1602 Clemson Dr - Unit B CITY OF PAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. 0. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning:
No. of Units:
Owner:
Address: — —
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit: No.•
posit"
Permit Fee:
1 ogre. to comply with the City of Eagan Surcharge:
Ordinoncu, Misc. Charges:
By Y Date Paid:
Dote of Insp.:
•
- --_ Insp.
CITY OF,EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: —
No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
B Surcharge:
y Misc. Charges:
Dote of Insp.: _ Total::
Insp.: Date Paid:
/ _____ ____
,----,, - - - • - - _. V.__________L_L .
li,..50
0 ' J1 I( /,-/•-\
o r
Use BLUE or BLACK Ink
I For Office Use 1 61
M of EaL ~fl ~ Permit _--I ~ _1J~.__~ ~
Permit Fee: 4Aq 9,
0 d _
3830 Pilot Knob Road
Eagan MN 55122 i Date Received:
Phone: (651) 675-5675
1 I
Fax: (651) 675-5694 1 staff.
2013 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
dq
81
Dam: - - IS
Site Address:16PQ J6eZ
)AQ0 C)~~ r__.._N__Unit`ll:
Name: ~raoms--- Phone: 2. 721- I M2&_
RLSrdetttl
Owner Address / City / Zip:
Applicant is: Owner - Contractor
Type of Work ' Description of work: I-10roQF.-1-a-- _
Construction Cost 0 0Multi-Family Building: (YesZI Na
Company:
f}-_T UG ~I d__,Y Contact:
3 3
Cantracfar Address: 0 .2, city: Mint2~► p~h"S
~
State: MAI_ Zip: 5-5 VO (v Phone: ~ 211__
License - 12"0 2-- Lead Certificate #:-N,41- 2
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:_
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plane 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 the are trade secrets.
CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 45440002 for protection against underground utility damage. Cal 48 hours
before you intend to dig to receive locates of underground utilities. www.gQphwstateonecall.ora
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 State Building Code must be completed within 180
days of permit issuance.
x l~t/f Z.~~+t?!_~ e =n ) x r
Applicant's Printed Name Applica s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA146037
Date Issued:10/05/2017
Permit Category:ePermit
Site Address: 1602 Clemson Dr B
Lot:59 Block: 01 Addition: Thomas Lake Heights 2nd
PID:10-75951-01-590
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Helen E Wiese
1602 Clemson Dr Unit B
Eagan MN 55122--186
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
SEDGWICK HEATING & AIR CONDITIONING CO. Janet& JOB NO. 115 139
1408 NORTHLAND DRIVE,RSUITE 310 • MENDOTA HEIGHTS,MN 55120 • (952)881-9000
ADDRESS 1bo2 C/I+' cm,59, �rsl,, u^^ $ CGY7)-. DEC 1 8 ZU111
OCCUPANT 51IMt: OWNER Nett„ WI
SOLD BY Ala INSTALLED BY SifilreLP
MAKE teN1'w MODEL EIA(ha Uflo/veg
SERIAL NO. 5-9/ 7 3 t 44 03 INPUT N
THERMOSTAT �AHov jtuUti fno* VENT SIZE A.I.
VALVE "V�JJ TYPE OF LINER r "�(
LIMIT Fi yJ e-i LINER SIZE /f2 ��J �(
LIMIT SETTING li W'r FILTERS: SIZE r.'L/ /"�/ NUMBER --------
FAN SETTING -6440 ✓' �
WIRING
PILOT TYPE !`i.081 TEST TAG
IGNITION MODEL Q LIGHTING INST.----------
PILOT TIMING (, SC CO ityt ,�j
IF 7 DATE TESTED /v h
PRESSURE Ka, .. PERCENT CO2 `' i
INPUT CFH PERCENT 02
,,i,„4:iii
G��/ COMPANY TESTING
STACK TEMP. - 13 PERCENT CO 0 NAME OF TESTER
FORM 235(REV.10/10) FORM DISTRIBUTION:'WHITE COPY-JOB FILE YELLOW COPY-CITY
r For Office Use
a,t • ,� Permit#:
4.
„ EAGAF' 5!%!L , Permit Fee: I -6 C7
BY Date Received: /
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)4548535 I FAX: (651)675-5694 Staff:
buildinginsoectionsOcityofeaaan.com
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L / // / Site Address: 1401 61 (.&340. -pi 4A44-1, Unit#:
•
_ f�
Name: #4,110-
TV .�L / '7t/11D alf440'diPhone:
Address/City/Zip:
Applicant is: Owner X Contractor
Type:a
Description of work: I� am" /Qat.Ay 44 d c- /®j.i C A-
Construction Cost: Multi-Family Building: (Yes /No )
Jf`rP iC.ry/Company: f7E7 4d+ Af/7�f//I ontact:
i*, gent
C+€filt it Address: 1c/i. i ZI City: ` Le v1 Y / C
State:#Ntd Zip: criiily Phone: 4-7-.3106-YAk7nail:/heir av5tAtt'T.ztl.:f40e 24,01 C
License#: RL 2Z 9f ZZ. Lead Certificate#:
If the project is exempt from lead certification, please explain why:
Adglit_ RAI .91 74. 9
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:
G i
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTA Plans~ �` Y r
classifies(" �< .t ate.:.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.aooherstateonecali.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 pe '; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval lans.rd
x PALL L
Applicant's Punted Applicant's Signature
DO NOT WRITE BELOW THIS LINE i‘tD C /cinDri. Dd. e /�/ O /,
- SUB TYPES !�
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage _ Porch(4-Season) ____ Exterior Alteration(Multi)
— Multi /}0 Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of,l 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
pReplace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION _
Valuation 44Z/ `,�9' Occupancy ,..1Z4. MCES System
Plan Review Code Edition /77•1 'to I Jr- SAC Units
(25%_100% ?0) Zoning PJ City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
Roof:_Ice &Water _Final Pool:_Footings Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: /-eYYI 1ik/7i f , Building Inspector
RESIDENTIAL FEES
Base Fee 19 1 k/1) I •/ 0 6 59 fT,
Surcharge 6) .0 /5; o 0 5e• /c7`-
Plan Review
MCES SAC /Y/M ;,,y7 ✓gat / t'c
City SAC
Utility Connection Charge t X/-57-7e1, fug n f.
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3