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3795 Briarwood LaneINSPECTION RECORD CITY OF EAGAN 3830 Pilot Knob Road Eagan,klinnesota 55122-1897 (612).681-4675 t SITE ADDRESS: 1' 411-t. !R(1 PERMIT SUBTYPE: SURTYPE: •It Aimri “14 PERMIT TYPE: Permit Number: Date Issued: 11.11 I It 1 Mi 01—) 1 4 I 1..,8 f, 0410 CI i; it I lir t; MU• I APPLICANT: it i‘ pf- mumI i 041 ) f TYPE OF WORK: Pi ititi t 1.4 h [wry, _ .„,,,.. ',...' III S1)1= CTION -I ‘f P E ''' 1- 'T,•• Frio I i stati,:, ,...r• I'•-'.'',":,1.7: ' I E'41-1°2''.. ''' ^-,, 711,1-3p'-'2-F:r ' • ,,„,,I , ., , r,*'-,-,” ' I- 1 .f Ari 1 NI ."."•-• .' ,-- ' •,, ., ' IE - . INsP i ri 1NqIII Allot! 1 4 VI vt Ai 1 f 1 WAI i . . . RI-AARE i'IWA 11. I 1-n oiri id it t i"41 -4'r 1. 41-i 11111 AI cm 1114141N1i 1,111N" Pam* No. - Pennft Holme Date Telephone e 0 ELECTRIC PLUMBING HVAC 79 J,, %OO f Or " Inspection Date htep. Comments FOOTINGS V ox Zvo, FOUND • FRAMING /2.-4-4Ve /K$ ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL 044 411f /2-/3-1.6 41-- AA GYP BOARD FIREPLACE FIREPLACE AIR TEST , FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL A n /64 1G2 4,67 rtr2,24. co9'ly'rlrird', /NSliiiZ/At %aO/e/'laSi BSMT R.I. BSMT FINAL DECK FTG &//v‘ a ccccllll DECK FINAL ''x£??, •-•A'im' = - SEDGWICK HEATING & AIR CONDITIONING CO. p �„ _® n HOUSE HEATING TEST RECORD / 1 / �''Z"�'L�.K ADDRESS 2 --775)? �/'' 1 (7P U/d oS' Z. ®'n CITY E yelk OCCUPANT ``--- OWNER HEAT LOSS ' DATE HTG. INST SOLD BY = `' //,-1 i '' INSTALLEDAY e 5 C�C Electrical Work By f *1 -E A" Gas Line By., ems' �1� a C t TYPE OF HEAT GA_ FA_ HW_ STEAM SPACE HTR.. UNIT HTR. OTHER .'-�..•_1-1 x3778-7 GAS DESIGN MAKE I 1ti X model G)/- q -,3,4,,,_./17e--/ Serial `. i`'. S G G'1 '7 f INPUT / 0(?) Ci r O A:7" THERMQST,AT Valve k, i- g e r r ; / : ' Iimit Setting 0 Fan Setting 'L) CONTROLS Feat Plug 5, IA -- Pilot Type • j �, Pilot Make /''•• i' 0*''� .�t 'I a' Pilot Model `?} J ' S Pilot Timing it -7 - 117.'- L.W. '7 i L.W. Cut Off Pressure 3! 5 fl,,t . c Input CFH 41) Stack Temp. O Dr" Form 235 Percent CO2 Percent 02 Percent CO CONVERSION MAKE OF BURNER Model Max. BTU Rating MAKE OF FURNACE Model Vent Size KIND OF LINER / SIZE NONE Draft Hood .- k)d/, C P✓ Regulator Filters Size • Number Chimney Location Inside Outside Chimney Construction L. --Z {'/' S S .,,a Smoke Bomb Wiring Draft Test Tag Door Pressure Lighting Inst. Date Tested /� 75/1 Company Testing =�� f ��"`) f Name of Tester /`1%t' L f/ i S L. F�' BLDG.. 01-32101 1..Q1-3422 ,�„t?1-3445 01-3446 . .01-2155 3860 20=2275,'. 20-3865 2D-3868' 20-3716 20-2252 20-3713 20-3743 79-3865 -3855 0 1-fo 00, :Bidgb' Permit . . -71 a. PlaI%, Check, '4562 "*! .Surch. Adm. / . "SAC/Adm. Q ;Surcharge; 18 Bpac a nit ,,,O(.? 3 SAC Water Conn. . Water Trmt.. Water Meter Acct.Dep. Water. Permit Sewer Permit Sewer Conn. Park Ded. co 00 00 ��� TOTAL ^•/ : '3830 Pilot Kl BUILDING PERMIT To be used for SP Est. Valet {� CITY OF EAGAN gad, P.O. ,%Box 211 991 ONE: 454.8100 Site Address 3 OFFiCE E Lot 8 Block t Sec/Sub. 1111 110.11AIMI On Site MW By m Parcel No. On Site Well U�3tua4i City Water AL (Ai cc Name a Addy{ess 10X at, ` PRV.Regyired of'. ' o City s Phone Booster Pump Lerttth :. fepth ;r g Narmr � S:Fgotat ut Address F tr it ,: w . City Phone e;> mm > Name Addrerip City Phone Engr./Assess. Planner Council Bldg: Off: Pfan Re I hereby acknowl.dge that 1 have read this application and state that the. VariancS: information is correct and agree to comply with all applicable State of 10' esota Statutes and arty of n ,*rdi : es. •.t 4 ' S1 ature of Permittee At Permit is issued to• on t � eress condition that all wo ' :hall be.dne in accordance with all ap 'cable State of Minnesota Statutes and City of Eagan Ordinances: Building Official V Water Conn: Water lulu,. Rtfatl I lriit Treatment 0.1 Parks, TOTAL !!!U tip**. To OF EAGAN 3930 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ERMIT G JLC_ .dPHONE: 454-8100 2 �� r,.