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776 Bridle Ridge Rd PERMIT City of Eagan Permit Type: Plumbing Eagan. Permit Number: EA098120 Date Issued: 03/02/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 776 Bridle Ridge Rd Lot: 4 Block: 13 Addition: Bridle Ridae Ist PID: 10-14996-040-13 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: deb larson 8815 209th st Lakeville. mn 55044 952-469-6999 Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 Total: $».00 Contractor: - Applicant - Owner: Drain Pro Plumbing Daniel K Tweeton 881 - 209th Street W 776 Bridle Ridge Rd Lakeville NIN 55044 Eagan NIN 55123 (952) 469-6999 I hereby aeknowledae 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA078493 Eagan, MN 55122 . Date Issued: 06/25/2007 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 776 Bridle Ridge Rd Lot: 4 Block: 13 Addition: Bridle Ridge 1st PID 10-14996-040-13 Use Description: Sub Type: e-Fireplace Construction Type: Work Type: Gas Fireplace (new) Description: Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: Chimney/flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Andrew Hoffman 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: Fireside Hearth & Home Daniel K Tweeton 20802 Kensington Blvd 776 Bridle Ridge Rd Lakeville MN 55044 Eagan MN 55123 (952) 985-6675 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 PERMIT City of Eagan Permit Type: Plumbing 3830 Pilot Knob Rd Permit Number: EA085470 Eagan, MN 55122 . Date Issued: 08/21/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 776 Bridle Ridge Rd Lot: 4 Block: 13 Addition: Bridle Ridge 1st PID 10-14996-040-13 Use Description: Sub Type: e - Fixtures Work Type: New Description: Main Floor Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: matthew huntington 15230 carrousel way rosemount, mn 55068 Fee Summary: PL - Permit Fee (miscellaneous) $50.00 0801.4087 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Matthew Daniels Daniel K Tweeton 15230 Carousel Way 776 Bridle Ridge Rd Rosemount MN 55068 Eagan MN 55123 (651) 423-3730 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 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: I t;a (612) 681-4675 SITE ADDRESS: APPLICANT: toil, l l'ffw... kii it.i t11 itj IIi:I')1 1;4 ~-AC-11!!ai I l i t s €d 1 1'1 f t t., i r,! i ,;-1 7 Rd PERMIT SUBTYPE: TYPE OF WORK: ol! i.I INSPECTION TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR. IL Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Fig. Deck Final Well Pr. Disp. BLDG. PERMIT NO. r 01-3210 Bldg. Permit 01-3422 Plan Check J UO 01-3445 Surch. /Adm. 01-3446 SAC/Adm. s C) 01-2155 Surcharge -~,3860 Road Unit U~ 20-2275 SACS 20--3865 Water Conn. J 20-3868 Water Trmt. 20-3716 Water Meter ~r Cx-) 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. i X3855 Park Ded. TOTAL chi T, J J(._,i (Urtifiratt of (Orruvttnr 4Citp of (Eagan Meparim i of WuiibiM ImWertim 4 This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following.• ••RR r Use Classification Bldg. ltrmit No. Occupancy Type R3/M.1 Zoning District PD/ R1 Type Const. Owner of Building S y Address 5516 MI.M-1, Building Address 176 DRIM, FJDGE MAD Lmality L4, B1.3y. 9 Date: Building Official'" POST IN A CONSPICUOUS PLACE e- CITY OF EAGAN Permit No: ?-)660 Date: 6-13 3830 Pilot Knob Road Meter No: Size: P.O. Box 21199 Reader No., Date: Eagan, MN 55121 Owner: .°SM Ficrv-t t Site Address: 776.1 rifle Ridge Pi' 1.4 7!1' Bridle P' -Lr'e Plumber_ ke Side Pltsmb S5C.00PIi Conn. Chg: Zoning: Acct. Dep: -i5•t:►z~ No. of Units: Permit Fee: Cyr Surcharge: • "~4p: 1 agree to comply with the City of Eagan Tr. Plant 104.00P d Ordinances. Meter. 67 _ 00A Misc.: By WATER SERVICE PERMIT CITY. OF EAGAN Permit Na Date: * 3830 Pilot Knob Road B/P No: Date: P.O. Box 21199 Eagah,%AIQ 55121 Owner 7 Site Address: 7 3 r - =ja tee F 1' ST3 1,;i Plumber: owe 7-•~r MWCC: S5~.- Zoning- City Chg: 1 fit'! . No. of Units: Acct. Dep: Permit Fee: E^~ ?[lp,x I agree to comply with the City of Eagan Ordinances. Surcharge: Misc.: By SEWER SERVICE PERMIT CITY OF EAGAN 3830 Pilot Knob Road, P.Q. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 141 BUILDING PERMIT Receipt #S g:r To be used for &I+ DWGIGAR Est, Value $69,000 Date-HAY 3 19 Site Address 776 BRIDLE RIDGE ED OFFICE USE ONLY Lot 4 Block 13 Sec/Sub.BRiME R1'14't'-~ VS'~ On Site Sewage Occupancy R-3 11-1 - PIE) MWCC System Zoning Parcel No. On Site Well (Actual) Const V--N Name R5N. n 'Es' INC City Water X (Allowable) V-N z Address 5 516 180Th ST PRV Required # of Stories 3 o f r,.E` r,_ Booster Pump Length 38' o City P 1.'i 0f,, LAKE Phone t ..'pis Depth 461 cc (j me SAME S.F. Total 4 - o a Address - Footprint S. F. City Phone APPROVALS FEES Engr./Assess. Permit 4.50 • U-0 ww Name F Planner Surcharge 34.50 s z' Address 225.00 arc City Phone Council Plan Review Q W y n Bldg. Off. SAC, City 100. Ou I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 550. information is correct, and agree to comply with all applicable State of Water Conn. 55010( Minnesota Statutes and Cityrof Egg Ordina S Water Meter 67.0Ci Signature of Permittee f r " ~V r Road Unit 125. 00 A Building Permit is issued to: X28 HOKLS, 1,NC Treatment P1 204. 00 on the express condition that all work shall be done in accordance with al I applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks C$+ O Building Official TOTAL CITY OF EAGAN 3830 Pilot Knob Road, P.b. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING RMIT Receipt To be used far Est. Value Yea 4'' ` Date r t ,19 Site Address t' OFFICE USE ONLY Lot Block Sec/Sub t T"aJ#` rt On Site Sewage Occupancy MWCC System Zoning Parcel No. On Site Well (Actual) Const oc, Name + 4 City Water A (Allowable) $ Address PRV Required *of Stories G t k a,it7--f961ai Booster Pump Length City. Phone Depth p Name ' r4k'f:. S.F. Total o a Address Footprint S.F. P. City Phone APPROVALS FEES m Engr./Assess. Permit W y, Name Planner Surcharge ur Address a m city Phone Council Plan Review Bldg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC information is correct and agree to comply with all applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter Signature of Perm ittee Road Unit A Building Permit is issued to: Treatment P1 on the express condition that all work shall be done in accordance with all parks applicable State of Minnesota Statutes and City of Eagan Ordinances. TOTAL Building Official Permit No. Permit Holder Date Telephone # Plumbing ~6 a H.V.A.C. ee A -OA 1/1 1W Electric , -r S Softener Inspection Date Insp. Comments Footings 1 Footings II Foundation Framing p Roofing Rough Plbg. Y-iy- Rough Htg. Isul. Fireplace 5 a Final Htg. Final Plbg. Bldg. Final Cert.Occ. D-STemp. LP Deck Ftg. Deck Final Well Pr. Disp. _ _ y n:', ' sir: , _ ~ _ ..-v ! ~~~f^ST}1'.' -sr• > y r??G~/'t'.G PERMIT # MECHANICAL PERMIT RECEIPT # ]"flr?1 fC f; CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN,.MN 55122 DATE: CONTRACT PRICE: / ,e^ e-~:" PHONE: 454-8100 cra Site Address &.iox4' 9-D BLDG. TYPE WORK DESCRIPTION Lot cloak Sec/Sub Res. New i itR.- Name 4 c r Mult. Add-on v 41C a~ m Address / i[ 2'v 3 /9 Comm. Repair c City t4f Phone ~ ecv Other ~ FEES Name . i _ l r dii_ r RES. HVAC 0-100 M BTU -$24.00 i C Address ADDITIONAL 50 M BTU - 6.00 p City Phone C I (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM -1 PER PERMIT) - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU $ APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON $ Unit Heater M BTU REMODELS - 12.00 Air Cond MINIMUM COMMPRCIAL FEE - 20.00 - STATE SURCHARGE PER PERMIT - .50 Vent. %CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,440) Other gti FEE f SIC: f, Sl I<IATURE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN -7-. PERMIT # rr, PLUMBING PERMIT RECEIPT # L~ f CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address - o ,BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub Res. Ae New r,kL-- Mult. Add-on Name Y " Comm. Repair _ Address Other E City Phone ~Z: RES. PLBG. ONLY -COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ Name F Bath Tubs - $3.00 E c Address W Lavatory - $3.00 I, p City Phone -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 e 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) (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 STC,f Afi RE OF PERMlffEE FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL:/" 9-~- CITY OF EAGAN Permit No. lj- Date: 3830 Mot Knob Road Meter No: ~ Size: v L P.O.. Sox 21199 Reader No: Date: R' Efigan, MN 55121 Owner:- pcAt M„mpe Sits Address: 3uid,;-,e 1;d L4 B13 Brid -e- i_t _`kr Plumber.