4752 Berkshire Way
BUILDING PERMI
' To be used for SF Dy
CITY Of EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONEc 454-8100
T Receipt #
Est. Val ue $ 6 2, 0 0 0 Date
N° 11685
COO e`z?'
MARCFi 2 6
,19
86
SiteAddress 4752 BERKSHIRE WAY Erect ?l Occupancy R3
Lot 5 6iock 5 Sec/Sub. BERKSHIRE PONDSRemodel ? Zoning R
Repair ? Type of Const. V
Parcei No.
Addition ? No. Stories
¢ RSM HOMES Move ? Length 16
Name
z 1 308 MURPHY LAKE VD Demolish ? Depth 46
3 Address Int.lmPr? S Ft
° ci?, PRIOR L?one .432-2440 install ? p
Z o Name - SAMF. APprovals Fees
0 ¢ Address
? City Phone 432-2440
FW Name A.P.S. HOME DESIGN
?
? Address
a W City Phone
I hereby acknowledge that I have read this application and state thatthe
information is correct and agree to compiy with all appiicabie State of
Minnesota Statutes and City f agan ances.
Signature of Permittee
A Building Permit is issued to: RSM HOMES _
all work shall be done in accordance with alt applicabl t Minnesota
Building Official
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
BIdg.Off. 3f 26/&i
APC
Var. Date
' o
Permit
- 0
Surcharge '
Plan Review
UO
575
SA C .
O
Water Cann.
63
50
Water Meter '
Road Unit 290.00
Tr. PI. 156.00
Parks
Copies
, 0 0
094
Total '
on the express condition that
of Eagan Ordinances.
s
BUtLDtNG PERMtT
Receipt #
To be used for
?.?....?.? ?? ???GAR Esx Value $62t 000 Date
..? .? mmcli 2 6 , 19 86
--
Sife Address 4752 BERKSHIRE WAY Erect ? Occupancy 'ft3
??????????
lot5_ Biock 5 Sec/Sub ?ONDSemodel ? Zoning R3
. Repair ? Type of Const. '?-
Parcel No. Addition ? No. Stories
¢ RSM H(}MES Move ? Length 36
, w Name ,?
Y TrATtE BLVC3
18?08 I?UFtPH" Demolish ? Depth
'??
o ,
Address
P?2??3? ? 432-^?244?#
Gi Intimpr.
I
lf 0
? Sq.?'t
ry one nsta
oc Annrovals Fees
Z o Name ?MF -
? ¢ Address
'' City Phone 432"2440
? W Name R. ?' . S. Hi.??lE DE'":?C@?
? ? Address
a ? Gity Phone
i hereby acknowledge that I have read this application and state thatthe
information is correct and agree to comply with all applicable State of
Minneso#a Statutes and City qf Eagan Ordin,ances. ,
(
Signature of Permittee ,? ` -? -? •w '?"`--°
R1CMi
CITY OF EAGAN
3830 Piiat Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
? - . l. ,..
Permif
Surcharge 31700
159'50
PlanReview 57-5`00
SAC
Water Conn. 500.00
Water Meter 63.50
RaadUnit 2$0'00
BIdg.Off. 3d26/? Tr.PI. ??'?'•??
APC Parks
Var. Date Copies
Tatal $'4' ??
A Buitding Permit is issued to: on the express condition that
aN work shail be done in accordance with all appiicable State ofi Minnesota Statutes and City of Eagan Ordinances.
_...- ,
?.
Buiiding Official 4
.
» Psrmlt No. PermN Haldsr Daie Tslsphone q
Ph?mbing
H.V.A.C,? ?
Electric
Soffener
Ir?spection Date Insp. Commenta
Footings 1
Fopfings II
FoundaNon
Framing ?j ?',..
RooiMg
Rough Ptbg. -??- ?
Rouyh Hty.
InsaL
Firepiace
Final Hty. ?
Final Plbg. p ?6 m o
Bidg. Finai
CeK. Occ. klj
. Deck Ftg.
Deck Prmg.
Wttl
Pr. Disp.
PERMIT #
ARECEIPT # ? ?? ?
? •
? DATE
?
