te ba uue for (i ) Unit of 4 P&mdi. Dafe Sept. 21 _ 19 78
SiM Address Erect ? X Occupancy I
Lot? Blo£k2_._ Set(Sub.?rfes 7 Alter ? Zoning 3 R4
G8Tg... 1 S1K 1
parc,l #. Repair ? Fire Zone
Enlarge ? Type of Const. V--
c Name D. H GustBfson Move ? # Stories
? Address Gold Medallioa Cerp Den+olish ? Front 4 Plex h.
? Ci Mpls Phone 835- 7262 Grade p Depth - ft.
? Neme APMovab Fees
-- -
?a ? Address
Name
I hereby acknowledge thot I have reod this applicotion ond state that
the informafion is correct and ogree ro comply with all appiicable
State of Minnewta Smtutes and City of Eagon Ordinances.
Signacure of Permittee _
A Building Pertnit is issued
oll work shall be done in a
Building Offtdal
Assessment _
Wuter 8 Sew.
Police _-
Fire
Eng.
Planner _
Council -
Bldg. Off. _
APC
Permit ?o.Jv
Surchorge 16.50
Plan check
SnC 500.00
Water Conn. 250.00
Wcter MMer 60.00
Torci 925.00
D. H Gustafson Gold Medallion qRF&e exPress wndition that
with olk?Qppliccbie State of Minnesoto Statutes and City of Eagan Ordinances.
REACTIVATE
PERMIT #
"Wil-I
CITY OF EAGAN
1993 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work
34loo
Site Address: ?454 h-1t6h1LAratfJ?C2. ?°. ClAjCcuOt=°`5 34S42>,34S$
r
STREET Sl1ITE /
Tenant Name: (commercial only)
LOT 2 BLOC& 7 !5LJ1ERE?1 "Ef4F!-TS
SUBD P.I.D. 73c&'(? bL4 17
5 !0 .
7 714
Descri tion of work: Re S, a
The applicant is: ? Owner f$' Contractor ? Other (Descri6e)
Name 5, v tt e??, ?4 S 16w4?ewes AfSac Phone
Property LAST FIRST
Owner
pddress
STREET STE N
City State ZiP
Company P1f? r o 1 N c. Phone 5_S7 - U$
Contractor Address Iyd Vy a3 ? R'P NO License #M61 Exp.-7/3/ 9L/
City ? l?2OU?? State 1'n/N7? Zip 3"3
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I here6y 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.
Signature of Applicant: ?- `7
DATE
BUILDING PRRMIT APPLICATION
Include 2 ssts of plans, 1 site plan w/elevations and 1 seC of energy calculations.
To be used £or
Valuation aJ??,W _'0
Site Address:.3yG O
Lpt Block See. Sub.-
-v a
? 'd4mer
Address
Parcel Idumbgr
Telephone
Contractor
Address
Arch./Eng.
Address
Erect v
Alter
Pepair
Enlarge
Nbve
Demolish
Grade
Telephone
Telephone
OFFICE USE
Occnpancy T,
2oning
Fire Zone
7ype of Oonst. j/
#1 of Stories
Front
Depth ?7p- /C
OFFICE USE
Date of Approval & Initial
Assessment
Water/Sewer
Police
Fire
Eng.
Planner
Council
Aldq. Off.
A.P.C.
FEES
Pezmit ?g J
surcharse ?h
P1,an Check
SAC
t-?ater conn. J
crater Meter 6 O ?
TOTAI,
. t
, ,.
1991 BUILDING P%OICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
IiULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTUAAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH SLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRES5ES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLAWE? ONCE BUILDING PERMIT IS IS5UED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: ScrZeorl+ V/a?luation1? De
Site Address ? y40 ??'f?`??n'de OFFICE T
Lot 4 Block Q
Parcel/Sub j U
Owner r,(NSC -ICC?
Address 3 q d b /-((r/n /4^?r dc I`?c
City/Zip Code 62yUh (11J' cS,J /.2C_
Phone f! ?75L "? 3,6'aq
Contractor _ i„jo f('y -C'rc'e kawc'
Address SyLPI?o/ Q(uU
City/Zip Code 4'f4ovl's
Phone 9`. 7- 7?5-5 O( n)
Arch./Engr. (?Z2- C) E''tG
Pa?ph
Address
City/Zip Code
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.
12-3
F.
On site sewage_
On site well
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
APR " „ 1991
FHES
Bldg. Permit 51160
Surcharge s$?o
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct, Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL ?
Phone #
\ J ?q5g /,,1l?cn rse{cJy t?ry ?ussdr'?ns
,/j?J Cv/?' co?ncc{oJ ?j ; m. ?z-7- oGSyri'^?o7' . agrees that all work shall be done in accordance with
(Signature of ontractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.