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4306 Braddock Tr
07/24/2009 09:30 5073647328 ARCITECTURAL ENHANCE PAGE 02 -I I Permit City of Eagan ; Permit Fee: _ s l 3b38t1 Pilot Knob Road I Eagan MN 55122 I oath Received: _ I Phone: (651) 675-5675 I staff: J Fax: (651) 6y3-5694 i i 2,009 RESIDENTIAL PLUMBING PERMIT APPLICATION bate: Site Address: 14 3o 94-A pp k rzQ CA GA tJ Tenant: 9 E Z A '3 P A F C t Suite RESIDENT I OWNER Name: Phone: Address / City / Zip: CONTRACTOR Name: L $ G Licse e: y Address: ~ - J -c ,v A N A State:: zip: 5 0 City: 'a 3636ontact Person: N ~ Phone: TYPE OF WORK Z New _Replacement _Repair Rebuild _ Modify Space _ Work in R.O-W- Descri tlon of worts: PERMIT TYPE RESIDENTAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ / VB) (__w Main Lower Level) J ^ Septic System _ Water Turnaround Now Abandonment RESIDENTIAL. FEES: $50.50 Mini Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State surcharge) $50.50 Add Plumbing Fixtures, Septic System Ab nme Water Turnaround` (includes $-50 State Surcharge) "Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 Septic System Nam ($10.00 per as built) (includes County fee and $-50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $-50 State Surcharge) FEES i hereby acknowledge that this information is complete and accurate; that the work vA be in conlormance with the ordinances and oodea of the City of Eagan; that i understand thls is not a permit, but only an application for a permit, Landwork is to Startwithout it; that the work will be in ao anne with the approved plan in the case of work which requires a revow and a_ Fi1_ Ro L oz pp icant's Printed Name A e Signdturo FOR OFFICE USE Revlerrtsd By: Date: Required Inapectlnns: __Under Ground ,Rough-in -Air Test Gas Test -Final Parcel Files Cover Sheet Unique ID: 2062 4306 Braddock Tr 104507003003 Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. ~itp of pagan atpartmnd of %dQ g Jww?d sn This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in comoance with the >atlrl~us ordinances of the, City regulating building construction or use: For the fvllowing.• Like clas®fcadne SF DWG/GAR 9iag. Fetmit No. 11 O-P.-Y Type R3 Zoo* D)iWkt . RI Tw Conn :M2 o,,.« of B d h g JQE f ST AddrM 18133 904M S0,,gMWM MaUft Addrm 43U6 fXK . , U. _B,, IMI D., JA14 27, 1988 POST IN A CONSPICUOUS PLACE 4 t~~'+~r~r t af~j` y~ ,ire ~vP ' . MECHANICAL PERMIT CITY OF EAGAN RECEIPT # b : ~YJy/ 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE CONTRACT PRICE: PHONE: 454-8100 l02/'~? Site Address BLDG. TYPE WORK'DESCRIPTION Lot Block _ /Sup _ Res. New Add-on l'a Name Mult Comm. Repair m 1 Address c City hone ` Other FEES Name RES. HVAC 0-100 M BTU = $24.00 3 Address ADDITIONAL 5Q M BTU 8.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - i PER PERMIT) 1.¢0 EA. TYPE OF WORK COMMAND FEE - 1%.OF CONTRACT FEE Forced Air r _ BTU_ MINIMS E~N,t,IE - Unit Heater M BTU REMODELS - 1200 Air Cond. -F M BTU MINIMUM COMMERCIAL FEE 20.00 c Vent CFM STATE SURCHARGE PER PERMIT .50 (ADD $.50 S/C IF PERMIT PRICE.GOE'S I' S x Gas Piping, Outlets # BEYOND $1,000) Other $ 62z, FEE: 1441 SIGNAT RE 0 PERMITTEE TOTAL FOFV" ITY OF EAGAN PERMIT # PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOS ROAD, EAGAN, MN 55122 DATE:. CONTRACT PRICh.• PHONE 454-8100 fie !If Site Address BLDG. TYPE WORK DESC Lot BI k. Sec/Sub Res. New Mult Add?on Name . Comm: Repair m Addr Other City Phone RES. PLBG. ONLY --COMPLETE THE FOLLOWING: 1 R f NOD/ FIXTURES TOT Water Closet - $3.00 Name -Bath Tubs - $3.00 Addr A avatory - $3.00 ocre _ r flQ"` 3 .E9. Cl - Kitchen Sink $3.00 FEES Urinal/Bidet - $3.00 s COMMAND FEE -1% OF CONTRACT FEE Laundry Tray - $3.00 a APT. BLDGS - COMM RATE APPLIES Floor Drains - $1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES _E__4LWater Heater- $1.50 l MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool - $3.00 ti f MINIMUM COMMAND FEE -$20.00 --/-Gas Piping Outlets $1.50: 740 STATE SURCHARGE PER PERMIT 5Q (MINIMUM IVER PERMIT} I4 (ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5.00 f BEYOND $1,000:x. Well $10.00 Private Dispr $10.00 r Rough Openings - $1:50 SIGNATURtOf P. RMITTEE FEE: STATES/C: FOR: CITY OF EAGAN GRAND TOTAL• { r z ...-,r._. . .....t a2.-s w$ t..av ~lvi....c .u , ....m... n..r,r4 _ti... .~.~.a~.....,.~..._..a.3Au ^i n Y . Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. .sE,. ..w ~.,~y.,,--_ ;~.~r~~ :r~r. ~ "R f'iY?P;i I? .~..FiF "7~~•R- 4 ~r~., e_ . i R~ CITY OF ItAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagin, MN 55121 ` PHONE: 454-8100 BUILDING PERMIT Receipt # v¢ se's- To be used for 71 P"L= Est. Value U o Date is 19 - Site Address 4306 Lot 3 Block 3 Sec/Sub. LEEMIMI X OFFICE USE ONLY Parcel No. Occupancy FEES Zoning - W Name M T (Actual) Const Bldg. Permit Address Z-1306 1R M v1M (Allowable) Surcharge 4 ` # of Stories - C' Phone ~Y Length Plan Review Name MAIT-S-GW Depth SAC, City g Address 3350 V 13 S.F. Total - SAC, MCwCC City Phone 6100-07 S.F. Footprints On Site Sewage Water Conn Name On Site well water Meter iz Address MWCC System Acct Deposit C W City Phone City Water - PRV Required S/W Permit hereby acknowlege that I have read this application and state that the Booster Pump S/yy Surcharge information is correct and agree to comply with 811 applicable State of Minnesota Statutes and City of Eagan Ordinances Treatment Pl Signature of Permitee APPROVALS Road Unit A Building Permit is issued to:Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and Ctt'Y of Eagan Ordinances. Bldg. Copies 'i Variance Building Official TOTAL c; Permit No. Permit Holder Date Telephone # WATER SSrER PLUMBING H.V.A.C. ELECTRIC hspectlon Date Insp. Comments FootingsI Foundation Framing. Rooling .Rough Plbg. Rough Ht. Isul. R,place `3eSG n /74/ Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber EngrJPlan Bldg. Final Deck Fig. Dedc Final .Wen Pr. Disp. r Cities Digital _Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. A&COP RAM ItOT,1:~OAQR1,1 tM1G: flAT1r. s. VOUTRACT- it CA L dx is Alit 4 7 e~ kiD TYPE r Must. A+dd-OR Aev t i sum i- : Comm: a 3+~t><rr~ded c a. amt;, Other otr. ►•w • Phone 5 VAL Pun ONLY - NO. FIX111095 Name i+r/~~tr rl , ,~'p s ,4~+fx Water Closet > $3.00 3A;-. NI:•:rsA c k a x,,i Bath Tubs - $3.00 Address Lavatory - $3.00 p. City Phone Shower - $3.00 Kitchen Sink - $3.00 .a FM Urinal/Bidet - $3.00 COMMAND FEE i% OF CONTRACT FEE Laundry Tray -$300 'API. 3 COMM RATE APPLIES Floor Drains - $1.50 ::.`TOWNHOUSE S GOND6, RES. RATE APPLIES Water Heater - $1.50 ' ;MINIMUM RESIDEW ,K.FEE - $12.00' Whirlpool - $3.00 r, I MUM:--COMMAND'FEE -$20.00 Gas Piping Outlets -.$1,50 STATE SURCHAR©E kR PtiMIT - .50 (MINIMUM -1 pER PERMi'n (ADD $.50 S/C iF POINT PmCE GOES -Softener - $5.00 'i9EYOND $i,43lJ0.00) Weil - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 r: SKMTURE OF PEAN*rTEE FEE K STATE S/C: Foa cxne of EACAni' PD GuuwaX i Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. oil 1:1111111 11 1 -9 'ED 71-47 r, 45WAM CITY OF EAGIAN ;4 z. 38M Pilot Knob Road, P.O. Box 21-199, Eagan, M1#1 t~1 PHONE:484-8100 BUI G'PERNIT Receipt 0 14 .1_. To be used for .;,F o l Est. Value Date 13 431)6 MADDOCK V-11 Site Address OFFICE ! QNLY ; . . ~_..•;t.:~: try Lot Bock t3eclSutr 3:ts"i i?Oli" ~8se8ewa ~9ipsy Parcel Na fa~i zonirr~ Site Octo C Name ~d'1Q , I.'w .l: 1:{}°t i5' ' 'ry' ' City Water . wowwo) Address ' r AV9 ' PRV Required a of Stories 1 city b Phone r . Booster Pump Lanai 52 Depth 41 Name S.F. Total Address Footprint S.F. City Phone APPROVALS ME8 s Engr./Assess. Permit `~lAa • ° a Name 3. oLl Planner Surcharge - Address council Plan Review 192 . w city Phone , City l,ttiiJ . AJ Bldg. Off. SAC i j 1 hereby admowledge that i have read this application and state that the Variance SAC, Mill $25 Information Is correct and agree to comply with all applicable state of water Conn. hMnra Statutes and City of. Eagan Ordinances. water Motor t, 7. tX, Signature of Permktee. Road Unit 355. ixf A Building Permit is issued to, .3wi i e 4 LU' P.