658 Bridle Ridge RdCITY OF EAGAN N0 17206
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
) 1
BUILDING PEFIMIT PHONE:454-8100 Receipt d ) C S/oC10
Toheusedfor SF M/GAR EscValue $111,000 Date OCT 17 , 19$9
Site Address 658 BRIDLE RIDGE RD
Lot 3 Block 1 SeGSub. BRIDLE RIDGE 1S
Parcel No.
W Name BRIAN THORSON HOMES
o Address 4466 WEDGEWOOD DR
City EAGAN phone 454-0644
F I Name _
a Address
Phone
1.0@119ame
k,--Address
a W City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and a ree lo comply with all applicable State of
Minnesota StaWtes and ity ??agy r7nances.
??
Signalure of Permi[ee
A Building Permit is issued to B IAN THORSON HOME
on Ihe express condition that I work shall be done in accordance wilh all
applicable State of Minnasota Statutes and City of Eaqan Ordinances.
Building Official
OFFICE USE ONLY
Occupancy R-3 M-1 FE ES
Zoning PD R-1
(ACWaqConst V-N Bltlg. Permil 678.00
(Allowahle) V-N Surcharge $$. 50
# ol Stories '
Lenglh Plan Review 339. 00
Depih 4$ ' SAQ Cily 100. ?0
S.F.ToIaI - SAC,MCWCC 575.00
S.F. Pootprint5 -
On Site Sewage _ waler Conn 580. 00
On Site Well - Water Meter 90.00
MWCC Sys[em XX
XX
Acct. Deposit
30. 00
Cily Water
PRV Required _ S/W Permit 20.00
eooster Pump - SrW Surcharga 1.00
Treatmem PI 228, 00
APPROVALS qoad Unit 340.00
Planner - park Ded.
Council
81dg.ON. _ Capies
Variance - 70TAL 3,036. SO
DATE:
10/19/89
658 BR1DLS EIDGE EOAD. L3, B1, BRIDLB R1DGE lst
39X'2?Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
-I?
I
i
Yo6r Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer 8 Water Permit for the above property has been completed, but the meter. cannot
be issued or occupancy allowed until further notice.
- COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVEI,OPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
DATE: ?nI1QI8?
RE:2PSR nptnrA niprn anan. r.a, B1, BRIDLB BIDGE let
Rx V66i Sewer & Water Permit for the above property has been completed. It will be held at the
Aublic Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
-?(our Sewer & Water Permit for the above property cannot be crompleted for the following
ieasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice. ,
- COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
contirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY UEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
L
30
6
82
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Requ€st Dac¢., i Fire No. Rovghin Insp n
Z q 3 Requiretl? ? Pefltly Now ?i Will Notiy In9pactor
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a
ae
y
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I)6censed contractor ? owner hereby request inspection of above elecirical work at:
Jo0 Atltlress (SVeet. Box or qome ryp.l
t? 5 S(3
?
P Ciry
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?.-
Secnon No. TownsM1ip Name or No. Range No. County
Q?d?o -
Occupam RRINT) A
?»JPS?-?-?5 Phone No. .
Power SupPlir
we?f p
7?
Address n
-ZA/
Electricai Convacior(Company Name) I
i ContrectorY Licanse No.
,
S?- ?r?,c.??? oC 17i0
Maninq Atloress IComractor or Owner Making Inslalle[ionl ?
-(` ?
? yso33
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Aumonzetl Si5^awr ?C va or ner M nstallauon) Phone Number-?
3« Y
MINNESOTA STATE BOAflD OF ELECTRIQTV ? THIS INSPECTION FEOUEST WILL NOT
Gnggs-Mltlwey 81tlg. - Hoom S1]3 / 9E ACCEPTED BV THE $TATE BOARD
1821 llniverslly Ave.. St. Faul. MN 55106 /? ??'/?(? UNLES$ PROPEF INSPEGTION FEE IS
ihone(613) 642-0000 //?? ENClOSEO.
?^^?
? .J O lf V 2
RE?UEST FOR ELECTRICAL INSPECTION
? See instruclions lor rompleting this form on back of yellow coOY
'X" Be/ow Work Covered by This Request
'k E800001-OB
ew tld Rep. TypeofBuilding AppliancesWireE EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electdc Heating
Apt. Building Dryer Other..(Specity)
Comm./industrial ?Furnace
farm Air Conditioner
I Otner(syeciiyl Conhector's Remarks:
2?st.?ltAOw?3 `t' na?ea.?..
Compufe Inspection Fee Below:
? Other Fee # ServiceEntrancBSize Fee # Cirouits/Feeders Fee
Swimming Pool O to 200 Amps 0 to 100 Amps
Ransformers Above 200 _ Amps Abov _ Amps
Signs Inspeqor5 Use Only, ? TOTAL
Irrigation Booms 3 Q
Special Inspection
Aiarm/Communication THIS INSTAlLAT10N MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITfiIN 78 MO
I, the Electrical Inspecror, herehy
Certify ihat [he abOVe inspeClion has
been made. Rouqn-m a.,
F,nai - oa?e /?
ere
OPFICE USE ONLY
This reQUest voitl 18 months trom
P6 914 6 ;t •- ,?3i /?? / ? ? ,??`'
RequeslDale
,? Q?
!J r Fia No. Rough-inln on
Require
es ? No
? Ready Nax fQJA5lfRotity Inspector
When Ready?
