4685 Bristol Blvd' ?:
Permit No. Permit Holder Dafe Telephone #
S/W
PLiJMBlIVG
HVAC
ELECTRI ?77 op
ELECTRIC
Inspection Date Insp. Commenfs
Footings I 4)/? ?
Foundation Z?'
Framing
J
?
Roofing
Rough PI6g.
Rough Htg. i?
I5ul. re*A - o ?
Fireplace
l??.,. t?.¦
drsy.
Final Htg. r L 3 fip
Orsat Test
Final Pibg. Plbg. Inspector -Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final ? ,)-3
Deck Fig.
Oeck Final
weu
Pr. Disp.
, V `? ?
-?' -- 3
4?
?-.• .? ? _ . ..
..
,, _ ? ..
(?ertioca#e a?f ?fcCu?a?tc?g ?.
Mtv a f *agan
Tpartmcnt af Zaiihittg aui?pection
Tftis Cet7icade isstted pursuant to d:e requirements of the Uitifarm Building Cade
eertifying that at rhe time of issuance this strueture was in eompliarrce with the varivus
ordinances of the City rsegulatrng huilding construetian or use. Far the fnflvwing:
Ux Classification ?SF Dw Bldg: Permii No. 29')0"
Oceupancy Type R3Ix tJ 7.oning Dishicx Type Const. IN
Owncr af Building REItiTA JII+' ..'?i 00 ad- 3585 N- T-Ma-NMM-A&N;-?-RUIZ
8 gAddness 4 ?5 MU.%Y7f MM Lnr,ality/ j
, _ f ' I ? / f,•;? ?, ;f'
\ ??' Date:
Building?ffictial ?' :
1
POST IN A CON3PICUOIlS PLACE i.
1
Address 4685 BRIsmi. m.vn Zip 55123_
I.ot •. 30 Blk 1 Sub wPSiDN HTTS.S
THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: a ? Yes No Inspector:
Final gtade (6" from siding)
tIl-
Pennanent steps (garage)
Pennanent steps (main entry)
Petmanent driveway ?
Permanent gas V1,^
Sod/Seeded grass
TraiUcurb damage ?
Porch ?
Basement finish ?
Deck
Please verify with the builder the removal of roof test caps from the plum6ing system and the shutoff of water suppfy to
the outside lawn faucet before freeze potential extists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contraaor Copy
6
99
D- 5
Reques? Da?e >/ _ ? I
? Fird No Rough-in Inspection
R ulretl? NOTICE: You Mvst Call EIeGn?q speqor
IfAROUgh-In pecfi6e! '
es ? No . Is ReQw i
IXlicensed contractor ? owner hereby requesi inspection of above ele ical wor ?: ?,
Job Atltlress (Slreat, Box or floine No ) .
(a k? 5 Tbe?. EL-VD City
-
SecUOn No. Township Name or No. Rerge Na Couny
bilkKa`t14
OccupeM (PRINT)
Ro,??2 Phone No.
/4
Power Suppber AtldrESS
3oz hy,?T Po r
Elechical ConVac[or (CAmpany Name) ConVaclor"s License No.
?-Ll,L4., ?O'a (o OS
MaLng Pqdmss (COntractor or Owner MaWrg Installaiion)
19a9o %,o ekop 'Bti A„z' A+ao A. ss-?3
Authonzetl Signatu (COnhaMr/Owner Malu Installavon) Phone NumOer
Z'--??------ 7a 3--/-41
MINNESOTA STATE BOAfiD OF ELECTRICITY THIS INSPECTION FEQUEST WILL NOT
Grlggs-MlEway Bitlg. - Foom S179 BE ACCEPTED BV THE STATE BOARD
1821 Univ¢rbiry Ave., SL Paul, MN 55109 UNLESS PROPER INSPECTION FEE IS
Phorre(612)842-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ?? /?? ?,ge5
? See msVUCtionS for completing fiis Nrm an back of y911ow copy ?
M? Rq Q R :,..n Q-1,.?., ini .o ?,., rw? Qo..,,e?r l'1 0 '7 &
.• v v v v v ? .• v...v.. ..v... vv....v....? ....v ..vy..v... .n?' I C Y••
e Add Rep TypeofBmitlmg AppliancesWired EqwpmentWrtetl
Home Range Temporery Service
Duplex Water Heater Eledric Heatm
Apt. Building Dryer Load Management
Comm./lndustrial Fumace Other (Speciry)
Farm Air Conditionei
Other (specify) ConVaciwS Remerks:
Compute Mspecfion Fee Below:
# Other Fee # serviceEnlrancesize Fae # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps 700 _ Amps
SignS ' Inspeclor5 Use Ony. TOTAL SU
Irrigation Booms
Speciallnspection
AIarMCommunication " THIS INSTALLATION MAY BE ORDERED DISCONNECTEO IF NOT
Other Fee COMPLETED WITHIN 18 M F?(§.? `
I, the Electrical Inspector, hereby R-?? a ?' ??
certify that the above inspection has
been made. ? Date
? ' -`?j
OFFlCE USE ONLV
Thia requeat wid 18 manths from
-1kClTY?F EAGAN
3830 Pilof Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Bc 41acu•pe?i6 .
Coi?s?ruxtiqrr ?' e
zaning
Butlrtlos} 1-6ng°th?tr?
6(tlld#n,q.6di'•dth i ,
L "?
d-?-
BU LDING
ezzaes
10/22/93
SITE ADDRESS:
P.I.N.: 10-83750-900-91
DESCRIPTION:
SF DW6
NEW
R-3 M-1
V-N
R-1
cgootv OF adcjan
REMARKS:
PRV S& W PLBR - BJORLIN PLBG
FEE SUMMARY:
VALUATION $99,000
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Un3ts
Subtatal
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
4685 BRTSTOL BLVD
LOT: 30 BLOCK: 1
WESTON HILLS
Bo#Ld$'hpermit, Type
?ui ?,dI.•rrg? rk Type
$635.0@
$412.75
$49.50
$750.00
100
1
$1.847.25
MXSCELLANEOUS
7ota1 Fee
48
-06
$1, 744.50
$3,591.75
CONTRACTOR: - RPPllcanz - y i. Lll OWNER: '
ROMAR HOMES CO 14849044 0001281 ROMAR HOMES C0
3585 N LEXSNGTON AVE 330 3585 N UEXINGTON AVE
ARDEN HZLLS MN 55126 ARDEN HILLS MN 55126
(612) asa-aeaa (612)484-4044
?
I heweby ackrtbwl,edge taaz'T OPO21dat;idt
inforrnation 3.5 c•orr"t and a9rlee ,te. QQ,rtnpljy 4,%t=tI? u?:7;`A}
BtaYutes and City pf E,a+gari ?kwtl;%nartcrei,:'.
330
r.,?.. ,
.. .. . .. . . . i._ ....?_?...?
?
- - - APPLICA
- NT7P'ERAQITEE CLq7URE ISSUE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: '
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: LoT : 30 B L 0 C K: 1 APPLICANT:
4665 BRISTOL BLVD ROMAR HOMES CO
WESTON HILLS (612) 454-4044
PEqVIl?PBTYPE: TYPE OF WORK: ?
BUIIDING
022293
10/22/93
NEW
INSPECTION
FOOTING .. .
FRAMING .•
INSULATION FTNAL
FIREPLACE
? REMARKSc F'ftV 5& W PLBR - BJORLIN PLBG
- - - - ? - g , ;? _ .. . - -- - -
:
?
F i; ..s.f,.t., . ............
r.;;
?;-
r ? ? F a
REALTIYATE i ?`?'EV?ED
PER?Yi?` d '
T 1 5 1993
--
cinr oF EaGaN
1993 BUILDING PERMITAPPUCATION ??+-?4?•???
681-4675
cf. QQ 411.16 -22
SIN6LE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work gC?'1 me?
Site Address:
STREET SUITE #
Tenant Name: (commercial only)
LOT BIACK ? SIIBD. P.I.D. 0 '
aP\'C \O
Descri tion of work:
The applicant is: 0-Owner 4-Contractor ? Other (oe$cctbe)
Name a?L? Ac' Phone
Property LAST FIRST
Ow11er
Address
STREET STE /
City State Zip
Company Phone yq..y-yIN?IA
Contractor Address3?4???e?.Ex,?w?c,cc?.lQ??tF ??'^(JLicense #M16Exp.'\L?
City State '?\\o Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber ??W0 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 lnformation is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances. t ,
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE • y;
` `
? t:??S??
? 01 Foundation ? 06 Duplex ? 11 Apt./lodging 1,01 aser?F
i`h
X02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ?
