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4337 Braddock Tr
Parcel Files Cover Sheet Unique ID: 2074 4337 Braddock Tr 104507011004 RECEIVRD FROM AMOUNT CODE 3830 POI: rr KNOB ROAD EAGAN,'MiNNESOTA 2 u y DATE ;i BLDG. PERMIT N0. 14034 01 -3210 Bldg. Permit /4L41 50 15 2 75 01 -3422 Plan Check ac 01 -3445 Surch. /Adm. 01 -3446 SAC /Adm. 01 -2155 Surcharge ,I4' 17 -3860 Road Unit i C(.5 20 -2275 SAC 5 c7 20 -3865 Water Conn. 505 20 -3868 Water Trmt. 1 30 20 -3716 Water Meter 1 20 -2252 Acct. Dep. 20 -3713 Water Permit 20 -3743 Sewer Permit 79 -3866 Sewer Conn. X 11 -3855 Park Ded. 00 00 TOTAL c Q, 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. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681 -4675 SITE ADDRESS: r rf kk#ii►$ttit F ill; tt1N r'1tt'14 PERMIT SUBTYPE: f. ti; F VI gX► 1 N A I INSPECTION RECORD I 11 111 1>1 APPLICANT: PERMIT TYPE: Permit Number: Data Issued: I t t.7 r FI' 1 i I A3 o f i I 1 1 f 1 1 i9 TYPE OF WORK: 1 11ttN w v r r 'a• '+o^' o�^•"e�' —sue I:111 /11111-: Li •Ftq!1 t NI 1 rtt `tt ARAM _I' tiA'•? ECTFJC ELECTRIC Inspection Footings I Rooting ROMA MS Rough ift Rreplece Fired tkg. Onset hest Flnal Pbg. Cond. Meter EregrJPIan Bldg. Final De& Rg. Deck Red Pr. Perna No. Pbp. Inspector —heft Plumber Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. INSPECI1ONRECORLT CITY OF EAGAN PERMIT TYPE: Pilot Knob Road tA: Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: N 10-46070.•1 le 04 APPLICANT: COT 11 1111. 4 41A! BRAODOCV tti t fflt4 11111411 PERMIT SUBTYPE: Permit Number: Date Issued: OVffi 1OF TOP POOFTMO 1.!) itsti 41113 TYPE OF WORK: pf HO11.1110c 033f,q9 10/07/98 PFPA1R 1.(1. PERO(F -111 ll'ECTI■it4 I 400rtoo; Permit Holder Date Telephone PLUMBING HVAC Inspection Date keep. Commence FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION FLUSH MAINS CONDUCIVDY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL. DECK FTG DECK FINAL CITY OF EAGAN 3830 •P9ot.$nob Road P.O. 0 c 1199 Eagan idlN 55121 Permit No: c 9189 MeterNo:s3 /c2. 83 Reader No: C9F V Date* 10":30-87 size. ,..7.8 Date- /f 2 Rl n Poin#� the City of Eagan Owner Sons Conat. Site Address: Plumber 4317 Brarldnek T7seil 1:11 Bb Loy .T0hnaOn ii.xrav /Tr+gan Pluznbing Conn Chg. _OOFd� Acct. Dep 1 5 rr c�;r. i�s�} eau 4 1 f i� R m#fa3 Permit Fee: Surcharge: Tr Plant 180_.:)Li Meter. Misc o ELu a 4421 wi 67. 00pd By WATER SERVICE PERMIT 1 CITY OF EAGAN Permit No 9 2 *79 3830 PNctKnob Road Meter N� P.O. Box 21199 Reader N Eagan, MN 55121 Owner. Site Address: 43 Plumber. Conn, Chg: 5 Acct Der Permit Fee: Surcharge: Tr. `Plant Meter. 6T. Dater Size: No: Date: Zoning: R1 No of Units: 0 15 1Q. OOpd ..SOpd k T srvpitst n P1' I agree to comply with the C Ordinances. Misc By WATER SERVICE PERMIT CITY OF GAN Permit No: kt 3830 PUS Knob Road B/P No: 77896 Date 10-30-87 Date: 10 -1 -87 P.O. Box 21199 Eagan, MN 55121 Owner. S Site Address: 4 3'r Er d occ Trail Lill l4 3 ittgtoit Polxite Plumber /Eagan Plurb in MWCC: 5 5 00d Zoning. i'Ll City Chg: tO0. OOFd No. of Units: 5.4 d Acct. Dep i4 `1' I agree to comply with the City of Eagan Permit Fee: Ordinances. Surcharge: 50g Misc By SEWER SERVICE PERMIT CITY OF EAGAN 3830 PIIKnob Road P.O.' 'B9 *`21199 Eagfn, MN55121 Owner Sons Site Addres 4331 Permit Noe 1 10333 B/P NO: c?p77/ ,72e Count:' iraddoctz 'frail 'al 134 Plumber Johnson Ece. '•'t Plying MWCC: 525 t0r s 11 iU�dQ�� Chg 1. }o Q r digging Ca �l�Itiir• 15 u 'ECf Rid Acct ur g e DOF �L Permit Fear JL Surcharge r.? Misc BY EWER SERVICE PERMIT Ow 1O -30 -87 i !ate: L eXintO rt mpl)wit the.City of rota e an 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. Address lam! F Block Parcel No. gi tics Z 3o Pilot BUIL®INGMMIT To be used for SP 0 /4/"R. Est. Value $64.000 I hereby acknowledge that i have read this application and state that the information Is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee Bulidl*Permlt is issued to. SOS COU ION GO onthe express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and Clty of Eagan Ordinances. Building Qfflcigl CITY OF EAGAN Knob Road, P.O. Box 21 -199, Eagan, MN 38111 PHONE: 434 -8100 Receipt Date On Site Sewage MWCC System On Site Well City Water PRV Required Booster Pump °CURER 1 X .S. Total Footprint S.F. APPROVALS S Engr./Assess. Permit Planner Surcharge Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC ,4337 •$*ADDOCK TRAIL. 4 Sec/Sub. Lli.k I ?�GTO$ POI NTE SONS CONSTRUCTION Cf., Name Address "WI 8°116 LS MAN City PhonR 45 5355 Name AP Address City Phone Name Address City Phone ORRICE USE ONL Occupancy Zoning (Actual) Const (ANowable) 0 pf Stories Length 4t3 42.0# S255.c'. Water Conn. Water Meter Road Unit Treatment Pi Parks TOTAL. y 2 7 a i r CONTRACT PRICE L. Site Address 4337 Lot .BI t 7 o P881 TRAIL /Sub Name Address 14745 South Robert Trail Cit ROSMIOUItt Elli Phone 55068 4234144 son s Construction Name Address 46 1=01M M.1% Eage3litt APN phone= SZ*5355 55122 TYPE OF WORK Forced Air 75 M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent CFM Gas Piping Outlets Other. FEE sic TOTAL MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE 454-8100 .0314A RE OFP RM FOR: 01"i'Y OF EAGAN 24 WORK DESCRIPTION N =CM Mult Add-on Comm. Repair Other BLDG. TYPE Res XIDCXXXX 148t8IPT DATE OCIC I OSSRIZ 1987 FEES RES. HVAC 0-100 M BTU $24.00 ADDITIONAL 50 M BTU 6.00 (RES.04KAC INCLUDES Atc9 N NE! CONSTRUCTIO GAS'OUTLETS (MINIMUNE=1 PERPEtilin) '1•56 COMM/IND FEE 1% OF CONTRACT-FEE APT. BLDGS. COMM. RATE APPLIES TOWNHOUSE CONDOS RES. MISAPPLIES MINIMUM RESIDENTIAL FEE AIL* ADD-ON REMODELS 12. MINIMUM COMMERCIAL PEE 20.00 STATE SURCHARGE PER PERMIT (ADD $.50 S/C IF PERMIT PRICE G BEYOND $1,000) 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. PLUPABIN CITY OP 3830 PILOT KNOB RO CONTRACT PRICE PHONE Site 4337 Braddock Trail Biock Sec/Sub L. ti aeIII Name 3.U01 illg Address 5910 Cheater Ave. N orthfteld p hone 461- 20 96 City JAOUMO Sons Construction Name 4510 Rahn Road city a Phone FEES COMM/IND FEE 1% OF CONTRACT FEE MINIMUM RESIDENTIAL FEE $10.00 MINIMUM COMM/IND FEE 20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.50 8/C IF PERMIT PF00E GOES BEYOND $1,000.00) I( 42 4 5 IMMATURE OF PERIATTEE 4 -44 0worlorw°1 4 Pwr WIRNORWrimmyTT:lit PERMIT IP 50 J9 PERMIT 9111S 5 RECEPT It i EAGAN AD, EAGAN, PM 55121 DATE 4544100 BLDG. TYPE Rea Mult Comm. Other FIXTURES Water Closet $3.00 Tubs $3.00 _A—Lavatory Sh ower $3.00 hen Sink $3.00 $3.00 ._..4.1.sundry Tray $3.00 Drains $1.50 -_-Water Heater $1.50 Whirlpool $3.00 Gas Piping Outlets $t50 —Softener $5.00 Well $10.00 Private Disp. $10.00 -..23.