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3617 Blue Jay way Use BLUE or BLACK Ink 5. w - _ For Office Use City ~ ~ ~~1 rat Permit of ( "g_U6 I Permit Fee: 7 7L7, -1 3830 Pilot Knob Road i Eagan MN 55122f 14 I Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I - - - - - - - - - - - - - - - - 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: de 0 Site Address: '36 ~ 1~ ue Z Tenant: ~Aftl RESIDENT/ OWNER Name: !M Hat frD Phone: 6~6-l - 3 - 7 ! C"~ Address / City / Zip: r J Applicant is: Owne Contractor TYPE OF WORK Description of work: y1~nn j TES J J~ , Construction Costs Multi-Family Building: (Yes / No CONTRACTOR Name: V ,CI ea M66egy p, License #:'7-C (o 3o--6 Address: 1-2-4 City: HMO Is Wl State: 7k/Vty Zip:y 1 b Phone: Z 6 q ~S Contact:C1 a ,q~ (iU Gam-' S / Email- ~ I U I ~1 (L -77 yYn 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: 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 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.org 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. X0, C GG_ff1 x ~tj I Applicant's Print Name Applicant's Signatu e Page 1 of 3 3620 16-V tj1qL"( & DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage - Porch (4-Season) _ Exterior Alteration (Single Family) _ Multi _ Deck - Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ Oi of _ Plex Lower Level _ Pool Y Miscellaneous _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ Addition Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows Demolish Foundation - Replace _ Repair _ Egress Window _ Water Damage Retaining Wall q L7 d *Demolition of entire building - give PCA handout to applicant ~ DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25%-100%-) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other Roof: -Ice& Water -Final Pool: Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In Air Test -Final Windows __)o insulation Retaining Wall: - Footings _ Backfill _ f=inal Meter Size: Radon Control Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee r Surcharge Plan Review f MCES SAC City SAC / Utility Connection Charge n0~P S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2 Auk IT' City of EaRan Mike Maguire Mayor November 23, 2010 Paul Bakken cyndee Fields W. Casey McGrath Gar Hansen; 2124 Harriet Avenue South Gary Minneapolis MN 55405 Meg Tilley j Council Members RE: REFUND OF BUILDING PERMIT #96421 Thomas Hedges City Administrator Dear Mr. McGrath: On October 18, 2010, Permit #96421 was issued to you for a residential building permit for a lower level alteration at-3617 lue Jay way. In error, you were charged an incorrect permit fee. You were originally charged $470.41 and you should have been charged $246.88. We apologize for this error and we will be sending you under separate cover a check for the difference of $223.53. Municipal Center 3830 Pilot Knob Road If you have any questions, please feel free to give me a call at 651-675-5671. Eagan, MN 55122-1810 651.675.5000 phone incerely, 651.675.5012 fax 651.454.8535 TDD Sarah Br ndel Office Supervisor/Administrative Assistant Maintenance Facility 3501 Coachman Point cc: Dale Schoeppner, Chief Building Official Eagan, MN 55122 651.675.5300 phone 651.675.5360 fax 651.454.8535 TDD www.cityofeagan.com The Lone Oak Tree The symbol of strength and growth, in our community. RECFwFl November 11, 2010 NOV 16 2010 W. Casey McGrath d.b.a. Adaptable Builders 2124 Harriet Ave. S Mpls, MN 55405 612 655 4450 To Whom It May Concern: On Oct. 18, 2010 I was issued a permit to complete a basement finish. The drawings I submitted as part of the permitting process were misleading concerning the overall finished square feet that would be built during the scope of the project. I labled 2 bedrooms "finished bedrooms" giving the impression they would be finished as part of this project, when in actuality they were already finished The unit fee of $470.41 reflected this. In actuality the project square footage is only 0 . I am requesting that the adjustment be made and I be compensated for the difference. I have spoken with Terry Zelenka on this matter. He has seen the project and is aware of the mistake I made. Permit # EA096421 ,T'h/ank~~s,,~, A~ W. Casey McGrath V o l `9 n G PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA082781 Eagan, MN 55122 . Date Issued: 04/30/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 3617 Blue Jay Way Lot: 5 Block: 3 Addition: Lexington Place South PID 10-45060-050-03 Use Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Crew2 Inc Maximillia N Shemesh 2650 Minnehaha Ave 3617 Blue Jay Way Minneapolis MN 55406 Eagan MN 55123 (612) 276-1680 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA085234 Eagan, MN 55122 . Date Issued: 08/13/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 3617 Blue Jay Way Lot: 5 Block: 3 Addition: Lexington Place South PID 10-45060-050-03 Use Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Renewal Andersen Maximillia N Shemesh 1920 County Road C West 3617 Blue Jay Way Roseville MN 55113 Eagan MN 55123 (651) 264-4777 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. Applicant/Permitee: Signature Issued By: Signature INSPECTION RECORD :a 1 1 rs 1 NO 14 CITY OF EAGAN PERMIT TYNE: 3830 Pilot Knob Road Permit Number: (i 21. 10 3 Eagan, Minnesota 55123 Late Issued: (612) 681-4675 SITE ADDRESS: 14 1 APPLICANT: f: 1 :f 11111JI F x h y 1-46,Y 01 t MAPS tit h1 " 1f tiIN01oN .t}t 1;1 PERMIT SUBTYPE: TYPE OF WORK: (it c HI a I Perm* No ~ kobdar DdMe Stott PLUMUNIG i ELECFFOC rF~ b"PKO" Die maw ~ Frees e►++~kE low. pow E C tltaal'AW f1r Pip. const. Motor €riv hrs Bldg. FGA Deck FtQ. 740+ Dedc Final ` won Pr. Disp. CITY OF E AGAN WATER SERVICE PERK 383%Mi t Knob Road P." d. Box 21189 7830 PEWIT NO.: 7830,86 Eagan, MN 55121 DATE: Zoning: _ M o. of Units: Owner: Thompson lplaes Address: Site; 3617 Blue Jay Way L5 E3 Lexington P1 So Pkw6er. Genz-R an Meter Plo.: a; 500. O d Size: E! , , 15 , 0pd Reader No.: %9? d ~f 5 { getcNe e-? 10.00 pd m' Q d . • to oow*y With the C" S fl" 16F rfles: 156_. t}Opd Z1? Ordiwenais. C ,R 0. V E {~6 Total: 63 50pd meror By Date Paid: Date of Insp.: trdp.: ~,:.,m~r- -~*'.z-.,,.,...+.:..,-a ..o-,'ms.z..,~:: ..:;~i.t;i, •3~''ii=1l~#t.,mri3'9"a7vnJ~w. - x.-„=-...=.s~# -«..•~..-a+ CITY OF EAGAN r .6. 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, IMN 55 21 ' PHONE: 454-8100, R BUIk G PERMIT Receipt# To be used for SF DWG f GAR Est. Value $68r000 Date ARRI 28 , 19 Site Address 3617 BLUE: JAY WAY Erect ( Occupancy R3 Lot -5 Block 3 Sec/Sub. LEXINGTON PL SRemodel ❑ Zoning R1 Parcel No. Repair ❑ Type of Const UA Addition ❑ No. Stories OR IN THOMPSON HOMES Move ❑ Length 43 w Name Demolish ❑ Depth z 712 61OPKINS CROSSROAD int.lmpr. ❑ Sq. t. 3o Address City MTKA Phone 544--7333 Install ❑ o Name SAME Approvals Fees s Address Assessment Permit 337 • ~ City Phone Water & Sew. Surcharge 34. 00 Police Plan Review 1G$=50 rW- W Name Fire SAC 575.00 z Address Eng. Water Conn. 500. Qt1 a City Phone Planner Water Meter 13.50 Council° Road Unit 290.00 I hereby acknowledge that I have read this application and statethatthe Bldg. Off. 4125/86 Tr. PL - 256.00 information is correct and agree t comply with all applicable State of Minnesota Statutes and City of aniordiraa_nces APC Parks ` 1 ` f Var. Date Copies Signature of Permittee 12T. 00 Total $2 A Building Permit is issued to ORRIN TiiOtaPSOIrT HOME: on the expresscondition that all work shall be done in accordance with all applicable State. of nesota Statutes an i of Eagan Ordinances. Building Official 4 Pehnk No. Permit Holder Date Telephone N Plumbing HMA.C. C _f r~ E1e`etric t2_~qq ~ 3 Softener Inspection Date Insp. Comments Footings 1 Footings 11 Foundation Framing Toro Roofing Rough Pibg. Rough Htg. Insul. ~d Fireplace O Final Htg. Final Plbg. Bldg. Final Cert. oec. , Deck Fig. Deck Frmg. Well Pr. Disp. PERMIT # S ip f PLUMBING PERMIT RECEIPT # oa 0 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: August 2f, 1986 CONTRACT PRICE: PHONE: 454-8100 Site Address 3617 Blue 3a Way BLDG. TYPE WORK DESCRIPTION Lot 5 Block 3 Sec/Sub X7tXXXXXX Lexington Place South Res. New Name Gertz-Ryan ME Mult. Add-on S? Address 14745 South Robert Trail Comm. Repair c City ROSMW=t s M Phone 423-1141 Other NQ. FIXTURES TThomson O Name O~rxin Water Closet - $3.00 • c Address -Bath Tubs - $3.00 ' p City Minnetar" s MCI Phone -Lavatory - $3.00 3 • Shower - $3.00 -Kitchen Sink - $3.00 FEES • COMM/IND FEE - 1% OF CONTRACT FEE --~-Urinal/Bidet - $3.00 Laundry Tray - $3.00 3.00 MINIMUM - RESIDENTIAL FEE -$10.00 Floor Drains - $1.50 1.50 - MINIMUM - COMM/IND FEE - 20.00 Water Heater - $1.50 •-r STATE SURCHARGE PER -PERMIT_ - .50- Whlrlpooi - $3.00 _ (ADD $.50 S/C IF PERMIT PRICE GOES -Gas Piping Outlets - $1.50 ' BEYOND $1,000.00) Softener - $5.00 Well - $10.00 -Private Disp. - $10.00 _ 4.5 Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: 24.00 STATE S/C: '50 FOR: CITY OF EAGAN GRAND TOTAL: 24.50 PERMIT' MECHANICAL PERMIT RECEIPT # Q CITY OF EAGAN Aumust 21, 19$6 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE: PHONE: 454-8100 3011 "WER Jay Way Site jAd ess BLDG. TYPE WORK DESCRIPTION Lot Blo~(, Sec/Sub eing r J.aCe xxxx ~C Res. New en2- ya» F&H (D Name Mult Add-on Address 14745 South Robert Trail Comm. Repair c City Rosemount Phone Other Name Orrin Thompson Homes FEES L c Address RES. HVAC 0-100 M BTU -$24.00 p City Minnetonka, NN Phone ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU 12.00 TYPE OF WORK 75 s000 ADDITIONAL 6 M BTU 6.00 GAS OUTLETS - 1.50 EA. Forced Air M BTU 24. ~ COMM/IND FEE -1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU - STATE SURCHARGE PER PERMIT _ .50 Vent M BTU (ADD $.56 S/C IF'PERMIT PRICE GOES CFM • BEYOND $1,000.00) 7 Gas Piping Outlets # Other FEE: S/C: .50 SIGNATURE OF PERMITTEE TOTAL: ?6.00 } FOR: CITY OF EAGAN 4 a X44 PERMIT# ECHANICAL PERMIT RECEIPT CITY OF EAGAN A 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE:PHONE: 454-8100 'Site Address .37 (0 / +»Vt J A/ t,,2 BLDG. TYPE WORK DESCRIPTION Lot_ Block Sec/Sub % Res. le New Name 'r ' T 4 ,r Z' Mult. Add-on Comm. Repair ca Address c Citys s Phone ~f Other Name e r ! d % 4, r ~ 0'V d9 FEES 11 'DES. HVAC 0-100 M BTU - $24.00 ATAddress. ADDITIONAL 50 M BTU - 6.00 ty RES. HVAC INCLUDES A/C ON NEW City Phone # - ' Z; CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) , - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE CONDOS= RES. RATE APPLIES Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 MINIMUM COMMERCIAL FEE 20.00 Air Cond. M BTU $ STATE SURCHARGE PER PERMIT - .50 Vent. CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # $ BEYOND $1,000) Pther FEE: S/C: /Pk. OP =R TOTAL: FOR: CITY OF EAGAN CITY OF EAGAN Remarks Addition Lexington Place South Lot 5 Rik 3' Parcel 060 5(j 0Q3 Owner Street 3617 Blue Jay Way State Eagan Improvement Date Amount Annual Years Pavment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1985, 247.64 16.51 15 SEWER LATERAL 1011 1986 16 1.00 , 3 2 6. 2 0 5 Services 101 198 729.39 ` 145.87 5 WATERMAIN 1985 65.81 13.16 5 WATER LATERAL 101 1986 873.43 174.68 5 WATER AREA 10 I!k 1986 243-. 7 48'. 74 W AT LAT BEN IOLA 1 1.9 22.39 STORM SEWTRK 101 1986 426.54 85,30 5 STORM SEW LAT 1019 19'86 803.34 160.66 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK This request void _ l7 a Qr S / 18 months from ~J+ u E 2756 f/~.od Request Date Fire No. Rough- inInspection Required? ?,Ready Now C ]Will Notify Inspec- /V E]Yes o for When Ready W-'L .icensed Electrical Contractor 1 hereby request inspection of above ffLt--JJ~' Owner electrical work installed at: Street Address, Box or Route No. City EL- Section No. Township Name or No. Range No. County Occupant (PRINT) d ~1, . P~ Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Ma ng; IInst`aailation) g ~j, ~y \ y Authoriz Sig ture on ac w e Making Installation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. -8iEOUEST FOR ELECTRICAL INSPECTION EB-.00001-06 f•- I' See instructions for completing this form on back of yellow copy. E 275'68 "X" Below Work Covered by This Request NeV4Addj ReP. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures F Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other Specify Other (Sper,ify) Other Specify Other Other Compute Inspection Fee Below k Fee Service Entrance Size # Fee Feeders/Subfeeders # Fee Circuits 0to200Amps 0to30Am s 0to30Am s Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swimming Pool Above 100-Amps Above 100_Amps Transformers Irrigation Booms Partial"'O ee Signs Special Inspection $ Remarks /~j TO Rough-in Date 1, the- evctrical inspector. hereby rtify that the above Final 1e 7 inspection has been r d me de. This request void 18 months from This request void b 6 L) 18 mont from r 4473 Req st Date Fire No. Rough- in I nspection _~({Req fired? Ready Now Will Notify. Inspec- ~z ~ t/ ~Q Yes ~Np for When Ready Licensed Electrical Contractor I hereby request inspection of above ❑ Owner - electrical work installed at: Street Address, BB o~~No. C ectwn No. Township ; Name r No(' Range No, ~ouMy O upant (PRINT) one No. Pa r Supplier Address E trica Contractor (Company h~me) Contractor's License No Mailing Addr s (Contja or owner Making Instailati n 94) X/ Authori d Signature (Contractor Owner Making Installation} Phone Number NES.OTA STATEBOARD OF IGITY THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD ri'gs'Midway Bldg. - Room" 1 UNLESS PROPER INSPECTION FEE IS 1821 University Ave., St. Paul, MN 55104 Phone (612)-297-2111 ENCLOSED. ' y j b REOUEST FOR ELECTRICAL INSPECTION EB-00001-14 See instructions for completing this form on back of yellow copy. 473 X Below Work Covered by This Request ( L Now Add Rep. - Type of BtUjduig Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg.'- Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank farm.. -Other Sped v Other (Sp-0y) Other (Specity Other Other Compute Inspection Fee Below pi Fee Service, Entrance Siz e # Fee Feeders/Subfeeders # Fee circuits pp 0 to 200 Amps , of 0 to 30 Amps 0 to 30 Amps Above 2,00-Amps 31to 100 Amps 31 to 100 Amps Swimming Pool Above 100-Amps Above 100-AMP', Transformers Irrigation Booms' Ud.SliPartial )t r Fe' Signs Special Inspection / Remarks' $ TAL E Rough-in qte^~1t0 I, theElectrical ZZ r OOU JJ Inspector, hereby ertify that the above i Final "lolOnspection has been made. This request void 18 months from ' 7 CITY OF EAGAN NO 1185 6 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 54421 - BUILDING PERMIT PHONE: 454-8100 Receipt ft (t, To be used for SF DWG/GAR Est. Value $68,000 Date APR TT. 8 19--B-6 Site Address - 3 617 BLUE JAY WAY R3 Erect L Occupancy Lot 5 Block 3 Sec/Sub. LEXINGTON PL S Remodel ❑ Zoning R1 Parcel No. Repair ❑ Type of Const. Vn Addition ❑ No. Stories Name ORRIN THOMPSON HOLIES Move ❑ Length 43 W 1712 HOPKINS CROSSROAD Demolish C3 Depth o Address Int. Impr. ❑ Sq. Ft. City MTKA Phone 544-7333 Install ❑ i o Name SAME Approvals Fees 00 Address Assessment Permit $ 3 3 7.0 0 I- City Phone Water & Sew. Surcharge 34.00 cc Police Plan Review 168.50 F W Name Fire SAC 575.00 x 3 Address Eng. Water Conn. 500.00 a W City Phone Planner Water Meter 63.50 Council Road Unit 290.00 1 hereby acknowledge that I have read this application and state that the Bldg. Off.4 2 8 8 6 Tr. Pl. 156.00 information is correct and agree comply with all app ' able State of Minnesota Statutes and City of ga ces. APC Parks Signature of Permittee Var. Date Copies Total $2,124.-00 A'Building Permit is issued to: ORRIN THOMPSON HOMES on the express condition that all work shall be done in accordance with all applicabl of nnesota Statute / f Eagan Ordinances. Building Official" Z" k CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilau Knob Road r 7 -3 P. O. Box 21199 PERMIT NO.: Eagan. MN 55121 DATE: Ironing: _ No. of Units- Owner.'aa+ai 3IsrR Address: Site Address: 3617 Blue, va r Wj y L5 113 "J. So Plumber: :,en x p :t Meter No.. Connection Charge: 3(} 'ip Size: Account Deposit: li7*SG Reader No. Permit fees 1 lt?p 1 "Pee to aaM* wig the City of awn Surcharge: copy OrAlwoeoee. Misc. Charges: 156 <00pd TF Total: F'; tit~nrl mcafar _ BY Date Paid: Date of Insp.' Insp.: CITY Of EAGAN sma sr/w PERM. 3830 Pilot Knob Road $3E 4 P. O. Box 21198 PERMIT NO.: Eagan, MN 55121 DATE: --'58 $ Zoning: No. of Units: Owner: Thompson Homes Address: Site Address: 3617 Blue Jay 'lay Lr) B3 Lexington I ~o Plumber. Gent:-R'YBn 4-28-86 61926 10("'.40 1 "0 me to omnoy with dw CRY of Eegee connection Charge: b 7 QQ&d F Ordteeeess.- Account Deposit: i Permit Fee: D} Surciwrge: ~fitsd BY Misc. Charges: 1 Dote of Insp.: Total: Insp.: Date Paid: CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD ' EAGAN, WNNESOTA 55122 DATE 1 9 RECEIVED ,a"o FROM J (1..7L/:. C AMOUNT L Is & _DOLLARS 900 CASH n CFjFrCK FOR '-C L.: lyG < FUND CODE 'F M UNT ems:.: Thank Yo~u~~~ N_ 660.20 White-Payers Copy Yellow-Posting Copy Pink-File Copy RESIDENTIAL BUILDING Permit Application' ?J S City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Cert of Survey Reod (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks -Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date / 18-/ 0-6 Construct on Cost 00 • Site Address Unit/Ste # Description of Work l~~(,-C~2~ W 1 ~j ff_IMN T. Multi-Family Bldg - Y N Fireplace(s) 2 Property Owner Telephone # (U1151) LK6 9 118 Contractor C:;2b 1_50 R $4 Address RENEWAL BY ANDERSEN 1920 COUNTY ROAD C WEST City State ROSEVILLE, MN 55113 Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTR CTING A NEW BUILDING Minnesota Rules 7670 Category I _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet 0 submission type) Submitted Submitted • Energy Envelope Calculations Submitted . Licensed Plumber I' ieiephone # i ( ) Mechanical Contractor Telephone ) Sewer/Water Contractor _ telephone # ( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City 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 and approval of plans. / 0~ A A,-, A A A .bc~J Applicant's Printed Name pplicant's Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 AccessoryBldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Pibg_Y or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) .0 44 Siding , ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof 46 Windows/Doors ❑ 34 Replacement *DemoUtion (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump a Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. Footings (deck) _ Final/No 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) - Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total • ••v •.L auv x,. vu rtip too OIL 4400 KCI~ltS11AL ~Sk~' QPfUBtt►~tStM WUU2 re -.1 June 7, 2001 City Of &M 3836 Pilot Knob Raad EftM MN 55]22 To Whom It May Concern: Elder Jones is authorized to pull building permits for Renewal Elder Jones to provide this ~ervicc for us in EaM. ` by Md.... pipe SOW date beyond 616101 ; until a mtewal by An'Milt amchat 2adOn 14 valid for any to the City. arcprosly revokes it in wining I request this authorization be ~ our building Pcomits an d expeditiously, as to not delay in den pr!oeassiug of y fitrthcr. Please call me If thcao arc any, gncadons.. I can be ~ corttacstcd at 763-502-470b_ Your imm q - sdiate altcntion to this matter is aged. Sinoa~oly, _ . vnd R&au vstalladon Manager Renewal by Andsrscu Corporation ('.c:: Kst~w-Fdciex Tc~nee - . 4 pts,,L off D CAA "~„y ~o MAL Received Time Jun. 7. 1.07PM 7 l1 RESIDENTIAL BUILDING s-/ Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Cert of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions _ Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date Construction Cost t.J~..J Site Address Unit/Ste # Description of Work Multi-Family Bldg - Y - N Fireplace(s) - 0 1 - 2 Property Owner Telephone # ~~G • Contractor RMA Home Depot Installed Sales 3200 Cobb Galleria Parkway Ste. #200 Address Atlanta, GA 30339 City State 763-542-8826 License #BC-20268257 Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet 0 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone # ( j Mechanical Contractor Telephone # ( ) Sewer/Water Contractor Telephone ) I hereby apply for a Residential Building Permit and acknowledge that the info ion is com let ccurate; that the work will be in conformance with the ordinances and codes of the Cit Eagan an the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and 5 appr val of plans. Bejnscrv Applicant's Printed Name pplicant's Signature t ~ OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 AccessoryBldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or_ N ❑ 25 Miscellaneous Work Types ❑ 31 New p 35 Int Improvement ❑ 38 Demolish (Interior) t3 44 6idiIng ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Found4on) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* _ ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster PLwnp Nbr. of Units ' Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. - Footings (deck) _ Final/No 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) Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total i I Installed - Siding and Windows LIMITED POWER OF ATTORNEY COUNTY OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: , THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sales located at 660 Mendelssohn, Avenue North, Golder. Talley, MN 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "Work"). The powers conveyed to the Agent by this Limited Power of Attorney are limited solely to the express powers delineated herein and apply solely to the Work. This Limited Power of Attorney shall expire and automatically be revoked on the 21st day of May, 2004, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WITNESS WHEREOF this Limited Power of Attorney is executed this 21st day of May, 2003 t{ e { r David . Katz SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, 2003. 1 l 1 Notary P is in for the State o Borgia My Commission Expires: January 21, 2006 396816.0 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road Egan MN 55122 3C"? . ~J--l `Telephone #651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date OL41 '30/13'-f Site Address t J.. 1 ~~1 6:., Uui# # Property Owner Telephone # ( (D'S I t Contractor y..~ _.\C.r►.. Street Address _2-\S4k--~ City 2- State` Zip. 56g -_0145 Telephone # {W5' I ) AZ.,Z-'B? Bond Expires: The Applicant is Owner Contractor Other a Add-on or alteration to existing dwelling unit $ 30.00 furnace Additional Replacement air exchanger air conditioner New XReplacement other .SQ State Surcharge $ U, zv $ `5 C Total MAY 1 7 2004 B I hereby apply for a Residential Mechanical Permit and acknowledge that Y on n3 coi~Yete" an acirurate; that the work will formance with the ordinances and codes of the City of Eagan an with Mechanical Codes; that X understand this is not a permit*v~l, ut only an apph an for a permit, and work is not to start wi t; that the will be in accordance with the apanin the c o or whic a e a review and approval f p A phcant's rioted game t' tture i 2004 COMMERCIAL MECHANIC PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Rand, Eagan N 55122 Te h e # 651-675.567 Please complete for: cotnmercial/industrial buildings inulti-family buildings when sMande are W required for each dwelling unit Date 1 / Site Street Address Unit # Tenant Name (if applicable) Preview Tenant Name Property Owner Telephone # ( } Contractor Street Addre _ a city ; State _ Telephone # ( ) , Bond Expires: The Applicant is Owner C r Other Work Type New Construes Underground Tank Install Remove "'see below Interior improvement Iestail Piping ,,Processed Gas Nature of Work: **When InstallingIrwhoving undergmund ink, Jbr hispeedw by Fbe asl and Plumbing Inspector Permlt Fees: $70M-Underground tank insWaVonfremovai $%.SO n-jeam (includes state Surcharge) or Contract Value $ x l% $ . Permit Fee • If RuMA fee is $1,000 or less, add $.50 $ State Surcharge if Rmj* fee is ever $1,000, add $.50 for every $1,000 RMu t fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge thtt the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand tl is not a permit, but only an application for a pmt, and work is not to start without a permit; that the work will be in accordano with the approved plan in the case of work which requim a review and approval of plans. } Applicant's Printed N Applit`s Signattuc Approved By: Inspector Date: PERMIT CITY OF EAGAN -c13 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 021303 (612) 681-4675 Date Issued: 07/06/93 SITE ADDRESS: 3617 BLUE JAY WAY LOT: 5 BLOCK: 3 LEXINGTON PL $0 P.I.N.: 10-45060-050-03 DESCRIPTION: Building Permit Type DECK Building Work Type NEW Building Length 18 Building Width 12 REMARKS: FEE SUMMARY Base Fee $25.00 COPY .50 Surcharge .50 Total Fee $26.00 Subtotal $25.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: OSTMAN BEN 14521576 0006147 BOWMAN THOMAS 1300 DUNBERRY LN 3617 BLUE JAY WAY EAGAN MN 55123 EAGAN MN (612) 452-1576 (612)452-5250 I 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 Mn. Statutes and City of Eagan Ordinances. t APPLICANT/PERMITEE SIGNATURE ISSU D B :SIGNATURE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 021303 Eagan, Minnesota 55123 Date Issued: 07/06/93 (612) 681-4675 SITE ADDRESS: LOT: 5 BLOCK: 3 APPLICANT: 3617 BLUE JAY WAY OSTMAN BEN LEXINGTON PL SO (612) 452-1576 PERMIT SUBTYPE: TYPE OF WORK: DECK NEW INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. FOOTING FINAL a- REACTIVATE, REC~1~NED CITY OF EAGAN PERMIT 1993 BUILDING PERMIT APPL CATION J I~ N 2 2 1993 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3-registered site surveys, l copy of energy calcs. COMMERCIAL 2 sets of 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. Date Valuation of work Zoo Site Address STREET SUITE ! Tenant Name: (commercial only) LOT 5 BLOCK SUED. P.I.D. 0 Description of work: The applicant is: ❑ Owner e contractor ❑ Other (Describe) Name 77D/ylPhone ~ 2 - ~ Property LAST FIRST Owner Address STREET STE 9 city State r Zip ,S`SIZ3 Company~r~ Phone Contractor Address .VDU G/.z✓, ~e~y ~ ~ License #1,00,00k/y7Exp. City State li fur Zip Z Company Phone Architect/ En&eer Name Registration Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved'. 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. lG Signature of Applicant t OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex [3 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi Misc. ❑ 17 Swim Pool 13 03 SF Addition ❑ 08 8-Flex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-P1ex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add11. ~1C15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst Fl. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required pp Zoning S q. Ft. total Booster Pum of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth 2 On-site sewage SAC Code APPROVALS Planning Building Assessments 0 Engineering Variance REQUIRED INSPECTIONS ❑ Site Footing ❑ Framing ❑ Insulation ❑ Wallboard Final ❑ Draintile ❑ Fireplace Permit Fee • V J vatuaticn: S Surcharge SU Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit. Park Ded. Trails Ded. Copies Other Total SAC % SAC Units -CLARK ar]INErRING COMPANY 9 2815 WAYZATA BOULEVARD • MINNEAPOLIS, MN 9 PHONE: 374-4740 CERTIFICATE OF SURVEY FOR: ORRIN THOMPSON HOMES A Division of U.S. Home Corporation Scale: 1" - 40' BENCHMARK: Top nut of hydrant at the northwest corner of Duckwood Drive i Iron monument found and Blue Jay Way. o Spike or wood stake set Elevation = 907.46 ft. (NGVD-1929) .900.0 Existing spot elevation, 900.0 Proposed spot elevation Drainage direction FRONT GARAGE SLAB: Elevation = 903.43 ft. 2~6 BZ ~ ' D C. 33 r, I}e ~ ~ ~ 35 o G 8!°..' o~ ~ 0 o M H ~ R O / o ~ \ 232.59 ~ r ~ ry+ o 5 e, VA d 17 e ~J Lot 5, Block 3.. LEXINGTON PLACE SOUTH Dakota County, Minnesota I hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. I further certify that this survey was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the state of Minnesota. ~A A- MN Reg. No. Date V 0 r Proposed House k- As-Built House Drawn by.KAF Project no. 6SIQ4 f V f-1 p * T }'1' YAYT1F:i>Ii' OF J y AT 11,11 OF I 1 V * APPLICATION DOES NOT CONSTITCTI'E APPROVAL OF PERMIT. APPLICATION FOR PERMIT II INSPECTION OF SEWER AND/OR WATER ~OPERMIT HAS BEEN SANER AND/OR WATER' CONNECTION APPROVED. * (please Print) 1) PROPERTY ADDRESS: 36, LEGAL DESCRIPTION: T °~Lr L~ -Sv Lot Block Subdivision or Tax Parcel ID ) IF EXISTING STRL'C'IVRE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: (Nbn Year ) PRESENT ZONING/PROPOSED USE: C] C0,%1'ERCIAL/V=AIL/OFFICE R-1 SINGLE FAMILY El INDUSTRIAL R-2 DUPLEX (Two Units) C~ INSTITUTIONAL/GOVERNME'NT R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2) NAME=~i~ 7'}`or~so•~ d m ~s ADDRESS :l7/~ 17~ 1 ~(i141 S ago's.~ nofw CITY, STATE, ZIP: ,IN)fj~ 1 PHONE: may- /'may'" 3) R~: a• NAME: ~ For City Use . . Plumbers License: ADDRESS: Active CITY, STATE, ZIP:e Expired _ ®5~.~ 4 dQ✓~'~~ it/ ~'y~~ g Not recorded PHONE: MASTER LICENSE# St Iniial 4) 0aa ® ia~• NAME: ADDRESS: CITY, STATE, ZIP: PHONE: CONNECTION TO CITY SEWER CONNECTION TO CITY WATER C~ OTHER 6)°,o i PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE - PLEASE MAIL APPROVED PERMIT TO 1, 2, 4, ABOVE (Circle one) .1=CSR CITY USE ONLY PERMIT # ISSUED t, Pd w/Bldg. Permit FEES: $ $ /G °S2' SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SURCHARGE) $ -3; S $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ o r $ WAC 7.- 1 a $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER i WATER TREATMENT PLANT SURCHARGE $ OTHER: 1, I V TOTAL RECEIPT- RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: y z f1 A 6' 1986 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN COMMERCIAL SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For: Valuation: Date: Site Address OFFICE USE ONLY Lot Block Erect Occupancy 5 ( Remodel Zoning ~ Parcel/Sub. Repair Type of Const Addition # of Stories Owner Move Length 27:? Demolish Depth Address Int.Impr. Sq Ft Install City/Zip Code Phone APPROVALS FEES Contractors Assessments Permit Water/Sewer Surcharge Ty'~~7 Address Police Plan Review Fire SAC G2~ City/Zip Coder~8 b a Engr Water Conn Planner Water Meter Phone Council Road Unit Bldg Off.. { Treatment P1 Arch./Engr. APC Parks Variance Copies Address TOTAL City/Zip Code Phone # I NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. d'oCLARK ENGINEERING COMPANY • 2815 WAYZATA BOULEVARD • MINNEAPOLIS, MN • PHONE: 374-4740 CERTIFICATE OF SURVEY FOR: ORRIN THOMPSON HOMES A Division of U.S. Home Corporation Scale: 1" = 40' BENCHMARK: Top nut of hydrant at the northwest corner of Duckwood Drive • Iron monument found and Blue Jay Way. a Spike or wood stake set Elevation = 907.46 ft. (NGVD-1929) X900.0 Existing spot elevation, oo.o Proposed spot elevation E Drainage direction FRONT GARAGE SLAB: Elevation = 903.43 ft. V0 E 206 q : ' rD N 8 Sol 2~I fib, 33 i~>e ~ - a c q.43s 24.60 r ~O ~ N • b 3 \ o s m 44 ~D t ~a' na~~ Lot 5, Block 3, LEXINGTON PLACE SOUTH Dakota County, Minnesota I hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. I further certify that this survey was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. NN Reg. No.1,5%e Date Proposed House.X_ As-Built House_ Drawn by_ AE- Project no. 851na RESIDENTIAL 7 SDL- BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 0 591 0_o 06 7-3 c~/ New Construction Requirements RemodellRwair Reaulremerts C~ / 0 2- 9 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2,copies of plan (20% maximum lot coverage allowed) . 1 set of Energy calculations for heated addition: 1,~D, f 0/0 3 2 copies of plan showing beam & window sites; poured found design, etc.) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations . Indicate if home served by septic system for additions S D • 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units)., D L O DATE 5' Zq^d Z. VALUATION SITE ADDRESS 340D BIr~V, c,(~I MULTI-FAMILY BLDG -Y AN TYPE OF WORK RVO-Pivlwu ul .iJ FIREPLACE(S) 0 Z,1 2 APPLICANT C= e-~oro,,~ ?Qr 4oylte Inns Ine- STREET ADDRESS X13 '4J L; 41e_ C C\. l CITY L II C~ STATE ZIP .1~ I 1 TELEPHONE # 651-7~. S•~1?d~ CELL PHONE # 6(2 4116 DZ.5' FAX # Lam- 2tos -9egQ PROPERTY OWNER TELEPHONE # COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES` 7670 CATEGORY 1 MINNESOTA RULES 7672 (4 submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted e Energy Envelope Calculations Submitted Plumbing Contractor:------------- Phone # Plumbing system includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: ' Phone # Mechanical system includes: Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone I hereby acknowledge that I have read this application, state that the inf 'on correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan I es. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received _ Not Required Updated 4/02 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex Q 20 Pool ❑ 30 AccessoryBldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Pibg,_Y or _ N ❑ 25 Miscellaneous 0 31 New ❑ 35 Int improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) O 45 Fire Repair ❑ ,33 Alteration O 37 Demolish {Bldg)* ❑ 43 Reroof 13 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. _ Footings (deck) Final/No 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) Insulation - - Retaining Wall Approved By Building Inspector - - - - - Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total -153 Za 2007 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date Site Street Address ~Ic W & Unit # -3 17 A tw- Property Owner_ 4t* i Vh i t,, ,tk h e-me, ~ Telephone # (6~1 } ~ 3 " ~(J l Contractor b5 _ Telephone # ( , Address 0 , City t I State. ,V, f. Zip ; The Applicant is: ` Owner & Occupant Licensed Plumbing Contractor Septic System New _ Refurbished Submit 2 sets of plans and MPC license includes County fee $ 100.00 Per as-built 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee a lies when extensive lumbin re airs are made to a buildin . z Alterations to existing dwelling $ 50.00 Add plumbing fixtures to main level lower level. This fee includes 4 t~ installation of a water softener and/or water heater at the same time. ff you are installing only a water softener and/or water heater, do not complete this section; move to the next section and place a checkmark next to the appliance(s) you are installing. T Septic System Abandonment r ^Water Turnaround (add $136.00 if a 518" meter is required) f Other: Water Softener Water Heater $ 15.00 new replacement Lawn Irrigation ~RPZ PVB new "repair -rebuild $ 30.00 rQ State Surcharge $ .50 I Total 1 f I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that 1 understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a {clan is required to be reviewed and approved. Applicant°s Printed Dame Applicant°s Signature Use BLUE or BLACK Ink For Office Use , I , I Permit#: City of EaEd I I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 I Date Received: I I Phone: (651) 675-5675 I Staff: Fax: (651) 675-5694 L _________________I 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: AU Site Address: dk4k- j Tenant: A' al / Suite RESIDENT/OWNER Name: j 10Z J Phone>&5^~ ' tP C1 3 "~Il~ Address / City / Zip '3lY (Z AA, CONTRACTOR Name A Y S tw dkb+ 13 - L'L-C License #:5-$9 3 Address: s City: aT Vl State: V Zip: C-S~3 ~ : Phone: qS )--L ` S Contact: E02 01-1 1 Email: J ®L-S&I § 9 TYPE OF WORK New _ Replace - Repair _ Rebuild _ Modify Space Work in O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main / Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ 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.gooherstateonecall.orci 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. x A0 UX K 0 LsOK x Ilenne, (Tlt~ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Air Test Gas Test Final PERMIT City of Eagan Permit Type: Building Permit Number: EA105849 Date Issued: 0810112012 itj of 0n Permit Category: ePermit R Site Address: 3617 Blue Jay Way Lot: 5 Block: 3 Addition: Lexington Place South PID: 10-45060-03-050 Use: Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Replace Description: Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: Kara Benson 9533 - 367th Street North Branch, MN 55056 651-674-1766 Fee Summary: BL - Base Fee $500 $40.00 0801.4085 Valuation: 500.00 Surcharge - Based on Valuation $500 $0.50 9001.2195 Total: $40.50 Contractor: - Applicant - Owner: Renewal Andersen Maximillia N Shemesh 1920 County Road C West 3617 Blue Jay Way Roseville MN 55113 Eagan MN 55123 (651) 264-4777 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA126324 Date Issued:08/21/2014 Permit Category:ePermit Site Address: 3617 Blue Jay Way Lot:5 Block: 3 Addition: Lexington Place South PID:10-45060-03-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Tony Boerner 2090 County Road 42 W Burnsville, MN 55337 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 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 - Maximillia N Shemesh 3617 Blue Jay Way Eagan MN 55123 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA130847 Date Issued:05/18/2015 Permit Category:ePermit Site Address: 3617 Blue Jay Way Lot:5 Block: 3 Addition: Lexington Place South PID:10-45060-03-050 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Tashi Topgyal 3617 Blue Jay Way Eagan MN 55123 Hearth and Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 638-3309 Applicant/Permitee: Signature Issued By: Signature '' ,�..,,�'�Is� s��tt'��l�� 1 �cr '' � � �(r� ' � I��iT�t��:, �c�� j �� l � � ��.�� •�� ' � '/' '- �-�7 1 ' ��` ! P'�rr�it F�: L,� � „_, 38��1�'�tat�akt Raa�ct � # �� at�15�� '�� L�t�� : �"�`-�� # � �� _.. 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'��Per��&�tr��r�e;; � Tre�t�iietaf I��#: C�� ' ?AT�L �a��. �'�.AFcK It+��R�t�G �M�?A�iY • 283,� WA'Y�A�A BCXJLEYARi} �' �!I[9t�TEAPC)LTSr t� � �C�3�: 37!�-�f7�{1 � . - ..��i��n� � sc��t �. ��,17 ��c� �� (��.f I ��J�� FiR�N THQ�I�"�tJN H�N�E� l A i3iv��ion af t1,�. .Hcra� Corpora�icrn ' � ��i �� ,��y� �ENC�3M�4E�: nu� cf h arrt a� thh+e no�t�hw�st �rner of Due�r++dood Drive � ��cn mc�nu�nt f+oun� and H1ue �ay War�. SPilce`or �i s� �et Elev'a�ion = �'}'�.46 ft. (NG�U-1�329) � .�o.r� ' Existing spot �ei��ra��,�t, Prn'� sP�t �l��v�t��+n FRt�'!' GAF�14G� S�,AB. �--r- Drai.nag� d�,�e��ir�n Elevat.ion = 9C13.� ft. � s—' „ ��S� *� ,� �' � �!' S�3�.�� ' � '.• -�. �,:�.�.- � �"*'; , �.. , J� $, .. t� �s v� �.... .35'- #� � '�'f�'�i� '�`� � � � � ��,+� , , � �,c+ ,� � � rr, ,�� i � 11' a— `� '� � �� .•� "° � � �� ' f` � : '" e' �. � �G � �4, r � za�° �.�,',, � � � < �.', x„ � � ^� i' S ��. �, �' � � � I �} ♦ . ��. �r � A� 4 � ♦S . �� , I +CS . �1 � � � �'�!� � ��,'#:'�'i ,� }� �� k..• '��., ��' �{� ��, .� �� - � .�-- �. � ,�� -�,�� ,� � �� . �a �o�nt�� Mir�n�a s hereby certity �ts�t ��i� i� a tcu+�.�r►d c+�rr�t r�pZ��sentatic� of � survey of r.�e b�oun�3ariea t�f tha ��nd above+describazc� bnd �+� the i��►t�on ot a�l.bisiltli�. 3f �y, tt��e+eon, and ai,i viaibia er�c�cachmersts. it asry� fran or ov�, sa3tl lar►c�. 2 iu�rther carti�'y i.hat this aucvay vaa prepared by �pe s►t �r �ay dic�ct'supervia3an �a�1 that I am a du3y,tteqiatrred �nd �rvey,�r euu9er the:�awat .��: �he ��ate of !ltnneaoea, ' �' =t'�fi Atg, No.�'��L� i�'°L�e �.� ��(�i l. F�t�posed Hat�s��d.,. As-Hiiilt �ous�_,.:,,. D��s�n �E.. Pr� �t no. .�#J.tt! �, �- : . , .......�,�_.. ,,,�_ � City of Eaaaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use � / 2( Permit #: 13 O1 (A Permit Fee: I (, 1p Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 10/17/16 Site Address: 3617 Blue Jay Way 3Ji)1?t'?illi Unit #: J Name: Tashi B Topgyal Address / City / Zip: 3617 Blue Jay Way Phone: 612-636-5292 Applicant is: Owner X . Contractor Description of work: Re- Roof, Re - side Construction Cost: 20,000 Multi -Family Building: (Yes / No X Company: To Serve Contracting LLC Contact: Dustin Antoine Address: 5407 Boone Ave NCity: New Hope State: MN Zip: 55428 Phone: 763-425-7663 Email: dustinantoine@toservecontracting.com License #: BC664939 Lead certificate: NAT -F154643-1 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: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Fire Suppression Contractor: Phone: •:a'j, v CALL BEFORE YOU DIG. Call Gopher state One Cali 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.aooherstateonecall pro I hereby acknowledge that thls information Is complete and accurate; that the work will be In Conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a 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 B Iding Co,e c mpleted within 180 days of permit issuance. 4:42; I . r5 JI ,Dustin Antoine Applicant's. Printed Name x App (cant's Signature Page 1 of 3 For Office Use /1 o � � �� Permit# kt7 : ', �, Permit Fee: I 4/7. RECIEVED Date Received: /-/e/ 3830 PILOT KNOB ROAD(EAGAN,MN 55122-1810 (651)675-5675(TOD:(651)454-85351 FAX:(651)675-5694 Staff: buildinginspections(a?,cityofeagan.cam ,JUL 3 1 7018 -• 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: 5// / /3 yA-1— Phone:rot ($/,, 2 9 2- Resident/ Owner Address l City 7 Zip: 3(v/ 7 !c ,�=..j rP'y L, >/I`y Applicant is: Owner A Contractor Al Type of Work Description of work: 'i r44,7 Construction Cost: /. fJG?l✓ Multi-Family Building:(Yes !No ) Company. Jf7 Gc%,,L:rS ' LLl' Contact: 7rij /4-7-77-741 (_)Say Contractor Address: %3lie( city: l)`�— State:)2ldL,Zip: 5.7S--,/jib Phone/,/2-e4S. ?.7Email: t3 J/C4 ._c rt4rt.rts�rr st Lam' License#: ( ..j/ CC /u5 Lead Certificate#: AAT" -2-/IJ 7/3--o 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: Mechanical Contractor. Phone: Sewer&Water Contractor Phone: Fire Suppression 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.comisubscribe. Exterior wok authorized by a building permit issued in accordance with the Minnesota State[Mang Code must be completed within 180 days of permit issuance. 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. wwv gapherstatci nccaei.urg I hereby acknowledge that this information is complete and accurate;that the work will be in conformance ', the ordinances and codes of the City of Eagan;that I understand this is nota permit,but only an application fora permit,and work is • o s i • , a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approv= r •r% r x 1r7�7 � x t Applicant's rinted Name Ap, cant's Signature • DO NOT WRITE BELOW THIS LINE -Gj i 7 a& 3g-90A-(-1 / 6//D- 0 SUB TYPES Foundation — Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) — Exterior Alteration(Multi) Multi ` Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building — WORK TYPES _ New — Interior Improvement _ Siding , Demolish Building' Addition _ Move Building _ Reroof _ Demolish Interior Alteration — Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—ghre PCA handout to applicant DESCRIPTION Valuation 4s____ 0 Occupancy FAL. , MCES System Plan Review Code Edition j, , ;, (51 SAC Units (25°_ 100% 7\) Zoning i City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required — Footings(Addition) Final/No C.O.Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath Stone Lath Brick_EFIS XInsulation K Windows Sheathing Retaining Wall:_Footings_Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In Final Braced Walls Erosion Control Shower Pan Other. Reviewed By: /cir ,Building Inspector RESIDENTIAL FEES Base Fee irj Surcharge 14711114 Plan Review 06 .L' MCES ytr;iir ✓ City SAC Utility Connection Charge / / V y 1 A S&W Permit$Surcharge / I �l fes. o (11 i 2 i (� Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA151076 Date Issued:08/07/2018 Permit Category:ePermit Site Address: 3617 Blue Jay Way Lot:5 Block: 3 Addition: Lexington Place South PID:10-45060-03-050 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Tashi Topgyal 3617 Blue Jay Way Eagan MN 55123 Bruce Nelson Plumbing & Heating 1272 South Pointe Douglas Rd St Paul MN 55119 (651) 738-9354 Applicant/Permitee: Signature Issued By: Signature