E7`17° Swim irool
? 03 Sf Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comn./Ind.
? 04 SF Porch ? 09 12-Plex 0 14 Fireplace ? 19 Comn./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. O 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
C(31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition 0 34 Repair O 36 Move
GENERAL INF ORMATION
Const. (Actual) 'Y-M Basement sq. ft. MWCL 5ysiem YE5
(Allowable) v- N lst F1. sq. ft. City Water
UBC Occupancy
R=-M_l
2nd F1. sq. ft.
PRV Required ?
Zoning R-i Sq. Ft. total Booster Pump
N of Stories footprint Sq. ft. Fire Sprinkler
Length ? On-site well Census Code 101
Depth y 6, On-site sewage SAC Code ol
APPROVALS r
j
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site
? Wallboard
0 Footing
O Final
? Framing
? Draintile
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Traits Ded.
Copies
Other
Total:
v.lmciom g 9, OOC7
-
GAeAGE; n."22r 49tt v.Ib
r
5ShA? y2x24-/aoe
M1?°UN LEVEL : ? b b`! KIS = I S`I6 0
k3SmT.=
f?xi4n 2zy
SAC % D O
SAC Units ?
* p???
? eng?ne??ri
Certificate of
.
I ?
Ol
``'^
o o
v ??
??.
?
, II y3??o
?
31
625 Hlghway 70 Norlheast;
Blaine, MN 55434 ,
612) 783-1880•FoX 783-1883.
y for: Romar . Homes, Co.
Addrass: 4685 Bristol Boulevard Eagan MN
sl Name: 7he Cape 2
? 9J4. 29
r1`? ? ?135?
30 q,s•
• hi ? \
, q
.
4i? ?
?j 4O o
' ?'/ ??y.??• ?'`?y??`' Y?
\ J? ?0 clg` ?%?ti` .o ?•.
Qy? ? ? /? \tioi
\ o
t ?
yyo,+lG \46N
„
NOiE: CqNiRACTOR MUSTI
x gw.a ?Denotes Exist(n9
•? Oenotea Propose
- ? _ Denotes brainag
-? Denotes praioag
-o- Denotes Monutne
-9- Denotes Offset I
LOT 30, BL
DAKOTA
I MnEy carUfY tAi[ thls aurvey.
uneer Me Iews ef %M Swtt o1 Mlnns.
Inch-
/ ?
:RIFY ALL DIME SIONS AN&
EI tl
qf?
Ge
i
i
v ?•
??z
ii?'
I
$ gv
?
?
\
\?G
\
2422 Enlefpriee 0i'ive .
Mendoto Heighla, MN 55120
812) 681-1914•F'aY 681i 9488
Yo?
I
i .
o \,
Xq ?
4i'?? i
/
pci'
/
i
J!
DEPT.
evo on pROPOSED HOUSE ELEVATIOfI
I Elewtlon
dc Utility Easement Lowest Floor Elevotion:939_45'
.
Flow Direction Top of Block Elevatlon:941.66
it Garage Sla6 Elevation:941.33
ib Beafings shown are as t?alft,V' Ic?L LL)
)CK 1 WESTON H1LLS "
;oUNTY. MINNESOTA
?an of raport Wa? rap nd by me ormy d,lrec! Wporvlslon nn -ohqt I am duly flryialqrW 4nd Surviyor
a. Dated thM.sY of' A.O. 78?
`et n06lR7 e, f{ICN L.S. E. N . 1489 ''
/
S7. /
ix 9?7 ?l/
zl?9 W
-29 13173,02
0
b
-
,
LOT SDRVEY CHECRI,IST FOR RESIDENTIAL
SUILDING PERMIT APPLICATION
m
? U
¢
PROPERTY LEGAL• f'?d
a
-J w
?
? m nate o survey: / / 93
DOCIIMENT STANDARDS
8"? 0 • Registered Land Surveyor signature and company
8?0
- 0 • Building Permit Applicant '
0
3-- 0 • Legal description
8-?0 ? • Address
8' 0 0 • North arrow and bar scale
H?? 0 • House type (rambler, walkout, split w/o, split entry,
/
? lookout, etc.)
[? 0 ? • Directional drainage arrows with slope/gradient t.