I icensed contractor ? owner hereby request inspection of above electrical work at:
Job Cre S t, Box oule No.)
? Cit
Section No. Township Neme or No. ange No. Counry "
PRI
v?so
P?° 4 a? ,
Power Supplier Atltlress
Etectrieal actor (COmpany Name)
f
Convacror§ License No.
9
MailinB % 4 ? (COnirada or Owner Making Installefbn)
Auli,wizM 'gnaWre (ConVacYOrlOwrrer Making InataAetion) - Phone Number
NINNESOTA SiAIE'iOAR0 OF ELEG7pICRY U? THIS INSPECf10N REpUE$T WILL NOT
Gr199%dlitlway BMg. - floom 5173 BE ACCEPTEO BY THE STATE BOARD
I8Z1 Unhorafry Ave., SL Peul, MN 55109 UNLESS PR07ER INSPECTION FEE IS
Phom (812) 8q2-0800 ENIXASEO.
Illijs`9
P 69146
REQUEST FOR ELECTRICAL INSPECTION
? See ipstmdions lor cnmptetiig this brm on back o1 yellow copy.
X" Below Work Covered 6y This Request
EB-00001-0] ew ?ild Rep. TypeolBUilding AppliancesWired EquipmeniWired
Home Range 7emporary Service
Duplex Water Heater Electric Heating
Apt. Building D er Other (Specify)
Comm./Industrial urnace
Farm Air Conditioner
Olher (specify) ConiredaB Remerks:
Compute Inspection Fee Below:
# Other Fee # ServiceEnUanceSize
1 F e # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps
1 0 to 100 Amps
Transfortners Above 200 _ Amps Above 100_ Amps ,p
Signs InspacWrS Use Only: ? TOT
Irrigation 8ooms
Special Inspeciion
Alartn/Communication
Other Fee
I, the Electrical Inspecror, hereby
ti
th
t th
b
i Rou9n-in 3?; ?
ty
cer
a
e a
ove
nspection has
been made. Fi„ai te ^ 5? ?
OFFICE USE ONLY "
This requesl witl 18 months trom
r
-
^`R6 HEATiNC, TEST RECORd
iDRE wPT.-FL00R GTY E&?(j;UBUR6
:QIAAiI "• OWNER CJ-it f( 4 ?iJ
;AT LOSS_
? ?
DATE NTG. INST,
,(
LD BY _ Q -
'jIe1?S?
('LL? A(M INSTALLED 8Y
,ceieei.raork Br Ga. LiM By ??
7E O.F MEAT A?- RA NW - STEwr _SPACE MTR: _UNIT HTR _OTMER
/? GAS CESIGN CONVERSION
4
"-? !-LY MAKE OF BURNER
del y??
40 7 Mar. BTU Ret,.q
'UT ,?60?G0 6 K7'L? uAKE Of FLRNACE
J
Ms
?I
GONTROLS
?'iAT 1Mp pbe
?•• iiMD OM ?S? il'i! NAIL
.It ?' Gctrlloai A?dmr -
rt? Alltw? ii'? /?.?zS v? ?i..? r
r iM0(? OWry L+?r?W Istil? Oerif?
!at T? ?Iws GraMalac
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Z9 3Dtfd 91H 3QISHl(l05 99L0D88z56 OZ:EL L00L/LL/LL
RESIDENTIAL
I
b6 qlo BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122 J?? ??
651-681•4675 /
New Canstruction Reauiremenls RemodellReoair Reuuirements
• 7 registered sde surveys showirg sq. ft. of!o6 sq. R. of trouse: and all roofed areas • 2 copies of plan
(20 a maximum lot coverege allowed) . t set of Eneryy Calculatlwks lor healed adEitions
• 2 copies of plan showing beam & wfMow sizes; poured found desyn, etc.) . 1 site survey for exterior additions 8 decks
• 7 set of Energy Calculations . Indicate if home served by SepGc system for addilions
• 3 copies of Tree Preservation Plan if lot platted aRer 711193
• Rim Jaist Oetail Options selecfion shee! (bldgs wilh 3 or less wils)
DATE ?L -Z( -0 Z
SITE ADDRESS
TYPE OF
• Residential Ventllation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submilted
MULTI-FAMILYBLDG _Y _N
_ FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT SELA ROOFING & REMODELING
STREET ADDRESS ST. LOUIS PARK, MN 5541? CITY STATE_ZIP
ID #0001050
TELEPHONE CELL PHONE # PAX #
PROPERTY OWNER c?aO14_0_1; ?c ck-S6--1'7 TELEPHONE #ckS`( --351 `f 7
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ 1IINNESO"C:\ RCI.I:S 7670 C:\"fF.GOR1' l vIIYVESO"C:\ RCLES 7672
(J submission type)
Plumbing Contractor: `_
Plumbing systccn includes:
Mechanicai Contractor:
Mcchviic:il svslccn includcs:
Sewer/Water Contractor:
Air Conditioning
-- 1-Icat Rccovcy Systctn
Phone #
Phone #
Fce: 590.00
Pcr. 570.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Sfatutes and City of Eagan Ordinances.
SignatureofApplfcant 4 ?
OFFICE USE ONLY
Gt
Phone #
? Wacer Softener
_ Water Heater
_ No. of Saths
VALUATION
. New Energy Code Worksheet Su6mitted
_ Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received Tree Preservation Plan Received _ Not Required _
Updated 4102
2007 RESIDENTIAL MECHANICAL PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675
Please complete for. siugte family dweilings & townhomes/condos when permits are required for each unit
? .?
