4043 Albany Cir
100I-':+1C>
Use BLUE or BLACK Ink
r { I For Office Use
/i
Permit
City of Ea o~
3830 Pilot Knob Road Permit Fee:
I
Eagan. MN 55122 j Date Received:
Phone:' (651) 675-5675 I
Fax: (651) 675-5694 Staff: l
2010 MECHANICAL PERMIT APPLICATION
Date: Site Address: L43L1~ ALBAN-/ Cl RC L.~t-
Tenant ' Suite
RESIDENT / OWNER Name: Ocr-B bi~- Ks p t) sKy Phone: (.S I- 69(o 4$'11
Address/ City /Zip: L4O H 3 ALBAN y (,I iLCLLct, , CiAbA k) 'S6 I Z3
CONTRACTOR Name: FL_A.Pnc- H-, A-t i o b + A j L -10C.. License
Address: C1~603 PLY P' b0Tk A )rl- ~Ji City: &OLMW U ALlcc'/
State: MN. Zip: 5541:4 Phone: i63- 514 7- -1ILOLP
Contact: t.A~bY j-jY) Email: F,-rColY\
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work: I~B.PiA.c .i~~ U`t of Ccx isi tNi, pe-'o A ter-
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
/ RESIDENTIAL COMMERCIAL
PERMIT TYPE V Fumace New Construction _ Interior Improvement
Air Conditioner Install Piping _ Processed
Air Exchanger Gas _ Exterior HVAC Unit
_ Heat Pump _ Under /Above ground Tank C_ 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) $ 50 J® TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ X1%
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
- If Permit Fee 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).
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 dig to receive locates of underground utilities. www.gopherstatoonecall.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 st ithout a p rmit; that the work will be in accordance
with the approved plan in the case of work which requires a review and approval of pla
x !N-V0jiS I N'->mPSz~ti-j X
Applicant's Printed Name App rcant's Signature
FOR OFFICE USE Reviewed By: Date: _
Required Inspections: -Under Ground Rough In -Air Test __.:Gas Service Test -In-floor Heat -Final
Exterior HVAC Screening Inspection
c~ l~- - - A
43 J . f-vg *a
Request )ate Fire No. ough-in inspection J
Required? YJ Ready Now 0 Will Notify Inspector
" Z G Yes ❑ No l When Ready?
1 licensed contactor D owner hereby request inspection of above electrical work at:'
Job Address (Street, Box or Rouwflo.) City _
Section No. Township Name or No. Range No. County
Occupan PRNT) - Phone No.
Power Suppli Address
Electrical C tractor (Company Name) - Contractor'. License No.
a ~ ao 3 g
Mailing Address (Contractor or Owner, Making Installation) -
Authorized Signature (Contracto Owne Making Installation) Phone Number
14-3-
MINNESOTA STATE BOARD OF E! CTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. Room S-173 BE ACCEPTED BY THE STATE BOARD
1821.. University: Ave., St. Paul, MN 55104 UNLESS: PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION' ' Es-00001=08
P, ► See instructions for completing this form on back of yellow copy. `
J43 7 `4X Beiow Work Covered by This Request ` SIC3
ew Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
I Other (specify) Contractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool O to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs Inspectors Use Only: TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED' DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1S MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has Final pate
been made.
OFFICE USE ONLY
This request void 18 months from
1 YL
4 3 0 2~ rt) ~sp
Request Date Fire4Yo. Rough-in inspection
Required? ❑ Ready Now V Will Notify Inspector
Z Yes ❑ No When Ready?
I Zlicensed contractor Downer hereby request inspection of above electrical work at:
Job Address (Street,. Box or Route No.) City
Section No. Township. Name or No. Range No. Cod"k
Occupant RINT) Phone No.
Power Supplier Address
Electrical C E I IZ pan y Name) Contragtor's License No.
o3~I
Mailing Address (Contractor or Owner Making Installation)
Authorized Signature-(Cont tor/ ner Making tallation) - 74,~3umber
. r,
MINNESOTA STATE BOARD _OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS -
Phone (612) 642-0800 ENCLOSED.