-Rough Openings $t50 FEE 4. ,0 61) STATE VC GRAND TOTAL '344; This "Ce use. For t BUILD11MG PERMIT To be used for Est. Value $1 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Receipt Date 19 '�►i Site Address 433 7 TR Lot 11 Block 4 Sec/Sub l Il I Parcel No 8 Name SCOTT MHZ Address 4337 City EAGAN Phone 726-421* 'att13 Name S Address City Phone Name Address City Phone 140 Plan Review Length Depth &fit o SAC, City S.F. Total SAC, MCWCC S.F. Footprints On Site Sewage Water Conn On Site Well Water Meter MWCC System Acct. Deposit City Water PRV Required S/W Permit Li SO 28.00 OFFICE USE ONLY Occupancy FEES Zoning (Actual) Const Bldg. Permit 60 (Allowable) Surcharge o J0 of Stories 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 all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to• SCOTT K 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 Permit No. Permft Holder Date Telephone WATtR SEWER PLUMBIND H.VAC. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough PIbg. Rough Htg• Isul. Fireplace Final Htg. Final Plbg Cond. Meter Plbg. Inspector— Notify Plumber EngrJPIan Bldg. Final Deck Final 17frf 4/4' Well Pr. Disp. 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. t 9, Eagap1 I Receipt Date BUILDING 'FL To be used for CI .9930 PHOt Ktltl►b Road, RMIY PHONE: Name, Addre City Name Address City Phone Site Address 493 Lot I A Block Parcel Na Name ��r�ac "xLwibv4a" rw /Addre City Est, Value... 1 hereby acknowledge .1 have, read this application and state that the,: ,Variance information is correct agree to comply with all applicable State of Minnesota Statutes and ►cif Eagan nances- r "Signature of Permittee A: Bui.dlrid ;Permit is Nsued to` u a r gin' C1Iit on the express condition shat l tlsi'done irf accordance with all applicable State of Min Statutes and City of Eagan Ordinances: Building Official r,Y• bn Site Well pity Water PRI/ Required Booster Pump r. /Assess. Planner Council Bldg. Off Site Lot Parc cc w z 0 cc .o Ua CC F F¢ U w w w z E 43 U Z w BUILDING PERMIT To be used for SF DWG /GAR Signature of Permittee Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Address 4337 BRADDOCK TRAIL 11 Block 4 Sec /Sub. LEXINGTON POINTE el No. Name SONS CONSTRUCTION CO Address 4606 LENORE LN City EAGAN Phone 452 -5355 Name SAME Address City Phone Name Address City Phone I hereby acknowledge that I have read this application and state that the information is correct and agree t• omply with all applicable State of Minnesota Statutes and City of E. n 0 •'n A Building Permit is issued to: SONS CONSTRUCTION CO on the express condition that all work shall be done in accordance with all applicable State of Minneso Statutes an ity ctf Eagan Ordinances. Est. Value $84,000 Receipt `4 Date OCTOBER 1 ,1 9 N 14234 OFFICE USE ONLY On Site Sewage Occupancy R3 MWCC System X Zoning R1 On Site Well (Actual) Const Vn City Water X (Allowable) Vn PRV Required of Stories Booster Pump Length 48 Depth 3 S.F. Total Footprint S.F. APPROVALS Engr. /Assess: Planner Council Bldg. Off. Variance FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks TOTAL 447.50 42.00 223.75 100.00 525.00 525.00 67.00 305.00 1A0.00 $2,415.25 BUILDING PERMIT To be used for DECK CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 I hereby acknowlege 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 E .an Or. f nces. Est. Value $1 000 SCOTT KRANZ Signature of Permitee A Building Permit is issued to on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official '\..Ot A.4/ Planner Council Bldg. Off. Variance Receipt Date MAY 12 N? 1646 C. 117 ,19 Site Address 4337 BRADDOCK TR Lot 11 Block 4 Sec /Sub. I,FXTNGTON POTNTF, Parcel No x W 0 ct z° OQ U U w w F w 0 cc z a Name Address City SCOTT KRANZ 4337 BRADDOCK TR EAGAN Phone 726 -4215 688 6'18', Name SAME Address City Phone Name Address City Phone Occupancy Zoning (Actual) Const (Allowable) of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS OFFICE USE ONLY 14' 12' FEES Bldg. Permit 26.00 Surcharge Plan Review SAC, City SAC, MCWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI Road Unit Park Ded. Copies 1.50 TOTAL 28.00 Street Address, Box or Route No. City ection o. Township Name or o. Range No. County 17 Occupant (PR NTI Phone N power rS Supplier j_ Address 0 J Electrical Name) r Contracto 1 ompan Nam f ,t),, e l I C License Contractor's No. Mailing Address (Contraccttor r wner a ir. Insty ilati9,n) Author ign�A�'�CK al lati Pt, Number g3 This request void V 18 months from D 30490%/, Request Date Licensed Electrical Contractor Owner MINNESOTA STATE BOA ELECTRICITY Griggs- Midway Bldg. Room N -191 1821 University Ave.. St. Paul, MN 55104 Phone (612) 642 -0800 Rough -in Inspection Required Yes No I hereby request inspection of above electrical work installed at: O tc 4� CrD Ready Now �tN ill Notify. Inspec- tor When Ready THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. New Add Rep. Type of Building Appliances Wired Equipment Wired Circuits Home Acfe7 Range Temporary Service 0 to 30 Amps 31 to 100 Amps Above 100 Amps ]'49 Fee lig s �7 Duplex Water Heater Dryer Furnace Xt Lighting Fixtures Electric Heating Silo linloader Apt. Building Transformers Commercial Bldg. Irrigation Booms Industrial Bldg. Air Conditioner Signs Bulk Milk Tank Special Inspection 3 Farm Remarks OtheriSpecify) Other (Specify) Other (SpecifyT Other Other Fee Service Entrance Size Fee Feeders /Subfeeders Circuits Acfe7 0 to 200 Amps 0 to 30 Amps 31 to 100 Amps Above 100 Amps ]'49 Fee lig s �7 0 to 30 Amps 31 to 100 Amps Above 100_Amps Above 200 Amps) Swimming Pool Transformers Irrigation Booms Partial. Other Fee Signs Special Inspection 3 TOT Fri,/' AL .sAl Remarks /7 REQUEST FOR ELECTRICAL INSPECTION /.See instsuctions for completing this form on back of yellow copy. D -30490 '"X'" Below Work Covered by This Request ompute Inspection Fee Below Rough -in alf2747 Final Date k/.2'e p� the Electrica Inspector. hereby certify that the above inspection has been made. a te This request void 18 months from EB 7�� Ot -06 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (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) IF MULTI FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER S'Gc �7' d 7 4 ja.n TYPE OF WORK a9,2 ..9e61- s 1G.- APPLICANT e A-4-14442S ai ADDRESS 6l G S4^ 7 PAGER CELL PHONE Energy Code Category (check one) RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD 55122 651 681 -4675 Remodel /Repair Requirements 2 copies of plan 1 set of Energy Calculations for heated additions 1 site survey for exterior additions decks Indicate if home served by septic system for additions DATE d3 6S Q 2 VALUATION /3 &'Y JOB SITE ADDRESS Li 33 '7 NEW RESIDENTIAL BUILDING ONLY FILL OUT COMPL MINNESOTA RULES 7670 CATEGORY 1 Residential Ventilation Category 1 Worksheet Sub Energy Envelope Calculations Submitted MINNESOTA RULES 7672 New Energy Code Worksheet Submitted yc( 5 e4Se.e.Q OWA- lJ'-C FIREPLACE(S) 0 1 2 PHONE# S _3' AV 55103 ZIP CODE <S 903 FAX ,'�47� 7- 2446 Plumbing Contractor: Phone Plumbing System Includes: All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the informat with all applicable State of Minnesota Statutes and City of Eagan Ordinanc Certificates of Survey Received Water Softener Water Heater No. of Baths Signature of Applicant Lawn Sprinkler No. of R.I. Baths Tree Preservation Plan Received Not Required Fee: $90.00 Mechanical Contractor: Phone Mechanical System Includes: Air Conditioning Heat Recovery System Fee: $70.00 Sewer /Water Contractor: Phone is correct, and agree to comply Updated 2002 fru- 01 Foundation 07 05 -piex 02 SF Dwelling 08 06 -piex 03 01 of plex 09 07 -piex 04 02 -piex 10 08 -piex 05 03 -piex 11 10 -piex 06 04 -piex 12 12 -piex 31 New 35 32 Addition 36 33 Alteration 37 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const Footings (new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Roof Ice Water Framing Fireplace R.I. Air Test Insulation 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 Int Improvement Move Bldg. Demolish (Bldg)* *Demolition (Entire OFFICE USE ONLY 13 16 -piex 16 Fireplace 17 Garage 18 Deck 19 Lower Level Plbg_Y or N Occupancy Zoning Stories Sq. Ft. Length Width 20 Pool 21 Porch (3 -sea.) 22 Porch /Addn. (4 -sea.) 23 Porch (screened) 24 Storm Damage 25 Miscellaneous 38 Demolish (Interior) 44 42 Demolish (Foundation) 45 43 Reroof 46 Bldg only) Give PCA handout to applicant MC /ES System City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing HVAC Other Final Pool Ftgs Air /Gas Tests Siding Stucco Stone Final Windows (new /replacement) Retaining Wall 30 Accessory Bldg 31 Ext. Alt Multi 33 Ext. Alt SF 36 Multi Siding Fire Repair Windows /Doors Final Approved By Building Inspector 4t 4N770 New Construction Requirements 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas (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) RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD 55122 651.681 -4675 DATE j'a d) VALUATION (EXCLUDING LAND) JOB SITE ADDRESS 1 -I 3 -37 SCA OaC IF MULTI- FAMILY BUILDING, HOW MANY UNITS? S PROPERTY OWNER 04 kV/In TYPE OF WORK g..e pICtCIoG VON DO `"lam CS Ur rAtiri IPUS) 0 7 _2 APPLICANT Se 1( k) -`e `1 r' pO vcr\c Q-v1 PHONE ADDRESS ...ac 7 OCLPGW ire- Iv catk 4 -t,�- L' jn CODE 5C PAGER CELL PHONE LOP--g (.33i3! FAX 71103 qA/ S'S" eZ uawl- NEW RESIDENTIAL BUILDING ONLY FILL OUT COMPLETELY Energy Code Category MINNESOTA RULES 7670 CAI LGORY 1 (check one) Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted MINNESOTA RUI FS 7672 New Energy Code Worksheet Submitted Plumbing Contractor: Phone Plumbing System Includes: Water Softener Lawn Sprinlder Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Mechanical System Includes: Air Conditioning N Heat Recovery System Sewer /Water Contractor: Phone All above information must be submitted prior to processing of application. Certificates of Survey Received I hereby acknowledge that I have read this application, state that the information is c all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant RemodellReeair Requirements 2 copies of plan 1 set of Energy Calculations for heated additions 1 site survey for exterior additions decks 4 5p3 Phone Fee: $70.00 l2L4 9 Tree Preservation Plan Received of Required o comply with Updated 1/01 01 Foundation 02 SF Dwelling 03 01 of plex 04 02 -piex 05 03 -piex 06 04 -piex 31 New 32 Addition 33 Alteration 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const 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 07 05 -piex 08 06 -piex 09 07 -piex 10 08 -piex 11 10 -piex 12 12 -piex 35 36 37 Footings (new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Roof Ice Water Final Framing Fireplace R.I. Air Test Final Insulation OFFICE USE ONLY 13 16 -piex 16 Fireplace 17 Garage 18 Deck 19 Lower Level PibgY or Int Improvement 38 Demolish (interior) 44 Siding Move Bldg. 42 Demolish (Foundation) 45 Fire Repair Demolish (Sidg)* 0 43 Reroof 46 Windows/Doors *Demolition (Entire Bldg only) Give PCA handout to applicant Occupancy Zoning Stories Sq. Ft. Length Width REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing HVAC 20 Pool 21 Porch (3 -sea.) 22 Porch /Addn. (4 -sea.) 23 Porch (screened) 24 Storm Damage 25 Miscellaneous MC /ES System City Water Booster Pump PRV Eire Sprinklered Other Pool i Ftgs Air /Gas Tests Siding Stucco Stone Windows (new /replacement) 30 Accessory Bldg, O 31 Ext. Alt Multi 33 Ext. Alt SF 36" Multi Final CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681 -4675 SITE ADDRESS: P I.N.: 1.0--- 46070 110 -04 DESCRIPTION: REMARKS: FEE SUMMARY: Base Fee Surcharge Total F e e CONTRACTOR: FIREPLACE SPECIALIST 1200 9TH AVE S ST PAUL (612) 451 -1970 MN 55075 APPLICANT /PERMITEE SIGNATURE $25.00 Jt "7 $25.50 Applicant:: ST. LIC. 14511970 0003924 PERMIT C' [90.5`3 4337 BRADDOCK rr? LOT: 11 BLOCK: 4 LEXINGTON POINTE PERMIT TYPE: Permit Number: Date Issued: ERO CLEARANCE GAS) Perm Type FIREPLACE k Type NEW cit F g n OWNER: KRAN2 4337 EAGAN (612)688 -6484 SCOTT BRADDOCK TR MN 55121 ISSU DBK: SSI NATU E BUILDING 022929 02/07/94 �j 3 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681 -4675 PERMIT SUBTYPE: FIREPLACE INSPECTION RECORD SITE ADDRESS: O T a 11 B 0 1 o 4 APPLICANT: 4337 BRADDOCK TR LEXINGTON POINTE PERMIT TYPE: Permit Number: Date Issued: FIREPLACE SPECIALIST (612) 45:1 --1970 TYPE OF WORK: DESCRIPTION BUILDING 022929 02/07/94 NEW (ZERO. CLEARANCE GAS) INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. ROUGH—TN FINAL SINGLE MULTI- FAMILY COMMERCIAL 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. 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 9 y Valuation of work C QC Site Address: Tenant Name: l q 3 {I rot clock L-R, STREET (commercial only) SUITE LOT 11 f BLOCK SUBD j r t v P.I.D. Descri•tion of work: WO+ tA 1) Z C o The applicant is: Owner Contractor Other (Describe) Property Owner Name i r fir' S C o./-4 Phone 6V g-/ 1 LAST FIRST Address 0 2 7 E r c c k 4R STREET STE City Ec1yiNd State Mr' Zip Si` j Contractor Company Fire. pf4 cam. c11 0,);_J Er Phone Cpg'q 1 1 C y Address /20o CjcM AvaL Scj, License Y 92 4 1 Exp. City 5% S ?C J State M r' Zip cO7 Architect/ Engineer Company Phone Name Registration Address City State Zip Sewer water licensed plumber sewer water permits is two Processing time for days once area has been approved. I hereby acknowledge correct and agree Eagan Ordinances. Signature of that I have re -his appl ation and state that the information is to comply with a s l i cab1- e- of Minnesota Statutes and City of Applicant: r„, CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681 -4675 BUILDING PERMIT TYPE O 01 Foundation O 02 SF Dwg. O 03 SF Addition 0 04 SF Porch 0 05 SF Misc. WORK TYPE O 31 New 0 32 Addition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS O.Site O Wallboard Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC SAC Units 0 06 Duplex 0 07 4 -P1 ex 0 08 8 -Plex O 09 12 -P1ex 0 10 Multi. Add'1. 0 33 Alterations E3 34-Repair Footing 0 Final Valuation: OFFICE USE ONLY Basement sq. ft. 1st Fl sq. ft. 2nd Fl. sq. ft. Sq. Ft. total Footprint Sq. ft. On -site well On -site sewage Building Variance O 11 Apt. /Lodging 0 12 Multi. Misc. O 13 Garage /Accessory 0 14 Fireplace 0 15 Deck 0 Framing Draintile Assessments O 16 0 ►rte 017 Swim Pool 0 18 Comm. /Ind. O 19 Comm. /Ind. Misc. 0 20 Public Facility 0 21 Miscellaneous O 35 Tenant Finish 0 37 Demolish 3 36 Move MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Insulation Q Fireplace CIl( OP EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122 -1897 (612) 681 -4675 SITE ADDRESS: P.T.N. s 10- 45070- 110 -04 DESCRIPTION: REMARKS: FEE SUMMARY: Base Fee Surcharge Total. Fee APPLICANT /PERMITEE SIGNATURE PERMIT 4337 BRADDOCK TR LOT: 11 BLOCK: 4 LEXINGTON POINTE T.O. REROO(: F?erri.t: Type SF (MISC. rk Type REPAIR 434 ALT. RESIDENTIAL VALUATION $89.:25 CONTRACTOR: Applicant ST. LIC. OVER THE TOP ROOFING 14584133 20092025 S!20 JAREAU AVE S COTTAGE GROVE MN 55016 2) 458 -4133 PERMIT TYPE: Permit Number: Date Issued: $4,000 OWNER: KRANZ 4337 EAGAN (651)688 -6484 BUILDING 033599 10/07/98 SCOTT BRADDOCK TR MN 55122 ISSUED BY: SIGNATURE CITY OF EAGAN CASHIER: S TERMINAL NO: 808 HATE: 10/07/98 TIME 15 :50:4O ID: NAME: OVER THE TOP ROOFING 3210 9001 4337 BRADIDOCK T 2155 9001 4337 BRADDOCK T Total Receipt Amount: CR098178 USER ID: NANCY 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD 55122 681-4675 New Construction Requirements 1 RemodeVRepair Requirements 3 registered site surveys 2 copies of plan 2 copies of plans (include beam window sizes; poured fnd. design; etc.) 2 site surveys (exterior additions decks) 1 energy calculations 1 energy calculations for heated additions 3 copies of tree preservation plan if lot platted after 7/1/93 required: Yes No L ow -5 DATE: DESCRIPTION OF WORK T ?-A'12. C Zeceo 0 STREET ADDRESS: 337 QsrakdCoCI �TIZO. A Company :0U7 7z kocA et I hereby acknowledge that I have read this application and state that the info State of Minnesota Statutes and City of Eagan Ordinances. Certificates of Survey Received Tree Preservation Plan Received OFFICE USE ONLY Yes Yes Signature of App No CONSTRUCTION COST; 3E5 Vo LOT: I BLOCK: SUBD. /P.I.D. ~E'xi Name: n Z Co Phone PROPERTY Last First Street Address: OWNER LtE P gJ O G�C- City 2_4/ State: 7 '7 Zip: Not Req Phone CONTRACTOR Street Address: 1 J O.v ea 0 £V`2 U License aG)O`? 202. S City CTS State: Zip: ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer water licensed plumber (new construction only): Penalty applies when address chang and lot change is requested once permit is issued. is correct and agree to comply with all applicabl OCT ECIEDWZ 6X998 OCT 61998 BUILDING PERMIT TYPE 01 Foundation 06 Duplex D 02 SF Dwelling 07 4 -plex 03 SF Addition 0 08 8 -piex 04 SF Porch 09 12 piex 05 SF Misc. 10 plex WORK TYPE 0 3 New O 32 Addition GENERAL INFORMATION Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS 33 Alterations 34 Repair Planning Building Permit Fee 748 bl Surcharge Z. Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit SAN Surcharge Treatment P1 Park Ded. Trails Ded. Other Copies Total: SAC SAC Units OFFICE USE ONLY 11 12 13 14 15 Apt. /Lodging Multi Repair/Rem. Garage /Accessory Fireplace Deck 36 Move 37 Demolition Valuation: Engineering MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Variance 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) L _ CITY OF EAGAN 3830 PILOT KNOB RD - 55122 Uu V 651-681-4675 New Construction Reaulrements Remodel/Reoalr Reauirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house and all roofed areas (20% maximum lot coverage allowed) > 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) 1 set of energy calculations 3 copies of tree preservation plan If lot platted after 7/1/93 DATE: _.._C71? (n --06 2 copies of plan 1 set of energy calculations for heated additions I site survey for exterior additions & decks CONSTRUCTION COST: DESCRIPTION OF WORK: 1104 / /f1 STREET ADDRESS: 7S 5k 3 7 x6;- 7?a i I LOT: BLOCK: SUBD./P.LD. #: ?fxihjAil PU/h f el -4- Name: Zl-? r2) Phone #: PROPERTY Last First OWNER Street Address: ,r- City mat State: -t Zip: J 67) 3 Company: Phone #:7-?'?? (area code) CONTRACTOR Street Address: License #S"?Expo City c-_? State: (Al ' Zip: 0'S? ARCHITECT/ ENGINEER Company: Telephone #: ( ) Name: Street Address: Registration #: City State: Zip: Sewerlwater licensed plumber (if Installing sewer/water): Phone #: I hereby acknowledge that I have read this application, state that the Information is co oect?ond agree to comply with all applicable State of Minpesota Statutes and City of Eagan Ordinances. A , Signature of OFFICE USE ONLY Certificates of Survey Received Yes No ? Tree Preservation Plan Received Yes No Not Required 20 t b0.50 Called 321 1o 0 twl OFFICE USE ON%-T BUILDING PERMIT SUBTYPES ? 01 Foundation 13 ? 007 8 lex 06-plex ? 02 03 SF Dwelling plex 01 of ? 09 07-plex ? ? 04 - 02-plex ? ? 10 11 08-plex 10-plex ? ? 05 06 03-plex 04-plex ? 12 12-pleX ? 13 16-plex ? ? 17 Garage ? 18 Deck ? ? 19 Lower Level ? p1bg Y or_ N ? ? 20 Pool ? 21 Porch (3-sea.) Porch/Addn. (4-sea.) 22 23 Porch (screened) 24 Storm Damage 25 30 Miscellaneous Accessory Bldg. ? 31 Ext. Alt - Mufti ? 33 Ext. Alt - SF ? 36 Mufti W RK TYPE ? 43 Reroof 31 New ? 36 Move Bldg. ? 44 Siding ? 32 Addition ? 37 Demolish (Bldg) ? 45 Fire Repair [3 33 Alteration [3 38 Demolish (Interior) c3 46 Windows [3 34 Repair ? Give PCA handout t t to applicant (Foundation) for demolition permit * ft. GENERAL INFORMATION # of Stories sq. _____ sq. ft• ---- SAC Code - LL - Length __ Footprint sq. ft. ------- No. of Units --? - Width - Census Code No. of Buildings -- -- Basement sq. ft• ------" MCIES System Const. (Actual) Main level sq. ft. - City Water (Allowable) sq. ft. Booster Pump UBC Occupancy sq. ft. PRV Zoning Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Building planning Permit Fee Surcharge ___------ Plan Review ____---- License MC/ES SAC City SAC -------- Water Conn. - Water Meter Acct. Deposit S/W Permit -------- SNV Surcharge Treatment PI. Park Ded. _____------ Trails Ded. Other ------ ____ Copies ----------- Total: Variance Engineering ---- Valuation: $ 12 U U f SAC Units --------- % - SAC -- j A 1 f .T a a i"?%?:T+sRM????i.,IR?TT?F'TT?`?P??rP /+i+,M•eg. JjtF??,li)??:m?.? } l?14i V CITY OF 1*L 00 Q, CASHIEQu Y'EP` NAMEti OA!. kikLUY Q?? f;lfCf`0 M Of 46,4 BRAQCI `(I' 00 M y 'th3 L'O1 4331`B ???Q T! ?Jn?,Q 3 is gal ; 33li, *::.(E NE•?; `+;: :1" ?: Q,Co 5 51 5t Oi ?. 3 ' P, W?ET 'Q7R Qn C, . 3 ti S }?? ?.R7 N „f 01 - - a : it r • '".Ie AN Cities Digital ity 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. AND CO. •4RVEYING SITE SERVICES SONS EAGAN M NN SOOTA 55122' PLAN FOR: CONSTRUCTION V I '4..v--fir LEGAL DESCRIPTION: LOT.. .., LOCK 4 , LEXINGTON POINTE CCO4' ING TO THE RECORDED PLAT r HERESF DAKOTA COUNTY, MINNESOTA 04 LOT II DRa11 EASEMENT/tttV Lip too 3 - M 3 ? 0 Sr----4 O 15 ?_ 00 I " , t0O p01 N NO S 0 N 1. it %f ?Pott ?'Y I I Q Zap ZaL" N 1 N Q O LO T 12 SCALE I"=40' ?w'9) 75.00 0 S89°50'21"E -BRAD DO K 1. EG,E iV0 C finAU . • **********itirlnlrkIrtiFit?iryF•k****IF?I ****7Ir#?F9ritE Yo? R r OF CITY O F E A G A f SE `c Ti NO Do APPL A oN APPROVAL OF PERMIT. APPLICATION FOR PERMIT • I1?f??PECTZON` OF SE9M AND/OR N INSTALLATIONS WILL NOT BE SCHm-- SEWER AND/OR WATER CONNECTION 3 or UNTIL PST HAS BEEN APPROVED. (Please Print) 1) PROPERTY ADDRESS: ' 3 g DL ! ?°'aJ / LEGAL DESCRIPTION: L,Q ??t# 1.77 Lot BlockSubdivision or Tax Parcel ID IF EXISTING STRLVTUURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: (Mon Year) COMMERCIALA=AIL/OFFICE (R-l SINGLE FAMILY [O INDUSTRIAL R-2 DUPLEX (Two Units) ? INSTITUTIONAL/GOVE zgENT R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTHm/CONDOMINICJM ( Units) 2) p 4jop : ? cz ? t ci cL l a ADDRESS: J of d 1" V C_fj CITY, STATE, ZIP: v?r-- &rov'L /1/S ip SS`y"73 PHONE: 5/S%- c?' jTO 3) For City Use NAME: Plumbers License: ADDRESS: .? J ref. f t,d?c Active CITY, STATE, ZIP! ?4 A /z, Expired Not recorded PHONE: la MASTER LICENSE# 7 - _? Staff Initial 4) • •. .._,?? (+ , ( E N : AM OJj.l ADDRESS: C d 6 1 or ._ , CITY, STATE, ZIP: Ec PHONE: g_CONNECTION TO` CITY SEWER CONNECTION TO CITY WATER C( OTf-IER 6) " - • '' Q PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, (ABOVE (Circle one) 7) ?'?s kU; 163-2 .; _ • - FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ l/} SEWER PERMIT (INCLUDE SURCHARGE) $ $ /1 -5 D WATER PERMIT (INCLUDE SURCHARGE) $ (P ?'C $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ / U- ACCOUNT DEPOSIT SEWER $ $ O--Z) ACCOUNT DEPOSIT - WATER $ Z"' 0 7? $ WAC $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ 0-0 $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ TOTAL -77Z ?6 -M 7opl RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING U NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS APPROVED BY: /`7L TITLE: l O 7 DATE: 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 `-1 a ;O O 651-681-4675 C_a" ---? -(3,` New Construction Requirements Remodel/Repair Requirements > 3 registered site surveys showing sq. ft. of lot, sq. ft. of house 2 copies of plan and all roofed areas (20% maximum lot coverage allowed) 1 set of energy calculations for heated additions > 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) 1 site survey for