3669 Blue Jay Way CITY OF EAGAW' WATER SERVICE PERMIT
3830 Pilot Knob Road 7197
P. O.. B6x 21199 PERMIT NO.:
Golan, MN 55121 DATE: '
Zoning: T Z]. No. of Units:
Owner Orrin Thomgsmi. TIomes
Address:
Site Address: 3669 Blue Jay Wa L11 P Lexington P1, Sc)
Plumber: Thompson "loath
r
Meter No 17 5- -4-7 age: -00-002d
1 a . 03p
Size:
Reade No.~~N~nS?.b`` Permit F 1. U~?p x
I eon* to =m* with the City of Eaggo rc 'je: 1 Pcl
Ordinances. ise..Charges: 155.0 d TP
Total: 63.50pd meter
BY Dote Paid:
--0-- Taft=
Date of 1 Insp.:
CITY OF EAGAN N-0 1 5 6 4
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 4/ BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est. Value $66,000 Date MARCH 4 19 86
Site Add Tr 3669 BLUE JAY WAY Erect ff Occupancy R3
Lot li Block Sec/Sub. LEXINGTON PL SORemodel ❑ Zoning R1
Parcel No. Repair ❑ Type of Const. V
Addition ❑ No. Stories
ORRIN THOMPSON HOMES Move El Length 40
Name Demolish 11 Depth 48-
z 3 Address 1712 HOPKINS CROSSROAD Int. lmpr ❑ Sq. Ft.
o city MTKA Phone 544-7333 Install ❑
°C SAME Approvals Fees
o Name
Q Address Assessment Permit $ 3 31 .0 0
City Phone Water & Sew. Surcharge 3 3 . 0 0
Police Plan Review 165 50
F W Name Fire SAC 5 7 5.00
_a Address Eng. Water Conn. 500.00
m 63.50
UZ
a City Phone Planner Water Meter
Council Road Unit 290.00
Ihereby acknowledge that Ihave read this application andstatethatthe Bldg. Off. 2/27/86 Tr. Pl. 156.00
information is correct and agr a to comply with all 7). plicable State of
Minnesota Statutes and Cit f Ea dinance APC Parks
Var. Date Copies
Signature of Permittee I L Total 0
ORRIN THOM HOMES
A Building Permit is issued to: on the express condition that
all work shall be done in accordanc wi al plica le Sta irK eta Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN ,
*W 11564
r- 3830 PNt Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for SP . DWG/GAR Est Value $66,000 Date MARCH 4 19-96
Site Ad r ss 3669 ' BLUE JAY WAY Erect ❑X Occupancy R3
Lot Block 4 Sec/Sub. LEXINGTON PL +SQemodel ❑ zoning R1
Parcel No. Repair ❑ Type of Const V
Addition ❑ No. Stories
Name ORRIN THOMPSON HOMES Move ❑ Length 40
Address 1712 HOPKINS CROSSROAD Demolish ❑ Depth 4
o M''KA 54-7333 Int. Impr. ❑ Sq. Ft
City Phone Install ❑
9 Name SAM Approvals Fees
C Address Assessment Permit 331 • 00
City Phone Water & Sew. Surcharge 33.00
Police Plan Review 165.r 5Q
W Name 575.00
Fire SAC
Address 500.00
u Eng. Water Conn.
City Phone Planner Water Meter 63.50
Council Road unit 90.00
1 hereby acknowledge that I have read this application and statethatthe Bldg Off. 3/ 7f 6 Tr. PI. 1516.00
information is correct and agre to comply, with all applicable State of
Minnesota Statutes and City Ea dinances. APC Parks
Var. Date Copies_
114
.OB
Signature of Permittee, t t It Total r
A Building Permit is issued to. ORR N TIlOMPSQN HOMES on the express condition that
all work shall be done in accordance witn ail plicable State of,Wnesota Statutes and City of Eagan Ordinances.
Building Official
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b • PERMIT #
PLUMBING PERMIT RECEIPT # 0
CITY OF EAGAN L~.
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE.