- t,, ci t~ P1,~mhin - Conn. Chg: c S n n - , ' i'"! Zenirig: Acct Oep: j-'; Qn 6 NP. of Volts: - - Permit Fee. In )InH - Surcharge: << 1 agraae to complY,w)th !h's 9 t4f# Tr. Plant ~nz. Fnn:D(3 9~din.8pces. Meter. Misc. 8~ . WVATER 4I~RVICI; PERMIT - CITY OF EAGAN N 0- 14 9 31 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH ONE: 454.8100 pgi/r7~{ BUILDING PERMIT Receipt# bJT [T To be used for SF DWG/GAR Est. Value $69,000 Date MAY 3 1g 88 Site Address 776 BRIDLE RIDGE RD OFFICE USE ONLY Lot 4 Block 13 Sac/Sub.BRIDLE RIDGE 1ST On Site sewage Occupancy R-3 M-1 MWCC System X Zoning PD R-1 Parcel No. V-N On Site Well (Actual) Const a Name RSM HOMES, INC city Water X (Allowable) V-N w PRV Required # of Stories z Address 5516 180TH ST E o City PRIOR LAKE Phone 440-6900 Booster Pump _ Length 38' Depth 46' o Name SAME S.F. Total o< Address Footprint S.F. i- City Phone APPROVALS FEES m Engr /Assess. Permit 450.00 Name - 'WW i Planner Surcharge 344.5 i -Address - '0 Council Plan Review _22_.x..9.0 City Phone aw Bldg. Off. SAC, City 100.00 I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 550.00 information is correct and agree to comply with all applicable State of Water Conn. -550-0 n Minnesota Statutes and Ci[ f aaaOr ces. 0 Water Meter 67-0 Signature of Permittee a Road Unit _ 325.00 % A Building Permit is issued to:_ RSM HOMES, INC Treatment Pt 204.00 on the express condition that all work shall be done in accordance with all Parks applicable State of Minnesota Statutes va~nd ACity of Eagan Ordinances. 2, 505.50 Building Official w! A-all, IITI TOTAL This request void/~ e months Iron /YJ ~r q~~ n r~//~ 80 _21046 /3 Request W f, Fire No. Rough-i"I nspection Required ~fleady No~Will Notify Inspec- yes s ❑No for Wh¢n Ready Licensed Electrical Contractor I hereby request inspection of above ❑ Owner electrical work installed at: Street Address, Boa or Route No. City Section No. Township Name or No. ange No. County Occ nt (PRINT) Phone No. s Powe Supplier Address 4 ~Q-c YELri L = L/11 (f~ Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or caner Making Instail tron) y~~s t-~~a gyn. Autho ed S19natur ICo a o 10 r Making Installation) hone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone 16121642-0600 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB`-/0~0(0~001-06 ~ See instructions for completing this form on back of yellow copy. 1 9 E -21046 x" Below Work Covered by This Request And Rep. Type of Si rldnig Appliances Wired Egwpment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Bm ldmg Dryer Electric Healing Commercial Bldg. Furnace Silo Uhloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other peci y Other ISugaifyl 0l h,,, Spec fy Other Other i Compute Inspection Fee Below a Fee Service Entrance Size k Fee Feeders rSubfeeders b Fee evcwts U to 200 Amps 0 to 30 Amps a 0 to 30 Amos Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swinming Pool Above 100-Amps Above 100_Amp, 'Partial er Transformers Irrigation Booms 'JO ,les-rLkl%. Signs Special Inspection S4& b 70T F Henn rks Rough-m i1tQ I, the Elect', C ,7 Inspector, heroby e if ify :het iha above Final tt=~r inspection has been made. This request Void 16 months from This request void / ?L-}/ir 171J Ob 18 nwnths from V E 1-13 30 Request Date FveNo. Rough-~ Inspection Sat /61 C/ Requ ned Reatly Now Wdl NoLly InsPec- &4 Yes ❑No for When Ready Licensed Electrical Contractor 1 hereby request inspection of above ❑ Owner electrical work installed at: Street Address, Box or Route No. / City 2 ~ ~jr; (~C rIGIC r~ ecvon No. Township Name or No. K-FlAnge No. Coon Occupagt (PRINT) Phone No, Powe PPli r Address Electrical Contractor (Company Name) Contractor's License No. Ma ih- n-ress (Contractor or Owner Making Instaila uon) i Autho ed Sig natur (Coot act r Owne akmg Installavonl Phone umber / -6V4~ MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phonp 16121 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION I EB-00p001-06 It Sae instructions for completing this form on back of yellow copy E 1 Y 3 0 ..X.. Below Work Covered by This Request Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighhng'Fvxtures Apt Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm OmFi peci y -ther (SPRnfy) t ,r Speufv Other Othnr i ompute Inspection Fee Below IN Fee Service Entrance size h Fee Feeders/Subfeeders k Fee Circuits 0 to 200 Amps 0 to 30 Amps 0 to 3aAws Above 200 Amps 31 to 100 Amps 31 to Swimmin Pool Above 100_Am s Above ps Transformers Irrigation Booms PartiaSigns Special Inspection $ S"d 1. Remarks T A}7EE Hough-m Onte 1. EI al Inspector. hereby Final cenily that the above Final Onte inspection has been a/ ~ 5 AK made. This repuesl void 18 months from PERMIT C -7 7 o -94 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55123 Permit Number: 0 2 3 8 4 7 (612) 681-4675 Date Issued: 06/10/94 SITE ADDRESS: 776 BRIDLE RIDGE RD LOT: 4 BLOCK: 13 BRIDLE RIDGE P.T.N.: 10-14996-040-13 DESCRIPTION: Btiildih~-Permit Type DECK isuilding 46,rk Type NEW .I ~n r f aCal an REMARKS: FEE SUMMARY: Base Fee $30.00 COPIES $1.00 Surcharge .50 Total Fee $31.50 Subtotal $30.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: MIKE WALLIN HOME IMPROVMNT 18949034 0001805 MIKE WALLIN HOME IMPROVE 12213 ALLEN DR 12213 ALLEN DR BURNSVILLE MN 55337 BURNSVILLE MN 55337 (612) 894-9034 (612)894--9034„ I hereby acknowledge that r have read Ibis Applic01;,I n and state that.the information is coreecat and agr`are to comply with all dp,libable State of 14n- Statutes and City of Eagan Drdxnatress., L J c I/ v c c PPL CANT/PERMIT SIGNATURE ISSU BY SI URE INSPECTION RECORD CITY OFEAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number 023847 Eagan, Minnesota 55123 Date Issued: 06/10/94 (612) 681-4675 SITE ADDRESS: APPLICANT: LOT: 4 BLOCK: 13 776 BRIDLE RIDGE RD MIKE WALLIN HOME IMPROVMNT BRIDLE RIDGE (612) 894-9034,, PERMIT SUBTYPE: TYPE OF WORK: DECK NEW INSPECTION TYPE .DATE INSPTR. INSPECTION DATE INSPTR. FOOTINGS FINAL - ~jj, CITY OF EAGAN ~ 1994 BUILDING PERMIT APPLICATION/ S-~ 681-4675 fie. 6/ SINGLE & MULTI-FAMILY casets of plans, 3 regis erej W )y su~rvveeys, 1 copy of energy cs. COMMERCIAL 2 sets of architectural &CCI- aaS 1 set of specifications, 1 copy of energy ca cs. 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 . tlxfe_ 9'41 Valuation of work /C5_V Site Address: ZZZe Bildle_ R; Q6 Rc~ 'ii~'a STREET TE # Tenant Name: (commercial only) } LOT BLOCK SUBD./2 ~(jQ" yL~ P.I.D. # Description of work: >04 The applicant is: ❑ Owner contractor ❑ Other (Describe) Name ffayrl7~2sc~ led ,7a0 ~ PhoneU0l-lam Property LAST 1 FIRST Owner Address STREET STE # City & State _W5~7_ Zip s/~3 Company Z v .,-ZS Phone RgV-90,3Ve Contractor Address 1._ Llg I en P- License #O Exp. City P d rjj2 ✓jIIe, State Zip f5-~37 Architect/ Company Phone 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 with all a plicable State of Minnesota Statutes and City of 'Eagan Ordinances. Signature of Applicant: I S11wellor05 Certificate SURVEY FOR: R.S.M. Homes 111c. DESCRIBED AS: Lot 4, Block 13, BR11'.IIi MIXai 1ST A0111I10N, City of Hagan, Dakota Cowlty, Hinnesota and reserving easements of record. i h Ntr rya n, I 12'y~a E I 1 ryy. ~ OGI l it \9 ° 3 s pp / / v qP `o \ ~T O I n 2 h 10 P 1. ZI ry ,7 r4 :o) t h / `~~4<$~ ? fir ~C iZ \ \ ~ to \ /o /64.73 `'j' 99>-_a 896.2 N834° 74'I33A 2 I By- Dat t s > EA AN ENGIi I DEPT i PROPOSED ELEVATIONS BENCHMARKS Top of Foundation T• 69G.1 Garage Floor • 8q4. 3 I Basement Floor i, 873, 5 MIN. SETBACK REOIREMENTS Approx. Sewer Service Elev.. y.