1425 Appaloosa Tr• . - a , CITY OF EAGAN . . ? „ ,.A
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 y L• ???`?`?
PHONE: 454-8100
BUILDING PERMIT aeceipt #
To be used for Sp ?/GAR Est. Value $13$.000 Date jin. ? . 19811
.
Site Address 1423 A!'tA2p08a TQ
Lot 5 Block _L Sec/Sub. SHE11lDOD DOMlf3
Parcel No.
W Name .N]6EPN M HI1.UR COiSTtUCTIOl1
o Address 16133 CED1! A1R S
City rARMIl16"iWl Phone 431-2001
F Name SAM
;Q Address
Phone
City Phone
I hereby acknowlege that i
infortnation is correct and
Minnesota Statutes and Ciq
that the
State of
Signature of
shall be done in
; and City of Eac
OFFICE U SE ONLY ?
Occupancy R-3 -ML-1 FtES ?
Zoning &-I I
(ACtual) Const V? Bldg. Permit 773*00 ?
(Allowable) -Ynp "
? J
Surcharge •
# ol Stories
?e ?h
n9
?!
Plan Review ?
?Z•?
DePth ? SAC, City 100000
S.F. Tota1 - SAC, MCWCC 630,?
?
S.F. Footprints - .
On 5ite Sewage _ Water Conn 660a00 ?
On Site WeU ? Water Meter 95t? ?
MWCC System
30
00
City Water X Accl• DePosit •
PfiV Required _ 51W Permit 30*? F
1
Booster Pump - SIW Surcharge •50
?
Treatment PI 276*
APPROYALS Road Unit 370.00 ?
Pianner - Park Ded. ?
Council
BIdg.OH. ^ Copies
3,553.50
Variance - TOTAL
• Permn No_ ParmN Holder Date Tclephone #
WATER
S6YVEfi
PLUMBING
H.VA.C. ? ?, 7? /? ?/D-(pO 2
ELECTRIC
Inspeetion Date Insp. Commatts
Footings I `?,e?
Foundation
Framing 9 /?P ?
Roofing
Rough Plbg.
Rough Htg.
l5ul.
Fireplace
Finai Htg.
Or.W Test
Final PIbQ. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Deck Ftg.
Dedc Final
Well
Pr. Disp.
?L .
? S
, .
' SEIMER & WATER PERMIT
CITY OF EAGAN ?
3830 Pilot Knob Rd.
j Eagan, MN 55122-1897
'
DATE Tune 26,1991
OFFiCE USE ONLY
METER #'?` 4 e? g PERMIT DATE 07/05/ 91
CHIP ?da? 2 y3 a? PERMIT # 1.2118
METER SIZE vsu 5 B.P. RECEIPT # L 14318
ISSUE DATE ?- - B.P. RECEIPT DATE v 7 V3 91
_ PRV - BOOSTER PUMP
SITE ADDRESS 14 2`:, 10 o s a i r
LOT BLOCK ? SEC/SUB =? E+ r*•7 n nd il pSguo
APPLICANT: '''
ADDRESS: 113133 Ole da r Av S n
CITY,STATE ' arrnington, ZIP'
PHONE: 43 1- 70(] 1 ' `PLUMBER:
ADDR€SS: 14._7T_, S; , ?? , r.?
CITY, STATE • ZIP -
PHONE: 'L 7 ? --1 1 4 Ct
PERMIT REGIUESTED
_X SEWER -r WATER - TAPS
_ COMAAIIND x RESIDENTIAL
_Yi NEW _ EXISTING
Lawn Sprinkler Meters are to be Installsd
Ahead of Domestic Meters on Water Line,
Gredit Vtif14L NOT be given for Dedu)?t Meters.
?
,.-
.Y WITH CITY
OWNER: ra ? im vnvl?a.?.? oil
ADDRESS: w
%
CITY, STATE ZIP
PHONE: SIGNATURE WHEN METER 15SUED
PIEAW'ALL01N TW? ?11?6RICING DAYS'FbR PWCE5SING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
. j ??_ :
.il
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: . ,, J,
? ;,! A 1"O
Ei? k.i ??i???? i,ii?.ii••? ,
PERMIT SUBTYPE:
11 'Ifti o
lcaxn
PERMlT TYPE:
Permit Number:
Date Issued:
APPLICANT:
4 4 . _, 4
r
TYPE OF WORK:
i tNiii
-1
Permlt No. Permit Holder Date Telephone #
5NV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings i
Foundation
Framing
Roofing
Rough Plbg.
Fough Htg.
lsul.
Flreplace
Fnal Htg.
Orsat Test
Final Plbg. Plbg. Inspector -Notify Plumber
Const. Meter
Engr.fPlan
Bidg. Final
Deck Ftg. i ?
Deck Final ?g, C-_4 L
Well
Pr, Disp. - +v
G` cr/l, ri r??s
UI=?
?
?
7L I
? . .. Il'
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
? (612) 681-4675
SITE ADDRESS:
? , r,t a ?ik di 11:
, i }aWrtlll+ [,t(1Wt+f'.
PERMIT SUBTYPE:
1 n 0
1 M t• L Ft(i
TYPE: 1 1.11 1 r4 i
ber: 4Y.•?.?,c?;?
,,^ tc?.??, F 1 . , APPLICANT:
?( i? i.' 1 r•}3t? Mi lh
TYPE OF WORK:
i 1'4 '., I 1 I/1 1 1 CY N
I i Nni
??? rlFtifzh?,- A ',FFIARIIII PhR Mll I ', t:i r,llifkFO frtTit AMf"! i'Il±t-iil'I"I; O;2 t l ff i171f.fit 41e?t7!
Pe?mit No. Pennlt Holder Date Telephone M
ELECTRIC
PLUMBING
HVAC
Inapecdon Date Inap. Comments
FOOTINGS
FOUND
FRAMING J ?
.«i
ROOFING
ROUGH
PLUMBING
?l(,?
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL ?
GYP BOARD
FIREPLACE
FIREPLACE
AIR 7EST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSM7 R.I.
BSM7 FINAL
?
vr
oecK F-rc
DECK FINAL
p
Reyuest Oaie
$- 2]- 9 1 Fue No Rouq?-in Inspedion
Requnetl
r N.
? Ready Now f otify Inspector
When Reatly'
I'l nsed coniractor J owner hereby request inspection of above electrical work at
JobAyiff?,eeAepy,??b ft A TRAIL CitY EAGAN
secnonNO TownsniorvameorNO FlangeNO county DAKOTA
o"°P,jb1V'l"h ILLER CONSTRUCTION PnoneNO 612-431-2001
PoweeftbTA ELECTRIC, ASSO Atltlress FARMINGTON, MN
Electr?W?C,p?yraStq1V ?a CDmp?yl+?.jryeln RlC, INC.
I°I 1111, A 11 l, L L l, 1
q?o
Contracror5j; Uc?1n$eg1
APPLE VALLEY, MN 55124
Autnonzeo omrac?o' mg M l P?one Number
612-432-6688
MINNESOTA STATE BO ELE THIS MSPECTION qEQUEST WILL NOT
Griggs-Mitlway BIEg - Room BE AGCEPTED BV THE STATE BOARD
18Y1 Univerelty Ave., $t Paul. MN 55104 _ UNLE55 PROPER INSPEGTION FEE IS
Phone (611) 662-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
di• :
? 0. Sae mstr?c:ians lor compleMg this torm on bacR ol yellow copy
Q? 1 7 g "X" Below Work Covered by Thls Request
evfdtl. 9e0. Typeof6udding AppliancesWired EquipmeniWired
Home ange Temporary Service
Duplex Water Heater Electric Heanng
Apt BUilding Dryer Olher (SpaCify)
Comm.!Industnal nace
Farm r Conddioner
I I0:M1er(sVecrtyl
Compufe Inspection Fee Below. ConVactors Remarks
# Other Fee anceSize I Fee
# ServiceENr # CircuitslFeeders Fee
Swimming Pool ? 0 to 200 Amp
s /6 0 to 100 Amps
Transtormers lqbove 200 _ Amps A6ove 100 _ Amps
S mspeorors use onry TOTAL
AlarmlCommumcation THIS INSTALLATION MAV BE ORD Eb bl$CO ECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONT
07
I, the Electncal Inspector, hereby Ro,n-m oa?e ,
certrfy that the above mspecllon has
been made. F,,„ - oate r?
?
OFFICE USE pNLY
Tnrs request voitl 18 monlhsirom
- '° CITY OF EAGAN
" NO 1 g369
•
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ?r
BUILDING PERMIT Aeceipt # ? - / ? IL ?
Tobeusedfor SF DWG/GAR Est.VaWe $138,000 Date .1111• "i , 1941-
Site Address 1425 APPALOOSA TR
Lot 5- Block I_ SeGSub. _ SHERWOOD DOWNS OFFICE USE ONLV
Parcel No. ocapancy R-3 M-1 FE ES
R
1
Zoning =
w Name JOSEPH M MILLER CONSTRUCTION (qcmapCOnst V-N BIdg.Permit 773.00
; Address 18133 CEDAR AVE S (Allowable) V-N
69
00
° Surcnarge .
City FARMINGTON PhOne 431-2001 Nof Stones
64, Plan Review
0
502.0
lenqth
o Name SAME Depth SAC
Cit 100.00
i
.i Address S.F.7otai _ ,
y
6 5
? SAC, MCWCC n _ 00
City Phone 5 F. Foolprints _
t
r C
nn
W nn
66n
On Srte Sewage _ a
e
o _
?
$w
NamB
On Si1e Well
W
t
M
l
0
95
0
?? Address MWCCSystem X a
er
e
er .
a W City Phone ciry waier ?C Acct. DePOSit 30. 00
30
00
PRV Raquired - S/VJ Permit .
I hereby acknowlege ihat I have read ihis ap iC? on antl st thal the
?
'
' Boosfer Pump - SMI Surcharge . 50
inlormation is corract and agree co y
v
!(all app
e e State oi
Mmnesota Statules and City of S. Treatment PI 27 F- 00
SignaturCOfPeImIfBB APPROVALS RoadUnil 370.0?
A Building Permit is issued to: JOSEPH M MI i T.FR CnNST Plm"af - Park Ded,
on the express contlition that all work shall be tlone in accordance with all Counctl _.
applicable State of Minnesota Stafutes and Ciry of Eagan Ordinances. gldg. pry. Copies
,I
? ,q 3,555.50
Building Oflicial InI1?QA
lm!I variance - TOTnL
Requ t pa Fre No ough-In Inspection ReQwred
(YOU st call inspedor when ready) Inspeclion Olher T?a Rough-In
? Reatl
Now Will Notity Inspedor
y
Yes ? No Oate Read
I? licensed contractor Nfl""ner hereby request inspection of above electrical work a[:
JoD ACdress (Street, Box or Route N^o ) <?
z ?'J Q, ' ? l.'o?
I? Qty
/??
? W"?
Sectmn No. Township Name or No Range No Co sai ?
G?
Occupant
?Y 1RS T) ?(ld.
V
PhoneNO
?.J
P we S p hep r. 4 p?-.?e-. ?-1 /. Atltlress
Eleclncal Contraclpr (Company Name)
G D I k
?DIA- 1 Conlracto/s Lmense No
Meibng Adtlress Copkaclor or 01 Making Inslallatwn)
5' t
?
Fut etl Si ature (COnVa king labon) Phone Number
cd- b 9 6 -8
MINNESOTA $TATE BOAND OF EL CTNICITY I THIS INSPECTION REDUEST WILL NOT
I
Grigge-Midway 61Eg. - Paom 54Y8 II II I I I I I I I I I I
? I III BE ACCEPTED BV THE STATE BOARD
1821 University Ave, St. Paul, MN SS10G ? UNLESS PPOPER INSPECTION FEE IS
Phone (612) 642-0800 1 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION 4"`'? e^e-ooaoi-os
? S. insVUCtmns lor compleling this form on beck ol yellow copy ?{[y?? ?
-? ?
"X" Below W4;rk''Cov2red by This Request ?;,?,.
Ne Add Rep. Type of Building Appliances Wired Eqwpment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Building Dryer Load Management
Comm /Industrial Furnace Other (Specify)
Farm Air Conditioner
Other (speoiyl Canvactoi e Rnmerks
Compute lnspecnon Fee Below. l? l/
# Other Fee # Service E t ance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps -P:mps
SigOS Inspeaors Use Only 1 TOTAL
Irrigation Booms
Speaallnspection (
AlarmlCommunication BE DERED DISCONNECTED IF NOT
THIS INSTALLATION iM
Other Fee COMPLETED WITHIN 18
I, the Elecincal Inspector, hereby Rough-in oete
certify that the above mspection has
been made. oate
OFFICE USE ONLY
This request vatl 18 monNS Irom _ r4
? tU ? L ,
Address: 1425 AppALOpSA IRAII, Lot 5 Blk ] Sec/Sub SBERWOOD DOW
These items were/were not complete at the time of the final inspection.
10/23/91 Yes No 6,11
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanent dtiveway (.?
Permanent gas ?
Sod/seeded grass
Trail/curb damage
Porch
Basement finish t?
Deck Ll?i
Pleasa 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. ?
RL?ttF4NIG
White - City copy Yellow - Resident copy Pink - Contractor copy
CITY OF EAGAN t-i?sa
ititi 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 -4675
? S,e&tei sft s+rvap ? 2 oopiss of plan
? 2 copiq of Pym (incNWe bsam & wirWow saes; Pourod ind. dason; etc.) ? 2 site surveys (exterior oddRbns 6 dedcs)
? 1 ensrpy qkultdons ? 1 eneryy calculatiors for hsabd addkions
? 3 Cop" of tnN ptiNrvation plan if lot platlsd alter 7/1193
nquind: _, Yes _ No
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: i ; `TY.
?
! OT ? 9L.OCK I_ SUBD.IP.I.D. #:
PROPERTY Name:_ - phone #: V&-8215- _
OWNER ""'_ -
Street
City:
._,
CONTRACTOR Company:
Street Address:
zjp• ?J? 1 Z2
Phone #:
License #•
City:,
ARCHITECTI Company:
ENGINEER
Name:
Zip.
Phone #-
Registration #•
vl`eLl Md1JJiF.`?J,
Crty.
Sewer 8 water lioensed plumber:
change are requested onoe pertnit is issued.
State:
State:
Zip.
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the inlbrtnation is oorrect and ayree to comply with all
applicabla State of Minnesota Statutes and City of Eagan Ordinances. - 'j
Signature of Applicant .?' l?.t.=?
J
OFFICE USE ONLY
Certiflcabes cf Sunrey Received Yes No
Tree Prosarvation Plan Received Yes No
State: 0) L
PAY TO TFlE QEibER 0IP 'kOAM, MN ?612?
E C I 2 5 ?JJJ
u91ooooz=
-__ ??w .AYI V
ciTr oF EnaAR ?
OENERAL ACC0IMT
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex a 11 Apt./Lodging ?
0 02 SF Dweliing o 07 4-plex o 12 Multi RepaidRem. "o
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory ?
0 04 SF Porch o 09 12-plex ? 14 Fireplace ?
0 05 SF Misc. 0 10 _-plex o 15 Deck
WORK TYPE
0 31 New X 33 Alterations a 36 Move
n 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORAAATION
Const. (Actual)
(Allowabie)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Basement sq. ft.
Main le
vel sq. ft.
J
2hll sq. it.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
`e,,GU MC/WS System
City Water
? Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Engineering Variance
?_?7 y
o/
/
O
Permft Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. DeposR
5/W Permit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation:
g /s Go ?
% SAC
SAC Units
CITY USE ONLY
L ? BL ?_ RECEIPT #:
SUBD. urrnA-DC,'z"" DATE:
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dweilings
? townhomes and condos when permits are required for each unit
FIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Fioor Drain
Gas Piping Outlet * minimum - 1
Rough Openings
Water Softener
Private Disposal ' Dakota cty. license
U.G. Sprinkler ` home under const.
Alterations ` to existiny
Water Turn Around
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.50
5.00
20.00
3.00
20.00
20.00
STATE SURCHARGE
TOTAL
x
x
x
x
x
x
x
x
x
X
x
x
NO.
TOTAL
.50
20A
SITE
OWN
INSTALLER NAME: Muf ?'d ?4A
STREET ADDRESS: f qZJ
CITY: ^ STATE: I?1 N ZIP: 55/ZZ
PHONE #: ?2,) CP B?" D Z.? S "i? g
- EACH
r - .
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
COMMERCIAL
4?_?
2 SETS OF PL9NS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH SLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
`# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, SUT NOT PICKED UP &Y IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED 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.
To Be Used For: Ne, H ame ` Valuation: MEMVS
Site Address1425 Appaloosa Tr
Lot 5 Block i
Parcel/Sub Sherwood Downs
Owner
Addi'ess
City/Zip Code
Phone
ContractorJoseph M. Miller Const
Address 18133 Cedar Av So
City/Zip Code Farmington, Mn 55024
Phone 1"1 1 _,)nni
Arch./Engr.
Address
City/Zip Gode
Phone #
13 81 000
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
Date: June 26,1991
OFFICE USE
R-3 M- I
R-1
V-N
V-N
?
d
On site sewage_
On site well
MWCC System
City water al?
PRV
Sooster Pump _
APPROVALS
Planner _
Council
Bldg. Off.
Variance
Y
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL
j1z=f=2 44 9d= agrees that all work shall be done in accordance with
?(I9ignature of Contrac )
1991 BIIILD%7%2k9 ACITY OF EAGAN
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
GaPA-6?
1z-X2Z= ZG5/
?Dx.z4 = yka
'7y4 X 15= ql60
sS NIT,
3zk??. B6Y
?8 ?/6 = 288
2
?
?sr F?odp;
?--?---
?r? x3z. = 86y
x ?? ;:? ze s
2 X? - I?-
......_---?.
Il?yx 53= 6 z,7.Z2-
ZMa F'L.ooIL
Z-? u 3z = b6 t-I
_ ?
I?l1? = I?
I If4 13'
? nn ?C;S3 = ti
? 371 21 0
.-_ ,
I;760_78
411.45
651-681-4675
" Q (1)_a' 1
?
NewConstruction Reauirements
• 3 registered site surveys showirg sq. k. of lot, sq. 8. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam 8 window s¢es; poured found design, etc.)
. 1 set af Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 7/1193
. RimJoistDetailOptionsselectionsheet(bidgswith3orlessunits)
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
DATE 4' ?-(20 c? V-ALUATION ?I L4q 55
JOB SITE ADDRESS 1406 ??yc-aa- 1 YQ?-Q.
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWN
TYPE OF WORt ' - 1 ' FIREPLACE(S) _ 0_ 2
APPLICANT coor ? ° PHONE#7?/? 7?J 'aaal
ADDRESS ?n RaPids. MM Sr8483 ZIP CODE
PAGER # CELL PHONE # fAX #__I?'I30
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing CoMractor: _
Pliimhing System Includes:
Mechanical Contractor:
Mcctianical System Includcs:
Air Conditioning
Heat Recovery System
Phone #
Tee: $90.00
Fce: $70.00
Sewer/Water Contractor: Phone #
n
APR 3 0
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that t e informa 'on is y ct, and ac
with all applicabie State of Minnesota Statutes and City of Eagan dinance
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ Water Softener
_ Water Heater _
No. of Baltis
rtunwuenneuan nwunm?roum
. 2 copies of plan
. i selof Eneqy Calculations for heated add'Aions
. isitesurveyforexterioradditions&decks
. Indicate if home served by septic system for addNons
Phone #:
I.awn Sprinkler
No. of R.I. 13atlis
Updated 2002
F'?-_r, .=e.r Lr, ain.=...r, r'ia 6:?19 4:?--j F'.0L
2422 Enterprise Drlve
* PIONEER Mendoce Heiyht5, MN 55120
* eng* eer ng,.. (6121 681-1974
* .?c sh
Certificdte Rf SurvBy #or:JOJ /Y 114•'?rILLE/^S C,QNST CV •?C:r-
s a9 °ss'zsv? NauTH
fc? 0°17? a 998-?'k -
s
? -- - ? ?
69,0 ?r6 '?
M = ?o.o? F ? ?•S ° ? ? ?"?
. '.? ? I0 a ? GAz. si.s3 '?' c.T .
N p ?TdV? a
10,6 n,e7 a z?o = ? _.._ ` ?t•O e -----?? _.
q,ng ? ? o EAGAN ERtGIN EA1NG BEPT
? ?!
_,J N
n
--- 8 .00
N, 8G •s-r` 3a ?.
APPALoosA ;x 900. oo GenoFes Exisfing Elevatrons PaoMEp NousEEeEVATiaNs
x oo.aa penak5' Praposed 6levafrons Lowest Floor Elevatian qo'r ?lr
---- flenofts lJraina?e ?f/lrlify Easemen{ 7-ip o? 8/ocl? EYevafron ??. lra
----.-- Deno}es Draino e!ow x?rrows Gora e Slab Elevofim qip. 85
o penoreS Monumenf ?
Bear%ls shawn are a9sumed ? Denolcs a}fs'W qub
LOT 5 i BC OCl? 1 SNERwoao ?owNs
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I herebY canify thet thia survpy, plSn pr orpprt w^ai?p.'r?/n ared by m+, or under my direct SUp9/rv?i?Sion 0fld thBt I 8m duly Regi9tCVed LB??d SUxvgyO,
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U.i'i ur liUlLU1VU llENAti111li01
kx1ERI0R EIJVELUPE AVEF2AGE "U" COIiPUTATION
(To bo submitted,with building pormit application)
llwolling Owner
?
Cofitractor
Nf'{z ITN?E ?5- `/ r?
LIHF:AL FECT OF U / J
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ams
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1
? CFTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
??????
?//G-?
BUILDIN
021030
06J03/93
SITE ADDRESS:
P.I.N.: 10-67670-050-01
1425 APPAL003A 7R
LOT: 5 BLOCK: 1
SHERWOOD DOWNS
DESCRIPTION:
Buildin`q_Permit Type DECK
Building LJOrk Type NEW
rBuilding Len}t,h 32
' 8uilding Width"'-? 14
? t--?
?
?
,
•<- ,?,
Li U
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR:
CAVE BLORS, PAT
11906 MEADOW
MINNETONKA
(612) 544-4714
- appiicant - sT. Lic. OWNER:
15444714 0004227 BEBEL MURIEL
LN W 1425 APPALOOSA TR
MN 55343 EAGAN MN
(612)686-8215
I hereby acknowledge that I have read this
information is correct and agres ta comply
5tatutes and City ot Eagan Ordinances.
?
APPLICA PERMITEE SIG TURE
application and state that the
with all applicable State of Mn.
ISSUED B . IGNATURE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: Lor : 5 B L 0 C K: 1 APPLICANT:
1425 APPALOOSA TR CAVE BLDRS, PAT
SHERWOOD DOWNS (612) 544-4714
PERMIT SUBTYPE:
DECK
TYPE OF WORK:
NEW
BUILDIN6
021030
06/03/93
? - - ' _ ?
REACTIYATE _LO
PERMI7 d
.; ,
,xzz :;?? /o,3 d
CITY OF EAGAN
1993 BUILDING PERMIT
681-4675
S a3?
as ?
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: 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 Valuatio of work ,3?
Site Address: 1 . ?
STREE SUITE A'
Tenant Name: (commercial only)
T S SLOCK _L SIIBD.5??rj P.I.D. M
Descri tion of work: ?
The appl i cant i s: ? Owner Contractor IJ Other (Describe)
Name 3e?L? ! h /.Pn /0d Phone
Property LAST FIRST
Owner S'O (/CGe foI
?'
k
J
" /
pddress
STREEi STE M
? State 1140. Zip
-
City
Company C Phone ?a-44 l
Contractor Address /W, License #c0c>4?aa Exp.
CitY J?I10A u'?State 1124A-ID.. ZiP
Company Phone
Architect/
Englneer Name Registration
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this a plication and state that the information is
correct and agree to comply th applic le State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ?
APPLICATION
s?
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation
? 02 SF Dwg.
13 03 SF Addition
? 04 5F Porch
? 05 SF Misc.
WORK TYPE
t31 New
32 Addition
? 06 Duplex
? 07 4-Plex
? OS 8-Plex
? 09 12-Plex
? 10 Multi. Add'1.
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
)9 15 Deck
O 35 Tenant Finish
? 36 Move
Const. (Actual) Basement sq. ft.
(Allowable) lst F1. sq. ft.
UBC Occupancy ? 2nd F1. sq. ft.
Zoning Sq. Ft. total
d of Stories Footprint Sq. ft.
Length On-site well
Depth _142- On-site sewage
APPROVALS
Planning Building
Engineering Yariance
REQUIRED INSPECTIONS
O Site
O Wallboard
? Footing
.? Final
? framing
? Draintile
? Insulation
? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
tity SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
vatuac;onc $
. ?
? 16 Basement Finish
? 17 Swim Poal
O 18 Comm./Ind.
O 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
O 37 Demolish
MWCC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code ?
SAC Code
O
Assessments
SAC %
SAC Units
F i.?i. .." tria1 " acr ine 6 8 194 c.. F'.u?
PIOiVEER 2422 Enterprise Drlve
Mendota Heights, MN 55120
* eng* eer ng..
* (612) 681-1914
.?c yF
Certificate of Survey for:`?OSEPN /?'I• MI LLER (,,ONS1. CU• G?
s 89 •.zs'zs•IE
NoaTH
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AppALaosA
A 900. 00 Uenofes Exisfing Elevafrons pROP05E0 NGVSE ELEVATIONS
r oo.oo Denofes Araposed ?(evations Lowrst f70or Elevation ?'t. ?
?
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BL OCk'l SNER W44D D?OWNS
LOT S
,
oauora CouA1ry, ,Mr,vN#sorA •M ? sob1ect to tosemenfs of^record
I herebv certifv tha[ th.i su,wY. ptrn nr rrpnrt w?as ?p?rr/p arM by me or under my
I
L
A
^ diract suparvision end thnt I em duly Regyter?,rJ LOr.d Survtyor
19?
A
b
.1i<IflY o
,inr1¢r the lawt Of ?hr $tate pf Minnemta. Oaced Ihfs?
M ----
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C .
.
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scale - I ;E,. qp, eE -
o2?.0?. R BEitT B S?K14 L. . R?G. NO. 16l191
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
cROW
aur.LorNG
026662
i1J02J95
SITE ADDRESS:
P.T.eN.: 10-67670-050-01
DESCRIPTION:
PERMIT
1425 APPALOOSA TR
LQT: 5 BLqCK: 1
SHERWOOCI DOWNS
6,tiLl,di ng-_Permii: Type
8uflding WOrl? Tvpe
f ? {r
BASL:MENT FINISH
Ai.TERwrzON
Z?
1 ?rr
n f
'"" ? . .?.Jii" • ".JA. . __ , -
, '......-?T•..>{-:'?C A r ? v.?,
REMARKS:
Fl SFPARATE PERMIT IS ftEQU7REC1 I=OR ANY PLlJM87MG OR ELEC'I"RICRL WORK
FEE SUMMARY:
Base Fee $35.00
Surcharge $•5G7
Total Fee $35.50
II CONTRACTOR: OWNER: - A p p 1 i c a n t-
BEBF=L L"HRTS
1425 APPAL005A TR
EAGflN MN 55122
(G12)686-5215
Z her2by acknowledge that I have read this application and state that the i.nfarmaCion 3s carr^ect and agree tn eorriplywi.tti all appY3CabTe ?GaCC af Mn.
Statutes and C€ty qf Eagan ?rdinanCes, ?
? _.._ . ?.
?' AP LICAN IPERMITEE GN R ISSUEL) iG ? URE? 1
INSPECTION RECORD
CtTY OF EAGAN PERMIT TYPE: e u 1 LDI rt G
3830 Pilot Knob Road permrt Number: m 2 6 6 c> 2
Eagan, Minnesota 55122-1897 Date Issued: 11 /02/ 9 5
(612) 681-4675
SITE ADDRE55: f? . L . . L ? ? . - > ? Y? ? ? ? , 1 APPLICANT:
1425 APPALOOSA TR BE84iL CHRIS
SHERW00D DOWNS (G1") 686-9216
PERMIT SUBTYPE: TYPE OF WORK:
BASEMENT FINI5N ALTERATItlN
INSPECTION
FRAMING iA .
2NSULFlTI(.11V .•
ROUGH IN PLBG FINRL
REMARKS: Fl SEPARA7E pERMIT 75 ftEQUTREO FDft ANY HI.UMBING OF2 ELECTRZCAL WORK
?
?
tp ?
r
L
?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 00
?1 ?J I 'J 651-681-4675 ?
New Construction Reauirements
• 3 registered site surveys showing sq. N of lot, sq. R of house; and all roofetl areas
(20°/a maximum lot coverage allowed)
• 2 copies of plan showing beam & window srzes; poured found design, eta)
• 1 set of Energy Calculadons
• 3 copies of Tree Preservafion Plan if lot platted after 711193
• Rim Joist Delail Options seleaion sheet (bldgs with 3 or less units)
DATE
JOB SITE
0 '
RemadeUReoair Reauirements
• 2 copies of plan
• 1 set of Energy Calculations for heated addi6ons
• i site survey forextenoraddi6on5 & decks
VALUATION (EXCLUDING LAND) -k 2PJ I? Q ?
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTYOWNER L
TYPE OF WORK - S e
APPLICANT
ADDRESS
PAGER #
CELL PHONE
PHONE #
FAX #
_0 k 1 _2 _3
CODE SS- 3 )
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Cate9ory _ MINNESOTA RUL.ES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plum6ing Contractor: Phone #:
Plumbing Syslem Includes: Water SoFtener L.:um Sprinkler
Water Heater No. ot R.I. Badhs
Pee: $90.00
No. oF 13aths
Mechanical Contractor: A?01?016r Phone # 95?- 9?`¢??4 Z5e
Mcch.ulic.l Systcm Inclttdcs: Air Conditioning I'ce: S70A0
Hcal Rccoverv Systctn
Sewer/Water Contractor:
0
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 comply with
all applicable State of Minnesota Statutes and City of Eagan Ordina es.
Signature of Applicanf ` • ?? '
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 7lOt
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex p 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
0 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to appl icant
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 Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
REQUIRED INSPECTIONS
_ FinallC.O.
_ FinaUNo C.O.
_ Plumbing
HVAC
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
_ Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppiy & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
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` � � � � Use BLUE o� �,����� �� rt��.
� For Office Use �
' j Permit#: ��'?` ��� j
���� Of ����� ��E 1 O/'E -,� � �- -'
� Permit Fee: � � i
3830 Pilot Knob Road J�JN z G 20�4 i � i
Eagan MN 55122 � Date Received: � `� �
Phone: (651)675-5675 I �,. `,� I
Fax: (651)675-5694 B�: I Staff: /�"-� I
I I
`________________J
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5 ��S '�y Site Address: Unit#:
", Name: �l'l�E CV�L2E'vS Phon��/rl�`7!� ��{` l �.
Residen�/ 9�ir/, ��✓ S'$'��`�
Owner ` address i city�zip: /yr?S/9"/?ff.��4��� �G C'$G
Applicant is: Owner �Contractor
� , � ` r ���
�� � Description of work: /l.E�G�GG� S �6�✓�G�S ..��'/'T� �+C,! T/�?wC� ��� �
Type of Work �l
Construction Cost: � � Multi-Family Building: (Yes /No )
Company: �Lc GG f�Y'AT77�/f�1'�J CaG�tE��ontact:�6Y �lf�2GS��✓
COI1fC�CtOt' Address:�� 3�/"Y�'/9'.�arJS�G��C,. P� City: S%. LOV61' �i��/�
State: � � Zip: � SLf�-�i Phone:(�SoZ� 6 33�'G .��'�
License#: �C'��7�G17 Lead Certificate#: /�I�T''�2-S 7�
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY 1F CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
NOTE:Plans and supporting dacumenfs that yoe�sabmit are consrdereal ta,b,e public inform;ation; ;Portions of :
the information may be classified as non-public if you'provide spectfic��reasons that would-permit tl�e City to
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA147652
Date Issued:01/24/2018
Permit Category:ePermit
Site Address: 1425 Appaloosa Tr
Lot:5 Block: 1 Addition: Sherwood Downs
PID:10-67670-01-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Michael D Currens
1425 Appaloosa Tr
Eagan MN 55122
(651) 456-0495
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
Applicant/Permitee: Signature Issued By: Signature
eii
• a-
_ ,
For Office Use
;,; - ::::;ee': I
��
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RECIEVED
(651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 Staff:
a(�
buildinginsoections cityofeagan.com JUNL J
29201
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 1425 4`•'11010514- troll ) Unit#:
..t Name: Phone:
Zip: C�7 S �afc&(oosiA ` t 1 LaGt\k 66 t 2'7
CC�W11e1' : Address/City/ �
A'—1
it , , Applicant is: Owner Contractor
. Description of work:11 inbm. Logi i ! cw d la ct
7 ti..)/ I ICX cC—
Construction Cost: �, D7, pci Multi-Family Building: (Yes /No )
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Company: q I (�f/�d SCC G vt9� Contact: ((Al 7 b� Z; tpo
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` 4 Address:17 52ot )oD4j t=ta) $�v1� City: M
Contractor
* I A." Zip: FjGJ6'3 Phone: Email: gal Jh f/o rt&ati
� �� State:
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tr' :` 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:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Pians and up o r ocuments that you submdee e,considered to be public infofmtration Portion s t fthe ti rmation rn '
classified as non-P418.0ydou provide spec fic4reasons, t mould permit the:City to conclude that they are trade s tgm z: r, K
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaoan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.goDherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and ,irk is not to start wi hout a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and appro 1 of pla s.
x b h-R101 ° x �s�
Applicant's Printed Name Ap• ,,a is Signature
1
DO NOT WRITE BELOW THIS LINE 0 C7: A ;°-' pr 1o0.. / /x-: j
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration(Singly'Family)
1 Single Family _ Garage —
Porch (4-Season) _ Exterior Alteration(Multi)
Multi _ Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex — Lower Level _ Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation )7„.C7(VD Occupancy MCES System
Plan Review Code Edition Ai r N SAC Units
(25% 100% ) Zoning C City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V (V Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
Roof: _Ice &Water _Final Pool: Footings Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In _Air Test Final Siding: Stucco Lath _Stone Lath _Brick EFIS
Insulation Windows
Sheathing 7C Retaining Wall: k Footings Backfill '( Final
Sheetrock t Radon Control
Fire Walls Fire Suppression:_Rough In Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: \ , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge , 7, "~ '
Plan Review
MCES SAC I i 1 , Lif
City SAC
Utility Connection Charge 31
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
LOT SURVEY CHECKLIST FOR RETAINING WALL r QAZ
BUILDING PERMIT APPLICATION
Address: 112..0 tippaloc)-s-cf_ ir-
Applicant Name: ffina,1 V licitri" 0,4,410-1/,uQQ ATt.,t1a. iCd6freOnS
DATE OF SURVEY: O /8
LATEST REVISION:
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ea **Permits required for Retaining Walls 4 feet high or greater.
O z a DOCUMENT STANDARDS
it ❑ 0 • Registered Engineer signature and company
M 0 0 • Building Permit Applicant
,,0' 0 0 • Address
y2' 0 0 • Legal description
// 0 0 • Lot lines/Bearings&dimensions
/H' 0 0 • North arrow and scale
❑ ❑ • Street name
❑ ❑ • Show all easements of record and any City utilities within those easements
X 0 0 • • Setbacks of proposed structure and side yard setback of adjacent existing structures
ELEVATIONS
0 0 • Property corners
❑ ,er ❑ • Top of curb at the driveway and property line extensions(only if wall is within 30 ft.of curb)
0 ' 0 • Elevations of any existing adjacent homes
/Er ❑ ❑ • Adequate footing depth of structures due to adjacent utility trenches
�7
0 0 • Waterways(pond, stream, etc.)
❑ ❑ • At the foundation of the building and/or nearest structure
PONDING AREA(if applicable)
❑ j ❑ • Easement line
❑ , ❑ • NWL
❑ ,z1 ❑ • HWL
❑ ❑ • Pond#designation
❑ ❑ • Emergency Overflow Elevation
❑ 0 • Pond/Wetland buffer delineation
Y (1�J • Shoreland Zoning Overlay District
Y •
® • Conservation Easements
RETAINING WALL INFORMATION
❑ ❑ • Location of Retaining Wall on property
fr ❑ ❑ • Top&bottom elevation at each end of wall and any change in elevation in between
,Zr ❑ ❑ • Type of material (i.e. modular block, boulder,etc.)
,2 ❑ ❑ • Directional drainage arrows with slope/• a t I.
Reviewed By: i1> ��* Date 7/
Y _ �l Vi'
G:FORMS/Building Permit Application-Retaining Walls Rev.5-4-09
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PIOVEER / � 6j � JMend0g MN 55120
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Certificate of Survey for:JOSE ' ` ' MILLER CONST CO.
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NORTH
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APPALOOSA Ti.. - Ot
! soo.00 Deno}es fxisfing Elevations Popov NouseILEVAr1DNS
$0-0-0.4 Denotes Proposed Elevat:'ons Lowest Poor Elevation 90 A.06e
P,
Denofes Drainage ((Jfrlify Easement 7�"p ."Block Elevo/ion 1 i 1, lco
, r-- Denotes Drainage Flow ggrrows Garage;lab Elevva/ion eno. 8'5
b Denoftc, goptiment �'�'e
&arils shown ore mourned' a Dena/es cis / dub
LATS , BL SCI 1 , SHERWOOD DOWNS
04k'07A covwly, ,MINNESOTA •ei Subject to easements of record
1 hereby certify that thrs survey.pir.n nt report was pre are:4 by ms or under my direct supervision and that I em duly Registered LAtrd ry/Surveyor
unr4e,the taws of the Stet,of Minnesota,Dated[fits 25+-4+ (lay of , A,D.19 of j ,
Scale . 1 in _4041 _
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r{�$<tiRT B Siptu L. •, REG NO.16891
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