3822 Bridgewater DrCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
PERMIT
City of Eaan
Site Address: 3822 Bridgewater Dr
Lot: 6 Block: 2 Addition: The Oaks of Bridgewater 1st
PID:10- 75835- 060 -02
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Fee Summary:
Contractor:
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746 -5200
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
- Applicant -
$50.50
Owner:
Stephen J Beseke
3822 Bridgewater Dr
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
Issued By: Signature
Mechanical
EA091491
10/07/2009
ePermit
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
. INSPECTION RECORD
' CIT'1?' OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: APPLICANT:
??o-szx ?ar=u,?-?t ?.,nrr?• [,ra ?.uucs r:u
Ilil. ??hY:?. Ui lilrilrli f`t.tpfLit Ir,;,'Y Ti!- 3?.??3
PERMIT SJ?1?BTYPE: TYPE OF WORK:
Control No.
1111 i r n, r,ri
c+tr 1 uh„
0 7/?-'l
rvr:u
INSPECTION
r4 111 1 1 r4 1 t D. .
t?v f,ia1 ta6 ..
iroui n+. I fj N r trlni.
riurt?i nL r.
I
L
•?.,;i.a f'i Ish .. 1 111!MP•11IM i>t lst.;
Permit No. Permit Holtler Dete Telephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Foolings I j I '
Foundation
Framing ?, _CfZ
Roofing
Rough Plbg.
(
Rough Hig.
Isul.
Fireplece
!
Final Htg.
Orsat Test
!
Final PI6g.
/. - I/-6- 3- e7
?I g Insp?ector NoiPlu ber
Const. Meter
EngclPlan
Bldg. Final /
/,?
Deck Ftg.
Dack Final
Well
Pr. Disp.
?
Address 3892 BUTD=oM pu117F Zip 5512 3
Lo4 -. 6• Blk 9 Sub THE onxs oF sxrocEwnm
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 23 93 Yes No Inspector:
Final grade (6" from siding) ?j
Permanent steps (garage) i?
Permanent steps (main eniry) L/
Permanent dtiveway ?
Permanent gas ?
Sod/Seeded grass v
TraiUcurb damage ?
Porch i/
Basement finish ?
Deck
Please verify with the builder lhe removal of roof test caps from the plumbing syscem and the shuhoff of water supply to
the outside lawn fauce[ before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
K
9? X
4
,C a?
9 8 4
Request Date "• Fire No. FOUgM1-in In dion
Requiretl?
? Reatly NowXWill Notily Inspettor
?? ^?? es _ No When RaeOy?
I?Klicensed contracror ? owner hereby request inspection of above electrical work at:
JoD AEtlress ISUBeI. Brn or Route NoJ
22 , `? a,t ? ??^. Ciry
c?
SeCtlon No. Township Name w No. Fange Na. Counry
?
OccupantlPRINT?
a vC.c s Cu?(d
Go . Phone Na.
Power SupPlier
t?a L(cof-P C-I ecfrlc,
1 Atl
4 Eress
-3oo-2--L
o {?, St , CUe. s
Elecvical ConVactor lCompany Name)
? Contacror§ Llcense No.
r
l . ? . ? ? 60
MaiLn9 Atltlress ICOnireda or Own Maxing In letan)
2? ? ?- .?-e, ?-F?
Sf,
?'a , 1 ? r ! e
Aulhorizgp SignaWre ICOnVa1dor/Owner Making Installa4onl
R,? VV-p- V??Y? Phone Number
MINNESOTA STRTE BOAflD OF ELECTRICITY I. •hCf. .a I? (
Grl s-MWway BI
gg tlg. - Hoom S113
?
1821 Unlverelty Am.. SL Peul. MN 5510C
Phone (612) 6Gf-0800 ?? ? ?
THIS INSPECTION REOUEST WILL NOT
BE ACCEPTED BY THE STATE BOARO
UNLESS PROPER INSPECTION PEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION °?'? es.oo?om"on9
? See Inshuaions foi compleling Ihis torm on back M yellow copy. ?i
16 9 9 2 "X" Belaw Work Covered by This Request ?7 ? 123Z
?
e Add Rep. Type of Building AppliancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Heater Eleciric Heating
Apt Building Dryer Other.(Specity)
Comm./Industrial Fumace
Farm Air Conditioner
Othar (syaciyl CanlradOrS Remarks: ` '
Compute fnspection Fee Below: Iv ew t,? ?c 2-OO A
# Other Fee A ServiceEnirenceSize Fee N Cirouils/Feetlers Fee
Swimming Pool 0 to 200 Amps , 00 F 0 to 700 Amps Q, ?
Trensformers A6ove 200 _ AmpS Abo+re Amps , Od
Signs Inspecmr5 use Only:
/ 6 TOTAL
Irrigation Booms ?
??O 06190
90
Speciallnspection
Aiarm/Communication THtS INSTALLATION MAY BE ORDER DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONTMS.
I, ihe Electrical Inspector, hereby
certify that the above inspection has
been made. Rouqn-in
Final
/
e
OFFICE USE ONLY
TM1is request voiE 18 monMS Irom
F CITY OF EAGAN
. X3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
DESCRIPTION:
?