( SST Treatment P1 -T • OL on the express condition that all work shall be done in ac oordar with ail parilis appNcable state of Minnesota Statutes and City of Eagan Ordinances. TOTAL T2, 111. I a 1 Building Official lk"W ads T KVAr,. - Eleebic Iv ~ ~ 9 oa laspeed" Dab kkw COMMON" Fob I FootMgsN Fort 'I FMnft Rough Pft Rough Hts I" W F Fines H~ r Ge►J Fri Pig, i cert. Ooo. Tend. LP Dock Ftg. F~ e • 7c G1"#TY OF EAGAN 3830 Iiiot,Knob Road, P.O. 80x;2-199, EaganT MN 1541,21 PHOME, X54-8100 . ` , 'BUILDING PERMIT Receipt,># To be used for Est. Value. $ rt pate IY 3 t Site Address OFFICE USE ONLY oy Lot 3 Bloctc 3 . Sec/Sub. jQa ' 4 INW On Site Sege occupan r MWCC System Zoning . L° Parcel No. On Site Wall (ACtuei)Cyinst a W Name~j: CttyWater o (Allowat?le) . An SO ; Address 3133 CEDAR ' . PRV Required *of Stories o city I `I ; Phone ~ Booster Pump Length (depth °c Name ~ &Fjotal Address Footprint S.F. ¢ City. Ph o0 APPALS FEES Name Engr.%Asses;s. PerrYft Z Planner Surcharge _ Address W City Council Plarv • _ Phone Bldg: qff . SAC Ct{yQW. fvt3°i VariatlCe 3. ~r€ 1 hereby acknowiedge*hat I have reed this application and stata that the, SA~~MWcC ~ 9 O Information Is correct end agree to comply, with ail apOliaatile State of hMaY,a~.Cpnn. Minnesota Statutes and City of Eagah Ordinances. Water'Meter R; fi .#3 4 S19pature of Permittee Rid Unit f A;Buudln 4armft is issued to JO IWI1 treatment P1 i Ou on the express COndition that`all Wojk shall be done In $c cordandowltt► alb Parks applicable State of Minnesota ces. S statesand C_itybi' f Fagf~ art prdtno a_n; TOTAL Building OfficiaL BLDG. PERMIT NO. °7`Ttlf~~ 01-3210 Bldg. Permit 01-3422 - Plan` Check 01=-344J5 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit 0 20-2275 SAC 20-865 Water Conn. 20--3868 Water Trmt. Ea.- 203716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. , a 11-3855 Park Ded. TOTAL I '~-26-87 CITY-OF EAGAN Permit No: 10371 Date: 11 3830 Pilotknob Road B/P No: Date: lI-13-87 P.O. Bo~11199 Eagan !N 55121 Owner. Joe U1er Const Site Address: - I dock Trail- L3 B3 LexingCQ'P*int* u T.v g Plumber: MWCC: 525.00pd Zoning- City Chg: No. of Units: Acct. Der. 15.WPd 1 agree to comply with the City of Eagan no 11 Permit t Fee : Ordinances. Surcharge: f Misc.: By SEWER SERVICE PERMIT n 5 CITY OF EAGAN Permit No: 9222 Date: 11-16-87 3830 Pilot l4nob Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Owner. Joe 1ftller Coast. Site Address: 4300 Bra~,Oock Trail Q B3 Le,\iq&jLon Paiute PlumbePl; ut}: Plumbing Conn. Chg: 525.00pc' Zoning Acct. Dep: 15, i ODd No. of Units: 1 Permit Fee: 10. Cipd Surcharge: • 50Pj 1 agree to comply with the City of Eagan Tr. Plant 130•00pd Ordinances. Meter. 67.000 Misc.: By WATER SERVICE PERMIT G1TY OF EAGAN Permit No: 9222 Date: 11-16-87 3830 Pilot Knob Road Meter No: --F? / ~ Size: ~ P.O. Box 2199 Reader No: Date: ZZ 31 F7 Eagaln, All 55121 e Owner..fl Joe Nil:ler Const. Site Address: 4306 Braddock Trail L3 B3 Lexington Pointe P Conn. lumber. 9 Plymouth !i~)~"!' 525 DO~~ V1. Acct Dep: i rof,,tits: Permit Fee: ~AkLb d ,o ~ Surcharge: r- By 1 k comply with the city of Eagan Tr. Plant L . ( Ordin ces. Meter. 6Z. 419p Misc.: gy WATER SERVICE PERMIT Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB,ROAD EAGAN, MINNESOTA 55122! DATE 19 RECEIVED J,y. J t FROM.... l2I+✓~. C~H OUNT $ " f & -DOLLARS too ❑ CASH CHECK FOR FUND CODE AMOUNT Thank You. x ,Y i1 711'' White-Payers COPY' Yellow-Posting Copy Pink-File Copy ' f , V i CITY OF EAGAN N°_ 1 4 4 11 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-81007 / BUILDING PERMIT Receipt# 7 t To be used for SF DWG/GAR Est. Value $66,000 Date NOVEMBER 13 19 87 Site Address 4306 BRADDOCK TR OFFICE USE ONLY R3 Lot 3 Block 3 Sec/Sub. LEXINGTON POINTE On Site Sewage Occupancy MWCC System X Zoning RI Parcel No. Vn On Site Well (Actual) Const cc Name JOE MILLER CONST City Water X (Allowable) Vn z 18133 CEDAR AVE SO PRV Required # of Stories Address 3 52 Booster Pump Length City FARMINGTON Phone 431-2001 Depth 41 o Name SAME S.F. Total o a