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3206 Black Oak DrAddress 3?-L ? ?` ? l Q C_ ?? C?-?_ ? V' ? V t:Zip 5512 -j Lot ? Blk Sub THESE TTEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: $' Z` ' o?-- Yes No Inspector: 6%, ?j V Final grade (6" from siding) Permanent steps (garage) ? Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass TraiUcurb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside [awn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in right-of-way or installing underground spcinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy ? 2004 RE5IDENTIAL PLUMBING PERMIT APPL{CATION CITY OF EAGAN 3830PILOT KNOB ROAD, EAGAN MN 55122 651-673-5675 Please cvmplete far modifications to ex'rsting residential dweHings. Date . co I 1 04 Site Street Address =(o llnft # .._.? Rroperty Owner T?qajtQ Telephone # ( kJl) IQ -O 7U.- ContracEor N-iflrX?S 7elephone # (619') . Address ? ? ?1 3 ?'?+V? ? city ?-1 ?.??-'?Cr1^ i v??M state gip The Applicant is: _ Owner ! Contractor _Other Alteratians to existing dwelling $ 50•00 _Add fixtures to roams, exc{uding water softener and water heater _Septic System Abandonment _Watsr Turnaround (add $121.00 if a5!8" meter is required) Other: Water Softener Water Heater $ 15:00 _ replacemenk _ additional V Lawn lrrigation System RPZ_ new repair _rebuild $ 30.00 State Surcharge $ •?Q Tatal q 2004 -Iua 11 , , L?. ?s $?' ? ?? I hereby apply for a esidential P! Permit and acknowledge that the infarmati? is complete and accurate; that t e in conformance with the or.diriances and cades ? cif the C ity vf Eagan and the plumbing codes; that k understand this is not a perrriifi, but Qnfy an applicatian far a permit, wark is not to start without a permit and work wiU be in accardance vtrith the spproved plan in the event a plan is required to be reviewed and approved. Applicant's Printed Name Applican#'s Signature PLUMBING (RESIDENTL4L) Permit Applicatian City Of Eagan ??. 3830 Pilot Knob Road, Eagan Mn 55122 ??? •`?? Telephoae # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when pernuts are required for each unit Date aLr? / _0 ?.2 / 0 --??_ Site Address 3aGlil, ALACk (DAM )A?F- Unit # Property Owner Telephone # (6 9l ) /ZQC" - 02(24 Contractor Address City State Zip TeEephone # ( ) The Applicant is ? Dwner Contractor Other Septic Systean (Vew _ Refurbished Submit 2 sets of p6ans and MPC license $ 100.00 Includes Gounty fee. Additional consultant fees may apply. Alterations To Existiug Dwelling Unit, Inctuding $ 50.00 Adding fixtures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed -$121.ODa Other: YL I _ RPZ _ new installation ? repair _ rebuild $ 30.00 _ Lawn irrigation system Water softener Water heater - - $ 15.00 _ repkacement ? additional $ .50 State Sureharge Lll? I JI Tota1 ? I hereby apply for a Residsntial Plumbing Pem?it and acknowledge that mp ete and accurate; that tfte work vri11 be in conformauce with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a pemut; that the work will be in accardance with the approved plan in the oase of work which requires a review and approval of plans. AH f}z-.L,4 /to flae Applicant's Printed Name Applicant s Signature RESIDENTIAL BUILDING 5G `_?j Permit Application ? City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construc6on Reauirements RemodeUReoair Reouiremenis 3 registered site surveys showing sq. R of lot, sq. ft of house; and all roofed areas 2 copies o( pian (20°k maximum lot wverage allowed) 1 set of Energy Calcula6ons for heated additions 2 copies of plan showing beam & wiridow sizes; poured found desgn, etc. 1 site survey for addi6ans 8 decks 1 set of Energy Calculadons Add'rtion - indkate if avr-site septic system 3 copies of Tree Preservabon Plan i( lot platted after 711193 Rim Joist Detail Op6ons selection sheet (bldgs with 3 or less units 00 /? - Office Use Only _ Cert oi Survey Reod _ Tree Pres Plan Recd _ Tree Pres Not Reqd _ Onsite Septic System ` q-1 (_?? Date "'I ) 2 / 0 Construction Cost Site Address -3`.,21) 6 /S l Q ? Or! ?(Ze UniUSte # Description of Work ( yL ' 7 Multi-Family Bldg _ Y.X/N Fireplace(s) ZO 2 Property Owner ' Telephone # ( &Yj Contractor sa f ? Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesota Rules 7670 Cat?orv 1 (d submissfon type) • Residential VendlaUon Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor Minnesota Rules 7672 i• JNew Energy Code Worfcseet t?Seibmitted ? .., , Telephone # ( j Teleph?y. ?.?::? _?--J 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 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. " ;P)V19G1,& koug A (t .? 6?/ Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types O 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool 0 30 AccessoryBidg ? 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. (4sea.) O 33 Ext. Alt - SF ? 04 02-plex 0 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) 0 36 Multi Misc. ? 05 03-plex O 11 10-plex CP4 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous WorkTypes ,.T-,& c 1-j n? ?) 5' 519 7-tjj? '> 06'?- 0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bidg)" ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolition (Ernire Bidg) - Give PCA handout to appUcant 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 INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) A FinaUNo C.O. _ Footings (addition) _ Plumbing Foundarion HVAC Drain Tile Other Roof Ice & Water F Ftgs _ Air/Gas Tests inal Pool _ Final _ ? Frami.ng _ _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) ? Insulation _ Retaining Wall Approved By 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 < 3 2 c)? ? LA Gv- 0 p K iZ. On Apr;i 15, 2004 the Minnesota Energy Code, Ca;egory ! 6uliding Requirements far insulatian protection, air Ughtness, and venUlation, was adapted, As a result, the Clty of Eegan is requirin8 that the io0awing InformaUon be subrnitted prior io issuance of a Certificate of Occupancy. ? Thls sUucture: I: consVucled to meet minlmum requlrements of :he Mn EnerQy Code, Chapter 7670 OR _.,._ Tt;ls sUudure: witl constructed fo rneet moro reslrictlve requirements of Chapters 7672 or 7674 i APPLIANCE GA3 ELEC MMIUFACTURER MQDEL BTU'S VENTING 7YPE Water Nealer t(No w') S?'?tx! " od o p h? er v-L,I" Fumace a.Jo -k ' S 000 P va- U../J-AJOWOLJ ua dLj . ,. FXHAtJST $YSTEM LOCATION TYpE hR40El CFh!'s YENTEO YEE No K!tchen kitchen esthroom 1 ?-s?c Balhroom 2 rn Fl S"f -S R- ?( 1 t 30 esthroom 3 ? . - , i Bathroom 4 Othar - FIREPIACE(S LOCATION OA3 WOOD MaNUFACTURER -" MODEL BTU'S vErrriNo DIRECT ATMc+s tr,),vo NR, 35-3 o at doo * f-t {:V v-u?T" ? N s-r??r-?.?t t? *_ zoo cp, MAI(F-UP AIR MODEL TYP CFW: ? Om F,Pe _ X? 1 hereby aslviowledpe that the above i brmation is correct and agree ka comply wilh the Minnesola Energy Code and City ol Eagan requlremants, Da e . ' CornpAnp Name ? ' Tnis torm Is the responslbllNy oT Ltia Ganeral GonUactor. . y c?? • 0 RESIDENTIAL 10, su ry, ? Y s o i ";I. Is fA....,p_L,,?S?ILDING PERMIT APPLICATIQN g n.S-10 ?p ?° S•p ? a, ?, CITY OF EAGAN 'S83G PILOt KNOB RD, EACAN MN 55722 ?C ,?? •? ? 851-687-4675 Rew ConsVuction Raaulrememe RemodalfReoair Redukemwa • 3 repistered srte surveys showing sq, fl. of lat, sq, fl. of house, and AI roofed areas a 2 cr,pies of plan (2096 maximum bt coverage albwed) • 1 set ot Energy CalculaSians for heated additlons • 2 capies of plan showing heam & window slzes; poured found design, sic.) • 1 site Sunr for e3derlar addftlons & deCks • 1 sei oi Energy Calculations ?J- ndt?e if ine rved by sept? system for additions • 3 copies ot Tree PreservaTion Pfan if lat platted afler 7/1193 . Aim Jpist Deta61 Qpiians seleCtion sheet (bldgs wHh 3 or less unis) -? ? - I-? C) DATE 2-.,T &? VALUATIQN I f?f G? SITE ADDRESS ?Z L, b Zb;c" ?( Jk k- N?_- MULTI-FAMILY BLDG _ Y XN TYPE QF WORK_ t)Ic-,) ?L 1-,?-w?i ?? FIREPLACE(S) _ 0?41 _ 2 APPLICAIdT i. STREET ADDRESS 1373 I?Q_0 ST W ` I9 Z CITY? ?X f STATE MA)Z!P SS1Z`7 TELEPHQNE #75-,7 -9-3 f`<:, 777 CELL RHONE # 1,l 2 °314?,3 -2- 1115- FAX #2SZ "1-I3 I- 3011-5- PROPERTY OWNER 1Jf? ?? ?TY A)vnzs TEI.EPHONE #°I55?-03 ) 'b 777 a----------w--------------------.??-------------sw--------w-r---r-w--------a-----w-s----------r- COMPLETE THlS SEGTfON F4R'*NEW" RESIDENTtAL BUiLDlNGS 4NLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RiTLFS 7672 (4 submission rype) . Residential Ventilatian Category i Worksheet Submitted ? • New Energy Code Worksheet Submitted + Energy Envefope Calculatians Submitted ?o Plumbing Ccntractor: _5?j S*,,ti A-iii-T Phone # ? LI56 ???? E' Plurnbing system includes: T Water Softener I.awn Sprinkler Fee: $90.00 Watex Heater 1 No. of R.I. Baths ? No. of Bakhs Mechanical Cantracfor: 7!:n t, k, nj5 Mechanical system includes: ? Air Conditioning ? Heat Recovery System Sewer/Water Contractor: !5:?A5-T-Z'<%Az-T Phone # l4 2 3 -S `7 S -7 Fee: $70.40 U? a # ----------------------------------------------------------- ------------------------------- ------------------------ -....... I her ave read this applicatlon, state that the information is correct, and agree to c4mply wlth I? ` I a e t e nesota Statutes and Glty of Eagan Ordinances, APR 2 3 Z ? Siqnature of Applicant ?- '•oy ' arIFIcE vsE oNL? p Certificates of Survey Received ? Tree Preservation Plan Received _ Not Required ? ?l}l? T Updated 4l02 t"i4S £ I OFFICE USE C3NLY 0 01 Foundatbn X 02 SF Dwelling CI 03 01 of _ plex ? 04 02-plex ? 45 03-plex 0 06 04-p#ex 0 07 OS-plex ? 13 16-plex 0 08 OB-plex E3 16 FirepEace 0 09 47-plex C3 17 Garage ? 10 08-plex 0 18 Deck ? 11 10-plex 0 19 Lower Level 0 12 12-plsx Plbg Y or_ N ? 31 New 0 35 32 Additifln 0 36 ? 83 Alteration E3 37 E3 34 Replacement Valuation ! ? S 1 (200 Census Cade Jol_ SAC Units Nbr. of Units Nbr. of Bidgs ? Type of Canst VA) 0 20 Pooi ? 21 Porch (3-sea.) 0 22 PorchlAddn. (4sea.) ? 23 Porch (screened) ? 24 Storm flamage 0 25 Miscellaneaus 0 30 Accessary Bldg 0 31 Ext. Alt - Multi [] 33 Ext. AYt - SF O 36 Multi InF Improvement ? 38 Demolish (Interior) 0 44 Siding Move Bldg. 0 42 Demolish (Foundation) ? 45 Fire Repeir Demolish (Bldg)' 0 43 Reroof ? 46 Windows/Doors 'Damolitian (Entire Bldg only) - Give PCA handaut to applicant Occupancy MC/ES System Zoning City Water Stories ? Booster Pump Sq. Ft. 17q? PRV Length ,? Fire Sprinklered Width REQUIRED INSPECTIONS ? Footings (new bldg) ? Fina1/C.O. _ Footings (deck) _ Pinal/No C.O. Footings (additian) _ Plumbing ? Foundation ` HVAC Drain Tile Other Roof _ Ice & Water _ Final ? Pool _ Ftgs _ Air/Gas Tests -Final Framing _ Siding Stucca Stane Fireplace ? R.I. -,(Air Test \?Final Windows (new/replacement) Insulation 7r ? Retaining Wall Approved By Building In.spector Base F'ee Surcharge ?? G 9 plan Review MClES SAC 17q5 r city sAc Water Supply & Siorage S&W Permit & Surcharge Treatment Plant 6V""-Jt- ? ? a ? ! I ?f? Plumbing Permit Mechanical Permit License Search Copies Other Total / t ?Lk-?- R- • On Apdf 95, 2000 the Minnesata Energy Code, Ca!egory I Suflding Requirements for insuiaUon protectian, air ?ghNass, and venUlation, was adapted, As a result, #he Clty of Eagan is requ3ring that thc iallowing 1nformaUon be submitted prior to EssuanGe of a Certftate of Occupancy, ? This sUucture, 13eonsiructed io meei mfnLmum requlremenls af !he Mn EnerpyCode, Chapler 7674 QR _.,_.. ThIB SUvCturg: will be con5trucl6d #o meet moro resMCtlve tequirements of Ctiapt9ts 7672 or 7674 a AAPLIANCE I GA8 - ELEC MAHtUFACTl1RER )AODEL BTU'S YENTING T'lPE YValcr tiealer I? l?d ? I.? ? 7 A?t! Oh 4? 4 hga't? V?n?? Fumace rJo ? 01- Ll ?J'/U 0 W (,? ?} D W 1f - r r EX!{ALEST BYSTEM LOGAT[aN TYPE MODIL CFM'g YENTED YEs No Kltchen kitchsn ----. o,"jr .. 8athraxn 1 m6i N 6&5 kc. Balhroom 2 yn ra-r A) RIW-s [ C... 8atroam 3 881hrDom a 01her FtF2EPLACE1S LQCATEON OA3 woaa INAWUFACTURER -• htdDEL BTU'S vENriNa DiAECr ArMos M??+? ?laati. *?"~ Lt?Jrt1? /ricR? ?530 `?1000 MAKE-E!P AIR-.--- MQDEL Tyff; CFM': 464L., !V 56 ? !`tt_5cy H-{aV J1rOI-V trr?-Lcj9MdA1 /4c9. 206 cFw, I hergby adcnoyrfedge that the above infcxmation is coreel and ngrce ta compiy wilh the M+nnesata Energy Cade and Gity at Eagart rx?ulremsnts. S' r w oet • Cornpvg Nama ' TnES form is lhe responslbillty oF ttia Ger?era1 Conlractor. C t MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 3.0 COUNTY: Dakota STATE: Minnesota ZOIVE : 2 CONSTRUCTION TYPE: Single Family DATE: 4-23-2002 DATE OF PLANS: 4/02 TITLE: Kaur Residence PROJECT INFORMA`i'ION: 3206 Black Oak Dr Eagan, MN COMPANY INFORMATION: Variety Homes, Inc 7373 147th St. W. #192 Apple Valley, MN 55142 (0) 952-431-0777 (F) 952-431-3675 COMPLIANCE: PASSES Required UA = 488 Yaur Home = 362 25.9% Better Than Code Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Va1ue U-Value --------------------------------------------------------------------------- CEILINGS 1658 44.0 20.0 WALLS: Wood Frame, 16" O.C. 1862 19.0 2.0 1 BSMT: Conc. 8.0' ht/7.5' bg/8.0' insul 1666 13.0 13_0 GLAZING: Windows or poors, Abave Grade 332 0.370 1 GLAZING: Windows, Foundation, <= 5.6 ft2 102 0.380 DOORS 39 0.350 HVAC EQUIPMENT: Furnace, 92.0 AFUE --------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is cansistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy Code. Builder/Designer Date q17 2J ??? , x LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTY LEGAL: Le't 7 DATE OF SURVEY: 3?7- 02 LATEST REVISION: ? ? c ?a v DOCUMENTSTANDARDS O z v a / 2 /0 ? • Registered Land Surveyor signature and company / ? ? • Buiiding Pertnit Applicant 0 ? • Legal description f,? ? ? 0 • Address t ? ? • North arrow and scale ' G? 0 G/ ? • House type (rambkr, walkout, splt w/o, split entry, bokout, etc.) ? ? • Directional drainage arrows with slope/gradient % r./? ? • Proposed/existing sewer and water services & invert elevadon d ? ? • Street name GY ? ? • Driveway O/? ? • Lot Square Footage ? ? v ? • Lot Coverage ? ? • Benchmark ELEVATIONS Existin ? ? ? • Sewer service (ar Proposed) ? ? ? • Property comers o? • Top of curb at the driveway and property i'ine extensions c? o? • Elevations of any existing adjacent homes ? C?/ ? • Adequate footing depth of structures due to adjacent utilitp trenches ? f?' ? • Waterways (pond, stream, etc.) Prooosed ¢/ o ? • Garage floor Q/ ? ? • First floor ? ? ? • Lowest exposed elevation (waikout/window) ? ? • Property comers ? 0 0 • Front and rear of home at the foundation PONDING AREA ('d aDulicable) o a ' ? • Easement f?ne 0 id ? • NWL ? ? ? • HWL ? ?/ ? • Pond # designation ? C#' ? • Emergency Overfbw Elevatron DIMENSIONS 9/?/? O • Lot Iines/8earings & dimensions Cy/ O 0 • Right-of-way and street width (to baCk of curb) C? o? • Proposed home dimensions including any praposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent foodngs) C? ? ? • Show atl easements of record and any City utilities within those easements ?/ 0 0 • Setbacks of proposed structure and sideyab setbadc of adjacent existing structures f?' ?? • Retaining wall requirements, ff any Reviewed: Name / Date . . CERT[FICATE OF SURVEY for VARIE? ?OME5 ? t?9= ? ?/T- 0 ? S! L? f-EIUL15 "o-33.4 , IV \.?64? w 53V0$ _ %-Xm p Ctw \1 J r l ? . t/ vIa- ?8-o2 3:1 Mexirnum s" or Retainirg warl wtI 8e Required LaT = - !7? &?6 SV. P-' 40WE = ? ? ?44 !?0 . ? CNQW,C- ? 1-3X% Scale: 1 " = 30' 0 ? ? 3206 Blaek Oak Drive DESCRIPTION ! hereby certify thot this survey, pinn, or report was prepared by me or under my direct supervision and thot I am ti duly Registered Land Surveyor under the LQws of the State ofi Min.a.'?sota. ? - ??'"2.-?<-.. - ` bate ,Z Reg. Na 8140 Lot 7, Block 1, ORCHARD HEIGHTS D6kota County, Minnesota Plat bcarings shvwn o Denates iron manument - - ?. ? Existing_,, Proposed ? - ? w ? N ? ,z 16", 13"'RANDT ENGINEER:?NG & SUR1????NG 14041 Burnhaven Drive, Suite 114 Burnsville, MN 55337 (952) 435-1966 vIo-88-02 . . ! 9 ? RECEIVED aPR 2 9 2002 ckt?F?l? ENGINEERIN?`? DEPARTMENT PERMIT City of Eagan Permit Type:Building Permit Number:EA107976 Date Issued:11/08/2012 Permit Category:ePermit Site Address: 3206 Black Oak Dr Lot:7 Block: 1 Addition: Orchard Heights PID:10-54500-01-070 Use: Description: Sub Type:e-Reroof Work Type:Reroof Description:House Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Phalla P Kour 3206 Black Oak Dr Eagan MN 55121 Smart Builders Inc 7001 Garland Ln N Maple Grove MN 55311 (763) 691-5021 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r OF Fq For Office Use S.,. t� �•s,+l. c� Permit#: /yl 9/f � yp #.• :.tea �, e o Permit Fee: it -` oZ tstisas°, Date Received: AO- 7-i' -7 3830 Pilot Knob Road I Eagan MN 55122 r Staff: Phone:(651)675-5675 I Fax:(651)675-5694 J buildinginspectionsAcitvofeagan.com 01, " 1 2 IU17 2017 RESIDENTIAL BUILDING PERMIT APPLICATION l ( / ,,r6 3'/a I Date: I 0 / 2 3 r I 1 Site Address: ?'U Zp IS 14 c-V- 0 at IIL /DR.. 6 '�/ Unit#: . % - Name: 19 1/1 6t-11 1 CI ,b u..i'r Phone: e e / Address/Cit /Zi � � �®���-� �� Y P: JOU to alQ�L I�a.fc- p(Z- eel ahs`/Y1/`J���'( e-4-- It14 . Applicant is: Owner Contractor fl// '1 i 6.- , - - 41. C t.Description of work: /� P! -e. �Y)'-` ! �®ZAJS / O6A6wf`il, p GL7_ 044 4 Construction Cost: ii, 1-1074 / g• Multi-Family Building: (Yes /No ) , - 0?31 V I'r Company: �Y1 t ►'� Contact: v) r Address: 3S 10 Lit-) ""'\( j 2 City: ✓Ni3 0 t /l‹. 1.44 , _ 41 ,,"4 State:I' Zip: 55331 Phone: 95 Email:Nl�vivleelsI/ISAoet'? .,,ywr ,, e©01 ti\4� .t. License#:'✓�` / gs Lead Certificate#:N14 -Zz 5 oto If the project is exempt from lead certification, please explain why: C:).' :2 — C/ - 360 6 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: '. . .. 7g c (t that out a mi 'are`consld d toll publfcr fo atfo$ a �o thein or o ay# Aclas e ri ,,.me..'''''.7;V*. _t e sp cift aso s'that�i oul f p nl the i t� a 44, ` e t ade eco 4"4 4 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.citvofeagan.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.gopherstateonecall.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 approvedfplan in the case of work which requires a review and approval of plans. x /1-5// ) (�Ct! $ x ,,,,--o . Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA158514 Date Issued:10/17/2019 Permit Category:ePermit Site Address: 3206 Black Oak Dr Lot:7 Block: 1 Addition: Orchard Heights PID:10-54500-01-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Phalla P Kour 3206 Black Oak Dr Eagan MN 55121 Haferman Water Conditioning 12142 12th Ave. Burnsville MN 55337 (952) 894-4040 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA161501 Date Issued:05/29/2020 Permit Category:ePermit Site Address: 3206 Black Oak Dr Lot:7 Block: 1 Addition: Orchard Heights PID:10-54500-01-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Phalla P Kour 3206 Black Oak Dr Eagan MN 55121 North State Mechanical 1444 14th Street W Hastings MN 55033 (612) 207-0345 Applicant/Permitee: Signature Issued By: Signature