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1346 Berry Ridge Rd? ..^?:?i ar•^,?-• .,... . ? ? ' .' '_ " :. ' . . ?,.r^??4: ,•^rz'.'^.mR+?? ...;n?. . .. .. .. .. . ? .. . h:.:.. ? T^ .h .°`?{+.`did`.'.°°i53 vs''"v"? .. ....:, .: ? • "...:..,. "..2`::,? _ CA3H RECEIPT CITY OF EAGAN } 3795 PIL.OT KNOB ROAD EAGAlV, MINNESOTA 55922 DlkTE 19 RECEIVED FROM aMOU?vr ?-- - & DOLLARS oo r ? CASH -- -B`CHECK . ? Ft7ND ? CODE AMOUN7 -? Thatlk Y0 ? .,BX?' White-PaNers Copy Yetiaw-Posting CopY Nm ?, 3898 Pink-FiEe Copy . .V1.S'!? iv? ittL?7A? ..: 3iS „ •T?? . , ? 09S Peri lCnofi RouB PERt4tC7' NO.: 271 . 0 ` Ea+gae, NhN $5122 DA7E: r Zoning: F,tXI ^ No. of 3,ln'rts: ?, . Otunerc . ` Addcess: ' ? Site Acfidress: Plumber: : Meter No.: Conriec€ifln Clictrge. 2 ?» 70- ; Size: . ' Accautt .Ueposit: Reader A#o.: Permit Fee: r 1 agsee ta oompiy with tkre Cily of Eargarn Surchurge: 6$ 0--P4 tkdinonce?. Misc. Charges:. P - . Totut:' > By ?- Dn#e Raid: Date of trtsp.: 4.r,sp.: , ,? ? k " Q ?7??"rov"000 W'., PiMi? t?ooTr ?tcqA PERlvt(T #?O.a ,7??? F31?TE: ? -..? N0. oY' .LJi/RI l.S: l .'. 4 . y, *rr 4 ?+ ?# ? - -- - ------------ ' 'Aad+e*: 334?+ &?rz? um t?caad i.?25 S5? ?il?.t?.a ??t?,? ?? Pt?mk+er'• G?nss ,Ryatw P riq- F ea ?.? ?`$ P } p ? t. - ' . '. . .. , .4l1"019g 138W ' .. •' 1?.? ? ? ?? ? OPN)IY WIIb Efie-O}y Of tb9aA COftn@G'klOh iC1P00q•4-??-?.??.?-.? , ACenutlY Deps?s't y, ° ` i F e. Pem r t e Surcharge. t $1+ Mt`9C. CIIQFgeS: A Toia4: In4p. Date Poid: fj ? ? CONTRACT PRICE: Site Address d > Lot Block Sec/Sub m Name co Address '_ c City t f_??? Phone ? Name aD c :. . Address 4 , OO Ciry -.., Phone"? x' S,; 2/7-1 FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APFL!€S, MINIMUM - RESIDENTIAL FEE ?--?12A0 - MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PEF3 PERMIT -'' T.59? (ADD $.50 S/C IF PERMIT PRICE GOES `-` BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: GITY OF EAGAN PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE: 454-8100 PERMI7 # RECEIPT # DATE: r 0' BLDG. TYPE WORK DESGRIPTION Res. New Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00. Shower - $3.00 Ki?chen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 J-Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: GRAND TOTAL: Site Address 1346 '? ?IDGE RD Lot 29 Biack ? Sec/Sub. UxLL?OP ?TA'1"E! Parcel No. W Name STE'itI +{? t?I,d? ?'TC?L ? Address i3?' UUY RI?R ? 0 City "CA14 Phone , o Name ? ? ?OUS 114C 00a Address ??? 25SU IST V ? City ???NGTON Phone "3~"2876 t; ¢ WW Name ?., W ?? Address a W City Phone Buiiding Official Occupancy 1 hereby acknowlege that I have read this application and state that the information is correct and agree to comply with alf appiicable State of Minnesota Statutes and C?y of Eagan Ordina es. Signature of Permitee ?- , ? A Building Permit is issued to: ?? ofts im'?'+ on the express condition that afl work shall be done in accordance with ail appiicabie State of Minnesota Statutes and City of Eagan Ordinances. ?. Zoning (Actuai) Const (Ailowable) # or stories Length 111111mb Depth 08* S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off Variance OFFICE USE ONLY 11-3 FEFS -A!P Bldg. Permit Surcharge 4+00 JW4 Plan Review ? SAC, City -` SAC, MCWCC ? Water Conn - Water Meter ' Acct. Deposit `?•, S!W Permit - S!W Surcharge 7reatment PI Road Unit Park Ded. Copies TOTAI ??.00 Permit No. Permit Hoider Date Telephone # WATER SEWER PlUMBlNG rr H.V.A.C. ELECTRIC °J Mspection Dafe Insp. Comments Footings I Foundation Framing D ,S' Roofing Rough Pibg. Rough Ntg. Isul. S Fireplace Final Htg. Orstaf Test Firial Pibg. Plbg. inspector- Notify Plumber Const. Meter Engc/Plan Bidg. Finai Deck Ftg. Decic Final Weil Pr. Disp. CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 85122 , PHONE: 454-8100 BUILDING PERMIT Receipt # To be eted for &Est. Value • DaYe - ? 2 N2 5 1 19 79 .. Site Address n134t'; '?''