Address Footprint S.F. City Phone APPROVALS FEES Engr./Assess. Permit $ 384.50 W w Name z Planner Surcharge 33 •'00 =E Address 192.25 C.) m City Phone Council Plan Review Bldg. Off. SAC, City 100.00 I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 525.00 information is correct and agree to comply with all kpplicable State of Water Conn. 525.00 Minnesota Statutes and C' of EagAn Ordi. es. Water Meter 67.00 Signature of Permittee Road Unit 305.00 A Building Permit is issued to: J E MILLER CONST Treatment P1 180.00 on the express condition that all wo c shall be done in _accordance with all applicable State of Minnesota utes and City of gan Or nances. Parks Building Official TOTAL $2, 311, 75 CITY OF EAGAN N9 16310 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 { ~j BUILDING PERMIT Receipt # / To be used for FIREPLACE Est. Value $1, 000 Date APR 18 19 89 Site Address 4306 BRADDOCK TR Lot 3 Block 3 Sec/Sub. LEXINGTON POINTE OFFICE USE ONLY Parcel No. Occupancy FEES Zoning w Name MARK BROSSART (Actual) Const Bldg. Permit 26.00 o Address 4306 BRADDOCK TR (Allowable) Surcharge - 50 City EAGAN Phone 454-8589 # of Stories Length Plan Review Name HEAT-N-GLO Depth o SAC, city 0a Address 3850 W HWY 13 S.F. Total SAC; MCWCC City RIIRNSVTT.T.F. Phone 890-0758- S.F. Footprints On Site Sewage Water Conn W w Name On Site Well Water Meter sZ Address MWCC System Acct. Deposit aw City Phone City Water PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with 411 applicable State of Minnesota Statutes and Ci of~agan;Ordmances. / Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: HEAT-N-GLO 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. Bldg. Off. Copies Building Official Variance TOTAL 26.50 ;..►.~„r,(' /6 40 2 N 3 6 ca~D Request Data Fire No. ,Rough-In Inpsection Required Inspection Other Than Rough-in (You must call inspe hen ready) ly~'eady Now ❑ Will Notify Inspector ❑ Yes or No (jate Ready I*licensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) - City Section No. Township Name or No. - Range No. County A L-,Ap, Occupant (PRINT) Phone No. Power Olier Addres r PT s Electrical Contractor (Company Name) Contractor's License No. Mailing Address 1Contractor or r Makng Installation) ® -1--14 - Authorized Sig re IContractor/Own Making I tall ion). hone Nu ber MINNESOTA STATE OARD OF ELECTRICITY THIS INSPECTION REQUEST WILLNOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642.0800 ENCLOSED. (p 3[7~g REQUEST FOR ELECTRICAL INSPECTION QEB-00001-08 / ► See. instructions for completing this form on back of yellow copy., r N 6 5402 X" Below Work Covered by This Request New Add Rep Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner 71- Other (specify) Contractor's Remarks: R C Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to_ Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms 020 Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in r Date certify that the above inspection has Final Derp been made. OFFICE USE ONLY This request void 18 months from N32566 3,e,3 Sao Request Date Fire No. R -In Inpsection Required Inspection Other Th Rough-In '~t must call inspector when ready) E3 Ready Now IF Will Notify Inspector ❑ Yes No Date Ready 777 I ❑ licensed contractor 'owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) city 3~~ $RA4 ~a 72~j_ z E/~ GA Section No. Township Name or No. Range No. County ~KeT~ Occupant (PRINT) Phone No. M.49-1C 4 . T19n1~ l3~SSf}~Li ~Ll~ ~,lS~-~sS$~J Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Installation) Authori d Signat re IContrac downer Making Installatio Phone Number MINNESOTA STATE BOARD OF ELECTRICITY Q THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 n BE ACCEPTED BY THE STATE BOARD 1821 University Ave.; St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 fff ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION o?;158 9 Ili- See instructions for completing this form on back of yellow copy. 4' tea` - Y 3 5-66 X" Below Work Covered by This Request New Ad Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: 6. 6° 3 I I'5 y L # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TAIL Irrigation Booms 0 ' Gv Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date been made. d' f4 OFFICE USE ONLY This request void 18 months from This request void /~/Cf/~Qt j? 18 months from O E 14036 r33 0 Request Date ? Fire No. Inspection fugh-ein qrd? E] Ready Now C] Will Notify Inspec- ❑Yes ❑No for When Ready C] Licensed Electrical Contractor - I hereby request inspection of above` Owner electrical work installed at: Street Address, Box or Route No. City /-/-30 6A46 &oc,< -A6A--J ecuon o. Township Name or No. Range No. County Occupant (PRINT) Phone No. /J'7 k A Power Supplier Address t a94--o 7-74 Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Instailation) Authorized Signature (Contractor/Owner Making 1 tstallation) Phone Number l`. -./Sv C,( S& MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midwav Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 Universitv Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION 0 ES-00001-06 See instructions for completing this form on back of yellow copy. q 8,9_1791 E ~1 ~t 6 "'X" Below Work Covered by This Request Now Add Rep. Type of1kuildi.g Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Healing Commercial Bldg, Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other (Specify) Other (Spoc,ty) Other Specify Other Other ompute Inspection Fee Below p Fee Service Entrance Size' k Fee Feeder s~Subteeders p Fee Circuits 0to200Amps 0to30Amps 0to 30Arms Above 200-Amps 31 to 100 Amps 31 to 100 Amps Swimming Pool Above 100_Amps Above 100_Am s Transformers Irrigation Booms Partial-"Other Fee Signs Special Inspection Remarks TOTAL F 0 t Rough-in Da:~;4.PectFrtify the Etrical I that the above Final Date ate inspection has been made. yMMs request void 18 months from This request void`~~ y~ I r~ ✓f~if~1j~/ 18 months from J Regyyyest a•e' Fire o. r_ Rough- in Inspection } Required? Ready Now Hii11 Notify. Inspec- Yes QNo [or When Ready Licensed Electrical Contractor I hereby request inspection of above ❑ Owner electrical work installed at: Street Address, Box or Route No. No City D l8 3r l~ ection No. Township Name or No. Range No. Count Occupant (PRINT) Phone No.. Power Supplier Add ss ~5 -5 El ctrical Co ra or (Co any a Contractor's License No. ~ y~L9( Mailing Ad ress (Contractor or Owner Making Installation) (J G - - ~i . , L/ 3 3 ~1 Aut orized Signature (Contractor/Owner Making Installation) Phone Number NNESOTA ATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT riggs-Midway Bldg. -Room N.191 BE ACCEPTED BY THE STATE BOARD ` 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-06 li, n See instructions for completing this form on back of yellow copy. to f 1- O 6,3 2 "X" Be/ow Work Covered by This Request Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other pec,fy Other (Specify) Other Specify Other Other ompute Inspection Fee Below fl Fee Service Entrance Size ft Fee Feeders ISubfeeders q Fee Circuits pg~ 0 to 200 Amps 0 to 30 Am s LO to 30 Amps Above 200-Amps 31 to 100 Amps . 31 to 100 Amps Swimming Pool Above 100_Amps Above 100_Amps Transformers Irrigation Booms Partial-'Other Fee Signs Special Inspection S TOTAL FEF- 6r) Remarks Rough-in ` Date 1. the Elects 1 1) 16[7 inspector. hereby certify that the above Final D~leinspection has been ddd/ 7 made. This request void 18 months from : PA APPLICATION FOR PERMIT nrr CF AT Tzr OF APPLICATION D= Nar CoW srnuM APPRG M of MWT SEWER AND/OR WATER CONNECTION * USPB GN OF SO= Arn/M WATT IIermi.ATIms wuz Nom w scmum • * LVrM PMUT HAS BEEN APPRCAM. city.OF eagan (PLEASE PRINT 1) PROPERTY ADDRESS : 1436(, r cX c I.C Ili, 14 C LEGAL-DESCRIPTION;.. 3 3- (Lot/Block/Subdivision or Tax Parcel Ir) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: Mon ear PRESENT ZONING/PROPOSED USE: COMMERCIAL/RETAIL/OFFICE ~'v IR-1 SINGLE FAMILY Q INDUSTRIAL R-2 DUPLEX (Two Units) Q INSTITUTIONAL/GOVERNMEN'T' R-3 TOWNHOUSE (Three +Units) ( Units) L.r! R-4 APARTMENT/CONDOMINIUM ( Units) 2) a,+ NAME: ADDRESS: /$133 ~~46-~~ CITY, STATE, ZIP: J%,~a-awt : r~ S { v mx) T PHONE: 3!