9 '~-REQUEST FOR ELECTRICAL INSPECTION y"F EB-00001-08
10- See instructions for completing this form on back of yellow copy.
n
J -3 72 ;X°'-Be/nv Work Covered by This Request
New Ad Rdp.Type,ofBuilding Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks: - -
Compute Inspection Fee Below:
# `Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps I 0 to 100 Amps '
Transformers Above 200 Amps Above 100 Amps
Signs ` Inspector's Use Only: TOTAL
Irrigation Booms /
' c~bs-b
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHI MON S
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has Final Date
o4 OL
been made.
OFFICE USE ONLY
This request. void 18 months from
U
Of EA"+"' 4
383 Pilot Knob Road ~
Eagan, Minnev#s 55123
(612) 681-4675
4043 AlsAmy C1* v0 so' nit Jam.
HILLS f S 7001 Mi010+89 300 0 ,sr f 4
PER 7 Y x~1SULA
TION FINAL
t
asy
f
a PWV* Hoktw Dote T #
JIM
R
-x +C~mn~anta
4
Of,
n
777 ,717-,
truer -
con4 slow
BfV, Riud
Deck Fbg
ft. o*v.
,Address: 4043 ALBANY CIRCLE Lot 7 Blk 3 Sec/SubHgLS OF STONEBRIDGE 3RD
hese items were/were not complete at the time of the final inspection.
Date: 8/21/92 Yes, I No TnspPctore
inal grade (6" from siding)
ermanent steps garage
ermanent.steps - main entry
ermanent driveway
ermanent gas
od/seeded grass
rail/curb damage VII
orch
asement finish
eck
lease verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside-lawn faucet before
freeze potential exists. 9
AEGICLFD VAVEA
White - City copy Yellow - Resident copy Pink.- Contractor copy
PERMIT ( Control No. 0506
CITY Of EAGAN
3830 Pilot Knob Road PERWT TYPE-,_: „BUILDING
Eagan, Minnesota 55123 Permit NuMber: 0!06216
(612) 681-4675 Date Issued: OS/26/92
SITE ADDRESS:
4043 ALS"V C1'R
_ MILLS OF 5TOlIILORIA#11! IIk1D>>,;
DESCRIPTION:
Bu l d l" Pora,Ir t,.:,.Typ - SV 4-„
Building Work Type NEW
UBC occupancy
R- Construction Type
Zoning -i x
Building L*ngth
Suilidt"ag- Width
}
REMARKS:
RECEIPT C)i S&W 0111.62. VA'
FEE SUMMARY:
.VALlIMTIQN., ,>~10~x~~m.>.~, F
4
Base Fos ~ tS..60 ISC 1
Plan **view *601.2S -Total F** #
3urchargs $02 s
SAC
SAC % 100
SAC Units 1 ^
r Su►total is 2M6. a ,
V_e.
71 - 'i
CONTRACTOR: - 4001 wont - ST- I E) rIEI :
T1W "TTLU*O CO T*C 14710$04 000181 ROT'TL>1 O CO
6301 IE- RIVER no 6201 E IISZ IR R
FRIDLEY 00 55421 F'RIOLly Nit, 5021 ,
(611) 571-0304 ( 612)671. 0"4
I hsrvby acknowledge that I have read this applicatlen and state that the
information is correct and agree to comply with all applicable State o#-Mn.
Statutes and City of Eagan Ordinances.
5
APkI ANTJPE yftEE SIGNATURP MUED BM M A ' E~-
X5®6
INSPECTION IRI
CITY OF EAGAN PERMIT TYPE: #~t~i glt
3830 Pilot Knob Road Permit Number: 1111;
Eagan, Minnesota 55123 Date Issued: a!202;
(612) 681-4675
SITE ADDRESS: APPLICANT;
LOT`s 7 RLO'CK t 3 n .
