3650 Blue Jay Wayi INSPECTION RECORD
CITY OF AGAN PERMIT TYPE: Bti r t I Nii
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued: Now
(612) 681-4675
SITE ADDRESS: APPLICANT:
cyi?tpi tt 01 JA'Y WAY rt i..tttd i FN
tE 1Nt,IflN t't (,t soUtlt (r,12) 414-V)614
PERMIT SUBTYPE: TYPE OF WORK:
('t;1pitON fwni'i.$i)
F RAM tNi, #?it4)t;e4.4 1 N t't N6a
001161-1 IN 1110
t t N 4l.
L
S
Lt,
This request void
18 months from j
C 81;x; ?r.
7l G S ?/
Rea ire o. 1 -in Inspection
red?
V
QReady Now win Notify Insp
[or When R
d
es ?NO
1 ea
y
icensed Electrical Contractor I hereby request inspection of above
Q Owner electrical work installed at:
MINNESOTA STATE BOARD OF ELECTRI T
Griggs-Midway Bldg. - Room N.191
1821 University Ave.. St. Paul. MN 5&104
Phone (612) 642-0800
Stree
t
Address. Box or Route N Cit
/
_
?t P 0 - r?
ection N. Township Na06 or o. Range No. ounty
Occupant (PRINT) Phone No.
Power Supplier ddress
EI trical Contractor (Company Jame) Contractor's License No.
Mailing Addy s (C.ontrac r or Owner Making Installation)
Autho ized Signa re (C ntractor/0ner Maki g Installation) Phone Number
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
This request void
18 - ((n_ ? - { I1 Xf7,? (/ S
1months ths from 1-0 3 3
Request Date Fire No. Rough-in Inspection
Required?
Ready Now Will Notify. Inspec-
OYes ?No for When Ready
I.Licensed Electrical Contractor 1 hereby request inspection of above
0 Owner electrical work installed at:
Street Address, Box or Route°lIo. City
Section No.
Town hip Name o No.
Range No.
Conn y.,
Occupant (PRINT),' Phone No.
lip,
Power Supplier Address
E1,ictrical Contractor (Company Name) Contractor's License Jo.
z?
G d 730 -I
?f
L
!/
Mailing Adress (ContiactororOwner Ma ing Installation)
l
Authorized Signature (Contractor/Owner Making Installation Pho e((Nymber
THIS INSPECTION REQUEST WILL NOT
NNESOTA STATE BOARD OF E RICITY
Griggs-Midway Bldg. -Room 1 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
1821 University Ave., St. Paul„ MN 55104
Phone (612) 297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ES-00001-05
See instructions for completing this form on back of yellow copy.
-7,1 5?1
"X" Be/ow Work Covered by This Request
New Add ep. Type of Building 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 (Specify) their (Si) :ify)
Other (Specify) - Other Other
Cmmnute lnsnectlnn tea Helnw
# Fee Service Entrance Size # Fee feeders/Subfeeders # Fee Circuits
0 to 200 Amps j+--d 0 to 30 Ams 0to30An: s
Above 200 Amps , O 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100- Amps Above 100_Amps
Transformers Irrigation Booms Partial•"Other Fee
Signs Special Inspection 9 ?
TOTAL
Remarks - lL1
Rough-in P9. If -D F Date I, the Electrical
]..??
' Inspector, hereby
F - - i certif
that the above
Final Oat }
;F y
spectionhas been
s made.
This request void 18 months from
REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
See instructions for completing this form on back of yellow copy.
C 1.0 3 35 =X" Below Work Covered by This Request Q L
Add Rep. . Type of Building 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 peci yi Other (Suor, fy)
t er Specify Other Other
# Fee Service Entrance Size ft Fee Feeders /S ubfeeders # Fee Circuits
OD 0 to 200 Amps W.co 0 to 30 Amps 00 0 to 30 Amps
Above 200 Amps v?O,o 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100,Amps Above 100__Am.s
Transformers Irrigation BOOmS Partial, Other Fee
Signs Special Inspection
Remarks f
/ G . , .. ?- 1 k, . TOTAL F .
L.; ? ? .
Rough-in Date
1
, the Elec here
Inspector, hereby
Final
D certify that the above
?s / nspection has been
,
-
(J•
s/? 24'
mad
ade.
iIlls tequest vow 10 muntns front
BUILDING PERMIT
To be used for SF DWG/GAR Est. Value $ 57 , 00 0 Date JANUARY 14 t 9 8 7
Site Address 3650 BLUE JAY WAY Erect I Occupancy R3
LEXINGTON PL
Lot 24 Block ° Sec/Sub SORemodel ? Zoning R1
Parcel No . Repair ? Type of Const. V
. Addition ? No. Stories
°C ORRIN THOMPSON HOMES Move 11 Length 40
z Name 1712 HOPKINS CROSSROAD Demolish 13 Depth --
Address Int. lmpr. ? Sq. Ft.
0 City MTKA Phone 544-7333 Install ?
o 0 Name SAME Approvals Fees
s Address
~ City
CITY OF EAGAN
360 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2- 13096
PHONE: 454-8100
Phone
Q
F w Name
Z5 Address
z
a w City Phone
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 Cit of Eagan Or inances.
Signature of Permittee,?
A Building Permit is issued to: ORRIN THOMPSON HOMES
all work shall be done in accordance with all applicable State
Receipt # ?
Assessment.
Water & Sew
Police
Fire
Eng.
Planner
Council
Bldg. Off. 1/14/87
APC
Var. Date
innesota Statutes
Permit $ 353.00
Surcharge 28.50
Plan Review 176.50
SAC 625.00
Water Conn. 525.00
Water Meter 67.00
Road Unit 305.00
Tr. PI. 180.00
Parks
Copies
Total $2,260.00
on the express condition that
City-of gaganjOrdinances.
Building Official
CITY OF EAGAN
3810 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 NO 13096
PHONE: 454-8100
BUILDING PERIWIt Receipt # `- •?-?
To be used for SF DWG/GAR Est Value $57,000 Date JANUARY 14 19 87
Site Address 3 6 5 0 BLUE JAY WAY Erect IN Occupancy R3
LEXINGTON PL S(emodel ? Zoning R1
Loth Block 2Sec/Sub
.
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
ORRIN THOMPSON HOMES Move ? Length 40
Name
W 1712 ) OP INS CROSSROAD Demolish El Depth '°
z
Address
F
? S
Int. Impr.
q.
t.
City MTV Phone 544-7333 Install ?
x S Approvals Fees
0 Name
a Address Assessment Permit $ 353 • 00
City Phone Water & Sew. Surcharge 28.50
Police Plan Review 176.50
F W Name Fire SAC 625.04
Address
Eng. Water Conn. 525.06
W City Phone Planner Water Meter 67.00
Council Road Unit 305.00
I hereby acknowledgethat l have read this application and state that the Bldg. Off. 1/14/87 Tr. PI. 180.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and C1 f Eagan Or inances. APC Parks
Var. Date Copies
Signature of Permittee Total $2,260.00
ORRIN THOMPSON HOMES
A Building Permit is issued to.
on the express condition that
all work shall be done in accordance with all applicable Stateg Minnesota Statutes and City of Eagan Ordinances.
Building Official
Permit No. Permit Holder Date Telephone #
PIuMbing t ? ?c -s ti
41-
5
H.V.A.rZ.
Electric P 0.7i a4 . Cf/Y 1? ? Co ?9 O7
Softener
inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing 87 ?O
Rooting
ough Plbg. -c OV
Rough Htg. S g 7
D
z'7
Insul. D
Fireplace
Final Htg. I.?
Final Pibg.
Bldg. Final
Carl.Occ. /sue P?
Deck Fig.
Deck Frmg.
Well
Pr. Disp.
4 a PERMIT #; :
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN February 2 - 1987
3830 PILOT KNOB RO AD, EAGAN, MN 55121 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address 3650 Blue Jay Way BLDG. TYPE WORK DESCRIPTION
Lot 24 Block 2 Sec/Sub
Lexington Place South Res. XXX'2:XX New XXXXx
Name Genz-R an P&H Mult Add-on
Address14745 South Robert Trail Comm Repair
c City Rosemount, MN Phone 423-1144 Other
Name U S Homes - Thompson Division FIXTURES
N
Water Closet - $3.00 TOTAL
' c''
C Addressl?12 Hopkins Crossroad Bath Tubs -,$3.00 %.
p City Minnetonka. M Phone 544-7333 Lavatory - 400
ct3
Shower - $3.00
/_ Kitchen Sink - $3.00 r' -
FEES
COMM/IND FEE - 1% OF CONTRACT FEE -Urinal/Bidet $3.00
/-Faundry Tray - $3.00
op
-
MINIMUM - RESIDENTIAL FEE _$10.00 Floor Drains - $1.50 /- ue
MINIMUM - COMM/IND FEE - 20.00 '
-Water Heater
$1.50 %..y
STATE SURCHARGE PER PERMIT - .50 .
Whirlpool - $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
Rough Openings - $1.50
SIGNATU E OF PERMI EE FEE: Ci
STATES/C: 5a
FOR: CITY OF EAGAN GRAND TOTAL: a=
• PERMIT # s? 9 8 --
MECHANICAL PERMIT RECEIPT # ry /?C/ 7
CITY OF EAGAN 23
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: February 1987
CONTRACT PRICE PHONE: 454-8100
Site Address 3650 Blue ay Way
Lot 24 Block 2 Sec/Sub
Name Gen -R}
w Address 14745 South Robert Trmil
City Rosemount, M Phone 423-1144
Name U SHHomes - Thor son Division
c Address 1712 Holokns-Cr , " oad
c City Minneton -MN Phone -544-7333
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent.
Gas Piping Outlets #
Other
75 M BTU $ 24.00
M BTU $
MBTU
M BTU $
CFM $
1 $ 1.50
FEE: 25.50
.50
S/C:
26.00
TOTAL
BLDG. TYPE WORK DESCRIPTION
Res. XX> XX!s New X) XXXXX
Mult. Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100`,41-BTU -$24.00
ADDITIONA BTU
0 -- 6.00
ADD-ON AIR CO
. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/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)
SIGNATURE OF PERMITTEE
JI
FOR: CITY OF EAGAN
Orrtifirati of C®rruvaurg
Qitp of (Eagan
rpttr<tmprct of ntlhing ?iwpl'rtinn
This Certificate issued pursuant to the requirements of Section 306 of IkeIJniform Building
Code certifying that at the rime of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
Use Classification SI Bldg. Permit No. 1 U
Occupancy Type R3 Zoning District RI Type Coast v
Owner of Building 'S Address 1712 I rA?cnMs KM&
Building Address 3650 R M W&Y Locality L.2.4 s B2, L I It1 PL 90
Data: ., 15• 1987
Building Official
POST IN A CONSPICUOUS PLACE
- ?:. ,. ,T ,:,,.; ,. __...-n.; .' .d.. ,?:,. ,:F:n w?T ;.r.:... ?,: ?..Y, „?.. y. .. .. ,•.y ?r-vi:?r. .. ?_. r•:? t , ?F`•?L' i?rrn.,
PERMIT #
PLUMBING PERMIT
RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100 / I - 2S -7
Site Address ' r ' , : I BLDG. TYPE WORK DESCRIPTION
Lot Block ___ Sec/Sub Res. New ,_-
M ult. Add-on
Name Comm. Repair
Address Other
C City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00
Name Bath Tubs - $3.00
3 Address
---`+-? ( + 1-
7
-
Lavatory - $3.00
p City Phone __
42L )1?
:A Shower - $3.00
Kitchen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains - $1.50
TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - $1.50
MINIMUM - RESIDENTIAL FEE - $12. 00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE - $20. 00 Gas Piping Outlets - $1.50
STATE SURCHARGE PER PERMIT - . 50 (MINIMUM-1 PER PERMIT) o
(ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5.00
BEYOND $1,000.00) Well - $10.00
Private Disp. -$10.00
Rough Openings - $1.50
JK rya UREOF PERMITTEE FEE:
STATE S/C: 'so
- 5
FOR: CITY OF EAGAN GRAND TOTAL:
7
..-r'we"iSSia%7
r*a>:'g?r.!p4?+?*RR'.
PERMIT #CC
PLUMBING PERMIT RECEIPT #
dy,
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address
Lot Blo
k S
/
6b
c
ec
A
Name f I E WATER CONDITIONING
Address 102 €xselsio
A
r
vc.
City i5342 "Iffne
Name 1 ).
3 Address ,t l C.f
p City 6 Phone d ( 1
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGA T E N' OF PE MITTEE
v
BLDG. TYPE WORK DESCRIPTION
Res. New X
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
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
(MINIMUM - 1 PER PERMIT) ,
Softener - $5.00
Well-$10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
vL'
STATE SIC:
FOR: CITY OF EAGAN GRAND TOTAL: -
CITY OF EAGAN Remarks
Addition Lexington Place South Lot 24 BIk 2
Owner Street 3650 Jay Way
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
?G 4sk?'L
SAN SEW TRUNK 1985 247.64 16.51 .
SEWER LATERAL 10•-1 198 1631.0( 3 2 6 . 0' 5
Services 1OI 1986 729.39 145.87 5 i
WATERMAIN 1985 65.81 11,16 5
WATER LATERAL 101 1986 873.43 174.6,8 5
WATER AREA 101' 198 243.73 48 '74 5
WAT LAT BEN 1% 1986 111,98 22.j 5
STORMSEWTRK 101'l 1986 426.54 85.30 5
STORMSEWLAT 101 1986 803.34 160.6 i 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITYOF EAGAN Permit No: S487 Date: 2"°226-87
3830 Pilot Knob Road Meter No: Size:
P.O. Box 21199 Reader No: Date:
Eagan, MN 55121
Thompson Homes
Owner.
Site Address- an Jay Way Lexi ngton o
Plumber. _.. 9
Conn. Chg: 525.00pcd Zoning: P1
Acct. Dep: 15.OOpd No. of Units: 1
Permit Fee: 1 0.OOpd
Surcharge: . 50,pd I agree to comply with the City of Eagan
Tr. Plant 180.OOpd Ordinances.
Meter. 67 3Opd
Misc.: By
WATER SERVICE PERMIT
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road 7638,
-
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121
DATE: 2
26--87
Zoning: F-1 No. of Units: Z
Owner: Thompson Homes
Address:
Site Address: €` ? e Jay Way L24 P2 Lexington PI So
Plumber: Cenz-Ryan P & H
1-14-87 69925 LOO.OOp:!
I agree to comply with the City of Eagan Connection Charge: 525.00T3a
Ordinances. Account Deposit: Is. nila
Permit Fee: 1 U +1`lpot
Surcharge:
By Charges:
Misc
.
Date of Insp.: Total:
Insp
: Date Paid:
.
CITY OI . EAGAN
6PTL T KNOB ROAD !?AGAN,-M NESO 4 55#
<1 17
PAT 19
RECEFVEb
FROM
AMOUNT
& DOLLARS
+.._....--"" 00
L CASH D CHECK
frifR
r ei
FUND CODE AMOUNT
Thank Y
White-Payers COPY
Yellow-Posting Copy
Pink-File Copy
BLDG. PERMIT N0,
01-3210 Bldg. Permit
01-3.422 • -VI jn, Ch ?ck
01-3445 Surch./Adj..
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road-Unit
20-2275 SAC ,
20-3865 Water Conn.
20-3868 Water Trmt.L
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park bed.
TOTAL c.
CITY4GF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
3650 BLUE JAY WAY
LOT: 24 BLOCK: 2
LEXINGTON PLACE SOUTH
P.I.N.: 10-45060-240-02
DESCRIPTION:
(ROOFING)
Building Permit Type SF (MISC.)
Building Work Type REPAIR
REMARKS:
BUILD W
024265
08/01/94
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
CONTRACTOR:
SASS CONST INC
180 GEORGE ST
EXCELSIOR MN
(612) 474-4568
VALUATION
$35.00
.75
$35.75
PERMIT TYPE:
Permit Number:
Date Issued:
$1,500
- Applicant - ST. LIC. OWNER:
14744568 0003505 OTTER CHARLES
3650 BLUE JAY WAY
55331 EAGAN MN
(612)456-9711
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.
L
A PLICANT/PERMITEE SIGNATURE ISSUED (: SI NATUR
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
3656 BLUE
LEXINGTON PLACE
PERMIT SUBTYPE:
SF (MISC.)
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
LOT:
JAY WAY
SOUTH
24 BLOCK: 2 APPLICANT:
SASS CONST INC
(612) 474-4568
TYPE OF WORK:
DESCRIPTION
BUILDING
024265
08/01/94
REPAIR
(ROOFING)
INSPECTION TYPE .DATE INSPTR INSPECTION TYPE DATE INSPTR.
FRAMING . ROUGH IN PLBG
ROUGH IN HTG FINAL
141V CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
I 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 l S--c
Site Address: 3 ?l -y c?c y
STREET SUITE #
Tenant Name: (commercial only)
LOT BLOCK 2 _ SUBD.,
ri U.1 P.I.D. #
Description of work:
The applicant is: ? Owner Contractor ? Other (Describe)
Name b 1-le/1, / T,/r?r^r` e C,?CZr/ S Phone S?7/f
Property LAST FIRST
Owner Address 3i-S-0
STREET STE #
City State Z i p
Company S f { S S C , C Phone 1/ 7,v- ,S-6k
Contractor Address License # `3 Sze Exp. 3 '57-
City Xct'_/rState Zip Ss,3i
CompanyPhone
Architect/
Engineer 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 ith all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) 1st Fl. sq. ft. City Water
UBC Occupancy 2nd Fl. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
Census Bldg
APPROVALS Census Unit
Planning Building
Engineering Variance
REQUIRED INSPECTIONS
? ,Site ? Footing O Framing
? Wallboard ? Final ? Draintile
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
valuation: $
Assessments
SAC %
SAC Units
CITY
F EAGAN
APPLICATION FOR PERMIT -
SEWER AND/OR WATER CONNECTION
NOTE: PAYMENT OF FF.E AT TIME OF
APPLICATION DOES NOT CONSTITUTE
APPROVAL OF PERMIT.
INSPECTION OF SEWER AND/CR WATER r LA IONS WILL NOT BE SCHED-
ULED UNTIL PERMIT HAS BEEN
APPROVED.
?t
**********************************
?? trle?ase Print)
1) PROPERTY ADDRESS: 45`
LEGAL DESCRIPTION:-
,/- ?-Oc
/?tJ? ,s1 / ,SoUTfI
Lot Block..Subdivision or Tax Parcel ID #)
IF EXISTING STRL'CZL'RE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
PRESENT ZONING/PROPOSED USE: (Nbn )Cear
Q CO €RCIAL/RETAIL/OFFICE R-1 SINGLE FAMILY
a INDUSTRIAL C R-2 DUPLEX (Two Units)
0 INSTITUTIONAL/GOV '2 M R-3 TOWNHOUSE (Three + Units) C. Units)
R-4 APARTNNT/CONDOMINIUM Units)
2) « ?• d _1
NAME: QR R//V
ADDRESS:/7/a //OP?Ci? S C?iPoss,,?o.?v
CITY, STATE, ZIP:
PHONE: 7,.?3 3
3)
u ?• NAME:_'-!r-/) 2- 2Y4i) P? y
ADDRESS:
CITY, STATE, ZIP:
PHONE: _tfa23?//99' MASTER LICENSE# _/ j?!!!2/x
Plumbers License:
Active
Expired
Not recorded
4) •aa ?..i ???
NAME:
ADDRESS: .
CITY, STATE, ZIP:
PHONE:
Staff Initial
•5) :? «• a: • a?• : a • a• • ??
CONNECTION TO CITY SEWER CONNECTION TO CITY WATER Q OTHER
6) i• 0 PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE - -
PLEASE MAIL APPROVED PERMIT 70 1, 2,0 4, ABOVE
.FOR CITY USE ONLY
PERMIT # ISSUED
}
Pd w/Bldg. Permit FEES:
$ SEWER PERMIT (INCLUDE SURCHARGE)
$ WATER PERMIT (INCLUDE SURCHARGE)
$ $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ i L> ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIT - WATER
$ WAC
$ 7 r `' $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$_ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
?.
1 7
$ =
TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVA TION IN PUBLIC RIGHT OF WAY?
U YES -IF YES, THEN A "PE RMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE I SSUED BY THE ENGINEERING
E NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : j?1 L<
FF' (3O9
1987 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,` !1 ZO
$2,000 LANDSCAPE BOND ll
To Be Used For: '311_0_ __ Valuation: s l 000 Date: ? -` 1 Z- SCa
Site Address 3(.5O 3L - J fry L.Ok/
Lot 7-1 Block Z
Parcel/Sub LL`f IwGiiM PL, ZE -o?
Owner
Address
City/Zip Code
Phone
On Site Sewage Occupancy
MWCC System ' Zoning
On Site Well Type of Const
City Water v (Actual)
(Allowable) 7
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Contractor 4ZQ t+4 -01i+ Ps" N7Mc-'S
Address r7 !? ICt+1S
55 34
City/Zip Code
Phone 5"q-1- ?333
Arch./Engr.
Address
City/Zip Code
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Permit S -c 10
Surcharge -&a-. 6V
Plan Review / . Sv
SAC, City 00
SAC, MWCC
Water Conn 2 S, oQ
Water Meter ( 7 1 Q
Road Unit 3o3,w
Treatment P1 J.J
Parks
Copies
TOTAL 2-2(,0.00 Phone #
'RTaPW FTV_TNcPPTW: rY 1:)hMV 9A1 r. WINV7a'Pa wvlrtevaan a MTMMFIlmr.TC. MM . r)RrWF- Z7d_A7dn
CERTIFICATE OF SURVEY FOR:
ORRIN THOMPSON HOMES
A Division of U.S. Home Corporation
•
a
x900.0
oo.
E
PROPOSED E ION
FRONT GE SL B:
El. = 97.25 f .
N 88° 22 45" E
0
Scale: 1" = 30'
Iron monument found
Spike or wood stake set
Existing spot elevation,
Proposed spot elevation
Drainage direction
5
7T
LOT 24 (P
Z N ?
0
34
.
_ s
"OUSF, # 3650 .
W
N 6.0
%o.2
10.1
'
6.33
41
u
74
5 0 ??
.
II
(? - 22.17 ---- H
O 905.6
903.74 .
•
?{ ?o 44.0 •
- S SZ°134-W .4Z - _. L: 33
p° 16' 34" R= 3389.12
Q_
GU A6 Qo4.?B
903.x'
AY WAY -------4.
- ---------- -
Lot 24, Block 2,
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.
LL"k-0 k7l MN Reg. No. /?ZZ Date
Proposed House- As-Built House- Drawn by Project no..
RESIDENTIAL
?? BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Requirements Remodel!Rsaair Requirements
• 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 additions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks
• 1 set of Energy Calculations • Indicate if home served by septic system for adds
• 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 5 'Ca' y?f VALUATION o
SITE ADDRESS W MULTI-FAMILY BLDG _ Y N
TYPE OF WO FIREPLACE(S) 0 1 2
1-_U U
APPLICANT edar Vail TExier ors Inc.
STREET ADDRESS '#$20 Zilia 3trset CITY STATE ZIP
Coon Rapids, MN 55483
TELEPHONE # CELL PHONE # FAX #
PROPERTY OWNEW & _( b TELEPHONE # _45('-9 _l
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
('I submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• 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 D O M
Sewer/Water Contractor: Phon
I hereby acknowledge that I have read this application, state tha a informati corr ct and agree t comply
with all applicable State of Minnesota Statutes and City of Eaga rdinances f, 2
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 0 20 Pool ? 30 Accessory Bldg
? 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 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex 0 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement 0 38 Demolish (Interior) ? 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 *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
Citi of Eaall1
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
Tenant:
RECEIVED
JAN 142016
RECEIVED
JAN 142016
Use BLUE or BLACK Ink
For Office Use
Permit #: 1 3L_ -1(../
Permit Fee:
(P0 • OC)
Date Received:1- I ci-- 1 (fi
Staff3
L
2016 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Site Address: 365-0 &I T /tt y 111/41Ay
/'311vk /41de,
Suite #:
Address / City / Zip:
Name: 417/)EaS0.0 14 -1 -rt __LnG License #:
Address: 300 L/4) l e �/ /1iiii / LG City: -'✓.3d g/ le
State: fWA) Zip: 55313 7 Phone: ! - 997 - 7/ 3 9
Contact D/"1 00158') Email: * A,. !i t qO 0C-OgviCitS4- . n e) -
New X Replacement
Additional Alteration Demolition
€hunted
ictal Inspect
RESIDENTIAL FEES
RESIDENTIAL
kFurnace
S( Air Conditioner
Air Exchanger
Heat Pump
Other
n an j
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under/Above ground Tank ( Install / Remove)
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge
COMMERCIAL FEES
$60.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
0r 0 V TOTAL FEE
Contract Value $ x .01
_$
=$
=$
Permit Fee
Surcharge
TOTAL FEE
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.
Ap cant's Signature
x ] ori 4- 4, p36in
Applicant's Printed Name
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143381
Date Issued:06/14/2017
Permit Category:ePermit
Site Address: 3650 Blue Jay Way
Lot:24 Block: 2 Addition: Lexington Place South
PID:10-45060-02-240
Use:
Description:
Sub Type:Reroof & Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 12,000.00
Fee Summary:BL - Base Fee $12K $221.25 0801.4085
Surcharge - Based on Valuation $12K $6.00 9001.2195
$227.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Eric J Adams
3650 Blue Jay Way
Eagan MN 55123
(763) 268-9227
To Serve Contracting Llc
5407 Boone Ave N
Brooklyn Park MN 55428
(763) 425-7663
Applicant/Permitee: Signature Issued By: Signature