3602 Blue Jay WayOracarPT?ON
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Permft Haldor t?ate Telephcne #
PLUMBlNC; ,
HVAC
tnspact{on t1M+Q Mnp. Cornments
F4{7TlNCGS
Ft1LiPAD
FRARAING _
R04FlNG
ROUGH
PLUMBING
PLBG
AIR TEST
R4UGN
HEATtNG
GAS SVC
TEST
iNSUL
GYP BOARD
FiREPLACE
fiREPLACE
AIR fiEST
FINAL PLBG '
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAIfdS
_
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
. .,.. . . _.,..,4 _ : . ,.?:
cirv oF eaGaN _ TER 5ERWtGE PERMtT??4?`? {N
3830 Pitot Knob Road Z /?
P. O. Box 21199 /?" MIT NO.:
' Ea?rh, MN 55121 ATE:
Zoning: '"Rl No of Unitr. 1 ~
pwm,eM; ???(BXS$?I ?? ;Corp
" Site Address. 3602 gld? Jay Way L15 B2i716xin ton F'iace Sa
(,?Piumberc _ iomg???T . g ,` .
"Aeter No.:
5;ze: SC?
Reader` No.c n 9 C- o? /a (? ?f
e" #olew* wh6 !Ie Citr of Eegon
Onpaepni?l, :
By
Date of I .
3 i2f9s
Lonnqcijo, e:
''°r9
? 470.00 pd
p
A?, ?t
be ?
un
Acooposir.
15.00
d
Permit Fee: 10. 40 pd
Surchorge: .. 54 pd
M1sc. Chorges: 63.0pd meter'
Totol:
;
Dote Paid:
Insp.: J
4
CASH RECEIPT
?? ? CITY OF EAGA N u
P. O. BOX 21-799
EAGAN, MJNNESOTA 55121
DATE
.. RECfitV BD
FR OM
AMOUNT $ ? M so
. . . ? ? ? ? . . & DQLLARS . . ? .
? casH 1)41cHecx
?
e
POR ..T'
LAJ
.??FUMD? CODE??? ? AM?OUNT ? ? .
. ? l!
? ' ?
.
F
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.
3
.
. .
31
..
:_ . . . ? G ?`
x
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8Y
tNhite--?ay?rs??t?#
Ye11qw-PsiSting Cow
pirt#-^Fi1e ?. ,
C1TY OF EAGAN 9668
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ,
PHONE; 454-8100
BUILDING PERMIT
T- L- „--, 9- SF DWG/GAR
? 0 0,? BUIL JAY WAY
FiOMFS
Address
Receipt # `-) ! +
$55,000 ,_ NOVEMBER 6 ,a 84
Erect ? Occupancy ' R3
Rgmodel Q? Zoning
Repair Type of Const. I, V
Enlarge El^ No. Stories
Move Length 4
Derrr0l ish 01? Depth 40
l?liiCE1 Drt 4 r! 3 3 3 Grade Sq. Ft.
Crty , Phone
?
'SAME
?Approvql3
• ? o Name
Ac##ress
? AssessmeMt'
? YVader & $ew.
City Phong
p-
Palice
F
Yu? Name
w Firg
, Address Eng.
City Phone
a Planner
Councii
I tereby ocknowledge that I hove reod this opplicotion ohd stote that IT/ ? T/ v
Bldg. Off. ?
the 'tnlormotion is torreCt and ogree to comply with oli appficoble
5toh of Minnewto $totutea cnd City of Eogun Ordinonces. APC
..-,-,) > , , ;
.. Var. Date
Fees
----;--e---Z9?3 :'f10
PermiY _
Surchqrge-??' S0
7-1;Fg' 0 o
Plon ¢heck
SAC ' - 25 . O? 0
Wated Conn. 470.00
Wote+tMeter 63.00
Rond 'Unit 260.00
` Parks
Total $I1792."5D
Sipinc?ture of Permittee ..L'''? `?
R T_N T? HOt?lES on the exprless cond'rek+r? thw
/1 ButEding Permit is issued to: 0
alt work shoil be done in accordance with-att applicoble Stote of Miqnesota Statutes ond City of Eogan IOrdinor+cts.
Building Officioi ' \` , - " ; • - ?,
.. .
a.; .?
Pe?mit Ido. Permit Hoider Date
Plumbing ( V\ O .SU a 'a t4,? 3
H. V.A.c. ?Oa.#" I vd> ?Z g _ b g? 7
Electric ?b L(U o0
Softener
Irupection Date Insp. Other
Footings
V
Foundation
Framing 19
`
Rough Plbg. -?' ? /.3 /7• /- 8'L/
Rough HVAC
inwlatioo y?7 ?r
Final Pibg.
Final HVAC
Finai
CWtJt9cc.
WaYar Describe Locati n:
Wed
Sawer.
Pr. d'ap.
? Receipt ??? I PLUMBING PERI011T. Permit No.
GITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print /egiblY
Tot
- 1. Date 2. Installation Cost
3. Job dd e2 Blue Ja'? Way ?'
Lot 5
81k. ` Tract L'x PI S
4, Owner 47Cx1n ThompSfl22 HoICies
5. Contractor ThomLsst?Yl P1 umbiiig Phone 9 3 3- 2S 21
6. Address 12201 Minnc3 ttailka Bi rre? ,
7, CitY M.3.nnmetC+nka State j? Zip ?Q-
8. Buitding Type: Residentiat Qt Commercial ? Institutional Q
9. Work Description: New Ck Add ? Alter ? Repair ?
10. Describe
11.
No.
? fixtures
Water Ctoset No. Fixtures
Cesspool/Drainfield
Bath tubs $eptic Tank
Lavatory Softner
+l Shower Well
3, Kitchen Sink
Urinat/Bidet Other
1 Laundry Tray
I Floor Drains
Drinking Ftn.
Slap Sink
Gas-Piping Outtets
12. 1 hereby certify that.ihe above information is true and correct, and I agree to
comply with alt ordinances and cQdes goveAning this type ttwor,,
Signed : iG?1X1lie L1 ' Ll?i9tSy , x..t '
for '
Rough Final
tnspections: Date Insp. Date tnsp.
This is your permit when numbered and approved.
!4Pproved CI7Y OF EAGAN 454-8100
Rewipt MECHANICAL PERNIIT Psrmit No.
CITY OF EAGAN
Fee oc,
Fi/l in numbeted 4um S/C . SO
TyPe or Prini /egib/y Tot 2`7D,
1. Date 11-26-4 2. Installation Cost 30&-X'J,tY""
M?
3. Job Addresa 3602 B°t.te j= t?.otBlk. Tract
4. Owner RMRi TWMI",074 W??u'F:r:
5. Conuactor R;4Z +y? '.("aLTSA'' PhOfl@ 52> 69y-rt
6. Address 463°T Cb$.i:oxc? Ave,
7. City I?SIS. $tate 2ip 554107
8. Buiiding Type: Residential M Commercial O Institutional ?
9. Work Description: New lR Add 13 Alter O Repair ?
, ?
10. Desixibe Zt38"k??13. . ??.'?w--ig P.- "jGr)ue1 Type 14a
11.
No. F,quij,?mencSTU - M. Ea.
Forced Air 80
000 No. Eauiament CFM
Air Handlin
:
,V
AAf9• g
Boilers
Mfg. Mech. Exhausi
lMit Heater
Mf9• Other
1 Air Cond.Mi'?-.4 2 To32 }
Mts; , ?s m Btu
Gsc. Piping Outlets
.
? 12. I hereby certify that tbe sbove infor tion is true and oorrect, and 1 agree to
? comp y w? .a 9r an an -
.
?.'
?---- for .
?, Rou?h FielN -
Inspectioqs: Date 1ns 08ts tnsp.
This is your PeFmit when numbered and approved.
Appraved CITY OF Elr?GAN 454-8100
;
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'-, : ;,?.? -? ? ??..
Ct'F`Y C3F EAGAW
1KA?'? ?'!?{? ??T
.??PRot K Y ?oad ? `
?iw
. P. Q. "x-271 .
PEitivtt't' IYO.: ?
E.?ryg??R M ???1?Y E i7
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Addtosr.
3602 . 5fte puldrew Blue Jay ?$a?r Li ? Laxi?t;gt? R'?itce
-'
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T
haup8tsn Y3bg
? lwlumber: :
? Meter No.: 47
Connection tharqe:
? S7ze: ? /1WW41f?{ j ?.??. a.??. nwy?v'chivrl?a`-
? K•
aSG[/UQf NV..
„ .
.?PCrnit ?f"ee:
. `
F. ? ... ? 0f1Ni to Cwl* 1!'lih the my of EggQp .? ?. SljirMQfgB: ? • • ?
? OrAhm"bom
ToYal:
? gY Dote Paid:
! Date of Insp.: Ir?sp.: ?
,7 CITY O
? 3834 PiFot Knob Raad 70$$ ?
: P. 8. ftc 2190*9 PEkMET NO.:
t, Eapn. IIAN .55121 1}ATE: _.,._.
? Zcminp: ?Z No. oF Units: _... .?
? Owner
i llddress: ;
3602 ; 5#e` Address: tte 14y' Ity l??t p,.
, Piwr,ber: +tmwocru F2bg
11-- . '
k 1+e?rba,ewmpy ir? d. Citr of E?Sw c.on??ectaon t?a?+pa: ?25.0? '?c1i
'? a ? ? ? ? .,.
or&woom Accou?+t Depo?t. 1
; Pern,tt Fee: 10.Of3 ??
? surct,oroe; -s LO Rtr
By Mest. Citooest '
i. Data of 1nsp.: TctaL•
? Ir?sp.. , Dote Paid
CITY OF EAGAN Remarks
additFOn Lexington Place South Lot 15 Blk Z P?rcer-
Owner Street 3602 $ltxe Jay Way ' State Eag;?
450 E .,;02.
MN
lmprovement Date Amount Annual Years Payment Raceipt Dats
STREET SURF.
S'i'REET RESTOR.
GRRDING
SAN SEW TRUNK QAI - 1985 247.64 I6.51 IS
SEWER LATERAL 0 l 9 . O 326,20
:
Services
729.39 -- -
. 145 ,> 87
waTERnnaiN 1985 65.81 I3.16 5
,
.
.
,
? WATER LATERAL 1012 1 6 873.43 ?.7 4. 6S ?j ._
,.
WATER AREA ./.?. g7 L?
22.39
staRm sew TRK p ln
1 l 9 8 6 4
26.54 $ 5:`3 0 5;
sroRnnsEwLaT 1016 1986 ?03.34 ?160.66 5
i
' CURB & GUTTER
SIDEWALK :
STREET I.IGHT
Ro d Unit 260.00 ..
_
.
WA ER CONN. ?F7C?.00 it .
SUILDING PER. 11
ra '
` SAC 525 Q t? tt
PARK
CITY OF EAGAN M 9668
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 f? -75I G?
1
BUILDING PERMIT ?teceipt #
Te be wed fer SF DWG/GAR Est. Volue $55,000 ' Date NOVEMBER 6 , 1984
SiteAddress .
3602 BLUE JAY WAY Erect IN Occupancy R3
Lot 15 Block ? Sec/Sub. LEX PL SO Remodel ? Zoning Rl
Parcel No. Repair ? Type of Canst. V
Enlarge ? No. Stories
of Name ORRIN THOMPSON HOMES Move ? Length 43
z 12 HOPKINS CROSSROAD Demolish ? Depth 40
Address
? MTKA 5 4 4- 7 3 3 3 Grade ? Sq. Ft.
h
City p
one
? SAME Approvab fees
o Name •
?l Address
I.- City Phone
Name _
Address
City -
Phone
1 hereby ocknowledge that 1 have read this opplicotion ond state that
the intormotion is torrect ond ogree to comply with oll applicable
Stote of Minnesota Stotutes and City oon Ordinonces,
Assessment
Woter & $ew.
Police
Fire
Enp.
Picnner
Council
sid9. off. 10/29/8
APC
Var. Date
Permit 0
Surchorge 27.50
Plan check 149.00
SAC 525.00
Water Conn. 470.00
.•? 0
Water Meter 63
Rood Unit 260 _ 00
Parks
Total $1, 792 . 50
Sipnature of Permittee ,`? ,4 IS I
A Building Permit is issued to: ORRIN THOMPSON HOMES on the expreu condit?on that
all work sholl be done in accordorxe with licoble Stote ? soto Statutes and City of Eoyon Ordinances.
??
Building Officiol
. ?
This request void
18 mont
? ??? I__ 5?;,
Request Date ?
r
` Fire No. Rough-in Inspection
Required?
?Ready Now?Will Notify, Inspec-
i V
' ? gLyes ?No tor When Ready
KLicensed Electrical Contractor I hereby:request inspectionof above ? Owrner ` electrical work instatled at:
Street Address, Box or Route No. ?. ? ?. . City? ?. ? ?..
.
?.. 1? ` Ww.. . 5 V V. L-IQ?T 1?4 ..
ecUOn o. Township Name or N. ?Range No. County ? . ?
D 161 rv1p
Occupant(PRINTR Phone Nb.
` F41ji-4 1 '7O1"`S-0/-J ? 'C1W?J
? Power SuPPlier Address .. ? . . ? ? . .
?h
Eleetrica{ Contractor (Company Name) Contractor's Lcense No.
4
?
3 ?-3
N{ailing Address (Contractor or Owner Making lnstailation)
l
t
c
qc
ff C-0140
f-
Autho ized Signa ? ( ? tractor/Owner Making Instal?lationl? ?? Phone Number
?
? . . . . . . . ?N'? 53v!;- ' ? .
.
MiNMESOTp ?YATE BOARD DF ELECTRICITV `THIS INSPEGTION REQUEST WIIL NOT
Griggs-NlidwaY Bldg• - Room N-791 BE ACCEPTED BYTHE STATE BOARD
7821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 297.2111 ENCLOSED.
. : _ . . _ . _?- . . - .- . . . . . . .. . . .
REQUEST FOR ELECTRICAL INSPECTION EB'00001-0"
l ' See instructiurts for completing this form:on back of yellow copy.
B 4 980 '-x-- Be/ow WorA16vered by This Request
ladd Rep. Type of Bui{ding . -Appliances WiredEquipmenc Wired ..
Nome` Range Temporary Service
Dupiex Water Heater Lightiny Fixtures
Apt. Buitding Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
(ndusirial Bldg. Air Conditioner Bulk MilkTank °
Farm Other Specify Other (SUecify)
t rSnnrifv (lTh- (lthvr Cmmnutp lncnnf-ttnn Fon Ra/nw
# Fee Service Entrance Size # Fee -Feeders/Subfeeders # Pee Circuits
0 to 200 Amps 0 to 30 Am s A .00 0 to 30 Am
Above 206_Amps 31 to 100 Amps 31 to 100 Amps
Swirrming Pool Above 100_Amps Above 100_<'++mps
Transformers frrigation Booms 5tt 0 Partiaf-`Dther Fee
aigis bpeciai inspecuon -
TAL FE
?
?
,C
Ret?rks
( r G(!
Rough-in.
.. ?.the Elec ' 1 .
.. . ? ? ? /!
? - . In ? ? . hereby ? .
.
l! ? c ?fy that the?above
i
l D
F
na
0 ,? si insPection has b?n
?
. . . . . . . . . . . ...? . . .
made ...
1Nis tequest void 18 months from
. ?.
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
,-, 3830 PII.OT KNOB R.D - 55122
681-4675
New Construdion Revuirements
? 3 registered site surveys
? 2 copies of plans (inGude beam 8 window sizes; poured fnd. design; etc.)
? 1 energy calculations
? 3 ropies of iree preservation plan if lot platted aRer 7/1/93
required: _ Yes _ No
DATE: ??? ;a q i-1) DESCRIPTION OF WORK:
RemodeUReoair Requirements
? 2 copies of plan
? 2 site surveys (exterior additions 8 decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST;
STREETADDRESS:
_. ?
LOT: BLOCK: ?- SUBD./P.I. D. #: ?'?
Name: Phone #: Cf,2
PROPERTY Last First
OWNER
Street Address:
City State: Zip:
Company:_?J??rv??,?C?`? Phone#:(?121?`?-vlL?
CONTRACTOR "
Street Address:,,"L? oo License # ?20 ( 3 CI `}03
City L)?-? %? ?-- State: L,--\ Y--\ Zip:
ARCHITECT/
ENGINEER Company:
Name:
Street Address:
City State:
Phone #:
Registration #:
Zip:
Sewer 8 water licensed plumber (new construction only): . Penatty applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the infoRnation is correct and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservatrort Ptan Received Yes No
.
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
O 03 SF Addition 0 08 8-plex
? 04 SF Porch 0 09 12-plex
O 05 SF Misc. ? 10 = plex
WORK TYPE
O 31 New E3 33 Alterations
O 32 Addition 0 34 Repair
GENERAL INFORMATION
OFFICE USE ONLY
O 11 Apt./Lodging 13 16 Basement Finish
O 12 Multi Repair/Rem. O 17 .Swim Pool
? 13 Garage/Accessory ? 20 Public Facility
? 14 Fireplace ? 21 Miscellaneous
? 15 Deck
? 36 Move
O 37 Demolition
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License MCNVS SAC
City SAC
Water Conn. Water Meter Acct. Deposit
S/VN Permit
S/V1/ Surcharge
Treatment PL
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
RESlDENTIAL
?3 ? ?? BUILDING PERMIT APPLICATION
cirY oF EaGaN
3830 PILOT KNOB RD, EAGAN MN 55122
651=681-4675
Now ConatrucNon ReauMameMS RemodeURemir Re6u ments
• 3 reglstered site surveys showmg sq. ft. of bt; sq. ft. of house; and An roofed areas • 2 copies of plan '
' {200/o ma)dnum lot coverage albwed) . t set oi Energy Calculations for heated aiddffione
• 2 copies of pian showing beam & window sizes; poured found design, etc.) • 1 slte survey for exterar addRbns & decks
. 1 set of Energy Calculattons . Indicate ff home served' by septic system for addMons
• 3 copies of Tree Preservatbn Plan 'rf lot piatted after 7/1l93
• Rim Joist Detail Optlons selection sheet (bldgs with 3 or less units)
DATE VALUATtON
MULTI-FAMILY BLt?G _ Y
SITE ADDRESS ur" ?Iq wav
NPE OF WORK fIREPtACE(S) 0_ 1_ 2
APPIICANT
STREET ADDRESS Ct'IY STATE ZIPs;ar?
TELEPHONE # CELI PHONE # FAX #J41ni-
?
PROPERTY OWNER TELEPHONE #"?Wf ?
. ------------------------------------------- r. •-•--r---------- ..-r--- ------- r.- - i:? .
jWH RESIDENTIAL BUILDINGS OINLY
COMPLETE THIS SECTION FOR -N
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 M IJL4SM
(4 submission type) • Residential VenUlation Category 1 Worksheet Submitted • rnergy Code Worksheet itted
• Ene?y Envei?e c??,?cio? submircea U L 2 3 2002
Piumbing Conhacbr: Phone # gy
Plumbing system includes: Water Softener ^ Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
` No. of Baths i
Mechcnical Conhactor: Phone #
Mechanical system includes: Air Canditioning Fee: $70.00
_ Heat Recovery 5ystem
,
Sewer/Water Contractor. Phone #
! hereby acknowledge that I have read this opplication, state that the informdtion iscorrect, and agree to comply
I? with all applicable State of Minnesota Statutes and City'of Eagan Ordinances.
?I Signature of Appiicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Pian Received _ Not Required _
Updated 4i02
?
OFFICE USE ONLY
i 0 01 Foundation ? 07 05-plex ? 13 16-plex ? 24 Poo4 ? 30 AccessoryBidg
? 02 SF Dweiling ? 08 06-plex ? 16 Firepiace O, 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti
O 03 01 of ` plex ? 09 07-plex ? 17 Garage [3 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
, ? 04 02-plex ? 10 08-plex ? 18 Deck ;? 23 Poroh (screened) 0 36 <Multi
0 05 03-plex ? 11 10-plex ? 19 Lower Level 0 24 Storm Damage
? 06 04plex ? 12 12-plex PIbg_Y or _ N ? 25 Miseellaneous
? 31 New O 35 Int Improvement 0 38 Demolish (Interior) ? 44 : Sididg
0 32 Addition O 36 Move Bidg. 0 42 Demalish (Foundation) 0 45 Fire Repair
0 33 Alteration 0 37 Demalish (Bidg)* 0 43 ' Reroof 0 46 WindowsJDoors
? 34 Replacement
I
I
*Demolition (Errtire Bldg only) - t3ive PCAhandout tn appticant
,
Valuation
Occupancy
MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
, Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
i
Footings (new bldg)
Final/C.O.
Footings (deck) RinaUNo C.O.
Footings (addition)
-
Plumbing
Foundation HVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests _ Final
_ Framing Siding Stucco Stone
-
FirePlace R.I. Air Test
- Final
- Windows (new/rePlacement)
_ Insularion
'
_
Retaining Wall -
------------------------
-- - ApRroved By
--------- ----------- - -------
----- , Building inspector
- -
-
Base Fee - - ------ - -- - --
--
? Surcharge
Ptan Review
'i MC/ES SAC
' City SAC
I, Water Supply & Storage
? S&W Permit & Surcharge
I Treatment Plant
, P{umbing Permit
Mechanical Permit
License Search
Copies
Other
, Total
. ,
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
F' < I . N . : 10-45060-150-02
DESCRIPTION:
' REMARKS:
RERCIQF DUE TQ STORM CIAhIRGE.
STORM DRh9AGE
REPAIR
434 AL7. RESIDEN1`IAL
I FEE SUMMARY:
CONTRACTOR: - Ap p licant -- ST• LIC OWNER:
AA AMERTCA'S BEST INC> 17070100 20239701 DANKQ LYNN
2400 INTERLACHEN C1R 222 3602 BLUE .7AY WAY
SPRING PAF2K MN 55384 EA6AN N1N 55122
(612) 707-0100 (651)405-9267
PERMIT
PERMIT TYPE: ??ILpING
Permit Number: 032719
Date Issued: 07/2 9/98
3602 BLUE JAY WAY
LqTa 15 BLOCK: 2
L.EXNGTON• PLRCE SOUTW
o9z rann9z
APPLICANT/PERMITEE SIGNATURE UED BY: SIGNATURE
i? • , . -
,
? 2/84
? CITY Or EAGAN
APPLICATION FOR PERMIT
;
• SEWER AND/OR WATER CONNECTIOr1
(PIEASE PRINT)
1) PROP= ADDRESS : -?602
LEGAL DE..?IPTICII: /'7 /"l e - z .
ILOL/r6locx/SubctivisicrK,.,6r Tax Parcel I.D. Nurberj
E-'S'I'??L'CI?^:'?E, DAT?,' Oz' OR?G? dAL ?uIi^I::G _.??-5?
ppF= ?,,•IZir,/p??OPOS=, t'S'- LTR-1 S?;GL::. rPYILY
? R-2 ZUPL77? MNO LNITS )
0 P,-3 M.^:-?Ci?SE ('I'1?-'--- + L":1ITS ) ? UiVI"'S )
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2) APPLi= _ IPIE SE PRI7ii)
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ADDRESS:
CTi'Y, STATEo ZIP:
Pxo?:
3) NXIE. 41/ ?PLEASE " ) C FOR CITY USE ONLY
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ADDRESS : PLERS LICE4SE:
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CITY, STATE, ZIP: Expired
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PHONE:
PLUMBER UCENSE /? NO o R Cord
Staff nttia
4) OCCUpANT/CtyT1ER NI1ME (PLEASE PRINT)
:
ADD}2F:SS a
CITY, STA1'E, ZIP:
PHONE:
5} INDIG sTE WE-iICH PERNIIT IS BEING REQUESTID :
Q'' C0'VNECTION T'J CITY SE,Tr1ER
LUNNECTION T
LT
O CITY WATER
? 0IF1ER (PLEA.SE DESCRIBE)
6) Ir1DIGz -" C:E:
? PLEA.SE F?OID APPROVm PER.'?IIT FOR PICK-LiP BY ONE OF ABOVE
? PLEr'SE :,tAIL APPRCVID PER.tilIT ZYJ 1, 2 3; 4 ABC'1VE
(Circle one)
7) SICZATL'RE. DATE:
? -`-
.,; . .
F O R C I T Y U S E O N L Y
PERMIT '-` ISSUED
. ?
FEES : $ / 4• ti..?? d SEWER PiRMTT jURC:iARCc. )
$ /4. .8;_ C5) WATER PERr'tIT ( INCL'u'DL SliRCHARGE )
$ CD? ?J WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SE:vER TAP
$ R
$ ACCOUNT DEPOSIT - WATER
$ WAC
$ SP.C
$ TRli-NK WATER ASSESSi-1ENT
$ TRliiJK SEtidER ASSESS:IE.1T
$ LATERAL BENEFIT/TRUNK SEWER
$ LATE:tAL BENEF TT/TRUNK WATER
$ OTHER '
$ TOTAL
- /?
AitiIOL'NT PAID/RECEIPT
DOES UTILITY CON NECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLL06aING CONDITIONS: '
..
;.
APPROVED BY:
T I : LE :
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DAT° : -4?
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ALL CONTRACTOR US i E ICEN • TH THE CITY OF EAGAN - AV
? INCLUDE Q SETS OF PLANS,
? CERTIFICATES OF SURVEY
Pi:an Number : SET OF ENERGY CALCULATIONS
To Be Used For: Valuation: ? b?Date:
Site Address : ?b 0 Z t`0 ?
\
Lot :\S Block : 2- Sect/Sub : L?.1«,Erect : ? Occupancy : 2-3
Parcel #: Remodel: Zoning: R-1
Repair: Type Of Const:
owner: ORRIN THOMPSON HOMES Eniarge: # stories:
a ivisiono .. ome orporatiorr Move: Length: 43
Address: 1712 HOPKINS CROSSROAD, Demolish: Depth: 40
City/Zip Code- MINNETpNKA,MINN.55343 Grade: Sq. Ft.:
Phone # : S`'?`? -1333
Contractor: •
Address:
City/Zip Code:
Phone #:
Arch./Eng:
Address:
City/Zip Code:
Phone#:
Assessments:
Water/Sewer:
Police:
Fire:
Engr..
Planner:
Council:
Bldg. Off. :
APC:
Variance:
Permit: 216 ,??
Surcharge : 2-7.5°
Plan Rev. : 14 q
sAC : 5Z5 , a..
Water Conn: '410
Water Meter
Road Unit:
Parks :
ww"e2?
.
o• *
?_98• 00 +
27• 50+
149•C0+
25•0O+
470•C0+
63•Q0+
260•0O+
19792•50*
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ve"•
I
C. R. WINDEN 3 ASSOCIATES, INC. .
LAND SURVEYORS Ttl 645-3646
1381 EUS)!S Sl.. 51. PAUI, MINN. 55108
For : NOTE :
U.. S. HOME CORPORATION o Denotes Wooden Stake . ?• Proposed Garage Floor El. = 905.83 (`!DO) Denotes Proposed Scale : 1" = 30' ?
Finished Ground E1. O Denotes Iron i
.4 Denotes Direction Monument !
Of Surface Drainage
Vertical Datum - N.G.V.D. 1929
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UC, Kw00 G DR ?V E
_71 S 8;C' 21' 54" E q?AA2l •
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Lot 15, Block 2, LEXINGTON PLACE SOUTH,
Dakota County, Minnesota.
r.:.%s;c
To be subject to and together with
side yard easements.
wE MERE6Y CERTIfY THAT TMIS IS A TRUE AND CORRECT REPRESENTATION Of A SURVEY Of THE
60UNDARIES OF THE IAND I?60VE DESCRI6ED AND OF THE IOCATION OF All 6UIlDINGS, {f ANY,
TMEREON, AND All V15161E ENCROACFiMENTS, If ANY, fROM OR ON SAID LAND
Do?od ihis 1676 dor of DcIcber A.D. 1984 C. R. W, DEN d, AS50CIATES, INC.
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119091
Date Issued:11/14/2013
Permit Category:ePermit
Site Address: 3602 Blue Jay Way
Lot:15 Block: 2 Addition: Lexington Place South
PID:10-45060-02-150
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Laura Gillespie
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Tyler J Moyna
3602 Blue Jay Way
Eagan MN 55123
Able Restoration Group Inc.
17316 Kenyon Avenue, Suite 103
Lakeville MN 55044
(952) 378-5000
Applicant/Permitee: Signature Issued By: Signature