4043 ALSAII'Y C1#1 THE *OTTLOOD 90 INS
NI-LLS Of STO110MIDef SAG (6:32) 071-0*04
PERMIT SUBTYPE: TYPE" OF WORK:
*P s -
FOOTING FRANINB
FIMPLACE
..„;tl(11A#ICSt RECEIPT ♦ SiW hLI R. 1lIiLiLlE1' l11 6I
a V
FERMI , CITY OF EAGAN RECE Y17 o-J
i i Y'2 0 992 2 BUILDING PERMIT APPLICATION MAY 2 ~ 19012
681-4675
s7
SINGLE & MULTI-FAMILY '2 sets of plans, 3 registered site surveys., I copy ref energy-',
calcs.
COMMERCIAL 2 sets of architectural & structural plans, I set of
specifications, I copy of energy calm .
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot change is re uested nce gormtt-is-issued.
~
Date 5 / - Valuation of work J-18
Site Address: 4043 Apt Gitt~+e-
STREET STE 1
Tenant Name : ~ v od Gcs•
LOT BLOCK P.i.D. t
Description of work:
The applicant is: Owner Contractor 0 Other (o"cr;be)
Name 'C1m.: f o++NuhA Co. 2 ffc, Phone '
Property LAST FIRST
Owner Address SZO4 "
STREET STE S
City ickla State zip ._-T
t
Company Phone
Contractor Address License
City State Zip
Company Phone
ArchfteW
Engineer Flame Rogistration ~
Address
City State Zip
Sewer & water licensed plumber 1V b' ~ Pr t time for
sewer & water permits is two daysvonce drea has been pproved.
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.
r
Signature of Applicant: 19U 4tQ )dMMj_1---
BUILDING PERMIT TYPE
Q 61 Foundation ❑ aS Apt. Bldg ❑ 09 Basement Finish ❑ 13 fuhlt Fa
if 02 SF Dom. ❑ Ob Garage/Accessory ❑ 10 Swint pool t~ 14 A icou . Sri
0 03 Two family ❑ 07 Fireplace ❑ 11 Res. Add. / rtfi 15-*ii ems' oous
❑ 04 Multi-fm. T.H. CI 48 Deck ❑ 12 Comm. Ind. ~-r
.VM, RI# TYRE
*W31 New ❑ 34 Repair ❑ 37 Demolish
❑ 32 Addition ❑ 35 Tenant Finish ❑ 99 Undefined
Q 33 Alterations ❑ 36 Move
GENERAL INFORMATION
Const, (Actual) V_ h4_ Basomt sq. ft. 14KC System., Y
(Allowable) y- 1st Fl. sq. ft. " City Water
UBC Occupancy -t 2nd Fl. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
f~of Stories Footprint Sq. ft. + fire -Sprinkler
Length On-site well Census Code
Depth Deg-site sewage SAC Code ~
APPROVALS
Planning Building 5.z~z Assessments
Engineering Variance
REQUIRED INSPECTIONS
Q Site 0 Footing ❑ Framing 0 Insulation
Wallboard ❑ Final ❑ Draintile ❑ Fireplace
Permit Fee 86 . 5'"e' wtutora: s C'a a
Surcharge 192 22 = eta r.
Plan Review ~j, a x
License '
r"' 2 tt>
City SAC dd , o 0 ~e
Water Conn. 15, b 0
Water Meter x v /D e q
Acct. Deposit 3a.~o t-
S/W Permit
S/W Surcharge ~,6-0 12 X 1 q % Ae
Treatment P1. oa
3 $0 o a 4,6
Road Unit
Park Ded. 15T f~.o cxya.,
Trails Ded.
Copies 8~t T~
Other ;Z Y 7 t ~I
Total : t 9
Units % (Dig
~7 2~ Z .
~t
IV 0 -F~0,0
* 2422 Enterprise Drive
Mendota Heights, MN .55120
(612) 481-1 4-Fax` 9488
PIONSE:R U00 SURVEyaPtS • CIML ENGINEERS
engineering LAWD pt • LANZSCAPE ARCHITECTS 625 Highway IQ t SrtheOSt
Blaine. MN 554,34"-
(612) 783-teW-Fux 7,83
Certificate of Survey for: Th e-, RO
House Address: Albany Circle Eat n N
odel Name: Madi v t. 1
'L Q3 ?
9 .
° 06 4,~"
51
i 1
1 - Acs`.
A
IdL
`i
Q
lei
-J 1b
1n~` / nI
1E Vq.
G ~ s
L•
X 9W'0 Denotes Existing E.levcvUon
,490 Denotes,,. Proposed Elevation Lower Or
- - Denotes Drainage & 01ity Easement Top
x
Denotes Drainage now Direction
Denotes Monument age ~ ~r A7 3
---a Denotes Offset Hub ' . Bearings'-shown ar* ~assur d
T 7 B LO I ` f
LS-
------r-
DAKOTA - r-WNTY. MINNESOTA - - - R T F}
1 'he►eby'eertify that this mrxvey, pfan or rtpert was prepared by one or urufet p~a~ireot ~ that ! are the/'
under the laws of the State e# Womsote. D$ted this day of M p~ a.ft: t~w:
t ~y
jag) WON
o3tXt.1o
F?(TF. t!OR FNVF.i,nl'F AVEUAGE "ll" ct)mT tj,rAT V)11
OWNER ;x
«
SITE ADDRESS l-, e5 7 Q+c✓~ c s cs j' vim,
CONTRACTOR
bete in working. square footw.-e of each.
1. Total exposed vall ea • « 1-8)'? rte, ' sq. ft. X 0. 11
' 2 Total roof/,ceiling rata . « 7!!± aq ft. X, D_
Total exposed wall are ft nbove floc+r
a. Total, wall window area « « . • "
b. Total door area
cr Tonal sliding glass door area
d. Total fi replai: a vall area , . « . « « e. Total wall framing
area {average 10%}
Sr Total net wall area above floor
s B• Total rim Joist are& •
Total exposed foundation area
h. Totaa foundation. window area .
3,. Total net foundation area hbove grade . « « . « .
q
} Determine "u" value o; each wall nt•
0 01, stuff
Stuff
nut,. ,
d. to to
e. x .ttU:, -
'
-77
x US
h
x t'lln
,tuts ael - !
~r • ~ w w • ~ ie-r • • ♦ • • « r r « « « s« . r Tat.a] iir I .
If item 13 ~ the some +es. of 10sn 1,la-,n i Lem *1, ~ o wt t
of SBC 6006)?.
41
Total exposed roof/ceiling area = ~•G,.j ~i
,Total gross roof /ceiling area Total` sky- t area a ~
k. Total root'/ceiling framing area..... • •
1. Total net-;,,insulated roof/ceiling area
x
Determine: "W' value for ench roof/cal t Int etpKst..
k. X
fry. „U,
Total
if total of #4 is the same as, or less than w2, you have met the intent of
SBC 6006(c)l.
To utilize the total envelope system method, the values establishe$ by the
sum of items 13 and tit shall not be greater. thin the suss of iteacs #2 and N2.
• X53{~'.,.-
w
` /A 6 f T
D 044T
1 -7,j
,30yOATHlN(or ; 0,4f -
~4 7ft' lH%t-Ajlr*4-
-77
-rF - A 4 lup
M;F W 4p
40
PL444- VIEW.
(0,12 ,rat C~. t6p, qb A 0.0+%)~,w.• 0.
W-V
t) ,."4fpq
f Iww
C t . c is w
a
-14
1
s
~.....k WY.lM~rgaw~iwrwl~r
02-
Oft
f-w-may. Y:
~7~ -
n4
, op
tw* 0.10
n
L" BL 3 CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
SUBD. (612) 681-4675 RECEIPT Q
DATE.
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR AC S AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT. _ I -------i.I...Y-i~~i~M~.~~Y.►4.M ~~.M 1Ye M.M~M NM.. M W. Mr YaWY
WORK DESCRIPTION COMPLETE THE FOND:
NO. FIXTURES EA. TOTAL
NEW CONST REPAIR/ADD ON U.00
ADD ON SHOWER 3.00
REPAIR WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
OWNER NAME: KITCHEN SINK 3.00
LAUNDRY TRAY 3.40
SITE ADDRESS: HOT TUB/SPA 3.00
_ WA-,ER I iEATEA 3. 000-_
FLOOR DRAIN 3.00
GAS PIPING OUT.
INSTALLER: (MINIMUM - 1) :3.00
ROUGH OPENINGS 1.50
ADDRESS: Vn4m] OIJ OTHER
Q~WATER SOIgNER s .
CITY: ZIP: PRIVATE DISP. 15.00
PRONE t {)L U . G RNAROU 3.00
W. TURNAROUND 15.00
' STATE SURCHARGE 50
SIGNATURE OF PERMITTEE TOTAL: '
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME: CONTRACT PRICEt,
SITE ADDRESS: 1% OF {Cc■')}~~~NMCT''Mt.
STATE
TENANT NAME: EACH 41,000 . OF MMIT Fly` "
SUITE $25.00 14INM3M M.
INSTALLER: CONTRACT PRICE x J%
ADDRESS : STATE SUR GE -
CITY: ZIP:
TOTAL-
-PHONE
FOR: (SIf3iT1)
CITY OF EAGAN
i 7 ` 9L CITY OF EAGAN CITY USE ONLY
„f PLUMBING PERMIT
StTBD (612) 681-4675 RECEIPT
DATE
RBHID~TIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOk TOMOM AMD;CONDO
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
qp#.-----1YP---w-.--!•I ----YY- --.+F+4F4f4*'~vw~r~V..+.r+M'~a
WORK DESCRIPTION` COMPLETE THE FOLLOWING-
NO. FIXTURES EA.. TOTS.
NEW CONST REPAIR/ADD ON 15.00 _
ADD ON , SHOWER 300
REPAIR WATER CLOSET 3.00
a MTH TUB 3100
A'4 W 1
OWNER NAME: KLkv*TORY
ITCHEN SIM .00
ISITE-ADDRESS .A~~ ~ . _
HOT ~ Tug/SPA 3-00
WATAR: HE&TER 3.00
FLOOR DRAIN 3.00
CAS PIP-110 T .
INSTALLER: n I (MINMM - 1) 3.06
ROM OPENINGS I
ADDRESS OTHER
VCITY: ZIP: ~~--~J''Z---- AT~t
PRIVATE DISP 0,00
U.G. SPRIG 3.0+0,'.
PHONE W. T'u!.
STATE SamcK;
SIGNATURE OF PERMITTEE TOTAL'
CO IAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL./INDUSTRIAL BUILDINGS. .ALSO, FM 7 4AMILY
WILDINGS WHEN S19PAFtATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME
CONTRACT MICE:
SITE ADDRESS 1% OF CONTRACT FEE
STATE S .CMROE - $-50 F ft
T T NAME: EACH $1, 000 .0 PIT M.
I
SUITE $25.00 MINK S to
INSTALLER: CONTRACT MICE x 1%
M M! Ir-~iyM, 11
i
ADDRESS: STATE SURCHARGE
CITY: ZIP.
TOTAL: $
:
PHONE
FOR: (SI ;TURF)
CITY OF EAGAI
CITY OF EAGAN FOR CITY USE ONLY
` 3830 PILOT KNOB ROAD
EAGAN. NN $5122 PEom
PHONE 412 454-8100 RECEIPT
x;;f DATE:
PLEASE COMPLETE `UPPER PORTION ONLY FOR SINGLE F AY ` iYLIN Z
t TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
---Yuan- ------W i►MY~~~~rr~i• Wi~Y 1MaY----r--ir------Yr--4- VM-.w-
WORK w MAW rYY rF.14 +M1W Mri~WF~w.~
DESCRIPTION FEES
NEW CONST , ADD-ON MTNIM 1S
ADD ON HVAC 0400 m vm
REPAIR ADDITIONAL 50 N 37U ~t
GAS OUTLETS - MIVDM 3.0
OF 1 PER PEI."T
OWNER NAME: d
SUBTOTAL: $ ° „ • clr>
SITE ADDRESS : Q STATE SURCKAU :
LOT : BLACK SURD. TOTAL:
INSTALLER: FM & I
ZIF
ADDRESS: 7 S E C~. FEMITUE b
CITY: ZIP:
PHONE
PLEASE COmPutTE THIS PORTION FOR ALL RCIAL~N~RZ~1L surd s,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS itM SEP ARATI 'PER TS ARE
NOT REQUIRED FOR:EACA WELLING UNIT.
S
Y aYYSliM-- rY---rr raMM:ir+rrlilY ~+r - r- Yrn+r+Irr+r+riilr.rirr tsar YrYrYNr+Irali+IwYlrYYrlr-IHi!MrYrrr rrr NtIrsrYW+WM~k!►.rMriFYriYM.++b~wir..Yr[+~wrt+~lip
CONTRACT PRICE:
OMR NAME: It OF MCT F
STATE SURCHAMS $ : 50
SITE ADDRESS: EACH $1,000 OF~~PiER M.
PROMSED PIPING - $25, •
LOT: BLACK SUBDY $25.00 I1SIMM M. INSTALLER: COWMCT ,PRICE x It
ADDRESS: STATE ,CNAM
CITY: ZIP: TOTAL: $
PHONE
FOIL:
CITY OF EAGAN
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan r ~
3830 Plot Knob Road, Eagan Mit S5132
Telephone # 651-675-5673 FAX # 651-675-5694
complete for: Single Family Dwellings
Townhowes and Condos when permits are required for each uait
Date 1 f
Site Address unit #
Property Owner ~-f'
Contractor KP, PiPEWORAS
Address MN 55123 city
1340
State Zip Tene # >
The Applicant is owner retractor Other
tic System Now, Refurbished Submit 2 sets-of plans and MPG Roense;
100.CJQ
Includes C,ow* fee. Additional co tart fees may apply.
AI#erations To E ' Dwelifug Unit, Including $ 50.E
..;,Adding Wires to lower levels or room additions, excluding water soar mid ter heater
Abandonment of septic system
Wafter ttrmaround X18" meter if needed - $121.0})
Other
RPZ new hatakillon repair rebuild
30.x}
Lawn frrtation system
t
water softener ftter heater
replmertit a~tiona!
serge AUG 2 2Q03 , Sta
Total . By
I hereby apply for a Residential Pluming Permit and acknowledge that the motion is c and' a ,'it " 1Wi11.
a
be in conformance; with the ordinances and cedes of the City of Eagan and with tl 'lbing tbat I under d it
-not
permit, but only an application for a permit, and work is not to start without a perm t; t the w will be in auwordanoe with the
approved plan in t2ns caw of work which requires a review and approval of plans.
1
r~ +
Applicants P t A plicant s St e
00
1- RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Mew 9onsfructfon4ru~del~tectait tee P
3 registered site surveys WW*N Sq. ii: of tot, sq. it of house; and a roiled areas 2 copies of plan Cart otn -Y- -N
(20% maxirmmm lot coverage allowso 1 set of Energy Galcuta om for hid addib s TMPMPWPJXO - Y N
2 copies of plan std{ butt & wk*w sites; pound found deso, etc. 1 site survey for additions $ detest Tree t ( -Y ,,N
1 set of Energy Calou ltatiruts AdMon - itdcata don-site seek system t3" n Y _N
3 copies of Tree Preserx r Mein # lot platted after 7t1193
Run Joist Detall Optiorts (bldgs with 3 or less units
Date I 1 Constredtion Cost
Site Address 'e ( uVittste
1&4 YOM nA -7 r
Deseription of Rork n 'aas
LI/ /vim
1► ilti-Family Bldg Y N Fireplace(s) 0 ~C Y 3
pt operty thvner 7-f (I P Tdone) t
9-4~ 2-1
Contractor
Address ~ ~ ~ ct•✓ ~ 1 ~ city
state Zip M Telephfom ; D G
CtP4TE THIS ARIEA ONLY IF CONSTRUE
Energy Code oty '~sota RulKs 7¢70 Categm I
submission types) • Residential Ventilation Category 1 Worksheet • Now ~y Owe warsaheet
Suited 3t~rttff~d
4 ! Energy
on,
Have you previously constructed a lauil i n w t si r plank ~ Y W N If so, p4 4evfew
h 0a3
5~41
fee applies.
Licensed Plumber Telephone # ( }
Mechanical Contractor Q Telephone #(qo) ~-j®r,2
Sewer/Water Contractor Telephone #
I hereby, apply for a Residential Building Permit and acknowledge that the. info 4 n.is i:ple,14 a. W acquras o;
that the work will be in conformance with the ordinances and codes Of the City of Eag , i the Stite of
Statutes; I understand this is not a permit, but only an application for a permit, and work i not tD OW wi out a
permit; that the work will be in accordance with the approved planin the ease of work which requim a toview and
approval of plans
Applicant's Printed Name Applicant's Signatizr
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA081072
Eagan, MN 55122 . Date Issued: 11/14/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4043 Albany Cir
Lot: 7 Block: 3 Addition: Hills of Stonebridge 3rd
PID 10-32992-070-03
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
New Life Contracting Inc Joseph D Kordosky
2478 Hillwood Dr E 4043 Albany Cir
Maplewood MN 55119 Eagan MN 55123
(651) 274-6943
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
!"
#$%&'()' *+*,
-./$%'"&0-1 23/4$,+
-./$%'53/4-.1 67878GK
;*%-'!<<3-=1>9?7P?@>7A
-./$%'#*%-+(.&1- -./$%
B$%-'6==.-<<1''8>89''624*,&'#$.''
"#$ %& ''\[)**+ + , ''T+$$<'ZE'= ,.?0+*J.'\[0*
456 789\[!VV!98\[98"8'
;<.
;-<D.$0%$(,1
=>?'@AB. C.<+*., +/$
D 0&'@AB. C.B$/%.
6.<%0+B + , D/ .0'T./ .0
F. .0'=+G.F. .0'@AB.F/,>E/% >0.0=.0+/$'H>I?.0C.I .'H>I?.0 +,.'=+G.
4$./<.'%/$$'#>+$*+,J'5,<B.% + ,<'/ 'K(:7L'(":9:(":' '<%3.*>$.'/'E+,/$'+,<B.% + ,M
#(//-,%<1
-/0? ,'I , N+*.'*. .% 0<'/0.'0.O>+0.*'P+ 3+,'78'E.. ' E'/$$'<$..B+,J'0 I' B.,+,J<'+,'0.<+*., +/$'3 I.<'KF+,,.< /'= / .'
#>+$*+,J'- *.LM
4 '9'4.0I+ 'Q..'KD='RS 0'DTLU:VM88'8W87MX8W"
E--'B3//*.&1
=>0%3/0J.9Q+N.*U7M88'V887M!7V:
"(%*21
FG>H>>'
#(,%.*D%(.1IJ,-.1
9'')BB$+%/, ''9
-3/IB+ ,'4$>I?+,J` <.B3'6'\\ 0* <&A
\[("8'6 **'C*M_'c788X8X\[')$?/,A'-+0
Y/J/,'FH''::7!\[Y/J/,'FH''::7!\[
K(:7L'\[(:97\[X8K(:7L'!XW9((87
5'3.0.?A'/%&, P$.*J.' 3/ '5'3/2.'0./*' 3+<'/BB$+%/ + ,'/,*'< / .' 3/ ' 3.'+,E 0I/ + ,'+<'% 00.% '/,*'/J0..' '% IB$A'P+ 3'/$$'/BB$+%/?$.'= / .'
E'F+,,.< /'= / > .<'/,*'-+ A' E'Y/J/,'Z0*+,/,%.<M
)BB$+%/, S4.0I+ .. '=+J,/ >0.5<<>.*'#A '=+J,/ >0.