CONTRACT PRICE: PHONE: 454-8100
Site Address I LDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
i (Y
J Res. New i
Name r r i 4 Mult. Add-on
Address t. R' v Comm. Repair
c city 1t kG t it 2 f i Phone c. 1 Other
- , NO. FIXTURES TOTAL
Name' I r , f 1 Water Closet - $3.00 $ % Uj
3 Addr s ~1 L ,t t` GlrGi~- Bath Tubs - $3.00
O City c L Phone ; Lavatory - $3.00
Shower - $3.00 - G y
FEES Kitchen Sink - $3.00 - .t
COMMAND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00
MINIMUM - RESIDENTIAL FEE _$10.00 i Laundry Tray - $3.00 J G
MINIMUM - COMM/IND FEE - 20.00 TFloor Drains - $1.50
' STATE SURCHARGE PER PERMIT - .50 Water Heater-- $1.50"
(ADD $.50 1S/C ,0 IF PERMIT PRICE GOES Whirlpool Gas Piping - $3.00
Outlets - $1.50 5 v'
BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE:
STATE S/C:
FOR: CITY OF EAGANaRAND TOTAL: /
PERMIT # CITY OF EAGAN FEE
1 MECHANICAL PERMIT
RECEIPT # 454-.8100 s/C
~j,, MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL
DATE r ~fo MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res Comm Inst 2. New Add Alter Repair
3. Total Bid Price ' 4. Job Address t
Lot Blo Sec '9, lrtZrO./ lke 5. wner N 3. 1f+:
6. Contractor..' !c '
(Name ti,~ (Street) (City) (Zip)
7. Contractor Phone
RESIDENTIAL HEATING - 01-100,000 BTU's - $24.00. Each additional 50,000 BTU's or fraction - $6.00
RESIDENTIAL COOLING 01-24,000 BTU's - $12.00. Each additional 6,000 BTU's or fraction - $6.00
MODIFIC ONS/ALTERATIQ "10.00 minimum fee
HEATING VENTILATING HOT WATER STEAM AIR COND.
.__,(AIR"PIPING PROCESSED PIPING AIR HAND. EQUIP. REFRIG.
RES. GAS PIPING OUTLETS - $1.50 TANKS: - L.P. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
Approved Inspections: Date Rough Insp. Date Final Insp
CITY OF EAGAN Remarks
Addition Lexington Place South Lot 11
3669 Blue Jay Way I31k 4 Parcel- 10 45060 11 04
Owner Street
State Eagan, MN
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL -1985 - 247 64.-.. 16 51
6 -1631.0 32'6 : -2-2-1 5
vices' 1015 1986 729.3 145.87 5
WATERMAIN
WATER LATERAL
44A~ 19 b 81-3 . 4 _ " ' 17 4. 6 8 '5
101 , - ~ ] 43.,'7 48._74 5
WAT LAT BEN 1013 1986 111.9 _2_2..39; 5
STORM SEW TRK 017',- 1986 426."5 8'5•.30 5
STORM SEW LAT 1016' 1986, 503.-3 160.66 5
CURB & GUTTER
SIDEWALK _
STREET LIGHT
WATER CONN.
BUILDING PER.
_ SAC
PARK
Thi quest void C 6 (,r ' S~
18 nths-from {J
0 9f973 Request Date Fire No. Rough-in Inspection
Required? ❑Ready Now ill Notify. Inspec-
. Yes ❑ No for When Ready
Licensed Electrical Contractor I hereby request inspection of above
❑ Owner - electrical work installed at:
Street Address, Box or Ro to No. Cit
9W 9 6" 42~
ection No. Townshi am or No. Range No. C unt,
Occupant IPRINT) Phone No.
5,~f 33
Power Supplier Address
X70' SdGtJ<
EI rical Contractor (Company Name) Contractor's License
Mailing Addr IContr for or O r Making In tailationl
_ --3&
Authori d Signature (Contractor/0 ner Making Instal tion) Phone Number
/ 7 3
VA4NESOTA STATE BOARD OF E TRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg.- Room N-1 1 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
rt- REQUEST FOR ELECTRICAL INSPECTION
10 See instructions for completing this form on back of yellow copy.
""X Below Work Covered by This Request /
0 9 97J
AeC" 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 Other (Specify)
Other Specify Other - Other
ompute inspection Fee Below
# s Fee Service Entrance Size tt Fee Feeders /Subfeeders # Fee - Circuits.
/ p 0 to 200 Amps , 0 to 30 Amps 0 to 30 Amps
Above 200 Amps 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 v
Remarks TOTA EE )
- ,ryZ
r' W
Rough-in Date i the Ele cal
*vj°~' y nspector, hereby
certify that the above
Final A!r DiJ . inspection has been
i J .04 made.
