Loading...
1157 Blue Heron Ct+t. E ???N RECOR-1 ?. SM-aF EAG4N ?o ?bt wnoti Road . Eikga,, MimesoW 65123 (812) fi8t-4675 ' $ITE ADDRESS: '2 f!? ' ttL 14 E. !it_#t(?N I! I.Ji)Ult r, i }f I o- PERNT SUBTYPE: r, I 4 .?. Il W l:a , . ? t30'?tlMr;;. ' F-011F4Oi11'ION -, . : R 0 lt{ I MO . . . - . 5?.. ? a ??•`iIOI P11 { YiM ? }' ! Ni I}3 Al,h` . . . , . ? .gi t?r.?t?t?t?° rN (11 06 ? f,ia?i 6f) iN H 16 i"1 ttA! f'! Etci F( N A i. 14 t:iqltftV'.s :S' h GJ G1.lN?ii'Af:titld . f,t f.tJl_ €'1.?lMtN 11413 . Prrn?lt Mo. N?dt rtioleer @el* T? ? ? • `, ? !l9?ih9 ZJW FY?1 P?g. ,fJ`- #q?. k?r-Niily P9?rr?r Co?l NI? . EWJFtan 01dg. Flrr31 DeCk P6g. Dac F'?nai tlU'aB Pr. Dbp. t Odi;1 f' ! (d A( __ . ?> • , _. - . . .. . . ? sla ?F'' ?1". ?. . . . , . - ? . t.?f 'F 4 ? '? . . . . " . . . ' ? ' ? . . . ?. •. .. ? . .. . . . .?? ? ??. ? LA40viAL G +L. ? ? r Wertificate vf ccrioanm Mt4 of Cfagan ?epartment of isui[bcag auepection This Certificate issued pursuant ta the requirements of the Uniform Building Code certifying that at the time af issuance this structure was in compliance with the various ondinances of the City regulating building construction or use. For the following: Use Classification: SF DW Bldg. Pertni[ No. ZZS lO Oc-p-Y TyPr R-3lM+ I Zoning District RI _ Type Const. VN Ownerof Buitding PEDER.SCXd HCHES Ilr Address *IS 11 14 Tl Q w-.ROSMW Bwkiing anaren 1157 ffi11E HERn MiFtT LrAiry iA, R2} ST FRarx'TS wmn 6'tH Due: BuiWing Ofrwial,/ " ` POST IN A CONSPICUOUS PLACE Address 1157 NM HERON COM Zip 5512 3 , , • - Lot 4 Blk 2 Sub sT. FRANCIS WOOD 6IH THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspector: Z9 Final grade (6" from siding) f- Permanent steps (garage) f f ? Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass ? Trail/curb damage Porch Basement finish Deck ? Please verify with the builder the cemoval of roof tesi caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ? . White - City Copy Yellow - Resident Copy Pink - Contractor Copy ? 9?? ? KV T S 9 3t _ ' ' 6A? Ce Re ues? Date ?`?? ? Fire No. Roughdn Mpsection Required (VOU m call inspector when reatly) Ins ection Other Than ough-In ? qeady Now 1?II Notity Inspector Yes ? No Date Ready Ii? licensed contractor D owner hereby request inspection of above electrical work at: Job Adaress (Street. Box or Roule No.) lln ff/vcl c/ City .4 &-A ? Section No. Township Name or No. Range No. I County XD,4 /`.' y? ? ?. - Occupam (PRiNT) phone No Power Supplier AC J / I Adtlress Eiectrcai Contractor (Company Name) -J" AGc?z'j -n Mailing Address IConiractor or Owner Making Instailation) ?P6 Authorizetl;ygnature (ContractonOwner Making Instaiiatlon) MINNESOTA STA7E BOARD OF ELECTRICI7Y Griggs-Midwey Bldg. - Room 5-173 1821 University Ave., St. Paul. MN 55104 Phone (612) 642-0800 mhacloYS License No. G;Qo2L?1' d',,g /? ur f?? A-W ?Phane Number ------L3zz- Y? s? 7HIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. SJ? f4 REQUEST FOR ELECTRICAL INSPECTION ( ( ? See instructions tor completing this form on back of y9llow copy. 14 o.. ?9 13 "- `X" Below Work Covered by This Request ??... es-oooo,-os ?. ew Add Rep. Typeof6uilding AppliancesWired EquipmentWired Home Range Temporary Service ? Duplex Water Heater Electric Heating Apt. Building ? Dryer Load Managemerrt Co mm.ilndustrial ?arrn _ Furnace Air Conditioner Other (Speciiy) ( i IOther (sVecity) 1 I Compute Inspection Fee Below: Comrector§ Remarks: # Other Swimming Pool Fee # Service Enirance Size Fee 0 to 200 Amps # Circuits/Feeders 0 to 100 Amps Fee Transformers Above 200 Amps Above 100 Amps Si9f15 Inspeclor§ Use Only: TOTAL Irrigation Booms Special Inspection f Alarm/Communication THIS INSTALLATION MAY BE OROERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby tif th t th b i Rough•in y te l?yy? 37 - cer y a e a ove nspection has been made. F;,,ai - , ? Date • OFFICE USE ONLY ThiS request void 18 mombs from ??? PERMIT #: 6"" G CITY USE ONLY RECEIPT DATE: 5008 MII}F1VTIAL MECHMICAI. PERMiT APPLICATION crrY oF EAL&x 3830 PaoT xxoB Rn EA6lkN MN 55188 651-6$1-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: ;//? - c-I a - C) a ? SITE ADDRESS: OWNER NAME: TELEPHONE #: 6o.5 INSTALLER NAME: d?