?@? 0 • Proposed/existing sewer and water services
P? ,O ? : Street name
0'0 0 Driveway
ELEVATIONS
Existina
? 0, 0 • Sewer service
m` ? ? • Lot corners
?0 ? • Top of curb at the driveway
0[3-?? • Elevations of any existing adjacent homes
Procosed
0? ? ? • Garage floor
u- 13 ? • First floor
4!r 0 ? • Lowest exposed elevation (walkout/window)
0- ?
' 0 • Property corners
0
? 0 • Front and rear of home at the foundation
PONDING AREAS (if aDDlicable
fY ? 0 • Easement line
0r ? ? • NWL
Er ? ? • HWL
0? ??? • Pond # designation
? [3' ? • Emergency overflow Elevation
e ? ?
B' ? ?
0? ? ?
?? ?
,0?0 ? .
0 ? ?
October 19
DIMEN6ION8
• Lot lines
• Right-of-way and street width (to back of curb)
• Proposed home dimensions includinq any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent fobtings)
• Show all easements of record and any City utilities within
those easements
• Setbacks of proposed structure and setback of adjacent
k
OWNER
SITE ADDRESS
CONTRACTOR DATE PHONE yL?A
Determine working square foatage of each.
1. Total e:cposed wall area ......... _2 406- sq. ft. x./1/ = 2?
.
2. Total roof/ceiling area .... 1-2`dw sq, ft. x.D2(o
E.`CTERIOR EYVELOPE AVERAGE "U" COMPUTATION
Total exposed wall area above floor = ?( d?
a. Total wall window area ............................ :2
b. Total door area ............................... . s. S
c. Total sliding glass door area ..................... S-e)
d. Total fireplace wall area ......................... u
e. Total wa11 framing area (average lOX) ................ l 7 S
f. Total net wall area above•Sloor ................... ?(?' 1
g. Total rim joist area ................................ 1 l Z
Total exposed foundation area = 4f Co
h. Total foundation window area ........................ G?
i. Total net foundation area above grade ............... SS C.
Determine "U" value oE each vall segment.
a. Z?-z XIOU'l o us alU4;.;/Q
b. 4'57 X "U" .07 = 3,/S'
c. <'6 U x "u" 36.0
a. o x,.U,f o a o
e. / 7 5; X "U"
f. 1611 X ?rUll
g. I 7Z x "U,s
h. c X ?,Us,
.DS7 a /S:S7
fQuZ v U 7i66
I o10 a -'(O .55
O = 4D
X fl}}II
?J •! U
3 ......................................Tota1
If item tl 3 is the same as, or less than item O1, you have met the incent
of SSC 6006(c)2.
P/LJN' ? CF?.L?- A/.aCY0ti7
.: ? :w cw
ii.
?
Total exposed roof/ceiling area =
Total gross roof/ceiling area =
1 3Sy
j. Total skylight area ..................... .. -
k. Total roof/ceiSing framing area ......... .. i
1. Total net insulated roof/ceiling area . .. !2 ?'
Determine "U" value for each roof/ceiling segment.
J. p X?lUll O a
k. `''l o X?lUll a 0? ' 2. S47
1. R IIUII • D? ? a ?? • ?
4 ..................................... Total = 3?
If total of 1f4 is the same as, or less than 92, you have met the intent of
SBC 6006(c)1.
To utilize the total envelope system method, the values established by the
sum of items 03 and 04 shall not be greater than the sum of items 91 and 82.
i. :2L G6.Sdo
3. -7- NO. 20
+ 2. 3S15 Ff
+ 4. ?'.s•7S
= 30? .5y
27u•°i?
xccr•/ceuYyc
. ??
Vc11T
? ..
Venced Heac E2ow '
. up .
? . ,
i ,
FIG. #5 t? .
. i
.. . • , • '
.. ? • , • , .
. ? . -
- ----- ?
Construcl•ion R-V?liic
1.' Interior air film ,O.G1
2. 5/R a,Y 1? 13 fZf? ? o S 8
3. LOw•rl ?AiSv? 3£',.OU
4. Exterior air film (still) . 0.
'- Total 3C'e,go.
v=,025'
. . . ., . .
. , .
, 1. Interior air film 0.61
2. S/P,. GYP? P?20 SS
3. i.?SVL aVE,t rltU55 ' 3y ?q T
. 4. Eatcrior air film stx • . I"
• . , zotal- 3Ce,-? ?f
?J = ,pZ7
LCD t-T LG
i
Eecc florr up • .•vented
, . . . . .
• ? • :?.
• , FIG. #6.:..?. • :'_. .. .' .
- • • . . _?.. _.. . : - . .
i' , •
. HcaC '
' , , • £lov uP .
F?f'..,??•? .... , ... . .
I
,
'
. . • .
1. Inside ai.r film 0.61
7..
• 3. ' .. .
4.
' S. Outside air, Eilm 0.17
Total
• ? ' • . ' • , '
Notc: Use additional stieets •iF r.;ore spacc is
reeded for detai:s and ca'_culaCians.
, ?
.
' ,tYqL!.
61W1'Ee Uta 10% oL opaqua wall area for
frame construction
Ff211ilE IIALL
.?'
,? .
j uc 8
Construction . =?,._•
• R-Valuc
1. Interior air? film '
.2. 1L°C,YP f3R1J 0.68
4
3. sx(=, STC.os • doT$
4. 25'132 5HrGr z.OG
5. 51Q1wie- UvC-Y< FEGr
6. Exter9or air film 0.17
Total
(/= voB-7 1. Interior air film 0.68
2• VLGr. ? f3PL D o yS
3. F(/L t Gf/.? L 4'/?/i54L /-rj, bU
9• 2 S132- ?h'TG 2 OG '
5. SiD/-C?c- pyE.? ,F. EC.r 1 a1 6
6• Ecterior air film
0.17
Totax a s, 6 z
, U= vqv z
1. Interior air film
O,GB'
2. /.r.SVL • /%,UO
3. '2 X _ lz1 P A
/; rS 8
4. '25/32 SNTU
5. S?O?•vG? CJVE?,/r /-' 47-k ?
? y2 (?
6. Exteri.or air fflm
0.17
" Total 2 $.O S
.
o. ILv
1. Interior air film
0.68
2. 'e-// /.vSvG // CJO
3. 2x4 FuR a? r+c?
n. 12co? e. /3Coc« /.l£S
5. ,
6. Exterior air film 0.17
zrot
a
l 13e13 '
• .. ,
/
C/? s0'7?
? ? • r ?. .
..?r ?n?Trr ;? . ' ? ;? . ` ? • ' ,
-,A ; , .
. ? 6 . ', ? ? I11 =
rIG. If4 (!! ': I '? • ` (? ? i /(! !? ?'
• ?rc k ? ., a ? ? /'/
. • ?'I/ , - ' ? ??//i ?
. tl 3 ?_ .
y ` r
':• ' ' °, ? ?_
. ?EAVLoss ?LCULArIONs
_ WuiAentrip$ ?? • _ . . ? ? I
Mel exp,
Int. wAll
or sq,1ns.
r' - ra r
Inwl?tion
(t. E.pR oi oa. ins.
i "
Ing,
Mqjn?. W.A. l,eader area
NN
rL Room I Length /,j Width i
and Dmrs-('...L...'
Constructkn No. ?
!4?-
q4rI4w,
efT ylu
wlatn
4fLl
= Cee6 61u
?n611uliON
-LAL ( 4,
Eyp. wall
Ncl exp. woll ?
Int, wa)I
?tilin
? s
Floor
M .
w991 nm. K ?. II
_?e9uired iq, ft. E.D,R, or iq, iny, W.A. Loader ue?
. wall
exo.'
wel!
6.
ins. W.A. L,eader ara ?
a ?h WWth F{tiaht
ke a and Are.
? Meet i Ffl.
1JVS
or sq. mi. \
Aroik
or
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AL50, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUII2ED FOR EACH UN1T.
NO. FIXTURES C
I SHOWER 3.00 3. o+?
S2 WATER CLOSET 3•00
_ BATH TUB 3.00 fo.?_
LAVATORY 3•?
? KITCHEN SINK 3.00 3•0-0
S
-
LAUNDRY TRAY 3.00 -0
0
TUB/SPA 3•00
? WATER HEATER 3.00 3, o-o
/ FLOOR DRAIN 3.00 3.o-n
? GAS PIPING OLTTLET • minimum - 1 3.00 3• o-w
ROUGH OPENINGS 1.56 h! so
WATER SOFT'ENER 5.00
PRIVATE DISP. • DakCty. lie. 15.00
U.G. SPRINKLER • nome unaer oonsi. 3.00
ALTERATIONS • to austing 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL: //?0 85
?
SITE
?
L?
SIGNATURE OF PERMITTEE
1993 PLITMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
Qlk-
CITY :?,? - -? ?? STATE: ? ZIP CODE: 5?ru
PHONE #: ( ) S 3 3-4/ 3 S
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS VJHEN PERMTfS ARE REQUIItED FOR EACH UNTT.
? NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE .
DATE I I ' 1 qa,
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OU LETS (MI UM I@ S3. EACH)
Fhw1? , { e S
ADD-O /REMODEL (ExtsTI?G oNSTRUCTi
STATE SURCHARGE
TOTAL
SITE ADDRESS: `t
OWNER N
11 ?)noK (Y'"do(? ?
?Y-n
C> LehY\?1C ? a3 , n ? w__Q
FEES \ /p1?
$ 24.00
6.00
9-0?
U?AV abAW)
f--(Arns Owf'
$ 15.00
.50
Wia:)
TELEPHONE #:
INSTALLER: V06UUTinsaanconarioxiHa
ST LWS PARK MN 55426
ADDRESS: sai.ES929-s7s7 sea+nce929aatt
CITY:
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PER I EE
1993 MECHANICAL PERMTf (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
FAGAN MN 55122
(612) 681-4675
REQUEST FOR HOLD
Date:
Proj ect name: Gr/,.r.Q.?
Address:
Legal description: L o?0 B.? Sec/SUb
Reason for hold: I"?....,Q_ _e?L? _?2 on ,A".G
?
Place hold on:
!?
z?
Signature
ing permlt
If approved, this "hold" will remain in effect for fifteen working
days. Upon expiration, the hold may be renewed for additional
fifteen-day periods.
Certificate of Occupancy
Other (please explain)
------------------
i F-??? ;
j Permit
I I
? Permi[ Fee: D• ? I
I I
? Date Received:
I Siaff:
I -? I
-----------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: O ?X_ Site Address: `7 W ?S ; a G Ivl)
Tenant:
Sulte #:
RESIDENT / OWNER Name: I//N VOjci Phone: 6 S f- y?-q' gZgg
Address / Cdy / Zip: 7& g /6is>o L li1J .
Applicant is: _ Owner O Contractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes No I
CONTRACTOR Name: C/ License #: ,,0/3?
Address: iS; oG 1;1t1/ )
City: 'fj(.zAA/ State: Mn! Zip: !MZ?
Phone: l0/Z"?w?i- I?1L2 ContactPerson: hii,Z _
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code • Residential Venfilation Category 1 Worksheet • New Enetgy Code Worksheet
C8t0gOry Submitted Submitted
(4 SUbmission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a pertntt for a similar plan based on a master plan?
_Yes _NO If yes, date and address of master pian:
Licensed Plumber: Phone:
Mechanical Contrector: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you sirbmit are considered to be pubAc'Infoimatlon. -'Portions"o/
the information may be dassified as non-public iL you provide speciiic reasons that would permit the City to
o:sonclude that:#he a4trade secrefs »_;
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances aa s of the City of
Eagan; ihat I understand this is not a pertnit, but only an application for a pertnit, and work is not to start x?ihou? )errff rfi; t e work wiil be in
accordance with ihe approved plan in the case of work which requires a review and approval of plans.
x / /// 16x
ApplicanYs Printed Name App canYs Slgnatu
Page 1 of 3
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - -
I For Office Use I
Permit
City of Eap Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: r - Z I - L: Site Address: Unit
Name: 110.6 Phone: 6;1 Resident/ ~7
Owner Address/ City/ Zip: Xim ~ S 111 t /3) AeJ) _
Applicant is: Owner contractor
Type of Work Description of work: _F
Construction Cost: D 0a:7 Multi-Family Building: (Yes / No
Company: k i LD ft'VD-D 4&asj _JfIIJ C Contact: fS~ psi
Contractor Address: '/')03 / sec ~)v~l City: P;A60n/ .
[ State: JhtJ _ Zip: Phone: 6a ' fkl ltgL~
( License 134, f;a (p Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I
I
COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW 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 maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they 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.oopherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code a ompleted wit ' 180
days of permit issuance.
X j►~+/ L' Gs~ rn G. Yl x
Applicant's Printed Name Applicant's igna
Page 1 of 3