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4188 Amberleaf Tr RESIDENTIAL BUILDING PERMIT APPLICATION I', S CITY OF EAGAN VI1~ 3830 PILOT KNOB B RD RD - 55122 651-681-4675 $70,00 r New Construction Requirements RemodelfRegair Requirements . 3 registered site surveys showing sq. ft. of lot, sq, ft, of house; and all roofed areas . 2 copies of plan cd I i ej (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 711193 . Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE all 91~ V UATION (EXCLUDING LAND) K OB SITE ADDRESS til"f A'Gu xcf4 ~C 5~~ IF MULTI-FAMILY BUILDING, HOW MANY UNITS? 'PROPERTY OWNER I/~~GU ~r✓~- 1 }TYPE OF WORK &Q% $fl ~G%y~etit cXiLt~ ,gFIREPLACE(S) _0 D, 1 _2 _3 APPLICANT PHONE#5~1-12 36 0 ADDRESS ZIP CODE / PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Cod) Category _ MINNESOTA RULES 7670 CATEGORY I fn 1~ M f~ (check one Residential Ventilation Category 1 Worksheet Sub i lJ~ LS U l5 D - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted By ~l Plumbing Contractor: Phone Plumbing System Includes: Wafer Softener Lawn Sprinkler Ice: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical System Includes: Air Conditioning Pee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/01 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 118 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex PlbgA ' 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 2, oy0 Occupancy MC/ES System Census Code u 3 K Zoning City Water SAC Units Stories Booster Pump Nbr. of Units 6 Sq. Ft. PRV Nbr, of Bldgs ( Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. Footings (deck) X Final/No C.O. - Footings (addition) Plumbing Foundation X HVAC _ Drain Tile Roof Ice & Water Final _ Other `>l Framing - Pool _ Ftgs _ Air/Gas Tests -Final 2!~' Fireplace R.I. >r- Air Test Final _ Siding _ Stucco _ Stone Insulation - Windows (new/replacement) -----------------------APProved By rI 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 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: I 1 Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: 1 I t+1 111. , 19t!I , I F AI T( 1.p 1 1 PERMIT SUBTYPE: TYPE OF WORK: INSPECTION DATE INSPTR. INSPECTION TYPE DATE INSPTR. -l 1 1 r I . •1-all 1 i Itl, c6-? l 1 I'I IiM 1 f'. I.1 1_i111 V i1 I Ill: ANY 111 111411: 11.1- Irl : 1 1 I I, 11 AI 11 11 1 pC Permit No. Permit Holder Date Telephone A ELECTRIC C4te PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS Ile- FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL A&W S `5. GYP BOARD FIREPLACE FREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG i DECK FINAL v INSPECTION RECORD ` CITYOF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: i (612) 681-4675 SITE ADDRESS: APPLICANT: 1 II ~ t k. Ii J ~I 1' I ft III I I J:l H l:V" ! i PERMIT SUBTYPE: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. t, t t rJk, • 1 t:'. a " I I r i i {rl P1f.I 61 1'1 tll? U I I I I i WA 1 I io/A 1 I! Nis i F J Permit No. Permit Holder Date Telephone M ELECTRIC vz 0 00 PLUMBING HVAC -(k& ZAV !'Til:.. P.~ ~9Y'D017 Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING ZU1 PLBG AIR TEST ROUGH HEATING GAS SVC TEST C- 1 INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST /-TG FINAL PLBG U1b4 FINAL HTG L 0 ORSAT V TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL Address 4188 ArIBE A TsAn, Zip 5512_3_ LUt ' ' 16 Blk 1 Sub w Ev THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: 15r,1 9 Yes No Inspector: V Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas ✓ Sod/Seeded grass Trail/curb damage VI/ Porch Basement finish ✓ orte & m Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet 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 OFF'~ CEw1N9Y5 This reque t void IB moo hs from vahdalion dale pooled in his bo D 201-141 j/ PLEASE PRINT OR TYPE / D P.eque k Raugh.m inspectmn requ~red2 ea 10o Inspection Other Than Rough-In: Ready Now II Call J (You maxi call dre inspector whe rwdyl Dole Ready- 1, C licensed contractor ❑ owner hereby request inspection of the above electrical work at. Jab Address (5treel, Baa, or le No) I Gt~ Zip Code Secnan No Township Name or No Range No. fire No County __7711 p~nt Phone N. upplier C Address ~e 2 y'a ~a v-rnl , S z EI w4 Contramr Compon \ Conw d., Loense No Moarer Lc o. (Plant Elect. Only) Moibng Mdress hador or K7 Performing In ll.fi Z lv^1 Authodmd 5i not (Contranor or Owner P ormmg Inzrollanonl Phone No. EB- A-10 6/95 STATE BOARD COPY• SEE INSTRUCTIONS ON BACK OF YELLOWCOPY VIII IIBIIIII IIII iIII II III II I Ilillll MREQUEST FOR 181 Unisity innesot Stat Ave., d of ElecCicity Pau P MNT5~5104~/ 6. E s 0 2 0 1 1 4 1 1 * Phone (612) 642-0800 a p 95 Home Duplex Apt. Bldg. ~ihel': - New Addn Commercial Industrial Farm Remod Re air Air Cond. Htg Equip. Water Htr Load Mgmt. Other: D er Range Elec Heat Tem . Service V above the work covered by this request. Enter remarks in this space and on the bock of the white copy only. Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Clther Fee # Service Entrance Size Fee # Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps , a :0 to 100 Amps i Street Ltg./Traffic Sig. Above 200 Amps Above i nO_Amps Transformer/Generator INSPECTOR'S USE ONLY TOTAL !5~ Sign/Outline Ltg. Xfmr. S v Alarm/Remote Control Swimming Pool I hereb cedd ihot 1 ins eaed the eleen nllanon he on the dares anted Irrigation Boom Rooph.In l~✓--?3 Special Inspection 6 Final ( Investigative Fee rc THIS INSTALLATION MAY BE ORDERED DISCONNECTED MfWA 8 MONTHS. PERMIT x CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 030121 (612) 681-4675 Date Issued: 0 6 (0 9/ 9 7 SITE ADDRESS: 4188 AMBERLEAF TR LOT: 16 BLOCK: 1 ROONEY P.I.N.: 10-64560--160-01 DESCRIPTION: INCLUDES DECK E>JiIding,Permit Type sF ADDITION Building tJn-i-_kt Type NEW `CefistG C b d 434 ALT. REOtDENTIAL i. rr nt~~Il 1 ~Fr i{ r y i~•i .~"1 ,~Il rya Yom'- -,r`'° REMARKS: SEPARATE PERMITS REQUIRED FOR' ANY PLUMB11"G OR ELECTRICAL WORK FEE SUMMARY: VALUATION $14,000 Base Feiw $.:12.25 Plan Review $137.96 Surcharge °;7_70 Total Fee :j:357.21 CONTRACTOR: - Applicant: - ST. LIC. OWNER: RONCOR CONST CO 13885578 0002337 ST'ORCNAK VLADIMIR 1070.0 LYNDALE AVE S 4'138 AMBERLEAF TR BLOOMINGTON MN 55420 EAGAN MN (612) 88^u-5578 (612)405-0240 I hereby acknowledge that Y have read this_appli.cation and state that the information as correct and agrae to compjyy.with all applicable State of tln. Statutes and, City 0f Eagan fkrtl~rtanc~~, 4 ,~111111 M1' D/ I ~11.1~APPLICANTIPERMITEE SIGNATURE- ATUR CITY OF CACAN CASHIER: S TERMINAL NO: ::32 DATE: 06/09/97 TIME", J4::I.Sei?S 1D: NAMERONCOR CONSTRUCTION LNC 3210 9001 4188 AMRFRL EAF 21.2.25 3422 9001. 408 AMBERLEAF 137.96 21`,5 9001 409 AMBERL..EAF 7.00 e Total Receipt Amount: 35701 CRU 7 5074 USER ID: NANCY 3 I a I 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) l CITY OF EAGAN 3 S 7 a 3830 PILOT KNOB RD - 65122 681.4675 New Construction Reaulrements RemodelfReeair Reauirements .L /p ♦ 3 registered site surveys ♦ 2 copies of plan J ♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc) ♦ 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ t energy calculations for heated additions ♦ 3 copies of tree preservation plan if lot platted after 711/93 required: _Yes _ No DATE: CONSTRUCTION COST: 30 • d y DESCRIPTION OF WORK: a ~4 jc A4 14,6n Wl r--~~y ~ t STREET ADDRESS: r } - LOT BLOCK SUBD./P.I.D. I V / adl' ro; r _ PROPERTY Name: X40 RC jo Phone#: OWNER Street Address: cub v.>? L e q City: A w State: M w Zip: ~5 r a 3 CONTRACTOR Company: col"i CQv~ ~.vv-5 Phone#: Street Address: w '7 yv K w 1" kw 'c- License Mc*2 3 37 City: State: )V1 w Zip: _ 5-/a C, ARCHITECT/ Company: Phone ENGINEER Name: Registration M Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that 1 have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ` • OFFICE USE ONLY EIVED Certificates of Survey Received Yes No I'W 21 1997 Tree Preservation Plan Received _ Yes _ No _ Not Required ~uw m f3Y:------ - OFFICE USE ONLY - BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 _ plex ❑ 15 Deck WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 36 Move )k 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code V_ Census Bldg APPROVALS Census Unit 6- Planning Building -FM Engineering Variance Permit Fee Valuation: $ Surcharge 1T1 -r Plan Review License XJ(p X ~~/~a 2 O qlp . ~L) MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit I Z00 OO SNV Permit S/W Surcharge Treatment t Pl. ' 7OT?q-413, 24?(o . 00 Road Uni Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units PERMIT 6ea50 Z/& V CITY.OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 026782 (612) 681-4675 Date Issued: 12/01/95 SITE ADDRESS: 4188 AMBERLEAF TR LOT: 16 BLOCK: 1 ROONEY P.I.N.: 10-64560-160-01 DESCRIPTION: -r Building`Permit Type SF DWG Building Wor.k,Type NEW r'UBC occupancy R-3 Construction Ty{i`e V-N Zoning R-1 Building Length 69 Building Width 56 B41Iding stories 2 Feet 2,584 REMARKS: S & W PLBR - QUICKWAY EXCAVATING FEE SUMMARY: VALUATION $195,000 Base Fee $1,362.25 MISCELLANEOUS $1,892.50 Plan Review $476.79 Total Fee $4,679.04 Surcharge $97.50 SAC $850.00 SAC % 100 SAC Units 1 Subtotal $2,786.54 CONTRACTOR: - Applicant - ST. LIC. OWNER: LUNDGREN BROS CONST 14731231 0001413 LUNDGREN BROS CONST 935 E WAYZATA BLVD 935 E WAYZATA BLVD WAYZATA MN 55391 WAYZATA MN 55391 (612) 473-1231 (612)473-1231 E 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 Mn_. Statutes and City of Eagan Ordinances. ~ IMI~ APPLICANT/PERMITEE SIGNATURE ' ISSUED SIGNATURE INSPECTION RECORD CITY OFEAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 6 2 6 7 8 2 Eagan, Minnesota 55122-1897 Date Issued: 12/01/95 (612) 681-4675 SITEADDRESS:P.I.N.: 10-64560-160-01 APPLICANT: LOT: 16 BLOCK: 1 4188 AMBERLEAF TR LUNDGREN BROS CONST ROONEY (612) 473-1231 PERMIT SUBTYPE: TYPE OF WORK: SF DWG NEW INSPECTION TYPE DDATE INSPTR. INSPECTION TYPE DATE INSPTR. FOOTINGS FOUNDATION FRAMING ROOFING NSULATION FIREPLACE OUGH IN PLBG ROUGH IN HTG INAL PLBG FINAL REMARKS: S & W PLBR - QUICKWAY EXCAVATING : ~u ~~n~ CITY OF EAGAN 44, Glq C4 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) Co 681-4675 New Construction Reauirements Remodel/Repair Reauirements ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window saes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions 8 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 DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: f~ STREET ADDRESS: LOT BLOCK SUBD./P.I.D. PROPERTY Nam Phone OWNER Street A al(dress, City: State: Zip: 9 f CONTRACTOR Company: w Phone Street Address: V y License City: State: Zip' ARCHITECT! Company: Phone ENGINEER Name: - Registration Street Address City: State: Zip: Sewer & water licensed plumber. 6~-id4wx-7 Penalty applies when address change and lot change are requested once permits Issued. I hereby acknowledge that I have read this application and state the information is corre t~agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received No WCU a 7 1995 Tree Preservation Plan Received Yes No OFFICE USE ONLY r BUILDING PERMIT TYPE o 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging o 16 Basement Finish ~tS2 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex o 13 Garage/Accessory o 20 Public Facility ❑ 04 SF Porch o 09 12-plex o 14 Fireplace ❑ 21 Miscellaneous 0 05 SF Misc. ❑ 10 _ plex ❑ 15 Deck WORK TYPE 31 New o 33 Alterations o 36 Move ❑ 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const_ (Actual)!la Basement sq. ft MC/WS System (Allowable) N Main level sq. ft. 1021 City Water UBC Occupancy 3 _1,sq. ft, GoZS Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length m9.33 sq. ft. Census Code. Depth S/o Footprint sq. ft. z, $&K SAC Code of Census Bldg i APPROVALS 5ov t1) 0 Census Unit / wl ~.ih Planning Building Engineering Variance Permit Fee Valuation: $ 00 0 Surcharge Plan Review A~N I ~f.wr License MC/WS SAC o^`f8 1~~11 City SAC ~r y Water Conn. 15, 7f/ L7) Water Meter Z r ii. = zS L Acct. Deposit 3D,r, 3.33 = ~o° Ul fj U l SIW Permit (war y ~sX Z zv SM Surcharge o7 / ii n 53 ~/N 1NC15 ' I6 ° i/ n = /~iF 2s"= Treatment PI. y y y?s~ Road Unit / G 2/x Park Ded. g y ?3'/ _ fso!" ~~S = dZZ ~r= Trails Ded. Zy 33° Other Z Copies 3o7y S~ Total: 967,0 ~~33 = Z/x 3 y- 7~Y %SAC ~o,f~5•l7~ ' CFA /x x,33. 9 SAC Units /~o29x _ ~ Zy X32 72--7 -f ` 41 2422 Enterprise Drive " (812) 881-1914 fAX:681-348 * PIONEER LANG SJRVMRS • CMI, ENGINEERS an ihi erin0 LAW ° NERS• LANDSCAPE ARCRITEOrs 625 Highway 10 N.E. * k Blaine, MN 55434 4t (812) 783-1880 FAX-703-1883 Certificate of Survey for: LUNDGREN BROS. CONSTRUCTION 907.0 Q 4188 AMBERLEAF TRAIL 9.5 907.6 E AMeFjQ A G - TEL V. CIF CATv 5 j /~~p R t iJ r U \ ~o i a W NV.-Ie396.9 S~~• 906.5 DATE 1~a 906.5 17 ~A0x. * 907. 907, 3 BENCHMARK TOP ELEV 919. 08 91 7 ~JAAd\~ -1 5 O v3 BENCHMARK TOP OF IRON L,i` x 09.0 ELEV=912.03 5 rf z.g~ r ~x A0 /34,66 (0 -----r - 91 Q. ~y9126 I , 1 75 ri fE1 `I ~I o a.33 a v zz^ 918.61 y w n P 922.7 F 920.d- w dy N In m 1 00 y0, 1> 5, 2.67 a' a r 5 922.0 j 000/ 23.33 q 918.1 922.3 922,0 919.9 4.0 I '/1, °w} (z%.v) 4T 0 o N na ii p19.67 ¢ / a; 920.78 (920.9) x L~31 Q ao 920.4 1888 919. w 21,330 r t 918.8 0 1 919.5 1 16 919.2 920.5 18 w 92 .1 x~(gzo.3) CA/jy UP S 'AGE AN 71CITy 919.5 N Ir\C ll i V 5EA W N7' EWNT O U IJ V R PLAT By 921.2 ^ D _ y 2 r z) S77`46 2 E,erAN E CzINEERl~i1G DEFT. 19 67 966 19.4 NOTE: PROPOSED GRADES SHOWN PER GRADING PLAN BY. PIONEER ENGINEERING ~PROPOSED HOUSE ELEVATION NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAL AND VERTICAL LOCAIIQN Ci+3 OF STRUCTURES ONLY, SEE ARCHITECTUAL PLANS FOR BUILDING AND 1 LOWEST FLOOR ELEVATION: FOUNDATION DIMENSIONS. t TOP OF BLOCK ELEVATION: 2 1,5 NOTE' NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE 9 zD, SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT THE SPECIFIC HOUSE GARAGE SLAB ELEVATION: PROPOSED IS NOT THE RESPONSIBILITY OF THE SURVEYOR. NOTE: THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN x OOO.DO DENOTES EXISTINC ELEVATION THOSE SHOWN ON THE RECORDED PLAT. ( 000.00 ) DENOTES PROPOSED ELEVATION DENOTES DRAINAGE AND UTIUTY EASEMENT NOTE: CONTRACTOR MUST VERIFY DRIVEWAY OESICN. - - DENOTES DRAINAGE F1 OW DIRECTION NOTE: BEARINGS SHOWN ARE BASED ON AN ASSUMED DATUM • DENOTES MONUMENT -B DENOTES OFFSET HUB WE HEREBY CERTIFY TO LUNDGREN BROS. CONSTRUCTION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: LOT 16, BLOCK 1, ROONEY ADDITION DAKOTA COUNTY, MINNESOTA IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY MF OR UNDER MY DIRECT SUPERVISION THIS 25TH DAY OF OCT., 1995. R£V156D Ho1.s£ roc. h-9-aS" IGNED: PIONEER :ZtERINC P.A. SCALE : 1 INCH 30 FEET 037 94322,12 BJM ohn C. Larson. L.S. Reg. No. 19828 T0'd LOT SURVEY CHECKLIST FOR RESIDENTIAL o' BUILDING PERMIT APPUCA3;ION W m W PROPERTY LEGAL: G W V W a W DATE OF SURVEY: W ~ m LATEST REVISION: a s s DOCUMENT STANDARDS ❑ • Registered Land Surveyor signature and company 0,-'0 ❑ • Building Permit Applicant ❑ ❑ • Legal description 6' ❑ ❑ • Address ❑ North arrow and scale ❑ • House type (rambler, walkout, split w/o, split entry, lookout, etc.) ❑ Directional drainage arrows with slope/gradient % ❑ ❑ • Proposed/existing sewer and water services & invert elevation Street name p~ ❑ ❑ • Driveway ELEVATIONS Existing t]-'❑ ❑ Property comers M1 ❑ ❑ • Top of curb at the driveway ❑ C❑ • Elevations of any existing adjacent homes Proposed ff' ❑ ❑ • Garage floor Cr ❑ ❑ • First floor e' ❑ ❑ • Lowest exposed elevation (walkouttwindow) ❑ • Property comers ❑ • Front and rear of home at the foundation PONDING AREA Of aoolicablel ❑ • Easement line e NWL HWL d • Pond # designation • Emergency Overflow Elevation DIMENSIONS ❑ . ❑ • Lot lines/Bearings & dimensions ❑ .'i❑ • Right-of-way and street width (to back of curb) ir~0 Proposed home dimensions including any proposed decks, overhangs greater than 7, porches, etc. p.e. all structures requiring permanent footings) ❑ ` ❑ Show all easements of record and any City utilities within those easements ar :J31 • Setbacks of proposed structure and sideyard setback of adjacent existing structures ❑ ' ❑ • ' Retaining wall requirements, ' y Reviewed: Na e / Date iuly'lws aw, 37.T 65.0' A' _18 T. 1-8"-45' BEN HYDRAN I 1 ♦ , .1/2 ``STA. 39`'- - 1 6"-22 3+ 37 -6 DIP, 27.5' ; 37.2' 111 , GND. EL. 9C r. LT ' 42.4' S=0+80 i X82 2' 6.8' I, 6 1T1H. EL. 90 17 INV=900.041 1 C.O."907.0 81.2' CS=910.041 INV=896.53 y AF6.T I~l L -45' BEND 16 1 1 14 95.0 4-----= .83.2 _ I s=1+21 1+77 I HYDRANT INV=896.9 / I S~ +S4 - -'+L~ 1 8"X 6" TEE - CS=906.9 11 INV=897.' gTp• 2+21 WI 8 8'_6"DIP, CL 52 CS=906.: GND. EL. 914.2 LT TNH. EL. 916.4 5=0+27 % it it 2 INV=905.23 ; fit 37.0' 18 CS=915.23 _ 917.~``- \ r M1m0+ 12 "-8"- - - 0. 6$ $9 905.10 A.1-8 - I INV=904.0 Imp- 915.10 29_2' 53.6 - MH ` STA. 0+39 15 sl:,= 81.5'--t o `•75.0' 1 2.37 RT S=0+26 482 ♦ INV=898.20 1+76 X 19 cs=9o8.20 ; i s=4+8o-. INV=904.0 ® END ; 1 1I ' , 1-8"-nn1~ ~ CS=907.0 ; ' UNDERGROUND POWER CONDUIT 45' BEND 42.5 ` 1-8" G.VsI,= r CIe CF G!-~G'lE ~j DOES t sC?1' G.~! /c UNDERGROUND IRRIGATION CONDUIT , ¢ UTILITY I_OGIITIC,^ ` Prr1lt~~rY %r4j,m REMOVE PLUG,'_CO~1NETHIS In STA. 0+42. ` EX W:M OSES O j T EXIST,::B";_DIP 4tiP - - SNOUL. . MH MH STA. 0+00 fl„"----------------------------- - - - - _-~1- -G_!_ t - dl-FOR-SA%TAV -WA7-Rl - / - E Y S SAN t. UNDERGROUND POWER CONDUIT 37 01 vv „u I Lill- I < < I 1 Ivnu `T A Tf A If, I II/,H II AI A vvulvl + inlL_ nlu fllvflvvnl o, W Bid' 4. BLS. 87'. GRQDD': ' ...1.5.78' 90g~ . MN R=.... ' fi ' :•j 0.~9• : ~ ~ MIN:.:.. • „6j tL 1 •GLJ: ,s`i,. •.1.iSy'A . ' ~ ~.~:~FCJJa~~yyl~,prc .+iflet^~ ~F, _ D.I.P; ~2 AjJt~~ BStSk•: i ~ - 104 . SDR rOA% 0- S 0. pR . 26 p4c 35 Go* .00 rn a. " MA z kSBU • R ~ •~~.~w~~~.~:~ u:.x::" ~ .~A~;;~ . Test _ :.~~z~:. ~ ~ ER,_ 2• gr(+RE`A510N5' 3 tgA4' ' SHEEN v E j'AR`( "SEW t q REV+SION Date PpT z LVIDGM BROS. EXTERIOR ENVELOPE AVERAGE U COMPUTATION UNION PLAN CONSTRUCTION INC. Site Address l~~~ 0t/41 ock / R & U Factors R U 935 E. Wayzata Blvd, Opaque Walls 043_ Wayzata Wall Framing Areas 09 Minnesota 55391 Ceiling Insluation Area 023 (612)473-1231 Ceiling Framing Area .027 Rim Joist .04 Masonry Wall .469 Windows .35 Doors .31 Skylights .55 1) Lower Level (Basement) Total Exposed Wall Area Opaque Wall Area X (U) .043 = Wood Frame Area X (U) .09 = Rim Joist X (U) .04 = Exposed Block /0 X (U) .132 = 14SZ Window Area Z/ X (U) .35 = Sliding Glass Door X (U) .35 = Door Area f X (U) .31 = Total ~7, el 2~ ~un~~REn BRO5. 2) First Or Main Floor CONSTRUCTION Total Exposed Wall Area INC. / pp Opaque Wall Area ~GcIC~ X (U) .043 = 3p,o9 Wood Frame Area X (U) .09 = ~d 2- Rim Joist X (U) .04 =/o/y.-(~/ Window Area -2 SU X (U) .35 = O 7 935 E. Wayzata Blvd. Wayzata Sliding Glass Door 4Z U X (U) 35 = Minnesola55391 Door Area ~0~0 X (U) .31 II• 7~ (612)4?3-1231 Total 71 3) Second Floor If Two Story Total Exposed Wall Area IY7'/ /D Opaque Wall Area _ X (U) .043 40 Wood Frame Area 0 X (U) .09 = ~~GGS 2 Window Area X (U) ,35 Sliding Glass Door X (U) .35 = Door Area X (U) .31 = Total ~3Df~ 4) Total Ceiling Area /SZ3 Wood Frame Area / S Z X (U) .027 = 4Z,~ Opaque Ceiling Area 1371 X (U) .023 = 3/,J 3 Skylight X (U) .55 = To to l 3~i ~0 3 LunDUEM BROS. CONSTRUCOON INC MINNESOTA U FACTORS Total Exposed Wall Area ~9I ZX .11 = ~~44 7 MINNESOTA U FACTORS Total Exposed Ceiling 3y Area X .026 = (A) Total = ~/p 3 f 935 E. Wayzala Blvd j Wayzata Item I Item 216~,;7j + Item 3133), I Item h Minnesola 55391 (612)413-1231 If Total Of Items 1-4 Is Less Than Item (A), Building Complies With SBC 6006 (C)s _ P _ 02 - .-_.k 2422 Enterprise Orive--- --X. * * Meadoto He,ghts. MN 55120 # ~fCINEER a au- c eqs - c n crwartc's (812) 681-1914 FAX.-681-948S 4R 9f'ng f1~8P` A w+o n.w..ua• w.ose..c .w Wa+a * 9 625 way 10 N, E. * Blainee. . MN 55434 # l` 'f (812) 783-1880 FAX:783-1883 TREE CERTIFICATION Certificate for: LUNDGREN BROS. CONSTRUCTION 1 9070 LOT 16, BLOCK 1, ROONEY ADDITION (AMBERLEAF) 4188 AMSERLEAF TRAIL. EAGAN MINNESOTA (DAKOTA COUNTY) z 907.6 CA 4E qM 1200 SF Woodland A 51^\\ ~O SER E T~'-q~i~ E~9F TQ N • j \ 906.5 1 7 ooi 1LM 01 t9r ~2 Ee4GAR1 fF®AESTRN DIME ION Proposed °?1 I • 907.3 Retaining Wall 401 1 R `#7 2 _o Location and M 1 ti ~~~1~~ SC LE 30' Configuration '-'j ♦ B ~(T 92 is Approximate) 915.9 (972-4) ~(9o9 0) • { 5 1 Jj •+w X34.66 BY r vc/ ,0 0 1x M n m 97 P. Fi .`X DATE W Protective Tree • N Fence-typ- 1918.6 a g12~) i azz 7 0> 267 1 W 00 23.3 ( "SF 1C 51 ~ is ~ ~ o a3 1 S 922.3 t ' - - X920 e; sue ' 3 °gg r' 2 S / x S\ --K--1- 7:33 m] 24. 918.6 ~ 919. f7, 7S / 9t9:5~ 1 ~ / 919-Oi x 18 New Lo ti p 919-$ q etfAN A. 5~ c®i SIGNIFICANT TREES ' -c /s /701 2W WHITE OAK (SAVE) 19 TE 67, 9 - #702 11- WHI1E OAK (SAM }020 1r WHRE OAK-TPL (SAVE-W/RETAINIRG WALL) #937 22- RED OAK (REMOVE-aw RLL IN cR2) 0943 210 RED OAK (SAVIO REVIEWED FOR TREE , A 4r WHITE OAK-DTI- (SAVE) TREE SlB 101!1 9 1r OAK (SAVO G zw DOXEWER VEMMOVE-HOUSE) ,r ELELM REMOVE M ( ' ) WMFUANU WOODLAND SAVED - 1200 SF 1= P!1_Y In SIG. TREES SAVED - e (60x) CF N' ELM (REMOW-Houso] SIG. TREES REMOVED - 4 (4071) (G STUMP (REMOVE)] TOTAL SG. - ItrTilam- [H-K 4-4r ELMS (SAVE)] Remove Trees 1 & K EL 0' ELM (SAM] ~ TREE MITIGATION - o D4-0 4-8' ELMS (SAVE)] R e' BOXELDER (REMOVE-LEANING) I hereby certify that this plan woo prepared by me or under my direct NOTE: E ] NOT INCLUDED supervision and that i am a duly registered Landscape Architect under IN TREE SUMMARY the laws of the State of Mlnnesoto SIGNED: PI EER ENGINEERING. P, s ' DATE: /o - 30 -y!~jr- a s2~L eras* Hegland, "i_A R 09-14b. 23520 Revised 11/13/95 S- f OWNER/DA ro37 Revised 1/15/95 (R. Wall Trees INK-Remove) 943222 /OiGt3/ L ( BL _L CITY USE ONLY RECEIPT ~ SUBD. DATE: 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681.4675 Please complete for: ► single family dwellings ► townhomes and condos when permits are required for each unit New construction Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: W ll~IAb EEE_$ ► Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ► HVAC: 0-100 M BTU 24.00 Additional 50 M BTU (X Z) 6.00 ► Gas Outlets (minimum of 1 required @ $3.00 eachK2) (0 Do ► State Surcharge .50 TOTAL SITE ADDRESS: OWNER NAME: K,( &U-\ a `4 ,r) PHONE INSTALLER NAME: STREET ADDRESS. CITY: STATE: ZIP: PHONE (lpI Z)~I~-~ - Q~ e CITY USE ONLY L BL RECEIPT SUBD. DATE: 1995 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► all commercial/industrial buildings. multi-family buildings when separate permits are required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ► $25.00 minimum fee 2[ 1% of contract price, whichever is greater. ► Processed piping - $25.00 ► State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR CITY USE ONLY 5~ 33 ~ 1~ BL ~ RECEIPT SUBD. DATE: 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► single family dwellings ► townhomes and condos when permits are required for each unit FIXTURES EACH NSL TOTAL Shower 3.00 x 0 Water Closet 3.00 x 3_ = 5 Bath Tub 3.00 x 2- Lavatory 3.00 x S 5 Kitchen Sink 3.00 x = 3.Of Laundry Tray 3.00 x / = 3 Hot Tub/Spa 3.00 x = Water Heater 3.00 x 2. _ (o• Floor Drain 3.00 x ! = 3 • Gas Piping Outlet * minimum - 1 3.00 x 2• = r Rough Openings 1.50 x 3 = . 15£' Water Softener 5.00 x = Private Disposal * Dakota Cty. license 50.00 = (new and refurbished systems) U.G. Sprinkler * home under const. 3.00 = Alterations * to existing 20.00 = Water Turn Around 20.00 $ $ ,So STATE SURCHARGE .50 TOTAL ~J 9 SITE ADDRESS: OWNER NAME: C-C:D INSTALLER NAME: ap'c „i ~-'-C- STREET ADDRESS: Sv C- CITY: S ink yr.~ STATE: /h.V - ZIP: PHONE ((~iL) `7 KS- -~~G2 ~?i OFFICE USE ONLY L BL RECEIPT M SUBD. DATE: 1996 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: w all commercial/industrial buildings. multi-family buildings when separate permits are not required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of ReLmd fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE. TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE* SIGNATURE: APPLICANT OFFICE USE ONLY METER SIZE: DATE: INSPECTOR: Ii I L BL CITY USE ONLY RECEIPT#: / '75 ~7/ 0 ~ SUED. RECEIPT DATE: 60 aT ~ 7 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 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 NO, 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 = Water Softener ' for dwellings under construction 5.00 x = Water Softener *for existing dwelling 20.00 x = U.G. Sprinkler ' for dwelling under const. 3.00 = ~gs U.G. Sprinkler 'forexisting dwelling 20.00 = o° Alterations 'to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' oak Cry lic. 75.00 = (new and refurbished systems) Private Disposal Systems "Abandonment 20.00 = STATE SURCHARGE .50 TOTAL 1 hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicanfa responsibiilty to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: OWNER NAME: V r0.Ctj MV- Stp r e KQL k - INSTALLER NAME: .r-y- D G Y/ TELEPHONE* 972- STREET AD~q/DRES--S: SSY 6~ y~ CITY: ~ee ' STATE: All- / - ZIP: GNATURE OF PERMITTEE PERMIT # U~ 553 RECEIPT DATE: MMENTIAL PLUMING PERMIT APPLICATION CffY OF FAsnN 3830 PILOT KNOB RD EAfiM, MN 551 EE 651-6$1-4695 Please complete for: ➢ single family dwellings ➢ townhomes and condos when permits are required for each unit ➢ backflow preventer for irrigation system SITEADDRESS: 0cq G t p OWNER NAME:: ✓ / +^02 ~ lZeZ TELEPHONE#: 64/ L (AREA CODE) INSTALLER NAME: TELEPHONE (AREA CODE) STREET ADDRESS: CITY: STATE: ZIP: Place a check mark next to the permit work type New residential dwelling unit under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existing dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • water turnaround Nature of work: Z7 ( '114_~ _ Septic System, new/refurbished - $ 225.00 • includes County & Consulting trispector fees • requires MPC license I~ f~ aril f~ r nn I~ ~Jf L~FEI~B f2 8~J21OY101 I State Surcharge _ J $ .50 Total Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that l have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/r' f-way-wayleas SIGNATURE OF PERMITTEE Updated 1/01 PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA088953 Eagan, MN 55122 . Date Issued: 04/29/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4188 Amberleaf Tr Lot: 16 Block: 1 Addition: Rooney PID 10-64560-160-01 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: BLT Services Inc SeIefura Storchak 305 - 8th Ave NW 4188 Amberleaf Tr Forest Lake MN 55025 Eagan MN 55123 (651) 755-5866 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA092569 Date Issued: 01/13/2010 OR Permit Category: ePermit of E3 E Site Address: 4188 Amberleaf Tr Lot: 16 Block: I Addition: Roonev PID:10-64560-160-01 Use: Description: Sub Type: e-Siding & Windows Doors Construction Type: Work Type: Siding & Windows doors Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: 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. Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing Fee Summary: BL - Base Fee S6K $132.75 0801.4085 Valuation: 6.000.00 Surcharge - Based on Valuation S6K $3.00 9001.2195 Total: $135.75 Contractor: - Applicant - Owner: BLT Services Inc Serefima Storchak 305 - 8th Ave NW 4188 Amberleaf Tr Forest Lake NIN 55025 Eagan NIN 55123 (651) 755-866 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 Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature Use BLUE or BLAGK Ink ' r-----------------� . I For Office Use � 1 �� U �� j Permit#: I � �c'/ � � �, I Permit Fee: � � 3830 Pilot Knob Road � � Eagan MN 55122 i Date Received: � Phone: (651)675-5675 � Staff: � Fax: (651)675-5694 �_ � 2074 RESIDEN�'IAL�PLUMBING PERMIT APPLICATION Date:��!��Site Address: �"��C� �'�� `� `r� ��C�ar(��2___ ., Tenant: � !\(� , Suite#: _ . . ._ . ` � Y Name.�� 1.��.,! � �� v 1�"�� Phone:l� �� c�� `�: ��.��li'��" � ,° �; , , ``: Address/City/Zip: `'� � � � �� I'! � aa,. , . . . � .��, , . .� �, . ,.. ,�,,.�-, , I � �, � ['� ,. ` - ; Name: ;'1�'� i'�. l.� , �.�., LiCense#: �� L � l�� ; � � � � Address: �L'� �� _ �. \' IC.� City: �i LL�� u � ��"�±�� , � � ,, � � .. �.: State: , Zi : �"l� t �F Phone: `� �..)` �Jl.� ��C� i � ".,,.;. . � P � - FI ': � � Contac�t � Email: �, � � � m � `�° �� £ � � New �Replacement Repair _Rebuild _Modify Space �_Work in R.�.W. � . ��p��c#f��t'�t — — :::�; >i�r: � =�.� �� ;;�� Description ofwork: �,� _ `` ` � RESIDENTIAL - � ; � �. � � � Water Heater �n s � � � l�' Water Softener � � �awn frrrgation(_RPZ/_PV8) � �� Add Plumbing Fixtures�Main/_Lower Level) � � z Septic System New Water Turnaround � � a `� Abandonment 4 �,�„��.�,��,�m.. '— �,,�.�.�.� � RESIDENTIAL FEES: � '� ~ � � �� : �60.00 Water Heater;Water Softener,or Water Heater and Softener(includes$5.0o state surcharge) � $frQ.OQ L�v!tn !rr'igati0n (includes�5.Q0 minimi�m State Surcharge) � � $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water'Turnaround*(includes$5.D0 State Surcharge) � � *Water Turnaround(add$200.00 if a 5/8"meter is required) � $115.00 SeDtiC SVStem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) �C� � TOTAL FEES$ � �.��<,� CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateanecall.orq I hereby acknowledge that this irrformation is complete and accurate;that the work will be in conformance with the ordinances and codes af the City of Eagan; that I understand this is rrot 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 pla . _. �.� ,��,�� X � x ' Applicant's Printed Name Applican s Signature - - � � � :.-.�.:,,..,>:.: ....,:..,..,�::._...:.,...., _. :::.n.... } =��. <�f=.� � ,:_�,... � �� ,>:�,.4.::,:_-:;::<., x.�.. � � :>:::x:..., .�:_;:,;,�..;;,�;: ..,�:,,:;;y..>,... �' � ' r;:..:..�•:.�,. �..,...:.,..,: - ....;:_.,. 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