&J'1ZOJn ?),104J TELEPHONE #: STREET ADDRESS: CITY: STATE: ZIP: T Piace a check mark next tu the permlt work type Add-on, modification or alteration to existinp dwelling unit $ 30.00 ( urnace replacement • air exchanger • air conditioner • other Nature of work: ir' i y ? u ; 3 Q u State Surchar e $ ? • „ TOtal ` --- ? _ S N TUR E E EE t/o2 CITY USE ONLY PERMIT #: RECEIPT DATE: APPROVED BY: , INSPECTOR 2002 COMMEftClAL MECHkNICAL PERMTf AtPPLICATIOA CI'PY og EALsAN 3$30 PILOT KAOB ltD EMM,1NR 55122 651-6$1-4675 Please compiete for: all commerciallindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: STTE ADDRESS: OWNER NAME: TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y INSTALLER: STREET ADDRESS: CTI'Y: TELEPHONE #: PHONE #: - N. NAME: STATE: ZIP: WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank P*ocessed Piping Specify Nature of Work: When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removaUinstallation = minimum fee Contract price: $ x 1%_$ (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMITTEE Updated 1/02 A CIT1F OF EAGAN PERMIT vR?qqlt 3830 Pilot Knob Road PERMIT TYPE: B U I L O I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 9 5 6 (612) 681-4675 Date Issued: 0 7/ 0 5/ 9 5 SITE ADDRESS: 1157 BLUE HERON CT LOT: 4 BLOCK: 2 5T FRANCI5 WOOD 6TH P.I.N.: 10-65905-040-02 DESCRIPTION: Buildin"g Permit 7ype DECK Building Wark 7ype NEW REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: ? OWNER: - Applicant -- S1"ALOCM JAMES 1157 BLUE HERON C7 EAGAN MN 55123 (612)452-4138 I hereby acknawledge that I Mave read this appla.catian and state that the .informatiQn is correct and agree to comply with all app,iicable Sta'Ce'af Mn. Statutes and City of Eagan Orda,nances. APPLICANT/PERMITEE SIGNATURE ?(y) F o I'1r,.- ISSUED B: SI ATU E 1NSYE(:rF1lJl\ 1\ECVRD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Mirinesota 55122-1897 Date Issued: (612) 681-4675 SITE ADD'RESS: P' r. N.: 10-65905--040-02 APPLICANT: LOT: 4 BLOCKs 2 1157 BLUE MERON CT S7ALOCH JAMES ST FRANCIS WOQD 6TH (612) 452-4138 PERMIT SUBTYPE: TYPE OF WORK: CIECK NEW ? ? suzLoING 025956 07/05/95 ? ? rt V'TY OF EAGAN 3830 PILOT KNQB RD - 65122 1995 BUtLDING PERMIT APPLICATION (RESlDENTIAL) 681-4675 ? 3repisbr?d sibe surwys ? 2 copiK ot qm ? 2 eopiss of plna (NKNWo Omn & window siaes; pouNd tnd. dwipn, ebc.) ? 2 Nft surw"s (Ntbrbr addili?ons i dedcs) ? 1aroo aleubdoes ? 1*eanpy akdoidns iar heoM adlitlau ? 3 ooplsm of bee pnwvMon pbm iF lo't pWW alter 711193 wquked: _„, Yea _ No nATE: /10 -..;2 (V - ?-5 coNSTRuc-ntN cosr. ±Z/50 ? DESCRIPTION OF WORK: STREET ADDRESS: / /-'5'7 ?-Rhs £', d?i2L- 6_r? , LOT ? BLOCK SUBD./P.I.D. #: PtoPeRrr Name: .I•4M?"S ST?¢?-D?-F?' Phone #: OWNER Street Address• ?°' & Aerall 61 ? CitY• State: Z+p' CoNTRACTOft Company: Phone#: Street Address: t.ivense #' City: State: 74. ARCHITECT/ Company: 5e . Z ? Phone ?- ENGINEER Name: Regastration #• Street Address- City; S#ate: ? Zip. Sewer & water kensed plumber. -- - Penalty spplies whsn arJdran char+pe arxi lot dmqp we requested onoe pennit is issued. 1 hersby aftowlsdp thet i have read this application and state that ft irNorrration is oonec:t artd agtee to iaorrVly v?dt ali applicable State of Minnesota Stebutes and City of Eagan Ordinanoes. Signature of Applicant OFFiCE USE ONLY Cwdgcoes of Sunrey Reoeived Yes No ,1 U N 2 8 1995 Tree Preservatlon Plan Received Yes No .... _ _ - - - - rt .. .. - - . BUILDING PERMiT TYPE OFFICE USE ONLY ?? ??.,•r'"'"?ii ? ?.i.,?,+?ii"`?'?'!6' o 01 Foundation o 06 Duplex a 11 Apt.JLodging o 16 Basenerrt Finish 0 02 SF Darelling o 07 4-plex o 12 Muid Repair/Rem. 0 17 3wim Pool 0 03 SF Addition o OS &plex a 13 Garage/Ac;cessory o 20 Pubiic Faality a 04 SF Porch 0 09 12-plex o 14 Fireplace 10 21 Miscellaneous 0 05 SF Misc. 0 10 _-plex c? 15 Uedc WORK TYPE n 31 New o 33 Atterations c 38 Move 4::? Addition o 34 Repsir n- 37 Demoiition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy _ 2oning # of Stories length Depth APPaovaLs Basernent sq. R. Main level sq. ft. sq. it. ._, sQ. ft. sq. ft. ? sq. ft. Footpririt sq. ft. Planning Buiiding MCNVS System Cityt Vlfater Fine Sprinklered PRV Booster Pump Census Cocle. SAC Code Census Bklg Census Unit Engineering Varienoe ? ? ? ? Permit Fee Vshotion: Surcharge Plan Review Livense MCNVS SAC City SAC Wftber Conn. Water Meber Acet. Deposit SMI Permit S/W Surdharge TreatmeM PI. Road Unit Park Ded. Trails [iecl. Other Copies Total: %SAC SAC Units - $ ?? ? • ` /?l- 3 i , ?. Certificate of house locatian for: Pederson Homes Inc. ? 