This request void 18 months from
This request void L( 1 5 `Y" j ~ ( A -2 : z y
18 mon h f
B b 79 L ~ 1 (4
Request Date Fire No. Rough-in Inspection
i Required? FpqReady Now ❑ Will Notify, Inspec-
l ---11 ' ❑yes o- for When Ready
Licensed Electrical Contractor I hereby request inspection of above
❑ Owner - electrical. work installed at:
Street Address, Box or Route City
ecU on. No. T nship N%Ke or No. Range N. County
Occupant (PRINT) } Phone No.
Power pli Address
i
Elec L Contractor (Compan Name) Cont a tor's License No.
QaMnlje,Address (Cont~zw aking t i on)
-
-Ruth n ignature ( n ac ner Making Ins llation Phone Number
~ J ~1 G/ J
MIN STATE BOARD UlF CTRICITY THIS INS ECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Roo 91 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. P I, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 297.2111 ENCLOSED.
c 7~ REOUEST FOR ELECTRICCPECTION E13-00001-04
' See instructions for comp" form on back of yellow copy. I f ZY }
4979 "X" Below Work Covered by This Request
I Mm d Rep. Type of Building Appliances Wired quipmentWired
Home Range --I-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 Other (Specify)
Other Specify Other - Other
Compute Inspection Fee Below
# e Service Entrance Size # Fee Feeders/Subfeeders # Fee. Circuits
0 to 200 Amps 0 to 30 Amps 0 to 30 Amps
Above 200 Amps 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100 --Amps ' Above 1'00-Amps
Transformers Irrigation Booms Partial-'Other Fee
Signs Special Inspection
Remarks TOTA4°'FEE '
Rough-in. -Date 1, t Electrical
Insereby
c rtify that the above
Final Date spection has been
made.
This request void 18 months from
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements Remodel/Repair Requirements Office Use Only
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ 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 (buildings with 3 or less units)
Date / 05- Construction Cost 3,q Site Address c JC4~9 _ 1 U _ 0. C~~ Unit/Ste #
Description of Work I ~caK` b ~Q r00lp
Multi-Family Bldg Y - N Fireplace(s) - 0 - 1 - 2
Property Owner ~aI- 1 j ~Q , A- Telephone # (62,5/) yo5
1
Contractor zzlkscGV66CI S (Crl')0 Gk -/1 kq °t, {
Address /oz zS166h,"~ ,!T z)rl f/ ee( i~a-,A- City ?D t w-~ v~-q Cbti~
State M !'1 Zip S. UoZ) Telephone # ~-y
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
)
Licensed Plumber Telephone
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Telephone # ( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
❑ 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 - Multi
❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF
❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc.
❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous
Work Types
❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding
❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair
❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors
❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# 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 _ Brick
Fireplace _ R.I. -Air Test -Final _ Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
ciTY OF EAGAN
3=+% It Knob Road WATER SERVICE pERAW
P "O. Box 21199 711.1-11
Eagan, MN 56121 PERMIT NO.:
Zoning: ::1 DATE:: 2
o. of Units:
Owner: Orr- i. N } : w€?t rx 'l x e„
Address:
Site Address 366" 3 qu..I.,
,a~a 7. v;clra^eE 1 s
Plumber:
Meter No.:
Size: Connection Charge: !1o
Reader No.: Account. Deposit:.
Permit Fee: 1 , Ct1r,:}
a0ht to ee~a~r whh C*y of
Ordlnonop. E.W.
Surcharge:
Misc. Chorges:
By Total: .51.rt Vie!
Dote Paid:
Date of insp.:
Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 pilot Knob Road 8348
'P. O. Bost 21199 PERMIT NO.:
` 3-14-36
Eagan, MN 55121 DATE:
Zoning: No. of Units: 1
Owner: Orrin Thompson 'Ip`if'£t
Address: -
Site Address:3669 -Blue Jay Va-1 L11 E4 Lexington PI SO
Plumber. Thompoon Plum[, ir.
1 agree toeave* With of Cyr of Kagan Connection Charge: 475.00pd
Account Deposit: 15 • t 0pd
Permit Fee: 10.00pd
Surcharge:
BY Misc. Charges:
Dote of Insp.: Total:
Inds.' Dote Paid:
' • i ' ' ! i • i • ' • I I! w_ w
! • i i •
V. ! • X
. • / i i DI • • .1i•e
i
CITY OF EAGAN
APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION
( lease P int
1) PROPERTY ADDRESS:
1 BGAL DESCRIPTION.- 50.
(Lot lack Subclivisi or Tax Parcel I.D. Number)
IF EXISTING STRL'C'URE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
(Month Year)
PRESENT ZONING/PROPOSED USE: R-1 SINGLE FAMILY
R-2 DUPLEX (Two Units)
R-3 TOWNHOUSE (Three + Units) ( Units)
R-4 APARTMENT/CONDOMINIUM (-Units)
COMflHERCIAL/RETAIL/OFFICE
INDUSTRIAL
INSTITUTIONAL,/CGQVERNME W
2) waggNga OT %Nw3
NAME;: VVA& mzjn~~.,
ADDRESS:
CITY, STATE, ZIP:
PHONE:
3) r ! For City Use
--NAME: Phunbers License
4 ADDRESS:
C= Active.
CITY, STATE, ZIP: r-= Expired
PHONE: MASTER LICENSE # CJ Not Recorde
Staff -al
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5) . •
CONNECTION TO CITY SEWER XCONNECTION TO CITY WATER
❑ OTHER (Please Describe)
6}
❑ PIEASE HOLD APPROVED PERMIT FOR PICK-LIP BY ONE OF ABOVE
PLEASE MAIL APPROVED PERMIT TO I, 2, 3 41AB0
irc e one
(C )
rP'~ h.-r s°' .mss. ~ L f> ~~'a M~ ,h;., c°
TY USE ONLY 72~
ik6
E PERMIT " ISSUED Y y ~a{5
:l S f-.T' rt .sue. t t¢ x C 3. +
FEES ;PETS>4T~'..I'IL:~D~ SU°CTs~1RGc,
-~~'ERt~4IT -INCLUDE SuRCHARGE)
'
TERMETER/COPPERHORN/OUTSIDE READS
R
WATER TAP (INCLUDE CORPORATION STOP)
,
SEWER TAP 4
s
w yC ACCOUNT DEPOSIT WATER r r
WAC
$ °~YEAC U
o~z
TRUNK T CATER. ASSESSMENT
$ 4 , V, , fTRU.NK SE ~TM' AS gES SMENT
3,PrTsRAi~ BENEFIT/TRUNK SETTER
fXTER, L, 4E&PEFITTRUNK WATER
WATER TREATMENT 'PLANT SURCHARGE
- $ r OTHER: t y
TQTX~
$ /~~"'C ' °Ar14L'T P1 IDJRECEIPT tt ~o O
~ Sa
P - - - - - f ~ - _ - ~ ~ t• Yom' 'r~;'
DOES UTILITY CONNECTION REQUIRE EKCAVATI-ON IN PUBLIC RIGHT.-,0F,.WA'Y'' .
- j
YES IF YES, THEN A "PERMIT FOR WORK WITHIN
- PUBLIC RO bWAY"! MUST BS,'ISSUED BY THE
~7 NO ENGINEERING DIVISION. LIST AS A CONDI-
TION. h
y .
- e
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: :r
1.
TITLE: ~-y.~.~ rzv-~
DATE:
J
f
1 '
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
P~ 2Q3
INCLUDE 2 SETS OF PLANS
CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For: +
7 Valuation: (v (o Od0 Date:
Site Address: Zle(o9 -6L.UE 4A-1 Lc,~ OFFICE USE ONLY
Lc-wFu-~ma
Lot: Block q Sect/Sub ►oUZL Erect Occupancy (Z 3
Remodel Zoning
Parcel # Repair Type of Const
Addition # of Stories
Owner Move Length
Demolish Depth
Address Int.Impr. Sq Ft
Install
City/Zip Code
Phone APPROVALS FEES
Contractor 0IeVtI A 1 TVVMPS M assessments Permit 3,51
Water/Sewer Surcharge
Address 1 12_ 't}y?IG I N S I? &d2-S9g h0 Police Plan Review oS so
Fire SAC S-7j
City/ Zip Code M 11~11.1L-SITJ IC ,4 M" S' SM3Engr Water Conn 500
Planner Water Meter
Phone 7 Council Road Unit 7- L)
t~
Bldg Off • Treatment Pl / j(o
Arch./Engr. APC Parks
Variance Copies
Address TOTAL
City/Zip Code f J
Phone #
CLARK ENGINEERING COMPANY • 2815 WAYZATA BOULEVARD • MINNEAPOLIS, MN • PHONE: 374-4740
IFICATE OF SURVEY FOR:
ORRIN THOMPSON HOMES
A Division of U.S. Home Corporation Scale: 1" = 30'
• Denotes iron monument
Denotes wood stake
x900.0 Existing spot elevation.
BLUE JAY WAY
90 7.2 9as.~ 905, 2
5 89° IT 5 I" E 63.. -905.6
o ~
111 M, 0
0,0
IC? -907.EXISTING EL..
106 909.23=PROPOSED C,ARACA SLAG EL.
N-1
d o-___28_83____ 11 _-43
M 22.17
~ M
12.5 O d` N
0 A~ c 5.33 N a I-
N
6.0 11
- -NIB
i7.5_
w ' N -3
j
11 34.0 1 %D
17-
Q
d'
C 0 LOT ii o
ro (0
1 ,
I
~q 2
I
0002~~
0
Lot 11, Block !4,
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 R iste ed Land Surveyor under the laws of the State of Minnesota.
MN Reg. No._L_5Z Ze Date Z' ~6 ',6 (
Proposed House _X As-Built House, Drawn by P--^/ 'Project no. 85104
Use BLUE or BLACK Ink
t
- Mzm~
City of Erot
~_U0 I Permit Fee: t
3830 Pilot Knob Road U~ j t
Eagan MN 55122 1 I Date Received: I
Phone: (651) 675-5675 I _ I
Fax: (651) 675-5694 j staff• j
2010 MECHANICAL PERMIT APPLICATION
Date: =-~Ijd Site Address: LWW
Tenant: Suite
f~
RESIDENTIOWNER Name: Phone: (Ps~-24~ ' 39
Address / City / Zip: ~KDO
CONTRACTOR Name: iw =ci^ f
Address: 1 ~L V1~~ A City: a1pli)_~
State: { Zip: Phone:
Contact:
TYPE OF WORK New _ Replacement Additional -Alteration Demolition
Description of work:
r~t e rttc... a it C
tte.. ~C. ~eniog.metho s ;
eats , 1 th~ lle~hanicat,(nsRec,o.kfo ~ilifonnatton ort~.pe"' il.
RESIDENTIAL COMMERCIAL
PERMIT TYPEFurnace New Construction Interior Improvement
-Air Conditioner Install Piping ^ Processed
_ Air Exchanger _ Gas _ Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank Install Remove)
When Installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ _ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50 Minimum (includes State Surcharge) Permit Fee
If Permit eP is less than $1,000, surcharge is $.50.
- If Permit Fee Is > $1,000, surcharge Increases by $.50 for each Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
ti5SCO TOTAL FEE
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 dlg to receive locates of underground utilities. www.aooherstateonecall.ora
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 riot 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
wi the approved flan to the case of work ch requir a review and approval of plaric
CY x - ~-~x► n~~n (~~yny
Appllcanrs Printed Name Applicant's Signature Y
0!
rVv
Y•..R..:.~ :•~T C: " K " .L
Emenor-HVAC Screening inspect)on:::,:i: 1 9`'/ ) `
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA144171
Date Issued:07/17/2017
Permit Category:ePermit
Site Address: 3669 Blue Jay Way
Lot:11 Block: 4 Addition: Lexington Place South
PID:10-45060-04-110
Use:
Description:
Sub Type:Reroof & Siding
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: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
John P Holmen
3669 Blue Jay Way
Eagan MN 55123
(651) 216-3973
To Serve Contracting Llc
5407 Boone Ave N
Brooklyn Park MN 55428
(763) 425-7663
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155072
Date Issued:04/26/2019
Permit Category:ePermit
Site Address: 3669 Blue Jay Way
Lot:11 Block: 4 Addition: Lexington Place South
PID:10-45060-04-110
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Nicholas Kroeger
3669 Blue Jay Way
Eagan MN 55123
(651) 353-2625
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA160407
Date Issued:03/09/2020
Permit Category:ePermit
Site Address: 3669 Blue Jay Way
Lot:11 Block: 4 Addition: Lexington Place South
PID:10-45060-04-110
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Nicholas Kroeger
3669 Blue Jay Way
Eagan MN 55123
(651) 353-2625
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature