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3653 Blue Jay WaytT' °O EA(;AN WATER SERVICE PERMIT 3830 Pilot Knob Road 6225 21601 P. P.O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: 5 - 2 9 - ° 5 Zones: . 1 No, of Units. 1 Owner: CS Homes Address: S i t e Addre: 3 6 5 _ [ 1 av -WaY L15 134 r ' r 'hct l??rF? Plumber: " : 3 4/ cl ,I Meter No n bnt Charge. 5 ( `Qd . 00 Reader No.: 19 , r? 9 4 to comply wkb the City of Eaggw Swdtorge: 13 2 50 . 'Mi : d SIC . )Misc. C horges: ;0 d m t Total: . By Dare Paid Date of Insp.: "' Insp.: WATER SERVICE PRAW 3830 Pilot Knob Road P. 0.8+ he 21199 PERMIT NO.: Eagan, MN 56121 DATE: 5 - 2 - 8 5 Zoning: RI No. of Units: 1 Owner: VS 140-me Addrem Site Address 3153 Blue Iay Way 1,15 S4 Lexingro *1 Pi. Plumber: Thompson Numbing Meter No.: Connection Charge. 500 _ Q 0 pd Size: Account Deposit: Z 5 • C3 0 Reader No.: Permit Fee: 10 • C) 9 0- I again is amply with the City of Eagan Surcharge: .50 Misc. Charges: 1 0f)pd C. Total: 93.60pd Mete By Date Paid: Dote of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE Pte" 3830 Pilot Knob Road P. O. & ex 21199 PERMIT NO.: 7 4 14 Eagan, MN 55121 DATE: 5-29-8-5 Zoning: R1 No. of Units: 1 a Owner: US Homes Address: Site Address: 3653 _Bl ue Jam Way L15 B4 Lexingatnglf? Plumber Thompson Plumbing 5.29-85 52140 :4. tt03 0 1 0 Cfty of Eayow Connection Charge: 4200d.. OrdiesweilM Account Deposit 15 • Q Pom>It Fee: 10.00 Surcharge: s C? By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: This request void 7 > , + _ 18 h fr tt jj B.d a t 1 ) t'? '? 57- Wh R No r en eady ensgd Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Box, r Route No. 9 City ?? & g?? Section No. Towns ip Name or N Range 7o. County ?Ztn Occu ( IN Phone No. Power Supplier Addr ss Electrical Contractor (Corn any Name) Co ractor's License No. Mailing Address (Contractor o caner Making Insta' lion) Author' Signature ( actor/O r aking Installation) Phone Number MINNESOTA STATE BOARD OF TRICITY THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD Griggs-Midway Bldg. -Room 1 1821 University Ave., St. PHo J. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. Request Date Fire No. Rough-in Inspection Red? ?,/ Ready Now?Wll Notify Inspec- ? REQUEST FOR ELECTRICAL INSPECTION EB-00001 04 See instructions for com leting this form on back of yellow copy. Now (I `-` 3 6 3 2 1 ""X"" Below Work Covered by This Request Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater fighting Fixtures Apt. Building er Electric Heating Co cial Bldg. ooe 'Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other Specify Other (Specify) Other iSpecify) Other Other (_mmnimp incnerr,nn i-PP HPmw If Fee ServiceEntranceSize it Fee Feeders/Subfeeders # __-Fee Circuits 0 to 200 Amps 0 to 30 Amps 0 to 30 Amos Above 200 Amps 31 to 100 Amps Jop- 31 to 100 Amps Swinrning Pool Above 100-Amps Above 100_Amps Transformers Irrigation Booms Partial,`Other Fee Signs Special inspection TOTAL VJEE- Remarks 91 Rough-in t at '.. i 'I, the Elec /J 4 Inspector, hereby certrf that the above Final sPectian has been 42 made. This request void 18 months from v -' This request void 18 h f t mont s rom t 078 Licensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Box or R to City ? I av Section No. Townshi Name or N . Range No. County occupant (PRINT) Phone No. Power ppli Addres ;?;7 Electr' 1 Con or (Co pa Name) C trac r s Lic se No O er Making In iI -on) i ng ddress (Contracc h Au ri Signatu Contractor/ Making Installation) Phone Number MI OTA STATE BOARD ELECTRICITY THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD Griggs-Midway Bldg - R o N-191 MN 55104 UNLESS PROPER INSPECTION FEE IS 1821 University Ave., St, aul , Phone (612)297.2111 ENCLOSED. Request Date Fire No. Rough-in Inspection R fired? Ready Now Will Noti(y. Inspec t `, es tor When Ready REQUEST FOR ELECTRICAL INSPECTION VB'O00D1 C? ' See instructions for completing this form on back of yel low copy. 1 v Z ?l 4918 "X" Be/ow Work Coveted by This Request t I G ,od Rep. Type of Building Appliances wired uipment Wired Home Range emporary service Duplex Water Heater Lighting Fixtures pt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other (Specify) ther(Specify) Other (Specify Other Other f -mmMi?P fncnPrttnn tpP HPfnw ff F Service Entrance Size # Fee Feeders/Subfeeders # =Fee Circuits 0 to 200 Amps 0 to 30 Amps 0 to 30 An-Ds Above 200-Amps 31 to 100 Amps 31 to 100 Aigis Swimming Pool Above 100 Amps Above 100--Affps Transformers Irrigation Booms Partial. Other Fee algns apeciai inspection $ ^ TOT E Remarks Z??; Rough-in Date I I, the cal inspector. hereby ce rfy.:thot the above Final ate pection has been do. this request void 18 months from UILDING PERMIT To be wed for SF CITY OFEAGAN N° 10285 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?. _ PHONE: 454-8100 Receipt # ZL? _ DWG/GAR Est. Value $55,000 Date MAY 2 9 1 q 8 5 Site Address 3653 BLUE JAY WAY Erect ® Occupancy R3 Lot 15 Block 4 Se/Sub. LEXINGTON PL SORemodel ? Zoning RT. ? T ype of Const. Repair 3 7 No. Parcel ? Enlarge ? No. Stories I" m N ORRIN THOMPSON HOMES Move ? Length 38 13 a e Z Demolish Depth 41 Address 1712 HOPKINS CROSSROADS Grade ? Sq. Ft. City MTKA Phone 544-7333 Install ? $` N SAME Approvals Fats ame zU Assessment Permit $ 298.00 CU Address ? Water & Sew. Surcharge 27 , 50 City ?' Phone . Poirce PI n Review 149 00 C? Name Address '13 <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 Stotu ,s and City =1 Signature of Permittee y is LV anyrir?yiv A Building Permit Is issued to. all work shall be done in accordance with all applicable %ptq Building Official ?1'?, Fire Eng. Planner Council Bldg. Off. 5/28/85 APC Var. Date a SAC 525.00 Water Conn. 500.00 Water Meter 6 3 . 0 0 Road Unit 280 00 T.P. 132.00 Total $1,974.50 on the express condition that and City of Eagan Ordinances. CASH RECEIPT CITY OF EAGAN P. 0. BOX 21-199 EAGAN, 4 ESOTA 55121„ (.~ D t?+ l AMOUNT DOLLARS 100 CASH []CHECK 41 Y 611 7 77 .?F'?INO-.•/'` •% ,.___?-."' .'-CODE ?.. AMOUNT ,?,?? ? ScCy c?`'CJ r rod 37/- x7 Thank white-Pavers Copy Yellow-Posting Copy Pink-File Copy r ,. r. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454.8100 BUILDING PERMIT Recei To be used for Sa iC /? Est. Value rf .{> Date $,' Y 29 tg . 3653 BLUE a7 ,.5!! W A Erect t Occovency R . Site Address LEXT GTO?:v ?L 1. Remodel 0 Zoning #2j. Block - Sec/Sub. Lot Repair ? Type of Cont. U Parcel No. Enlarge ? No. Stories ORRIN THOMPSON HOMES Move ? Length 38 Name 1712 HOPKINS CROSSROADS Add Demolish ? a ? Depth 4 1 • ress Gr de Sq. Ft. 'i1KA 544"°7333 City Phone Install ? SAME N Approvals Fees ame Assessment Permit 27. C City Phone Water & Sew. Pol Surcharge 9 Revi Pl t'jac ice an ew ?.?Q W Name Fire SAE . ?G O Address Eng. Water Cars. <W City Phone Planner Water Meter ' rj Council 5 B Road Unit `7 ' _ C I hereby acknowledge that I have read this application and state that Bldg. off. / E' , the information is correct and agree to comply with all applicable APC Total 4'-0 State of Minnesota Statutes and City of. Eager Ordinances. Signature of Pennittee '.,Z c v Var. Date A Building Permit Is issued to: ORRIN '.'HCr,P„sON HOMES anther Wit all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Building Official Permit No. Permit Holder Daft T Pl sv, ( 2-11 & %3 S4 H.V.A.C. ?1 5 a t'11 Zo Electric I ?o T O , UU softee Inspection Date Insp. Other Footings Foundation. Framing 9 Roofing Rough Plbg. Rough HVA 21 Lif Insulation Final Pibg e7 A Final HdAC Final, Cort/Occ. Water Describe Location: WWII Sower PrDisp• Receipt MECHANICAL. PERMIT Permit No. 5 ?•`` CITY F PAGAN Fee Fill in numbered spaces S/C 3 Type or Piint legibly Tot. 20.550 1. Date 2. Installation cost 30000 3. Job Address36S Jay at 15 Blk. 4 Tract . P Se 4. Owner 5. Contractor ! N. H. C . Phone 25 6 -y . ?. 6. Address _141i37 Chicago MN. 7. CityState Zip 55407 8. Building"Type Residential Commercial 0 Institutional 0 9. Work Description: New Add 0 Alter 0 Repair 0 gas 10. Describe instal-I . oice ar he tit F n at tz -0 el Type . ,R Me. I 11. No. 1 Equipment BTU - M. Ea. Forced Air 80,0 No. Equipment CFM d Mfg. Air Han ling: Boilers Mfg. Mach. Exhaust Unit Heater Mfg. Oth Air Cond. 3, er Mfg. Gas, Piping Outlets 12. I hereby certify that the alcove informatigri is true and correct, and I agree to comply with- ordinan;a odes governing this type of work. Signed-- r- , ,? " for Rough, Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 t € r`_ CITY OF EAGAN /-? 1... FAY in numbered 019ces SIC Type or Pn t legibt y Tot 1. Date ?a?, v'`i 2. Instalbtion Cost 3. Job Address v a r Fdlk. 4. Owner 5. Con 6. Address Phone T..a' 7. Cityf sf r$ r,? Stag " 8. Building Type: Residential k Commercial n lnstit ti l L 9. Work Description: News Add Q Alter Q Repair 0 10. Describe 11. C No. fib Water Closet No. Fixtures Cesspeolilai rfield 1 Bath tubs Septic Tar* Uvatory Softnef Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray f loot Drains Drinking Ftn. Stop Sink Gas Piping Outlets 12. 1 herebyc*rtify that the above information"ishrue and correct,. I "Me e comply t/rtlr bspinafkes and codes g nigg this type of work. fore Ro Fi & 1rsf ,i&rps: date VhW. Date It>:. ' TMs is vow pwmit > n numbered and proved: AWWmd CITY tom' JI. 404 Receipt 1) PLUMBING PERMIT Permit No. (. CITY OF EAGAN Fee Fill in numbered spacs Sic Type or Print legibly Tot ) C„J - 1. Date ?- 2. Installation Cost L 3. Job Address ::•,?` ?'. _? ;/ t . Lot ?Bik. 4. Owner f `.J t / 5. Contractor ih Phone 6. Address A 7. City J1l . .3 i"r"YI State Zip 8. Building Type: Residential Commercial 0 Institutional Ll 9. Work Description: New ! Add 0 Alter 0 Repair 10. Describe 11. Nos Fixtures Water Closet No. Fixtures Cesspoot/l)rairfield Bath tubs tic Tank Se Lavatory p Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Stop Sink Gas Piping Outlets '12. 1 hereby certify that the above information is true and correct, and I a *a comply with all ordinances and codes governing this type of work. ,.'. Signed % 1 L e" for Rough final teps'peos: Date Insp. Date i n>,• Zit Thi • y permit when AimT&ered and, approved. ed CITY ? ?OPJEA o-: i?tV : i9? CITY OF EAGAN Remarks Addition Lexington Place South Lot 15 Rik 4 Owner Street 3653 Blue Jay Way -Parcel 10 45060 15 to Eagan, MN Improvement Date Amount ° Annual Years Payment Glp receipt Date STREET SURF. to 4.5 $(Q /5 a ./ C ( gym?-! d 6 19,9 7,? _____ -2 •?7 ' STREET RESTOR. GRADING SAN SEW TRUNK 1985 247.64 16.51 15 SEWER LATERAL 101 1986 1631.00 326 5 2/2-7 Services vices 101 1986 729.39 145.87 5 3 f/S1/ z Z7? WATERMAIN 71 1985 65.81 13.15 5 WATER LATERAL 101. 1986 873.43 174: 5 / st 1 2 WATER AREA 10111 1986 243.7 48 5 WA LAT BEN 1 1986 1.98 22. g .7- 4y_ 6 STORM SEW TRK 101`1 1986 426.54 85. 5 & it STORM SEW LAT 101 1986 803.34 160.66 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 500.00 itt ri BUILDING PER. - -10295 tt SAC _575 00 Itr ti PARK Cj 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 C?QQ ' New Construction Requirements Remodel/Repair Requirements Office Use On 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 Y _ N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _ Y _ N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ 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 7/1/93 Rim Joist Detail options selection sheet (bldgs with 3 or less units Date to / j d / O-1 Construction Cost 0 4 0 Site Address -3 6 S 3 \3 L^ y C 5A,w A `'( Unit/Ste # Description of Work FL_ to 1 O tM -C- Multi-Family Bldg - Y - N Fireplace(s) 0 /1 - 2 Property Owner A t j t 2t t J MSc F-t Telephone # (6-5-1 ) Contractor S a m €_ Address city State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category I Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envel(culations Submitted Have you previously constructeXa4 inE fee applies. o?opo1 ti Licensed Plumber_____________________ Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( 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. kwith a similar plan? - Y - N If so, 25% plan review --t, MticSC?W-e A r? w t e Applicant's Printed Name Applicant's Signature OFFICE USE ONLY to, y 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 ? 07 05-plex ? 13 16-plex ? 20 Pool ? 08 06-plex ? 16 Fireplace 0 21 Porch (3-sea.) ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 10 08-plex A 18 Deck ? 23 Porch (screen/gazebo) ? 11 1 0-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 Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation _A00-0 ___ Occupancy Census Code L-9 5'1 Zoning SAC Units Stories # of Units Sq. Ft. # of Bldgs Length Type of Const C? Width _ Footings (new bldg) Footings (deck) Footings (addition) _ Foundation Drain Tile Roof _ Ice & Water _ Final Framing Fireplace _ R.I. -Air Test -Final Insulation MCES System City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing HVAC Other Pool Ftgs _ Air/Gas Tests - Final Siding Stucco _ Stone _ Brick Windows Retaining Wall Approved By: T2-? , Building Inspector -------------------------------------------------------------------------------------------------------------------------------------------------------------------- Base Fee Surcharge d C.? ill Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies M 4' Other Total le"*" q?' For: U. S. HOME CORPORATION (11,903.6SJ ?Q C. R. WINDEN & ASSOCIATES, INC. ?J LAND SURVEYORS Tel. 645.3646 1381 EUSTIS ST., ST. PAUL, MINN. 55108 JAS WR d N 87° 13'47" E 47."'4 R: 33 3.12 A:O°15'43„ , 5. a 7 --- Scale: 1" = 30' ODenotes Iron Monument . BLUE W coo 0 tV U) W v) NOTE: o Denotes Wooden Stake Proposed Garage Floor El. 9" (904.0) Denotes Proposed Finished Ground El. Denotes Direction Of Surface Drainage Vertical Datum - N.G.V.D. 1929 Lot 15, Block 4, LEXINGTON PLACE SOUTH, Dakota County, Minnesota. s t 1985 /021% ING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY Plan: ?0 1 SET OF ENERGY CALCULATIONS To Be Used For: Residence Valuation: 'lull Date: C5,5, 0 co, 00 Site Address: -9)63 LUc- . OFFICE USE ONLY Lot: 1- Block Sect/Sub ?MTON Erect Occupancy Remodel Zoning ?-I Parcel if Repair Type of Const Enlarge if of Stories 19> Owner Move Length __ Demolish Depth - Address Grade Sq Ft City/Zip Code -------------------------------- Contractor Orrin Thompson Homes APPROVALS Address 1712 Hopkins Crossroads City/Zip Code Minnetonka, Minnesota 55343 Phone if 544-7333 Arch./Engr Address Phone # Assessments Permit Water/Sewer Surcharge 2I, Police Plan Review 141 . ?= Fire SAC 525. Engr Water Con n. Planner Water Meter (03.'° Council Road Unit 2.80, Bldg Off $ arks APC Treatment P1 13 2. Variance TOTAL ( 9 ___ 10 C. R. WINDEN & ASSOCIATES, INC. LAND SURVEYORS Tel. 645.3646 1381 EUSTIS ST., ST. PAUL, MINN. 55108 For: U. S. HOME CORPORATION BLU JR?J WR I-zJ 903.65) H87-11-47" E 47.74 K 906.8) --28.8---' 1F 11,5 6.3 ; fi? I u? L- - Proposed c? m House 34 han ` 'O q ven 2 03.0) R-!33?.I2 A:0 5.43„ 15.27 ^ X905.l6) o- coo 70 0b (892) ?-Iw ID- L_ _1 1 1 Scale: 1" = 30' / t W o Denotes Iron Monumen LU 00 (903, v) 3:1 S rope 900.o) (898.0 ) G3, 01 5 67- 13'47" W Q1 in Q NOTE: o Denotes Wooden Stake Proposed Garage Floor El. 907 (404,0 Denotes Proposed Finished Ground El. _4 Denotes Direction Of Surface Drainage Vertical Datum - N.G.V.D. 1929 Lot 15, Block 4, LEXINGTON PLACE SOUTH, Dakota County, Minnesota. WE 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. Dated this day of a A.D. 19 85 C. R. WLNDEN & ASSOCIATES, INC. by . 41 ' Surveyor, Minnesota Registration No. 77?- 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRIN 1) PROPERTY ADDRESS: ?, LEGAL DESCRIPTION: I"r EIS _ ---G SI'RUCTU -,E , DATE OF ORIGuIAL EUILDI::G _ ?IT ISSUANCE : PRESr :I' Z•.^,`7I;,r/Pv0POSED USE: R-1 S=LEE FAMILY ? R-2 DUPL (TWO UNITS) ? R-3 it NHCUSE (TI- , + UNITS) ( UNITS) ? R-4 APA??I`TT/CCi1)G>?I`Ir„1 ( UNITS) ? CCt%?yIE CLAL/REI'AIL,/OFFICE ? 1NMUSTRIAL (3 LtiSTITC"rIONAL/GOVE:-tj,T T 2.) APPLIC_-= L ASE PRINT) -x- ADDRESS: CITY, STATE, ZIP: '1f PHONE: _ 73 3) PIIMBE1, NAME: (PLEASE PRk FOR CITY USE ONLY ADDRESS: PLUMBERS LICENSE: A - CITY, STATE, ZIP: c v Expire PHONE: PLUMBER LICENSE # /7 / 1 f Record s at nit initial 4) OCCUPANT/OWNER NAME: (PLEASE PRINT) ADDRESS: CITY, STATE, ZIP: PHONE:.._, 5) INDICATE WHICH PERMIT I EING REQUESTED: CONNECTION TO CITY SEWER M'CONECTION TO CITY WATER 0 0`71 ER (PLEASE DESCRIBE) 0) L?UiLc 1: U:i?:: 7) SICz1L'RE: Li PIZ SE HOLD APPROVED PERMIT FOR PICK- BY ONE OF ABOVE D-PTZ SE MAIL APPROVED PER-UT TO 1, 2_ 4 ABOVE //p'? - /' (Circe one) DATE: - /! a1 +Ri+lsa r?s r? M EMsr aX gt s rs s:a as-aW:lr 4s ass __ u :a a AMUR ats??a r?? ?r 04 - Ss: ems` FOR CITY USE ONLY PERMIT R ISSUED FEES : $ L%N, $ ? a ['1 $ '? l ) $ Fem.. $ 1 h s? SEWER PERMIT (INCLUDE SURCHARGE) WATER PERNtIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ?_000U: T U: POSIT - ?_:,IR ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER WATER TREATMENT PLANT SURCHARGE $ OTHER: $TOTAL $ 74 Sr) AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NOENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE : /t?? a! sspa ?t w r in !? !r r?! s f? ?? !E sE ism wq" Mm asks! sf r-" s mum sE w sit w-pO ¦C-= N*r am sip w .? r --n T RESIDENTIAL ? BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements Remodel/ReaairReauirements • 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 additions • 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 10V0 Z VALUATION I? Y SITE ADDRESS 3L53 L 9U6 UY i MULTI-FAMILY BLDG Y TYPE OFV R?- P1-4CF / Ng- go o% kbf.?' ?9fr 5-0 FIREPLACE(S) 2 APPLICANT-117 mrrca,,P, gui dal ?,?a ?o?f c 4 ?~5 Gnc, STREET ADDRESS /.'1, t/7 NlG4//ef ;4,le So, CITYBvrr7y?//r STATE ZIPG0AT TELEPHONE #g52-7v7-'2c CELL PHONE # 4,/2=9/9-/6/i FAX#9.C2-707-9oias PROPERTY OWNER "ir?a, ,(ktvia? ?/ Saari cs TELEPHONE# Ccl- Noc• 18d'*'/ 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 I Worksheet Submitted • ?e t s mitted tv; • Energy Envelope Calculations Submitted 1" L,f 7 1. Zak ;`; MAY 1 Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener Lawn Sprinkler 1113y ------ fet-19D-.0d 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 information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordin nc 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 ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti 13 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 Plbg__Y or N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 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 10 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 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN- ---? _ 5 Q 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Reauireme RemodeVReoat Rgguirements • 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 additions • 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bkigs with 3 or less units) 00 DATE VALUATION I T,D A SITE ADDR S 3(0MULTI-FAMILY BLDG _ Y V TYPE OF WO iGil t, On FIREPLACE(S) - 0 ,L 1 _ 2 APPLICANT .1 i l o? STREET ADDRESS 12 r?c.© JL Yr. 11 CITY j.t)SUr1 STATE, & ZIP TELEPHONE # 707- 052 CELL PHONE # FAX # X51- Z07- 'I92I-- PROPERTY OWNER Q&211' 4frl TELEPHONE # 1 V ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 M (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted e • n diM' bmitted • Energy Envelope Calculations Submitted MAY 1 6 20OZ Plumbing Contractor: Phone # Plumbing system includes: Water Softener Lawn Sprinkler ee 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 information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. 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 ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Aft - Multi ? 03 01 of_ plex 0 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 Mufti ? 05 03-plex ? 11 10-plex 0 19 Lower Level 0 24 Storm Damage ? 06 04-plex ? 12 12-plex PINY or N ? 25 Miscellaneous ? 31 New ? 35 int Improvement 0 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 *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 r Stucco - Stone _ Fireplace _ RI. -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 WJvvai ova Use BLUE or BLACK Ink I I -For O-ff-c-e(-Us-te~ - - - - - - - - - - ~t EaEd n Permit City Of I Permit Fee: as I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (661) 675-5675 I I Fax: (651) 675-5694 1 Staff I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 053 fdl~k" DA5!:J Unit S Name: P- JOit Phone: ~OS(" ZO Resident/ Owner Address I City /Zip: 3(o s~ Applicant is: Owner 1 Iontractor r Description of work: IV1atn k-t_. ~Irt~ ItLnoa~ ('{L- Type of Work ' 'Construction Cost: i Multi-Family Building: (Yes I No ~ ~ Company: 614 Contact: Contractor Address: (015' E2M4 1fkA4 RA) City: ~ iJ~.JF.rt State: Phone: ' ; 2q Zip (051---3M -3519 s L51 License D-Y, t s kp?Jtj6 j D Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) F I I tr I COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eaga issued a permit for a similar plan based on a master plan? i _Yes No If yes, date and address of ma r pla Licensed Plumber: Phone: Mechanical Contractor: 1 Phone: jt 1 3 f i sewer & Water contractor. Phone: z , I 'NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of o 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. _ t 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.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 i accordance with the approved plan in the case of work which requires a review and approval of plans. g Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must ompleted within 180 days of permit issuance. x x Applicant's Printed Na a Applicant's S' Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA149661 Date Issued:06/04/2018 Permit Category:ePermit Site Address: 3653 Blue Jay Way Lot:15 Block: 4 Addition: Lexington Place South PID:10-45060-04-150 Use: Description: Sub Type:Residential Work Type:Underground Sprinkler System Description:PVB 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 - RPZ/PVB/Lawn Irrigation $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 - Ana Costa 3653 Blue Jay Way Eagan MN 55123 (612) 799-7250 Drain Pro Plumbing 8815 - 209th Street W Lakeville MN 55044 (952) 469-6999 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA150047 Date Issued:06/19/2018 Permit Category:ePermit Site Address: 3653 Blue Jay Way Lot:15 Block: 4 Addition: Lexington Place South PID:10-45060-04-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner 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 - Ana Costa 3653 Blue Jay Way Eagan MN 55123 Homeworks Services Co Dba Homeworks Plumbing Htg 1230 Eagan Industrial Rd Eagan MN 55121 (612) 400-9020 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA161008 Date Issued:04/29/2020 Permit Category:ePermit Site Address: 3653 Blue Jay Way Lot:15 Block: 4 Addition: Lexington Place South PID:10-45060-04-150 Use: Description: Sub Type:Residential Work Type:Underground Sprinkler System Description:PVB 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 - RPZ/PVB/Lawn Irrigation $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 - Justin Thomas 3653 Blue Jay Way Eagan MN 55123 (651) 212-3330 Drain Pro Plumbing 8815 - 209th Street W Lakeville MN 55044 (952) 469-6999 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA165544 Date Issued:11/05/2020 Permit Category:ePermit Site Address: 3653 Blue Jay Way Lot:15 Block: 4 Addition: Lexington Place South PID:10-45060-04-150 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Residential Additions, Alterations 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 - Justin & Dana Thomas 3653 Blue Jay Way Eagan MN 55123 Fireside Hearth & Home 2700 Fairview Ave N Roseville MN 55113 (651) 633-2561 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA170064 Date Issued:06/18/2021 Permit Category:ePermit Site Address: 3653 Blue Jay Way Lot:15 Block: 4 Addition: Lexington Place South PID:10-45060-04-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$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 - Justin & Dana Thomas 3653 Blue Jay Way Eagan MN 55123 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