3511 West 143rd Street Rosea?ount, MN 55068 DELMAR H. SCHWANZ LANO SUFVEYORS. INC. RepitterW Under Lawe ol TAa Slate o1 Minnosola 14750 SOUTH ROBERT TRAII ROSEMOUNT, MINNESOTA 55068 612/423-1768 SURVEYOR'S CERTIFICATE N , ? Scale 1 inch = 90 feet ? ? p = Iron pipe monument \ ? = Set wood hub = Existing spot elevation I ? Q = Propoped elevati:on ? . I ? , , • O? ? Drainaqe & Utility Praposed garage floox elev. = 9? •? N ? ------ Q N? Easements \ Proposed top of block elev. = 9061Z -z ? vl Proposed lowest level elev. = 896 s? \ I ? Description: Lot 9, Alock 2, ST. FRANCIS WOOD 6TH -p??. ADDITIONr according to the recorded plat thereof, Dakota County, Minnesota. I V`??? ?(Jw \ ? Also showinq the location of a proposed n v ? house staked thereon. ?yy c n„ ?? tt ? , ?y' ? ?L??? • ? ? " A4iS !.. - \ ?/ W ?a ?r? ?w ?,,,•?' ? ? ?? ?? t • ? r pP 00 ?e,30^' ? ? 1} • q8 ??? \ ?,v ' A'oy . . , ?? ?? •? ? qn• , ? `° ? ? (?0?01? ?3'L '.??? O6,o ? p \ ,`" •0?_ 1`1?;i1141it1U!!llyj? ? ?/\ mr {E.'Z'olu4?l4+ .7 ???l, •??' • T rr 'V?2 •?? 1 ??' ?41 l,,,A? ? .... •?.,?, ?^/ 6?.q8i- f .: ••.?? .?. ?,i ? .5 ?--T, . DCLMAR H. ?, " ? •?' od`?4' T n i SCHVJANZ rr ; '• . ';',;.:''' b• v,t" . . . •.•: ' ?:k' ..... ":??: '`' AZ1 U?? ? 1 hereby certify that this survey. plen, or report was prepared by me or under my direct supervision and / that t am a duly Registered Land Surveyor under the laws ot the S18te of Minnesota. December l, 1993 ,.,Delmar H. Schwenz Dated _ lufinnesola Registration No. 8825 ?l Revised 12-21-93 . /f .• Roa: qrrl LOT: ? BLOCK: 2- Sl1BD./P.I.D#:-Si 40hCIS VVDd +k 2000 BU1LDtNG PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD - 55122 13?7;- 651-681-4675 New Construcfion Reauiremenfs ? 3 regfstered site surveys showing sq. ff. of lat, sq. ff. of hause and all roofed areas (20% maxlmum lot coveraae allowed) ? 2 copfes of plans (show beam 8. window sizes; poured fnd. design; etc.) ? 1 set of energy Calculatians D 3 ccpfes of tree preservatfon plan if lot platted aiter 7/1 J93 ? Rim JoIsF Detaii Options seiection aheet (bulldinas with 3 or less units) Name: '^`E N0 (.iNo Tf'fo 62 L4Av ,0 Phone #: 06' 36 lost Firs1 DATE: I1' 2- r3p CONSTRUCTi4N COST: L 1 rzzC? DESCRIPTION OF WORK: i?ArZ o;7r` / /?E6Zr?v -F If mvffi-family bldg., how many units? STREETADflEtESS: l I57 904e h? ?X-a A,, c T PROPERTY owwER CONTRACTOR ARCM ITECT/ ENGINEER SfreetAddress: 1(57 ??C #'?crton? c T City C'A G falV State: (RE51DENTIAL) 1215-25 Remodei/Renair Reavirements 2 eopies of plan 1 set of energy cafculations for heated addMans 1 sEte aurvey for exieriar additions &decks /in AJ Zip: s S 1Z3 Company: ?-NeC5'T-Lfr.v Phone#: ?67 5141 -03Uy (area code) 5treetAddress: 4700 i 3n A 1-1- /? Llcen:e# 26 t stt'd? Exp, $-15!'0j City P4-- Y/'" o ?„T !t Stote: Zip: Company: Name: Telephone #: ( Street Address: Registration #: CHy State: Iip: Sewer/water Gcensed plurnber (if installing, sewedwater): Phone #: ( I hereby acknowledge that I have read this app[icafion, state that t nfo atta Rect, and agree to comply with all applical?le State of Minnesota Statutes and Ci ag an . Signature of Appiicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Freservation Plan Received YES No Not Required OFFICE USE ONLY CJ 01 Faundation O 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex 0 05 03-plex O Ofi 04-plex 0 31 New ? 32 Addition 0 33 Alteration E3 34 Replacemen# VALUATI4N Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const El 20 Poal 0 21 Porch (3-sea.) ? 22 PorchlAddn. (4-sea.) ? 23 Porch (screened) ? 24 Starm Damage ? 25 Miscellaneous 0 30 Accessory Bldg GI 31 Ext. Alt - Multi 0 33 Ext. Alt - SF 0 36 Multi ? 35 Int Impravement ? 42 Dernolish (Foundation) ? 45 Fire Repair ? 36 Move Sldg. ? 43 Reroaf ? 46 Windows/Doors ? 37 Demolish (Bldg)* ? 44 Siding ? 38 Demalish (Interior) " pemolition (Entire Bldg only) permit - Give PCA handout to appllcant Occupancy MC/ES Systern Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinkiered Width IAISPECTIONS REQUIRED _ Footiags: New Bldg _ Insulation ? Windows - new/replacement _ Footings: Deck _ FinaUC.O. _ Siding _ Footings: Addition ? FinaUNo C.O. _ Stucco/Stone , Foundatinn Fireplace: ? r.i. _ air test ? final Roof: _ ice & water _ final _ Framing Pool: _ ftgs _ air/gas tests _ fina] APPROVALS Planning Base Fee Surcharge Plan Review MCIES SAC City SAC Water Supply & Starage S&W Permit & Surcharge Treatment Plsnt Park Dedication Trails Dedication License Search Capies Other Total: ? 07 45-plex ? 13 16-plex 0 08 OB-plex 0 16 Fireplace 0 09 07-plex ? 17 Garage 0 10 08-plex ? 18 Deck 0 19 10-plex ? 19 Lower Level 0 12 12-plex Plbg_Y or _ N Building Engineering Variance PERMIT , CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: B uI L D xN r 02281.0 01 J28l94 SITE ADDRESS: p e i. No : 10--65905-040--02 DESCRIPTION: 11 IS 7 I3LUt_ H[?FOIV C"i l_OTs 4 BLQCKe 2 sF FRANCIs wraOD 61ta s f- uwc, P. r_ w R- 3 M-- a. v N R- .t 74 40 REMARKS: ?'j ?. `?t?r? ?• ? ??,? _ ?? i??I ?? S&W C:UPdTRWCT'UR - PESNe PLUhfi3TNCi FEE SUMMARY VALIJ!•1TI!)'tV Eia ,e Fee Pl,?n Revip4,p Surcharge 5(hC: SRIu °i SAC; Units St.abtota1 $961 e 50 $6?4<98 $9t? ? 00 00 100 1. __ . . _.. ._, ?$2 , 482 , 48 $192, 000 M I 5 C F E E S _.._.._.._.._._ $1 2 8_0 50 Tntal Fe?c $4.:.i1fdT9f3 CONTRACTOR: - flpp t.r can t -- s r e i, r c e OWNER: F'ECIERSQM IIOMES :ti4C 14233086 0001.466 PEDERSC)N MQMES INC; :315 11 11;3R1J 5T UJ 3511 LA;.',R p ST W RCJSEMOIJNT MN 56068 kOSEMDUiV`fMN 55068 (E;:li' ) 423-3086 ( 61?) 4?.'3--3086 I hereby acknawSedqe that I t7ave read L'his applicata.on ar'id state that the infcrrmatinrr is carrect and aqree i:a comp:3.y with a11 apPlacable State af Mne ? 5tatutes and ty of Eagan [)rdi.nances. - APPLICANT EE SIGN TURE ISSUED U. SI ,?R INSPECTION RECORD CITY iJF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: [Or: ?? ?LOcK: 2 1.157 BLUE HERON (:"fPFt)Ef?5ON HOMES 1.NC 5'1` FRAN(?I5 WQU[] 6TH (6:L1) 42:;i--'i08Fi PERMIT SUBTYPE: S F UWG TYPE OF WORK: NEW Bua-i._DxtvG 022810 0L/?8f94 INSPECTION FOQTINGS .• . FUUNDAIIQN .A FF2AM:CNCa Rf?Uf=ING TNSl1LATTON F]:F?FF'L.ACE RUUGH T.N PLE3G ROt1GM TiV FITG FTNAL PLBG F7NAL REMARKSo S&W CON1"f;ACTOR -- PE1hlE F'LUMBTNi3 ZZ ACTIVA P".:RMIT # CiIY aF EAGAN 1809"BUILDING PERMiT APPLICATION ?flA J-fO I4? 581-4675 T` SINGIE & MUL7I-F14MILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets af irthitectural & structural plins, 1 set of specif9cations, 1 copy of energy calcs. Penilty applies: 1) when permit is typed, but not picked up by last rrorklnq day of ?acnth- s requested once permit d or 3) lot change i h dd i . ange ress s c in Mhich request is oade, 21 a is issued. Date 12 / 29 ,_ / 93 Val uat i on of work 175,000 Site Address: 1157 Blue Heron Court fTREET . WITE • Tenant Name: (commercial only) LO? _4 BLOCK ,2_ SIIBWt.Francis Wood 6th P.I.D. #t Descri tion of work: Sin le Famil The appl i cant i s: ? Owner__ ? Other (oe.??ibe). - Name James Staloch phpnL454-4138 Property LAST FIRST - Owner pddress iTREET ttE ? City aaan State MN tip Company Pederson Hmoes, Inc. _ PhOne423-3086 Contractor Address 3511 143rd St, West Litense #0001 466 Exp.3-94 City Rosemount StateMN _ Zip55069 Company _ Phane A?chitect/ Name Registration # Engineer - Address City State tip Sewer & water licensed plumber Peine Plumbin ' . Processing time for sewer 5 water permits is two days once area has en ipproved*. I hereby acknowledge that I have read this ap tication and'state hat the information is correct and agree to comply with 1 appli ab State of Mi es Statutes and City of Eigan Ordinances. -? Signature of Applicant: ?? - - oFFicE usE oNLY BUILDING PERMlT TYPE O 01 foundation 0 06 Duplex 0 11 Apt./lodging 0 02 SF Owg. 13 47 4-Plex E3 12 Multi. Misc. ? 03 Sf Addition ? 08 6-Plex O 13 6arage/Accessory ? 04 SF Porch ? 09 12-Plex O 14 Eireplace 0 05 Sf Misc. ? 14 Multi. Add'1. O 15 Oeck WORK TYPE E 31 New O 33 Alterations O 35 Tenant Finish O 32 Addition ? 34 Repalr E3.36 Move GENERAL INFORMATION Const. (Actual) J(? ?Allowable) UBC ccupancy -? K-/ I Ioning / of Stories z Length 2Y Depth 0,33 APPROVALS 6asement sq. ft. ! 3Q9 lst Fl . sq. ft. / 30q 2nd F1. sq. ft. 162y Sq. ft. total footprint Sq. ft. On-site well On-site sewage Planning Buildin Engineering Varlance REGIUIRED INSPECTIONS ? Site ? Wallboard footing ? Final JT f rami ng D Oraintile Er Insulation ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Atct. Deposit S/W Permit S/M Surcharge Treatment P1. Road Unit Park Ded. Trails Oed. Copies Other Total: SAC 7G SAC Units wturcton: $ _ lg-Z DAd t(k- 7 Z; 4.G 3 -2 =-i4/4 k 38 2 3 y )3, G 9.+- 2 '----` ? 3o9.3y,? 69 = 9a3ys!srG 2h? f2/!. ???o«Zy,?SY ; , C7 16 Basement fin9sh O 17 Srrim Pool O 18 Coara./Ind. 13 19 Comm.Jlnd. Misc. O 20 Public facility O 21 Miscellaneous 0 37 Deawl i sh MWCC System City Water ? ARV Required Booster Pump Fire Sprinkler Census Code SAC Code i ? /- Assessments 90y ? z? ? - 2z ,r ) ,-71-35 , N .. . . Ce,rtifidate of house locatioa for: Pederson Homes Inc. 3511 West 143rd Street Rflsemount, MN 55068 DELMAR H. SCHWANZ uNO suave,roas. INC. , RpfaNrW Undsr Lwvs of Tha Shte of Minnssota • 14750 SOUTH ROBERT TRAIL ROSEMOUNT, MINNESOTA 55068 812/423-1769 SURVEYOR'S CERTIFICATE ? I r Scale 1 inch = 40 feet f \ p = Iron pipe monument ? ? = Set wood hub ? ,CQ9'7 = Existinq spot elevation I \ (D = Propo¢ed elevation O ? \ O? Draina9e& Utility ? Proposed qarage floor elev. _ O N? Easements \ proposed top of block elev. = 9Q6,Z Proposed lowest level elev. = 89(.Z I \ ? Description: Lot 4, Block 2, ST. FRANCIS UTOOD 6TH ADDITION, according to the recorded I ? V? ???•/? Q? plat thereof, Dakota County, Minnesota. Also showinq the location of a proposec ? 4v honse staked thereon_ V?'?? IE E D `pA , B - o0 o y,{ R F1AG A:,?" E.ti' C`:]VE.r,,d.flNC =?EPT. \ B94, z? y FQ' 0 W B?l? ?j ao'?' 13•y \ `8$?a .0 49977 ? ?y???2 .gb y? ?i,-=?" ?o?Or ?,,,h . •, t ? k.= ? ., . _:-R,t. Y ! r?i??k? i?. LJ ! ? `B` ?? L"U Gr . / 1 hereby certify thet this survey. plan, or report wes - /? prepared by me or under my direct Supervision and that 1 am a duly Registered Land Surveyor under the laws of the State of Minnesota. December l, 1993 Oelmar H. Schwenz Dated Minnesota Registration No. 8625 Revised 12-21-93 Revised 12-22-93 ? ? _ ?D 0 ? Q D VI 3 I3` 0 Ll VQ 13 ?t) 13 ?d D LOT 8IIR?EY CSL"CICI.IBT FaR REBIDZNTIn r Dat• e! aurv.y: DDCIIMENT 8?AERNRDB • Aeqistered iand surveyor sf qnature and cvaapany 0 8uilding Permit Applicant + Leqal description • Addrsss • North arrow and bar sca2e • House type (=ambler,, Wnikaut, aplft Ltjo,, sglft lntty',, lookaut, etc. ) • Directicnal drninage arrows wit3i alcpe/gradierit #. • Fraposed/existinq sewer and vatsr serviGea • Street name • Drtveway 13 8""?D • ILMTIONE Zxf stina Sewer service ? 13 H • Iot cotnerB 0 0 IIAOfCi • • Top of curb at the driveway i EIevat ons of ary sxisting adjacent homes . 7`13 0 • ?ro? Ga=age floor - B"' 0 0 • First floor ?!G m • Lcwest exponed elevatfon (walkout/windoW) a? 0 • Property coartsers 13 D • Front and rear af home at the fvundation PQNDING AREAs fit aRplieablll el • Eesement line o VD fCl D Y • • NWL ' HWL E • Pond f designntion 13 ? • Emerqency Ovsrflaw E1evation ? IC3 D ? G • ??MEN8?1N8 Lot 13.nes . . 0 • Riqht-of-way and street width (tv back of eurb) • Praposed hamG dimensions fnc2udtnq any pragosed -decks, overhangs qxeatel' thafl 21, POrChes, eto, ( f. s. O].l ?I3 0 • structures requirirrg permanent footfngs) Shaw all easemer,ts af record and any City utSlitfes within thase •asement6 ?0 0 • Setbacks of p=opased structure and sethack of adjacent / existing homes ??/G • Retainfng r gui ants, if any Raviewed: V:5 Nam / Da . tiCtober 1992 , . Page 1 E.\TF.RY08 ENVELOFE AVERA!;E "U" COHI°ili'A'C'IQIV Oc+ner Addreas 1'lione 4 7 r c /' -!?- Legal Description oF Property: Lot_?- 8lack Z, AddiCian 11P.1j-CV ?? a"V bate Site Address ? C ? ? 5(-G ec' (,•?'?„?;y p?[ ??? AVEEtAG£ [.INFJtL FEET OP El:P05ED k'ALL AttEA ABOVE GRADE Tlafn Ievel Llneal ft. of framed wa11 above grade 4-9 x heiRht of aali 2NO ?'I ? TJ ? Rim joist area ?? ? Lineal Et. of rien x heiFht of rim Lowe r icvc 3 f? Lineal f t. of framed wiil above grade?x height of aall ? ? ? 7? . Lineal EC. of aeasonry aaii above grade GM x heigh[ above grade? -T- TOTAL Wail area above grade including windovs aad doors - 3?0 Z .0 !a x "l!" value 4AY1'erv v G-ust sq. fc. x fou.. (U)(A) sq, f t '°v"7 ?(U) iA} sq. ft "U" ----??(lI) (A) Mo? ? . 9-5 a 7. ? ? sy. fe "u,? Z (L) (n) ?? `!3_ i sq. f t "U If. 3 (G) (A) _ ?t.d-6n 7 113 sq. ft •lU'"? ? (U)(A) I d"?C L4'' S i 619 7 sQ. f t •'ll"?'?If (li) (A) -7- Q 3 G? 4- 17 sq, fc flu,• ? 00 (u) (n) z ,3? F? -z.• sq. ec "U" • .?7. 7 p (t3) (n) 7 ..sq. fC nU?. L(L') (A) sq. ft. x ??U•? ? _ (U) (A) sq, ft. x •'0" (lT) {q) sy.. €r. x "u" N)(a) sq. ft. x ..uli- . CEt)(A) sq. f[. x "U" ft (i')(A) sq. ft. x (L') (p) sq. ft. ... x .,?{L?)I+?a X IT•,• (C) (a) sq. ft. „ 7j 16 !?f l?? DOORS: Area x "U" value , -': "' /-- ? 9 ? Make S tYPe ? k q. ft_ 74re-4- x ..v. ,r'?. (U) (A) r u i ?lT7??l`'?""' ?"+J4 Sq. fC. X 17. .rUn y ?le)l (U)(A) sq. ft. x (U) {A) sq. ft. x (U)(A) - " 9! ?3 ? t ?,g OPAQUE ?IALL C ONSTRUCTiON; Area x U" value , • "'•'""? FRANER KAI,L (to[al area less Aetail refer- opening, fxaming a?embers in eate from wgll, riat joist area 6 masonry V4/'4LL ) s 2276 +5rx ft „u Gp .Q?'3 - ??rt?t? (l )FA) actached shee[s .. F€amfnR members fn wnll q. . . €?,2.?f x . "U" Q ? Z'Z? (G)?A) , gim ioist area sq, ft. 4fl, D x "U° D 11, 04. (l!) (A) . lSasonrv area ab_ o?Pradr sq. f [. . 0(?x U. I '3 7 ? 1 , 14- (U) (A) ? r 04Zs WINDOWS: A ?take 6 type 1t 1 ., ,. n u a u 1? 11 .. ,? TOTAL h'all Area IncludinR Wiodows S Doars ?7,? ?* Q TO'fAL (i1) (A) ? ? ? ? ? TOTAL (U) (A) VALUES ?0 AVG. "U" DIVIDED BY TOTAL tiltLL AREA AVERACE "U" ll3ainwm .11 or less fnr 1? 2 fam£Iy daellings • NOTE: Mfnidsum .23 or less for all okher buildings If average "U" valuas es uleulaCed above do aoe eaet the 6nergv Cod• r'*qui "•Al,eruaen 6nveLope Rraign" a• iadicahd ovPaRs S way bs.usad.; ..,.,..? .?q-.,,,?' . 4,Ai 112 d" ' - WALL SECTI04S Page 2. NOTE:• tJse lOX of opaquc vall area ' for framing members . R-Value FRAMINC MF?iBERS IN WALLS Top Viev Exterior air film ..1.? _ Siding ------------- Sfieathing !?Z, `, 06 ?1 ?Aofc vord Q V nn, Y"..dr.y vall .45 ? ?• Interior air film '68 `-- '" TOTAL R dB5 u=i/e u_ •OR' . FRA21ED kALL Exterior air film Siding Sheathing a batt insulation _ .17 •61 Z?0 • OD .45 If" drv va12 - InterioY air film .68 Z2.9'7 'U ? 1/R U RIM JOIST ABEA- Exteripr air film J T Siding ? ,_ • 4j_ Sheathing Zf 0(0 1. 88 14" sofc woQd Insulati .68 Interior air film - TCTAL R a Zf,Q' O U- 1/R u. _a 0¢ MASONRY 11ALL Exterior eir Eilm .17 Page 3 ?? - tiAftR aE 411c.rNti Uutside air film .17 9uiltyP..r_anfing . 33 Insulation liood decking / Intezior air film .61 TOTAL R ? / U - 1JR U ' ROOF/CL•ILING: 'COTAL AREA: sq. Et. as (U) (A) "U" O x sq. ft.?' G?2 ' Detail reference, b , ? O '?.? • ?v?? i? i? x sq. ft. ?r 7 === - (u) (A) ove. from a Describe openings "U" (U)(A) x sq. ft. '- - (U) (A) in roef x aq. ft. . (11) (A) x sq. Et. (U)??) v.? ..U..- x sq. ft. ---- X sq. ft._ . (U)(A) TOtALS 1 sa . f t. .J .?1 (11) (A) ? TOTAL (U) (A) VALl1ES DIVIDEO BY TOTAL ROOF/ ` J a?? ? AVG. "li° • ? CEILLNG ARSA Z (I ? AYERACL "U" .02 tes ventila ted roois , .Y ,?.,;ri a ?Sw• 'Nf 'i, ?'.! r .. - A ,: c933 ?84 ?l? tE11?? '+ , ? _.. ,;.r .. RQO? CeILINr, _Outside air Eilm -61 •?------?? lnsulation 6f _ 0 4" Dryvall .45 Interior air film .61 TOTAL R- g7,6 7 u - ila u - 'D ZO Outside air film •6?.--1 --- Insulation /0 ,I r, r. ' 34' eb - Iz I poi j ? .60 ? Drvuall .45 Interior air film .61 rornL R u - i/R u - ?? ?J Page 4 ! *fin. R 7.5 Slab on grade Eaterior air film ,92 h" plyr?ood 6 ?I" partiele board .66 Iasulation Iaterior ais film ,gz TOTAL R ? U- 1/R U. ,Insulntioa shall have a ainimum R-Velue of 7.5 end muat extend horiaontally (as iilustrated) or vertically a diatance equivalent to the design frost line; that is: Zone 2? 3 Eeee 6 inchea .,,..; 4 ti L.,.'Ii? 1?^ .o?? . ' • THE TOTAL ENVI'_LOPE CALCULATION HF:THOD The regulaCions state thac alternative ovetall "U" values for buildiao seetions are permiseable if it is shovn tha[ the total building envelope heat loss/Pain does not exceed that of a similar building that meecs the regulation "U" value maximuos. In chis case. ve vill consider oaly the valls and roof/ceiling criteria•. assuainP thac the remaieder of the buildinp ceets regulatior requirements. A. Total heat loss ne desiqned (valls and roof/ceiling) 8TU/hr. degree P. w'alls - UaAo m AvernRe "U" of , vall assembly x aveYaga vall ssea sq. ft. ? RooE/Cei11nR - UaAo + AveieRe "U" oE ceiling x average ceiling area sq. ft. ? TO'CAL 9. Total heat loss if designed to meet the regulation minimum (valls and roof/ceiling) Nalls o U A . i4lnimum requfred 0 0 "U" value of vall x average wall area sq. ft. ? . ? Roof/Ceiling - oAo e Miaimum required "U" value of ceiling x average ceiling area sq. ft. ? TOTAL pi a •.? r ?`r i ?' ` #?.. l 1 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ---------------------------------------------------------------------------------------------------------------------------------------------- NO. ? -?? -? ? ( l -? ? -? SITE ADDI OWNER N INSTALLE ADDRESS: ?oi>? CITY: STATE: ZIP CODE: '.? PHONE #: ( ) 4134 FIXTURES SHOWER WATER CLOSET BATH TUB LAVATORY KITCHEN SINK LAUNDRY TRAY HOT TUB/SPA WATER HEATER FLOOR DRAIN GAS PIPING OUTLET • minimum - 1 ROUGH OPENINGS WATER SOFTENER PRIVATE DISP. • Dak.Cty. lic. U.G. SPRINKLER • home under const. ALTERATIONS • to existing WATER TURN ARDUND EACH TOTAL 3.00 .3 °'0 3.00 ? - n" 3.00 3•cr'' 3.00 • 0-° 3.00 3 • ? 3.00 3- ? 3.00 3.00 3• ? 3.00 -3 • ? 3.00 9 • ? 1.50 • S-f 5.00 20.00 3.00 20.00 20.00 STATE SURCHARGE .50 TOTAL: I ( -,f "' 2 :,"Ga-f-A- •???'rJ i I-X-- ?R?y SIGNATURE OF PERMITTEE 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 1994 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. NL'W CONSTRUCTIUN ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ Fi:i:: l°Io OF CONTRACI' FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF F,FEE. ..................: AIINIA'[U111 FEE: $ 25.00 .............. CONTRACT PRICE X 1°l0 STATE SURCHARGE TOTAL SITE ADDRESS: $ $ $ TENAIVT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: PHONE #: FOR: CITY OF EAGAN STATE: ZIP CODE: APPLICANT PLEASE COMPLETE FOR SINGLE FAMILY DWEI..LINGS. ALSO, F4R TOWNHOMES AND CONDOS WHEN PERMTf"S ARE REQUIRED FUR EACH UNIT. ...._.--------------------------------------------------------------------------------------------------------------------------------- NEW CONSTRUCTION ADD-41V AJC ADD-4N FURNACE FIREPLACE INSERT DATE FEES HVAC: 0-100 M BTU ADDITIONAI, 50 M BTU GAS OUTLETS (MIIVIMUM 1 @ $3.00 EACH) ADD-ON/REMODEL (EXISTING CONSTRUGTiON) STRTE SURCHARGE TOTAL S1TE ADDRESS: ? /!5- 4WNER NAME: 9--.4-A INST $ 24.00 6.00 $ 20.00 .50? ? ee?_ TELEFHONE #: ADD CITY,??? STATE: ? TELEPHONE #: ??^ ZIP coDE: SIGNATURE OF PERMITTEE 1994 MECHANICAL PERMIT (RESYDEN'TIAL) CITY OF EAGAN 3830 PIIAT KNOB RD Fa?cAN Ntlv ss122 (6I2) 5814675 1994 MEcHANIccaL pOVArr (coMMEUCiai,). CITY 4F EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 FLEASE COMPLETE FOR ALL COMMERCIAL,IINDUSTRL4I. BUILDINGS. ALSO COMPLETE F4R APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUTI.DINGS VVHEN SEPARATE PERMITS ARE N4T REQUIRED FOR EACH DVVELLING UNIT. DATE: CO]VTRACT PRICE: $ NEW BUILDING INTERIOR IIviPRQVEMENT WORK DESCRIPTION: FEES ????' FEE $ 1 % OF .,.. . _. _? _?:v :::.:<.>v:?:.;;:.?:N FROCESSED PIPING: $25.00 MINI]vIUM FEE: $25.04 STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE. TQTAL $ SfTE ADDRESS: QWNER NAME: TELEPHONE #: TENANT NAME: (IMPR4VEMENTS QNLI') 1NSTALLER: ADDRFSS: CITY: STATE: ZIP CODE: TELEPHO]VE #: SIGNATURE OF PERMITTEE CITY TNSPECTOR RESIDENTIAL BUILDINC PERMIT APPLICATI4N CITY OF EAGAN 3830 PILOT ICNQB RD, EACAN MN 55122 657-687-4675 New Construction Reauiremerrts • 3 registered site surveys showing sq. ft. of lot, sq. ft, of house; and all roofed areas (20% maximum lot coverage allow+ed) • 2 copies af plan showing beam & window sizes; poured found design, etc.) • 7 set o# Energy Ca[cula6ons . 3 eopies of Tree Preservation Rlan if lot platted after 711l93 • Rim Joist Detail Options select+on sheet (bldgs with 3 ar less units) ?" ? . d 5 RemodeUReoaie Reauirements ? • ? copies of pian • 1 set of Energy Calculations far heated additions . 1 site survey for exterior additions & decks . Indicate if hame served 6y septic system for additions DATE I ' 'QN-Ce. VALUATION ?`,\ V?SIT?hDDcS 1151 b LWE 14JEfOM Q,,.T MUETI-FAMILY BLDG -Y *JV - APPLIGANT STREETADDRESS_??%:? MlC.al&E3! *Vr7S,CITY. TELEPHONE # 702-(& OOV' CELL PHONE # ? FIREPLACE(S) _ 0 _ 1 _ 2 -A&,STATEMXZI PS$..? FA?C #WR"` 4'tf t4 (o IT= PROPERTYOWNER_ _& &WWLAPM TELEPHONE#?j`4??'_G?G COMPLETE THIS SECTION F4R "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RLILES 7674 CATEG4RY 1 MINNESOTA RULES 7672 (d su6mission type) • Residentia! Vent'rlation Category 1 Warksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations 5ubmitted Plumbing Contractor: Plumbing system includes: Mechanical Confiractor: _ Mechanical system includes: Sewer/Water Cantracter: _ Air Conditioning _ Heat Recovery System Phane # Phone # JUl 2 4 2002 -------------------------------------------------------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the infarmatiQn is correct, and agree to comply with afl applicable State of Minnesota Stcatutes and City of Eagan ik4z, t Slgnature of Applicant OFFICE USE ONLY Water Softener Water Heater No. af Baths Phone # Lawn Sprinkler ? No. of R.I. Ba.ths ? Cerkificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updaied 4102 QFFICE USE OPILY .; C] 01 Foundatian 0 07 OS-plex ? 13 16-plex ? 20 Poof 0 30 AccassoryBldg ? 02 SF Dwelling ? 08 06-plex 0 16 Fireplace 0 21 Porch (3-sea.) 0 31 Ext. A!t - Multi ? 03 01 of _ plex 0 09 07-piex ? 17 Garage ? 22 Porch/Addn. (4-se2.) 0 33 6tt. Aft - SF ? 44 02-plex ? 10 08-ptex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-pfex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-piex Plbg_Y or_ N ? 25 Miseellaneous ? 31 New 0 35 Int Improverrsent ? 38 Demolish (lnteriar) O 44 Siding ? 32 Addition ? 38 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration 0 37 Demoiish (BEdg)* ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement '"Demolltion (Entire Bldg only) - Glve PCA handout to applicant Valuation Occupancy MC/ES System Census Gode Zoning City Water SAC Units Stories . . Baostet' Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire SprinkPered Type o€ Const Width . REQUIRED INSPECTIONS _ Faotings (new bldg) ? FinaUC.O. _ Footings (deck) FinaUNa C.O. _ Footings (addirion) _ Plwnbing Foundatian HVAC 17rain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (ewlrep3acement) ? Insulation ? Retaining Wall Approved By , BuiEding lnspeetor Base Fee 5urcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & 5urcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other TQtal PERMIT City of Eagan Permit Type:Building Permit Number:EA128991 Date Issued:12/22/2014 Permit Category:ePermit Site Address: 1157 Blue Heron Ct Lot:4 Block: 2 Addition: St Francis Wood 6th PID:10-65905-02-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Frank J Schmidt 1157 Blue Heron Ct Eagan MN 55123 (651) 688-6700 Window Geeks Llc 1200 Center Pointe Curve Mendota Heights MN 55120 (612) 315-1481 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r For Office Use zi City Ol Eaaan :::e: 1 Co . 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t1 - 5 'J 7- Site Address itC1- i / - � -i G/'' Unit# IName: �r�,,,,,lc I- /4•'zL-e-Chc -C,,,.._,,.(/-. Phone: .,... Resident/ p Owner Address/Cit /Zi I/' I, f Applicant is: Owner Contractor Description of work: n� � � �w. M. .. � �..tv-iis� .r cs-gr.r Type of Work p /t I �( a � J Construction Cost: 1/ZC>fJd Multi-Family Building: (Yes /No k- ) 1 Company: _/..----A1-2 S i---e,4)t ( LI -- L.c Contact: - ✓}cit Contractor I Address: /LA)L-e ,.L.SC,,..,,C / '-L. City: Z_okr J,-/cc State: t/L1✓t2ip: cc-0441 Phone: & f-1147 y mail: _)�s��(®i G z-✓S rGu c�u 1-t r ,c'e C5--- License#: /6G-6,3 D Las ,� Lead Certificate#: � If the project is exempt from lead certification, please explain why: 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: i Mechanical Contractor: Phone: I Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE Plans and support/ng documents that you submit are considered to be public information. Portions of the information may be classified as nonpublic if you provide,specific reasons that would permit the City to i conclude that the 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.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 approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be comps-ted within 180 days of permit issuance. x A4fGw T x //%// � ,L Applicant's Printed Name Ap t �,:'ure Page 1 of 3