PERMIT
PERMIT TYPE;
Permit Number:
Date Issued:
3822 BRIDGEWATER DR
LOT: 6 BLOCK: 2
THE OAKS OF BRIDGEWATER
SuiIdi,ng Perrnit Type SF DW6
Buijding,Work 7ype NEW
UBC aceupanCy R-3 M-1
ConsZructi4n'vType VN
Zoning R-i
8uilding Length
Buildi.nq 'Width
60
63
4.?..s ??"' I? ?.,' t;`-JL1K• ?xs
REMARKS:
RECEIPT «CDaa--
S&W PLBR - THQMPSON PLB6
BUILDIN6
001067
07/21/92
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Un3ts
Subtotal
VALUATZON
$176,fD00
$905.50
$588.58
$88.@0
$7@0.00
100
1
$2,282.08
CONTRACTOR: - a p p 1i
CUDD CO
1802 WOODDALE DR
WOODBURY MN 55125
(612) 731-3153
MISC FEES $1=610.50
Total Fee $3,892.58
cant - ST. LICp?yNER:
17313153 0003945 CUDD CD CHARLES
1802 WOODDALE DR
WOODBURY MM 55337
(612)731-3153
? I
Z hereiay aeknawlvdge thaC 2 have reast tMis aPP3.icatitrrr aa-id stAte tk+at the
infnr+natlan is cerrecL and ogree to comply witb mi1 apPi3cable StatB of Nn.
Statutes and C3ty nf Eagarr Ord::Cnances.
L .. _ ?
APPLICANT/PERMITEE SIGNATURE ? ISSUED Y: SIG RE
TNCP1P.(''TT(1N 12F.(`'(1RTl I Control No.
Control No.
, IT f ?
-
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
9d.
JUL 1 4 RECD
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural_8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typini of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date '1-14-012 Yaluation of wark !o'It 4-aV
Site Address: 3FZy P?¢?r?cWcrrp?.. A2??/C
STREET STE f -
Tenant Name: (commercial only)
T
LOT BLOCK ?- SUBp, V.I.D. Y
Descri tion of work:
The applicant is: ? Owner 9 Contractor ? Other <oezcrtne>
Name c--yPMS R<b 6taJ'fG.^LT=?2 Phone "13l - 3i ?'iZ-
property
*O LA51 FIRS,
wner
Address T60z:YZ WDc?GC??E., Ga2
. STREEi STE f
?533?
City W?esva-`y' State Mt-3 ' Z i p
Company Gs,,O 0 4e2. Phone 'f
C011tfeCtOf Address I ft702 WOOflP?2_. License # Cb3'0l44 Exp. 3 31 ?
City State Mti) Zip ,*5 :5-1
Company ?rn? f? A2,?? Phone
ArchitecU
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber TV4flMP5orJ PWMF'.>1?JC,!t . Processing time for
sewer & water permits is two days once area has been approved.
hereby acknowledge that I have read this application and state that #he information is
rrect and agree to comply with all applicable State of Minnesota 5tztutes and City af .
4
gan Ordinances. I
Signature of Applicant:
OFFICE USE ONLY
,
BUILDING PERMIT TYPE
O 01 Foundation
O OS Apt. Bldg 009 Basement fi i
nish O 13 Comm/Ind New .
0 02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool ? 14 Comrn/Ind Add
E3 03 Two family ? 01 Fireplace ? 11 Res. Add. ? 15 Comm/Ind Rem
? 04 Multi-fam. T.H. ? 08 Deck O 12 Res. Porch E3 16 Public Fac.
_ ? 17 Agricultural
WORK TYPE
0 31 New O 33 Alterations ? 35 Move
? 32 Addition O 34 Tenant Finish O 36 Demolish
GENERAL INFORMATION
tonst. (Actual) VN Basement sq. ft. /3 z 9 MWCC System
(All owable) v lst F1. sq. ft. City Water
UBC Occupancy ? 2nd F1. sq. ft. /z y PRV Required
Zoning ! Sq. Ft. total Booster Pump
i of Stories z Footprint Sq. ft. ' Fire Sprinkler
Len9th On-site well Census Code i0i
Depth On-site sewage SAC Code 0/1
APPROVALS
Planning Building Assessments
Engineering Yariance
REQUIRED INSPECTIONS ?
? Site 0 Footing 0 framing 13,Insulation
? Wallboard fa? Final ? Draintile ?'fireplace
Permit fee v.iuas;d,• s 6006
PlanhReview Bs»rr. d(?a
8xYy3=//33,i9
License z2 3zx zo 3=
MWCC SAC
c;ty sac G y
y? 16 3? ? z
Mater Conn. 13 ?.?, ?- sY 7 ??, s
Mater Meter
Acct. Deposit
S/W Permi t
S/W Surcharge 96,zYF, q2 ?-?-?
Treatment Pl.
Road Unit
Park Ded. z z% dfG -/oi z ? zkiy,r yS? ?(o 0,
Trails Ded.
Capies Other
Total : l2 yy,?.S3 = ?vSG3 z
sac %
SAC Units
i
rea (A) . . ... ......:. . .:.. _ .
Assembi . (Shaw calculations oniiprksheets - -(SqFtl : . U-Value U xA
,( 0'x of Total?Ceiling. •ea, ess ry ig t .., . ;..
I nsulated AFea:.Area'-See
`,i':? an;xar ?I '.: .r L :}S ..<'i . .
?
' ._..,? ?,.+d.
?
?
' f x 4„??
'
? ..'-+A?1}??.c
?
'
'
f?
F2min Area.QO%of-Totat
Ceilin Aiea.`See_Fi.2) 4
1
I,0 •?
?'° J,
?
?.
$. Sk li fits(From Pa e .7
" Other. (Describe)
l?I??. ? ? 3v?pl
?
? ,?r2 ^Ave'ra e-U-Value.'NxA7/(Al.kom"L"ine 1 :?_: ` . , =-.
*k'•*'?k ,'. I?? -?='"?`"`?`k "-
? V;
?'- -
3 ? Y)
R rced U-Value (FOr."one arM:tro•:family drellin9sant
,•, z-- ,,,. ( of otal Wa 1 Area;ess Window an
-
?
ea..Dooi
lrn
T?Oat66A
rea
S??'?' ` ?
'Yd"?
E
`QOY.f
? ?
m.Pa e
r
o
?
?
+
cW'" ?
"
'
7)
me
L
'*?"'' p,a,''
??'t?i;
`
o
?A
e
' ?0 •? ?r
$:0?' . `I`?.Y'?$
`
.
.
,. -
im J
r
ist
a.(See
Fi ..51 . ,
^ ,
n
a
y
r5
4
F"e9lace',Wall.
-
° on
' I?
?/ '
?3 ?
14
1
oundati
VfJall:(Above Grade
Less Window Area See Fi . 6) • ? -
?
x
W
<. . -
:
oundation Windowz (FromPa e 7)
? . :,._, _ . . :. ,_ ,....
ffier. (Descri6e) ' -
'-? - . , ..:.,.
"--'
ther: (Describe). . . . . . •?-. -? . . ?
a -rotai5 4cd?'4 ?**tk* ?i : i?l
5 Avera e U-Value. NxA)/tA1 GomLine 4-...
6 Repuired U-Value (FOr one and two family dxetlings only) *****k .11 **t***
If line 2 is less than tine 3, and line 5 is less than 11ne 5, Aroposed assemblies meei code
repuiremenis. If line 2 is greater than line 3, or tine 5 greater than line 6, complete the
folloring to determine aliernato U-Yalue for total exterior envelope.
a
0
? 7. Uz4 (Line I) + UxA (Line 4), +
0 8 Area (Line 1) x U-Value (Line 3)
x =
d
?
9
(L
4
E
w +rea
ine
I
) x U-Valut (Line 6) x
-
o
"Budaet", Line 8-F line 9 I
f-
If Line 7 is greater than Line lU, alter azsemblies as required so Line 7 dnes not exceed Line 10. ?
If Line 7 is less than Line 10, proposetl assemblie5 meet code requirements. .
1
, (caa.th"'attic a
f 1
R_
?
Interiar`Air Film''
Insulation 39..oa
wood Member y 31i
Continuous Vapbr Barrier 0.00.
Interior Fiaish e SZ
Iaterior Air Film .61
Total Assembly R-Value ys /G
Pssembly U-4alue (1/R) . a.2
Enter on Page 1
Foz additional roof assemblies, see pages 3 and S.
2
Figure lA
Y
Ceiling/Roof Insulated Area: S4- Ft.
(without attic aiea) ---
R-Va1ue
3
a
Assembly II-Value (1/R)
Enter on Page 1
For additional roof assemblies, see pages 2 and 8_
Figure 3
Exposed Wall Insulated Area: Sq. Ft.
R-4alue
Interior Air Film .68
Znterior, Finish
Continuous' Vapor Barrier 0.00
I
`
Insulation I 9. od <
Sheathing o G 2
?.,
ExteziorZEiuish
z. , . _
. . . ._
. . .
"
.: . ..14i.. . . . .
Total Assembly R Value .' y ...a. ..
.
?
.,_ . -
Ass embly II Value`- (T/R) "?';•- . ' . Os?"
.
.
,?,:. ,..:.
. . . _Enter_ on Page , l ,...,.. , _,
C f
Figure 4. Exposed.Wa11 Framing Area:- Z?3?K Sq Ft.'
? .
_, . .,. . . . :.._ . _
: . , >•, R-Value
€.
4
Assembly [I-Value (1/R)
Enger on Page 1
For additional wall assemblies, see page B_
J -1
Figure 5 Exposed Wall Rim Joist Area: 4fTi Sq. Ft.
R-Value
Iaterior Air Film .68
rVapor Barrier"t 0.00
}
? Insulation
,.
94 ?VI
Wood.Member ..; ?_ ... :
r
,
,>.
t ?
..
7 7
m,?? Total*Assemblq, R Value Z'Z _ ? s' y
?
Assembly II Value (1/x) ` O?/ "` ; _
n
Eater on Page 1 _
, ...: ...? _
Hotes: , l)Flooss oves nnheated+'spaces: For floors of,heated~;:or mechanically
t e' - spac f?7.?es??r w?lu?t ?eeed Oe05:' the overaiZ-II.-Value
- :'"-For floors over outdoo
air, snch as overhaa4s..t1?e overall B-value for the floor
sha11 meet the same rez,;remeat as for rooEs, II-Value of
` 0.04.- .? r.,
21 Slab-on-qrade floors•: For slab-oa-4rade, the insulation
around the perimetez o£'.the exposed(.floor shall haoe
miaimum 8-valne of 6.4The insnlation must extead downward
+ from the top of the slab am;,,;mum of 316" or.downward'
• to the bottom of the slab thea hcrizoatally beneath the `
slab for an eqaivalent distance.
3) Vapor baniers. The Ts:;mwn Perm rating for the vapor
barrier is 0.1_ A miaimum cf 4 mi-1 polyetheline, or equal,
is reguired-to achieve this. The vapor barrier must be .-
continnoas stith all joints overlapped and made over framinq
members or blocking_ 4) For notes on foundation wall see page 6_
5) For additional assemblies not illustrated use worksheet
on page S.
5
. F.
Fxwre 6 Exposed Foundation Wall Area _.
Concrete Slock or Poured - Wood £ounda 'on Insulated
Cosscrete Foundation Area: Sq. £t. Area: Sq. Ft.
./YY-( . R-Value ' 1 ? ? ,?
In[erior Air Film •b? ?
_ s
Continuous Vapor Barrier, 0:00 ?
Foundation Wall
; I ! S, ao
? ,Insulation
^?
a 17 ? , ? c ?c<?' ?
" Excerior, AFilm ? .
r rx?'?t?? ,s,
?„ ,?,tF K, , ? , . ,; • .? -'-W r_ .F I _
ly " R-Value?? "`
Total`Assemb
z ,
. . u
-? - n " Page,
EnterlYon
?
C-
?:i .
.r z• ?/ e .. , ' N R i# Y t(?n... .Ye _ ..
N i
Noces i) Only,the'abore grade area af ehe'[oandatioarall u ,xu be iacluded an the enerSY ulculmtions ° ? z ?<? ?oC
?! ..
2),She7Eaer;y Code?ieqnires tLas;if;;the floorabova thq ^.
r bueaens or crsvlsPue. is aotiasvlued??. the founda 0
ioavalI`musc•be-insulatad =Eisher,shefoundacioa ; . ?O?
ansc hive?i ?iafmun 0.-10,iasulatioa applied cron she':; •#? .?)
,-top,of she, fouadation to t4e frnst line or a miaimum, _
,
,. .... , ' r ?R<S?insulaciaa.applied.ovea-the:.eatirefoundation 000
The+R-Yalue specifud is for the insulanon ,.
S)?If rid;id foam iasulition is co be appliedto 2he ?J-,o000 0o
--eznerior af the foundscion wall, nhe aborc grade
:ponioa avss bo- prottesed Erom che sua, the reachez ? p o0?00 0O pD
. - . . ' aad pitYsical abuse. p DOO??, t9
1)If rid;id faaa -insulasioais to 6e anplied so tde
- iacerioz, it nuss be prntecsed by miniaum 1/Z^ Vp.
` board or equal (az zpeeified in secciaa 1:12 oE the -
-- Uaifazm HnildiaY Code). . . . . :?. ' .
.5). Fouadasion rall'.insulatian £or vood £oundations .nss
6e inscalled asspecified by.the Nacioaal Forest
. 'Products Aszociasioa's Oesign Maaual• -. . ? .
s _ . . - .' .. :
Wood Founda ' n Framed
Area: Sq. Ft.
R-Value
- P.ssembly U-Value (1/A)
Enter on Page
b:
?r?- -?-r---- . - , -
TY? a
Z
'
4
t kt '
?
Skvlio '
.... .?. ..:?." ?
>Y
Ooors
. -. ,,` ?-. . , . . :? •
SKYLIGHT, WINDOW ANO DOOR ASSEMBLIES
i! 1 x
,T)? ; m
ManufaCUre
. ? - ?Ax
?Z ?Sw'}"`t"£' 1911 v a ;'e?k. 'WEC xs ?w+a»ri ps.uv ;?? , ?.
???._ t ._ '..y`?•`?,' j}Y!"411?FG6'. d1 Y 1. ?? `??_ ''??i?yr ??-?'.' ?.?? ?f1'.Sx ,? ........ ----
" y
?
.
krr
. . '-.
'
a . .;
.
.
....:_ ?z,
_ .
. . ?.,>, , . , . .t. .:
. `
.. .? .:
?.. ,. . . __ ?.. ,, .
. ,. _._ ..-... .. _:? . _ .,
?
?
'
" a
°:.IU=1/R
l
V
" -
?9,, •
ndaw' MamufaMse
MamuFaeture No.
Na. Used ?
Arci fA)
Tatal Sash
a
ue
R-
?,??
` P?3 3
?.
R-Valtu Storm Doa ( Door ll-Value UzA
Tatai Door.Area SN Ooor (lE llse? Assemhl U=1/R
Manufacture Size Na. Used I
?? 1 1?3z
e
??.13n I ? I ,? I 1144.rre
2e l ? 1"J, bl ? 14.8 ? ? ?, 0'1 ? 1•Z
7
7"t r 3:?e xy? v cai #-, .
? ?.
. _".- .... .. . ? ? '
SURVEYOR'S CERTIFICATE SIENNA CORPORATION
REVISED 3-21-91
TO yWpW
PROPO6ED HOt4E FOR
CHAIPLE9 CUDD CO.
REvISED 4-8-91
I GAR, LEF7']
It a0 yl
? 25
'
? 010.2 30.0
0
?
a
F
N
x
0
u
?
¢
W
O
2
v
1 s2ao -
I 10
M ?
LA ? .,. _ ._..
v? I
$
1
?
eEXCN .MARN
TOI' OFMrC
lICV.•914.9T
1Q.0Q
C?
?
sas°4s'o7"E
'._.,.• are.i ?
. tA
d 1
? . ..ZGb 5.. Q n nob.a
0
I' a
•I . - - ?.? ._ i
I ?? I <
i2o
I
? (?TNs
54
6 ?? ?
D12d y N '
9I3.9 919.e+ • 30.00 - 34,25
25 ?ry?pb) i4?oT?oy?? M.?K
5?°48'o7°E
NO7E: BULpING OiMETlSIONS SHpWN ARE FDR HO IZONT'
9 VERpCAL LOCA710N OF $TRUCTURE ONLY.
. Aq(y{ITECTUAI PLANS FOR BVILDiN6 d iOUN TION
DIMENSpNS.
NOTE: NO SPECFIC SDILS INVESTGATION HAS BEEN COMPLETED
ON THIS LOT BY TyE SURVEYOR. TYE SUITA81LfTY DF
SOiLS TO SUCPORT THE SPECIFIC }10VSE PROPp3ED IS
k0T 7HE RESPONSIBILITY OF THE SUR4fYOIL
+ DENOTES PROPOSED SURFACE DRAINAGE
15
903.2
?-
7%/
1
?
0 ?
L't
m c; f
-`n --
0
V)
c?
_q _
40
1 ? J
1 LJ
U?
O ?
?
U UENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
0 DENO7ES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 92 o 3 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - FEET
(000.0) DENOTES PROPOSED ELEVATION pROPOSED TOP OF BIOCK- 'yZa.'7 FEET
WE HEREBY CERTIFY70 SIENNA CORPORATION THAT THIS IS A TRUE AND COARECT
REPRESENTATION OF A SURVEY OF THE BQUNDARIES OF:
Lot 6,Block 2, THE OAKS OF BRIDGEWATER IST ADDITION, accordiriq to the
recorded plot ihereof, Aokota County, Minnesata.
IT UOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEP7 AS SHOWN. AS
SURVEYED BY ME OR UNOER MY OIRECT SUPERVISION THIS 22ND DAY OF JANUARY , 1991.
oun , vtrcu.pr nnt urs UNUtH MY UIHECT SUPERVISION THIS 22ND DAY OF JANUARY
• +?
APFf7pVED FOR SIENNA SIGNE : M S R HILL, INC.
CORPORATION
BY: eYC?
DA'fED: ,> JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
m ? T N ? W O ? ? ? - ?
?
oF
-41?
-0
?
?o z
i
NA
_ f m T
cn
N D
??
0 m z io ? c„ D p r? m z
?
x? ? Q z ? c; uZi ? ca
- - (0
V m ;
` - ?
1991. ,. ?
James R. Hi11, inc.
PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE S. • 61-00MlNU7UN, MN. 55431 • 612-884-3029
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date ? ! / 6L57
p
Site Street Address a/ Unit #
Property Owner SI-IfIre Telephone # (6.F?)
Contractor /G??zG'C Telephone# (p?Z).31372?
Address (l?Z2 q7y? J/- ,r
6 ° CityStatw/zx/ Zip?
?
The Applicant is: _ Owner Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_:Septic System Abandonment
Water Turn ound/ (add $125.00 if a 5/8" meter is required)
?Other. QS! //le//J
Water Softener Water Heater $ 15.00
_ new _ replacement
_ Lawn Irrigation _RPZ _PVB ?new _repair _rebuild $ Agkn-
State 5urcharge $ 50
Total $
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand th' s not a permit, but only an application for a
permit, work is not to start without a permit and work ill be in arowdance with the approved plan in
the event a plan is required to be reviewed and ap7t?
47DV'_ ?
Applieant's Printed Name Ap anYs Sign ure
._17i ;?" Sf qlrs
PERMIT
CIT'Y L-?F EAGAN
38?0 Pilot nob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMITTYPE: gusLnzNG
Permit Number: B 3 3 7 7 6
Date Issued: 1.0/2719 $
SITE ADDRESS:
G.I.N.: 10-75835-060-02
3822 aRxoGEwArER nR
L07: 6 BLOCK: 2
7FIE OFlKS OF E3RTLl6EWRTER 1ST
DESCRIPTION:
Bu,iccldirl4--,Permit Type
e a 1 d i n g d,r'"b^v?k T y p e
?nsus ?csde ?
. ..:-;t,. .
?? ?
?. Y t? ?•''`..
BASEMENT FIPdISH
ALTL"RATTUN
434 ALT. RESInEN7IRL
?
f r 1 j
e?-
REMARKS:
PLAN REVIEWED B'9 CRATG NOVFlCZYK.
SEpARATE PERMIT REQUIftECI FOR ANY PLUM6ING WORK.
CflIL 445-2840 REGflRDING ELECTRICRL PERMTT ANIJ INSPECTIONS.
FEE SUMMARY
BdHB F2P $50o00
Surcharga 60
Total Fee $5O.50
CONTRACTOR:
t
I
OWNER: ° ApPlicant -
JoMEs Jaavss
3522 BRIDGEWATER DR
EAGAN MN 55123
(651)495-0789
I herebY ackno•wZed9s CYtat 3 tlave read this appl3.ca.tiara anci staCe tMa'C `Ctte
.intnrmatiort %s correot and agree to camply with a1l ap{ala.ca4le State of Mrt„
Statutes and CjLty qf Eagarl Ordirri€aces,
--
?1?
APPLICANT EPMIT E SIGNATURE -?-3ISSUED eY: SIGNATURE
1998 Btl'ILDIh''G PERMIT APPLICATION (RESIDENTIAL) s 50'5D
New Construdion Reouirements
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
bsi.ab7s
? 3 registered site surveys
• 2 copies of plans (inGude beam 8 window sizes; poured fid. Cesign; etc.)
• 1 energy calculations
? 3 copies ot tree preservation plan 'rf lot plaKed aRer 7/1/93
required: _ Vas _ No
DATE: .10 -
DESCRIPTION OF WORK: bQ??en?
STREET ADDRESS:
RemodeVReoair Reauiremen"k?
j? 2 copies ot olan J?(S'? 4'!? Lt 5
?? 2 sRe surveys (extenor adaitions 8 decks)
? 1 energy wlculations for heated addRions
CONSTRUCTION COST; v.j( ? 20100-0
Drw i C?a?ao
LOT: & BLOCK: D- SUBD./P.I.D. #: -?-L UAA- &? n L A w cd?r, I,S+
?
PROPERTY
OWNER
j (?Oi'V??„S?? L/e??4l1$
Name: T t??-'fl?/U -Af% /2?&
Last First
C " L' l/j? q
Phone #: ! 0? -07? /
StreetAddress: L?ri-vPi
CONTRACTOR
ARCHITECT/
ENGINEER
Ciry State: Zip: ?1-:;13
Phone #:
Street Address: License 9
City
Stare:
Zip:
Company: Phone #:
Street
City
Sewer & water licensed plumber (new construction onty):
and lot change is requested once permit is issued.
Penalty applies when address chang
i hereby acknowledge that I have read this appliption and state that the information is correct and agree to comply with all applicabl
STate of Minnesota Statutes and City of Eagan Ordinancea
Signature of Applicant:
OFFICE USE ONLY RECEIVED
Certificates of Survey Received _ Yes _ No ???
Tree Preservation Plan Received _ Yes _ No _ Not Required BY
Registration #: _
State: Zip:
. . . . .. -------
--- --------------
8419 AIR CONDIR?Nl1?10 00.
5919 CEN'[ER DRM
, . • aoasa YMAT]arG TssT RscoxD -
;0DREESS ;m. R c.:? 5??
occ?Arrr ow????
EMPT_LOSS ?TG_SiiST.
SOLD 3° 72IS^_'ALLED 3Y
=...^ CTRSCAi, WOpa 3Y GAS L=Ivr, 3°
T`??E OF F"?.^Tn_' G? FA nF7 S'?'?is2d SPaCE ii'?_ DI4I'?' OT_^R
Gr'LS DESIGiI COIQVi:'tiSION
24WM . L^?ll /iX9?? u.gK.. OF 3IIRNER
?!ODEL. S - ?- MODEL.
SEP.I?.I; /475 '7 ?ia.X. 3TII R?TING
;*rD.IIT o u= or 'URb-a?
*SODEL,
?J CON'S'ROLS'
--== MCS_AM ?S,uG VENT SIZE 6?'
V?-LVE Gv l? /Zn??s RI2ID. OF LiN?'?2 SIZE NOIdE
LMZ'=" DRPF':" HOOD REGDT.aTOR -
LyMST58TTSNG .L/ X-C?J = T_LTG'BS . 5=Z :- 2{'.7??F1 NII2d9ER
?'?.N 5E'=_ING 25-i vcC// C--:.'a2:?° :,DC2TION I?QSiDr.. OIITSiDE -
PT ;p•r TYoc C`IHMt,T CONS='RIIC;'SON
?_TiO?' ?rAr_. .-UA/] +J' ?eGlilar.I.C"s
LC'' ?!ODE ; 52!O= 30Y8- W_:L?IG
?ZD_' ==m-ZNG / ?PG DRA.?T' ^"';ST' T?,G
L.W_ c= OFr DOOR. ?D,ESSi7ti?,'.' ° =Gn ?NG =NS=..
==?SSIIii3 P:.,rZCF..YT. C02 SS DFTE': 2'ESTED ? c?-29 - 9y
=*r??T 02. 7 co?Arrr ^Es._NC S;i
S _nC?' ':'E.u? 3 r t'7 ° ? :RC.?.'h = CO NAME. OF' ?'ESTER ?--
FORu 235 R-=_ 01 DP---= 8/1-5/90
/
•
?.
f
1990 BIIILDING PERMIT I
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
4e-7?
D
2 SETS OF PLANS 2 SETS OF PIANSk! 2 SET3,90 F1?ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SlAVEYS - RAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CRLCS
# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES iTHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS IlADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
f NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRE55 IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
lb To Be Used For: 56n?LE 1?4t,n,iLa? Valuation: ? Date: 3
Site Address 3822 ?i2.tD4?lticae? b21vE
Loc 6 slock Z
Parcel/Sub ?AKS oF `RR[p?4El.,La.7'C2 ISr
Owner GH-ARI.LS GuDD CA,
Address 1902- /.,JoooOAtt 7>2l6'e
City/Zip Code J{/od,nW&n? Mn/ SS-lZS?
Phone '73 l - 3 l s
Contractor c(-EAeLES GuOD GGo,
Address Sann.E
City/Zip Code
Phone
Arch./Engr.
? Address
City/Zip Code
4!? 7 000 OFFICE USE ONLY
FEES
occupancy
Zoning
Actual Const V- N Bldg. Permit
Allowable Y- N Surcharge
# of stories Plan Review
Length 70' SAC, City
Depth 3y, SAC, MWCC
S.F. Total Water Conn
Footprint S.F. Water Meter
Acct. Deposit
On site sewage_ S/W Permit
On site well S/W Surcharge
MWCC System t/ Treatment P1.
City water ? Road Unit
PRV _ Park Ded.
Booster Pump _ Copies
SUBTOTAL
APPROVALS Penalty
Planner TOTAL
Council
Bldg. Off.
Variance -
, I r;.r110
Phone 3t
VA?-uqT1DriJ
a? ? i 2 ?. zsz
36 k343 = I I u fl
?
POnG?? .
12}cI ?-l = 166 X ?P336o
I sr
[3s?,T = 13J 6
I 334 x 53= '7o9oZ
z rv b r-Lo ') ?2
30 y 3`3 = ??yo
b= sZ
__------
II?Zx s3= G3?'7?
1?? 3?t2
jr.
O,i? 16'7 vvo
r-,
.?
?
0
,
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-5100
91A?.;
FOR CITY IISE ONLY
PERMIT #
RECEZPT #
DATE:
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
----- --------------------
WORK DESCRIPTION
NEW CONST v
ADD ON
REPAIR
OWNER NAME:
SITE ADDRESS:
LOT: BIACK SUBD.
INSTALLER: SUBURBAN AIR CONDfl70NING CO.
ADDRES S: KNEAPOLA MINNESOTA 55438
CITY
ZIP:
PHONE #:
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
CO1?fEa?CiAT.?ZNT3GSiRIAT.-. PiEASE COMPLETE T&IS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDYNGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARR
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FEES
18 OF CONTRACT FEE.
STATE SunCiiAnvE a.50 FCR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
$
( S I GNAT[7RE )
FOR:
CITY OF EAGAN
UU
SUBTOTAL: $?
STATE SURCHARGE: .50
r,-I
l BL
SUBD
CITY OF EAGAN
PLUMBING PERMIT
(612) 681-4675
REBIDENTIAL
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT
DATE
AL50, FOR TOWNHOMES AND CONDOS
WORK DESCRIPTION
NEW CONST _
ADD ON _
REPAIR _
OWNER NAME: Charies Cuid 4nvne-5
SITE ADDRESS: 3822, Rd?qe w4er r._
INSTALLER: Swavisor? Plumbina ? I?e?ir?a. ?n1C
nnDRESS: 35"So Yerrni ffinn Uree}
CITY: ?ns`kno s ZIP; S.5-o33
PHONE jj:_ (612J 437- q2tir
STATE SURCHARGE .50
SIGNATURE OF PERMITTEE TOTAL: soI
-? •sv
r nnwvnnrar_ .
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS: _
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
1 SHOWER 3.00 3•°O
_3 WATER CIASET 3.00 q,oo
1 SATH TUB 3.00 Z_2?
+? IAVATORY 3.00 )z•60
1 KITCHEN SINK 3.00 3_ob
I IAUNDRY TRAY 3.00 3.00
I HOT TUB/SPA 3.00 3•rie
I WATER HEATER 3.00 .i.en
1 FLOOR DRAIN 3.00 3.ao
GAS PIPING OUT.
3 (MINIMUM - 1) 3.00 4.ao
_2? ROUGH OPENINGS 1.50 3.00
_ OTHER
-F- WATER SOFTENER
- 5.00
^^
1
5
5
d-
- PItYdATE 8-F&Y.
U.G, SPRINKLER e
?
_
3.00 •e
?
_ W. TURNAROUND 15.00
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
? n CITY USE ONLY ?±pn ry
? CO BL o? . ? RECEIPT #: 7 O 7 0? ?
SUBD. ? ?t- /`? RECEIPTDATE:
1998 PLUNIDING PERMIT (RESIDENTIAL)
CZTY OF EAGAN
3830.PILOT KNOB RD ..
EAGAP7, MA1 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
----- --------------------
FIXTURES -- - - - --------- - -
EACH
# TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet * minimum - 1 3.00 x =
Rough Openings 1.50 x =
WaterSoftener `fordwellingsunderconstruction 5.00 x =
Water Softener ' for existing dwelling 20.00 x =
U.G.Sprinkler 'fordwellingunderconst. 3.00 =
U.G. Sprinkler `torexistingdwelling 20.00 =
?Alterations " to existing residence 20.00
Water Turn Around 20.00 =
Private Disposal System ' MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems "Abandonment 20.00 =
RPZ (new installation only) 20.00 =
STATE SURCHARGE 50
TOTAL k ?D I C?;o
----------------------- ------------- ------ ---------- -------- ------•--•----------------•-----------
I hereby ecknowledge that I have resd this applicetion, state that the InPormation is correct, and agree to compty with all applicable City of Eagan ordinances.
It ie the applicanPs responsibility to notiTy the property owner that the City of Eagan assumes no liability for any damages caused by the City dunng its
normai operetional and maintenance aGivities to the facilities construded under this pertnit within Ciry propertylright-of-way/easement.
SITEADDRESS: 1%O? Orld°yvoaT?^ Prive• / t?A6,jkj
OWNERNAME: JGLY-VIS VOneS V-A- ?YiL `QV)
INSTALLER NAME: &'fC WYL1 ?Y_°Gl 0. Z' ? ELEPHONE #:
STREET ADDRESS:
CITY:
STATE:
SIGNATURE OF
yLl-r-F?oaS
ZIP:
CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1998
. . .. • G:
c? ? • 'i
WQL`tifiCRte nf CCC1tpQriC4
C it? o f Wagan
2-eparhnent of Zui[bing anocctivn
Thrs Certrfcate issued pursuunt to 1he requirements of the Uniform Building Code
certifiWn,q that at the time of issuance this structure was in compliance with the variou.r
ordinances of the City regulating burldrng constructron or use. Far the fullowing:
Use Classification: Bldg Permit Pk)_ 1067
Occupancy Type R3 ? f Zoning District R, Coa? ?
WOODUM
Owner ? ?? 1802
of Building ? Addmss
Building Address Localiry , ,
? 03/23/Q3
Date:
Building OtTicial
POST IN A CONSPICUOUS PLACE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
k--3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITE ADDRESS:
PERMIT SUBTYPE:
APPLICANT:
TYPE OF WORK:
?F 7
I
Permft Holder dffie Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inspectlon Oate Inap. Comments
FOOTINGS
FOUND
FRAMING
al
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
-
GAS SVC
TEST
INSUL
GYP80ARD
FIREPLACE U5
FIREPLACE
AI R TEST L /D
? y?
?
FINAL PLBG
F-
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
coNOUCTivm
TEST
HVDROSTATIC
TEST
BSMT R.I.
BSMT FINAI
DECK FTG
[DECK FINAL
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA131292
Date Issued:06/11/2015
Permit Category:ePermit
Site Address: 3822 Bridgewater Dr
Lot:6 Block: 2 Addition: The Oaks Of Bridgewater 1st
PID:10-75835-02-060
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Stephen J Beseke
3822 Bridgewater Dr
Eagan MN 55123
(651) 341-9826
Austin Remodeling Contractors
19306 Oelke Dr
Prior Lake MN 55372
(952) 441-7613
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r————————————————�
I For Office Use �
' � Permit#: ��� j
Clty of ����� ' ��'� �
� Permit Fee:
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: {651)675-5694 I Staff: I
I I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
„ , ��
�� - � � �
� � , Name: __ ��✓�� Phone:
�'�$��� �t ///��f
���� �� Address/City/Zip: .���Z /�id_��__„�� �i
� j � -
�� „ Y � �..: Applicantis: Owner Contractor
��f�
< °��.�t � ��� Description of work: S, �.�.�.v
�������� '
� �—
�:_` , Construction Cost: ��� Multi-Family Building: (Yes /No�
Company: � a ,.�s-� Contact: v<a c�
�' s�x� 4 4v _
�� � �* �
�'� � �� l�D 1�est
>�� � ��� � `� ` Address 2�/�O� City: /��
�i����:��"
� � ���.
`���� �_��� State: �it/Zip: �".S'/Zj/ Phone: �SZ-LL�•S',�mail: /��� �..�,.�,5._ �2fiCJ � �
�
,. �a�� ` License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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: II
Mechanical Contractor: Phone: ''
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
' �"�AS��,a��i'���'�(' ��t����S���5Y7���`�8t��������"����1'���l� PO���!#�'
t�i�il�fcr���{�l�f r�t�'�e����'�1����+��/c�`��`c��'�,�+1�n►�+�at�e s���C����'�o�"�",������
�,,, ,'.:. �, �y,,,:;.1 .,,,. f`�' .�i, . , ,.'..�,. ,,.: ,�„�,.,.�������4 , ..�:al+.�� ("� ��n � '�� I ,n�.R.,:..
CALL BEFORE YOU DIG. Ca11 Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hou�s
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.ora
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work autho�ized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
X � �� �vs� X f��
Applicant's Printed Name Applicant's Signature
Page 1 of 3