71
CITY OF EaGAN
PLUMBING PERMIT
454-8100
MtNfMtJM RESIDENTIAL FEE - $10.00 + $.50
MtNIMUM COMMERCIAL FEE - $20.00 + $.50
FEE r!??•t'"1
srC "5z'
TOTAL P?-7
Bidg. Type: Res Z Comm Inst 2. New _A Add
Alter Repair T
3. Total Bid Price e"') 4. JobAddress
Lot S? Block ? Sec 5. Owner
6. Contractor
--- . _- --_, -
-;(Name
-"_)-..--- _?,
7. Contractor P?one # ? .??'
NO. FIXTURES
? Water Closet - $3.00
TBath Tubs - $3.00
Lavatory - $3.00
7-Shower - $3.00
-/ Kitchen Sink - $3.00
-Urinal/Bidet - $3.00
?•'?Y?.,? ??. :??:? ,.?? .? ? S?r9?.? .?+:3.?='
y"(Stree? (QitY) (zip)
-- _a ,
?
NO. FIXTURES NO. FIXTURES
? Laundry Tray - $3..00 _Weil - $10.00
! Floor Drains -$1.50 Private Disp Syst -$10.00
! Water Heater - $1.50 :2:Rough Openings w/o
?Whiripool - $3.00 Fixtures - $1.50
? Gas Piping Outlets - $1.50
_Softener - $5.00
COMM.liND. RATE - 1"/o OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACM $1,000 OF FEE.
Signed: for
ApprQVed :Inspe4ns: Date Rough Insp. Date Final Insp.
• ' 3830 PII
GONTRACT PRfCE: &..A& ?A..A, r j I. "
Site Address 4752 Y"
Lot 'r Block SeclSub
Name uuL4&ifY1?i.1C
? Address p' a. BOX 1
? City ?urnsvi1.1e
He.a
Phone
Name xbn nomes
(D
Address77?G tioper 145th S
? City...11i?A3C 1411AX Ptiane _
TYPE OF WORK
Forced Air Boiler
Unit Heater
Air Cond.
Vent.
Gas Piping Outlets #
Other
75,000 M BTU
M BTU
M STU
M BTU
CFM
s
PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN ?
r KNOB ROAD, EAGAN, MN 55121 DATE:
r,l. PHONE : 454-8100
BLDG. TYPE WORK DESCRIPTION
& - A C Res. X New x
Mult Add-on
Comm. Repair
` Other
FEE:
S/C:
TOTAL:
FEES
RES. HVAC 0-100 M BTU -$24.00
2 44-0- - = --ADDfTIONAL? - 5f3"TkV
ADD-ON AIR COND. 0-24 BTU - 12.00
24-00 ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% t7F CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STA7E SURCHAftGE PER PERMIT - .50
(ADD $.50 S/C fF PERMIT PRICE GOES
1.50 BEYOND $1,000.00)
.50 ?
L
SIGNATURE OF
I
26.00
FOR: CITY QF EAGAN
MI-#? ??
PE ? ' 0 .
` CONTRACT PRICE:
Site Add?ss
:- Lot Blo¢k .
,(<? .. ,?,r,?_,.
? Name WLVZ:, ? Z '?47N
a?
m Address / 4p
c City •'`Y'+?°?? Phone
MECHANICAL PfRMiT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
PHONE: 454-8100
Sec/Sub
BLDG. TYPE
Res. i,-"
Mult
Comm.
Other
WORK DESCRIPTtON
New
Add-on ?.-
Repair
Name J4-
c Address
pp City Phone ?
TYPE OF WORK
` Forced Air
Boiler
Unit Heater
: Air Cond.
Vent:
. Gas Piping Outlets #
Other
M BTU
M BTU
M BTU
2- 41 M BTU
CFM
FEE:
S/V.
TOTAL:
FEES
RES. HVAC 0-100 M BTU -$24:00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEFiOJlil') - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
LS
REMODE
?
d2.O
MINIMUM COMMERCIAL FEE ,
STATE SUReHARGE PER PERMIT ,
- .?.?3
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
? ,,.?? ,?? .. • '»`?
' F??i',...-,"y*,kw?.,;d',,4'j? ?',? J ..?,?/,ye?n,V?•y.,J.pcyr
S75 11 S1d? E=
FOR: i OF EAGAN
C(TY OF EAGAN Remarks
addition BERKSHIRE PQNDS Lot 5 eIk 5 parcel 10 13750 050 05
Owner
Street 4752 Berkshire Way
? lmprovement Date Amaunt Annual Years Payment Receipt Date
STREETSURF. g 1982 239.09 23.91 10
STREET RESTOR.
GRADING
SAN SEW TRUNK 07 1982 176.04 il. 7/a, 15
SEWERLATERAL 1982 57.2(F 3.82 15
4?L-3 1985 497
88 53
WATERMAIN 6 1982 .
46.09 3.07 15
-NVATER LATERAL , -
WATERAREA ?Og 19$2 176,o4 11,74 15
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SlDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PAR K
RESIDENTIALBUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
i
New Construction Repuirements Remodel/Reoair Reauirements Offlce Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 7/1/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date / Z Construction Cost zU?apO-
Site Address L f??? !? ? 2/? S? ?2 E C-v 14 f' SS (? Z Unit/Ste #
Description of Work 666 C A /00 P? I'( C10 r
Multi-Family Bldg _ Y_)?_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner /42 k 4 T i rl/ 4 GJ 2/'G h f' Telephone #(
Contractor 1V 8?1 E ow/v4= 2
Address
State /L i3 0Jc- City
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Cate?rv 1
• Residential Ventilation Category 1 Worksheet
0 submission type) Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
,
; :,; ? • ! 'Mechanical Contractor Sewer/Water Contractor '
y ?._..._:.... f?
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and wor is not to start without a
permit; that the work will be in accordance with the approved plan 'n the case of wo? w requires a review and
approval of plans.
g IIJ
pplicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 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 ? 18 Deck ev 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
)& 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
?, p a o
\ l?`1
_ Footings (new bldg)
Footings (deck)
?C Footings (addition)
Founda.tion
Drain Tile
Roof Ice & Water Final
i0 Framing
_ FAtreplace _ R.I. _ Air Test _ Final
Insulation
Occupancy vz- ? MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By 0 , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
"Demolition (Entire Bldg) - Give PCA handout to applicant
k ? C eaV ?°?Z ?`'? '????J? ?
-2 o a K750 = ?0'* 0
h
?cc? ??cr??icr • i- oT s j
-- COvw-r Y 4
?.
?
(93 ? ?7)
?
?
Z N
?
h
>C 10
0
?
?
`Q33 2? ?
? --, I
w • i n ?± tDHS11LTINC3 EHCiiHEf:1S. •
? N?7! N E? IlI ??7 PiAHHE:IS nad tAHD Si1AYE?TO?s
COMPRNY, tNC.
-?lQ00 EJI.T 146zi S,e E=T? QllRHSVILLE t LtINHE!:-,.l .`,Z=7 P4 4:2-jpGfl
CerZz?`z
i
NQ? 7 H
SGAGE ' / "- 30'
7
BG4CK 5? BERKSl7IRE -RO?V,Q?? Z>f{KOTA
-?
?NSPECTIONS
30 ' ?RONT gU/LO/NG ? ?
'S,erBAGr L.iNE ?
? N86° Z6'48 "'vV
149,17
?-
?
o ••? ? -?
1?
o?
00
?o
?
o` N Z? 6? p ? 2 5.? 67
??C ?-
\
?t/86 ° Z6 '48 "w
, oRAiNAGE ?= , So' Bu??-niNG
vTi?. iT }? EA Sc'mE iv-' ??SETBACK ?JNE
r
?o
?
?
? z 6.0-)
?? 6.o)
(93/? ?? 4?ENO'TES Ex1571NG E[.EVA%/aN
?93/•2-) DENOTF,$ P,qOPOSEo ELEVAT/ON
/NO/GAT?'S L=)/RECT/O/V dF SURGAGE
? .ORA /NfaG-E
p GARAGE F<ooR ELEVAT/IOA? : 934.83
I her*by eartify that this ia a t: e and car?:f raprraentit3on of a trsct of
lind as showt?' ind described heracn.- Aa prsparzd by me on this ?y_ diy o!
/ylstieul , 19 Qc. . ' .
,-? ,?4 -
Hinn. Reg.
W
?
?
?
w
x
?
?
Q
?
1999 BUlI.DING PERM17 APPi.iCATl4N (RESIDENTtAL)
ciTr aF EacAN
3830 RILOT KNO13 RD - 55122
-3 `?-41 ss1-681-4675 New Conshuetion Rm rmeMs
> 3 regMerad site sunreya showing sq. B. of bt, sq. #t. ofi house 2 copies of plan
and gl roofed areas (20% maximum lot cavercgt atiowed) 1 set of energy calcvkdicns for Meatoci addftm.
3? 2 copiea af pians (sficw beam & windowt sizas: Powed Md. drsign: etc.) 1 sMe swvoy br exfericw addNkm & decks
D 1 se1 of anergy cakuMfions
D S copkss of iree prosencdion plan If lot pfa#ted adter 7/1/93 a
DA1'E: `r I' CONSTFtUCTtON COST:
QESCRIPTION OF WORK: S?? rn c[Qre-'-q? ?
?---
sTREEr ADUeEss: Sm/
LOt: ? BtOCK: ? SUBD.iP.i.D.
Name: ( fL' 1- L Phvne #:
PRflPfR?Y tast Rst
4WNER
Street Address: -- 7
/ 2--?--'
City Stote• yz:'?, ZiP;
a
Company?? Phone #: cs
(area cade)
CONTRACTOR
Sfre?t Addre?? sl? i?c?snae # ?`5$?'f
Ci}y ujcz? edi:n=2 Sttite• S:74ad.t= Zip:
/#RCHITECT/
ENGINEER Company: Name.
Telephone #: area code ( )
Street Address: Registrcrtion #:
Cffy S#ater Z[p:
Sennner L wctter Ocensed plumber (reauired for new conslruct,?gn onhrl:
PenalFy appNes when address change and Mt cbange is reques#ed once permtt is 1ssued.
! hweby =knowfe+dge tha# i heve read ihis appNcaffcn, state tMat fhe irdOryaHcn Wre , nnd ta coev* wRlt dll cpplicabl
Skite of MMnesota Statutea and CHy of Eagan OrdMances.
.._._.•------'..""
Sfgnptme af AppNcoM:
OFfICE USE UNLY
CeMcatss of Survey Received Yes No
Tree Preservation Pian Received Yes No Not Required
Of FICE USE fJNLY
BUILDING PERMIT TYPE
0 01 Foundation 13 06 4-piex 13 11 10-plex 13 16 Fireplace 13 21 Parch (3-sea.)
A 02 SF Dweliing 0 07 5-piex D 12 12-piex 0 17 Garage CI 22 PorchiAddn. (4sea.
CI 03 1 of _,_,_ plex ? 08 6-plex ? 13 16-plex O 18 Deck ? 23 Porch (screened)
? 04 2-p1ex E3 09 7-plex ? 14 Apartments 13 19 Louver Level )W 24 Storm Damage
O 05 3-pfex ? 10 &piex ? 15 Lodging O 20 Poal Cl 25 Miscellaneous
W4RK TYPE
0 31 New 0 35 Tenant impr ? 39 Gas L.ine 4nly 0 43 SidinglSofF'its/Fascia
0 32 Addi#ion ? 36 Move Bidg. ? 44 Gas tnsert D 44 Windows/Doars
0 33 AI#eration ? 37 Demolish Bidg.* 0 41 Vllood Stave Ca 45 Fire Repair
? 34 Repair 13 38 Demoiish (In#erior) 0 42 Reroof .
* Give PCA handout #o applicant for demolition pennit
GENERAL INF4RMAT14td
Const. (Actual) 8asement sq. ft. Census Gode
(Allowable) Main level sq. ft. SAC Code
UBC Qccupancy sq. ft. No. of Uni#s
Zoning sq. ft. No. of Bklgs
# of Stories sq, ft. MC/ES System
Length sq, ft. City Water
Width Foatprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee
Surcharge
P{an Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Vaiuation: ?
SAC Un+ts
°lo SAC
?C_l Q0 RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements Remodel/Repair Reauirements Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of SuNey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detaii Options selection sheet (bidgs with 3 or less units
I .-
Date Ov
Construction Cost rZ4600
Site Address ? f 7 5 z ?t-- IZ Unit/Ste #
/?- I? KJ f9?? ?/ L Z-
Description of Work ? -Qi4441-4)
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ Li,?::;?2
Property Owner M lq" W 12+ ` 6 A T Telephone # ( lnS_1) 6,8 6-73e4L(
Contractor -2vt 13 p
kl?;, 7-
6
ft Z O Z ? C u??-
Address 'ty k
State p Telephone # ) ? V
c
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Cate?ory 1
(?l submission rype) • Residential Ventilation Category 1 Worksheet
Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone # (
Telephone # (
Telephone g
)
;
;
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City ts?f Eagan and the_.St? of MN
Statutes; I understand this is not a permit, but only an application for a permit, work is not to start without a
permit; that the work will be in accordance with the approved plan in Ze e case of rk whic?equires a review and
approval of plans. I . L
A q- 2 k, 4 w C 6 it -f
Applicant's Printed Name
OFFICE USE ONLY
Sub Types
? 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 ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Inte(or) ? 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) - G ive PCA handout to applicant
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
_ Footings (new bldg)
? Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water
_ Framing
_ Fireplace _ R.I. _ Air Test
_ Insulation
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
Final _ Pool _ Ftgs _ Air/Gas Tests
_ Siding Stucco Stone
_ Final Windows (new/replacement)
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Tatal
Final
Building Inspector
Reuder No.: ? fAfF4 V.- _ lu. vvp4a
tig?w to'oom*11y ?rhh tM ? aysn? ? tl?? . 50pd ?
? Q?„??REC??'..1s6,oa? ??
• 7ot?1: 63.50pd meter
BY Date Pcid:
Dats of Insp.: ' Irusp.:
_ _ , _?, ... _. . _ . ?... _.. __ _....?. . . .?..._ _. _ .?._.. . . u .. . _ ? _ _ _
CITY OF EAGAN ? ?cl Pmmff
3830 Pi{ot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 3 t
DATE: 4-?' t- ?
Zonirp: No. of Units:
r{ :? • ?.
Owner:
Address: ?-
Site Address:
,
Plumber:
S?•'-_-
1 M aoIn* w1lh t!u Glp of Eegew ConnecNon Clwrpe: '`
Ordiaeeom
Acwunt Deposit: ?. ?
?: i i,,•. ?},,
Pemnit Fef: •? `'
Surcho?ps: ' Q
By CFarges:
Misc
.
Date of Insp
: Totol:
.
I nsp.: DoM Paid:
; CITY Of EAGAN ??? ?" PSUM
3830 Ptffot Knob Rosd .
' P. O. Box 21199 , ?
PERMiT NO.:
Engan, MN 55121 bATE:
Za?in9:
:
No. of Units:
' Owmr.
IIWrea.
Site Addrcss: ? . ' i> r '_ ? ' x ?' ;??•
PIYMbEC ??r 4 s'r ?•_ _
' Meter No.. Connection Chorge: } • `? ?"",
? Size: ActouM Deposit:
Reoder No.: Pe?mit Fee: -
' 1 evree h oosnolp wilU !be City oi Eeyow $urchorge:
Oedlsenea. Misc. Choryes:
Totol: ;-
By Date Poid:
Dote of Insp.: 1nsp.:
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?
C I T Y C? F E A A i? ?*?' PAYMF'NT OF FEE AT TIP? OF *
, - . ?. APPLIcATIoN ooES nxOr CONSTITUM ?
. ? APPROVAL OF PgtNIIT. ?
APPUCATION FOR PERMIT
- . ? IAISPF7CTION OF SEWER ANID/OR
WMR
, ... ? TNSI+AT r.ATTONS WIM 1VOr BE SCHE3- *
SEWER AND/OR WATER CONNECTION ??m Umm Pm:tblIT HAS BM ?
. . . . . ? APPrOVED. ?
* *
__. **************************?*********
, P ease Print
? 1) PROPERTY ADDRESS :
LEGAL DESCRIPTION:
, Lot Block Subdzon or Tax Pareel ID
)
IF EXISTING S'IRL'GZL?RE, DATE OF ORIGINAL BL?ILDING pEF2MIT ISSL'ANCE: "
; .
PRESENr ZONING/PROPOSID L'SE: (Month/ )Cear) -
? CONVII2CLAL/RETAIL!0FF'ICE 121__R.-1 SINGF.,E FAMILY .
Q INIDL'STRIAL 0 R-2 DL?PLEX (Two LTnits)
[I INSTITfJTIpNAL/GOVERNMNT CD R-3 'IOWNH0L?SE (Three + Units ) ( Lnits )
. ? R-4 APARTNENT/CONDOMINILTM ( Units )
2) .
... ,
NAME:??L? ?rt`?r ?L_i,K`??"? ? ?-C, /-?"?? /?- •
ADDRESS: t ? q` `- -
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CITY, STATE, ZIP : ?'? • _ ? - ,-- _"? ' ( --
. r?PHONE:?? IJ
3) • ?. ?• _
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ADDRESS:_- Z,2 `?
CITY, STATE, ZIP:
PHONE:_ MASTFR LICENSE# II?
?A- S 1l C3
4) ?• • ia?•
' NAME:
_ ADDPESS :
CITY, STATE, ZIP:
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L'lUR1b2rS I,].CP_I1Se:
Active
Fxpired
IVot recorded
5t =tial
PHONE:
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•5) iMo «: • ?• : a ? a??
? CONNECTION T0 CITY SE'WEi2 ? CpNNDC'rION TO CITY WATER C( OTHER '. : 6) ' ? _ • ? [? PI,FME HOLD APPROVID PII2MIT FOR PICK-L?P BY ONE OF ABpVE --
?. PLEA.SE MAIL APPROVED PERMIT TO 1, 2, 3l 4. ABOVE ...
' - (Circle one) :
7) I, /_A
?i?
_ .
. FOR -CITY J
USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $_ ?,?"• ? ? SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLLDE SURCHARGE) .
$ ?"•%'-5 ?-' $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ? ?• ?'` '' ACCOLNT DEPOSIT - WATER
$ ? ?tC? • C; $ WAC .
$ ? 7 -Zj $ SAC _
$ $ TRLNK WATER ASSESSMENT
$ $ TRLiNK SEWER ASSESSMENT
$ $ • LATERAL BENEFIT/TRLNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLAIVT SURCHARGE
$ $ OTHER:
$ TOTAL
o
RECEIPT RECEIPT ?
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ?
• F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
Q
NO ROADWAY" MLST BE ISSLED.PY THE ENGINEERING
DIVISION
LIST AS A CONDI
ION
. T
.
SLBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
TITLE:
DATE :
.
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?IcvEL A
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
COlMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
SINGLE FAMILY D6IELLINGS
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For :??nW Valuation a(P2-,dd0 Date :
Site Address /
Lot ? Block ?
Parcel/Sub
Owner ..t??? ?1ayy]?/?
Address Lyze
City/Zip Code 10,1&..,1„1,-J1.7f
.Phone
Contractor
Address
CitylZip Code.
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USE ONLY
Occupancy K•3
Zoning ?•I
Type of Const ??
# of Stories
Length 3(0
Depth
Sq Ft
APPROVALS FEES
Assessments Permit 311T
Water/Sewer Surcharge 31.
Police Plan Review 1,5FI.
Fire ? SAC 5"75
Engr ? Water Conn Sc?
Planner? Water Meter ?.
Council Road Unit 290.
Bldg Off3 J Treatment Pl
APC Parks
Variance Copies
? TOTAL o2 0
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NG?NE?3?ING taHSUC7IHa ExasxfERs.
PLAHHE:iS nad LP.HD SZIAVE'iOAS
COMPRNY, tNC.
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I hersby cart4fy that this ia a t: e and car.-:t rapreaentation of a traet of
ljnd ss •hewn snd described heraan.- Aa prapa: ad lsy ma on this ?yT? diy o!
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CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19 ?:?
• RECEIVED ?,` ? ? ? ? p .s?.. ? ?,I J.?-?• -f' ??I???, (?-?`
, FROM
'AMOUNT
White-Payers CoPY
Yellow-Posting CopY
Pink-File Copy
Thank You
.r
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ev
S1 6eo
.
Use BLUE or BLACK Ink
r
I For Office Use II ~j I
Permit
ppEagn T i
City of I C,
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: f
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 I Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: reI c h Phone:
Resident/
Owner Address/ City/ Zip: yySa f~l, ks L,,'~ j„/m,✓
Applicant is: Owner Contractor
Type of Work Description of work: r 6?o7/1
Construction Cost: OdU Multi-Family Building: (Yes / No
Company: L awn .r/ G„. frr `o, s Contact:
Contractor Address: S"G 7 141.. /_?'F Sf City:
State: MN Zip: 5 S3 7 F~ Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are "trade secrets.
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.oopherstateoneGall.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 Gcr / ~ J.
X
Applicant's Printed Name Ap cant's Signature
Page 1 of 3