{. For City Use 3) NAME: 9C4 P62 •@-v P1wiers License: ADDRESS : Active r I ILI Expired CITY, STATE, ZIP: ue.~. Not recorded PHONE: $ S 1- .3t 7~ MASTER LICENSE # O(o+S NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 5) s M• SNM CONNECTION TO CITY SEWER 1. -CONNECTION TO CITY WATER Fj OTHER 6 ) W3 05 1, -N -k -Fz M- ~Pz THE GOLD COPY OF THE PERMIT WILL BE SENT DIRECTLY TO PUBLIC WORKS TO FACILITATE MMM PICK-UP. I* PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. SOMEONE FROM THE CITY WILL CONTACT YOU IF THERE * ARE ANY PROBLEMS. . FOR -CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT - (INCLUDE SURCHARGE) $~°5 WATER PERMIT (INCLUDE SURCHARGE) $ Lo ~`CrZ~ $ WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /S• ✓ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ ZS ' u WAC t $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER i $ $ LATERAL BENEFIT/TRUNK WATER $ /~b=tom $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: TOTAL RECEIPT RECEIPT- DOES UTILITY CONNECTION REQUIRE EXCAVATIONIN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY:G~ TITLE: DATE : ll fi 1117 I 9 1987 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS 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 - RESIDENTIAL RENTAL UNITS FOR SALE 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, $2,000 LANDSCAPE BOND i u, To Be Used For: x6zr~ Valuation: Date: Site Address 7~ r 66,00OFFICE USE ONLY 2 la°' Lot 3 Block ~J On Site Sewage Occupancy -3 _ MWCC System ✓ Zoning Parcel/Subcf-q On Site Well Type of Const~ City Water (Actual) V-N Owner (Allowable) V-N # of Stories Address Length ' Depth H City/Zip Code S.F. Total Footprint S.F. Phone APPROVALS FEES Contractor 1~G(X~i7✓ ~,~rn.Q~ • Assessments Permit 38q, 5 Water/Sewer Surcharge OO Address Police Plan Review 17 2. ?-5 Fire SAC, City t00Ia. -9 City/Zip Code a C Engr SAC, MWCC 00 Planner Water Conn Phone Council Water Meter 5 6",b0 Bldg Off 12 Road Unit .D0 Arch./Engr. APC Treatment Pl I go Variance Parks Address Copies TOTAL City/Zip Code _ Phone # i 8 -2 TRI-LAND CO. SURVEYING SITE PLAN FOR: SERVICES MILLER CONST. 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 LEGAL DESCRIPTION: LOT --3-) BLOCK , EXING:[ON POINTE' ACCORDING TO THE RECORDED PLAT THEREOF DAKOTA COUNTY, MINNESOTA SCALE: I"=40' N R=3927311 I L--35029'1 BRADDOCTRAIL _ 1411 I _ 1 ~1 p21293 p-6153 ° a 3; LO_ 4 N~ 43 C-j ° I f 0 I ' i ~ C"tK a LOT 3 N~ ~o ~6 GE LEGEND INVERT ELEVATION AT SERVICE EXTENSION DENOTES IRON -~MONUMENT PROPOSED GARAGE FLOOR L VATION E E q RoF a DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION 95t)-x•S DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR ELEVATION ELEVATION DENOTES PROPOSED SPOT ELEVATION DENOTES DRAINAGE DIRECTION NOTE' VERIFY ALL.FLOOR HEIGHTS WITH FINAL HOUSE PLANS 1 hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Bradley J. son, Mn. Req. No. 15235 Registered Land Surveyor under the Laws of the State of Minnesota. Date 11f,,~~ ' BASED OV CHAPTTR I OF THE MOULL ENERGY CODE - 19EDMON Adoption Effrctivt 1/1/84 )caner Phone _ ra ~P ;i to Address 6 c>r 3 &Ocv, texta d ` NmTC ,ontractor hone )uilding Classification: Type Al (Single Family S Duplex) Type A2 (Residential (3 stories or ess (Other) (Over 3 stories) 3ENERAL INFORMATION 1. Building Perimeter ft. Wall height (ground to eave). 15, 0 ft. 3. 1. x 2. (above) gross wall dLgA. 2 _ft; Building dimensions (L)6, jtoeJ~~, (W) OZ ft.2 roof S floor area 5. Square fcot area of rim joist - Floor joist size (2 x l~? 11~?_ x Perimeter - Rim foist area ft2 2 Doors Area S Thic Hess n~fnctor , 14 A,4i Type of Construction -Perimeter ft. Manufacturer 7.. , Total door's perimeter 8. Windows: Manufacturer L,SJ~ 1'T' State approve U factor. ,52 TYPE SIZE AREA (F,.2) NUMUR OF TOTAL FEET 2 EACH UNITS a, Total ft.2 Glass l`jS 10~ Fireplace area: Width x height ■ x ■ Ft.2 11. Exposed foundation: Height x Perimeter ',71_x_ 14-_ • 16Z Ft.2 )MPLETION OF THIS FORM IS REQUIRED FOR ALL KEW CONSTRUCtIOU. MAJOR RE1400ELING AND BUILDINGS BEING 43Y£D WHERE ENERGY. OTHER THAY THE MINIMAL CODE ALLOWAKE. IS USED. - _ _ v. y1 u» "d 1 1 area. 13. „Gross wall area ZOOp ft.2 Window area A / 2 ft. U windows • Z U x A (,ot Rim Joist area A ft.2 U rim Joist • D U x A f Dour rea A ft.2 U door area • U x A •.14 ~ rD 2 i Face area A Z ft. U fireplace • . U x A --jam Exposed foundation A ~b ft.2 U foundation = •d U x A ■ Framing area A D f ( 7L f t.2 U framing area = , b9 U x A = Net wall area A / -,-y (0 ft. U wa l l • . D t~~ U x A ■7, Ad (138) TOTAL . . . . . . . . . . U x A 9(; 9i Gross wall area x 0.11 (A-1 single family b duplex allowable U x A/Code (13, above) x 0.23 A-2 other residential) x .23 (Other buildings) X .28 (Over 3 stories) BTUH Must be larger th A x~~-- CZ 138 above-- I5. Ceilinlfracaing area (Af) equals lo%- f ceiling area C or the same as) (SA. Gross ceiling area (L ) 5 f(V) _ ~pZ ft.2 158 Joist area (A f) ■ 10% ceiling -area /03 ft.2 15C. Net ceia ing area (Ac).. (15A - 158-)'x`.. r.. .rte . ,s. , i n,• ft.2 U ceiling x A c` , bZ,Z x 14,32 U framing x A f` ° , - /plt) Z. 3z 150. TOTAL U x A 16. Ceiling area (15A) x 0.026 (A-1 single family & .duplex - code allowable U x A x 0.033 (A-2 other residential) x 0.06 (other) A A x - BPH Must be larger than 150 (above) D F (or the same as) OZtO NOTE: Use U and A values obtained from ops 1. 3 and 4. r Fr~1 2 4 t a J O u t Z 2 4.5 X 14 U4 L A= s 1 t ] u 1, tt 1 t: ~ r 12 - 1. 11 1. Is -941 n - r 1~ u ~ 20 - - t z. 41- 22 2 27 d 2: 24 2. 13 Z Doe- 2• 20 11 i] 2. 20 21 21 2! 20 it 21 21 2 2 72 2: 21 It 1-1 '1 1 1 74 l3 IS 20 21 21 21 20 71 20 21 41 40 "Ls o wpkLL 1SUiL-i K174--- u -4.Ut LALLULAI IUN~l ALUE U VALUE 4 Inside air film .68 WALL Ucartor wall • (Wall) U 1 1t SECTION Insulation Sheathing 2.0(0 .Qt?, T~ Siding -67 • 1 Outside air film _ .17 A TOTAL 23,63 Inside air film .68 STUD Interior wall 81.9 1 - SECTION Aw scud C(0~) R' 4vWb, 50(Framing) U R Sheathing 1 Siding •(07 •aqS Outside air film .17 R TOTAL Inside air film R' .68 2ND WALL Interior wall -1 SECTION Insulation (Wall) U. Shea / _ Exterior, call . rind- Exterior air film R A TOTAL P Interior air film R= .68 AIM Insulation (`~,OD 1 JOIST th inch soft wood R=1.88 (Rim - U 1~-- Joist) Sheathing 200 Exterior wall covering .47 Exterior air film R= .17 A TOTAL Interior air film R= .68 Insulation ~~•oo Foundation Lza (Fdn.) U • - Exterior air film R= .17 a7~j R TOTAL posed Stock • ' CEILLNG PITH YEUT"c0 4,1`71C SPACE ABOVE • R VALUE LUE FRAMING CEILING 0.61 Air Film 0.61 Insulation +_____3 8 Joist 5Zp Ceiling t~ 3 0.61 Air Film 0.61 4z,t& Total R 1 oZ•3 U F!4T ROOF OR CATHEDRAL CEILING Va ue R VALUE FR;,1iING CEILING 0.61 Inside air film' 0.61 Ceiling Joist (stud) Insulation Air space Roof 'decking . -Insulation • guilt-up roof 0.17_ Outside air film 0.11 Total R . l U . R 4indow infiltration 5 cfm/lineal foot of crack lesidential door infiltration 0.5 cfm/square foot or door and minimum code requirement tan-residential door infiltration 11.0 cfM/lineal foot of crack - 1b 12" concrete block no insulation a A7• R 2.1. j 1b 12" concrete block insulated cores • .26 R 3.8 15 12" lightweight block - .32 R 3.1 1b 12" lightweight block insulated cares a .12 R 8.3 J single glass • 1.13; with storm wind.Tw .54 1 double glass ■ .55 1 triple glass - .41 All exterior wails and ceilings must have a vapor barrier (0.10 perm max.). Vapor barrier must be on the, inside (heated side) of wall. iapor barriers of the polYethelene thin film have no R value. I • 1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MDST 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:I~sr14'yL L~C"Valuation: ptll~?5'° 19d Date: Site Address ~--314 OFFICE USE ONLY Lot Block r Occupancy FEES Zoning Parcel/Sub -L4iM 'j r/-M Actual Const Bldg. Permit Allowable Surcharge 150 Owner # of stories Plan Review Length SAC, City Address 313dQ~/~ % Depth SAC, MWCC S.F. Total Water Conn City/Zip Code 1:!~-flAgAN /-1;W Footprint S.F. Water Meter Aeet. Deposit Phone On site sewage S/W Permit On site well S/W Surcharge Contractor /V MWCC System Treatment Pl. City water Road Unit Address 1~~ 13 PRV required Park Ded. Booster Pump Copies City/Zip Code LI/QNS Y/ L G C G'f TOTAL APPROVALS Phone Planner Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building permit fee. Processing time for sewer and water permits is two days once a licensed plumber has applied for a permit at City Hall. RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 1 l.r New Construction Reauirements RemodoUReaair Requirements 1 • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) 1 site survey for exterior additions & decks • 1 set of Energy Calculations Indicate if home served by septic system for additions • 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 712_L/~ 2 VALUATION SITE ADDRESS MULTI-FAMILY BLDG -Y _N TYPE OF WORK FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT ifG%YJLS ~'L t~S ixc ~~7 c%'"s STREET ADDRESS ~20 7 ICZ~ S5 Z W CITY %/lV%PV STATE ~ ZIP 3 ~r~ 9 TELEPHONE # -`33?-b CELL PHONE # $Z ~r~ FAX # &f2 '2E- Z!L/y rs~r S' ^ ti y/ PROPERTY OWNER TELEPHONE # COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I M Torksle (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted neegy C T bmitted • Energy Envelope Calculations Submitted ,,,~Ul_ 2 2 2002 1~ Plumbing Contractor: Phone # By Plumbing system includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical system includes: Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applic OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 III - OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. - Footings (deck) _ Final/No C.O. - Footings (addition) _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water Final _ Pool Ftgs _ Air/Gas Tests -Final Framing _ Siding _ Stucco _ Stone Fireplace _ R.I. -Air Test -Final _ Windows (new/replacement) Insulation _ Retaining Wall Approved By , Building Inspector - - - - - Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total PERMIT City of Eagan Permit Type: Mechanical Eaaan. Permit Number: EA097221 Date Issued: 11/30/2010 OR Permit Category: ePermit 40~ it~ of E3 E Site Address: 4306 Braddock Tr Lot: 3 Block: 3 Addition: Lexington Pointe PID:10-45070-030-03 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Furnace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector. (952) 445-2840 Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $5.00 9001.2195 Total: $».00 Contractor: - Applicant - Owner: Angell Aire Reza Shafiei 1223 Nicollet Ave S 4306 Braddock Tr Burnsville MN 55337 Eagan MN 55123 (952) 746-200 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 Cite of Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature For Office Use a-7; ; ; � :::e: %, %. .° E AGA N a Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinainspectionsi citvofeagan.com L 2019 RESIDENTIAL zBUILDING PERMIT APPLICATION Date: �Z-�-��7 Site Address: 9 J 0 ( P y U S-- V O, ) Unit#: Name: ('1 Z Phone: Resident! Owner Address/City/Zip: 4 C Nro-�A O a,'N I Applicant is: Owner XContractor Description of work: 4)4,, J1£ t �1 oType of rk Construction Cost: / i O v Multi-Family Building:(Yes /Nos/ ) Company: 9 LCL. Owl—Ei � � t k.e lr' ontact: 'V` Y1-)7 Contractor Address: /69O �-(o Ls1OY� Y - City: r 'Cc State: yZip: ;7539? Phone: CO1 2-'27 S" 7 2,2.— k-D Y a�l 212 Y u i h&- Li License#: })C U) -t;J Lead Certificate#: ,w � - S9 30/— If the projectisexempt from lead certification, please explain why: AVO 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: Fire Suppression 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 youprovide specific reasons that would permit the City to conclude that they are tracts secrets. 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.citvofeacian.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.cioaherstateonecall.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. x Applicant's Printed Name pplicant's Signature