exterior additions & decks > 1 set of energy calculations 3 copies of tree preservation plan IF lot platted after 7/1/93 DATE: - ?? CONSTRUCTION COST: f DESCRIPTION OF WORK: C.?', y r? C b S lnV Q STREET ADDRESS: " l Ur Y, 0, f LOT: BLOCK: SUBD./P.I.D. #: Name: k rc?n2_V" Phone #: PROPERTY Last First OWNER p Street Address: e rjdp jj City a State: M/V zip: S? Company: D ell G ?OKt,yS Phone #: S1 _ ( _(1 (area code) CONTRACTOR Street Address: a' a3 0 _ c H ' A License # Exp. City State: A A Zip: S S l ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) Street Address: Registration #: City State: Zip: Sewer & water licensed plumber (required for new construction only): Penalty applies when address change and lot change Is requested once permit Is issued. I hereby acknowledge that I have read this application, state that the Information Is correct, and agree to comply with all applicabi State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY 6 19. -a Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace J&I 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE 31 New ? 35 Tenant Imps ? 39 Gas Line Only ? 43 Sidi ng/Soffits/Fascia 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Win dows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair 34 Repair ? 38 Demolish (Interior) ? 42 Reroof Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code 7 (Allowable) Main level sq. ft. SAC Code <> / UBC Occupancy sq. ft.. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee } Valuation: $ 'v Surcharge L I Plan Review License MC/ES SAC .2 o? `l City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SIW Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: I r7 a v SAC Units % SAC J / "t%-o "r ,ND CO. ,JRVEYING SERVICES 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 LEGAL DESCRIPTION: SITE PLAN FOR: SONS CONSTRUCTION LOTji.,6LOCK 4 , LEXINGTON POINTE CCO ``ING TO THE RECORDED PLAT HEREOF DAKOTA COUNTY, MINNESOTA LO i 12 LOT !t0 SCALE= I"=40` LEGEND o DENOTES IRON MONUMENT a DENOTES WOOD HUB SET DENOTES EXISTING SPOT ELEVATION DENOTES PROPOSED SPOT ELEV ( DENOTES DRAINAGE DIRECTION iNvER T .LtVAi ION AT SERVICE EXTENSION= PROPOSED GARAGE FLOOR ELEVATION ¦ _`3--2Z- PROPOSED FIRST FLOOR ELEVATION = 9778 PROPOSED BASEMENT FLOOR = _ ELEVATION • NOTE : VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Bradle4jt e nson, Mn. Reg-No-1U33 a Registered Land Surveyor under the Laws of the State of Minnesota. Date I v.vv • S89°50'21" E BRAD DOC K - TRAIL CITY OF {::a iCi O r'y CASHIER: Oh-, JS 76 '.+ 1'?i Y t:M{'.:: J. t' i1.t.. .gin INC . y 37 :* iDDOC ; Y, 167.25 glg 3 43 7 0. 05 3430 9001 40df 50 205 9001 kk ?'3.?d;s3? T {!''AD?:DOCK t? } 4. Total Receipt is :tou t ;t irU1,409 11t' AN ISPR s 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 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 MAY 0 9 1989 H Ur To Be Used For: Valuation: X09- °` Date: Site Address 4V? LaAn d T( L Lot Block Parcel/Sub L ir%C?dy Qoivck Owner ??,f C c Address ti X37 e k kdoek If L City/Zip Codea y? `SS 1 Phone fi$g " ??? ,?u,Pk ?aG° W?1S Contractor ?aMt 0.S Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # /oPi OFFICE Occupancy Zoning Actual Const Allowable # of stories Length Depth /2-' S.F. Total Footprint S.F. On site sewage On site well MWCC System City water PRV required Booster Pump APPROVALS Planner Council Bldg. Off . Variance Council S/10 ONL FEES Bldg. Permit d _O - 0 O Surcharge 30 Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Copies ,4-' TOTAL ??. o 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. 4 RI-LAND CO. SITE SURVEYING SERVICES SONS 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 PLAN FOR: CONSTRUCTION LEGAL DESCRIPTION: LOTJ:,.j6LOCK 4 , LEXINGTON POINTE 0004 ` ING TO THE RECORDED PLAT HEREbF DAKOTA COUNTY, MINNESOTA /CIK `Qyah' LO i 1? LOTII DRAIP EAsf:MENTILITY L() T i0 103 0" Lv L 0 0 I cD a) N ??00?? ZaG° 5 I5 4 °O1 SCALE = I" = 40' c ?ns•?? 75.00 S 89° 50' 21" E BRADD CK TRAIL LEGEND iNVERi ELtVAIION AT SERVICE EXTENSION= 0 DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION s X77 3 DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = 977, 8 DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR = '?0- ELEVATION ELEVATION • DENOTES PROPOSED SPOT ELEVATION DENOTES DRAINAGE DIRECTION NOTE : VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS I 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 jenson, Mn. Req. No. 15233 Registered Land Surveyor under the Laws of the State of Minnesota Date _t 2z/a? 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 To Be Used For: Residence Valuation: 34,999.08 - Date: Gp,t_24,i ARC Site Address 4337 Braddock Trail Lot 11 Block 4 Parcel/Sub Lexington Point Owner Sons Construction Co. Address 4606 Lenore Lane City/Zip Code Eagan Mn.55122 Phone 452-5355 Contractor Sons Construction Co. Address 4606 Lenore Lane City/Zip Code Eagan Mn. 55122 Phone 452-5355 Arch./Engr. Brian Austin -Draftsman Address 4606 lenore Lane City/Zip Code Eagan Mn. 55122 Phone # 452-5355 gy Ooa OFFICE USE ONLY On Site Sewage MWCC System On Site Well City Water APPROVALS Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off 3 APC Variance Occupancy R-3 Zoning R I. Type of Const (Actual) V-N (Allowable) V- N # of Stories Length Depth 32. 0, S.F. Total Footprint S.F. FEES Permit 14'? Surcharge 2.00 .Plan Review 23.'15 SAC, City 00.00 SAC, MWCC 25.5.00 Water Conn 5 25 5.00 Water Meter 6'1.O0 Road Unit 05,00 Treatment P1 1180.00 Parks Copies - - TOTAL ? ? gl 41 w .2q X,20= qoo x / a = 5 ,?60 28 x -26 = 72g x <y = /D i92 )5T 4ioo, : `721 eZ X L l 2 rj4oxliq 3ZSGo 2ND FLOOR, 2?S x zg = ?18Sl x yq 3i 96 83Do8 0 , A 1 J U `' c.,/"G%-f -r TRI-LAND CO. SURVEYING SERVICES 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122, SITE PLAN FOR: SONS CONSTRUCTION LEGAL DESCRIPTION: LOT *81LOCK 4 , LEXINGTON POINTE ACCOF"'ING TO THE RECORDED PLAT IEREF DAKOTA COUNTY, MINNESOTA X5 a4 ya ?/ o,5°;??h 1 LOT II Q r DRAINAGE A#0 LMLIrV LOT iO 3 5? N9?°ot''3'p? N 0 n M 0 0 0) 0 I NO N z?' ( M 5 5 e (`n5'3) 75.00 (g74"q) S89°50'21"E M LOT '12 SCALE=I"-40' BRADDOCK_ TRAIL LEGEND o DENOTES IRON MONUMENT c DENOTES WOOD HUB SET DENOTES EXISTING SPOT ELEVATION DENOTES PROPOSED SPOT ELEVATION DENOTES DRAINAGE DIRECTION I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the Laws of the State of Minnesota. Bradley J en son, Mn. Reg. No. 15235 Date: ?JZL1& an INVERT ELEVATION AT SERVICE EXTENSION= PROPOSED GARAGE FLOOR ELEVATION = cj 77 3 PROPOSED FIRST FLOOR ELEVATION = 977x,8 PROPOSED BASEMENT FLOOR ELEVATION NOTE'. VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION )WNCR: 50QS GON$T42UGTt0r.j GO TE ADDRESS: Ore A,IZ z S5-roe'Y 'y 33? RAIOc.,k ONTRACTOR: DATE : q _ 25 g1 PHONE : 452-5355-_ DETERMINE WORKING SOUARE.FOOTAGE OF EACH: TOTAL EXPOSED WALL AREA, . . . . , . . 231 S sq ft x "U" .11 = ffe 2. TOTAL ROOF/CEILING AREA •••••••• 103 sq ft x "U" 026 1. TOTAL EXPOSED WALL AREA CALCULATIONS: Total exposed wall area above floor •.•.• ••• sq ft a) Total wall window area: - glazed,..... l_Pj,C sq ft x "U" .57 glazed •...•, sq ft x "U" b) Total door area •„•,••,• 20 sq ft x "U" .2.3 4 .(00 c) Total sliding glass door area: glazed...... 80 sq ft x "lull ..:5'8 1111 (a ?6 glazed...... sq ft x "lull d) Total fireplace wall area sq ft x "U" e) Total wall framing area (Average 109,1) .......... sq ft x "U" . 10 23. S f) Total net wall area above floor (Insulated)....... ltn9cll sq ft x "U" ___ _ b-1, 9 ('P q) Total rim Joist area...... 330- . sq ft x "U" 10 4 1320 Total foundation area (Exposed) .........sq ft h) Total foundation window area ............sq ft x "U" _ i) Total net foundation area above grade........ sq ft x "U" TOTAL a) thru 1) = 23°l.?!o If Item #3 Is the same as, or less than item fl, you have met the Intent of 2 •tCAR 1.16008 A and 0. Page 1 4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed roof/ceiling area........ 1003 sq ft J ) Total skylight area ....... sq f t x "U" k) Total roof/ceilinq framing area (Average 109,) ...... 100 sq f t x "U" OZ?? ?? 1) Total net insulated 02? 21..0"7 roof/ceilinq area....... 90 3 sq ft x "U" 4. TOTAL J) thru 1) If total of #1+ is the same as, or less than N2, you have met the intent of 2 MCAR 1.16008 A and 0. ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and 112. i. + 2. R 3, + 4. C E R T I F-I C A T 10 N I hereby certify that I have calculated the "U" factors and "R" values herein and that the buildinq here described meets or exceeds the State of Minnesota Energy Conservation Act. gnature _ 9-2s-87 (Date) Page 2 r A ONSTRUCTiON 'RAMiNG SECTION: 1 interior air film 2 3 .51Izi' inches.so t 4 11 EwA-rr 5_?DIN? 6 Exterior air film- WALL SECTION (INSULATED) 7? L 01 R VALUE 0.69 .S TOTAL R - 10.15 U - 1/R - .10 --(1 Interior air film 6R ---(2 ., -----(3 aNS1JL. p --(4 SNE??TN r iGr_ ---{ 5 S ?I tD ---?1; Exterior air film 0.17 TOTAL R 'Oft V D SLAB ON GRADE *, ' -: ? .?.... t - ° ?.'. d - d . ,• ••. , , . U - 1/R - •04L. RIM JOIST SECTION: 1 Interior air film in. 6R (2 __-- 3 _I'l2"Jo i $ i 4 I .A1 4hJc1 b( 5 StDlAlfa •(07 -(6 Exterio air film 0.17 TOTAL R - FOUNDATION INSULATION REQUIRED: Min. R-5 on entire wall OR U - 1/R - Min. R-10 down to frost depth FOUNDATION SECTION: ---{1 Interior air film n,($ 2 u45ut• 12. 5 3 21 1 "4 ? = 4 Exterior air film 0.1177 (5 (6 TOTAL R - t 1K U- 1/R- i Unheated Slabs: Minimum R 6.2 CONSTRUCTION R VALUC- CEILING SECTION (INSULATED): 1 Interior air film 0.61 AIR 2 S "l CHUTE 3 N'4 4 Exterior air film still 0.61 TOTAL R - U - 1/R= F CEILING FRAMING SECTION: 1 Interior air film 0.61 2 5 eo r7f -11W Au. • Sty 3 t,. 30,00 4 Interior air lm still 0.61 5 3' y Inches soft wood 4.38 TOTAL R - ZSe? U - 1 / R - _c2.1 to CEILING SECTION (INSULATED): 1' interior air film 0.61 2 3 4 Exterior air film (still) 07-1 TOTAL R = U - 1/R- CEILING FRAMING SECTION: 1. Interior air film 0.61 2 3 4 Exterior air film still 6.61 S inches soft wood TOTAL R = U- 1/R= H 1 2 3 4 S Inside air film 0.61 Outside air film n.17 TOTAL R U - 1/R= Page 4 VENTED GUIDELINE TO (R) FACTORS FROM ASHRAE MANUAL OF TYPICALLY USED PRODUCTS AIR FILMS SHEATHING • .. •,••. Interior Air Film (Walls) 0.68 3/4" Wood Subfloor or Sheathing 0.94 Exterior Air Film (Walls) 0.17 1/2" Plywood Sheathing 0.62 Interior Air Film (Vented Ceiling 0.61 1/2" Particle Board 0.66 Exterior Air Film (Vented Ceiling) 0.61 Gypsum or Plaster Board 3/8" 0.32 Interior Air Film (Non Vented 0.61 Gypsum or Plaster Board 1/2" 0.45 Exterior Air Film (Non Vented 0.17 Gypsum or Plaster Board 5/8" 0.56 Plywood 3/8" 0.47 Plywood 1/2" 0.62 BLOWING WOOLS Plywood 3/4" 0.93 " Sheathing, Reg. Density 1/2" 1.32 Approx. 3 9.00 Sheathing, Reg. Density 25/32" 2.06 Approx. 4 1/2" 13.00 Nail-Base Sheathing 1/2" 1.14 Approx. 6 1/4" 19.00 Approx. 7 1/4" 24.00 Approx. 1.4" 30.00 ROOFS Approx. 18" 40.00 Built-up Roofs 0.33 All other insulation materials must Asbestos-Cement Shingles 0.21 be verified (R Factor) Asphalt Roll Roofing 0.13 Asphalt Shingles 0.44 INSULATION Insulation: 2-2 3/4" Fiberglass 7.00 SIDING Insulation: 3 1/2" Fiberglass 11.00 Aluminum Siding 0.61 Insulation: 6" Fiberglass 19.00 Aluminum with Backer 1.82 Insulation: 3 5/8" Fiberglass 13.00 Aluminum with Backer & Foiled 2.96 Insulation: 9" Fiberglass 30.00 1/2 x 8 Lap Siding (Wood) 0.81 Insulation: 12" Fiberglass 38.00 7/16 x 12 Hardboard Siding 0.67 Insulation: 8" Cellulose 29.00 Asbestos Sidings 1/4 Lapped 0.21 Insulation: 10" Cellulose 37.00 Stucco (Brown and Finish Coat) Insulation: 12" Cellulose 44.00 insulation: 1 1/2" Thermax .12.00 Insulation: 2" Thermax 16.00 DOORS ?U 1 3/4" Solid Core Door .46 ,IOODS w/Storm, Wood .31 Fir, Pine & Similar Soft Woods w/Storm; Metal .26 1 1/2" 1.89 Pease Steel Door Insl/N/GL 7.45R .13 2 1/2" 3.12 Sliding Glass Door, Wood .65 3 1/2" 4.35 Metal .72 5 1/2" 6.87 CONCRETE BLOCK WINDOWS 8" Concrete Block (S & G Reg.) 1.11 All Windows (w/Storms 1" to 4" Space) .56 (Filled with Vermiculite) 12" Concrete Block (S & G Reg.) 1.93 1.28 Removal Double Glazing (RDG) " .55 (Filled with Vermiculite) 3.15 Air Space Thermo or Welded 3/16 " .69 8" Light Weight 2.18 Air Space 11/4 " .65 (Filled with Vermiculite) " 5.03 Air Space .58 1/2 (Other windows specifically tested 12 Light Weight (Filled with Vermiculite) 2.48 5.82 can use better ratings) Page 5 AD CO. o JRVEYING SITE PLAN FOR: SERVICES SONS CONSTRUCTION 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 LEGAL DESCRIPTION: LOT.:,6LOCK 4 , LEXINGTON POINTE CCOFp ING TO THE RECORDED PLAT r HEREOF DAKOTA COUNTY, MINNESOTA LOT 10 Ayq LOi ?' LOT II Vi DRAIN " AF'D ,u.T' NT ifAbEml 3 C. Sr-?ot'30.w ?5 . NM M0 O I M0) O ? I 0 N0 O '^ I SCALE=I"=40' J. M 4 0. (cn5' 75.00 0-/" 1) S89°50' 21" E BRADDOCK TRAIL LEGEND iNvERT ELLVAIION AT SERVICE EXTENSION= o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION • 977 3 a DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = g77, & DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR g ELEVATION DENOTES PROPOSED SPOT ELEVATION DENOTES DRAINAGE DIRECTION NOTE' VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS I 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 en son, Mn. Reg. No. I`a235 Registered Land Surveyor under the rt1z?? Laws of the State of Minnesota. Date 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 / Oat) RemodeUR tr Requirements New Construction Requirements footings, sq. ft. of house; and all roofed areas 2 copies of plan ?o dd joist iti of lot sq ft s showin r e i ns office use Only Soils Repot y Recd - Y -N Y _ N , . . g v y te su 3 registered s (20% maximum lot coverage allowed) oil b d di t I na o set c c'1 ditions & decks Tree Pres Plan Recd _ Y -N. _ N s e ur s I Soils Report if proposed building is to be placed on A e on-site septic system Tree Pres Required 2 copies of plan showing beam & window sizes; poured found design, ! c System On-site Septi _ Y _ N 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711/93 ,.l U L 0 2 007 Rim Joist Detail Options selection sheet (buildings with 3 or less units) , . Minnegasco mechanical ventilation form a1 II 7 s m ?.. { ? r Plans are considered public information= unless you s.itatc they are trade secret and the e b n. y- 1 1 2 / - ®(`3 Construction Cost Date 3 `3 f3.r 6A A 00 4 T r, Unit/Ste # Site Address h Description of Work 0 LC f de - l r, 61-a e, vt?Li vi C - oe' Multi-Family Bldg - Y J[ N Fireplace(s) 0 - tr''1 2 - Property Owner c o,1 1 - 4 c ( 4 - I i ? ? , c n J? r O f Z-- Telephone # (( 6l) (n li` b q Contractor r" V O V 2' Address State City Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota R7672 Minnesota Rules 7670 Cats o 1 - New MEnergy innesota Rules u Code Worksheet Energy Code Category . Residential Ventilation Category I Worksheet • Submitted ('I submission type) Submitted Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # Telephone # ( I hereby apply fora Residential Building 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 the State of MN Statutes; 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 Applicant's Signature U2U14iIJ File No. Exhibit PROPERTY SKETCH (This is not a survey) REVI 1A - t- W S- © 01 co : O.Ia©?2 c3Ptst?tx S N 32 T ii 28 't Fe M Date -7 Z' STORY a .?.,.. ?.....__ 20 er FRAME ° EAGAN ENGINEERING DEPT. 2 CAR 25 co 2' 23 ° DR. UT. ESMT. °_ 75.00' =e) 1qt BRADDOCK TR. \ock i.. - 11337 BRADDOCK TR. EAGAN Property Address "The location of the improvements shown on this drawing are approximate and are based on a visual inspection of the premises. The lot dimensions are taken from the recorded plat or county records. This drawing is for informational purposes and should not be used as a survey. it does not constitute a liability of the company and is Intended for mortgage purposes only." POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS Address: Applican t Name: SGJ £ K0,Al e.e? krdl,,z U GENERAL INFORMATION o z ¢ ? ? Applicant name and contact information ? ? Property owner name ? ? Address of property ,III ? ? North arrow, scale (1" = 30' or 40') JA ? ? Site Plan, drawn to scale showing location of house, pool, and other existing or proposed structures, including retaining walls. ? ? Location and name of all streets adjacent to property JAr ? ? Directional drainage arrows (existing and proposed) ELEVATIONS Existing Ja ? ? House corners ET ? ? a ? ? Property corners If applicable, ground elevation at each end of retaining walls and at wall's greatest height Proposed ? ,21 ? Finished pool deck corners ? ;' ? Top of proposed retaining walls (if any) and at each different elevation (if it changes) W ? ? Pool bottom (or max. depth) DIMENSIONS Existing .l ? ? All property/lot lines ? ? All Easements on the property Proposed „Z ? ? Pool ? 21 ? Pool plus integrated deck/patio 0 ? ? Shortest distance from outside edge of pool Reviewed: lot lines and house Date G:FORMS/Pool Permit Checklist/02-13-07 PERMIT City of Eagan Permit Type:Building Permit Number:EA117131 Date Issued:10/15/2013 Permit Category:ePermit Site Address: 4337 Braddock Tr Lot:11 Block: 4 Addition: Lexington Pointe PID:10-45070-04-110 Use: Description: Sub Type:Reroof & Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 12,000.00 Fee Summary:BL - Base Fee $12K $221.25 0801.4085 Surcharge - Based on Valuation $12K $6.00 9001.2195 $227.25 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 - Scott A Kranz 4337 Braddock Tr Eagan MN 55123 (651) 688-6484 Ryan Windows & Siding Box 5937 Rochester MN 55903 (507) 281-6363 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA164158 Date Issued:09/21/2020 Permit Category:ePermit Site Address: 4337 Braddock Tr Lot:11 Block: 4 Addition: Lexington Pointe PID:10-45070-04-110 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 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 - Scott A Kranz 4337 Braddock Tr Eagan MN 55123 Haley Comfort Systems 3708 Broadway Ave N Rochester MN 55906 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature