3724 Blackhawk Lake CtCITY bF EAGAN Permit No: Q199 Date: _1.1 88
3839.PoIot,ftob Road Meter No: ( S;Ze: S/
.g, f?ae,
P.O. Box 21189 Reader Na i'D ID/ 3 Z 8 Date: a?"? 9
EaQan, MN 55121
Owner. JOHNSaN-REILAND CONST
Site Address:_ 3724 BI.ACKHAiiK LAKE CT. L22 B2. SLACKHAWK
Plumber PLYMOi7TH PLBG RIDGE
Conn. Chg: S550.00 ..A
Acct Qep: t 4. Op pd
Permit Fee: In? nn Ta
Zoning: R-1
No. of Units: 1
Surcharge: .5e-d 1 agree to comply with the City ot Eagan
Tr. Plant-_ 204.00 ncl Ordinances.
Meter. 67.00 2d
Misc.:- pRV RFnIIT RFD gy _
WATER SERVI PERMIT
E
Requ?t ate ire No. I
/
74/9 'R ough-in I ction
e qui
C Ready Now Notify Inspector
Wh
R
d
?
f • as ? No en
ea
y
I " ensed contractor ? owner hereby request inspection of above electrical work at:
Jab Ad re treet Box Rout o.
^
City
/ 1
?
Section No. own ip Name or No. rnge No. Courriy ^
? ?
?RINn ? ? Phone No ?4???3 ?
Power Supplier ? Address
ElectrijjtMja?'L
°1"? ?CTRIC ntrador? License No.
Mailing Addre r REtila
}
APPLE VALLEY Iv1
Authorized Signature (ContractodOwner Making Installation) Phone Number
MINNESOTA STATE BOARU OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
GHggs-Mldway Btdg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 Unlverslty Ave., St Paul, MN 55704 UNLESS PROPER INSPECTION FEE IS
` Phone (672) 642-0800 ENGLOSED.
REQUEST FOR ELECTRICAL INSPECTION
? See instrudions (or completing ihis form on badc of yeliow copy.
E„8"r?'-61 0 `X" Below Wark Covered by This Request
EB-00001-07
ew A 4ep. TypeofBuilding AppliancesWired EquipmentWired
-
T-- Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building er Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) CoMractorg Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps A 10 Amps
Slgtls Inspectoris Use Onty: 7'p
Irrigation Booms
Special Inspection
Alarm/Communication
Other Fee
?* .
I, the Electrical Inspector, hereby
ii Rough-in oiti?
cert
y that the above inspection has
been made. Final
,' -
OFFlCE USE ONLY '
This request void 18 months from
A-;/ 7 / IFS?
E 6 0 J 6 G
Req ate 70 . Rough-in Inspection
Required? ?
? Ready Now
? Wili Noti(y Inspedor
? Yes ? No When Ready?
I ensed contractor ? owner hereby request inspection of above electrical work at:
Job Add 77eW Street, Box Ro .) City
157
Section No. To hip Name or No. Range No. Couniy oolf
Occyp?[?(PRI Phone o.
PowerSuppfl l Addrm
Electricel ConVaclor (Company Name) Coniractor's ' se No.
Q ?
???? ?
3 4540 PENN4CK LANE
Phone Number
MINNESaTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Grlggs-AAldway Bldg. - Room 5173 BE ACCEPTED BY THE STATE BOARD
1821 Universlty Ave„ St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSEO. AA
j,?/• ;/????' RE(aUEST FOR ELECTRICAL INSPECTIQN
? See insWdions (or completing this form on back of ysllow copy.
E 6 Lj3f)8 `X" Below Work Covered by This Requesi
M ee-ooom-o7
..t ? ? ?),-, t?
ew Add Rep. Type of Building AppiiancesWired EquipmentWired
? Home
Duplex Range
ater Heater Temporary Service
Electric Heating
Apt. Building ryer Other (Speciiy)
Comm./Inclustrial i urnace
F
Farm Conditioner
ir
Other (specity) Contracior5 Remarks:
Compute tnspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers AbOVe 200 Amps A6ove 100 Amps
$ignS Inspector's Use Onty: TOTA
Irrigation Booms
Special Inspection
O
Alarm/Communication ? 3 •
Other Fee
I, the Electrical Inspector, hereby
tif
th
t
h Rough-in Dace
y
cer
a
t
e above inspection has
been made. Fin8l pap ?
OFFICE U3E ONLY
This request void 18 months from
s?-
i 1 4 3 4 5
?--- -
-
rReques', Date ?Fne No.
?Rough-in Inspection
?- .. ? ---- I IRe vetl?
?
? j1 _?___s _ No
I?? Reatly Now?Will Noufy Inspector
When Reatly9
I
I I? licensed contractor Xowner hereby request inspection of above electrical work at:
?----- ------ ----- -r--- -
IJob Address IStr et Box or Route No.1
I ?L°` A4g! ?1----- ICiry
-- - ------
?
?Seciion No. ITownship Name or No. iRange No. ounty
IO
t
PRINT
? - ?Ph
N
CCUpan
)
I
,,?,'L?c?a-J?,?'?'f'i'-`?l S ----
-- one
o.
----?-- -------
I
IPower Supplier Adtlress
`
i
----------------
-----
IElectncal Con!ractor (COmpany Name)
I -?i------------- -- ------
Contractor's License No,
--L-----------
rMad-ng Adtlress (Conhacior or Owner Makmg Installation)
? aJ
c.
-----------
i ?ihonze S?gn ture ICon!racror 'Owner - - -
M -ak.ng Inslallalion1
L--_?--------
?------- -
IPhone Number
--? ?yl? ! ?U f -
MINNESOTA S7ATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway 81dg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1827 University Ave.. St. Paul. MN 55104 . UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL lNSPECTION
? See instructions for completing this torm on back of yellow copy.
' 4334?0 „ '7C" 49elow Work Covered by This Request
p?e
?•??? ??!?i EB-00001-08
?Jew Atlo-? Ree. r Type of Building
Home Appliances Wired
Range Equipment Wired
Temporary Service
Duplex Water Heater Electric Heating
Apt. Building _
Dryer Other (Specify)
omm./Industrial Furnace
Farm
?? Other (spetilyl Air Conditioner
Contractor's Remarks
-
Compute lnspection Fee Below:
# Other -TFee # ServiceEniranceSize Fee # Circuits/Feeders Fee
Swimming Pool ?
? Transformers -
0 to 200 Amps 0 to 100 Amps
Above 200 Amps i Above 100 Amps
Sigr1S ?
Irrigation eooms
? Inspectors Use Only: TOTAL _
` L ?c? •l?'
Speciallnspection
AlarmlCommunication ?
?ther Fee
THIS INSTALLATION MAY BE ORDERED ISCONNECTED IF NOT
COMPLETED WITHIN 1 . THS f
I, the Electrical Inspector, hereby Rough-in ?? ate
.? ?
?y?..
certify that the above inspection has
been made. Final ? oate-$
. :.,
e?
FFICE USE ONLY •
?
This request vold 18 month5 Irom
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N0201 8 0
PHONE: 681 -4675 ?
BUILDING PERMIT 0
Receipt # 1_ 7?J?l
?-
To be used for BASEMENT FINISH Est. Value Date MAR 4 , 1992
Site Address 3724 BLACKHAWK LAKE CT
Lot 22 Block 2 Sec/Sub. BLACKHAWK RIDGE OFFICE USE ONLY FEES
PSfC81 N0. Occupancy R_3
35
i .00
Bldg. Permft
ng _
Zon
Napg LINDA VETTRUS (Actual) Const - Surohazge .50
w Address 3724 BLACKHAWK LAKE CT (Allowable) - Plan Review
?
Ciiy EAGAN MIN Zp 55122 -
# ol S?ories L
lh
??
? eng
-
Phone 452-9281 Depth - SAC, City
Naf11e SAME S.F. Total - SAC, MCWCC
0 S.F. Footprints -
? Address on Site sewage _ Water Conn
city Z'jp On Site well water Meter
?
f?lOf12 =
MWCC System
Acct. Deposit
8 _
Ciry Waler
VC2nSe # PFV Required _ S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump - 5!W Surcharge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City o,j Eagarl Ordinanc 7reatment PI
5ignature of Permitee VA APPROVAIS Road Unit
A Building Permit is issued to: LINDA VETTRUS Planner
- Park Ded.
on ihe express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan OrdinanCes. Bldg. Off. - ?OP1eS
Building Official Variance - TOTAL 35.50
\
-..,.?..?,? .,?.,",??.. ?-. ... iT.. ,?...:. .' "; ?'-.-...e?,..,,,.....,...: __;+.r*stivw?+r.??er.-?r _•-.,?._. . : . .. .,.crrn-..._,-. ?.r . .. _ ,- ... , .
CtTY OF EACAN ?,
;k,{
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 I,µ?? 4%.1
R PHON E: 681-4675
BUILDING P-ERAQIT Receipt
To be used or FIN15H Est. value Date MAR 4 , 1 992
Site Address 3724 SLACKHAWK I.AKE CT
Lot 2 a Block 2 Sec/Sub. BL°?CKHAWK RIAGE
Parcel No.
Name LINDA VETTRUS
W Address 3724 BLACKIUw"K LAKE CT
? C?y EAGAN P4N ZP 551.22
Phone 452--4281
? Name 3AtjE
? Address
? CftY Zp
Phone
8 Lioense #
I hereby acRriowlege that I have read this application and state that the
information is correct and agree to comply with ail applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permitee ?
LItdDA VETTRUS
A Buildirig Permit is issued to:
on the express Condition that all work shall be done in accordance with all
appiicable State of Minnesola Statutes and City ot Eagan Ordinances.
Building Official
Occupancy
Zoning
(Actual) Const
(Allowable)
# of Stories
Length
Depth
S.F. Total
S.F. Footprints
On Site Sewage
On Sile Well
MWCC System
city water
PRV Required
Booster Pump
APPROVALS
OFFICE USE ONLY
FEES
sklg. Permic 35.00
- Surdiarge . S? _.
= Plan Review
Planner -
Council --
BIdg.Ofi. -
Variance -
licerse
SAC, City
SAC, MCWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permil
S/W Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
3S•50
Permit No. Permit Holder Date Telephone #
SN• v
PLUMBING ,.77 -3
HVAC
ELECTRIC
_,2
??.
ELECTRIC
Inspeclion Date Insp. Comments
Footings I
Foundation
Framing 3• 2 F!? y 7 9. ?? f U ,
Roofing
Rough Pibg. '. Z z p
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg.lnspector - NotifyPlumber
Const. Meter
EngrJPlan
Bldg. Final
Dedc Ftg.
Dedc Final
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N9 15873
PHONE: 454-8100 YL7 q`,Q
BUILDING PERMIT Receipt # c?( O
To be used tc3r S F D WG / GAR Est. Value $143 , 000 Date NOVEMBER 17 19 88
Site Address3724 BLACKHAWK LAKE COURT
Lot 22_Block 2 Sec/Sub. BLACKHAWK RIDGE
Parcel No,
oc Name JOHNSON-REILAND CONSTRUCTION
z Address 1526 E. 122ND T.
° City BURNSVILLE Phone_894-9300
¢
.o Name SAME
? Q Address
? City Phone
Ua
y? W
Name
_ o Address _ ___
u Z
Q City Phone
W
I hereby acknowledge that I have read this application and state that the
information is correct and agr o comply with all applicable State of
Minnesota 5tatutes and City ?ggll OLoryances. If _v--
Signature of Permittee
A Building Permit is issued to: Jv111v0ULV_7LiCV1•LA1VLZ_L;UNST-_
th all work sha e done in accordance with all
on the express condition ?
applicahie State of Minne o Statute?s n City o agan Ordinances.
n
Building Official_.___.
`
OFFICE USE ONLY
On Site Sewage Occupancy R-3 M-1
MWCC System X Zoning D R-1
On Site well (Actual) Const V-N
City Water X (Allowa6le) V-N
PRV Required X # of Stories
Booster Pump Length 77
Depth 3n
S.F. Total
Footprint S.F. -
APPROVAL5 FEE5
Engr./Assess. Permit $ 714.00
Planner _ Surcharge 71.50
Council Plan Review 357. 0
Bldg. Off. SAC, City 100.00
Variance _ SAC, MWCC ?5 .?0-00
water Conn. 550_ DO
Water Meter 67 _n0
RoadUnit 35.DnO
Treatment P1 204.00
P.ksvOP1Q S - 5n
TOTAL $2,939.00
CITY OF,fAGAN
3@30 P11ot K.rqb Road
P.O. BRx 21199'' Eagan, MfO 55121
PermitNo: #') 1e21 Date: 11/22t.88
Meter No: _
Reader No:
Size:
Date:
Owner. Jt3N'NSi?N-REI1,ANB COiQS$
Site Address: 372$ BLAC"AiiK LA.KE C'!+, L22, B2, BLAO-K?1.?t'kX
Plumber PLyMflU'f#i PLB? ?IDGg
Conn. Chg: $550•00 od Zo . R?`?'
Acct Dep:_ 15.00 ntF
Permit Fe? it).?;0 ?ct
Surcharge: - _ 5t? „?A
Tr. Plant 204•? '?d
Meter. 57.? nd
nmg.
No. ot Units: ?
1 agree to comply with ihe City of Eagan
Ordinances.
Misc.: kaY 1moil1g.r. gy
WATER SERVICE PERMIT
CITY.OFE?AGAN ti FermitNo: 11262 Date: 11/22/?'
38?°30 Pilot.Khofi,fltitad B/ P No: 8923$
P.O. Date:
Bdz? 21?199 ? . ,
Eagan, MN 55121
Owner. 3onmm-RBII.AIit) C0uS'L
Site Address: 3724 DLAC'iCRIAWC i.14xg y? . i L22,E2.BLA=AitK
Plumber: PLYllMR PL$G
MWCC: $550.00 pd Zoning. iC-1
Ciry Chg: I00"00 pd No. of Units: I
Acct. Dep: 15.01I pd .
10.00 pd I agree to comply with the City of Eagan
Permit Fee: Ordinances. ?
Surcharge: .50 pt!
Misc.: ? nQuifto BY ,
SEWER SERVICE PERMIT
. =i
AMdUNT
& ? ooL?:?aRs
. .
p CASH L?CHECK .
;?
FM _ ? ??' ?? •, -. /?? C{
- 1 zr ?
,??. ., ? ???_:_..?? ? =? -- ?. f< < :..--c??,??
FUfi? OBJEGT AMQUNT
C, U
?
Thank You
ev
?
M Yelbw-Pos11n8 C-oPY
Pink--File Copy
#.
[ t t . c
. FAQAM; +
.' ?
Thank You ?
?---???
? _
?
BY
vmft-*"- CIVY
Yeibo-Pm" Cop,
Pink-FN8 Copy
& DOLIJ4R8
.. wo
O CASH ?1CHECK
.,, . ....,_ ..,. ? A -
J .."':r
BLDG. PER IT N'G.
` 01-3210 Btdg. Permf#
J
?I 01-3422 Plan Check
01-3445 SurcFi./Adm:
01-3446 SACfAdm.
? (}1-2155 Surcharge
ri 75-3860 Road Unit
20-2275 SAC
+q
20-3865
Water Conrt. 77.
20-3865 Water Trmt.
-,-' 20-371 B WaEer Meter
. 20-2252 Acct. Dep.
? h 20-3713 Water Permit
20-3743 Sewer Perrnit
79-3866 Sewer Conrt. C?U
28-3855 Park Ded.
.
TQTRL
7 .. `Pyf.l ',' a,, ?y -. . . . q. v .. f,F Tw"'Ta,-t }• - -- . ....rs,
C F EAGAN
3830 Ptlot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
` PHONE:454-8100 .
BUtLDt'NQ PdR11RiT -?
To he used for Sg p1w(;/(;Ajt Est. Value $143 ,00Ci
Site Address 372s ?RAWK ti"E COURlf
Lot 12 Block Z Sec/Sub. MACKRAW KIM
Parcel No.
cr -Name
z Address 1526- ?.. 122Nl) ST.
? City WRI'SV1LU Rhone : J1#4--93Od?
,.., ,
°C Name '$AW ... ,
i Address
-i- City " Phone
Receipt
oate 30vOMIEar 17 OFFICE USE ONLY
On Ske Sewage Occupancy 111-31h-?
MWCC System ?• Zoning ro/lk-t_
On Site Well (Actuaq Const V-m - .
City Water ? (Allowable) V-N
PRV Required X_ # ot Stories
Booster Pump Length 77
Depth ?
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge ?i • ?
Council _ Plan Review ?_00
Bldg. Ofl. _ SAC, City
Variance _ SAC, MWCC ?
WaterConn. sso20
Water Meter 17•0
Road Unit 125-AA
Treatment P1 "A«?
• TOTAL
?W Name
_ ? Address
Q W City Phone
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
Minnesata Statutes and City of Eagan pcdiqances. ?
Signature of Permittee ?y?/?y ryr
?\/?i?747V1l7'?(yp? ?pR' Vr`?? A 1
A Building Permit is issued to:_
on the express condition that ell work shall be done in accordanCe with ali
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Oificial __ _
. . Psrmit No. Permit Holder Date Tetephone #
Plumbing 400
L^ o`! c z_o?? -?: ON-c • 11?0
H.V.p1.V. ?g
• ?it, ?/a(c a . u?.?, 'ia' ??i
Electric. Ylo
.?• a??G'?? ?g c?J v? ?
Softener
Inspeceion Date Insp. Comments
Footings I f.
Footings II
Foundation
Framing 04.0 A
Roofing
Rough Plbg•
Rough Htg.
Isu1.
Fireplace
Final Htg.
Final Pibg.
Bidg. Final
Cert.Occ. ? 23
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
CONTRACT PRICE
site Address -"Y
Lat ?,Z? Blo '
? Name . ?'
m Address ? ` >
V
c Cliy
,. Name
c Address ?'"'=??f ? ?',?'.?- ??•
p City Phone
TYPE OF WORK
Forced Air L?? < BTU $7
Boiler M BTU $
Unit Heater M BTU R
Air Cond. M BTU $
Vent. CFM $
.. , - PERMIT # 261/Lt
MECHANICAL PERMIT RECEIPT # 9 0Z `
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
PHONE: 454-8100 f
r '' ;, . ? -? 1:.. < BLDG. TYPE
e /Sub Res.
Mult
Comm.
.?J? L ..,,..
Phone Ot78C
WORK D IaN
New _
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES._HVAC UVCI.UDFS A/G OM NEW .
CONSTRUCTIbN)
GAS OUTLETS (MINIMUM -1 PER PEFIMIT) -` 1.50 EA
COMM/IND FEE - 19'0 OF CONTRRCT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APRC]
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS 12.00
MINIMUM COMMERCIAL FEE - 20.00 ?
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C IF PERMIT PRtCE GOES ?
Gas Piping Outlets # _._.?.__ • ` " BEYOND $1,000) - . ? .
Other
FEE:
S/C: -`- SIGNATURE OF PERMITTEE
.? ,
TOTAL•
FOR: CITY OF EAGAN
, •. ? ,,:..
.
:?• :, .._ .. :. :?.? :. :. ,_ , .. ; . . ?;_ , . ...4 . . .?.? .. .,,? r? ?? _?,?? ??.?,?.,?.? ,u?
CONTRACT
Site Address
Lot -_-L -_??_
[?C?iS!tF7' # " ? '`? ,
PLUMBIWG PERMiT RfCHRT #
CITY O0, EAGAN -
3830 PILOT KNOB RQPAO, EAGAN, MN 5S122 DATE:
PHONE.1454-8100
Sub
w Name /46 41? ? Cf 6 "rh''/c-
? Address
c City ;Z4t*6t Phone
? Name - .?•t?,.,/ .f?z,J - iCC1?,
3 Address
p City Phone
eo
FEES
COMM/INO FEE - 19/o OF CONTRACT FEE
APT. BLDGS - COMM RAl'E APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT RRICE GOES
BEYOND $1,000.00) ,1,.7
G?' .
OF
FOR: CITY OF ZAGAtU ;?.,
BLDG. TYPE WORK DE3CRtPTtON
Res. Ix_ New
j; Mult. Add-on T
k- Comm. Repair -
' Other
?- RES. PLBG. ONLY - COMPLETE:THE FOLLOWING:
FIXTURES T T?
?
?
Water Closet - $3.00 ?:.
Bath Tubs - $3.00 .
-&! Lavatory - $3.00 T3-W ,
Shower - $3
00
t
_
.
-
' --Z_Kitchen Sink - $3.00 2-
Urinal/Bidet - $3.00
_-Z-Laundry Tray - $3.00 J.
_1 Floor Drains - $1.50
?Water Heater - $1.50 ? .
, Whirlpool - $3.00
=Gas Piping Outlets - $1.50
'
(MINIMUM -1 PER PEfJNET)
Softener - $5.00
Well • $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATES/C:
?..?_... --GRki?f?"1'?J?Ait?: '•??s !?
;
. ,y
CITY OF EAGAN '
3830 Pilot Knob Road, P.O. Box 21-1_99, Eagan, M N 55121 " 173 [17 3
PHON E: 454-8100
BUILDING PERMIT Receipt#
To be used for I
P D'4tG/GAB Est. Value $143,000 Date ?VCMI r 1' ,19-"-
Site Address 3724 SLAt9RAi1[ IAX$ t.'flllRT
Lot 22 Block 2 Sec/Sub. BLACMwK RiO=
Parcel No.
rc Name _ d0RX3M•REILAX4 C0NS21UL"t10N
3 Address 1526 E. 122fi? S'I'.
° City Hi1RliSYIW.E Phone $44-9300
, o Name , aAt?i
? ` AddresB
? City ' Phone
1- c
yVj W Name
W
_ z. Address
6 W City Phone
I hereby acknowledge that I have read this application and state that the
inforihation is correct and agree to comply with all applicable State of
Min'nesota Statutes and City of Eagan Or!i7nces. ?
Signatuie of Permittee
A Building Permit is issued to: JORNim"?ILMY.
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
_
OFFICE USE ONLY
On Site 5ewage Occupancy
MWCC 5ystem.- = Zoninq "
On Site Well (Actual) Const y..8 -'
City Wster (AllowBbte) v.y ?."
PRV Required _jC-•. #t of Stories
Booster Pump L'ength ' -_77_ "
Depth
r?8:F. Total ,
Footprint B.F.
APPROVALS "FEES
Engr./Assess. Permit
Planner _ Surcharge n•?o
Council Ptan Review
81dg: Off. SAD, City
Variance SAC, MWCC 12G.W
Water Conn. M.b
Water Meter b?.Ab
Road Unit
Treatmerrt P1 ?•?
w*.Cs}i*s • ?
TOTAL
. 6 • t
?
` . (9rr#iftira#t uf Orr?panry
Citp of eagan
aPparbUPttf Dd iiltei" jttH.pPtfton
This Certif?cate issued pursuant to the requirements of Section 306 of the Unifonn Building
Code certi)ing that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following.•
u9e c6sirxadoo SF L1WC'/C,AR ewS. ftmi, lvo. 15873
oavpancy Type R3/I`i 1 zon;ng nistrict PD/-R I TyPe cu,ut. VN
owner oe euuaius JMM?-REII" r',.,ONST. Add„ess 1526 E. 122NID ST., B'VILiE
auuai?naeTess 3724 Si.fMM LAtT CT. Lmgty L22, B2, BLA3QW RIDGE
na.: .JUPtF 23. 1989
POST IN A CONSPICUOUS PLACE
6gill-
20Q5 RESIDENTIAL MECHANICAL FERMIT APPLICATI0IV
City Of Eagan
3534 P'ilot Knvb Road, Eagan MN 55122
Telephone # 651-675-5675
Please domplete for: single family dweUings & townhomes/condos when Frermits are required for caeh umit
owso
Date
Si
Add it #
e • U
?
Lak
te
ress n
t
-
'
Property Owner 1
66 cr ? 6 1 o Teleghone # (&S1 ) 7 Si? " ? e?j
Con#ractor J
e
Add Cit
ress
t
Stre y
State 2ip (J Telephane # {??l ) ^
Bond #• Expires:
The Applicant is Owner ?ontractar Other
Add-on or alteration to eaisting dweiling unit MA Y
42005 30.00
$
.
_ furnace _Additional ,_Replacement ?
Y?
air exchanger
i
diti
_
t
N
CR
R
a
r con
oner
_tr acemen
_
ep
ew _
ather
?
State Surcharge , $ 'ga
Tvtal ?
.
! hereby apply for a Residential Mechanical Permit and acknowledge that the ittfunnation is compleft ant1 sceumte; " the wvrk well
be in conformance with the ordinances and codes of the City of Eagan and ' Mechanical Cndes; tha.t I us?ctersmad this is not a
'?Y rmit; that the work will b+e in accomdance with the
ut only an application for a permit, and work is not to start wi
app d plan in the c?e,?of ?vvark yihich?requires a review and appraval o lan /'`t n_lt Ar
Applicant's Printed Name Xpptilant"s Signature
2045 CQMMERCIAL MECHANICAL 1'ERMIT APPLICATIUN
Gity Of Eagan
3530 Pilo# Knab Road, Eagan MN 55122
Tetephaae # 651-675-5675
Please complete for: cammercisUindustrial 6uildings
multi-family bnildings when sepsrate pennits are Mt cequired for each dwelling unit
Date : ! /
Site Street Address Unit #
Tenanf Name (if applicable) Previoas Tenant Wame
Prnper#y Owner Tclephonc # ( )
Contractar
Street Address Ci#y
State zip Telephone # ( )
Bnnd Expira:
The Appticant is Owner Contractor Other
Work Type
_ New Construction Underground Tank _ install _Remave *'`see be/aw
_ Interior Improvernent _ Insfall Piping _ Processed w„`Gas
Nature of Work:
"Hlfhen 7nstalling/rerr?ovrng underground #ank, ca1t fcrr lnspecfian by Ftr+e Marshat and Plumbing tnsp?tor
Permit Fees: $70.50 Uadergroundtanlc installatiozU'remaval
$54.50 Minknum (sncludes 5tate 5uwJarp)
or
Contract Value $ x 1°fo = $ Permit Pee
• If ermit fee is $1,000 or less, add $.SO =:> $ Sf.dc 5urcharge
Tf p_qLm_ij fee is over $1,000, add $.5() for
evety $1,040 permit fee $ Tatal Fee
t hereby apply tor a Commercial Mechanical Permit and aclnowledge that the information is cotrrplete and accurate; tha'k the vvorlt
witl be, in conformance with the ordinances and codes of tlte City of Eagan and with the Mechanioal Godes; tlmt I understand this is
not a permit, but only an application far a pertnit, and work is nat to start withnut a permit; that the work witl be in accardance with
the approved plan in the ease of work which requires a reView end approval af plans.
Applicant's Printed Name
Applicant's Signature ,
Approved By: , Insptctor Date:
PLLTMBING (RESIDENTIAL)
Permit Application
City Uf Eagan
3830 Pilot Knob Raad, Eagan Mn 55122
Telephane # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when pexmits are required for each unit
ct l?s- S-D
? / 103
D
ate (-
Site Address ?l 7a / fc1? ?niE #
Property Owner Telephone # ( 6$1) `?i.1?" 3?
Contractor lJ?A.?'j'L
Address _2y/ auof, City ?!!_.l?P lfG?i`f
State Zip Telephone #(1SZ) Ef( ?- ? 9 A 9'
The Applicant is Owner Contractor ' Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC lieense $ 100A0
Incfudes County fee. Additional consuitant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or roorn additions, excluding water sofitener and water hea#er
_ Abandonment of septfc system
_ Water turnaround (+ 5/$" me4er if needed -$121.00)
Other:
? RPZ ew installatian _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener Water heater $ 15.00
dditi
l
l
?
ona
_ rep
acement
a
p
State Surcharge ?? .50
$
Total
I hereby apply for a Residential Plumbing Pernut and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and with the Plumbing Codes; that I understand this is not a
permit, but only an applicarion for a pexmit, and wark is not to start witbout a pemut; that the work will be in accordance with the
approye4lan in the case of wark which requires a review and approval of plans. ? /7 /? .
A icant's Printed Name Appli t's Signature
1808 240013UILDING PERMIT APPLICATION (RESIaEN
Neyi QgngojgM ReauirernArtitt • . ,n ?iGq 7a (r Rernodei/RMr Reautmnwa
r
D 3 regiafored afte aurveys alww{nq sq. fl. of lot. s4. it. of house i?s?erp? r c
and gij rooted areaa dcuMM ror heatea addinons
D 2 coplsa of plans (ahcyw bean & wlndorv slzes: Poured fid. deslgn; etc.) 1 site sunreY br extedor adcUflona & deCka
> 1 sot of er'feryy calculailona KI
> 3 Coplea of treo proaorvallon plan H lot platted dler 7'l1/93
DATE: /8-00 GUNSTRUCTION COST:
aESCRIP'nDN OF W4RK:ICc' AW-9 Z We -
STREET AQDRESS: 3 47 X%4 MACtLI&A Wg.
L4T: BI.OCK: SUBDJP.I.D. #: ?kck hqw ? e
Mame: Tir1A &g-&ost Phona #: 651
RoPEMnr ? Rfst
OVYNER Sheet Address• 31? BA&j4AAryiK. LALG=L, ??
City Ce M&P) - 5tate: Zip: ??
??•?-? ? CITY 4F EAGAN ,
3530 PILOT KNOB RD - 55122
851-68'l-4875
. Company: Phone#:
- - (area code)
CONTRACT4R
Street Address: ? cense A?? Exp. *401
t ?
city SUgASVILL L• _ stats: xp: = 3 W7
ARGHiTECT/ Name:
ENGINEEIt Campany:
Talephana #: (
Strset Address: _ Regishafilort #:
Clfy
Sewedwater Iacensed plumber (if instailira sewerhaater5: Phone #: f_ 1
State: ZiP:
I hereby ocknowledge that I have read tFris appflcation, ac1e thal ihe iMortmdion is ctanect. and awee io comply wiih ap aPPftable Sfate
of Minnssota Siahiles and City of Eo9an Qrdinances.
51grtahue of Applicant: Gertificates of Sunrey ReGeived
OFFICE USE ONLY
Yes N JOL 1 9
Tree Rreservation Rlan Received
Y? No ? Nat Required
A5
OFFICE USE ONLY ?
BUlLDING PERMIT SUBTYPES
p 01 Foundation 0 07 05-plex 0 13 16-plex ? 21 Rorch (3-sea.) E3 31 Ext. Alt - Mutti
?(32 SF Dwelling 13 OS 06-plex O 17 Garage 0 22 PorchlAddn. (4-sea.) 0 33 Ext. Alt - SF
D 03 01 0! _ piex ? 09 07-plex ? 18 Deck E3 23 Rareh (screened) ? 36 Multi
CJ 04 02-plex CI 10 OS-plsx 0 19 Lvwer Level ? 24 Storm Damage
C] 05 03-plex 0 11 14-pEex Ptbg Y or_ N ? 25 Miseeilaneous
CI 06 04-plex O 12 12-plex ? 20 Poal ? 30 Accessory Bldg.
woRK TrPE
? 31 New ? 36 llAave Bidg. [3 43 Reroof
? 32 Acidition ? 37 Demolish (Bldg)* O 44 Siding
0 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair 0 42 Demolish (Foundation) ? 46 Windows/Doors
* Give PCA handaut ta applicant for demolitian penmit
GENERAL lNFORNlATtON
SAC Code # of Stories sq. ft•
No. of Units Length sq• ft-
No. of Buildings Width Foatprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MiSCELLANEOUS INSPECTIONS
? StuccolStane
APPROVALS
Planning Building Engineering Vadance
Permit Fee
Surcharge
Plan Review
License
MG/ES SAC
City SAC
Water Cann.
Water Meter
Acc#. Qeposit
S1W Perrnit
S/W Surcharge
Treatment Pt.
Park Ded.
Trails Ded.
Other
Copies
To#al:
Valuatian: $
SAC Units
%o SAC
v
zolto
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATIaN
681-46T5
f E@ 2 7 RE6Q
SINGEE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy af energy
caics.
CQMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of mantM in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuation of work
Site Locatian: c;e/, 4 wrt L,C CY,
STREET STE 9
Tenarrt Name:
LOT BLOCK SUBD. P.I.Q. #
Descri tian of work: 'Sa 5-e?-,
The appl i cant i s: il Owner ? Contractor ? Other (Descri be)
Name I/e-_ Phane
Property 4AST FIRST
4wner . Address
STRE€T STE #
C i ty c, k-7 State Zi p.?
Company ? C..1 ? Phone
Contractor Address License #
c; ty state z; F
Company Phone
Architec#/
Engineer Name Registratian #
Address
City 5tate Zip
Sewer & water licensed plumber _ Pracessing time for
sewer & water permits is two days Qnce area has been approved.
I hereby acknowledge that I have read this application and state that the infarmatian is
correct and agree to comply with all applicable 5tate of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Appl icant:
. fi
BUILDING PERMIT TYPE
0 41 Foundatian
? 02 Single Family
? 03 Two-family
? 04 Multi-fam. T.H.
? 05 Apt. Bldg,
WORK TYPE
90 New
? 91 Addition
13 92 Atterations
OFFIGE USE ONLY
? 06 Garage/Accessory
? 07 Fireplace
? 08 [leck
1?C09 Basement Finish
O 10 5wtm Poo1
? 93 Remodel
? 94 Repair
0 95 Tenant Finish
GENERAL INFORMATION
Occupancy ?
Zoning
Const, ?Actual}
(A1 awable)
# of Stories
Eength
Depth
APPROVALS
0 11 ites. Add./Porch
? 12 Cumm./Ind. New
C] 13 Comn./Ind. Add
? 14 Comn./Ind. Rem.
? 15 Public Fac.
D 96 Move
? 97 Demoiish
? 99 Undefined
? 16 Rgri cul tural
? 17 Building Move
El 18 Demo]ition
? 20 Miscellaneous
8asement sq. ft. MWCC System
lst F1, sq. ft. City Water
2nd F1. sq. ft. PRy Required
Sq. Ft. totai Baoster Pump
Foatprin t Sq, ft. Fire Sprinkler
On-site well Census Cade
On-site sewage SAC Code -
Planning Buildin9 DS 3-3 92.
Engineering Variance
REQUIRED INSRECTIONS
0 Site 0 Footing ? Framing
O Wallbaard O Final ? Draintile
C] Insulation
0 Firep]ace
? ---??
Perrni t Fee T2 Yaluation:
Surcharge Pian Review
License
MWCC 5AC ?-
City 5AC
Water Conn.
Water Meter
Road Unit .
Treatment Pl.
? Road Unit
Park Ded.
Trails Ded.
'Copi es
' Other .
Total;
SAC %
S14C Un i t s
Assessments
APFLIC'ATIaN FQR PERMlT
SEWER AND/QR WATER C4NNECTIQN
[s0'1'E: PAYMKbP OF FE@ AT TIME OF 4 *
* tPrrIcMzoN nXM rrcrr caN- *
.*r STIN= ABPRGVAL OF P$RN1IT. w*.
* aNSeBCTsoN oF sEWM AND/offt WAxEt *
* IrSrACLArioNS w= rxrr $E scED[UM *
[?[di'IL PERMIT F?LS BFaI APpROVkD.
ft,?**r *t*i*,rr*r**?***#+rr****?*******?*
tvoF eciqcin
(PLEASE PRINT
1) PROPIItTY ADDRESS : 3 7Ay C. u.,f :
T,BGAT• DESQtIPTi()N: za ??- 6z
vision or
IF EXISTTNG STRE.'CTC?ftE, DATE OF ORIGINAL BLILDING PERMIT ISSUANCE:
Mont Year
PRESENT ZONING/PROPC7SID LSE:
? CQMME2CIAL/RETAIL/OFFTCE
? INDL'STRIAI,
Q INSTI'I'UITIONAL/GOVERNMENT
1-R-1 SINGLE FAMILY
E=j R-2 DT-IPLEX ('3'wo Cni ts )
? R-3 TOWNHOUSE (Three + Cnits)
? R-4 APAE2TNIENT/CaNDQMIIVILM
Lnits).
( L'nits }
2) , " • NANE: 14
AnDxEsS: 16aG f,
CITY, S'FATE, ZIP: -73ur..su? I ?--
PHONE: g q 4(- q 3vA
• For City Lse
?
3) ? : ?
NAME: Plumbers L ci
ense :
ADDRE55: 9
19D Active
- .
-- --? ------- -?- Expired
CITY, STA'I'E, ZIP :
PHONE :
X y
7 M
ASTER LICENSE # /n Not reeordee
Staf-f I' n a1.
? ?.
4) MiUMUM64477
NAME :
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5} s (O.' w ¦?• ?r ??
?-EONLVECTION TO CITY SEWER @-CONNECTION TO CITY WATER El Q'I"HER
6) M,?
******?r**************?**?***?**??******************?x***??***?****************?**********?*?**????*,
? .
* THE GQLD COPY OF THE PERMIT WILL $E SEBTr DIUCTI,Y TC) PUSLIC WORKS T[} FACILITATE MM PICK-L?P. ;
* PLEASE ALTAW ZWO WiQRKING DAYS FOR PROCESSING. SSONNk7QNE FROM TM CITY WrLL C01VTP,CT YOL.? IF UtffiE y
* ARE ANY PR0BLEMS. '
???*?***?*************t??************************?*???*????**?*??**?**?***???*?*?r****??***???***?*=
- .L F4R CETY USE ONLY ' PEFiMIT # ISSUED
e l 04
Pd w/Bldg. Permit FEES:
$
$ SZ'
? a
SEGdER PERMIT (INCLL'DE SL"RCHARGE )
$
$ ?
WATER PERMIT (INCLL'DE SL"'RCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLUDE COFtPORATION STOP)
$ $ SEWER TAP
$
$ e--c=
ER
Ot'I
DEP4SIT - SE
ACC
VT
W
$ $ ACCOL'NT DEPOSIT - WATER
$ $ WAC
$ $ SAC
$ $ TRLNK WATER A5SE5SMENT
$ $ TRLiNIi SEWER RSSESSMENT
$ $ LATERAL BENEFIT/TRL'IVK SEfniER
$ $ LATERAL SENyFIT/TRC'NK WATER
$ $ WATER TREATMENT PLANT SC'RCHARGE
$ $ OTHER:
$ $
TOTAL
RECEIPT RECEIP'I'
DOES UTILITY CONNECTION REQLiIRE EXCA VATIQN TN PL'BLIC RIGHT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK WITHTN PL'BLIC
ROA DWAY" MLTST BE ISSUED BY THE EIVGINEERING
? NO DIV ISION. LIST AS A COIVDITT01'V.
SL'BJECT TO THE FOLLOWING CONDITIONS:
APPR€3VED BY:
TITLE:
DA'TE:
November 22, 1988
FLYMOUTH PLUMBING INC
9290 ZACHA.RY LN N ?4k ;.)A..
MAPIaE GROVE, MN 55369
REs 3724 BLACKHAWK LAKE CT., L22, B2, BLACKHAWI{ RIAGE
1532 BLACKFIAWK RIDGE CT., L6, B2, BLACKHA,WIC RIDGE
WARNTNG: BBF'OlIE DIGGING, CALL LOCgL OTILITIES - TEI.EPHQNE, ET.ECTRIC? G95,
ETC. - REQQIRED BY LAW
XX Your Sewer and Water Permit for the abave property has been eompleted.
It will be held at the Public Works Garage (3501 Coachman Raad) unt3.1
the meter is pieked up. BE SiTRE TO CALL PUBLIC WORKS (454-5220) FOR
YdIIR PERMANEI?TT WATER TURN ON.
Your Sewer and Water Permit for the above property cannot be eompleted
far tne fallowing reasons:
Your Sewer and Water Permit for the above property has been eompleted,
however, the meter eannat be issued ar oecupancy_allowed until further
natice.
CONIlHERCIAL PRO.TECTS ONLY
Your Sewer and Water Permit for the above property has been completed.
It will be held at the Publie Works Garage (3501 Coachman Road) until
the meter is pieked up.
Please eome ta City Hall to pay for whstever size meter you will need
for this pro,jeet. The size must be confirmed by either our Public Works
Dept. (454-5220) or Bill Adams (Pluznbzng Inspeetor - 454-$100) befora
issuance.
Sineerely,
Jan Severson
Seoretary
JS
?
19$8 $UILDING PEHMIT APPI.IChTIQN - CITY OF EAGAN
SINGI.E FAMILY DWELLTNaS
.
INCLUDE 2 SETS OF PLANS, 3'CERTTFICATES OF SURVEY, 1 SET OF ENERGY CALCULATI4id5
? 7._ - NQTE: ADDRESSES F08 COAN??-LATS--- CONTRAGTaAlHQMEUWNER MtJST DESTGNA1'E WHIC$
IS AESTRED. HO CHANGE3 WTLI. BE ALLDWED BNCE BUILbZNG PERMiT IS ISSUED.
_.y,
ADDRESS
MIILTiPLE DWELLINGS REN'tAL UNITS FOti 3ALE UNITS # OF (IwITS
..?_ .?.._ ?,.._
INCL[TDE 2 SETS OF i'LANS O CERTTFICATE OF SUAVBY - CHECS WITH BLDG. DEFT'. V
1 SET 0rENERGY CALCULATI0N5
COMMERCIAL
INCLUAE 2 SETS OF ARCHITECTURAL & STAUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET 4F ENEAGY CALCULATIONS -° ,'??Y ? 4 ?? , a
To Be [Ised For: 5WGI.A? 69=11-y° Valuat3ona Dates
Site Address ,D29- &&L?1Wr- L"Le cl-.
Lot 'ZZ Bloek 'Z-
Parcel/Sub (?f.,?C,Cf/?sJK 6/DV/d-
chuner 3G17j5&2 - &2L&tjo CA?Si
iddress 1%-'2.c- C- . !TZ a 0 S i ,
City/2ip Code ?kk1rt^j5\/1l-'6 .5 S33"7
Phone 8?q- 93clo
CantraeGor
AddreSs
City/Zip Code
Phvne Areh. lEngr.
.
Address
CitylZip Code
Phone #
r ?306Q QFFICB LTSE ONLY
On site sewage 4acupancy - -.
NIFICC 9ystem ? Zoning E2 . pl-r
On site well Actua1 Const
City water ' ?.llowable ??
PRV required ? # aP stories eir,
Baaster Pump ! Length
Depth
S.E. Total
Footprint S.F,
APPRavkLs FEEs
?
E1f1gY'/A99e99 PB2`m3,t
Flanner Surcharge
Couneil P].an Reviex
CAM ,
00
Bld$r Off. ?111.P .
-
SkCit Ciriy
Variance SAC, MWCC JAM9LQD
Water Conn ? G
Water Meter E?a
Road Unit .
Treataaent P7.
Parka
Capiea ?
TOTAL
??
?A L u.A,~no,J
?
?? ,2
5-xz- ? C??)
?` ? ? = Cy8)
1 Y/t
--_?
3z x Z s - `7oy
? y 7- = 440
y?= 1
_?-----r75 j X 1y ? toSr t4
J
? l Z.IDOI°?
?,Lq - S 7 q Zc?
!G 23? ?
a•?
?14-o0+
' 71 • 5u+
' 357•uo}
,,=` 1 7??•UU-t
0 ? 5U +
2?9.39•OU*
' 714•UL)+
`I 1 • 5 U f
37`7 ° O(1+
1?79r;•oljk
i 0,50t
2s 9? 9
;
?
?
.
* PrQNEER,.,._
? eng * eering ..
* ?C *
(612) 681-1914
Certificste of Survey for: QAl 'RE«41Q
?•
?
?
?
J
?
?
Q
Z
?
?
'Q
ED
b
. i
?
?Q
?
oM
Z?
lsv.C
F /
4?1
I
1?0
.
AI89°4S'S¢"W
?•o '?o•o ? .G_ - - - -
} °
i.e ??°• ? 's
i
--f?
???
:N:,
?n
_ 7
r?
/
r/
r Z'a
?00
i '
}?? . yb?j fo Ie
I
?
?
?
I
I
m ? ._ .?,_..?.?.
....,.?.+..,..?.?
?v??INEERING D
/
?
i ????N
F? FV IE V,1TE D
?
33y 8 _ ? _._?
,; F-Z796 /2•o
BLAGN14AW?
? k,- o
+Pfyv
r QOQ.a Denoles exisfi'n? Flgvafion PizaposEO NvusF EtEvqrronrs
Denolps propand Elevotiart j.owesf Floor Elevafi'an =928•0
-?? ?-- Denofes Drarn4 eOfilr?lrrawf EasPment
; Uenotes D?-4ina P Ffow Top ot" 81ock Elevcxll ari =1./
a Dei2oles monc[menf C'iaro z Slafi Elevation 83545
ee4rrt shown are assu m ed PAV, R Q uIRED
LOT 92 , BLpCK 2 ,8LACk1t4AW9 RIDOW
QAkO7q COUNTY, MfNNESoTA $(JB.IECT TU EA.?;EAfENTS OFRFCOAD
I herehy tertify tlvat this survey, plan or report was pr pared by me or irnder ?ny direct supervision and that i am duly Ffegistered land 5urveynr
under the ix,vs oF the State o! A/Einnesofa. Deted ihisday of ? q.p. 1g-4?w-
?
,P?d: !I- 10 -88 ti41?i• ?/.
SCLile: All-ch- 40+PEf -
rvn. 1481)1
J;?G' (.a i;. 42-
2422 Enterprise Drive
Mendota Heights, MN 55120
M 1KE wql PPS '
' • • - ? '? . -
?xz•rr1.?z ?:tavi:l',Ol'L AVt:EV?cE „v" coMru?rn?rzON
c?;n.ER
siTL ADDucss LaT 22. ?t,oe-1t Z 3IAcK%4.,0k 1Zit?L?' .
CONTI21?Ct'OR DhTES PIiON.I:
• ' ?.
. Aetermi.ne wo.rking squarQ foat-age of cach.
1. Total exposec3 wall area ...... ?o?o'? sq- ft-
2. Total roof/ceiling area ...... w l 2?1 sq. ft. X?
A. 'Total wall window ar.ea.......................... 22 L .
D. Total door arc1 ........... :..................... $Co
C. 'rotal slidincl glass doo1 area ................... ll.. Total fircplace wall area.......................
??? . .
B. Total wall xxcmning area (average Xc)%) ........... I'. Total I:i.m joist axea............................
.? ? 5 I ,
G: '!'ot;a1 Pae i walY area above floor .................
••' , x?oial ex-pc•sed fowidation area - ? ?
II: Total foLndati.on [4i1130h' area .................... 3
X: 'otal net: foundation axea above grade...........
(?
De::ermine "U" value at c.zcli ital], scytannt.
x -.U..
_x "U"
C.
, a? HU"
.
i
a.
? ----
Y
1.u„
--- ?
..---- .
-
e. x ?iu„.
X „U,
. ?. ? ? 5 t ? ?: „nN _. ? ? 3 ? ?'z.?i • .. -
.h, 3 • x ,.U..
a ,.u" 7, 48 ? . .
J?•••••....•....... ..w.......•.... A,Jtk.L, La?I"5?'? •
If .itr.m I13 i.s. Glic! same as, c,r lc:;:; than 9.L•<,m tEl, you havE! Met Clic inLesit ot
Sl3G G006 (c) 2.
? • , ? . .. ' r' J w ' •~ ?
? • , • S * 1
? • ?` . y r. ?
Y • ?
Totat e::posed roaf/rr.ilinc?
J. Total R;l:yt.ighc c,rca ................................
k. To1a1 rovf/c6ilinc{ Lr.ainiilU arca (avexaqe 101) ... . ..?? ?
1. ZbLal ne:t ili.ulaLc(l reof/ceilinq area .. .. . . . . . . . . . . _....?
' Diterinine "U" value foz e:ach xcxoffceili.tig seginent•.
? . ? X fov l$ - ?, ..----
? ? k.x „Ut, . o Z /.
xf,U„ , o q8
4 ..... ..............................ToCal. • ?. 2?
IF 1:ota1 of ;14 is the sane as, or less tlian 02, you have met ttie xni:ent of
SYC 6006(c)1.
, A.lrernai;e Bu3.lding Envelape t?esS.gri • ?
7'n util.ize tlze i:atal envetooe sysl:em method, the values esLabl3_shc:d hy tlic
su?n of itens 1,3 and I'M s1ia11 no:: be yreater than t1?o sum of items Ibl atid 42.
?.. 33`. q3 + a. 33?• ?-? ? _? 370. 3q
s. + a. ?8 . s8
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tin'r' l4-r• I ru ?vf waa2 arc.•ti fox .
.? ?
' ir??:nc cc,n:?tzuctior?
,
BFiSill: .
Irnz,r,
. . . . ' -• -
Const:ruction ' R-Valuc
1. f 1m - 0.64
2. ?/z." ?? Ou? - y S
3. v'li ncl2cs soit w20-1 4 •-dLOL,
4, lf? /32. s?tiib z.pc__
5.
_
6. Exl:r.r.iar ziix filin : 0.3.7
ToL•a1 ?o,C( {
G?r z .
ToMEw oF
VIU12t1: WnLL
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1 IG. d12
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• Q . '.
r
; -' ,,,,,•"?'•
' . . .
1. Intcri.or air film 0. Gf3
2.
3. ? iNSJ? l ?) .c.u
Q.' ??_ i?t"1b. ' Z.c?C.
5.
- --
--
G. l.xL•cr.i??: aia? film 0.17
-` ' 7total 2$ 03
I. Ini:er. Yor. air fiJ.m 0. Gt3
2: R. t?i r? rr ?q , u?
4.
5. s1v??_? ? G7
Fi. L'']CtCYI.oY i21Y. Sllnl ?• ???
' . ToLaZ ?{c,
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2. , 12- . '1 %3 ? T'f -1 rrt?
• 3. 1°. L.t, c,(c_ • I . Z 3
4.
5•
6. Extcr. ior aiz film 0.17
Total c? `3
. 63
SI,Ab • Oy GRAM
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l?aari?ric?»l ot 1h::ul;tit:ic»i.
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tr? i? j:'•?'•?a? -?.i?^c????':1?? ?!_?f'?4?^wt??;?t=.f
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('onri.ivcl:inlf (Uso Ior Il:em L) _ }t?V<<lt???
? ?. Intr..xior air film U.G1
2.
s. 57
a. ,'J.'xter1ot- :«r "ijA,n i ?.?.-1) 0 .61
Tatal
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3s ITlcllt'S LJCOd
4. 7[nc:hes i?isul a},ove ?jG_. w
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? 7_?Lt?? y......_ ? • ??
. . , d 'i-? . . .
].. ttiterior ai.r 'fil.m
2.)
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? 3. _--
4. 7:xterior a?r filin (,till) 0.61
. Total _ ?......-
. - • . • .
d
I .
2.
4.
' S. Uilt.!; ttlc a].1: f:D:n
ToLal?-
l:t>t:c: U::cs ?i:t,?.iL•i.??»??1. t;h??c:t.:3 x? morrt :;??it•?? L:
~ ~ tAOMl::i{ fos: cpotail:c an.l calctt!lit:ion:z.
.
a
?
LBL ? CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
'
.=,c4 (612) 681-4675
SUBD. 6? , RECEIPT ? &c?
DATE
R88ID8NTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
---------
-
------------------------
WORK DESCRIPTION ------------------------------ -
----------------
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
NEW CONST REPAIR/ADD ON 15.00
ADD ON SHOWER 3.00
REPAIR WATER CL(}SET 3.00
BATH T[TB 3.00
J // 1
-
S
? IAVATORY 3.00
L4 -
_
/ t
OWNER NAME: L?? KITCHEN SINK 3.00
?
t LAUNDRY TRAY 3.00
• _
SITE ADDRESS :3??Z I4-C-
1ta wK &K- - HOT TUB/SPA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING OUT.
INSTALLER: f-7 e--(' _ (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
-,r
ADDRESS : 7 7?- OTHER
WATER SOFTENER 5.00
CITY: F-Q? ZIp; PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE #: W. TURNAROUND 15 . 00
STATE SURCHARGE .50
OF PERMITTEE
TOTAL: S 15•5 D
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
GITY:
PHONE
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CQNTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
$
$
(SIGNATURE)
Use BLUE or BLACK Ink
r
For Office Use
l
' I VI `2 (a
City of EaEd~ , Permit ,
l
I Permit Fee: l
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
,
Fax: (651) 675-5694 1 Staff: l
I I
014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
J
Name: Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
_
, ~ , v
Type of Work Description of work:
Construction Cost: Multi-Family Building: (Yes /No
Company ' A 6P' C-0 Contact:
G f~ 4w) AV
Contractor Address: C.~City:
State: O h one:/C:_'~ Email:
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 ANEW 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:
I
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. _
~
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.oopherstateonecall.org
1 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 ordance with the Minnesota State Building Code must be co pleted within 180
days of . issuance.
x C7:Z; Ic x
Appli nt's Printed Name Applican s S ature
Page 1 of 3