✓,�-� Receipt * Est V , ue ` l'--1 `''" Date NARCH Site Address Lot Block Sec/Sub. Parcel No. /VAAN.;6y 1 Name Address City Phone Ns Ac Ci Phone A City Phone iokalosiVecige that I have read this application and state that the informatiOrt.ie,correct and agree to comply; with all applicable State of Minnesot i *tatutee and City of, agan ordirtairees. Signature of Permittee A Building Permit is issued to: on the express condition that all wont shall be done in accordence with all applicable State of Minnesota Statutes and City of Eagan Ordnance*. Building Official P OFP= Wit On Site Sewage OceusenbY MWCC System X Zoning On Site Weir =� City Water PRV Required Booster Pump Length Depth S.F. Toni Footp6Nt S Engr./Assess. Planner Council Bldg. Variance War T Permit No. Permit Holder Date , Telephone # /�� 9Plumbing 7 4_' :L , )C 4 /kV H.V.ac. 9)28Y i• ,� e/g(el Electric /1� IV 1- — C (� 1'`/O/ g8 %9 0 Softener Inspection Date Insp. Comments Footings I _.45,2780,, zdig., Footings it Foundation 4% t 4 S Framing Er2?8y Z r5 Roofing Rough Plbg.�(%`. r Rough Htg- �-(,-iii �. (44f/tZ ars; CIS' Sag e�s�s 2 ism. -2v,f 0.‹ Fireplace driAdiir Final Htg. kft6 ,- �' �_ L-.-;37-c--,7�e Final Plbg. r.'_- ' �� o`{{« e:: Bldg. Final �'b/a/G 1 r �� .,.. . .cue_ Cert. Oc c. Temp. LP Deck Ftg. ;„, /309 Deck Final Well r-"741.fY.0. .e- gM%l /' Pr. Disp. 7ty 7 o 0 er7-- uf P's' .Q' 1.14 t.cg '#j 'r )'`D '6 Ara °9►/f�fi 6136194r0"0 -- -,0 PLUMBING PERMIT CITY ;OFEAGAN 3030 PILOT KNOB ROAD, EAGAN, I Pi AEs: c'(3 PHONE. 4544100 SSS BLDG: Res. ?Ault. Comm. Other Phone OW' $3.2.2 FEES COMM/IND FEE - 1% OF CONTRACT FEE APT, BLDGS — COMM RATE APPLIES TOWNHOUSE & CONDO -4- RE& RATE APPLIES MINIS — RESIDENTIAL FEE - $12.00 MIIIMUNI- $ COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD SiSO`Sit IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN RES. PLBG. ONLY – COMPLETE THE FOLL FIXTURES Water Closet - $3.00 Bath Tubs - $3.00 .__Lavatory - $3.00 iShower - $3.00 _Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 —TGas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 .-Rough Openings - $1.50 FEE STATE$iC • CONTRACT PRICE: .6'4 PERMIT # MECHANICAL PER 1!L _. pe RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PHONE 454-8100 ` �C? /id/ Name Address City Name Address City Phone Sec/Sub ' CK HTG,_ & AIR COND. CO. 1'dEN-11ORTH AVE. SO. NNEr, JS, Mr: 55420 BLDG. TYPE Res. ✓ Mult Comm. Other A TYPE OF WORK Forced Air . APO M BTU $ Boiler M BTU $ Unit Heater M -BTU $ Conti -M BTU $ vent Gas Piping. Outlets' #s Other FEIN RES. HVAC 0-100 M BTU ADDITIONAL 50 M BTU (RES. HVAC INCLUDES A/C CONSTRUCTION) GAS OUTLETS (MINIMUM -'1 COMM/IND FEE - 1% OF CONT APT. BLDGS. — COMM. RATE TOWNHOUSE & CONDOS — RES. MINIMUM RESIDENTIAL FEE — A MIN)M(JM COMMERCIAL STATE SURCHARGE PER" (ADD $.50 S/C IF PERMIT BEYOND $1,000) IGNATUREO7 'PERMI T sem. ._�• .vim CITY OF EAGAN Permit -No" 3830 Pjot.Kso Road : Meter No: P.O. Box 21199 Reader No: Eagan; EVAN 55121 Owner. Goodwiar' Idris Site Address: 3795 Eriazmd 9416. -24- Plumber Conn. Chg. Acct. Dep: Permit Fee: Surcharge: Tr. Plant load.sen P ' & E 550.00pd 15.000 10. 000 Lane L8 BI .SOpd 204.00pd Meter. 67 Misc By WATER SERVICE PERMIT Zoning: No. of Units: I agree to comply with the City Ordinances. �CI1Y OF GAN Permit No: 3830 1IIQt iriip Road B/P No: P.O: fipx 21199 Eagan MN 55121 `'`Owner. Opodvi.nlders Site Address: 379431i. d Lane LB Ri The Woodlands 10564 51 Date: 3-24-88 Date: 3-22-88 Plumber Madsen `?.' & R MWCC: 550.0 pd City Chg: 10• 00Pd Acct. Dep: I5«00pd Permit Fee: 10.00pd Zoning No. of Units: I agree to comply with the City of Eagan Surcharge: • Sod Ordinances. Misc • By SEWER SERVICE PERMIT 2 8 9 - ^ 4 9 PLEASE PRINT OR TYPE OFFICE SE ONLY This request void 18 months from validation date printed in this box. 00 i J int , k„ 4ZYe9 Request Date Ia - ) -i7 b Rough -in inspection required? 