1949 Berkshire DrCITY OF EAGAN
3830 Pi{ot Kno6 Rosd
P. O. B+px 21199
Eagan, ?MN 55121
Zoning: _. '.1
Owner. 'zs"1 Llotr.e
Address:
Sih /lddresr. 19 4 ' ) B er
Plumber:
., Meter Na.: MtU
WATER SERVICE P
PERMIT NO.:
DATE:
. No. of Units: -
re vonag
.,- .
15.
, 1'7
Readsr No.: w Permit Fee: - -
S?'f)ll
I y!N t0 0011Wy MiIlI1 !b ABeyaA SUfCF10Igl:
Misc. Choroes. 13''
TOtGl:
OrJ7m-&?
gy Date Paid:
?e of Insp.:
CERTIFICATE
SURVEY
' ?. . _.. ._i,...M,. ? -. .
'
CITY QF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Rwd -
" P. 0. Box 21199 PE7tMIT NO.:
Eagan, MN 55121 DATE:
Zonin0: No. of Units:
Owrrr: _ .:
/?ddrcss:
Stte Address• ? er. S
Plumber.
f ym to aanrlr wNi fw C&y ef Eeoew Cannectton Chave:
OdIMnoM. Account Depogf: ?•,,?
hrmit Fee:
Surchorge: .
BY Misc. CFarges:
Dote of Insp.: Totoh
Insp.: Date Poid:
r;
e
m
ITY 0"' EAGAN
3830 Pilot Knob Road
"P. G. Box 21199
??Eagan, MN 55121
?Zoniny: _
?Dwner:
iAdd?ess:
aite 1lddress: 3 7
'Plumber:
?JlAetar No.:
i+es?a.
1. - -
Reoder No..
1som h oaw* MilU 1M Gty ei Esmn
; "neaa&
Rv
DOfE Of I nSP.:
WATEit SERVICE PERMR
PERMiT NO.:
DATE:
Na. of Units:
DYive L13 37 Bericsr.ire F=ds
Connection Chorge: . .
Acoount Deposit:
Permit Fee:
Surcha?ye:
Mlsc. Choryas: ? ' ?1t}p:i T?
Total: , -., , ..
Dots Poid:
I14fp.:
?
f
?»
L
A r .
INCLUDE 2 SETS QF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
INCLUDE 2 SETS QF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For ;? F?WUI ??-Valuation :(cZ,CCx'?1o
Site Address OFFICE U.
Lat ? Hlack ? Erect
Remodel
Parcel/Sub 22Y Repair -
Owner RSM Hames, Inc.
Address 18308 Murphy lake Blvd,
City/Zip Code Prior Lakei Mi 55372
Phone
Add ition
Move ?
Demolish
Int.Impr.
Install ?
Date : (2 3C) .65
Occupancy
Zoning
Type of Const
# of Stories
Length
Depth
Sq Ft
APP?ROV_ALS FEES
Assessments Permit
?
WaterlSewer Surcharge
Police Plan Review
___-_----
Fire SAC
?..?.,.
Engr Water Conn
Planner Water Meter
Gauncil Road t3nit
Bldg Off -.?• Treatment Pl
APC Parks
City/Zip Code Inver
_?._.._
Phone # 450-0867
,?`",? " •
p• *
? 319• +
31•+
159•5+
575. }
? 500• +
63•5+
280• t
132• +
2y 060• *
0
i,- - - - - - - - - -
?
INS
?
CITY OF EAGAN PERMIT TYPE:
? 3830 Pilot Knob Road Permit Number: 14
Eagan, Minnesota 55122-1897 Date Issued: '
(612) 681-4675
SITE ADDRESS: 0 APPUCANT•
{ 1,1 r 1.'• ti 1 C11 ? '
i , . [i( f•;h, i6iIltF hF? ! ?I : !?'.:; , ; i,,; ??? , r .
LL
-1
I
PERMIT SUBTYPE: TYPE OF WORK:
,,c PAI Ft
?; ,!. +? i 1 I?A a 0.& frERn(ir
Permit Holder Oate Telephone N
PLUMBING
HVAC
Inspection Date insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BQARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLUG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVIN
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
• ?r
PERMIT # VS?-
6
REP
,EIPT DATE 4)04'??
1. Bldg. Type: Res
3. Total Bid Price ?
Lot? Blocls,
s. contracsor LL
' {Nai
7. Contractor Phon
CITY OF EAGAN
MECHANICAL PERMIT
454-8100
MINIMUM RESIDENTIAL FEE - $10•00 + $.50
MINIMUM COMMERCIAL FEE - s20.0Q+ $.50
Gomm Inst 2. New ? Add.-
y
,__ 5. Owner _LL FEE
4. Job Address
ca? Sec 4t, 1-7
S/C
TOTAI.
_ Alter Repair
401 /1?e Y?"l?f ?;
(SMeeQ (City) (Zip)
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.OQ
MODIFICATIONS/ALTERATIONS -$10.00 minimum tee
L111-11,
HEATING VENTILATING HOT WATER STEAM AIR COND.
?AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
_G RES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM./IND. RATJ&_- 1% OF TOTAL, BID PRIq PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE. Signed: ? for
Approved Inspections: Date Rough Insp. Date Final Insp.
` ` 1
PERMIT #
RECEIPT # 5 yr' `J ?
DATE
CITY OF EAGAN
PLUMBING PERMIT
454-8100
MINIMUM RESIDENTIAL FEE - $10.00 + $.50
MINIMUM COMMERCIAL FEE - $20.00 + $.50
FEE
S/C
TOTAL
1. Bldg. Type: Res x Comm Inst 2. New ?X Add Alter Repair
r' ?? L'? . <,•J ? ji '?j ?lir.C.Sf/?t'?
3. Total Bid Price 4. Job Address
l.o! ? Block e?. Sec 5. Owner ?S? //<•'s9l 6. Contractor ??'C? /?? .l'?c.ac ? ?'T? ?s'Y. S .?, ?.ra,-J?1?. ? ?. .??c%J? :;,.:,?'
.....,..,
7. Gpntractar Phone #=, c SY 7 e i.,.oo.
?-??- _ ? ....???r?
NO. FIXTURES NO. FIXTURES NO. FIXTURES
? Water Closet - $3.00 Laundry Tray - $3.00 -Well - $10.00
? Bath Tubs - $3.00 ?Floor Drains - $1.50 Private Disp Syst - $10.00
LavatorX - $3.00 ?Water Heater - $1.50 ?Rough Openings w/o
ZShower; $3.00 Whirlpool - $3.00 Fixtures - $1.50
-Z-Kitchen Sink - $3.00 Gas Piping Outlets - $1.50
-Urinal/Bidet - $3.00 Softener - $5.00
COMM./IND. RATE - 1% OF TOTA L BID PRICE PLUS $.50 STATE SURCNARGE FOR EACH $1,000 OF FEE.
Signed: for .. ? : < ???.c Y '? ui
Approved Inspections: Date Rough Insp. Date Final Insp.
s
'? MECHANICAL PERMIT
RECEIPT #
?
? f UU CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address
? BLDG. TYPEf WORK DESCRIPTION
Lot '
-? Bloc k Sec/Sub Res. New
? Name . Mult Add-on _Le_ I
?
Address Comm. Repair
r
Oth
y
c City ;
Phone e
I
? FEES ,
Name r RES
HVAC 0
100 M BTU
2
00
? .
-
-$
4.
c Address r ADDITIONAL 50 M BTU - 6.00
? O CitY Phone IeS g . ' (RES. HVAC INCLUDES A/C ON NEW I
_ GONSTRUCTION)
1 PER PERMIT'I
GA5 OUTLETS
MINIMUM
1
5
EA
(
-
-
.
.
0
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU $ TOWNHOUSE & CONDOS - RES. RATE APPLIES
- MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
?
Unit Heater M BTU REMODELS - 12.00
Air Cand, (r' M BTU MfNIMUM COMMERCIAL FFE - 20.00
s STATE SURCHARGE PER PERMIT - .50
Vent. CFM ? (ADD $.50 S/C IF PERMIT PRICE GaES
Gas Piping Outlets # BEYOND $1,000)
Other $
FEE:
^ r i
S/C: SIGNAT R E
TOTAL:
?
FOR: CI OF EAGAN
?
.;.
Site Addr s / ? ?
Lot ? Block
m Name
? Add?e
c City L
L Name
3 Addre
p CitY -
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
/ 0 0 0- aHONE- 4se41e0
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMJM - RESIDENTIAL FEE
MINIMUM - COMM/IND FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
1 ?., .
PERMITTEE
$10.00
20.00
.50
FOR CITY OF EAGAN
PERMIT #
RECEIPT # ?-
DATE
BLDG. TYPE WORK DESCRIPTION
-e
Res. New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
UrinallBidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whiripool - $3.00
Gas Piping Outlets - $1.50 _
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL• -'?}
y.,
?
BUILDING PERMIT Receipt#
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
r'4 -, jj C '7 .ir
To be used for SF D14G/Gi1Ii Est. Value + b2 1000 Date 19 1, 6
Sit
Add 1949 }3Y:ItriSHltt?'?', DK Erect anc
't"s
?1 Occu
ress
e
Lot 13 Block i Secisub. IIERI:S;-i IR.E. P011DSlemodel ? y
p
Zoning 1Z1
Parcel No Repair ? Type of Const. V
. Addition ? No. Stories
W Name RSI-i AOI"iES Move
oemolisn ?
? Length 41
Depth 41?
o Address 16308 hlURPHY LAKIs SLVU
Int Impr. ? Sq. Ft
City PI2IUid Wone 432--24417 Install ?
= F Name SAM
? Q Address
~ City Phone
Assessment _
Water & Sew.
F W Name A. P. S. iIOMF: DESIGN Foece
? n Address 2779 ? 5TH ST C: Eng.
< W Ciry I•?? • j?-Pnone 4 5 0- 0$ 6 7 Planner
Council
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 1/3/86
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. APC
Var. Date
Signature of Permittee ?
RSM HO[fk.5
A Building Permit is issued to:
all work shall be done in accordance with all applicable State of Minnesota
Permit ? J 1 y• U v
Surcharge 31.00
Plan Review 159. 54
sAC 575.00
Water Conn. 500. 00
Water Meter 63.50
Road Unit 280o00
Tr. PI. 131.00
Copies
Total 4?• r U60. 00
on the express condition that
ot Eagan Ordinances.
Building
PermH No. Permfl Ho1dK or• rN.pnoo. 0
Plumbiny S' ? e
H.V.,,.C.
???c
Soh*n«
Inspsctlon Dats Insp. Commaft
Footlnys 1
I
?/b
FooWys II
Foundatlon
Framiny
RooHnp
Rouyh Plby. ? = U `QL _.y .Tl • /
Rouyh Hlq.
.
,
IeauL
Flnplac? ?/
FMaI Htp•
FMsI Plbp.
&dp. FY?ai
34
Cert.Otc. ?
D.dc Ftp.
D?elc Frmp.
wwi
P?. Dhp.
CITY UF EAGAN Remarks
Addition BERKSHIRE PONDS
Owner.
Street 1949 R Shi D iv -
10 13750 130 02
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. Z 1282 239 . 09 23.91 10 g,? d b
STREET RESTOR. O , 3 00118,07
?
GRADING
SAN SEW TRUNK 07 1982 176.04 11.74 f -! 0O
SEWERLATERAL -161 1982 7.24 3.82 1 Coll v
* -1-3 1985 427.89) -3 19 3"70 - ?
WATERMAIN , 1982 46.09 3.47 15 30,1
* WATER LATERAL 1985
WATER AREA 1982 176.04 11.74 15
?
STORM SEW TRK 1985 385.03 25.67 1 33."I ?b
STQRM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road U 't 280.00 58951 1/91/86
WATER CONN. 500.00
BUILDING PER. 11431
SAC
PARK
"
t A
N2
l
G 11431
- 3830 Pilot Knob Road
P.O. Box 2
-
1 9, Eagan, MN 55121
Sly?
BUILDING PERMIT PHONE: 454-8100 ReceiptR 170
Tobeusedfor SF DWG/GAR Est.Value $62,000 pete JANUARY 9 19 86
1949 BERKSHIRE DR
R3
f
SiteAddress
Erect C
Occupancy
Lat 13 Block 2 Sec/Sub. BERKSHIRE PONDSRemodel ? Zoning
Parcel No. Repair ? Type of Const. V
Addrtion ? No. Stories
a Name RSM HOMES Move ? Length 41
z
dF
18308 MURPHY LAKE BLVD Demolish ? Depth
o Address
Int. Impr ? Sq. Ft
cjiy PRIOR L4one 432-2440 Install ?
o a Name SAME Approvals Fees
i
sp
Address ASSBSSmOnt
Permit $
319.00
? City Phone Water 8 Sew. Surcharge 31 . 00
Police PlanAeview 159.50
FW Name A.P_5. HOME DESIGN Fire SAC 575.00
?3 Address 2779 75TH ST E Eng. WaterConn 500.00
aw City I•G•H•Phone 450-0867 Planner .
WaterMeter 63.50
I here6y 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 a a Ordinances
Signature of Permittee
A Building Permit is issued toRSM HOi k S
all work shall be done in accordance with all aoolicatrte Staigof Minnesota
Council
eid9.On. 1/3/86
APC
Var.
RoadUnit 280.00
Tr. PI. 132.00
Parks
Copies
Total $2,060.00
- on the express conditlon tha[
of Eagan Ordinances.
Building Ofiicial
FERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: aurt_osNG
Permit Number: 0 3 3 2 7 4
Date Issued: 0 9/ 16 / 9 8
SITE ADDRESS:
1949 BERKSNIRE OR
LOTa 13 6LOCK: 2
BERSNSRE PONDS
P.I.N.: 10-13750-130-02
DESCRIPTION:
i.tilclk?it?;;4J
enaus=,.C.0
T.O. & REROOF
ermit Type STORM DAMR6E
?q?rk Typa REPASR
? •???? 434 ALT. RESLDENTIAL
S"
s; z
? 1P?Gv?
°C ."' a`5 ,.
,? _ .5?v: QYLS -= 3P¢
?'.-,i:: =,-??-' `4ta ! vs? ?w„ala ;r _ ?? e ??'' ? (p° g?w` L£"'?v .or'=5ix
v„ su i? °eia: ,r3' ek? s3 y,wat = i_,°,? si^_ v"ei . @kj' ?,t Eg ffi?
=r??.b>g??:?S+ ?, :`F:.°?r.?' ?sd?:C.`?!&:???@?°"-,??'a?s3is?? fJ?
;ta " ms
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Flpplicant -
WESTURN CEDAR SUPPLY 15410304
705 N HWY 169
PLYMOUTH MN 55441
(612) 541-4207
sr. Lic. OWNER:
20014207 WOODYARD ,]OHN
1949 BERKSHSRE DR
EAGAN MN 55122
(651)686-8576
X' hereby acknawl sdge that T have i°aad;thxs
c,?irtp
`5'ta t uC'§s an?"'Gf,?y.?? ??c?ra,ea E?rtlEr?er????c.
??. . . i . _ .e. ... .. .. .... .. .. '. . ....
F?
APPUCANT/PEFMITEE SIGNATURE
acv?fst4 tq t hic?-,?`°t h t` `
??aEfJ t' ,s'€ato' of M,n,p .'
w1atha,ll`"aRA ?
°
7
I UED 8V SIGNATU E
1998 BUILDING PERMIT APPLYCATION (RESIDENTIAL)
CITY OF EA(iAN p
S ?
3830 PII.OTRNO;RD - 55122 q_ -lr
New Construction Reawrements
RemodeVReoair Reauirements
? 3 registered site surveys • 2 copies of plan
• 2 copies of plans (inGude beam 8 window sizes; poureG fid. design; atc.) ? 2 site surveys (eMeNOr aOdihons & decks)
? 1 energy Caleulations ' ? 1 energy calculations for heatetl addifians
• 3 wpies of Vee preservahon plan A lot pWBed after 711193
required: _ Yes _ No
DATE: CONSTRUCTION COST; 3 77O TL
DE C TION OF WORK: ?el+ILOFiG '-/- /?iP?df'- 6T6i2/Yl Zh/'i'! 461E=
STREETADDRESS: /'f 'Fy
LOT: _4-1-P BLOCK: SUBD./P.I.D.
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
EhIGIrIEER
Name: wa,o7g,W V Ue/" Phone #: !0AQ ' O<3-7?
Last First
Street Address: /7 0 236X46HAG M-1Ut?7
Ciry r-Ar,A"/V State: / 7i/v! Zip: ??/ zz?
Company:IL?zIK/V Ei? 6vlP??i?f Phone
StreetAddress: ?6s- /4J! LicenseN ZQ01C12-6::2
City 2IJl10fi0LJ7-H State: //'/V i Zip: ,7??"f/
Company:
Phone #:
Name: Registration 1!:
Street
City State:
Sewer & water ficensed plumber (new construction oniy):
and lot change is requested once permit is issued.
Zip:
Penatty appfies when address chang
t hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all appiica6l
State of Minnesota Statutes and City of Eagan Ordinances. /? ??
Signature of Applicant:?/
OFFICE USE ONLY RECEIV ED
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No Not Requir y:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 5F Dwelling ? 07 4-plex
? 03 SF Addition ? OS 8-plex
? 04 SF Porch ? 09 12-plex
? OS SF Misc. ? 10 = plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actuai)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planrting
0 11 Apt./Lodging ?
? 12 Multi RepairlRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace O
? 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq. ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Building
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Depcsit
S!W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
% SAC
SAC Units
r ? i ?• •
•?• •?? • ••
czTSt oF EAGA,N
- APPLICATION FOR PEE2MIT SEWER ADID/OR WATEE2 CONSECTION .
° Please Print)
1) PROPII2TY ADDRESS:
T•FY;AT• DESCRIPTION:
IF EXISTIA]G STRL'CT[7RE, DA2'E OF ORZGINAL BUILDING PERNIIT ISSC'ANCE:
(Ro5nth ear)
PRFSENT ZONING/PROPOSID USE: F2-1 SINGLE FAMILY R-2 DLPLEX (Twn Lnits)
R-3 TOWNIIiOi'SE (Three + Units) ( Units) i
TR-4 APARTMENf/CONIDqhffNtL'M ( Lnits) „
CONA7E2CIAL/RETAIL/OFFICE
INIDUSTRSAL INSTITUTIONAL/GOVERbPE7T
2)
ADDRESS:
CITY, STATE, ZIP:
PHONE:
PLLP?IBER
CITY,
For.City Use
mbers License:
Q
RGCOrde(
NAME: ::TNC-
ADDRESS:
??
CITSt, STATE, ZIP:
PHoM: ? ??- r-? 4(?b •
5) ? '?• • ?¦
JeLCONNECTION TO CITY SF,'WER A:?_CONNECTION TO CITY WATIIt
?
Q OTIIER (Please Describe)
61 ?? •
? PLEASE HOLD APPROVID PERNIIT FOR PICK-DP $Y ONE OF ABO`7E
% "7._ (Circle one)
? r--.
7) ??.?? P < ?'`/???,?? ?? ? /'??--?`? - ?^
L?i IL?. S?. cl?
t-2- 4 cf
5 c ? A v <Jfi5
?-K
A'
F O R C I T Y U S E O N L Y
PER-MIT °- ISSUED
?
F°ES: $ & v
$ /o'J0
$__
S
S
$ ??(7U
$
$
$
?o. v v
_ ?7S-UU
S
S
$
S
$
$
$
$
/S3 L?
SE:•iLD nERMrT (I`ICLUDE SliBC4aRGE)
WATER PERP1ZT (INCi;uDE SliRCHARGc)
WATER METER/COPPERHORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SE:dER TAP
..?v5I7 ACCOUNT DF,POSIT - P7AT°R
WAC
SP.C
TRUNK WATER ASSESS24ENT
TRli:IK SELdER ?SSESSilEiIT
Lr1TE:LAL SENEFIT/TRUNK SE:?ER
LATERrIL BENEFIT/TRUNK SVAT°R
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
AMOCJ:;T PAID/RECEIPT rc 7/?e9
DOES UTILZTY CONNECTION REQUIRE EXC.IVATION IN PUBLIC RIGiIT OF WAY?
YES IF YES, THEN A"PERMIT FOR W0RK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? HO ENGINEERIr1G DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO TIiE FOLLOS9ING CONDITIONS:
APPROVED BY:
TI:LE:
DATE : _ ? I /9 (
~ ~1
ry1
~ ) C1 ;
e ) b~ !
e~ ~a~~~
~ scAie : = 30`
~
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s ~ (9~G.~~.) OENOTe"5 PRof'~J~~C ELE~,~7lot~r . s
,rs,,' iND1CAT~:,+ DlRC "rlD;~;~ OF SURF~iC~ DR~~If~?.~:.
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~ ~I ~ESIGNED CMECKEO PREPtse~.~i,~ r~'~ . I HEREBY CERTIFY THAT THIS P~AN WAS ~ SHEET R@V.
~O~$U~~B~~ ~~C~I~~&~~EAS, PREPAREO BY 1NE ON UNDER MY DitiECT f~~':'': ~ ,
I~~~W~~~S Q49~ LI~~9D SU~~E~~I~~ , SUPERVISIOk AND YNAT41 AM .A OULY % ORAWN DATE REGISTERED L~:~1~; ...."dJ:..v.9r' ~ ~ 1~2.U.~,+~,~ ~ ~ 1? } ~ !
UNDEq THE LAWS OF THE STATE SCAIE I I OF kINP7 TA. ~ ,Is ~~l= j
w~ ~ ~ ~ F-~ ; 1 y"....,,..z~,~2. ~:-4~ a ~ JOB N0. NG. oF
~ ^J;~~~.z r :I` N0. DATE BY REMAflKS ~ , UATE~`~ ~ REG.NO ~
7 H ~a2-~000 REVISIONS , I~i~ EAST 14GIh STREET, iURNSVfLIEs M{NNES~7A 5533 r
, , ........_.._ ... ..�,-.,.._.....
r-�---`---___-_�__-
I For Office Use I
' � Perrnit#: 1� ��� / �
Cl�� Q� �� �� ; . . � .�� ;
� Permit Fee. ��
3830 Pilot Knob Road ����.�����`;�..� � /� �
Eagan MN 55122 � Date Received: �v �� C �
Phone:(651)675-5675 (��� '� � ��`�k � �
Fa�c:(651)675-5694 � Staff: �
I I
2014 RESIDENTIAL BUILDING PERMIT APP�ICATION i Q���
�
Date: Site Address: Unit#:
� /� / s /
Name:__`a�D�i /�/oTCC.cva.�f Phone: .�o���'�3�' �.1Q3
� � a
, �;���� �r Address!City l Zip: �� � Q,�G�CS�l.'y`� �/'• �
_ Y ,� Qu a,� /'�n. .�sia i
Appiicant is: �Owner Contractor
s � �� � �
' ° Description of work: �acl� �' q�a lec�
������r�x
= Construction Cost: C�Z/ Multi-Family Building: (Yes /No,�)
, � /
` Company:���0����Te✓������. Contact: � fr� �5��
� �"�r--
� ' �� ..�'li..4 � ��A
� F " � ° Address: � � �/�_ City: �Gyxs�r� r�
����� �
� State:�Zip: �t'o Phone: �o`oZ�'`�Y3�?Y 1�Email: OS /'-a /?J�i�'r��
�,�
� License#:,p]� fc ���3� Lead Certificate#: ��%I�7?�'�
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
1��� ��
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 morrths,has the City of Eagan issued a permit for a similar plan based on a master plan? I
_Yes _No If yes,date and address of master plan: '
Licensed Plumber: Phone:
Mechanical Contractor. Phone:
Sewer&Water Contractor: Phone:
���j �g[�� �y�J { f/ y■ y� �yy�
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ti
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, .,.,....4 < .......x.,? . .,��,.... { y .�:
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.popherstateonecall.orq
I hereby acknowlsdge 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.
Exterlor work authorized by a building permit issued in accordance wlth the Minn State Building Code must be completed withtn 180
days of permit issuance.
x \J 0.•�.G�5 �. ��p� �
Applicant's Printed Name Applica t's Signature
Page 1 of 3
��`f`�' L��`'t���' �'r_ /� `7�J,�'
DO NOT WRITE BELOW THIS LINE �
SUB TYPES
Foundation _ Firey�lace _ Porch(3-Season) _ Exterior Alteration(Single Family)
� Singie Fam11y _ Garage � Porch(4-Season) _ Exterior Alteratlon(Multij
_ Muiti �C Deck _ Porch(ScreeNGazebo/Pergolaj _ Miscellaneous
! 01 of_Plex _ Lower Levei � Pool � Acaessory Buitding
WORK TYPES
� New _ Interior Improvement _ Siding _ Demolish Suilding*
� Addition _ Move Bullding _ Reroof � Demolish Interior
_ Alterffiion _ Fire Repair � Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window , Water Damage
_ Retafning Wall *Demolitlon of entfre building-glve PCA handout to appl�ar�t
DESCRIPTION /
Valuation �j, b �� - Occupancy �c� MCES System
-T-'
Pian Review Code Editlon � p�S C SAC Units
(25%_100%� Zoning �� City Water
Census Cotle Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Sprtnklers
Type of Construction �'z�T Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
� Footings(Deck) Finai!C.O. Required
Footings(Addition) � Final/No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Fin�l Pooi:_Footings Air/Gas Tests _,,,_Final
� Framing Drain Tile
Fireplace:_,",Rough In _Air Test _„Final Siding:,�Stucco Lath �Stone Lath _Brick ,
Insulation Wlndows �,
Sheathing Retaining Wail:�Footings�Backfili_Final ��
Sheetrock Radon Controi
Fire Walis Erosion Control
Braced Walls Other:
Reviewed By: �C7 , Building inspector
RESIDENTIAL FEES
Surcharge ��t �Z Ut i 2.C� C� � j � ��
Plan Review
MCES SAC � � � �
�
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies �
TOTAL °
Page 2 of 3
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City of Eap
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #: C
Permit Fee:
Date Received:
Staff:
// 2016 RESIDENTIAL BUILDING PERMIT APPLICATION
.16. Cj Site Address: ) I ��i , �f K s--/A-t V-2 ev- Unit #:
sident!
Owner a.:
Name: JCd 1 Mo ✓ dJ a [ I Phone: 6-6-1—LIS ... x-103
11 t J
Address / City / Zip: 1 'j-ev iLs I 1 1/ 1-Jf
t
Applicant is: Owner Contractor
Te of
p
(K.
Description of work: -Re� C0.Le _c4
Construction Cost: '2 i SO , O 0 Multi -Family Building: (Yes / No X )
Cont`ctor
Company: %a44 F Contact:
Address: City:
State: Zip: Phone: Email:
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE Plans. i' supporting idoc that ,you submit are considered to 1 e publi ormati tin. Porti
the information may he classified as" non pu iic,if you provid : specific; ' asons that would
conclu hat Ow Arq-2ra p ec! D
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.gopherstateonecall.org
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 authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x hod Ma✓d Loc l (
Applicant's-PPrinted Name
Page 1 of 3