•, v,t• r_ 1 Proposed Elevations Existing Elevations Front - 30' House Side - /o ' m i Drainage Directions r - -r Rear - is' Goragea,..Slde- 5' o i Denotes Offset Slake e D SCALE: 1 loch a 30 Feet N• Du., geew. cc I hereby cerllly that this survey, plan or report was prepared by me JOB NO.: HEDLUND or under ve direct supervision and that the S1 am a duty Registered _ 68R-195 Land Survey" under r the the laws of tM Slate of Minnesota. BOOK: Planning Engineering Surveying eA~ [.w e,omi.p,an rrwwq. •oomx,plon, Ml,mem,.ls.]0 re,pns•tr,ewmee Ogle: A PAGE: ` 'i 4.VL eren, Llcense N414376 APPLICATION FOR PERMIT :NOTE: PAST1M OF FEE AT ME OF ; APPLICATION DOES HOT CON- * SPI= APPROVAL OF PERMIT. SEWER AND/OR WATER CONNECTION I : INSPECTION OF SEWER AND/OR WATERER INSTAIdAVONS WILL NOT BE scmuLED ; . DNITL PERMIT HAS BEEN APPROVED. ++++www++ww++wwx:+++:++++++ww+xw++++++ a i dtV o_F eagan (P E PRINT li 1) PROPERTY ADDRESS: ~v 61 ir LEGAL DESCRIPTIONS (Lot/Block/Subdivision or Tax Parcel 15 IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: Month/Year PRESENT ZONING/PROPOSED USE: I, Q COMMERCIAL/RETAIL/OFFICE J " `SINGLE FAMILY I' Q INDUSTRIAL R-2 DUPLEX (Two Units) a INSTITUTIONAL/GOVERNMENT q R-3 TOWNHOUSE (Three Units) ( Units) Q R-4 APARTMENT/CONDOMINIUM ( Units) 0 2) - NAME: ADDRESS: G A-- CITY, STATE, ZIP: PHONE: ~f ~!J (P 9O J For City Use 3) NAME: G~ P1 rs License: ADDRESS: Active /-;z Expired CITY, STATE, ZIP: Not recorded PHONE: 7~ p MASTER LICENSE # 6 2.4ZD Sta InI ti 4) • NAME: ADDRESS: I CITY, STATE, ZIP: II PHONE: r 5) s a •a~ u a• CONNECTION TO CITY SEWER 0 TION.TO CITY WATER la OTHER i 6) Emil * * THE GOLD COPY OF THE PERMIT WILL BE SENT DIRECTLY TO PUBLIC WORKS TO FACILITATE METER PICK-UP. i' PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. SOMEONE FROM THE CITY WILL CONTACT YOU IF THERE ARE ANY PROBLEMS. FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ ~C S SEWER PERMIT (INCLUDE SURCHARGE) $ / $ /el - S WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ ClC• ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ 5'S 'CT I) $ WAC $ L~ 5r0 - QZ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ Z Zl -71 - Lr $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE-EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: i(l/ ice ~7~ TITLE: DATE: 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN r SINGLE FAMILY DWELLINGS J_ 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 RENTAL UNITS FOR SALE UNITS 11 OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG.pDEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS Q To Be Used For: S F-0 Valuation: Date: C) / 1,,a;dl~L Site Address -77Cp Sr e~d;_ OFFICE USE ONLY i p Lot A Block ~3 I On site sewage_ Occupancy ~ 3 M 1 r~ 1 YKTi' MWCC system J Zoning PD, RBI Parcel/Sub On site well Actual Const _ y-N City water ✓ Allowable V-N Owner 1 ✓nes PRV required 11 of ;stories -T- Booster Pump _ Length 38_ o, Address Depth S.F."Total City/Zip Code ~C ~Q~Lq Irlll~ Footprint S.F. Phone APPROVALS FEES Contractor Engr/Assess Perimit oo§§ Planner Surcharge , Address Ct!q Council Plan Review ?--1" 0 Bldg. Off. 4~~zy SAC, City /2Q.00 Variance SAC, MWCC 5, Oy City/Zip Coda Water Conn 5 SJ, Uo Phone Water Meter _6'l. 00 Road Unit 325.00 Arch./Engr. _ I Treatment P1 7_04,Oo Parks Address Copies TOTAL S u City/Zip Code - Phone 11 ' VAI.v.ATtor`1 GA i2a.Gr,- 2.0 XSo=4oU z Y- y C~ 3q2 X 14 T-5 m7- 24-y 3L1 vd4 - Is x /v lg~ 1040 X 11. 14190 D flo~5e I U UU t 1090 zX~ I`I 12~? •UJF ~i7U UU~ 2Y~1 »U UU G'!•Uu~ III 1C WS' SU4S16 ~l i JU F 9y1yC- u. 7J7' 7U.< CRAWL swNejQ D c G.i~t t4 X22= 346X13- (SIUK~ smWelloras Certificate SURVEY FOR: R.S.M. Homes Tnc. DESCRIBED AS: I,ot 4, Block 13, BRIPLE RTDGF 1ST ADDITION, City of Fagan, Dakota Comity, Minnesota and resenring easements or record. h H1► ti°I• to I Z264~0 E. 9 ` r v 0 IT, ~K~%Sb 10 ~/o io \ 25 159.73 'j 992.1 3'r 2.2 844.2 N89e 1913 A ° o R rl UN By Dat TT/1 01 EA AN ENGIIRI DEP'P PROPOSED ELEVATIONS BENCHMARK. Top of Foundation $Q~.,"I Garage Floor • 894. 3 Basement Floor : 893, 5 MIN. SETBACK REQIREMENTS Approx. Sewer Service Elev.. e...•p• Proposed Elevations r ~3 Front - 30' Moues Side -/o m Existing Elevations Drainage Directions r-......r Rear - i5' Garage Side- S' _ Denotes Offset Stoke . o w' e"" Aea.._ SCALE: t loch = 30 Feet % w I hereby certify that this survey, plan er report was prepared by m• JOB NO.: HEDLUND or under direct r me supervision low* that t am duly rsd 88 R-195 Lend Surveyor undo in* lows of the e State of f Minnesota. d) BOOK: Planning Engineering Surveying s»r [.n swnkv. F...wq. in.*gl.. w 'M. sun - rr.gn.wltmseswse q r q onto: 7~J1 't 'A PAGE: Je • L eren, Lleense NaN378 REDI-NOTE DATE 44 2-K 19 Iii TO R SN1 O Ml=` T N L SUBJECT ZNC l1G4 CA L(ZtkLAT- (0N~ THE CE ILIn1C INSULA`TIC)N MUST MEET t, -y,cn--Ti) EHQQ&G / CoDE )zEDtAtREhtchrf of i WHICH ~L,uAlS AN L (/AUJE OF • OZC~ NoT' o~ PL'cASE LOSE THE CoPRE-cf/E e!26YRE o N ynui2 N EX7- A P/24-l eATIOA1 SIGNEDO 2 N~erc-bta,(C..I REOIFORM, 45464 IX NO REPLY NECESSARY 'D REPLY REQUESTED - USE REVERSE SIDE POLY PAK (50 SETS) 4P462 FISM HOMES, INC.' $XTERIOR EtdVET CP° AVERAGE `V' C4V1I$WU iPtn LAKE BLVD' PRIOR . . OWNER 04, LAKE. MN. 6W72 Inc SITE ADDRESS L . hY 7 R 1. 14A.. CONTRACTOR /~5 ♦~1 c.w y`s tDATM 5 $Otl Determine working square footago'ar 94oh. 1, Total exposed wall area X ,+r^ e a 3!s w;: M1 2. Total roof/ceiling area ,...4Z4 42 6,g1 rut, x Total exposed wall area aboye rloor a,- .Lr ni a• Total wall w16Zow 4rea b. Total door area , 1 . , , . r G4 ,r...;5 ,y '<.~s c, Total sliding glass area d. Total fireplace wall area e, Total wall framing area (average l0~},,. / S.D- " +,Y,` f. Total net wall area above rloor fir, S. Total riff Joist e Total exposes} foundation area h. Total foundation window area O 1. Total net foundation area above grade Determine "U': value of each wall oegment. lluji b, x e. i 9~ • u g U u e.r. . y x )IU,: DYf~ ,.;a; X $ U r o~ a s• ; h. c~ X ;U a o z 1. X "U j' 3.. r • r r • • . • • , • . • , • . r • • , 1 , ~ I }ptTl ~ ~`^""..,R~w If Item k3 is the same as, or leas than Item N1, V94 navq"40 intent of SBC G006(c)2. 00 r- 4, Total exposed roof/ceiling area F '442.'4'q J. Total skylight area k. Total roof/ceiling framing area (average !O 1. `i'Otal net insulated roof/ceiling area Determine "U- value for each roof'/cellIng seem#nt, D X "U v s a f-Uh • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . „ ..Total w S, p" ~c~„ k y ~js'. o~ .L • :s Gic iw 5Qc oQF~c.)J 11' total of N,y is the same as, or less than #2; you have met Pho Intent of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelope system method a the valww e4tabZlobed by the sum Of Items N3 and N4 shall not be greater than the sµm,of Items h'1 and d2. 3 4 P Chi ~lu..» .J Ir li - - - - - - - - - - - - - - - City of L'(t ~(1 1PlQ Qn j Penult#: 1 I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: j Phone: (651) 6755675 Fax: (651) 675-5694 - I Staff. I I ------I 2008 RESIDENTIAL BUIL DING PERMIT APPLICATION Date: n 5` Site Address: V Y F41 `R d4 bq Tenant: Suite M RESIDENT / OWNER Name: 4/G' j'l~tlOeeTan`.' r~ I1 Phone: (S(^ OF 7A5 Address / City / Zip: l 2ri4 Applicant is: Owner Contractor TYPE OF WORK Description of work: 6 )c 7naT 7(./fr,Frr 4&crt?- Construction Cost: 16fC'owo- Multi-Family Building: (Yes _ I Noo CONTRACTOR Name: -License#: Address: %Q Q( 1214 &{yT' lik17` c~yy City: 1(OJC/)frrL~rc7 /}//I/ State: Zip: J (i08 Phone: C19~~~ R~ g3 Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE Plansa s~rppor#fng tlocamen s that 015m it consfdar be pubft-M9'ahrratfon~' Po tsns s iron publec` > ou ro de spe'c'A" asstns2 flat, ul oarm tthe 'tn tWjbf Tmaitoft maybe c?a WQ'e b I P. F`SF 111 L t flil,. x,..:.. . _ d1l_'-C.KiltBhlde..i:te Ir~i~~~i~I33i. (I1I~1~~~ 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 accordancewith the approved plan in the case of work which requires a review and approval %ns. QZdk ! ec?eAf ar x App nfs Print Name W/ F D Applic s Signatu Page 1 of 3 JUN 0 6 2008 0! DO NOT WRITE BELOW THIS LINE ` SUB TYPES ❑ Foundation ❑ 05-plex ❑ 16-plex ❑ Accessory Building ❑ Pool ❑ Single Family ❑ 06-plex ❑ Fireplace ❑ Porch (3-season) ❑ Ext Alt. - Multi ❑ 01 of - Plex ❑ 07-plex 9~ Garage ❑ Porch (4-season) ❑ Ext Alt. - SF ❑ 02-Plex ❑ 08-plex ❑ Deck ❑ Porch (screen/gazeboipergola) ❑ Multi Misc. ❑ 03-Plex ❑ 10-plex ❑ Lower Level ❑ Storm Damage ❑ 04-Plex ❑ 12-plex ❑ Miscellaneous WORK TYPES ❑ New ❑ Interior Improvement ❑ Siding ❑ Demolish Building` Addition ❑ Move Building ❑ Reroof ❑ Demolish Interior ❑ Alteration ❑ Fire Repair ❑ Windows ❑ Demolish Foundation ❑ Replacement ❑ Egress Window ❑ Water Damage Demolition (entire building) - give PCA handout to applicant DESCRIPTION: v~ Valuation ! Lu=o Occupancy MCES System Plan Review Code Edition ~ SAC Units (25%_ 100% ~ Zoning City Water Census Code L/Z L4 Stories Booster Pump # of Units Square Feet PRV # of Buildings 1 Length Fire Sprinklers Type of Const. I~ Width REQUIRED INSPECTIONS _ Footings (new bldg) Sheetrock Meter Size: Footings (deck) Final/C.O. Footings (addition) y Final/No C.O. Foundation 7-~ HVAC _ Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace:-R.I. _AirTest -Final Windows Insulation Retaining Wall Reviewed By: Building Inspector RESIDENTIAL FEES: Base Fee Surcharge r b J /Y / ~O /1 Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Page 2 of 3 Certificate of Boundary Survey for.- DANIE'I~ & TERESA TWEETON il ~~(~I~rapertyAddress' 76&70/e Rldga Road o Property Description, ,S ! ` f>, ~(c~oc~ R ta~~9PtoLfpiWde el~nnnnol~`Y~xmdn~ 7, t5.o t ,•1,, y • \ LOfA/aa=14SR9sWR(Q37 apes/ T ,g ~ r O~ ' .F.a~'n9Hse_ S~d[e~a' 1,573sq: R r I r Fwamd GwageADWWAlm =4850.9 N ~N • ! \ f dg2.` tr. A- \ m Fouts true Fun Molnrrmd ry0 gi a tt O = s.e noo taw Mom. mm,t luo.■aa rt,en SLOT 4 DELMAR H. ScHwANZ BLOCK 13 LAND SURVE'YORS , INC. ! "t to DRAWN DATE 1455550. RCH1Ffi1'iflA1L 1 o I JM 4/28/08 Rt75Fw)UNT, MN 550% ~ e LL N 8°9'79'33" E 159.73 APPROVED DATE 651.423-1769 MAS _ 4/29/08 JI/~ersbYm~Ye~at~pb'two'Rraiwaeni4a~sd eygmoxx6r5ryrasdmpaufsiatdMeat/emsatsy[wxneuG SCALE SHEET PROJECT h10. LaaYSawlA'vxkrdEe6aa afftSYaoahmmsaft r -21 ~oS 5. AlsrmR Cdv/ i" ° 90' 808026 - For Office Use City of Eapn ' Permit#: e3Arw 41 Permit Fee: ' 3830 Pilot Knob Eagan MN 55122 Road j Date Received: o~P z~P Ca Phone: (651) 675-5675 Fax: (651) 675x694 j Staff: 2008 MECHANICAL PERMIT APPLICATION Date: O SNe Address: -7 1~ C (e Zt . e- R Tenem: J Suite RESIDENT /OWNER Name: ~C1 rl 1 cl G TO Phone: h51- a-1f -3,21g Address / City / Zip: 77(,o r ; d R (ra S51o7 CONTRACTOR Name: \ ~R ~h 1 Cl ^ ~w license Address) ~pa1 6 , 1) 0 City: r 1 V^ \ C\ kk State: h 1 V Zip: S J Phone:(:~'s ~4~t1 -i` Contact Person: IN S~Lt S Uhk TYPE OF WORK - New - Replacement _Additional _ Alteration _ Demolition Crl99 of Work rn axe- ftC 2.e t NOTE: Both root mounted and ground mounted mechanical vyutpment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL X Furnace _ New Construction - Interior Improvement Air Conditioner Ire - install Piping Processed Air Exchanger 1 - Gas _ Exterior HVAC Unit ' HVAC units must he screened Heat Pur• : _ Under / Move ground Tank Install / _ Remove) Other k When installing/removing tank(s), rail for inspection by Fire Marshal and Plumbirin 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 $.5o State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) Permit Fee - ff Permit FqQ is less than $1,000, surcharge is $.50. - 0 Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge $1,000 Permit Fee (i.e. a $1,001$2,000 Permit Fee requires a $1.00 surcharge). $ TOTAL FEE 1 hereby acknowledge that this information is complete and accurate; that the work will be in romformanre 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 me work will be in accordance with the approved plan In the case work wgich requires a review and approval of plans. x l\Jt-y\~. N Q," L- v 5 ~h 9 x .A,. ~ IA,~~ Applicant's Printed Name Applicant's Ignature FOR OFFICE USE Reviewed Sr. Date: Required Inspections: Under Ground Rough In Air Test _Gas Service Test In-floor Heat Final ~ pu~:i3jflae:U~e I City of Ea~aIl 1 I I v v Permit I Permit Fee: 66-611 ~ 1~`~"'" i 3630 Pilot Knob Road I Date Received- '7U P .(So Eagan MN 55122 I Phone: (651) 675-5675 staff: I Fax: (651) 675-5694 2008 MECHANICAL PERMIT APPLICATION Date: Site Address: -7 1 (o $ r i C` e t e- ' Tenant: Suits RESIDENT/OWNER Name: -DCXrX 1 ti)eC+0 n Phone: 6251-a - ,2J`(f Address / City / Zip: 77G r` d R,` 550 {X - CONTRACTOR Name' ` l• ,,D ~ X- ^ ! ~i License ~ ,.l 6 1) 0 Address:, n Yi ~S `A k\ 1 n » City: P r" V ^ \ C\ I~Srtate: , V Zip: S s Phone: 0\ -1i ,a "i Contact Person: \`'i~ /GAL, S L~k TYPE OF WORK New Replacement ;)I/'- ✓ Additional J Alteration Demoli'on Description of work: NOT 9,ofh roof mounte "R, ground molrnted mechdrrlcaf egufpment is requUed to he scroyged,by City, °Cpoi ° Nlease ConfBCl thepllleChanleaf lnspectaror otre of the Blanners.lor irifa»ratfon on= 7ttetlscneenin` .methods: RESIDENTIAL COMMERCIAL PERMIT TYPE New Construction Interior improvement Furnace Air Conditioner Re- (14) (1d -Install Piping Processed - - l3a 1, r~ Gas _ Exterior HVAC Unit Air Exchanger HVAc units must be screened Heat Pump ~XItA Under / Above ground Tank Install / _ Remove) Other d -Lt When installing/ramming tank(s), call for inspection by Fire 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 $ x 1% $50.50 Minimum (includes State Surcharge) Permit Fee - If Penn i[ Fee is less than $1,000, surcharge is $.50. - If gmit Fee is > $1,000, surcharge increases by $.5o for each State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 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 f wo Ich requires a review and approval of plans. x 73 NQ,06 x,A„ Applicant's Printed Name Applicant's ignature FOR OFFICE USE - RaviewedBy . Date Required Inspections: Ground, Rough In TAir Test Gas Service Test _In-floor Heat~Final'- " . Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - For Office Use Permit City of Eapn I e~ I Permit Fee: G C i 3830 Pilot Knob Road 1 ) Eagan MN 55122 Date Received: Phone: (651) 675-5675 1 I Fax: (651) 675-5694 1 Staff: I I I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 7~ 76 Trick :Lfal / 'I Tenant: f17-r,r Suite RESIDENT / OWNER Name: f P h o e: J Fas?5~65 Address / City / Zip: 77C ` ~3rda (2) ,Cl-P ~Cf Applicant is: Owner Contractor TYPE OF WORK Description of work: / ,e &67-"l Construction Cost: `3000 Multi-Family Building: (Yes / No CONTRACTOR Name: _-Dr6 yl x- lr eG,Pul - License Address': YL 07- City: I~ { State:; Zip: 5SQCP Phone: Contact Person: r (k COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 accordance with the approved plan in the case of work which requires a review and approval of plans. x C C Pv x Applicant's ' to ame Applicant's Sig ture - Page 1 of 3 Use BLUE or BLACK Ink For Office use ~ j Permit #.---C~Z ofEa an , I Permit Fee: U I 3830 Pilot Knob Road t I Eagan MN 55122 I Date Received: ` Zi (Z I Phone: (654) 675-5875 I , t Fax: (654) 675.6694 ;fir I start: 61 ~ INFLOW & INFILTRATION PERMIT APPLICATION _,K Plumbing 1 Sewer & Water Date; 11-11- I z Site Address: -7 96d , 2 J u tL Tenant: Suite M Name: Phone: 9 RESIDENT OWNER T +o)-\ C-S Address t City Zip: s ° Name: _ e.S S i 4 n 3 e r v ,''ip. T c~ License PC (o ~l ~Y 35-9 Address: c vi t City. CONTRACTOR State: Iql k/ Zip: .5 S a Phone: 6 S i- k 1 ~ 2 S a 4 Contact: Yee 1 c f Email: rm' Kz b ~ ca ~ +n l 4. rr. b r h h ~ ~ PLUMBING (Within the building envelope) SEWER $ WATER (Outside the building envelope) TYPE OF WORK 7 Sump Pump Repair Repair Other: Other. DESCRIPTION s Description of work: P Q i 12 < tl m LA r- r2 Lu L u 4,r i d FEES A ch $60.001 Each (includes $5.00 State Surcharge) k v TOTAL FEE $_nj 0 t CJ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ili repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractor can be found by visiting www.citvofeaaan.corrt/inflow, or City Half at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4544)002 for protection against underground utifity damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www oopherstateonecall.orei 1 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 worts which requires a review and approval of plans. X f ! 1 i loz J C. Y'1 i ) + z... - .4 "k jj:i-A Applicarift Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground ,Rough-in __Final