-= RiOge "'oae Erect [3' Occuponcy Lot 29 Block r Sec/Sub. 1.111??n tst'' Alter ? ' Zoning ? ., Parcel # 1?'; ^3-?201 291 05 Repair ? Fire Zone -? Enlarge ? Type of Const. e ? Move ? # Stories :?: Ld ress - Demolish p ? Frqnt ft. •x???" '- Phone -? Grade ? Depth ft. oe Name Approvals Fees UQ Address Assessment , : . .. Permit ce r Water & Sew. Surcharge Ci Phone Police Plan check F, WW Name Fire r?V- -Vr; SAC ' 4 ?. s? Address Eng. ? .'; Fs s5 WaYer Conn. ? aW Ci Phone Planner Woter Meter Councii ?t','.t, a. -;r, I hereby acknowledge that I have read this appiication ond state that gldg. Oft. the information is correct and agree to comply with al) applicable APC Total ? State of Minnesoto Statutes and Ciry of Eagan Ordinanees. Signature of Permittee A Suilding Permit is issued to: on the express candition thot all work shall be done in occordance with alf oppiicable State of Minnesota Statutes and City of Eogan Ordinances. Building Official ' Permit .# Date Issued PeemiKas Plumbing 1 8,3 S `.13 - Mechanical -- y qGt Z -_ C E-kt? 1?' bR?-ab S - a IPfSPECT10NS DATE INSP. Rough-In Final Footings ? Date Insp. Date I Foundation Plumbing Frame/ins. -41_? 17 Mechanical o? ? Final Remorks: J? /*.Y-- I"IW A l??? Aop / , r. CITY OF EAGAN . ' #. 3795 Pilot Knob Road ' Eagon, Minnesota 55122 , Phone: 454-8100 , ?e•--;?., DOYe: - Site Address PERMIT No. Receipt No.: Single u Residential ? Lot Block Sub/Sec. Multi Res., Comm.jlnd. I Nome ? - New/Alter.JRepair 3 Address Cost af Instollation O ?""?._°`S? ?".?,;???-., ? ?•°» yw;="r ?y?; g',?-i C?"-+ty Phone: _ Permit Fee _ N e Surcharge ? w Address c V City ? Phone: Totnl This Perm+t is issued on the express condition that ail work shail be done in accordance with all applicable State,of Minnesoto StaYutes ond City of Eagan Ordinances. Building Official l _./ CORRECTtON NOTICE A DATE: 1-2o- 77 ; Address f?I Q!?ze Site Name Owner/Agent vf-4 k,? TelePhone Owner/Agent Address Ordinance Nos, and Corrections - Correct By For reinspection Eagan Dept. of inspection Inspector: . 3795 Pilot Knob Rd. , Eagan, Minnesota 55122 ?.? 454-81oo Dept.: f > . ? , - -t?? p - To ' v (t 3 Z? - oate rrn,e Wa-liILE C9 ??? 1.! 'lAtE?E t711.lT ?C?T .v' t PO r't.G3t.?r M . af 3 0 0 fl ? Phone Area Code Number Extensfon TEIEPHONED PLEASE CAi.L CAILED TO 8EE YOt1 W{Ll C111t AGAIN WANTS TQ SEE YOD URGEMf I RETURNED YCiUR CALL Messege ? ??LrC{^'l.? 1,oi k ["??`' . Qparato AMPAD 23-4?SHT. PAQ Cr ?A EFFtCIENCYp 23-001 250 SHT. DiSPENSER BOX CITY OF EAGAN Remarks ? Additi,on HILLTOP ESTATES Lot 29 eik 5 Parcel Ownerl?tl& 5 De15c?4.? S. ?DYVtj&,street 1346 Berry Ridge ROad state Eagan, l?IIxt 5 S123 Improvement , Date Amount Annual Years Payment Receipt Date STREET SURF. ? C006539 9-26-79 I STREET RESTOR. GRADING SA9U SEW TRUNK ig'73 172.14 8.61 0 5-23-79 • SEWERLATERAL 2$$$ j9 C006538 9-26-79 * WATER LATERAL WATER AfiEA 977 181.34 12.09 15 145.10 A007799 5-23-79 * ` .* STORM SEW TRK * STORM SEW 1.A7 980 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 75.00 WATER CONN. 270.00 13898 4-18-79 BUILDING PER. # sac 525.00 13898 4- 8-7 PAR K I C1TY OF EAGAN 3795 Piht Knob Rood Eagae. MN 55122 Ng 5 162 e PNON8:454-810G BUILDING PERMIT APPLICATION Receipt .# Ta 6e used for SF Dwlg & Garage Esr value 50i000• pate 4-18 19 79 . Site Address 1346 B=YR?_cl = Road Erect [X Occuponcy R3 Lot 29 Biock 5 sec,sUb. _xiiitop Estates Aiter ? 2oning Rl 10 33000 290 05 Repair ? Fire Zone 3 parcel # Eniarge ? Type of Const. j1 MC?'hCpTis??lOri Name y Move p # Stories W ? Address 1471 Br1dgEV12w Qemoiish .p Front 50 ft. C+ Phane 452-5373 Grode p Depth 48 ft. ? p Name 5? Approvais Fees ?U Address ?- ?:... Name Address ! hereby ocknowtedge thoi 1 have read this applitotion ond state thot the information is correct and agreejo compiy with a i oppiicable State of A+iinnesotfl Stntut,es)ond CIW of Eagan_ ces. Assessment Water & Sew. Police Fire Eng. Pianner C.ounci l Bidg. Off. APG Permit , av Surchorge 25.00 Pian check 70.25 snc 525.00 Woter Conn. 0 270.0 Woter Meter 60• 00 Zoad unit 75.00 Total 1,165. 75 Signature of Permittee McCarjlly A Buiiding Permit is issued t. OmStruCtion on the express condition thot all work shall be done ifi a w' appli St of Minnesota Statutes and City of Edgan Ordinunces. Building OfFiciQl Mo? f Eatdn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(65y)675-5694 o CC???M(? D SEP 1 1 200$ 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 34(v Tenant: k'Y? Suite #: RESIDENT / OWNER Name: HQJ1SkC,- Gd'O" Phone: 6,?-[ & 63 (D 308 Address / City / Zip: ?? ?? ? HAf Applicant is: Owner 4 Contractor TYPE OF WORK Description of work: tA)i?lA0c,--1-s Construction Cost: q DOo . oo Multi-Family Building: (Yes / NoX-j CONTRACTOR I Name ?Qa40 -??r7t`./KS4 &'t`i'1L'tlCnSLicense #: J030 1e)?) Address: ? City: U4Uq. Phone: ?p S I ??I(y P-)3Ce (,a Contact Person: State: /-Iiv! Zip: ?S W) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateqory 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submisSlOn type) • Energy Envelope Calculations Submitted 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: 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 s. accordance with the approved plan in the case of work which requires a review and 9:? X U&?Coc?- Printed Name pplicant's Signature Page 1 of 3 ? RESIDENTIAL BUII.DING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ?c.?. d sj13? 03 New Construction Reouirements RemodeVReoair Requirements 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 8 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-Ve septic system _ On-site Septie 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 LAI i Date?/ Co st ctionCost 3-rL , ??vl s ? Site Address G? -? ? Unit/Ste # a a ? v? 3 Description of Work Multi-Family Bldg _ YKN Fireplace(s) _ 0 ? 1 _ 2 Property Owner 11 Mp1v?S Telephone # (447 3ID ? Contractor Address -? City ?LLC ? -T State Zig ,c - - tj T?lephone # ( ?? ) ??? rCJ ?(?" ? COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING - Minnesota Rules 7670 Categor? Minnesota Ru1es 7672 Energy Code Category . Residentiai Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Wqter Contractor Telephone # ( ? P ? i, t'-? ? elephone # ( MAY 0 6 2003 ? elephone # ( 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 tVIN Statutes; I understand this is not a permit, but only an application for a pernut, 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. ? .? % IYlarAZI Meler Applicant's Printed Name Applicant's Signature Sub Types OFFICE USE ONLY ? s ? 01 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E3ct. Alt - Multi ? 03 01 of _ plex ? 09 07-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ty, 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Mtsc. ? 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 (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors 0 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered , Type of Const Width REQUIRED I NSPECTIONS ; Footings (new bldg) FinaUC.O. ? Footings (deck) ;( FinaUNo C.O. _ Footings (addition) ? Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final y Framing _ Siding Stucco Stone 4 Fireglace _ R.I. _ Air Test _ _ Final Windows (new/replacement) _ Insulation _ Retaining Wall Approved By?_z? , 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 I i !FORIIA NO( 48 ? I, --- -_ - --- -- ---? --? l i ? _i i -- !- ?-, ? ; . s kcompuT,ATION SHEET CITY USE ONLY PERMIT #: RECEIPT DATE: 2002 RUID$1QTIAL 1K$CB"CAI. PERVIIT Af'FI.ICATIOR crrY oF akshu 3830 PnoT KNoB iln EAGM MA 55122 651-681-4675 Piease complete for: ? single family dweliings townhomes and condos when permits are required for each unit Date: /a f 3`D :;L. SITE ADDRESS: OWNER NAME: 2VAU?2 TELEPHONE #: CS/- gW 3^- D3d? IPISTAI..LER NAME: _bil,.,? fI, ?(?? '? lJIL? _ TELEPHONE #: STREET ADDRESS: Wj/ ? oi'??,????/ CITY: ?,?, , STATE: UiAW ZIP: .S'S/a :),,, Place a check mark next to the permtt work type _ Add-on, m' ' r aiteration to existin dwelling unit $ 30.00 furrace rep9acemen • air e ch ' anger ??? ?" ` .,.'?air con i?n?.?. ? -?: • other Nature of work: ?- 1J ? ?y State Surchar e $ .50 TOtal $ 3ca ? \- 4. _. I - -xr?... . SIGNA PERMITTEE 1/02 CITY USE ONLY PERMIT #: RECEIPT DATE: APPROVED BY: , INSPECTOR '+??? COJUMCj&. IMCE"M PFJ= 1?MLICATIOR WYt OF FAGEN 3$34 PILOT KN4$ ftD EA6W, bIN 55188 651-6$1-4675 Please complete #or: all commercial/industriai buildings multi-family buildings when separate permits are not, required for each dwetting unit DATE: STTE ADDRESS: OWNER NAME: TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? PHONE #: INSTALLER: . V STREET ADDRESS: CTTY: TELEPHONE #: Y N. NAME: STATE: ZIP: WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work: When installing/removing underground tank call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: 1°l0 of contract price Olt $50.00 minimum fee, whichever is greater. Underground tank removaUinstallation = minimum fee Contract price: $ x 1%_$ (Base Fee) State surcbarge calculate at $.SO for each $1,040 Base Fee TOTAL $ SIGNATURE OF PERMITTEE Updated 1/U2 -AP ? . ? PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55123 Permit Number: (612) 681-4675 Date Issued: ? SITE ADDRESS: ' DESCRIPTION: ? ?, ? ? ?kwo ?p ?? ? Wa e.0i 9 %",.av A° ? ? -10 c O ?, q ? a, . ? ?m ? ?pgg -.6 ?W ? a?? _ ea REMARKS: FEE SUMMARY: CONTRACTOR: OWNER: ??"- ??k / APPLICANT/ ERMITEE SIGNATURE (SSUED , Y: IGNA 1RE - - - - --- - - -- - --- ? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: - 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: REACTIVATE PERMIT # ? - iSSN4 CITY OF EAGAN 1993 BUILDiNG PERMIT APPLICATION 681-4675 ? ??. oio SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy, calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy af energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, Z) address is changed or 3) lot change is requested once permit is issued. Date 3- Val uati on of work 3. F? Q Site Address: 13 y fo - _;Pvf lG ? k 16 STREET SUITfi # Tenant Name: (commercial only) LOT ? BLOCK P . I . D . ?Ik . ? Descri tion of work: 7-c-? d r= The appl i cant i s: ? Owner Contractor ? Other coescr;be> Name S? /41 TcH£ Lc Phone Property LAST FIRST Owner ? BERP J G z ? ? 3 y ?" - Address . O S? 1 ( 57REET STE * City State Zip Company C 1°1 Phane Contractor Address ILI/ p 9- 1"f ? kdc-tC kU License # 3 ?{?la Exp. City Y,>UJ'?S ?'f ? Q ?c State Zip --?T_3 3 Company Phone Archltect/ Engineer Name Registration # Address City State Zip & water licensed plumber . Processing time for & water permits is two days once area has been approved. by acknowledge that I have read this application and state that the information is L t and agree to comply with all applicable State of Minnesota Statutes and City of c ' E Ordinances. agan ure of App licant: ` OFFlCE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation CI 02 SF Dwg. C] 03 SF Addition ? 04 SF Porch ? 05 SF Misc. O 06 Dupiex ? 07 4-Pl ex ? 08 8-Plex ? 09 12-Plex E3 10 Multi. Add'l. WORK TYPE D 31 New O 32 Addition ? 33 Alterations ? 34 Repair GENERAL tNFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS ..`.- -.. 0 lI Apt./lodging IkAl Aa't AA te?Finish O 12 Multi. Misc. P?OO?I O 23 Garage/Rccessory ? 18 Gonan./Ind. E3 14 Fireplace ? 19 Comm./Ind. Misc. O 15 Deck C] 20 Public Facility ? 21 Misceilaneous [3 35 Tenant Finish O 36 Move Basement sq. ft. lst F1. sq. ft. 2nd F1. sq, ft. Sq. Ft. total Footprint Sq. ft. On-site we11 On-s i te sewage Planning Building Engineering Variance REQUIRED tNSPECTiONS ? Site O Footing ? Wa7lboard 0 Final D Framing ? Draintile ? Insulation O Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl, Road Unit Rark Ded. Trails Ded. Copies Other Total: SAC 96 SAC Units vatuatian: $ ? 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Assessments . s COMPUTATION SHEET EST. NO. SNEET OF DATE _ . , . l ? ? ? $ I .. ?. ' ; . _. • 'i ? d? j 1 ? . __ ._._. . `. _-- . i t. .. -_ _ .. -- _ _ ,.._ { ?- . t. ?.._ ._ ! ?_e... . ! ?/t ? r- DATE 7 l ? - BL'ILDI:VG PERMIT APPLICATI0:3 Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy caieuations. To be used for Re- Valuation ?ci G? Site Address: Lot Block Sec. /Sub. Parcel Number J? :?3pC9C? ?91? L?S 2 q 5-' h?,'???a? Owner Telephone ?_ Address K? ?- _ Contractor Telephone Address Arch/Eng. Telephone Address OFFICE G'SE ONLY Erect Alter Repair _ Enlarge Move _ Demolish Grade Date of A roval 112d Initial :j • Assessment __5 Water/Sewer Police ? R Fire Engineer _ Planner _ Council _ Bldg. Off. r. A.P,C. Occupancy ,2U Zoning 'If / Fire Zone ? Type of Const. # of Stories Front .?U Dep th D Fees ? Permit Surcharge ? Plan Check ?93 ' SAC v a? ?2? ? Water Connection ? 7G Water Meter TOTAL ?l??' ? ? ft. ' ?E • 1 ? ? ? ?] j\] COMPUTATION -- ? ? ? SHEET I DESIGNERS • ENGINEERS • BUILDERS LISTED BY CHECKED BY OWNER _ LO CATI O N EST. NO. SHEET OF CONTRACT N0. DATE -A? _...?..?_ _.....?...?..-,........-..,_._.„ ._ _...?... . ...__ ` . _.. .- °---- __.,.._ _ _...??_.__..._._.,....,.._._ ...? .W__. ._.....? I declare under the penalties of law that this account, claim or demand is just and conect and that no part of it has heen paid. Signature of Ctaimant ? Street and Number ??.? . i01,r7 City and'?6te 2ip Code M.S.A. 471.38, 471,391 (1965) 66 Size I- Walter S. Booth & Son, Minneapolis, Minn. - Security Ptg. Co., St. Paul, Minn. - Bankers Certified Servtce Co. REAL ESTATE TAX STATEMENT rHOMas v. NOVAK, PAYABLE in 1980 pAKOTA COUNiY PAYMENT COPY COUNTY TREASURER GOYERNMfNT CENtER VROPERTY IDENTIfICATION F/O: nAL E T& P J MACNAUGHTON HASTINGS, MINN. 55033 d5T PIAT LOT BLK 10 33000 290 05 9CP „ooR:134b BERR ,u- EAGAN ?tri 1961 NAME OF TAXPAYEN IRO/fRTY NOM[SIiADEO D A L E T f, P J M A C N A l •:of 1346 BERRY RIDGE R[ lAN. 1, MH OM IUN. I. 1t7t EAGAN MN NO YOU MAY BE ENTITIEp TO A REFUND To find out il you ore entitled to a refund of port of your property to¦ss Irom the ttote 01 Minnesota, ws ths inlormation on the bock,ol this lorm. USE iNESE AMOUNTS when you fitl out your iroparly Tox Refund Form M•1PR: i Ovalifying Tor Amounr limitad to dwelling ond up to 1on pcres (or 440 acrea of lond and building+ ii forM.) t. itate ?oid Memestwd G?dif 1f rhie box is checked, yeu owe delinquent tasms ond moy net opply for the 1roporry iox ReIvnd. GROSS TAX DISTRIBUTION 3 STATE • QQ 4 tOUNTY ]. ? ? 7 O S TOWNSNI? OR dIY 13.91 6 3CMOOl DISTRICT 50.rj 1 7 OTHER TAXING 015TRICT 2.86 a. NSCAI DIS?ARITY b. DEVELOPMENi OISTRICT • TOiAI GROSS TAX 8!* .9$ 9 REDUCTIONS o. StATE SCMOOL AGRICUITURAI CREDIT - ' - . b. STATE PAIO NOMESTEAD CREOIT 10 TOiAI TAX - $4? 4$ 1 t SVECIAL ASSESSMENiS t / 2 7 3 TOTAI (Sordefa?l ol RiqM) V . T „ TOTAI AMOUNT PAYABLE 352.32 NRSi HAIF INSTALIMENT 176.16 SECONO NAtF INSTALIMENi L76.16 ' RIDGE RD 55123 ESi1MAifO MARKEi-VAWE 2, 520 IGNTON i UMITED MARItEi VAIUE 55123 2,070 . ASSESSED VAIUE V 891 ?ROYERiY DESCRI/TION ?OT T BlK O,rr? ILLTOP ESTATES,; ,,, , , ? Z? ? ? .-. SPECIAL ASSESSMENTS ASSESSMENT AMOUNT STREET 428 267.34 SPECIAt ASSESSMENT TOTAL (TO IINE 11) 267, 34 INTEREST INCIUDED IN ASSESSMENTS 133.67 IINCOME TqX PURPOSES Y 1 O O N 55123 'I PROPERTY IOENTIFICATION asr vlnr ior eiK 10 33000 290 OS 9 1980 i0 AVOID PENAITY ST PAY ON OR BEfORE /NAY 31. 1980 1 ST HAIF TAX 176.16 THOMAS V. NOVAK DAKOTA COUNTY TREASURER TRAN. TAX PD. TOT exeise PEN P0. DAI.E T S P J MACNAU 1346 BERRY RIDGE R(3 EAGAN MN .., LOAN CODE: ? O . .'. T E . PAYABLE TO: OFFICE USE ONtY ? - CHECK O - COUNTER O - CASH ? - MAII NH DALE T E PJ MACNAUGHTON , 1346 BERRY R[DGE RD . EAGAN MN 55123 OAM COQE: PROPERTY IDENTIFICATION N DIST PLAT lOT BtK 0 go 1 33000 290 05 9 E D. . D CASH T980 TO AVOID PENALTY CHECK • ' 2NO PAY ON OR BEFORE OGT. 31, 1980 2ND HALF TAX 176. 16 [;7ABLE To: THOMAS V. NOWAK DAKOTA COUhTY TREASURER ONIY TRAN. TAX P0. O - CHECK O- EOUNTER 5/N PEN PD. ? - casH NM O - MAII TOTAL -?,u.? - .._....__......_ -? . _. _. _ .. _ _ ?._. _ ..........?. ............?.,.. .?wr,....,.-.?wW..,, :.«?r.r.,?.w=-.,.,.sr-..,.y,.._,... ? ' . .. , ?...'».n.....?..n«...,>. . ...,..... - .. .._.?.... . 1991 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS ? ? COMMERCIAL 6-- 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - GONTRACTOR/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 FLUMBER. JUN To Be Used For: ? ??`-?r8" Valuation: () f>t\i? Date: ? Site Address Lot 7 2_L Block i? Parcel/Sub ?40 "i Owner 54C-,; C_ '? T>ro:,=e_ 1 r\1 rj:' < Address City/Zip Code - ? Phone ,?- Contractor Address ? Uj City/Zip Code Phone ul - 7 Arch./Engr. Address City/Zip Code Phone # OFFICE USE ONLY Occupancy Zoning Actual Const Allowable # of stories Length °? - Depth : S.F. Total Footprint S.F. On site sewage` On site well MWCC System _ City water _ PRV _ Booster Pump _ 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 / taiv f APPROVALS Planner Council Bldg. Off. Variance ?4&?:L agrees that all work shall be done in accordance with (Signature"of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. 2000 FIREPLACE PERMIT APPLICATION C(TY OF EAGAN ? 3830 PILOT KNOB ROAD - 55122 651 681-4675 4 ; Date: ? • ??? ?(}? (? Description of Work: _ Job address: Lot: i =?_ Biack: Applicant (circle one only): Construct new fireplace _Gas _Masonry Alterations to existing ' Install gas insert onlv Install gas line onlv Other ??. ? Subdivision/P.I.D. #: -ex Owner CCo trac Permit Fee: $60.50 4 Name: Phone PROPERTY Last First OWNER Street Address: 4cyZ2 Ciry State:/?/?' ' Zip: 92? -7J Company: Phone #: l?/? ,Y/ 4rj?' -4?61-S T? (area code) FIREPLACE ???? J INSTALLER Street Address: City State: Zip: Company: Phone #: (area code) GAS LINE INSTALLER Street Address: 7? City State: Zip: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota-S OFFICE USE ONLY BUILDING PERMIT TYPE ? 16 Fireplace WORK TYPE ? 31 New ? 33 Alterations ? 39 Gas Line ? 41 Wood Stove ? 32 Addition ? 34 Repair ? 40 Gas Insert GENERAL INFORMATION Census Code 434 SAC Code Ol REMARKS Chimney/flue must be inspected before concealing. C PERMIT # ? k , ?? RECEIPT DATE: 8008 PXSIDE8TIikL PLUM$INC PERMIT APPLICATION CITY OF EAfiAN S$SO PU.OT KNO$ gD EAsAx, Mv 551 2E 65i-6$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITE ADDRESS: OWNER NAME: : INSTALLER NAME: STREET ADDRESS: CITY: ?GL(AD!y- TELEPHONE #: ZIp: _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATfON TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. Water turnaround - existing dwell'ng unit (+ 5/8" met if needed -$118) Other: _ RPZ: new installation/repair/rebuild $ 30.00 _ lawn irrigation system ReplacemenUadditional: _ water softener ?i water heater , $ 15.00 State Surcharge $ .50 Total - I hereby acknowledge that I have read this application, state that the information is correct, and agree to is the applicanYs responsibility to notify the property owner that the City of Eagan assu s n ility operational and maintenance activities to the facilities constructed under this permit pro r Y in rA (AKtA GUUt) (AREA CODE) with all applicable City of Eagan ordinances. It 9mages caused by the City during its normal ITTEE PERMIT # RECEIPT DATE: 8008 USIDENTIAi. PLUHY$INC PEftMIT APPLICATiON crrY ? KA6M 3$30 PILOT Kft0$ liD F-AsAiv, Mv 55122 651-6$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backfiow preventer for irrigation system . SITE ADDRESS: ( 3 4b a iZl A 6,e OWNER NAME: : INSTALLER NAME: STREET ADDRESS: CITY: STATE: ZIP: r _ SEPTIC SYSTEM, new/refurbished (requires two sets of pfans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118) ? Other: a 2 " V, iopta-u n ? _ RPZ: new installation/repair/rebuild $ 30.00 _ lawn irrigation system Replacement/additional: _ water softener ? water heater $ 15.00 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 ardinances. It is the applicanYs 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 wi ' op lrig -of-wayleasement. S GNATUR F PERMITTEE 1/02 T_F_L_E!'HONE p (GC? ? ? (AREA CODE) TELEPHONE #: 477 - I? b 15r (A A CODE) - - ? INSPECTION. RIECORD £ r C# IY OF ?'?llGAN OGRMi i I i',r: . i ? 3830 Pikat Knob Road Permit Number t ?', ?agarr, Wnnesota 55123 Date #ssued: ? (612) 681-4675 ? ? ? M ADDRESS: APPLICAN7: ? 1 :14 CA NFra?? R06F RD c ? .? 000FxN6 #?l't I I i ?? 4"b .!. ¢z ? .8 9 ? .,.,-. K. _ ??tAff SUBTYPE: TYRE OF WORK: iiF' i ce IPTTOM REPAIR t7F-Rt?ofloo , ? E ? ? ? ? ? ? ?. , _.• CITY Of EAGAN ' ? . 3795 Pilot Knob Road ?`? •???`? ? - ?3?rIT''Yr- ' Eagan, Minnesola 55122 Phone: 454-8100 Date: 5-?"+.1-79 PERMIT Site Address: ? No. t 4&l103 Receipt No.: Single X Residential ? Lot Block Sub/Sec, Multi Res., Comm./Ind. I Name - New/Alter./Repoir. • 1 4, 3 Address Cost of lnstallation _- 0 eity Phone: _ Permit Fee - - i4$i3'4 }?•t,). N e - Surchorge . i;-.`?t ??'vTt` ? ;`•.??;'. v ; Address ? 0 City Phone: Total ' i This Permit is iasued on the express condition that all work shall be done in accordance with all applicable State.of Minnesota Statutes and City of Eagan Ordinances. / / Building Official ? y/ - - , - CITY OF EAGAN • 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 PERMIT ..;-??„„• =c? Date: Site Address: ? Lot Name _ Biock Sub/Sec. _ e Address 3 O City _ Phone: N e .. ; ' o°., Address e 0 V ',r? -:' 3"'?,'+'? ? 'wi? '•t,: .?'"?' . ,`±` City Phone: This Permit is issued on the express condition thot afl work shall be Minnesota Statutes and City of Eagon Ordinances. No 13Y . " 41 ')4 Receipt No.: Single Residentiol Multi Res., Comm./Ind. I New /Alter./ Repair Cost of Installation ., : Permit Fee - Surcharge ?..,.. ?, ,.? Total done in accordance with all applicable Stnte of Building Official This reque' rjl months from ?'?°? ?4S iJw_;t?r 'R2 3 5 4 0 Date of this Request '- 2- a -- ?? I, as,4 Licensed Electrical Contractor 0 Owner, do hereby request inspection of the above electri- cat wiring installed at: Street Address or Route No. Section Township Range County Which is occupied by Is a roughin inspection required on this job? No 0 Yes? Ready Nowl? Will Call O Power Supplier ddress Electrical Contractor ? Cont tor's Lice sei (Company Pfame) Mailing Address Authorized Signature STATE i#?AIDtftu CapY ? - - This inspection request will notbe accepted by the State Board unless proper inapection fee is enclosed. i4plo?Of?jj nesota State Board of Efectricity f t?54 U• Or sit y Ave., St. Paui, Minn. 55104-Phone 645-7703 ? ?" REQUEST FOR ELECTRICAL INSPEGTION ? ? C9wC]Z?LOW WORK COVERED BY THIS REOUEST C'' ?'SG079 'R 23540 Type of Building New Add. Rep. Check Applian ces Wired Foa Check Equipment Wired For Home ? ? Range ? Temporary Wiring ? Duplex ? ? Water Heater ? Lighting Fixtures ? Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commercial Bldg. ? ? ? Fumace ? Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Fazm ? ? ? List ? ?thers n List Rthers? Other O [] ? eie ere COMPUTE INSPECTION FEE BELOW SeFVice Entrance Size: # Fee Feeders& Subfeeders: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Am res 0 to 30 Am eres 101 to 200 Amps. 31 to 100 Amgeres 31 to 100 Am eres Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee Signs 3pecial Inspection Minimum fee $5.00 Ttemarks : TOTAL FEE < "3 a I, the Electrical Inspector, hereby certify tha bov %stiln ha beeri mad ^ 7 pf a? , (Rough in) (Final) ? te -7-- 12-?? This request void 18 months from • This re void 18 months from f 'R ";, 426 Date o this Request -f-- ? I, as Licensed Electrical Contractor OOwner, do hereby request inspection of the above electri- ? cal winng installed at: ?ac? IStreet Address or Route No. ' &C.'2-m-+-j eD , City ???,t/ Section Township Which is occupied by Range County Is a roughin inspection required on this job? No ? Yes ?l Ready Now 0 Will Call ? Power Supplier,Q/a.1L[? Address Electrical Contractor??Tl? ?? L?t :TI?-? ?..• Contractor's License Nv 1 (Company Name) , „ Mailing Address Authorized F,Wtrical Cont N STATE BOARD COpY This inspection r'equ wil t be accepted by tne State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity ?19 niversity Ave., St. Paui, Minn. 55104-Phone 645-7703 *EEGUEST FOR ELECTRICAL lNSPECTION CHECK BELOW WOP.K COVERED BY TNIS REOUEST R 68426 Type of Building New Add. Rep. Check Applian ces Wired For Check Equipment Wired For Home ? ? Range Temporazy Wuing a' Duplex ? ? Water Heater ? Lighting Fixtures Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commerciai Bldg. ? ? ? Furnace X Silo Unloader ? Industriai Bldg. ? ? ? Air Condi ioner ? Bulk Milk Tank ? Fazm ? ? ? Lfst JA5 ? 2,45 ?? .? List Other ? ? ? p Hehersj 5 D:sl3L- _ p Hehers? COMPUTE INSPECTION FEE BELOW Seivice Entrance Size: # Fee FeedersBcSubf Fee Circuits: Fee 0 to 100 Am s, 0 to m 0 to 30 Am eres 101 to 200 Am s. ,?,tGt 31 t m 31 to 100 Am res Above 200 Amps. o Abo Above 100 Amps. ransformers Rem Co Paztial or other fee Si ns S ecial Ins ec Minimum fee $5.00 Remarks TOTAL F yy, o0 I, the Electrical Inspector, hereb fy t t e atSove inspection has been m?de. (Rough-in) Date (Final) Date This request void 18 months from CiTY OF EAGAN Np y 192 0 4 ik 3830 Pilot Knob Road, P.O. gox 21-199, Eagan, MN 55121 PHONE: 454-8100 BUIIDING ?? MK? Receipt # Xd4 To be used for 3-SEAS013 PORCH Est. vaiue $8 000 Date JUN 7 , tg 91 Site Address 1346 BERRY RIDGE RD Lot 2 9 Biock 5 Sec/5ub. HILLTOP ESTATES Parcel No: W Name STEVE & DIA13E MITCHEL ; Address 1346 BERRY RIDGE RD ° city EAGAN Phone o Name EE 30NES INC ?? Address 6905 255TH ST W ? City FARMINGTON Phone 463-2876 ? W Name 0 ; Address <W City Phone t hereby acknowlege that I have read this application and state that the information is correet and agree to comply with ali applicable State of Minnesota Statutes and Ci of Eagan Ordina es. Signature of Permitee _ A Building Permit is issued to: E E JONES INC on the express condition that all work shali be done in accordance with afi applicable State of Minnesota Statutes and City of Eagan Ordinances. Buiiding Officiai OFFICE USE ONLY Occupancy R--3 Zoning FEES 99.00 4.00 (ACtaaq Gonst ? N Bldg. Permii (Altowabte) V-N # of Stories length POrC.ll 12X. 4 Deptfi DeCk 5x12 S.F. Total - S.F. Footprints - On Site Sewage - on site weii _ MWCC System ____ City Water PRV Required _ Boosier Pump _ APPROVALS Planner ? Council BIdg.Off. ? Variance - Surcharge Ptan Review SAC, City SAC,MCWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL lU3.U0 CiO. for Office t,~se City O JJ ~t_ajj ~n Permit 3830 Pilot Knob Road I Permit Fee: Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: 1 - - - - - - - - - - - - - - - 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: i- - ' I Site Address: 1 ~ (L [ (4 ~ Tenant: Suite RESIDENT /OWNER Name: M ARSAQ 1 E j C Phone: Address / City / Zip: Applicant is: Owner K Contractor TYPE OF WORK Description of work: I EAk CC-C- ' P_E i' tic J < 3 Construction Cost: (~11 116 Multi-Family Building: (Yes / No _J CONTRACTOR Name: t ~r ~ I~(~; t l..<,Yl Sl"'R"uC.i") on License -19 Address:!5 41 t F_H Lz{ Pe City: S~t Stater1) Zip: 5 12) Phone: 43Contact Person: c2 e fl COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category I Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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 may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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. x 0 A ? ~ 6\ x a Applicant's Printed Name Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink r________________� � For Office Use I I I � Permit#: � ��0�� � Clty of ����� ; . . ��� 5 �� � Permit Fee. �� I 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � "1�— � � Phone: (651) 675-5675 � � Fax: (651)675-5694 I Staff: ,�� � � I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: �I��" ��� �'i Site Address: ��o ✓ �`�;G. Unit#: Name: 1�'�/�� �'VIC+�Gt/ � Phone: Resident! Owner Address�city i z�p: (3�� l�c.,�-y I��� ��`c.-.��- Applicant is: Owner �Contractor Description of work: ��� r��f Type of Work Construction Cost: �Vr �� � Multi-Family Building: (Yes /No� Company: ��-� �' ��S �S {YVc.-4,�„` Contact: �'a � Address: Z��3 l ���, �.✓c,�e City: ��G��n �/Yj I`� Contractor State: �l`� Zip: S`�3Y'L Phone: (P12-�'iD•� cjG9� Email: ,/��r���ses �v y�� • �y..� � License#: � ��Q-54 Lead Certificate#: � If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) . � �s� -T$ 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 documenfs that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to � conclude that they are trade secrets. _�M.��� 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.aopherstateonecall.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 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 �G�-����� �.� xc����. ,(�� ApplicanYs Printed N me Applicant's Signa ' re Page 1 of 3