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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