Date& / O
Site Address ?
?t' S p" ?-t'L? /L"-., Uoit #
Property Owner Telephone #(,?,, ?l ) 51;-Y- 3 9 y?
Contractor ?ir??•(' ylttt?.,,._, d- ? /?- ?
$treetAddress /e)F/77` /?G?4n?r-? City
State ? Zip.s?31-Telep6one#((S.?) dSly..?Y.?J7
B
d #• '? (
a E
O-P 6- p?
i
on
p
xp
res:
The Applicant is _ Owner ? Contractor _ Other
Fire repair (replace bumed out appliauces, ductwork, etc.) S 90.00
This fee applies when extensive mechanical repairs are made to a building.
Add-on or altera6on to existing dwelling unit . $ 50.00
? fumace _Additional X Replacement _ New
air exchanger
air conditioner
heat pump
other
State Surcharge $ .50
Total $ ?- S- Z)
I hereby apply for a ResidenNal Mechanical Pemtit and aclmowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of [he City nf Eagan and with the Mechanical Codes; that [ understand this is not a
permit, but only an application for a permit, and work is not to start without a pertnit; that the work will be in accordance with the
approved plan in the case of work which requites a review and approval of plans. / 1 aGP t- Zt" ?P. S i E.' F'C_r G /La77.tta? x
Applicant's Printed Name Applicant's Signature ?
11?? OCT 1 8 2007
CITY USE ONLY
PERMIT #: /& yJ RECEIPT DATE: -OI
fiE.SIDENTIAL MECHANICAL PEiMIT APPLICATION
crrYoF gasaiu
S$SO PII.OT KNOB RD
£A&AA M1V 55122
651-6e1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: ? J Z0o (
SITEADDRESS: vS() &;PqC fl;'^ SJ2 flOq`--Q
e?. I
OWNER NAME: TELEPHONE #:Gsl-
(AREA CODE)
INSTALLER NAME: f?-?C" LOWWC%S I[.PMjS+ 0 f ? TELEPHONE #: QZ 9'66 P29
(AREA CODE)
STREETADDRESS: b3°?S ?CcoMr???'pl`? '7(rC S
CITY: 1LiCKPeSTATE: Mr Zlp: S5413"' I?6g
Place a check mark next to the ermit work t e
New residential dwelling unit under constructionand not owner/occupied $ 70.00
? Add-on, modification or alteration to existinq dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner
• other
rb?j(tc. 0tQ f" /?
1'Ic-
Nature of work:
State Surohar e $ 50
L Total $ So' S o
Reminder: Ca!! jor inspections.
M", l?%' ItS?/Z
SIGNATURE OF PERMITTEE
Updamd 1 /01
A:C[TY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT ? (-11K- //> 13?
??/?
PERMITTYPE: BuiLDiNG
Permit Number: 021709
Date issued: 0 8/ 12 / 9 3
SITE ADDRESS:
P.I.N.: 10-14996-030-01
658 BRIDLE RIDGE RD
LOT: 3 BLOCK: 1
BRIDLE RIDGE
DESCRIPTION:
3R0 LEVEL FINISH
&u'ildi;ng)Permit Type BASEMENT FINZSH
JBuilding blc?rkType ALTERATION
i
?-,
c???U uo-? G ?a (o (?j ???
REMARKS:
SEPARATE PLUMBING & ELECTRICAL PERMITS REQUIRED
FEE SUMMARY:
Base Fee $35.00
Surcharge $.50
Total Fee $35.50
CONTRACTOR: - Appii
VALLEY INVESTMENTS CONST
2401 LEXINGTON AVE S
MENDOTA HTS MN 55120
(612) 454-5191
cant - sT. LIC. OWNER:
14545191 0004241 SHROYER JOHtJ
658 BRIDLE RIDGE RD
EAGAN MN
(612)681-1904
I hereby acknowledge,that I have read this application and state that the
information 3s correct and agree to comply with all applicable State ofi Mn.
Statutes and City of Eagan Ordinances.
L
?APPL NT/PEFlMITEE SIGNATl1RE ISSU : ? GNA7URE
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: Lor : s
658 BRIDLE RIDGE RD
BRIDLE RIDGE
PERMIT SUBTYPE:
BASEMENT FINISH
ALTERATION
DESCRIPTION 3RD LEVEI FINISH
J
F- 7
PERMITTYPE: BuzLorNG
Permit Number: 021709
Date Issued: 0 8/ 12 / 9 3
BLOCK: 1 APPLICANT:
VALLEY INVESTMEN7S CONST
(612) 459-5191
TYPE OF WORK:
REMARKS: SEPARATE PLUMBING S ELECTRICAL PERMITS REQUIRED
REACTIYA7E _
vERMIT r.
c::? (7 0
CITY OF EAGAN
1993 BUILDING PERMIT
681-4675
APPLICATION S- p
43? J
SINGLE & MUL71-FAMILY 2 sets of plans, 3 registered site su f energy
_
;
cal cs . ,
?
? ''
COMMERCIAL ?f of
lp?
2 sets of architectural & structu al
-
specifications, 1 copy of energy lcc.
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 thanged or 3) lot change i,s requested once permit
is issued.