'Yes 0 No (You must call the inspector when ready) Inspection Other Than Rough -In: 0 Ready Now 0 Will Call Date Ready: I, ip licensed contractor ■ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, or Route No.) r l �c 1 9. cS' Q:, r . t0r W O V tl MA NI_ City CZ) Ok In Zip Code Section No. Township Nome or No. Range No. Fire No. County AkCi "\ Occupant Phone No. Power Supplier 'D c\ \f— 0-V1. 0 e C\v. t c Address LI 3 L 0 <7,. 0 VZ j.''.`^'� Electrical Contractor (Company Name) Nt\rnv,s NA\\ E\ ec -�, C. --j '�,\I.-c- Contractor License No. C A 6 l 1& 1 Master Lic. No. (Plant Elect. Only) NrA6 a i 7 Y Mailing Address (Contractor or Owner Performing Instalation) :\ N.,-\). •AV, N S $ n../ gS'wu e0,.4. e\� Au rued Signature (Contractor or Owner Performing Installation) Phone No. 6/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY 1111 LIII II 11111111 11 REQUEST FOR ELECTRICAL INSPECTION 6' Minnesota State Board of Electricity 1821 University Ave., Rm. S- 28, St. Paul, MN 55104 Phone (612) 642-0800 / i/9� Home Duplex Apt. Bldg. Other: New Addn Remod Repair Commercial Industrial Farm Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other: Dryer Range Elec. Heat Temp. Service "X" above the work covered by this request. Enter re'''marks in this space and on the back of the white copy only. Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Other Fee I Service Entrance Size Fee # Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps N 0 to 100 Amps Street Ltg./Traffic Sig. Above 200 Amps _1Q0 Amps Transformer/Generator INSPECTOR'S USE ONLYrty I/ '.> OTALL -+0 _ , 0 Sign/Outline Ltg. Xfmr. _ Alarm/Remote Control Swimming Pool I hereby cedify that I inspe - • the el-. - - des c •ed herein on the dates sta l Irrigation Boom Rough-Ind, Date W41.5 L � Special Inspection 114 Investigative Fee Final //�%'j- / f7 THIS INSTALLATION MAY BE ORDERED DISCONNE D IF NOT COMPLETED WITHIN 18 °WINS. This request void/� �^4.. fzer / 18 months from r g G� D A5410,.A�_? o Request Date ire No. Rough -in Inspection Required? eady Now Q Will ify. Inspec- hen Ready MI Yes � ownship Name or No. censed Electrical Contractor ❑ Owner I hereby request inspe ion of above electrical work install at: Street Address. Box or Route No./},,4 Ci ection 1o. ownship Name or No. Range No. ou ty i 1 OP 'P, Oc upant (PRINT) 7P©0 C7 r iA 5, L1 1 / 4' 1,3 '.f. vc Phone No. y -,IS- L Pgwer Supplier �/Ip[yp Address EleAfr 'cal'Contract (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Installation) (/ e--� t -7 ��--L.. _ 675'3 / S� ' A t e'd Signat� ntractor/Owner ing Ins11 n) eA f. -- ) Phone Number Y' Y -- vo w MINNESOTA STATE BOARD OF ELEC- T- RICITY Griggs -Midway Bldg. - Room N-191 1821 University Ave.. St. Paul, MN 55104 Phone (612 200 THIS INSPECTION REQUEST ILL NOT BE ACCEPTED BY THE STATE ARD UNLESS PROPER INSPECTION FE S ENCLOSED. ///g"/ 5 g ' REQUEST FOR ELECTRICAL INSPECTION < , See instructions for completing this form on back of yellow copy. 85410 Below Work Covered by This Request EB -00001-06 New Add Rep. Type. of Building . Appliances Wired uipment Wired. # , Fee Circuits Home Range emporary Service 0 to 30 Amps Duplex Water Heater Above 200 Amps Lighting Fixtures 31 to 100 Amps Apt. Building 31 to 100 Amps Dryer Electric Heating Above 100_ Amps Commercial Bldg. Furnace Silo Unloader Transformers Industrial Bldg. Air Conditioner Partial -'Otter r Fee Bulk Milk Tank Signs Farm Special Inspection Other (Specify) � FA E __ _D Other (Specify) Other (Specify) Other Other ompute Inspection Fee Below # Fee Service Entrance Size # Fee Feeders/Subfeeders # , Fee Circuits 0 to 200 Amps 0 to 30 Amps 0 to 30 Amus Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swimming Pool Above 100_ Amps Above 100_Amps Transformers Irrigation Booms Partial -'Otter r Fee Signs Special Inspection ,../20,49.27 � FA E __ _D Remark$ Rough -in Final r Date J, the jr T Inspector, hereby certify that the above inspection has been made. This request void 18 months from a _ Permit No. 94 6' Date: 1-2 f oad Meter No: 14.03 , 73 Reader No. /Z. 37,2v rev a GoodwinBldrs. Ad+dre 3795 Briarwood Lane L8 Bl The Woodlands rits®r .. Madsen Conn Chg: 5 PRP$ , Lail local Zoning: Per{ief3: 77 `1YCif initsr tit Fee i . 4 i iC - GAS Etc. � Surcharge: a et '_ D 6 1.114:$1:0 comply with the City of Eagan Tr. Plant` 20 , e I .. ces. Meter Mise • 67.00pd By WATER SERVICE PERMIT '..fJ`(•.:>K**% :>;CiE;:' *:fit+`***** **?ICiK? ?s!*?,'*?k `+*D}:*'y: 'i, **** CITY OF 1 -:AG( N CASHIER 4 ::.:'::R,, G TERMINAL. NO:, 43 10/31/96 T M.r... 13;:401;56 r^ I:y . SON REMODELING 12 9001 2795 BRIARNOOD 2422 r001 rr?,CRT R xOO_ 55 90 i:1 3795 C.1•.!.f'"`.IAIf:'...D 3430 9001 3?95 BRIARWOOD mARLYNN a:,.:¢;4; ';Yy -,....e.;r.:.:i'h..yb+.)'*ir:H:.`.*a(.+,k<::::ai.)}:''.j`.**.1r. ^.it. 174.75 87.33 5.50 PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota. 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: BUILDING 029144 10/31/96 SITE ADDRESS: 3795 BRIARWOOD LANE LOT: 8 BLOCK: 1 TRE WOODLANDS P.I.N.: 10-75875-080-01 DESCRIPTION: & DECK iildirig_Permit Type Work Type ensus Code SF ADDITION NEW 434 ALT. RESIDENTIAL gan REMARKS: SEPARATE PERMITS REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK FEE SUMMARY: Base Fee Plan Review Surcharge Lic. Search Fee Total Fee VALUATION $11,000 $174.75 $87.38 $5.50 $5.00 $272.63 CONTRACTOR: — Applicant — ST. LIC G P & SON REMODELING 14261252 0001088 12360 GOODVIEW AVE N WHITE BEAR LAKE MN 55110 (612) 426-1252 1 hereby acknowledge a lhave c read' information is correct and agree to cam Statutes and City of an. Ordinances. OWNER: NORGAARDEN WILLIAM 3795 BRIARWOOD LANE EAGAN MN (612)687-9455 APPLICANT/PERMITEE SIG RE ISSUE Y: SIGNATURE New Construction Reauirements 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 • 3 registered site surveys • 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) • 1 energy calculations • 3 copies of tree preservation plan if lot platted after 7/1/93 required: Yes _ No DATE: Remodel/Repair Requirements or ♦ 2 copies of plan • 2 site surveys (exterior additions & decks) ♦ 1 energy calculations for heated additions CONSTRUCTION COST' DESCRIPTION OF WORK. �� 7 STREET ADDRESS: 3 2 A-er;-/ze-vtro-1 LOT BLOCK ) SUBD /P I D #. c-411-1- "J" ;2/4 PROPERTY Name � #7, Q a€ c', — �, G l Phone #: OWNER v LAST ` FHtST Street Address. 3 -, 91 s od City: 'y---. State: r. Zip. CONTRACTOR Company:ie?'� sc5e 4- a ir1,' Phone #. ala 4-/-.'s--- Street Address: /360 a ,„11v ,,' .4/;License #. City: - h' 't -.,r,7 t etState: )11 I Zip. S S ARCHITECT/ ENGINEER Company: Name: Street Address. City: State: Zip. Phone #• Registration #. Sewer & water licensed plumber: . Penalty applies when address change and lot change are requested once permit is issued. 1 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. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes Tree Preservation Plan Received Yes No 1 No OCT 2 8 1996 BUILDING PERMIT TYPE ❑ 01 Foundation 0 06 Duplex 0,02 SF Dwelling 0 07 4-plex % 03 SF Addition 0 08 8-plex o 04 SF Porch o 09 12-plex o 05 SF Misc. 0 10 = plex WORK TYPE o 51 New ❑ 33 Alterations 32 Addition 0 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning OFFICE USE ONLY ❑ 11 ❑ 12 o 13 ❑ 14 o 15 Apt./Lodging ❑ Multi Repair/Rem. ❑ Garage/Accessory ❑ Fireplace 0 Deck ❑ 36 Move ❑ 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building M.13 Engineering 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Variance Permit Fee Surcharge Plan Review License r MCANS SAC?=4040.404— City S _City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: % SAC SAC Units 15se 7 Ism I s,e'7 , 2 O , tomb zc- r 214- CITY OF EAGAN N® 14703 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 C? �) BUILDING PERMIT Receipt# O l To be used for SF DWG/GAR Est. Value $161,000 Date MARCID 18 19 88 Site Address 3795 BRIARWOOD LANE Lot 8 Block 1 Sec/Sub. THE WOODLANDS Parcel No. a W O Name GOODWIN BUILDERS, INC Address PO BOX 82, 218 PINE ST City CHASKA Phone 448-5522 ,o cc Z F Ucca 1- Name SAME Address City Phone Uocc w w w Z 8 • Z aw Name Address City Phone Signature of Permittee I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and ty of . gan rdin es. /I J t A Building Permit is issued to DWI BUILDERS on the express condition that all wo `' hall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official OZ/T - /d� OFFICE USE ONLY On Site Sewage Occupancy R-3 MWCC System X Zoning R-1 On Site Well (Actual) Const Vn City Water X (Allowable) Vn PRV Required # of Stories Booster Pump Length 74' Depth 36' S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess Permit 772.00 Planner Surcharge 80.50 Council Plan Review 386.00 Bldg. Off. SAC, City 100.00 Variance SAC, MWCC Water Conn. 950.00 Water Meter 67 00 Road Unit 325.00 Treatment P1 204.00 Parks TOTAL 3,034.50 CERTIFICATE OF SURVEY fol .s�sy LAND SURVEYORS Survey for: .5g5 zi ;so � /09.6.8 � 4asltV R. (,W.Va. Pied. 8113 DUPONT AVENUE SOUTH BLOGMINOTON. MINN. 55420 868.2004 000DW1N BUILDERS 464 31`I 66o/3)0100 v -L h/a6+,0,N,c7Tj 1 •n1 Proposed Grades: Top of Blocks 893. Garage floor g ? Basement floor g/34/...5-: S. DESCRIPTION: Lot 8, Block 1 o TIIE WOODLANDS i /-a 1,.l' Scale: 1"-30' We hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon and all visible encroachments, if any, from or on said and. Dated this 25th day of February , 19 88 by Ir!' . . Mi,ln¢ ota Regi$tration No. 9018 1.0T ' 8Ik otyDLANla3 . EXTERIOR ENVELOPE THERMAL TRANSMITTANCE STANDARD WORKSHEET Site Address V.!')✓7 U4 tib Owner Phone Contractor Building Type (check one) bd One and Two Family Dwelling PAGE 1 S 1 Assembly (Describe type from Table 3 or show calculations on Page 2) Area (A) (SgFt) U -Value U x A I. 23.24 Insulated Area / • r %/3� .041 1 tL Framing Area ?f 2 2 �✓ 1 3• 4 Skylights, Type 471 Other (describe) 5 Other (describe) 1 Totals . (2/e/ 27. Z4 2 Average U -Value, (UxA)/(A) from Line 1 ****** ****Ar 3 Required U -Value from text) ****** / ©2f / - a *irk*** Insulated Area 3 2/ ei' .04 (57, 20 . Framing Area 4. 4- 251 -01 2,Ze/ Windows. Type -Ii. S 2840 •56 /51,5C, Doors, Type 41 ? ee< , 4o e4,,00 Rim Joist Area # 5 2q/- .0 g: g5 .- Fire,lace Wall • 3f Foundation Wall (above grade) 4� 2Qg 60U / , /Z47 MI d VC; 1 Foundation Windows, Type lithilJ ed IP 31) a?. --5 • ir) Other (descri be) r moi' e. „.. Other (describe) , Other (describe) , 4 Totals 33420 ****** 31, O , 5 Average U -Value. (UxA)/(t1 from Line 4 ****** 41(;)**' 6 R • ired U-Valuefrom text ***it**/ ***irk* 1 Total Envelope Method 1 If following Line 2 is greater than Line 3, or Line 5 greater than Line 6, complete the to determine alternative U -Value for total exterior envelope. 7 I Area (Line 1) + Area (Line 4). + • 8' _, UxA (Line 1) + UxA(Line 4), !._+ . ■ • ****** 9 Area (Line 1) x U-Value.'(Line 3) x • ****** 10 Area (Line 4) x U -Value (Line 6) x • ****** . 11 "Budget", Line 9 + Line 10 ****** 12 Alternative U -Value. Line 11/Line 7 ****** If Line 8 is greater than Line 11, alter assemblies as required so Line 8 does not exceed Line 11. • S 1 ASSEMBLY " ! 1 1, : L hMi11:afla 1 , I. : - GYP Bd 5/3" .56 CELLULOSE ' 12" , 44.0 , INTERIOR F -VALUE .b1 FXTFRIOR F-VAIIIE .bl 1 I I ii: 1 :•: I i ' 1 ASSEMBLY U -VALUE 11ITFR ON PArIF 1 .021 ASSEPIBLI P2 CFI' TNA FRAPITNG MATFRIAI (0FCCRTRF) THTCKNFCS R -VALUE GYP Bd5/8" ti:.,.__ .56 SOFTWOOD 31/2" 4.33 CELLULOSE.. 0.5" _ ...21....0----. ' 1: - & 1 EXTERIOR F -VALUE il:�' -- AlieFFI J y TFRP1.41 RFSISTANr. iQ 55 �I�f�$$��y UU 99AALLII�ENTER ON PAGE 1 r... A.SCFMRI Y 113 WALL II SULAT I0N MATERIAL (pESCRIBE) THICKIIESS R -VAI II( , , GYP Rd 1/7" .45 FIRERGLASS 5 1/2" 19.0' SHTG .25/32" - 2.06 . • SIDING 1 1 INFERIOR F-VALU • _ 17 FXTFRIOR F VAIIIF ASSEMBLY 5 RIM MAIFRJA1 (AFSr.RTRFIST • INSULATION (F.G) BL SU-VkLUTHERMA _., RE$ISTANCE FNTFR nN P4GF 1 23.23 .04 ASSFMRI Y ft -L, WALL FRAMING IATFRIAI (nFCCRTRF) GYP 13d SOFTWOOD THICKNESS 1/2" i 1/2" _9.VA�LIIIr .45 6.88 '0F sIITG SIDING . 1. • TN1C KNFSS R_ VA111F, INTERIOR F -VALUE 811 2" 25 32 1 / 2"AVE FXTFR TOR F -VAI IIF TOJAI ASSFMRI Y THFRMAI RFSJSTANCF ASSEMBLY U -VALUE FN7fa• n'l PA'S 1 27.63 .12 _ .7 6 .17 33.29 .03 ASSEMBLY #6 FOUnnA71()+t ABf1VFirpAOF GYP Bd FIBERGLASS 3 1/2 13.0 19 rnllr Rl k 12' ; t sta` jjjIFRTOR F-VALUF ELIFRTOR F-VAIIIF -.6 .17 SEfBY -ViLU FNTFRJIN PAGE 1 .061 sirru 11. WRAP 25732" 2.06 .17 SIDING _.UJT F.1.11RF.V11LU E EXTERTAP E- VAI lIF 11 .68 .17 FO TOTAl ASSFMRLY 1j4EPtj 1 RFSTSIAHrr ASSEMBLY U-VALUEFNTEo nn PAGE 1 U INTERIOR F -VALUE R U� SISTAK,E. 11 .11 EE --- ENTER. -0,"1 -RAG€ 1 n4 ,EXTFRIOR F-VAIIIF ,:lak TBLiSU-VALUEUFRMAI RFSISIANCF SSEt' L (J- EHTE.R-JUL-PAGE.-1--- .ss APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION city o_F ecacican (PLEASE PRINT] ma ie�ersse+aav U+ # HYIE:PAYPENTc FM Ar mg APPLICATION DOI3S MIT cow- * STITtflE APPROVAL OF PERMIT. INSPECITC SSR AND/OR 'WATER *. INSTAL ATI S WILL Nur BE MEWLED UNTIL PERMIT HAS BE APPROVED. 1) PROPERTY ADDRESS: .3 "96- r. d f* r v®o d 1.4p, LEGAL DESCRIPTION: ,477 $.. ,B//f 7/le. idov d 4a.4d S (Lot/Block/Subdivision or Tax Parcel II) #) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: 3 -kr PRESENT ZONING/PROPOSED USE: E COMMERCIAL/RETAIL/OFFICE INDUSTRIAL ET INSTITUTIONAL/GOVERNMENT (Month/Year) rjEl R-1 SIDLE FAMILY 1 R-2 DUPLEX (TWo Units) E R-3 TOWNHOUSE (Three +.Uxlits) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2) `APPLICANTI NAME: Vt1- 0 C e 1, /'L /? ADDRESS: 7 o co ,QJ 1/v v' CITY, STATE, ZIP: 14 o h ci i/4n S 3‘ PHONE: Li '7 02- C 9 > 3) PLUMBER NAME: ADDRESS: CITY, STATE, ZIP: PHONE: /44 d se. h lc)iam�i h o� �e a 7'/ a 7o Co + /14, jlo /14.v d Ss,S3 it MASTER LICENSE # /i"/ .. . For City Use Plumbers License: Active Expired Not recorded Staff Initial 4) UPANT/OWNERI': NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 6-00d 06,i4 ,dr,, %ie e^ v Chaska ssaz 5) ,-INDICATE[ WHIC.Hii PERMIT SIS4; RRINGG REQUE ED, M CONNECTION TO CITY SEWER 121 CONNECTION TO CITY WATt OTHER 6) SIGNATL .wi/ =,DATE, 2-.23 _ rr **************************************************************************************************** * THE GOLD COPY OF THE PERMIT WILL BE SENT DIRECTLY TO PUBLIC WORKS TO FACILITATE METER PICK-UP. *k PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. SOMEONE FROM =CITY WILL CONTACT YOU IF THERE * ARE ANY PROBLEMS. * I*************************************************************************************************** FOR .CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ /0 - b SEWER PERMIT (INCLUDE SURCHARGE) $ /G ,3-7) WATER PERMIT (INCLUDE SURCHARGE) $ C 7 0 $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ l,j `Ol) ACCOUNT DEPOSIT - SEWER $ $ /s: Q d ACCOUNT DEPOSIT - WATER r $ S > '0- 0 $ WAC $ 6 s-- ' $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ (F •7 , G v $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ / `f ? / + c a $ 7 /i TOTAL (' 2 -/s RECEIPT # RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? 1 I YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION. LIST AS A CONDITION. I NO SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: 31a/fi IFD K,RSGre-_ ENGINEER,Nb MEMO TO: JAY BERTHE - POLICE DEPT. CRAIG KNUDSEN, ENGINEERI TOM COLBERT, DIRECTOR OF JIM STURM, PLANNING DEPT JON HOHENSTEIN, ADMINIST BILL AKINS, ELECTRICAL I JOE CONNOLLY, WATER DEPT.I FROM: DOUG REID, DEPARTMENT OF DATE: - 1- 88 The preliminary G TECH. PUBLIC WORKS ATION SPECTOR PROTECTIVE INSPECTIONS c nstruction )C plans for LAN TS — We are in our plan review section for S o e. Please return this form to date of review. Failure to return considered your approval. If yo plans, it is your responsibility problems. Thank you. /JS co -4- 4%IIs Revised arc! A,dn your review and comments. with your initialed comments and the fora to ,-S�e.within five (5) days will be have any objections to approval of these to notify this department and resolve any BUILDIN c PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4875 New Construction Reaukements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and l( roofed arrias (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan If lot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE 5420/02- SITE /20/02- SITE ADDRESS 379/5- 8 yJ ah (,uooc TYPE OF WORK eiA APPLICANT OA STREET ADDRESS 99L D Z ,2(&. 444 ( CITY 00??7 TELEPHONE # 95.111- "<1 CELL PHONE # 642-266- 7 9 a'C FAX # Remodel/Repair Reaulremsnis • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterlor additions & decks • Indicate if home served by septic system for additions VALUATION 46,,o,o L ?rim ca ecnia MULTI -FAMILY BLDG _ FIREPLACE(S) PROPERTY OWNER J,fl'LtJ NATE /Y/lf1IP , c7-20 95,z—fa?--(fW$" TELEPHONE# (O5 / 36 eeTs° COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category (sl submission type) Plumbing Contractor: MINNESOTA RULES 7670 CATEGORY 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing system includes: Mechanical Contractor: Water Softener Water Heater No. of Baths Phone # MI Lawn Sprinkler No. of R.I. Baths Mechanical system includes: Sewer/Water Contractor: Air Conditioning Heat Recovery System !y 1;d tliu MAY 2 2 2002 Fee: $90.00 Phone # Fee: $70.00 Phone # I hereby acknowledge that I have read this application, state that the-inform with all applicable State of Minnesota Statutes and City of Eagan Ordinanc Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 VALVA'C loN GARAGr 12 x 24 = ZB8 22 X 22 = W $y 72Z x 14=10808 ZY 4o= IIv, it x iy z 56 6 1 = �2 2 l<7, a) I1-1-itXI3= 16444 k -r FLO Q. Ewcr = 12 4 2 axe ` 16 1,458x yC= 4I642 ZNv FL -00A sr Ft-chNe, aoti I\qZ x49 5`8408 foecM 2,-3q X 49 1988 BUILDING PERMIT APPLICATION — CITY OF EAGAN SINGLE FAMILY DWELLINGS /5703 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS — CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY — CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: ,,./74 Site Address '-gr iUY 44;ri 4' i € Valuation: Lot Block Parcel/Sub TheVel e (H w QIS Owner c0(/J),fr1 j ,;- Nehc a r Address /1?() 51c 2./g" /int .5 t City/Zip Code C465/(9 ,r, S 5-9/ Phone -71( � S` Contractor Address r Date: 1,72 8') /1JiP st (/'u 51i', hl,1 City/Zip Code Phone 4/44 Arch./Engr. Address City/Zip Code Phone # OFFICE USE ONLY f On site sewage MWCC system On site well City water PRV required Booster Pump APPROVALS Engr/Assess Planner Council Bldg. Off. Variance v Occupancy -3 Zoning Actual Const V -J Allowable 1[- N # of stories Length Depth S.F. Total Footprint S.F. FEES 76'' 3(;," Permit ` ' g ,;.. G` 0 Surcharge Plan Review SAC, City /0O.C`0 SAC, MWCC{;. Water Conn 550 Water Meter 6ri, 00 Road Unit 3, ;:'0 Treatment P1 e 7.: , 4)0 Parks Copies TOTAL V MECHANICAL (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit n -bO . �Z Date AO / �3 i 03 Site Address 37 C( 5 r -"a \. ..ruc Unit # �- _-- 55/2- 3— 22 Property Owner 1\11\\I\ \<0,' e' Telephone # ( (05 1) 3405-419_50 3 19 5 r t o.,. Liz ojc L -�.qer.., Mj 55/23— 229y Contractor , r-P Street Address 7LALc 5 !-4 Lu • 0 • 4$5City f Qf.ki+ i 550 Ge State �� Zip p 5 Telephone # (L 5/) 322 -892 -Co The Applicant is Owner Contractor Other Add-on, modification or alteration to existing dwelling unit furnace replacement $ 30.00 air exchanger air conditioner other State Surcharge $ .50 Total $ 30_.•j U I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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 approv d plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA097310 Date Issued: 12/07/2010 Permit Category: ePermit Site Address: 3799 Briarwood Lane Lot: 9 Block: 1 Addition: The Woodlands PID: 10-75875-090-01 Use: Description: Sub Type: e -Fireplace Construction Type: Work Type: Gas Fireplace (new) Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K $88.50 Surcharge - Based on Valuation $3K $1.50 0801.4085 9001.2195 Total: $90.00 Contractor: Hearth and Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 633-2561 - Applicant - Owner: Joel Bachul 3799 Briarwood Lane Eagan MN 55123 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. Applicant/Permitee: Signature Issued By: Signature Ahhh_ 71P City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: I l 3(11t, Permit Fee: I). ws. - Date Received: I 1 t - ( 3 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Resident/ Owner Site Address: Unit #: Name: � Phone: Address/City/Zip: 3775 112+/A tt4pIg / 6444 Applicant is: Owner Contractor Multi- amily Building: (Yes / No X) Company: Contact: 1?c A40.&-Gt....crip. Address: 1c1+4" ,AF- Z1 7-41L, City: GA(01 rry State:M L Zip: 95/14 2 Phone: LQ` Z. _70/ ., G4* License #: BC-tP3 17//1 2 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional inform tion) irf 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: Sewer & Water Contractor: 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. Call 48 hours before you intend to dig to receive locates of 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 State Building Codeynust be completed within 180 days of permit issuance. x''f4. A plicant's rinted Name Ap'plicant's Sinafur Page 1 of 3 3795 )60 "- ji/ La -1Y DO NOT WRITE BELOW THIS LINE 1/93 SUB TYPES Foundation /_ Single Family Multi 01 of Plex WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% Census Code #of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair tit) REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Porch (3 -Season) Porch (4 -Season) Porch (ScreenlGazebolPergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Siding Reroof Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* Demolish Interior Windows Demolish Foundation Egress Window Water Damage *Demolition of entire building — give PCA handout to applicant , Framing Fireplace: Rough In _Air Test _Final Insulation Sheathing Sheetrock Reviewed By: T7_, MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final /'C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Other: Pool: _Footings _Air/Gas Tests Final Siding: _Stucco Lath Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL PAJt P67 Page 2 of 3 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: I 3 0I (ak Permit Fee: (1)0:j' I/a3-// 3 Date Received: Staff: 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: I + Site Address: Tenant: Resident/Owner /PI J Suite #: Name: -e- Phone: I. Address / City / Zip: 3 7 (s C3 r14: --)-- Name: % Name: ky fr(/-e.✓ Ph16/1.1 - PG. License#: / 47//.7��% Address: 2c:73 Z 7 7-,.zi ,i;- City: L k 4'//t. State:)IZ, Zip: -5-5� 4�y Phone: C� (1 lar 0 7 2 1(--') I Contact: �G /12.`""'"-d— ��"G4 S Email: ci rVl/ —®/4..&-7 h-,� New _ Replacement Repair Rebuild Modify Space _ Work in R.O.W. Description of work: c;11 RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment /-c.b {. ( Water Softener Add Plumbing Fixtures ( Main / Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) "Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ 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.gopherstateonecall.org 1 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. x Applicant's Printed Name x Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough -In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Staff: City of EKE' 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Date Received: " ! i ' Lf Permit #: Permit Fee: Staff: 1 7 2014 RESIDENTIAL �PLUMBING PERMIT APPLICATION - /c/ Site Address: 3 7[ Date: 3 - S k A Tenant: Resident/Owner Name: Address / City / Zip: Contractor Name: Phone: Suite #: 3 7 TSG/-\ X' f (A.. Az.. /Sf License #: Address: ? State: f'�'/%? Zip: c�_' y1.` Phon Contact)%Le-e-- �SEmail: Type of Work City: Zct /(7c— State: (/: e: /2 New _Replacement Repair /' Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL Water Heater Permit Type Lawn Irrigation ( RPZ / PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main / Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ 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.gopherstateonecall.org 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. Applicant's Printed Name x Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough -In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Staff: