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3788 Blackhawk Ridge Cir i j ` ?. , ?_. ? ?A? This Certificate issued pursuant to the requirements of the Uniform &uilding Code ? certifying that at the time of issuance this structune was in compliance with the various ?I ` oirlinances of the City i+egulating building construction or use. For the following: Use Classifiqtioa SF M Bldg. Pecmit No. 2M4 l uP?YTYPe ?/Mtai aoniogDistrict ? } ? T Const. j Owner of Buildiqg ?`?O?? A? " g 13. ' f ?. 3788 PCT??? ?I.???ty ?'" Address " I ?.t,t:x .•?'""'.-- ?? r 1 ' Bnimiog Of6ial-? ? POST W A CONSPICUOUS PLACE Address 3788 Bt,A..1ZHAWK RIDGE rlR,.rLE Zip 5512? . Lot, 5 Blk 2 Sub m.a_? F-mrE zzm THE •''?S MS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. te: ? No Inspector: ?.. ` Fina rade " from siding) Permanent steps (garage) Permanent steps (main entry) ?. 5kv? g Permanent driveway Permanent gas Sod/Seeded grass ? Trail/curb 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 suppiy to the outside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in right-af-way or installing undergraund sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Copy ? ???? Re uest D Q t/ 0 3/ 9 3 ire No. Rou h•in InsPection Required? ? Ready Now A Will Notify Inspector xYes ? No When Ready? I?,jLlicensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) 3788 Blackhawk Ridge Circle City Eagan Section No. Township Name or No. Range No. County Dakota Occupant(PRINT) Sons Construction Phone No. 452-5355 Power Supplier Dakota Electric Address 4300 220th St. W., Farmington Electrical Contractor (Company Name) e{is?t;?o. ? Gontractpr's_L6 Joos Electric Co. ? Ai?l 1 y Mailing Address IContractor or Owner Making Installation) 2104 Great Oaks Drive, Burnsville, MN 55337 Authorized Signature IContractori0wner Ma ng Inst tion) ? Phone Numbe +31-4755 MINNESOTA STATE BOApD OF ELECTF:ICITY / y?THIS INSPECTION REQUEST WILL NOT Griggs-Midway 81dg. - Room 5-173 BE AGCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ?RICAL INSPECTION ? ` ? See instructions fof compi in his form on back ot yeltow copy. i. 42595 "X" Below Work Covered by This Request es-oooo,-oe ew c.d Rep. Type of Building AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other 1Specify) Comm.flndustrial X Furnace Farm Air Conditioner Other (specify) CoMractor's Remarks: Compute fnspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuils/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs fnspector's Use Only: TOTAL G 6 5 50 Irrigation Booms . Y Special Inspection AlarmfCommurncatiorr THIS INSTALLATION MAy-B ROERED D CONNECTED fF NOT Other Fee COMPLETED WITHIN 18 S. ; I, the Electrical Inspector, hereby f Rough-in ^•. , ??? r certi y that the above inspection has been made. Final ace _., ,Z ....? OFFICE USE ONLY This request void 18 moMhs from ?'CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILDINC 020844 e5/04/ss SITE ADDRESS: 3788 BLACKHAWK RIDGE CIR L.OT: 5 BLACK: 2 BLACKHAWK RIDGE 2ND DESCRIPTION: S F DWC NEW F2-3 M--1 VN R-1 PD 52 30 M1 v , F ? ? i Ema go- -. - - ,?S °" ... _ e-e.a..re. ....... _ _ REMARKS: 5&W GONTRACTOR - R C PLUMBING FEE SUMMARY: VA LUATION Base Fee Plan Review Surcharge SAC SAC ? SAG Units Lic. Search Fee Subtotal $549.50 $357.18 $4Ql.00 $750.00 100 1 $5.00 $1,701.68 $80,000 MTSC FEES $1.744.50 Total Fee $3,446.18 CONTRACTOR: -- Applicant -- ST. L][C. OWNER: SQNS CpNST 14525355 0002608 SqNS CONSTRUC"fIqN 1091 TIFFANY DR 4600 FATRWAY HILLS [lR EAGAN MN 55123 EAGAN MN 55122 (612) 452-5355 (612)452--5355 (612) 681-4675 SITE ADDRESS: APPLICANT: LOT: 5 BLOCK: 2 3788 BLACKHAWK RIDGE CZR SqNS GQNST BLACKHRWK RIDGE 2ND (612) 452-5355 PERMIT SUBTYPE: TYPE OF WORK: sF nwG NEw INSPECTION .. . .. FoorrNG FRaMxNG TNSULATION FINAL FIREPLACE B"Qi1dinr?,..,Aermit Type Bui.lrling 14ark 7ype UBC Occupancy6, Gonstruction "t Zqning Buil'ciing Length Buz.lclirt,:g Wictth REACTIVAT PER14IT # CITY OF EAGAN ? ?3?-q (? ? 1993 BUILDtNG PERMIT APPLICATION ? 681-4675 rAPR 223 REm dx& W-" 03 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAI 2 set3 0f architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. G - Date Valuation of work Site Address: ?,? ? STREET SUITE ?k 7enant Name: (commercial only) 1AT BLOCK A_ SUBD .,64W,?,L?, 16'? ?? . I . D . ? Descri tion of work: The appl i cant i s: 0 Owner ? Contractor 0 Other (Describe) Name G'Z 7`' Phone I- Property Owner LAST ? FIRST /?"l'lll.'-C /??' &-t b 't address 57REET STE # G /?/Z? \ 4 Z-7 f? - City State Zip Company ??12 5 ?'vPhone ' k& 2_6aP ?1°?015 C011tCaCt01 Exp: Address nse # r City State Zip ?-- Company L Phone Architecti Engineer Name ?- Registration # Address Zzi City ?-?j 'r-? ':?-7 State Zip ?1 Z.?- Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I°ave re t is a li ion and state that the infarmation is correct and agree to compl t; p ic4i 1 S e.r=of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: v OFFtCE USE ONLY BUILDlNG PERMIT TYPE O 01 Foundation ? 06 Duplex O 11 Apt./Lodging X02 SF Qwg. ? 07 4-Plex O 12 Multi. Misc. ? 03 SF Addition O 08 8-Plex ? 13 Garage/Accessory 0 04 SF Porch ? 09 12-Piex O 14 Fireplace 0 05 SF Misc. 0 10 Multi. Add'1. 0 15 Deck WORK TYPE ?31 New ? 33 Alterations 0 35 Tenant Finish ? 32 Addition O 34 Repair ? 36 Move GENERAL INFORMATION . ,? O 16 8asement Finish 0 17 Swim Pool O 18 Cortun./Ind. ? 19 Comm./Ind. Misc. C] 20 Public Facility ? 21 Miscelianeous ? 37 Demolish Const. (Actual) V- N Basement sq. ft. MWCC System Ya5 (Allowable) y-N lst F1. sq. ft. City Water YE& UBC Occupancy R-3 m-I Znd F1. sq. ft. PRV Requ9red Zaning pP R-r Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. ? Fire Sprinkler length ? On-site well Census Code >p/ Depth _ ? On-site sewage SAC Code ?5w APPROVALS ?ot ?? Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ? Site 0 Wallboard ? Footing ? Final ? Framing ? Draintile ? Insulation ? Fireplace Permi t Fee veiusti«,: $$D, doo °` Surcharge P1 an Rev i ew 6- qPA4F- F z2A 30 = &6 o r-I & , lb :5 6 ? License ,3oX,zYz .:. SAC W 13'r?- x 3y2 = (4 q) ty SAC C Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. 6 16 Road Unit Park Ded. Zk j2,l? ? Trails Ded. orl G ? ? Copies Other 7ota1: 117? # SAC 96 01-1 SAC Units I .? Proj Sitie ,- •?,4 ? A.r??-?- ?? ect Title Address ""?•- L EXPOSED WALL CALCtTLATiONS A. B. C. Opaque Wall 1. Masonry/C=rete a* b. c. 2. Iftux1atio-m-W&M 8. ' b. 3. WoW Franaa? a. Iruulated Area b. Fraraing A?raa .(Avs. 35% at 16" . oc) c. FramW Area (Ave. 100 at ??1" +Ac) 4. Periphotal F3AOic 84gtARM Joiat a. b. Clazirig 1. Wlnc3ows ?fZb' rc_..i? b. .:r...?P?.?.._ 2. Doors Doors 1. Woocl a. Solid_ ?en„?, ??,cX?.._._.... b. With st,ogtu door 2. Metai 3. Overhead 4. Other x 'a". x z?d' ??? ? ......?.?,..... ? .?•.:'? ?..- D. TOTAL fAIZ ARFA, sq, f t . . . . . . . . ... ... ....... 11-3.,,4- E. TO?rAL of ARFA x"U" ...................................... ?.... ?...?.:.. 14174to II. BOOP/CBiLiN(3 CALCULATiONB A. Roof/beiling Lnsulated Atea B. Aocf/Ceiling Framirg (Ave. 1St ak 160 ac) C. Rmf/Ceiling Frataing (Ave. 10t at 20 oc) 0. Skylight E. TOM FY70P/CEILI= AItEA Sq. ?k . . . . . . .. ... .. . ...?,???,.?.. F. %0= R'' ARF,A 7C "UN ...............s..?.....*.?::se???r.?rs??R?s???s• • ?'? ,. FacTMoa.ErrvaLQPB satuax cw*.?????1?????" To Detsnnine t7cuplianco With tbe Mi?? ?, ? (Swct?at SQ2 0? ? St?K?d?l ?9@3 #? ?? ?od??1 , . .. _ r"- . 4. TOTAL EXPQSED ROQF/LE !LI NG CALGUI,AT I,QAS: Tota1 exposed roof/cel l(ng area... .:...? l0 ,w„ s9 ft Total skyllghtarea..... .. --"'" sq f.t k) Total roof/celllnq framinA a rea (Averaoa W) . . . . . . ? ?q ?r . ? 1) Total nat insulated ro4f/cel l (nq orea. ...... ? sq r ft l • I '- !`. '. J r . _ 7777" I f total of d4 is the same as, or less th,an N2. you havs n?'. 2 MCAR 1.16008 A and 0. ? ? ALTE RNATE BUILRING ENVELOPE DES1W ? To utilize the total envelope system method, the valuas eFi ?, A_ bY t ,? of I tems #3 and !+4 shal l not be greater than Ehe s tum of i?,,?? :?d ?• 1. I l0 2 ? ± __...?.._,. + 2. 11 1 l0 3 . + 4. ijz' C. E R T I f i C A 7 1 A M ,. ' I hereby certtfy that t have calcui,aCad Che valttes herei0and that the bui)dinp here dwscribod of Minnesota Enervy Canservatlon Rcx. ,. . CAP.02 * * ** 1 * PtON6raR U ??. _ . wr eng neie?r r?g 'M° * * * * 2422 E?terPri9e Drive Mendota Ket(jncs, uH 55120 (612) 681-1914 • Fox 881-9488 ms • cmvL EWNUxs . uNDSCAPE AreaMTEc1s 625 tii9hwoy 10 Northsast Bloine. MN 55434 (612) 783-1880•Fax 783-1883 Certifiicate of Survey for: S S COn trU ti01'1 CO. House Address: Model Name: Blackhawk _Ri q., ircle agan, M .- / q r?. ?- ' rZ119 t '? ?- ? a? 1 b ? ? tt ? d" ? ? c?i?, / ??? ,b / H .r k?''? / ?ve J 4 ? ?.?,? ? ?? ?k??3 ?? / ? ' x ?? ? ? \ ,L i.5, 6v e40L A4? ? ?• \ ??'a ? "?' \ a \/ ao.oo ? '?' ? ??r 4$• ?3 d? . ? -?-- ? R ? p s?•2s; :Pf 949•1 94s 1. of,? NOTF: CQNTRACTOR MtlST 1lERlFY ALL DIMr-INSIONS x ooo.o Denotes Existing Elevaticn PROPOSED HOUSE ,?4.EVA'f10N x oo,o Denotes Prapnsed Elevcition Lawest Floor Elevattan: RC2.36 ., __ Denotes Orainage & Utitity Easement Top of Block Elevation: BsI•. -- Denotes Orainage Flow DlrectiQn Gnrage Slab ag7.n Elevotian: Denotes .--o-- Monument _ -..8-- penotes Offset Hub Bearinga shawn are 4ssurned LOT 5, BLaCK 2. B?ACKH AWK F2IDGE 2N f? pAKOTA COUNTY, h11NNESOTA i henby certitv that this survey, pian or r?port was prepartd by R+e or undf+' my dtrect supervisi0n and that I sm duly Rapistered Und SnrveYor under the 4aws 0f thE Stsie of Minnasota. bat4d thit Lk2t dey Of PNPA 1` A.o.185.;- . JGdI e. ?_Inch=3Qfeet ?? ., . PdiG. ? ROBERT B. SIKIC R Q. Np. 14891 }r ! . irOT lVA4tY CatCtLIBT !OA uSZDtliTZ7lL sQIbD2N t'iRlilT tLt u ZB.?ZRTY 2seit. nato Oi susveji ? I t4zl?z 0? • Rsqistersd Lsna furveyor aiqnatuta a:sd ompany 6? • nui?ldir,q Parmit 11,pplieant e'D G • LEqai Qescription ' . D 8' fl ? 1?ddress rD 0 ? North arrorr ,ar,d Dar scal• • S''D G • Nous: type (ramblsr, valkout, split w/o, split aatry, lookout,?tc.) D?D D • Dir:ctional drainsq• arrovs yith •2ope/qradiant •. ?Y 0 0 • Prcposed/oxistinq afvar and wnter strviess td'?0 G • Strset name ?rr D 0 - Drivsvay LLLPaTi02?B j?iLs.i.3r.3.8.Q fl Q? D • Sever sezvice 8" 0 0 • Lot corners 8" D 0 • Top of eurb at the d=ivsvay ? D G • Elevations of ar,y existinq adjieent homss - t?4.ltd !d? n 0 • Garage floar ? 0 D • F3zst floar j'OWest exposed elevation (walkaut/vindov) Pzoperty carners ? D D • Fzor,t and rsar oi boms at tAe ioundation ?2r'DIt?'G ?,RE7?8 ?if a??liea?l?? fl rD D • Fasement lin* . D 0? 0 • N?+•I, . D ? C • NWL ' . D D' 0 • Pond t dssiqnation D ? D • L'merqoncy OvsrZiov Zlevat3on nir.?xszoxs • D?0 0 • Lot lines . 0 0 • Riqht-oi-way and strost vidth (to biek of euzb) Dr D D • proposed Dome dimensions ineludin9 any propostd decks, overbnnqs qroater than 210 porehts, ate. (l.s. all strvctuzes reqvirinq permanent iootinQs) zo, D D • show all sas:ments cf s*eord and any City vtilities vlthin tbose •asements ? D 0 • Setbacks of proposod struetuze and attback ot adjaeent •xisting bomes n D • Retaining 1,i rs am*nj? ts, ! any • Revi?vad : _ _ __ _ I . _ PLEASE COMPLETE FOR SINGLE FAMILY DW]?LI,IrTGS. ALSO, F4R TOWNHOMES AND CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNIT, A NEW CONSTRUCTION ADL•ON A/C ADD-ON FURNACE DATE g.? _6 Z2 FEES HVAC: 0-100 M BTU $ 24,00 ADDITIONAL 50 M BTU -6;gg- *AS OUTLETS (MINIMUM 1 @ $3.00 EACH) 4. oD A.DD-ONjREMODEL (EXISTING CONSTRUCTION) $ 15.00 STATE SURCHARGE .50 TOTAL SITE ADD UWNER NAME: ?f?? ( 1f'?'?-? TELEPHONE #: ? ??? ' ??? INSTALLER: GENZ-RYAN PLUMBING & HEATING C0. ADID":ESS: 14745 South Robert Trail CITy; Rosemount STATE: M ZIP CODE: 55068 TELEPHONE #: (612) 423-1144 Ll MECHANICAL PERMIT (RESIDEN'I7AL) CITY OF EAGAN 3830 PIIAT KNOB RD EAGAN MN S5I22 (612) 6814675 . .. s PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ---------- -----__.? .__._________________? , -- --------------------- __--._--- N4. FIXTURES ? SHOWER ?- WATER CLOSET -? BATH TUB ? LAVATORY KITCHEN SINK ~T- LAUNDRY TRAY HOT TUB/SPA -? WATER HEATER ? FLOOR DRAIN GAS PIPING OUTLET • minimum - I ? ROUGH OPENINGS WATER SOFTENER PRIVATE DISP. • o$iLay. uc. U.G. SPRINKLER • home und'er const. ALTERATIONS • ta ?t,ng WATER TURN AROUND STATE SURCHARGE TOTAL: EACH TOTAi. 3.00 3- 3.00 Cv - 3.00 ?o - 3.00 9 -- 3.00 ?4 - 3.00 .3; °- 3.00 3.00 3• _ 3.00 3.00 --? _ 1.50 5.00 15.00 ? 3.00 1$.00 15.00 .50 SITE ADDRESS: 3788 Blackhawk Ridge Circl P OWNER NAME: Sons Construction INSTALLER R C Plumbing ADDRESS: 5910 rhester Ave CTT-y. Northfield STATE: Mn ZIP CODE: 55057 PHONE #: ( 612 ) 461-2096 19?- IGNATURE O PER EE 1993 PLUMBING PERNIIT (RESIDENTIAL) CITY 4F EAGAN 3830 PIIAT KNOB RD EAGAN MN 55122 (612) 6814675 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PII.OT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMFLETE FOR ALL COMMERCIALJINDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUP DINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH DWELLING L':::T. NEW CONSTRUCTION ADD ON REPAIR woRK nESCiuPTIoN: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF p!ER;MiT FEE MINIMUM FEE: $ 25.00 ... .. . CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL SITE ADDRESS: $ TENANT NAMEs STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: PHONE #: . FOR: CITY OF EAGAN APPLICANT Volume tof • ? Cer i icate o Title AWNER`S DUPLICATE CERTIFICATE Ccrti(cnte No. 8 3 S 5 5 Document No. 215905 District Court No. Transfer (rom No. 8 0 5 9 8 OQeinal5? regislered 1he 18th day ?f April V ?q 59 olume Forty State of Minnesota,(ss_ COU7tlty Ot Da.kOta,. J -%? X cJ ??t ?a cn.l????, ???;( P1eritor Development Corporation 605 West Travelers Trait ofthe City of Burnsville Counry of Dakota and Sroce ot Minnesota 1s »ow the ocvner of an estate, to wit: fee simple of and in the followinq described land srtuated in the County of Dakota and State oF /Lfrnnesota, to wrt. lot Five (5), Block Two (2), in BLACKHAbJK RIDGE 2ND AODITION, according to the recorded plat thereof. Subject to the encumbranccs, liens and inter-est noted by the memorial underwritten or endorsed hereon; and subject to the foftowing rights or encermbrances subsistrng, ns provided in Laws 1905, Chapter 305, 5ection 24, name(y: 1. Liens, clarms, or rights arisrng under the laws or the Constitution of the United States, which the statutes of this stale cannot require to appear of record; Z• Any reat property tnx or special assessment for which n sale of the land has not Geen had at the date of the certificate of tit/e; 3. Any lease for a perrod of not exceeding three years, when there is actual occupation of the premises under t/le fease; 4. Al( rights in pubfic highways upon the land; 5. Such riqht of appeal or right to nppear and contest the applrcntion as is aflowed by /aw; 6. The rrghts of any person in possession under deed or contract for deed from the ocuner of the certiTcate of title; 7. Any outstandrnq mechanics lien rights which may exrst under sections 514.01 ro 514.11. "7'hnr the s?rd Meritor Development Corporation is a corporation organized and existing under X?XX ??EXXXXXXXXX ?( Y,?K?,i??XXX the laws of the State of Pennsylvania. XX???XXXXXXXXX ? X Scxxxxxu?? ?j??y; it ylcfl2ej1 111n.rco ! have ??jWnto su6scribed my name d a?xed the seal of my o??g this day of ?ay 19 JAMES N. DOLAN Regrstrar of Titles !n nncf for• the County of Dahota and Stale of Minnesota. (Sea!) 1??E14V1HAL i?,ra. N li. '^+ o/ F,RLaIeR, F.axementx or ('har{reR on the l,nnd dexcribed in the GerLiifcale o/ Title hereto allached. OOCUMENT N M NIND OF DA1E OF REGISiRATiON DATE Oi1NSiRUMENT V BER INSTRUMENT MONTH OAY YEhR NO A.M. UN P.M. MONTH DAY YEAR AMOUNi RUNNING IN FAVOR OF SIGNATURE OF RfGISiRAR 215904 Declaration f Pr ec ive oven nts and o he land ) Ma 17 198 3:0 4 27 189 - The Public James N. Dolan 239209 Pressure R ducin V Ive gree ent (and th r lan s) Between City of Eagan and ? I Fe . 2 6 19 91 10: 46 12 719 - Meritor Development Corporati n James N. Dolan ? 0-r V.I D, ?00 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knab Raad, Eagan MN 55122 Telephoae # 651-675-5675 FAX # 651-675-5694 New Canstruction Reauirements 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage aliowed) 1 Soils Report 'rf proposed building is to be ptaced on disturbed soil 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Enetgy Catcu{ations 3 capies of Tree Preservation Pfan ff lot platted after 711193 Rim Joist Detail0ptions seiection sheet (buildings with 3 or less units) Minnegasco mechaniql ventilation form ' RemadeUReoair Reauirements 2 copies of plan showing footings, beams, joists 1 set of Energy Calcufa6ons for heated addi6ons 1 site survey for additions & decks Addifion - indicate if on-site septic system `72- 901 ?? ? ?? c? (3ff'ice.?se' Onlv Cer#ofSurvey?ecd Sa?fs Reporf ?4 ,.,; ' Y` N. T?ee Pces,Plasa ?te?xJ „ m l' N, Trae PresRequiretlu: `t Ai Orr ?rt??epUc aystei?r ?Y ^ ?t Date 63 Construction Cost `7 t ! ? Site Address Unit/Ste # Description of Work T f/ l x,w e? Ir Multi-Family Bldg _ Y_ N Fireplace(s) 0 - 1 _ 2 Property Owner A-A-? k ?e sti ? Telephone # ( ? Sl } '? S 3 ° ? ? C ? Contractor ?7? ?4'`7 - _: Address 5WA%7?0";v'k,1- ?T?- ?; / City :.?'?3 fJCtlGt???l! State pq Zip Telephone # (,(167) y?,9,`? 3 ?-G CONfPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 ? Minnesota Rules 7672 Energy Code Category 0 Residentiai Ventiiation Category 1 Worksheet • New Energy Code Worksheet (q submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 monfihs, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y _ N 1f yes, date and address of master pian: Licensed Plumber Mechan'rca! Contractor Sewer/Water Contractor Telephone # ( Tefephone # ( Telephone # ( I hereby agply 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 cades 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 arzd approval of plans. a q? ele `? 4?? Applicant's P'nted Name Applicant's Sgnature * q ;t ?y?y Y „ " ' . ' S . ? .. ? b 4 T f F 1 - . > ?. ?. ... , ' ' 3.. . . . . % _ ` ' .M1 T ?{ ? ? } F - e' . . , . . , ?S .. ; . . Y S • ? .+?N *?i# ?}?y Y"1( p+ y?0#t? i? p #; ?y PC. CT ., . .. . . . ??.*? r 7 N)S . a ° ..:.__- -- ?' ? ?- ? ? . l ? WA ? i , i ' Q??; ? ? P? a* Pho ? g ? J Do* FIW i wo Ph'. tT11p. . 9 Pft b"edor -NOW ftw*W aa10?1