Date Valuation of work /0 ao/
Site Address: 891OLAF- K!D('? ??
fT0.EET fUiTE 0
Tenant Name: (commercial only)
IAT ? S1ACK F
N '
Descri tion of work: 3?6 L_v-_JEL_ NI S
The applicant is: ? Owner Contractor 0 Other co.4«tbe>:
OPhone ?((?f - l lO ?
?
?O ? ?? ?
Name -
?
Property ,- FIRST n =
LAST
Owner
Address 6s-? 84t!r- (pr'F
55REEi C7E Y
City R-YL/ State ZiP
Company ji? d T"S C"- Phone ??y4-?6.1
? ? License N4?941 Exp.3
?f/I 1?
JCT"
X
d
COntreCtOr _
iJ
d,?,
Address
-
City J NO(7 State 42-n?_ Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State ZiP
Sewer 8 water licensed plumber ' . Processing tlme for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read thls application and state that the information is
f
correct and agree to co y with all -applicableState of Minnesota Statutes and City o
Eagan Ordinances. ?
Signature of Applicant: "M ?
V
L.
vFrict u*t unLT
BUILDING PERMIT TYPE
O 01 Foundation ? 06 Ouplex ? 11 Apt./Lodging /6 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. 0 17 Swim Pool
O 03 SF Addition ? 08 B-Plex O 13 Garage/Accessory O 18 Comm./Ind.
? 04 SF Porch O 09 12-Plex ? 14 Fireplace ? 19 Cowm./Ind. Misc.
p 05 SF Misc. ? 10 Multi. Add'1. O 15 Deck ? 20 Public Facility
? 21 Miscellaneous
W ORK TYPE
? 31 New O 33 Alterations O 35 Tenant Flnish O 37 Demolish
? 32 Addition 0 34 Repair ? ,36 Move
GENERAL INFORMATION
Lonst. (Actual) Basement sq. ft. MWCC System
Allowable) lst Fl. sq. ft. City Mater
?
UBC ccupancy 2nd fl. sq. ft. PRY Required
2oning Sq. Ft. total Booster PumP
/ of Stories Footprint Sq. ft. Fire Sprinkler
length On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REDUIRED INSPECTIONS 9,<j> c.CvcZ ?i?„?s?./
? Site ting raming ? Insulation
? Wallboard fi 'ETTraintile ? 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.
Trails Ded.
CoPies
Other
Total:
3_5-I V.l,et;on:
1510
SAC %
SAL Units
SIIiGLE FAMILY DTiELLIPGS
? SETS OF PLlNS
AEGISTEHED SIiB 30H4EYS
9 SET OF EBERGT ClLC3.
1989 BIIII.DIIiG PERMIT APPLICATION
CITY OF EAGAN
? ?
MI)LTIPLE DNELLINGS
2 9EtS OF P[.ARS
BEGISTfiAED SITE SOR9E2S -
(CRECH iiITH BLDG DIV. )
t SET OF ENERGS CLLC3.
COl4ERCIILI.
2 SETS OF lRCHIlECfUAAL
i ST80CTIIAAL PLANS
1 SET OF SPECIFICATIONS
1 SET OF ELIE6G2 CALC3.
!lIJLTIPL6 DHELLINGS AENTAL D9I?S FOS S1LE OliIT3 f OP' DHITS
i6TEt LDDRESBES FOH COAIQER LOT3 - GOHl1GGTD8/BoNgOiiaiER !!0.4? DESI(3NAiE i1HICH ADDAESS
IS DESIRED. 80 CH9NGES iJII.L BE ILLOWED ONCE BUILDIAG PEAMIT FS 2330ED..
SEfiER 6 1fATER PERMIT FEES lPD ACGOUAI' DEPOSIT FfiFS WII.L BS INQ.IIDED iiT'PH SgE BUILDINf3
PERHIT FEE. PAOCESSING iDiE FOA 3EYEA EAD iiAlEA PEB!lTfS IS Ti10 DAYS 0liCE A PEAMTT H63
BEEN CMPLE7ED SADIClTING A I.ICEASED PLtIlBEA.
PENALTY APPLSES idHENs PERMIT IS NOT PAID FOA IN SAME MONTH IT IS REQiTESTED.
LOT CAANGE IS REQOESTED ONCE PERMIT IS ISSIIED.
To Be Used For:?
31te Address 61L?
tot 3 siock ?
Pareel/Sub All / /?
Owner
Address ??a
9 `
'?ty/Zip Code
Fhone
Contractor
kddress
City/Zip Code
Phoae
irch./Engr.
AdMess
City/Zip Code
111''D0z) Aate:
Occupancy R-3 M -I
Zoning PD 'R-I
Aetual Const V-iJ
Allorrable V-N
i of stories
Length 52
Depth 48'
S.F. Total
Footprint S.F.
On aite eewage
On aiEe xell
MWCC 3yatem ti
Citp vater J
YRiF reqaired _
Baoster 8wmp _
iPPA0iAL3
Planner _
Council
Bldg. Off. Jj?mof,3
Yariance
Pgj 12 1989
Bldg. Permit 678,00
Surcharge SS,Sa
Plan Aeview .?9 ?ao
3AC, Citq }oo.Op
SAC, MWCC 575,o D
iiater Conn 590, ae
Water Meter 9 O,Ob
dcet. Deposit .30,W
S/W Permit O ,1oo
3/W 3uroharge ,na
Treatment P1. 22,6,00
Aoad Unit 4070
Park Ded.
Copies
SUBTOTAL
Penalty
TOY3L. , =
/S¢V/
Phone #
VALuA,1-IOtJ
G nU.4c?e
ay x?-z = sze xI5 =r79
.
gsrn-r
a6?cuy = I 14y
Zg9
11?t1Z? !32
I S(? S x14= Z?Gr?
?-1 bLCS E
?7 k IyZ ?
ZX??
1S6 5
U1
r?
16 z2 x?o ? ?i ?o?
,?----
? ?OQ30
. . :o.* ?
618•00+
" 55•50*
339•00}
''•1904•00+
3, 035• 50*+
F? Y
o'7S•U0+
55•50+
339•00+
1)904-00+'
3>030•50"
,: ,. ? ,. . .. '?.?. .
?rW?t i.1'F? J 1 Yt? ?FKr ?
1
? . . - i .A . . .
Pf10f1Q
•1":::.'.: , . ? .
?none
.???:t4t!I? C4010tatlb?: Yype A1 (SinqlLFa-n11y 8 OuPlex)_1L,_„1Ype A2 (Residentlal
(3 stories qr est
v;
y?? y
,,.,Jotlier) (Over 1 siories)
r r. ;
. r n.w. t ' .
2.
ti ' • ` , _ -rc?? ??
?.. .iratI hsi9ht.(groufd ik.val
2
/. / .
x'2.,,(,60ev41) 006 MPj1 eree? -70Z:-rc.
801tltn4 4100e9ons -?O x (u)?? • 1-?`,`(?o ft.2 roof s floor •rea `.. ,
f?rDX"*yli ot riwJotst - Floor toist size (2,x lQ?
`d X PerinietRr • Rim ,?pi's-C.-ii?ea • t1
,•' • .. ,'?'
DOCT'3
TF-T-raCtOr
?t.
`Y NN?ufat;turer?_ •_?, ,
Totel doo.r's pirlaatAr Z,Zeb ft
? .
Min¢p1+i: .:Mlfplf'u.Lirew Stat• aPProved .
,.' ., U
TYPE: Si1E AR:A (F_.z). !JUMSER OF T07AL FEET Z
EACH U(IITS
?A-S • ? 1 ?O _ S2, .. ?n !5 L ? a~
'1 O Z, \ ? s 40
2_1
}'. X?CZ -ro
Z cl
?a(o.. :;3 o.o o0
t 9, total ft.2 61ass
j?.f1re01etf'A pN: Niqth x hoioht ft.2
11. Exposed foyv*tlon: 11e1yht x Perimtter ($@, x_`i S Ft.Z .
` E1I0(1.OF , RE li?p F4R ALL NEW COfISTRUCTION. MAJOR REMOOELINO ANO BUILDI!?GS SEIlIG
?MEitE':;,l?I,??? ?' ?YFi?..MIKIMAI CODE AIIONANCE. IS USEO. u
l.:' . '' • o.' ?-. . . • . . , . . .
i
. j. 'I .i?Myr -•?. y ? . .
i. ?? . . .
p YAITJ ,ry?;y!} v [}?C-•vi-r , { t N
i.l. ''l- ??Y•..ri !i'.?YlV:iri4li?JFiV7??1?k"M'kA??:.rf.? .ri.... ...... . . .. i,M??.?Y:aM.tiS7T.;7 ? .?M4! ? ¢?.•?•??1
r R M1''d}.. .' Y:Lkv?
? , ,Ytt?W?ny er??_a t1r!? 0?..
W y?'?ss wa ? i ui ?sa .
r , 2 i. ;:
?7J:'? ?ff IN?? ifM ?? L7? ff, . t:i
,? . Mindow ar?s A ?\? ?,`? ft.2 L' windOw4 ¦ _?3 U x A¦ ???:.?`2
Yi ? ? - -w.
??'.?- R1n? Jotst arta A_ ??Q ft.Z U rim joist ? r -0'4 U x A e d.? i
4??. , L
?•. poor area A '?1 ,-? 1 ft. 7 door ares •_\?a3 ? x A•? ?.
r ;?` 2 --
Fireptace ar'ea A f:. U fireplsce • ?- U x a? C?-- ?
?-c
'?? ' Exposed foundatlon A \?? f*..- J foundation ? .\? U x A? ??. Z1
f •
t'??: Franting area A .?'7p, Z ft.? U franing area ? ??R U x A= ZQ.3,i
??? M1et wall area A ?? ?O „\4 `[. ?J wall ? ?, ?'?? U x A• ?.ar?i
r??? (?,4; , .;a? . . . . . . . . . . U X A i ? '???4??
}s?
<'?.. Gross walt ;rea x'0.11 (A-1 single famiiy 5 d?;,;=x • allowable U.c ,?/Code -?
; . (l3. above) -'?"`
' x 0.23 (?-2 other residentia';
?'?!, x .23 ;Other building;!
x .2B (Over 3 stor;?;)
??? ? N MusL Ce larger then
i?? a ? `7 O ? x L' Ccde . _ ?\,__ ? `? ?f - z? . 138 abnve
?i5. Ceiling framing area (A ) aquals 10^: ?f ??;i,?n area?=-? or ihe same as)
r„ f
' ?+ h.2??! \'T ,.l) ? ? \5? ?
`?;?,1. Gross ceiling area ? (l.) -q n x !'d)?(?, • ? -4 `?' (o ' ft.2 ';
1;1
;:;.5d Joist are? {Af) ? 10".. Ceiling area =___?__? ?-4?, (? ft.z
?SL. Ne! ceilina area IAc) (15A - 158) • \??? . 4. ft.z
??` u ceilinq x A ?- _e p z?? x?_ZF,,,? ? zSc?.q?, ;
. ,
?, U framing x A f• ¢p ?(?,'-E x ?-?Z ,(? ? ?
?' -
• (f?--. - • ;
j:50. "QTAL U x A ....................................... 1?_?-? .?'C---?, ?
tr T _ -. l
;T6. Ceiling area (15A) x 0.026 (A-1 single `amily S duptex - code atlo?+ablt U x A ,;;;
-.?--
? .. !.d
x O.C33 {A-2 other reside^tial) `";
/, :: .?
• x O.C6 (other) ' ?
y. . ,.
+. A(15A,? ?(o ?( onel ?(?,BaUH M?st be l,arger than 150 (above)
x O F Or Lhe 'Same as )
''„
i ? -? . :?
. ? ;
?;:?? C ? ? ???? ?
i' ?
. ?? _ -- ';?
!V?TE: Use U and a value: obtained f••om nps 1, 3 and 4, i
? ? ':?
f.': ? ; ?;?
,,..
f, • - ;,+?
,;: , ?
??, ;
_
,
'1?. I ?M ?yp,r? ?.` ?,?,+}j? rY? T ?l !p g?fLtl u ,,?fY.- _-- ? ?
?r ?'M.t... .. .. ......??aauw??Y+'A`.i?4NFZ?t? 1?vWYt.:T?+1YUl?yf ? r.. ?:.11i1..?:..L.t Y?KI.+'.%iT.ryh?.???...N.L_?__...?.v..??wr-?..! i..'
?,?• .. ,'' . ! , ? . .
NRGL
' SEC1'ION
.
¢ •'
? . ST6'D
SLCTION
2ND uALL
SECTI?K
RIN
JOL'ST
inrlda ?ir Rtlm .6a
Interlor yail •45 (uall) L: • ? +
!nsulwctvn \R •oo
`h,athin¢ --
Sidtnq • ?o?,; ?_ ? o4t-.1,
Ju[side air .(lm .17 '
R TOTAL
'nstde alr [ilm .fiA
7Ca:{OC /1lt •43
" 8' 1
?s?ud 1 k= (Fruntng) U - F -
ea[hing Z.o(c
ding . (:.7
itslCe air flln .11•
,. "OTaL \ D . I::\ O
Inaide alc [!lm R' .69
InterLor wai1 .45 •
ineulet.on (Vall
v Sheathtng z n a ^
Exterior va11 covering , (.7 -
ExCrr Lvc air f I Ifc "n
R 70TAL z3 . o ?
In[cr iur air C! l:n ?' .63
:r.suln:.ton oa ?
?,F 1 lk ir.ch w(t xuud R=1.88 (Rim U a?.
? f Joist)
, rr ?y Sheath ing ? . o ?o
?-tst'e-rAor walL covering
Exterlor air ftlm It- .17
I R TOTAL
i i
? Intrrlor aic f!lm z U.
?
Insul.a,lor. CD o
w ?•?o (
f?? ? ?? Core?dL?FounJaCiun pdn. U,R' •
:ctcrtor air :[ln R• .17 1
? ?'•\ F TOTAL 5
? I ' ,_ •- ? \
I ? -?, ?- -
,fzpused 31uck
t'T---- ? ,
„'.:.
. ;:
t2 , • ? ?'? `?'?--?. ,, ,raCe i •
, ..,,. .?. . :
. .wTr t>.?,- ., ,. . .. .
4 `. .
`?, • - '
Inside air fitm 0.6i
Ceiiing 1
Joist (Stud
Insulation
Air space
Roof de:king
Inautatlon
Built-up roof
Outside air fflm Oit,
Total R
I a U
R -
Jindow lnflltraticn .5 cfm/lineal foot of creck
tesidentlal. door infiltration 0.5 cfm/square foo;
or dcor and mininur code requlrement ::..
:..i?
4on-residential door inflltration 11.0 cfr/lineal `oct of crack
lp 12" concrete block no lnsulation =,47 R 2,1
!y 12" concrete block insulated cores =.26 R 3.8 '
Jb 12" ligiit:reight block ?.32 R 3.1
;b 12" lightweight block irisulated cores =.12 Q 8.3
J single glass = 1.13; wlth sto m windoN .54
1 double 91ass v .55
'1 triplt glass • .41
711 exterior walls and ceilings must have a vapor
barrier (C.10 perm ir.ax.). ?.,
:apor Darrier must be on the inside (heated side) of wall.
iapor berriers of ther polyethelene thin film have no Rvaluc. ?
• .t
. h
?
. . .
. . ? . . ' '..ijy
f
4
• . : .
`
`'
' ' s ??1
, ,
.u .
.
.
.,. ,.:,, a i ' .' ..r:?_.?_ ,..... .. . . ,
..
-_"
??`_"+'?' ue
??u
FRAAMItIG • ' ' ' CEILfNG
0.61 Air F11m 0.61
3\ .'1 5 Insulation 44.O
4 . 3 4?, Joist ., • .;
Ceiling . 5?
.E1
3'1.9:!S
Air Film 0.61
Total R --A Z,
u
• T
F!.4i ROOF OR GA7HEORAL CSIIIING
R Ya ue R 'lALUE
fR;,MING CEILItIG
, :oz(. 4
SURVEYOR'S
CERTIFIC-ATE
G?
`\O ?S
/ 918.0
\O?? ?riQ'
917.9`NIQ) ?ELEC. BOX
0. 918.6 L a ^ 1
91BA ` 0b /
2 A
36.01 ? a'h ?5/
R = 404.27
,„
d= 5°06 /4 I
921.1 I
2S ? %
?. i
? x921.8
ti .
\
0.?(pQ?.?1• /
?
? ?"ti?
? ?
OF, '
x 920.9
? F
".n ?.
? 92
? c
3
?BENpI MARK
TOP OF PIPE
' ELEV.=91Z90
9
0
918.9 r
49,? s
?
SIENNA CORPORATION
U' " \
i \
. , ,
--?-f--- 'ss
v ?
J
?eoyy`
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\
?
2?? \ 917.1
?
h0 ? ? \\
ryo-??.
F
N
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9M.7
a
L A, /0
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? 91 r.5
?PpyE? a? ? 1
s61o CJ
/ 6
?
?0 6• ,:\
/ 01
n?/?5:? ? ?--? ess?o / ???
µ !' 'k
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? C' 4y 1 ?
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B9
Data
----?.=---?-
FAGr??? ??T?INEERrflsG ?rk°Pr
? DENOTES PROPOSED SUAFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GAFAGE FLOOR - 722.3 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR -?7i5• 3 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK- 922•7 FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 3, Block I, BRIDLE RIDGE IST ADDITION, according to the recorded
plat ihereof, Dakota Caunty, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. A5
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 21 :,T DAY OF ?TANUFlRy , iggg,
APPROVED FOR SIENNA ?" '
SIGNED: JAMES R. HII:L, INC.
CORPORATTON , . ?
BY : BY: ?
HAROLD C. PETERSON, LAND SURVEYOR
DATED, MINNESOTA LICENSE NUMBER 12294
ti
r
W 2 ?
j
UZ ??
A v?
? Z I
O ? c
_D p m cfl
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 812-884-3029
REVISED Q-10-89 TO
SHOW PROPOSm HOUSE
FOR BRIAN L. TFDfiSON
HO MES.
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIItED FOR EACH UNTf.
10. FIXTURES
SHOWER
WATER CLOSET
BATH TUB
?-
-? LAVATORY \
KITCHEN SINK 9A?.l
LAUNDRY TRAY
HOT TUB/SPA
WATER HEA'I'ER
FLOOR DRAIN
GAS PIPING OLTTLET • minimum •
ROUGH OPENINGS
WATER SOFI'ENER
PRIVATE DISP. • DaLQy. lic.
U.G. SPRINKLER • eome uneer consi.
ALTERATIONS • w adsting
WATER TURN AROUND
STATE SURCHARGE
TOTAL:
SITE ADDRESS: ? ? ,?
F.ACH TOTAL
3.00 3100
3.00
3.00
3.00 - ? o
3.00 O?
3.00
3.00
3.00
3.00
3.00
1.50
5.00
15.00
3.00
15.00
15.00
.50
/S• 6-0
CTI'Y:-S"wir/ STATE: ZIP CODE:
PHONE #: ( (y /oZ} ysa - is? ?
11 .. 7111, 00-
SIGNATUE OF PE E
1993 PLUMBING PERNIIT (RESMEiVTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
ADDRESS: /fg el
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675 I SITE ADDRESS:
I I I 1 f 14 $ lit,l
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
1 n 1 . r-l
I t I : t Itr I t) .
PERMIT SUBTYPE:
APPLICANT:
"; ';
.I i i, n i-:i
TYPE OF WORK:
I t' ( 1 I rhl
II MiN
?
?
?--------
1 i N fl 1
1t1t1 1 411 Ni,
N.' ( It1??
i i F uA i 1 11 N
ViV I F vt i F l N 1(:H
7
Permft No. Permtt Holder Date Telephone N
S/W
PLUMBING ?
HVAC
ELECTRIC
.
ELECTRIC
Inspection Uate Insp. Gomments
Footings I
Foundation
Framing P_ 3 ?
Roofing
Rough Plbg
Rough Htg.
isui.
Fireplace d G_ "
O
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
81dg. Finai ? - V - --- -- - - -- --
Deck Ftg.
Deck Finai
Well
Pr. Disp.
(gertifirttte uf (Orrupttnry
Citp of eagari
ioppartnpnt nf Bui[ding Itcapprfintt
This Cenificate issued pursuant to rhe requiremenu of Section 306 of the Unijorm Building
Code certifying that at the time ojissuance rhis structure was in compliance wrrh the various
ordiaances of the City regulating building construction or use. For 1he jollowing.•
Use Classificauon SF M/C'AR Bidg. Permit No. 17206
Occupancy Type R3/M I Zoning District PD/R l TYP? ??? VN
Owner of Buildin? THOR" RMS Address 4i66 MMMWWD DR• iEMAN
Building Addrea 658 BP= R= ?MD Locai;ty L3, B 1, WtIUIE FtM I ST
? Da,e: JAR!AFZ 16, 19%
?
, Building 015cia1
POST IN A CONSPICUOUS PLACE
?4 . ., _' -r ?c a-. . . ... . a - . .. . ?.t.. , _ . .. • - . . . . ? . . .
?. >> CITY OF EAGAN ?0 ? 7?!??
.
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 '
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for -'? ???•?1??? Est. Value r 11 I, 000 Date ?' i l _? q 89 ,?
Site Address 6? B?I?? ?I?E j,.ii
Lot ? Block 1 Sec;'Sub. ?IllL::. ftItk>?: E:? OFFICE USE ONLY
P3fC21 N0. Occupancy ??3 ° ?=i FE FS
? K
1
? ,?
Name BF< IA?? TtI0RS0i3 fi0MS5 Zoning -
V-N 678
OQ
w
;
Address ?4?? ?`???'E5100D DR (ACtua?l Const V? Bidg. Permd .
o
?GAT?
Cit
Ph
??"?6? (Allowable)
r
t St
-
Surcnarge ss? SQ
y
one ones
+
o
52 ?
339??
lenglh Plan Rev?ew
Zo ?
SA`4F.
Name
Depih
*
?
sac
c?:y
i?•?
?¢ AddreSS S.F.Total - , STS?QQ
Cli
Y PhOnB
S F. Footpr?nts SAC, MCWCC
_ S?
?
? Cn Site Se?vage _ ?Na?er Conn `
? W Name
On Ste w
u
90
0?
??, e Water nneter .
¢Z Address MWCC System ? 30??
a W C?tY PhOn2 C?ty Water ? acct. Deposit
?Q
?
PRV Required _ S W Permit ?
I hereby acknowlege that I have read th?s application and state that the 8oos?er Pump i.?
information is correct and agree to comply wdh all applicable State ol S W Surcharge
Minnesota Statutes and City of Eagan Ordinances. 22g'?
Signature of Permitee APPROVALS Treatment PI 3?' ?
Road Urnt
A Building Permit is ?ssued to: ??IA? THOR$OM HQNES Planner -
on the express condition that ail work shall be done in accordance with all
Counc?l park Ded.
applicable State of Minnesota Statutes and Ciry of Eagan Ord?nances. Bldg. Ofl. _ Cop?es
Building OffiCial ? Variance - TOTAL _?_?Q36? ?
, Permit No. Permit Holder Oate Telephone #
WATER
SEWER
PLUMBIIVG
; t? ? `/
H.V.A.C.
..?t
ELECTRIC ? r11? '? I ;? t ?/Y:? ?G':::•> `
Inspection Date Insp. Comments
Footingsl
Foundation
Framing I2 /
Rooling
Rough Plbg.
Rough Htg. ; d?; •'+? ?
i5ui. 11y ,"la
Fireplace
Final Htg
Fnal Plbg. !
Const. Meter Plbg. Inspectar - Notify Plumber
Engr.IPlan
Bldg. Final
Oeck Ftg
Deck Final
Weil
Pr. Disp.
CONTRACT
PRICE
FOR: CITY OF EAGAN
?
Ts t .
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAM, MN 55122
PHONE 4548104
Site Address '
Lat T_ Black SecrSub
Name '
? address
? City Phone
Name
c Address
? City Phone
FEES
COMM./IND. FEE - 1°k OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE)
SIGNATURE OF PERMfTTEE
For Office Use Only
PERMIT #
RECEIPT #
DATE:
BLDG. TYPE
Res.
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
Np. FlXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
? Shower - $3.00
' Kitchen Sink - $3.00
UrinaUBidet - $3.00
00
Laundry Tray - $3
.
r Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
T Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Saftener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
PERMIT FEE:
S7ATES S/C:
GRAND TOTAL:
PERMIT #
• • ' . MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
' 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub Res. New
Name Mult Add-on
Comm. Repair
m Address c Ciry Phone - Other
Name _
c Address
o City
-
Phone
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent. CFM
Gas Piping Outlets # •
Other
r
FEE: _
S/C:
TOTAL: =
?
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIn - 1.50 E!i
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL AOD-ON 8
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
SEWER & WATER PERMIT
CiTY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
_ PRV _ BOOSTER PUMP
SITE ADDRESS
LOT BLOCK SEC/SUB
APPLICANT: =
ADDRESS:
CITY, STATE ZIP
PHONE:
I PLUMBER;
I ADDRESS:
CITY, STATE ZIP
PHONE:
OWNER: _
ADDRESS:_
CITY, STATE
PHONE: _
OFFICE USE ONLY
METER # l Z 5 Ja V L`? PERMIT DATE ? ? ? ? 221
CHIP #? 6 7 3?o 911 PERMIT #
METER SIZE ? 6C ? B.P. RECEIPT #
ISSUE DATE z" B.P. RECEIPT DATE
ZIP
PERMIT REQUESTED
V SEWER - WATER - TAPS
- GOMM/IND - RESIDENTIAL•
N E W - EXISTING
Lawn Sprinkier Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES ?
SIG"TURL'WHEN METER ISSUED
PLEASE ALIOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
PERMIT DATE
PERMIT #
B.P. RECEIPT #
B.P. RECEIPT DATE
_ PRV _ BOOSTER PUMP
SITE ADDRESS
LOT BLOCK SEC/SUB
,
APPLICANT:
ADDRESS:
CITY, STATEZIp
PHONE:
PLUMBER:
ADDRESS:
CITY, STATE ZIP
PHONE:
OWNER: _
ADDRESS:_
CITY, STATE
PHONE: _
METER #
CHIP # -
METER SIZE
ISSUE OATE
ZIP
OFFICE USE ONLY
PERMIT REQUESTED
- SEWER _ WATER _ TAPS
- COMM/IND _ RESIDENTIAL
- NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.