4540 Blackhawk Rdr oF ea?aw WATER SERVtCE PERMIT
Knob Road PERMIT NO.:
? MN 55122 DATE:
Zoning; No. of Units:
OWner.
Address:
i Site Address'""'?`? :12 trvi.k-•7
Plumber.
- -
Meter No.: Connection Chorge:
Size:
Account Deposit:
Reoder No.: Permit Fee•
1 agree to eonepiy with the City of Eagon Surcharge:
Ordinances. Misd. Charges:
Total:
BY Date Paid: j
' Dote of Insp.: Insp.: I
% .yy. :..<:.oVg "E?*; ?: , .- ..''r•; Y .a ,,#T, '
,?F E.?VA?1
` , ?nob Raad
MN
Zoning? _
Owner. C . !At3 .19l`A$@*
'. Ac#dress:
5ite Address4540 BlglCk??'t+?'? Rp?
PlCm9ber.
` NAeter No.: :
Seze:
. Pkeade7' N0.:
1,a"e ia coutpiy w#h the Gt1r of E090a
' Cnnonces.
By
, ' {Tats af Msp;:
W.?., 4fz°i ,h•? ?*, .:.. :, .° .?v"7? .: ..e. .ce..; ,..
??? ?Vfa,??fVNM .
PE2IviIT FVO:: 279
bATE:'
Wv. ofi lJnits:
. ??
LS D2 GIeaoLear k -,
`?'- . ?? ?'.
PC
Cannection e1large: Z-50r 90
Accc?rant Deposit;
c
Permit ?€ee:.
?.
4,50
Sureharge: . j?
Misc. Ghmrges: 60r 00'
Tatel: 16. 00 ? ,
Dqte Paid!
i nsp.:
3
?.
.
w
. ;
Mr ?
y
'
IVE
?ITY
?a
?
{
FMy1?'{ 353'?
I7'? ? tCaolr Raad .P?`F2MIT. ?l?3 ?:
gaoa, MN 58122 DATE:
ZorAn
9: ?
- No. of tln;ts:
Osvr'ter. C. Le_ JeFts@Ei
Acldress..
Vne Address:4540 $laGkhBSJk T:C?ad, L5 ?eI. `:?.ei3? ?1f
Plurnb2r: Ron Kis13.F1r - i
7/20/79 15229 ' 100.0cl P
1 agrree #o campty wM the Cily af Eagua Connectic>n Churge: 425100 pd
4rdinanaes. Aecou?i' Deposit: ??•?} ?
T
Permit fee: 10.00Y?
. Surcharge:
?
$v Misc. Charges:
t?ate of insp.: Tofat: j
lnsp.: , Date Paid:
,.
' .. .... ... .. . . . . .. ... .
. . . . ,
;.
. ' . . ., j??* '.J
CASH RECE1FT
.I1 Y dF EAGAN
3795 PILOt KNOB ROAD `?
EAGAN, MtNNESOTA 55722
^E
DATr:. }g ? a
x.
RECEIYED
?`ROM ? . ? ?.{...--+us ' . ?"? .... -; u.-•,KZ-•_t-.,
. ?...,.?
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Y AMOUNT '$
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p1 ?
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ARS p
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FUNC CODE AMOUIJT-
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4 ?! 40 PI+ACRIA?WK RD
Erect ?
4c+cu{,ancy `
?` :.
? SeclSub. CLElF?RVIEW
Remadei L]
Z€ming 4
?
F? R?ir U Type d# Cctnst.
, Addition EX Rto. Stories
?? WITTELUD AAove ? tertgth u
Demolish ? {?Wh A
..,.,.. ????????
,,......?? Phone int. lmpc ?
tnsta{I ? Sq. Ft -- °
?-
rr?ii
Wi7CH4AR 4QNG1T IN4`
Appmv
aft Foft
- ?
AAA* "- 4550 EtL+ACliCHAWK I2D Assessment Perriit
Phone '? ?4-213Ci Water & Sew. Surc#taPgo 200? ?
PoNce
Plarl Rviow +',a?
5AC
watet conrv? ?
ftw ?
Rcad Us*.__._.?._..__..._.., ?
7r P"1. - ?
Pwks
Tta?i..
Fire
Eng.-
Planner
Council
?. kX?pAWFh*4 read tttis application and statethatthe Sidg. Off.
M?, '+16?? to camply w+th all applicable State at
C#!y oi Eagao Ordinances. APC
` t ` ''•. Var. Dafe
?
'A' ing lWrr* is is$tuad ta: TICn WacMR eOiNsT ca
cun tt? exorM #1004W
on wotlc OWA 110 dtam in accordance with aN appli of Mirtnesota Statutes 8nd Caty tf EDW Ord't ;
? ' .: • ? ? - - -- _ e? _.r'??-?: ? <? ?
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?aF.?w+"`? -s:9 "AC'3?1'r •;??` •'k*Pje'a?y?ar??>;??--7??°r _ :
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t?TV tF E,t? ??€+C" #? ?
3M NWr KW)8 ROAD, E40MP ? 66121 caATE: 7
; tMTRAClr PRcE: PHONE: 4"4"0
c*1
City
8u)m nrPIE
_ secrsub
.
Re$. ?
Mutt
Comm.
Phone Other ?
tu1F
R?S. HVAC U-1fI?31? ?Bl'4J
Phane ? e) ' AF3LHTtONAL 50 M STlt 4'fx?
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ItnfOEE - 196 t'?F CON'€'AACr PEE?
M BTU AAI1+dlMttM - RESIDENI'1AL #'EE
pro# Fiea-W RNfNIMUM- CtJMWIND FEE
; Ak Cortd. ,- ---- ?- - - "a'T'U__ i0??t?_
vot CFM (AC3C?tS4 SIC IF PEFMT 'PV4CAEG6Wv
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PE
R
Rl.UMBlF?G PERMIT
.?
RECE3?1' ?#
.. ?
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Ct'fY t3F EAGAN ;
?
3830 P1LO7` KMQ$ ROAD, EAGi4N, MN 55122 DA?`;?;
. #?t'?W?RACT'P!RtIC?: PHOFIE: 454-0100
" S#e AddreV BLDG, TYPE W€3FtK E?ESCRil'M "`
,
,15 Btock SectSub Res: ?? . New . ?
?
r°'
Mult. Add-an
Name Comm. Re{aair,
Adtlress lr`j?"otS.?--d Other
,
c City _.
??? Phone ?-?:?,'? RES. PIBG. ONLY - COMPLET'E THE FOLLt?WiNS?: ?
? FIkTURES TAL
N.Q.
,
_, rWater Closet - $3.00
? Pt$me 140 . .t.
? ?
-?--Bath Tubs - $3.00 +
f, ? ?-e?,,'?.r
Address ,Yr
--??--. ? ? w ? k ? 2 _Lavatory - $3.00 {
p City Phone -_L_Shower - $3.00 ov ` i
L_Kitehen Sink - $3.00 jry
--
FEES ,
UrinallBidet - $3.00
w:f; fJAAMiIND FEE - 1% QF CONTRACT FEE Laundry Tray -$3.00 -
,AP'fi BLDGS - GOMM RATE APPLIES Fioor Drains -$1.50
;*TO"MOIJSE & CONDO - RES. RATE APPLIES Water Heater -$1.50 ?
AAUM ---- RESID€NTIAI FEE . - $12.lJO Whfrlpoat - $100
GflMM/tNbFEE - $2t1.OQ Gas Ripi.ng Outfets - $1.50
'
ATE SlJiiCHRR{`aE PEEi PERMiT - .50 l)
(MiN1Mt3M - 1 PER REWMi
' • $•SQ SJG.IF RERN7 i'RfCE GOES
? Saftener - $5.90
?
?dDr$11{300,04} Well - $YO.t?Q
Private i7isp. - $tO.OQ
Rough Operfings - $1.50 ?
'
?RE OF PERMIfT €
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. STA14 V71?+e . ??4.
Of.? EAGAN :. G#'#A17D, t?;?
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BUILDING0PERMIT
CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N2
PHONE: 454-8100
Receipt #
13192
Ai7DITION $40,000 FEBRUARY 9 87
To be used tor Est. Value Date , 19
Site Address 4540 BLAC2ZHAWK RD Erect ? Occupancy
Lot 5 Block 2 SecISub. CLEARVIEW
Parcel No.
Name ANN WETTELAND
W
3 Address SAME
° City Pnone 454-2075
o Name TED WACHTER CONST INC
Z
0? Address 4 550 BLACKHATn7K RD
'' City EAGAN phone 454-2130
~ ¢
W Name MARK LIATDELL
F
C Z Adaress 14 7 5 0 SO ROBERT TR
<W City FtOSEMOtWWne 423-2254
1 hereby acknowledge that I have read this application and state thatthe
information is correct and agr e to comply with all applicabie State of
Minnesota Statutes and City ' Signature of Permittee A Building Permit is issued to: TED t+AAC$€TER NST CO
ali work shall be done in accordance with all
Building
Minnesota
Remodei ? Zoning
Repair ? Type of Const
Addition IKI No. Stories -
Move ? length
Demolish ? Depth
Int Impr. ? Sq. Ft.
Install ?
Approvals Fees
Assessment Permit $ 276.50
Water & Sew. Surcharge 20.00
Police Plan Review 13 8 - 2 5
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bidg. Off. Tr. PI,
APC Parks
Var. Date Copies
$ 75
434
Totat .
on the express condition that
and Ciry of Eagan Ordinances.
.. .
This request yoid
18 months from .
? [ A 4400?
`??c?
Request Date
? r No. Req9lred? nspection OReady Now Wil! Notify, Inspeo-
?[or
Wh
R
d
Yes ? No .
en
ea
y
t+censed Electrical Cvntractor I hereby request inspection of above
Owner etectrical work insialled at:
Street Address; Box or Route No.
4O GV?QG aKil.v" /L
C?Q?? City
f,:w
ection o. Townghip Name or No. Range No. County
dr
OccupantlPRINT) hone N?. ,..,.
°Ao :11
?ower Supplier . Addcess
Electrical Contractor (Company Name)
?a d:n?,?
r• e
?
Contractor's License Nb.
a cto_(a k(o ? f,?
.
Mailing Addre (CoAtractor Ownei Making Instailation)
?
? , ? 5 IS
?
.
?
0
Authorized igna ure IContraci F aking Insfaliationi Phone Num6er
VfZ14Lj ' D * /R . .
MNGNESOTA STATE BOARD OF ELfCTRlCITY THIS INSPECTION REQUEST WtLL NOT
Griggs-Medway Bldg. - Room N•191 BE ACGEPTED BY THE STATE BQARD
1827 University Ave:, St. Paul, MN 55104 UNLESS PROPER INSPECTIpN FEE IS
Phone (612) 287_2111 ENCLOSEQ.
E
REQUEST FOR ELECTRICAL INSPECTlON • a-oooo?-a
`See iostructions tor completing this torm on back of yellow ¢opy. 7'/
?? ?
? q, 4, q, O 0 X Below Work Covered by Thrs Request
Now Add Rep. Type of 8uiiding Appliances Wired EquiUment Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Buitciing Dryer Electric Heatin
Commercial Bldg. Furnace Silo Un4oader
InduStriai BIt1g. Air Conditioner Buik Miik Tank
Farm ocner peci v otner tsnecisyt
trnrt FPO RA/nw
# Fee ServiceEntrance5ize ft Pee Feeders/Subfeeders # Fee Circuits
U to 2?0 Am s 0 to 30 Am s to 30 Am s
Above 200_qmps 31 to 140 Amps 31 to tOQ Am s
&wimming Pool Above 10(}_..Amps Aboue 100_Amps
Transformers trrigation 97oms Partiaf,'Other,Fee
5igns SWecial inspecUOn S ,,;? ??`Q7AL EE ?
Rema rks 6,)b
Rough-in , D / 1, the Elec '
InsPector, hereby _
certify that the above
Final inspection has baen
o,, ? made.
This request void 18 months ftom r
CITY OF EAGAN Remarks
Addition Clearview Addn. Lot 5 Bik 2 Parcel 10 1775Q 050 02
oWner 16n0 ;;' 4hb1o, ?k'&( A screac 4540 Biackhawk Rd. scate Eagan,NN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, _--- - 8
• STREET RESTOR. 1980
GRADING °
SAN SEW TRUNK 1974 11.66 15 p8j.d
* SEWER LATERAL _ ., t? 31 1980 7103.84 473.59 1
WATERMAIN
* WATERLATERA! 1980
WATER AREA S 6 23 76
STORM SEW TRK
* STORM SEW LAT 1980
* service 1980
CURB & GUTTER
SIDEWALK
STREET IIGHT
WATER CONN. 250-00 1-5229 7-20-79
BUIL,DING PER.
SAC
PARK
'?.
EAGAN TOWNSHIP
BUILDING PERMIT N° 1900
Owner --••-L•- =---?'-•-• -?----=-'-?:'•`-.?e="=`J•----------•--•----..................... Eagan Township
Address (Present) ...-? 5S••-L-............................. •...... -7'v°-?`-•---?-?--` Town Hall
Bui ? d
lder .•--•- -•?'.:??:--•-••--. ...... ?
:%----•.......... Date .........
Address -•--- -- .-•---•-°-•---•-- - -
-----.--:7
DESCRIPTION
Stories To Be Used For Front Depth Heigh! Est. Cost Permi! Fee Remarks
,,??,?
??? i/ ., ??, p _
? 7
11-2'
3- 1- f ?
?0'
LOCATION
Street, Road or other Descripfion of Localion I Lot Block Addifion or Tract
This permit does not auYhorize the use of sireeYs, roads, alleys or sidewalks nor does it give the owner or his agent
the righi fo creafe any situation which is a nuisance or which presenls a hazard to the healYh. safety, convenience and
geaeral welfare to anyone in the aommunity.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK I5 YN PROGRESS.
• - -•• ••--...----••-•--•--•--.- upon
This is io certify, 3hat..... ?-=•-•• j:•-- -•---- .......... -.............. has permission 3o erect a.- • ------- •- • - -
?
the above described premise subjeci io the provisions of the Building Osdinance for Eagkn Towns p adopted April 11.
1955.
..................... ------------ai-- ? -.?C.?e.'-'--
--•-------••-•••-.-•.. Per --••--•-•-•••-....... ----•-- • - - - -•-1 - • • - • - •••-
=- - ---••--••-- -- -° "
Ins ecfor
Ch man of Tnwn9oard BuildinJ P
?.
0 CASH RECEIPT .
CITY OF EAGAN
3830 PILO NOB RCOAD
EAGAN, MI OTA 55122
DATE 19
RECEIV£D
FROM
aMouNr $
t?
8c DOLL.ARS
?oo
? GASH
F6R ?? ?f" ??
?
zz jant?2_r `4
PUNC I CODE' I qMOUNT
c
Thank You
N°_ 71174
BY
?
White-Payers Copy
Yeliow-Posting Copy
Pink-File Copy
? INVOICE
- P.O. Box 21199
- 3830 Pilot Knob Road
Clt of Ea a11 Eagan, Minnesota 55121
y g 454-8100
'if
TO:
b» a ? . a
r -?
AFM uITTUAND Date: v,.j.Feb. 27. 1 c;87
' 4540 EI.Acx11Iii ROAD
EA40, Mq 55222
L J
DESCRIPTION AMOUNT
iiatsr TzaataMmt Plaat Suscher s I $180 . 00
,
Tt7TAL 1$180 . 00
?:.
Total Due Upon Receipt - Thank You
*0'1ty Of Wan
3830 Pi{ot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
-------------------
? Ft?r:f?!#(u'e #Jss / /.?Q i
j Permft
` Permit Fee: ?
? Date Received: j
t 1
1 Staff: f
JF? I
r
?
2008 RESIDENTIAL BUILDtNG PERMIT APPI.tGA
oace: A/0-9 /0S_ Site adaress: 4S
Tenant•
0 L? u ul
AUG 2 9 2008
RESIDENT / OWNER
,?-
Name: !?A ??'? Phone: 6'51-"(46b`OV1
Address / Cityt Zp: ?7v Gul??? 2-9...
u
Applicant is: Owner ?Contractor
TYPE OF WORK Description of work: ?Q1 YVOr
Construction Cost$-B[u?.J Multi-Family Building: (Yes
CONTRACTOR Name: ? ,4?kl,L ci ense #: ?0 o3?-7f,:?D
D Ul
Address: . O
LI-AA)
Ciry: ? State: .Wx--'?_ Zip: 9,E?t
Phone: ?j ?u Y ' ?7 ??
? Contact Person: Ccl ? Ir 12 .
COMPLETE TH1S AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesoia Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet `• New Energy Code Worksheet
CBtegOry Submitted Submitted
(4 SubmissiOn type) • Energy Envelope Calculations Submitted
In tfie Iast 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:
Nfechanical Contractor: Phone:
Sewer & Water Corrtractor: Phone:
NOTE: Plans and supporting documents thaf yov submit ace consldered #o be pubfJc inbrmafion. Pdrtions of
the informa#lon rnay be classifled as nonpwblic if you provide specffk reasons that would pwmtt the City to
concJutle rhat the are frsde secrets.
I hereby acknowledge that this information is canplete and accurate; that the wrork will be in conformance with the ordinances and codes of the City of
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a perrnit; tMat the work will be in
acco ance with the approved plan in the case of work wrhich requires a review and approval of plans.
.
X , ,? A4,tll ?j
Appt cant s PHnt me /gApp k4tslimoWtuic
Page 1 of 3
,
,
1986 BOILDING PERMIT APPLIClTION - CITY OF EAGAN
NOTE: ALL COATRACTOxS MUST BE LICFNSED WITH THE CITY OF EAGAN
SINGLE FgNiILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
M[TLTIPLE DWELLINGS - RFSIDENTIAL RENTAL UNITS FOR SALE [TN3TS
INCLUDE 2 SETS OF PLANSt CERTIFICATE OF SORVSR - CHECK WITS BLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
CEMMRC7.gL:
INCLUDE 2 5ETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND l SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: "',Valua
Site Address 4?46'
?
Lot ? Block
PareellSub
Owner ?-?-?.z-,, ?? ???-•?
Address
City/Zip Code
-7l
Phone
ContraetorgJ??
Address
City/Zip Code
Phone
Arch./Engr. o??.-vL,?t'0 ,??
_fX
J 7 ? o ?? . z .z-a??:-Address
City/Zip Code J?S6
tion: $ * cjG C-G. CC' Date: o - ? "` 9' 7
OFFICE USE ONLY
Ereet Occupancy
Remodel Zoning
Repair Type of Const
Addition ? # of Stories
Move Length
Demolish Depth
Int.Impr. _ Sq Ft
Install
- 9PPROVgLS FEES
Assessments Permit 2-7( so
o.
Water/Sewer Sureharge ZD,
Police Plan Review ( 38 . 25
Fire SAC
Engr Water Conn ?
Planner Water Meter
Council Raad Unit
Bldg Off Treatment P1
APC Parks
Varianee Copies
TOTAf. 217 ITT
Phone # `/ -A 3 - `-). -R ?-s-q
NOTE: ADDxESSES FOR CORNER LOTS - CONTRACTORIHOMEOWNER MUST DESIGNATE WHICH ADDRESS
iS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PEMIIT IS ISSIIED.
??
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INOUSTp1AL
•ugINE35
CITY LOTS
TOPpGRAPMIC MAPPING
:ht
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ot?
C. E. COU LTER $t ASSC?CIATESI 1 N-C.
JOHN A. PE'TERSON ? FRANK R. LF-NZ. .JR. PIATTtHO
LAND SUFtVEYORS. swreM suRVCrs
REGISTERED UNDER t,AWS OF STATE. GR MINNESOTA LAKErMOR[ ?
. 4ICCN56D !• ORO/N4NC[& 0? 4ITY OF MIMNEAYOl18 J4p??IAL
3300 LYNDALE AVE. 50. MJNNEAPOLIS, MINN. 55408
82A-037Q '
!?i?ucbtpor'?c ?tctifitatc / V
sc?,?6 . 1,`. Go??
3'1to,5?"s - .. ?.. „?
,553/.14?
'L ? 83 &Z,4," PAR$L€Y ?k ?,1lJ D?RS Q?1 1+1
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P-1
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city oF aagan
3830 PILOT KNOB ROAD, P.O. BOX 21199
EAGAN, MINNESOTA 55121 .
PHONE: (612) 454-8100
February 27, 1987
Ms. Anne Wetteland
4540 Blackhawk Road
Eagan, MN 55122
Dear Ms Wetteland,
BFA BLOMQUIST
Mayor
THOMAS EGAN
JAMES A SMITH
V1C ELLISON
THEODORE WACHTER
Council Members
THOMAS HEDGES
City Administrator
EUGENE VAN OVERBEKE
City Cierk
It has been brought to my attention that the water serv3ce to your
property has been connected, with the watar having been turned on as
of February 10, 1987.
During 1985, the City Council established a connection surcharge for
the Water Treatment Plant, which is to be collected on all new water
accounts established in the City. This applies even in those cases
where the other connection fees had been previously paid. The 1987
rate is $180.00.
At the time the water was turned on for your property, this fee was
not collected. Therefore, an invoice for this amount is enclosed.
If you have any questions, please contact me. Thank you.
Sincerely,
Ken Damlo
Ass't. Finance Director
THE LONE OAK TREE. ..THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIN
.
' CITY OF EAGAN
SUBJECT:
APPLICANT:
LOCATION:
EXISTING ZONING:
DATE OF PUBLIC HEARING:
DATE OF REPORT:
REPORTED BY:
VARIANCE
ANNE WETTELAND
4540 sr.AexHAwx RoxD
LOT 5, BLOCK 2, CLEARVIEW ADDITION
R-1 SINGLE-FAMILY
MAY 3, 1988
APRIL 27, 1988
PLANNING DEPARTMENT
APPLICATION SUMMARY: An application has been submitted
requesting a side yard variance of 3' along the southern
property line of Lot 5, Block 2, Clearview Addition.
An 18' x 33' addition was built onto the existing home and, in
error, constructed in the side yard setback area. The addition
was not built in the 5' drainage and utility easement and meets
all other setback and code requirements.
The variance shall be subject to all applicable code
requirements.
ZONING MAP
- PK
1
k 4
4 '::G S
H ..
?
p
%
?.?
LE
? Is
??L1J
°? -uF '?• ,? --
? '' A A 1 A A A --
. ?.. _
l
R-2
AJ ? .a
A R 6. ?
1988 STREET MAP
.
IwousTeuL
bVSiMCSS
CITT Lots
TOPOGRAPMIC MAYrINp
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O
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Y
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J
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C. E. COU LTER & ASSOCIATES, 1 IVC. .
JOHN A. PETERSON ' ''•? • . • • • FRANK R. LF-NZ. JR. PLATTI"c ' -
LAND SURVEYORS. ' - • , rwew suAVCrs
NEGISTEqEO UNDER I,AWS OF STATE OF MInNE50TA LwKCSMOwc
. LICCN6[D •• ONOINANC[5 O/ C,ITY Of MINNEAYOUS . , JIJOICIAL
3300 LYNOALE AVE. SO. MINNEAPOLIS. MIIVN. 55406 ..
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RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
New Construction Reauirements RemodellReoair 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 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 sunrey tor additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Addition • indicate if on-site septic system _ On-site Septic System
3 cmpies of Tree Preservation Plan if lot platted after 7/1193 ,
Rim Joist petail Options selection sheet (bldgs with 3 or less units
Date
Site Address
? Construction Cost
yrL) 6?lA e-1f1/o9 wk k fl' Unit/Ste #
Description of Work °a"' Sj W/ V' *, '' t-
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 , 2
Property Owner 0 ANA_1 4(l.4 e `/TE n.. Telephone #(6) Z) 7/g !F G
Contractor JA/
Address
State / f()??'1 Q 1`Ze• City J?PG4?,,43e"
)Iti Zip Telephone #(9 ?,9 1" z Z / pi
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 CategorI Minnesota Ru1es 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
. Energy Envelope Ca4culations Submitted
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer/Water Contractor
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 af 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.
?
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
sub rypes
? 01 Foundation ? 07 05-piex ? 13 16-plex ? 20 Pool ? 30 Accessory 81dg
O 02 SF Dwelling C] 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex 0 09 07-plex ? 17 Garage O 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 Cl 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 Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 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
7ype of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & W ater _ F inal _ Pool ^ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ 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
Total
Building Inspector
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