3645 Blue Jay Way
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This request void
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Re,Uuqgt Dace
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Required? ' r. ???d? Now.-• ?1f hf?t' R?e,
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icensed Electtical Contractor I hereby ieqaest ins?section ot abovs
? Qwner electrical work installed at:
Street Address, 8ox9 or Route City
ection o. ownship Na e or o. Ratlge o. Cou` t
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Aufhorized Signature (Contractor Owner Making InstakfaYion) J Fhone Number
M IVESOTA STATE BOAftD OF RICtTY ?HIS INSPECTIiON REQUEST1AtILL N87
Gr'rggs-Midway Btdg.'- Room - 91 BE ACCEPTED BY THE STATE BOARLI
UNLESS PROPER'1NSPECT,lOW ]FEf 1S
?Q1 University Ave:, &t. Paul, MN 55104
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°"Phone 0121297-2111
arv o? EAGaN WATER SEWCE PERAIIT
3830 PiKnob Rodd
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,
, MN 55121 6-11?86
DATE
Zoning: RI No. of Units: Z
Owner: 2hompson . ;3omes
Addr*as:
5? Addrow. 3645 Blue Ja Wa i,17 Leain taa Pl So
Plumber: Geuz-R an
Meeer No: , : 4
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i CITY QF EAC,AAI Irwat $,R
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PERMiT Nd
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ryt-t: 55121 DATE:
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CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21 199, Eagan, MN 55121 11980
BtJM71NQ PERMIT PHONE• 454-8400
R .
tf
eceipt #
To be used tor SF ' D?`a/fCsAR Est
Value $68?000 Date MAY I-9
.
Site Address 3645 BL[3E JAY WAY Erect [Z Occupancy R3
`Lot12 Block 4 Sec/Sub. L??INGT?N Pxa ?()emodel 1:1 Zoning
Parcel No Repair ? 7ype of Const.? Y•N
. Adtlition ? No: Stories
¢ G1Ri3IN `1'H01+IPSC}tl HC3NES Move ?
Name length 42
; ?
Address 2712 HOPKINS CROSSROAD Demolish ?
tnt. Impr. ? Depth ..??
Sq. Ft.
o CitY MTKA Phone 544M'7333 install ? At
ae
o
Name SAME Approvals Fees
`
? Q Address Assessment Permit ? 337.00
1- City Phone
? W `Name
,0 Address
a W City Phone
I herebyacknpwiedge that I have read this application and state that the
information is correct and ag7'? e to comply with all applicable State of
Mirmesota Statutes and Ci Ejgacti.s?rdinances,
Signature of Permittee ? - I ?--
.
Water & Sew Surcharge 3? ¢
Police
Fire
Eng.
Planner
Council
BIdg.Off. 5/f?.9/8?
APC
Var. Date
'? •?
Plan Review 168 w50
SAC 575.00
Water Conn. 500. IJ'i3 `
Water Meter 63 • 50
Road Unit 290 * 00 4
Tr. PL , 3.'?J 6»00
Parks
Copies
Total $2 r l24.pQ
A Building Permit is issued ta ???? ??OMPSQ? ?OMES on the express condition that
ail work shall be done in accordance with ail applicatlte State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
-, Permit Mo. Pemd# Holder Date Telaphone #
PknMgft ?
(o
H.V.A.G,;
Elsctr,c Lv
softelm
Inspectbn Date Insp. Comments
Footings 1
Footings il
Foundafion
Framing 7, ? Qf
Roofing
Rough Plbg.
Rough Htq. ?d
InsuL
Firoplace .??.
'Final Hlg.
Finai Plbg. ,
IBidg. Finaai Z?,p o
Cert.Occ.
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
` .r
?
CONTRACT PRICE:
Site Address ?
Lot - 17 Block
' PERMIT #
PLUMBING PERMIT ` REGEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
? OGb_ - PHANE! 454.8100
Sec/
Name
?s Address /C/.7r S S? .?'vL
c City Phone l
Name
3 Address
p City Phone
BLDG. TYPE WORK DESCRIPTION
> Res. ?_. New ?
Mult. Add-on
Comm. f Repair
' Other
FEES
° COMM/IND FEE - 1% OF CONTRACT FEE
P MINIMUM - RESIDENTIAL FEE - $10.00
! rMINIMWM - COMM/IND FEE - 20.00
;STATE SWRCHARGE PER PERMIT - .50
(ADD $.5Q S/C IF PERMIT PRICE GOES
BEYONDI$1,000.00)
? t
?
l,
SIGNATURE F P RMITTEE
;
` FOR: CITY OF EAGAN
NO FIXTURES
f Water Closet - $3.00
?Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
itchen Sink - $3.00
' al/Bidet - $3.00
Laun?Tray - $3.00
?Floor Dra- $1.50
_?_Water Heat4?,$1.50 VVhirlpool - $3.06. :' -
_?Gas Piping Outle??•$1.50 ?
Softener - $5.00
Well - $10.00
Private Dis . - $10.00
?Rough O enings - $1.50 FEE:
STATE S/C:
' ' GRAND TOTAL• r ? ?
f
PERMIr # CITY:OF EAGAN FEE
MECHANICAL PERMIT
RECEIPT # 454-8100 S/C
MINiMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL
DATE MINIMUM COMMERCIAL FEE - $20.00 + $.50
i
1. Bidg. Type: Res _,,zComm Inst 2. New ? Add ' Alter Repair
3. Total Bid Price 4. Job Address ? ?? "`?'?' •?-'?+ ?'
,...-
Lot Block ` SP?? 5. Owner ?2
,
'? -t'..'".?k .?• ?t,:_ ?? . ?;, ..ar? ?sz? ?1'
6. Contractor
(Name) (Stree? (City) (Zip)7. Contractor Phone # `?`"?
RESIDENTIAL HEATiNG - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or#raction -$6.00
RESIDENTIAL COOLING -' 01-24,000 BTU's -$12.00: Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
HEATING VENTILATING HOT WATER STEAM AIR COND.
oIR PIPING , PROCESSED PIPING AfR HAND. EQUIR RtFRIG.
__,.C`FiES. GAS PIPING OUTIETS -$1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./IN -? F T 1D PRICE PLUS $.50 STATESURCHGE FOR EAC ,000 OF FEE.
,
? ?
Signed: for
,,, ?. ..
C'Approved Inspections: Date Rough lnsp. Date ?Final lnsp.
57M ?`?•+?? PERMIT# ",7II 'J-?
' - MECHANICAL PERMIT RECEtPT # ^-
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address u Q a '' a BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/
^ w ?
R
? N
- Name t,"' `
` e
es.
Mult Add-on
?o Address ft d?L fi1 v¢• ?
?,
Comm. Repair
c
- City ?A I $ Phone 3 '??'"` ? ? 3 ? Other
5403
Name hompson Homes FEES
?
c Address? 2 H.opkin
_ C ross RdSe RES. HVAC 0-100 M BTU - $24.00
p a 3
City KTk Phone 544- 7333 ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK GAS OUTLETS - 1.50 EA.
Forced Air M BTU 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
. (ADD $.50 S/CJF PERMIT PRICE GOES
Vent CFM .
BEYOND $1,000.00)
Gas Piping Ouflets # $
otr,er 1 n s#, Panae 10 Q0
i FEE: '
? 50 SIGNATURE OF PERMITTEE
' S/CC'
10,501 1
TOTAL:
FOR; GITY OF EAGAN
?? ^sr? --[ ,??.? 'Y`yx?.wk',? y?-"'?`'3?'? fa'*'?°#' ;:?+*''°""°aaF?,?.;;'{?,?-i?"?g?+?'.?,?;s3r,•?°?'?a??., ?o • ?rc?i?xij?{?1
P /
PERMIT # /[ '1
?
P4UMBING PERMIT RECEIPT # ?2? CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ?
CONTRACT PRICE 0C PHONE: 454-8100
Site Addr s
Lot Block - 0-"
- e
ub
? Name
a?
Address,-340'?Z
I t`
co
? City ?igone 6 33 - G o rP?
Name ?- `? " .>• ,? ?,.,? •.,;?.,-.?
Address?J?
3
0 City Phon
I (
FEES
' GOMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
; MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
, ?, ? ?i...... ....?.._._-.
81GNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. , New
Mult. Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50 '
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50 ?
/ Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C: - S?
GRAND TOTAL•
,. . . _. . i . -- . . __. . .._...?,?.
?_ , ?. ? -?--•?,.__.-?..?.,- .„,- ?. _ ?-- ?, a„?
' CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 11 J80
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est. Value $ 6 8,0 0 0 Date MAY 19 19 86
8ite Address 3645 BLUE JAY WAY Erect ? Occupancy R3
L'ot ' 17 Block 4 Sec/Sub. LEXINGTON PL S(Diemodel ? Zoning Rl
Parcel No. Repair ? Type of Const. Vij.
Addition ? No. Stories
W Name ORRIN THOMPSON HOMES Move ? Length 49
Z 1712 HOPKINS CROSSROAD Demolish ? Depth q,g
o Address Int. Impr. ? Sq. Ft
city MTKA pnone 544-7333 Instau ?
°C SAME Approvals Fees
, o Name
0 Q Address
~ City Phone
? W Name
? ? Address
a W City Phone
I hereby acknowledgethat I have read this application and statethatthe
information is correct and a ee to comply with all applicable State of
= Minnesota Statutes and Ci f E dinance .
; Signature of Permittee ? ? ?/'? ? ?
A Buildin Pem rit is issue d t- ORRIN THOMPSON HOMES
g o.
ali work shall be done in accordance with all
Building Official
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. off. 5/19/86
APC
Var. Date
Permit $ 337.00
Surcharge 34.00
Plan Review 168.50
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290 . 00
Tr. PI. 156.00
Parks
Copies
T..?..I ?'?00
1
on the express condition that
and City of.Eagan Ordinances.
'EQUES?T FOR ELECTRICAL INSPECTlON E?s-UUVu1 _?,q i
See in tructio+ss for compYetrn9 this foiart on back of yetTow copy.
n i JoW _ ' rk- Coioered,4y Fltit.Req,ues:ts
iiome Range 'Femporary Service ?
" OLiplex Water He.ater tightin,y Fixtures 3
Apt. Building Dryer Eleetric'Meatin ?
Commercial Bldg. Furnace Silo Unloader, ,
Industrial Bldg. Air Conditioner Bulk Mslk Ta y
Farm tner peci;sy
? Tiner
t er Sueci,fy Otfie
r Other
mmDtite lnsoection Fmn Relnw
Jf Fee ' ServiceEntranceSize `tf Fes Feeders IS ubfeeders # , Fee Circults ?
U to 200 pmPs 0 to 30 qm s 0 to 30 Am s`
Above 200Tqmps 31 to 100Amps 31 to_}00 Am s
? Swinuning oQl,
T'ransTOfrners Abpv .,10 s
irr+g?"tbn 13barns ; Above 100 +nps ,
'Partial-'?CTxher Fee
Rema rks S, gns 5pecial Inspection
TOT
?
floeph-in Date 1, the Electueal '
Inspector, herabv: ?,
csr .a{hat Yhe abt;vg
Pinal ein tias,been
' ,
??r - T{ft,rg4+?st vo?d! ?$ montt+s fcom
:
CITY OF EAGAN 'Remarks
Addition Lexington Place 5auth Loc 17 eik 4 Parcel
Owner Street 3645 Blue Jay Way State Eagan
Improvement Date Amount Annuai Years Payment c41ptt
STREET SURF.
STREET RESTOR.
GRADING
.
saNSewrRUNK 1985 247.64 16.51 15 .
, " ` ;
-
sewER LarERaL 101 19 8 6 16 31 . 0 0 326. 2 5: .
ervices 1016 1986 729.39 - 1,?+5.87 5
WATERMAIN
?.9 SS
bS .$l --
13.15
S
I WATER LATERAL 1012, 1 98
6
873.43
?174. 6 8
5
WATER AREA 6 243.73 :
48,74 ;
W 1 1986 111.98 _.
•:
2
?3g
2 5 `
' sroRnnsEwTRK 10111 19$6 426.54 ,
.
?
.83.30 S
sroR nn sEw LaT 101 1986 803.34 ? 160. 6 6 5
CURB & GUTTER : .
, SIDEWALK
STREET LIGHT
?
WATER CONN.
BUIIDiNG PER. „ A
SAC
` PARK ?
? :
/?2 RESIDENTIAL BUILDING
? ) ?PJ3 Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
co
New Construcfion Repuirements Remodei/Repair Reauirements Office Use Ortlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan CeR of Survey Recd _ Y_ N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions TreePres Plan Recd _ Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Reqd _ Y_ N
1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _ Y_ N
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 f Z
Site Address 36, 415 156 oL c,)P?-A ll.? ? \ 4 Unit/Ste #
C40 1J
Description of Work b'-),57AL?_, 64rJ
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 11_ 2
Property Owner "JL)V Telephone #(6j/) laO/ '4X?Vtf
Contractor c,
Address 3) s-D LJ I/i,t,)`''l 13 City
State Zip ?3?3 7 Telephone #(CI>Z) Ly 5`J -0'7 V
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category 0 Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(?1 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a buifding in Eagan with a similar plan? - Y N If so, 25% plan review
fee applies. --°? °• ?'; -;;?
Licensed Plumber Telephone # ( ) ' DEC 1 0 2003 ''? !
Mechanical Contractor ? ?1 ? ` Telephone # (
Sewer/Water Contractor L? _----- = -' 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 plari in the cas• work which requires a review and
approval of plaqs.
e
?,?1 ? ` i?J -
Applicant's Printed Name Applic nt's Signature?--=
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
_ FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests ` Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex ? 20 Pool
? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to applicant
Building Inspector
s- ?`C? 7 RESIDEWTIAL
BUILDINC PERMIT APPLICATION
CITY OF EACAN
3830 PII.OT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauirements RemodeURmirReauiremoft ? `
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and ?II roofed areas • 2 copies of plan
(20% maximum lot coverage aliowed) • 9 sei of Energy Calculatim for heated additians
• 2 copies of plan showing beam & window sizes; pouretl found design, etc:) • 1 site survey for exterior additions & decks
• 1 set of Energy Calculations . Indicate if home served by septic systen for ac#ditlons
• 3 copies of Tree Preservation Plan if lot piatted after 711/93
. Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE /0 - 2? - a Z VALUATIC?N w (o? to4
SITEADC iULT1-FAMILYBLDG - Y X N
i'YPE Of FlREPlACE(S) _ 0_, '! .._ 2
APPLICANT ? ?4v
STREET ADDRESS _ qq,
LT?'J?.c?c?tn: dN2, S? CItY?_.-?._STATE?{,,,ZFP
TELEPHONE # 12-331-12--3- CELL PHONE # FAX #
PROPERTYOWNER r v'ti C'4 TELEPHONE`# G??,yt -GO.ffi
COMPLETE F4R "NEW" RESIDENTIAL BUILDtNGS 4NLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residentiaf Ventilation Category 1 Worksheet Submitted • New Energy Code Warksheet Su6mitted
• Energy Envelope Caiculations Submitted
Plumbing Contractor: --N-?,-----Y-?------?_-----?--^_ Phone #
--------------- -
Plumbing system includes: Water Softener ? Lawn Sprinkler Fee: $90,00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: r(q,
Mechanical system includes: ? Air Conditioning p _?r?'? :$74.00
Heat Recovery System OCT 2 4 2002
Sewer/Water Contractor: cne-#
I hereby acknowledge that 1 have read this application, state that the inf4rmation is correct, and agree to compty
with all applicable State of Minnesota Statutes and City of Eagan Or ' nces.
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received Tree Preservation Plan Received Not Required
- - ? updated 4102
C)FFICE USE ONLY
? 01 Foundation ? 07 05-piex ? 13 16-plex ? 20 Pooi ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ' ? 21 Porch (3-sea.) ? 31 Ext. AIt - Mufti
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 ' Ext. Alt - SF
0 04 02-plex ? 10 08-plex ? 18 beCk 0 23 Porch '(screened) ? 36 Muiti
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Misceilaneous
0 31 New ? 35 Int impravement ? 38 Qemotish (Interior) ? 44 Siding
? 32 Addition 0 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish(Bldg)* ? 43 Reroof 0 46 WindowslDoors
? 34 Replacement *DemoNtion (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 Sprir?k4ered
TYpe of Const Width
I REQUtRED INSPECTIONS
_ Footings (newbldg) FinaUC.O.
_ Footings (deck)
- FinaUNo C.O.
Footings (addition) Plumbing
Foundation
- HVAC
Drain Tile Other
Roof Ice & Water
- ` Final , Pool Ftgs Air/Gas Tests Finail
Framing Siding Stucco Stone
Fireplace _ R.I. Air Test Final Windows (new/replacement)
Insulation _ Retaining Wall
----------------------------------
----
-
-
-
- Approved By
--- ; Buiiding Inspector
---------
----
-
-
Base Fee - -----
-
- ----------------------------- ---------------------------------------------- ---
-
--
`Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Sureharge
Treatment Plant
PlumbingPermif '
Mechanical Permit
License Search
Copies
Other
Total
RESIDENTIAL
BUlI.QINC PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNQB RD, EAGAN MN 55122
651-681-4675
New Gone2ruction Reauirements RemodalfReoair Reauirenwts
• 3 registered sife surveys showirig sq. ft. of loi, sq, ft. of house; and a(I roofed areas • 3 copies af plan
(20% maximum lot coverage aliowed) • 1 set of Energy Caiculatim for heated addiUons
• 2 copiss of pian showirig beam & window sizes; Poured found design, etc.) .` tsite survey for exterior additions & decks '
. 1 set of Energy Calculations . indicate if hom served by sepdc system for addWons
• 3 copies of Tree Preservation Pian if lot platted after 7!1193
• Rim Joist Detad Options setec6on shest (bldgs with 3 orless units)
DATE In - 8-? Z VALUATIQPI 4I3/sOp
SITE ADDRESS MtltTi-FAMftY BtDG ._ YXN
TYPE OF WORI FIREPLAGE(S) .,_ fl^ 1_ 2
APPLICANT
STREET ADDRESS ?q5- Irj?ti+ ClTY /i STATE?ZIP sS_'-1,,q
TELEPHONE #(dZ",_f3I')SY_-5L CELL PH4NE #612'I&.y-63 2-3 FAX #
??0 VI.-
PROPERTYOWNER ??k, YGh i 5Gh TEtEPNONE# 657 -681 =gC1gb
COMPLETE FflR "NEW" RESIDENTIAL BUILDtNGS QNf.Y
Energy Code Category MTNNESOT:1 RL`LF.S 7670 CATEGOR`t' I • 7472
(J submissiort type) • Residential Ventiia6on Category 1 Worksheet Submitted ?y ? heet Submitted
• Energy Envetope CaJcuiadons Subm+tted D?OC? ? ? ???2
Piumbing Canhactor: Phone
----
Plumt?ing system includes: ? ?Vater S4ftener .,?. I.awn Spri --- ee: $?,00
$aths
Water Heater ? N0. of R.I.
No. oF Baths
Mechanical Contrcctor: Phc+ne #
Vlcctiaiiral systcm inctucles: Air Conditioning Fec: S70.0{}
Hcat Recovcry Systcni
Sewer/Water Contractor. Phane #
I hereby acknowledge that 1 have read this applica#ion, state that the information is correct, and agree to comply
with alf applicable Sfiate oP M+nnesota Statutes and City o# Eagan 05jpances.
.•-?
Signature of Appllcant
QFFICE USE ONLY
Certificates of Survey Received _ Tree Preserva#ion Plan Received Not Required _
Updated 4l02
oFFIcE usE oNLY
0 01 Foundation O 07 05-plex C! 13 16-piex 0 20 Pooi ' 0 30 Accessory 8kfg
? 02 SF Dweiling C] 08 06-plex O 16 Fir+eplatte ? 24 Porch (3-sea.) 0' 31 Ext. Att - Multi
O 03 01 of _ plex ? 09 07-plex 0 17 Garage Q 22 Porch/,Addn. (4-sea.) E3 33 Ead. Alt -;SF
0 04 02-plex ? 10 08-piex 0 18 Dedc CI 23 Porch (screened) O 36 (VNtlti
? 05 03-plex ? 11 10.ptex Cl 18 Lawer levei 0 24 Storm Damage
O 06 04-plex D 12 12-piex PItg._?Y or _ N O 25 Miscellaneous
? 31 New C3 35 int lmpravemen# ? 38 Demolish (Interior) ? 44 ' Siding
? 32 Addttion 0 38 Wiove 81dg. d 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration D 37 Demolish (61dg)' 0 43 Recoof Cl 46 Windows/Daors `
? 34 Replacement *Domoiition (€ntire Bidg oniy) - Cive PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Storiss Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
RECtU1RED iNSRECTI4NS
Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNa C.O.
Footings (addirion) ? Plwmbing
Foundarion I3VAC
Drain Tile Other
Roof Ice & Water _ Final Pool Ftgs _ Air/Gas Tests Final
_ Framing? Siding Stucco Stone
_ Fireplace _ R.I. Air fiest Final T Windows (newlreplacement)
_ Insulation Retaining WaII
Approved By , Buading Inspeetor
Base Fee
Surcharge
Plan Review
MCiES SAC
City SAC
Water Suppiy & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanicai Permit
License Search
Copies
Other
Totat _
. ?` -
?? I O 6 2000 BUlLDING PERMlT APPLtCAT10H ` tRESIQENTIAL!
1 C„Y o??GAN
3830 PILOT KNOB RD - 55122
?
?N
651-881-4875 CA?lo ? f
?
-71b hb ahsWe
C . . . f ?s ? ? .. . . . 0 ....
? 3 re"red sNo wnroys showinqsq. tL ot lotr `^7• 11. Vt1 wJYiv .. &' 7'U
?d ? roofed oreas (20X mcpdmum lot ccve? db?rec? ' i se# of eneW odk.ulaMons for heated adc?tio?
> 2 acples of Pla?s cshow beam dr window $lrsa; pcwred (nd. dssiqn; etc.) i aift wrvey for exoAor addHiona d? decka,U
? 1 sat of anerqy Calculatlons
? 3 cop(ea of tree presorvallor? plan N lot plaited ater 711 /93
s o2/ /--1000 '?/ 3 od, ao
DATE: C4NSTRUCTIQN COST: - --,
DESCRIPTIONOFWQRK; 3 se?soh ,por?? ? .DeG?`
STREET ADDRESS: ,3 6'?S
?
IOT: BLOCIG ? SUBD./P.LD. #. G-2 ' ?
Nome. Ln r s 4-h cJ os??? ?tOtle #:
PROPERTY ? ??
OWNER
Sheafi Address: 3 C? StGft6: ?;
. Compony: Phone #:
(areo code) CONTRACTOR
Sheet Address: Ucense # ' Facp;
City Stofe• 7ip:
ARCHITECT/
ENGINEER Compony: Ncme:
' Telephone #: ( )
Sheet Address: Regisfrotion #:
Clty State: Zip:
Sewerlwater licensed plumber fif instailirm seweriwaterk Pfione #: (, i
1 hereby acknowledge thot I have read this appNcation, state fhat 1he Womnatkan ccureat, cnd a9ree ia cornpiY wilhh cp applcable StctE
of Minnesata Statutes and Cin+ of Eaqan OrdMances.
I Signaiute of Appiicanh ?
OFFIGE USE ONLY MkY 2 6
Certificates of Survey Received Yes No
Tree Preservation Pian Received Yes No Not Required
. . . . . . . . .. . . . . . . .. ?+ . .-,
OFFICE USE ONLY -
,
BUILDING PERAIIIT SUBTYPES
? 01 Foundation ? 07 05-plex O 13 16-plex ?"
.e?' 21
Porch (3-sea.)
? 31 Ext. Alt - Multi
? 02 SF Dweiling ? 08 06-plex 0 17 Garage 13 22 PorchlAddn, (4-sea.) O 33 Ext. Alt - SF
plex ? 09
0 03 01 of 07-plex C! 18 Deck D 23 Porch (screened) 0 36 Mutd
_
? 04 02-plex ? 10 08-piex 0 19 Lower Levei O 24 Storm Damage
O 05 03-plex ? 11 10-piex Pwg Y or _ N ? 25 Miscefianeous
? 06 04-plex O 12 12-plex ? 20 Pool 0 30 Aacessory B1d9•
WORK TYPE
I '3? 31 New O 36 Move Bidg. ? 43 Reroof
? 32 Additian ? 37 Demolish (Bidg)* 0 44 Sidirg
0 33 Alteration 0 38 Demotish (Irrterior) ? 45 Fire Repair
? 34 Repair 0 42 Demalish (Foun+dstioti) O 46 WindowslDtaorS
* Give PCA handout to applicant far demolitaon permit
GENERAL INFORMATION
SAC Code D? # of Stories ?sq. ft.
; No. of Units U Length t? s#. ft.
' No. of Buildings t Width OL Footprint sq. ft.
Const. (Actuai) Basement sq. ft. ? Census Code H3?
(Ailowable) Main level sq. ft. ? MCiES System
UBC Occupancy sq. ft, City Water ,?.
Zoning sq. ft. ? Booster Purnp
PRV
Fire Sprinkiered
MISCELL.ANEOUS INSPECTIONS
.
Stucco/5tone
? .
APPROVALS
Planning Building Engineering
Variance
Permit Fee Valuation: ' $ 4
Surcharge
Plan Review
?'
License 1 H ' ? 6 4r 7 .2- 0
n K O
MCiES SAC
Oo
?'
City SAC ,Z
Water Conn.
Water Meter
Acxt. Deposit
S/W Permit
SfW Surcharge
Treatment PL
Park Ded.
Traiis Ded.
Other
Copies ! 10 0
TotaL•
SAC Units
% SAC
' * •dNGINEERING COMpANy , 9A1 S wnv72imn nnrtr rvnon _ MrXn.,L,r.,.,r T?
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,c?RTIFICATE OF SURVEY FOR:
ORRIN THOMPSON HOMES
A Division of U.S. Home Corporation
BENCHMARK: Top nut of hydrant northeast
corner Lot 16, Block 4, Lexington Place
South
Elevation = 905.46 ft. (NGVD-1929)
6L U E
-1 a xv w ruvivc.. 3 /4-4 /4U
Scale: 1" = 30'
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x 900. D
900. 0
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JAY W/
Iron monument found
Spike or wood stake set
Existing spot elevation,
Proposed spot elevation
Drainage direction
?Y
PROPOSED ELEVATION: . •49 c°Rg
FRONT GARAGE SLAB:
el. = 904.33 ft. I ?
N 87° 07' 316"f 62.96
90? 0
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Lot 17, Block 4,
LEXINGTON PLACE SOUTH
Dakota County, Minnesota
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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 buildin9s, if any,
[hereon, and all visible encroachments, if any, from or on said land. I further
certify that this survey vas prepared by me or under my direct supervision and that I
am a duly Registered Land Surveyoc under the laWS of the State of Minnesota.
f ? '' ?' 1• ' IM1 R29 . NO. y 7.Ti Da t e
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1986 BIIILDING PERMIT APPLICaTION - C?TY OF EAGAN
ANOTE: ALL.L CONTRACTORS MIIST BE LZCENSED WITH THE CIT7C OF EAGAN
SINGLE FAMILY DWELLZNGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIOtVS
MIILTIPLE DWELLINGS - RFSIDENTI9L RENTAL UDiITS FOR SALE IINITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRYEY - CHECK 'rIITH BLDG. DEPT.,
i SLT OF ENERGY CALCULATIONS
COM4iERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRU.CTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used ror: Valuation: 4---0,x0Date:
_ -----•
Site Address c
Lot 12 Bloek
Parcel/Sub
Owner
Addrsss
City/Zip Code
Erect Occupancy ?
Remodel Zoning ?
?
Repair Type of Const
Addition # of Stories
Move Length ?
? Demolish Depth
Int.Impr. Sq Ft
Install
Phone
Contractor
Address
City/Zip Code I`5?53
Phone J;H ' ? 5S-:3>
Aren./Engr. _
Address
City/Zip Code
Phone #
APPROVALS FEES
Assessments Permit lCJo
Wa'ter/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter 3.
Council
Bldg Off„}7 Road Unit G r Go
Treatment P1
APC Parks
Variance Copies
TOTAL
JaD
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,JpTE: ADDRESSES FOR CORNER LOTS - CGNTRACTOR/HOMEONNER MIIST DESIGNATEWHICH ADDRESS
iS DESIRED. NO CHANGr^S WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSIIED.
?
tLWK yENGINEERING COMPANY . 2815 WAYZATA BOULEVARD • MItJNEAPOLIS, MN • PHONE: 374-474n
CCRTIFICATE OF SURVEY FOR:
ORRIN THOMPSON HOMES
A Division of U.S. Home Corporation Scale: 1" = 30'
BENCHMARK: Top nut of hydrant northeast 0 Iron monument found
corner Lot 16, Block 4, Lexington Place o
South spike or wood stake set
Elevation = 905.46 ft. (NGVD-1929) xgoo.o Existing spot elevation,
900.o Proposed spot elevation
E Drainage direction
6L U E JAY WAY
PROPOSED ELEVATION:
FRONT GARAGE SLAB:
el. = 904.33 ft.
_.---------------- •Lgoi.49
I ?
N 87° 62.9(
9o/.c2' Q
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Lot 17, Block 4,
LEXINGTON PLACE SOUTH
Dakota County, Minnesota
LOT )-7
yo2,19
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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 Nas prepared by me or under my direct supervision and that I
am a duly Registered Land Surveyor under the laus of the StaCe of Minnesota.
ro MiV Reg . No. 7,? Date ?<? '.._??
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Nouse# 3(.45
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Proposed HouseA-- As-Built HOllS2- nrawn hv KAE Prn-iae-t nn_ _&5:I04
NAME:_0t?f?1? ?1'? o?'1J?''S4•J }? m ES
ADDxESS :17/? r??Pr'{'/?V S C?iP4,S5 x?1?,+??
CITY, STATE, ZIP:??l?f??,?
_ PxoNE:?°'??'?'"
1) PROPERTY ADDRESS: ?
LEGAI, DESCRIPTION: 46
J _L? 71: 57
IF EXISTING STftCCIL'RE, DATE OF ORIGINAL BLILDING PERMIT IS5L'ANCE: '. '
(Nbn )(ear T :
PRESENT ZONING/PROPOSID L'SE; COi•iKERC7AL/RF,'TAIL/OFFICE ? R-1 SINGLE FAMILY
Fl IN7(.'STRIAL ? R-2 DLPLEX (Two tJnits)
n INSTITL'TIONAL/GOVIIZIqMENT ? R-3 TOWNHOL?SE (Three + Units) ( Lfiits)
? R-4 APAR7Iv=/CONU0MIIVIUM ( Uni ts )
2) «•
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Cl>iYY OF LAGAi'i
APPLICA°f`ION FC:?? PERhUT
SEWER ANDI61w? V?`ATLH CONNEC;1`ION
NAME :
ADDRESS:
?*****#**##?#****Xx*k-k??*?***#*##*??{'
?*iC71'E: PA`i?uiEW Om ?T:E AT MSE O^
*
? APPY,ICATZON DOES NC7I' CONSTIUM ?
,*f AP'PR0VAL OF PERffT. *
? INiPr7C.'1`ION OF SF.?M ANID/OR KWE2 ?
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* IISS'7'11LL11TIONS WILL N'JT BE SCHID- *
? i= UNTIL PIIZMiT IiAS BFEN *
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*************?**********************
ease Print)
tLOt/Block/SUbdivision or *Tax Parce
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CZTY, STATE, ZIP:
PHONE:y MASTg2 LICEIVSE#
For Clty Use
Plumbers L.icenses
Ar-tive
Expired
Not recorded
Staff Initial
6) ? ' • ? ?' ? ,+= (? PLEA.SE HOLD APPROVID PEf2MIT F'OR PICK-UP BY OIQE OF ABOVE
PLF.,A.SE MAIL APPRCJVED PERMIT TO 1, 2, (D 4, pB}VE? .
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F . C1TY US Q L.Y
PERMIT # -ISSUED
6.
Pd w/Bldg. Permit
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$
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$
$
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S ?.J•S'?? <?
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$
$
$
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FEES:
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SEWER PERMIT (INCLUDE?SURCHARGE)
WATER PERMIT (I-IVCT;L*DE sLRCHARGE)
.
WATER METER/COPPERHORN/OL'TSIDE READER
$ WATER TAP (INCLL'DE CORPORATION STOP) _
$ SEWER TAP
?
$ /•?j r'Z' ACCOLNT DEPOSIT -- SEWER
ACCOLNT DEPOSIT - WATER '
$ WAC $ SAC
$ TRLNK WATER ASSESSMZNT
$ - TRL'NK SEWER ASSESSMENT
. b
$ LATERAL BENEFIT/TRL'NK,SZlWER $ - -- F,ATERAL BENEFIT/TRt;'tNK• tRATER
S
$
WATER TREATMENT PLANT SiJRCHARGE
OTHER•
$ TOTAL
l°?b •
RECEIPT - RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC .RIGHT:OF WAY?
? ...
"P.LBLIC
YES IF YES, THEN A"PERMIT FOR WORK jV3THIN:
ROADWAY" MUST'BE ISSCiED BY THE 9NGINEERING
? NO DIVISION. LIST AS A CONDITION.
SL'BJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE: ' .
DATE :
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APPLICATION FQR PE?MLT SEWER 'ADID/OR WATER CONIION -?`
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� For Office Use
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C�� O� n� �� j Permit#: I
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�•s: ' ., i Permit Fee: �
3830 Pilot Knob Road �
Eagan MN 55122 e��,� �� � � �����, � Oate Received: �
Phone: (651)675-5675 I �
Fax: (651)675-5694 I Staff: I
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2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �-�-�5 Site Address: 3�0�15 t`J�� 5��( �`-��`'�1 Unit#:
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� '�� ; Name:5U2 � O��n,n�c. �,t�O�,c1�Sc�� Phone: losl-(��S\-UC�S'�C ?
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� Residentl '
Owner � address�c�ty�z�p: 3�k S 'b�U.e �_v.�c._� �..c�c�c� c'c�c� SS\d�_ �
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f � � Contractor �
x � Applicant�s Owner x
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` ' Description of work: e,u:����a c�y.nq� �, �,�c�o. :
Type of Work � � .
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� Construction Cost: Lh�� Multi Family Buiiding (Yes /No�( ) s
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r Company:�A,.tc�,q�� '�c�c"�eRv�S Contact:���"� c'c�c��1SUC1 ;
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Contractor = Address:��,1 �,,�c��� uue S City: �
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; State:�CL Zip:ss�tao Phone:`1So�-�51-11o1?�mail:
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! License#:Q[�(os(�L� Lead Certificate#: ���""�-'a,a,���5-c�, '
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If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) '
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; COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING �
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� 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:
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� Licensed Plumber: Phone: �
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< Mechanical Contractor: Phone: �
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; Sewer&Water Contractor: Phone: ;
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NOTE:Plans and supporting documents that you submit arevconsidered to be public informaiion. Portions of `
the informatron may be classified as non-public if you provide speci�c reasons that would permit the City to �
conclude that they are trade secrets. `
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.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 wlth the Minnesota State Building ode m st be completed within 180
days of permit issuance. ,
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Applicant's Printed Name Applica S' ture
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159451
Date Issued:12/18/2019
Permit Category:ePermit
Site Address: 3645 Blue Jay Way
Lot:17 Block: 4 Addition: Lexington Place South
PID:10-45060-04-170
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Joseph Yanisch
3645 Blue Jay Way
Eagan MN 55123
(651) 681-0088
Homeworks Services Co Dba Homeworks Plumbing Htg
1230 Eagan Industrial Rd, Suite 117
Eagan MN 55121
(612) 400-9020
Applicant/Permitee: Signature Issued By: Signature