3676 Ashbury RdCITY OF EAGAN
3830 Pilot Knob Road WATER SERVICE pERMn
P.O. Box 21199
Eagan, MN 55121 PERMIT NO.: 7976
Z?,?' - R? DATE: 9-26-86
Owner:. iimdoren Rroc No, of unin: 1
Addren:
Site Addrea 16,Z6 Aahb r? R yd 6 B7 Blackhawk Clen
Plumper. _1nnd9nen Brnc n..- bine
Mater No.: ?
?
- ---?-
Conroctian Chorye;
_ 00 p
a
?;
Reoder No.: ? 7n ? y y 8 ?01"r p°po?r. _
15.0_ Ond _
I p"s fO a1p* Wbh the NY of GW" Perm7t Fee:
Surcharpa: 10.00nd
. SOpd
O?Jiwnsa,
Miac. Chargas; 156.00od Tp
B TotaL• -
_ ?
q 5nnri ro,;ar
Date of Insp.: Nto Pofd:
Irvn.?
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199
Esgan, MN 55121
Zoniny:
WATER SERVICE PERMR
PERMIT NO.:
DATE:
No. of Units:
OwrNr,
Address:
Sih Mdress:
Plumber.
Meter No.: Connection CJwrqe:
Size: Acoount Deposit:
Reoder No.: Permit Fee:
I ywe !o aow* wM6 tl» Ciep of Eqp¦ Surchorge:
OerfMnar. Misc. Ctarpes:
Totnl:
By _
Date
of Irup.:
Date Poid:
Irnp.:
CITY OF EAGAN SEWER SERYlCE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PEltMIT NO.:
Eagan, MN 55121 :
DATE: -
Zonfr+0: RI No. of Unfts: i
Qyy,wr; Li3RGj[IE'i3 !'ilnS,
AddfESS: ?
Site Address: 3576 Ashbury Etoad L6 B1 Biackhetak rlen
-
Plurnbsr. 571nd€;ren 3r.os. Plumhing
1 ym h?opy wM% !M Clhr of Eegam
"Meam
By
Date of leup.:
100.04pd
Com@ctlon Choe": 475 _ QOpf,
Acoourrt Deposit: 3.4 _ ?f 3n ;
P'eetnit Fee:
Surrhorpa:
Misc. Charyst
Total:
Doft Pold:
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE] ° V " 19
Rectiveo ! : ? Y-
FROM
AMOUNT $ I
4 DOLLAR!
teo
? GASH :Q CHECK
Thank You
BY
White-Paye?s Copy
Yellow-Posting Copy
Pink-File Copy
FOR '
BLDG. ,PERMIT N0.
?,.
u??? ?J
? ??r tc n
01-32-i-?' ]fldg. Pe?mi
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Metei
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
r --- .
CITY OF EAGAN 12639
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ?
BUILDING PERMIT Receipt #
SF DWG/GAR Est Value $108, 000
Site Address 3676 AS:iBURY RD Erect 13 Occupancy R 3
Lot 6 Block 1 Sec/Sub. BLACKHAWK GL EN Remodel ? Zoning 81
Parcel No. Repair ? Type of Const.
Addition ? No. Storie9
¢ Name LUNDGRr:l BROS CONST Move ? Length 8
2
Z 935 E WAYZAT?? BLVD Demoiisn ? Depth
7
3
° Address
Ci? !dAY
ZRT4hone 473-1231 Int Impr. ?
Install ? Sq. Ft
a
OV
U -C
¢
?
Name 5IV'1F% wpprovam
Address Assessment Permit
THOMAS A WHITLOCK
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 pf EaQart,Ordinances.
A Building Permit is issued to: '
all work shall be done in accordance
Building Official
CONST
Water & Sew.
Police
Fire
Bldg. Off.
APC
Var. Date
Surcharge •''' - "v
Plan Review '126.50
SAC 575.00
Water Conn. 5 0 0. 0 0-
'
Water Meter 63.50
Road Unit 290.00
Tr.PI. 15 6 .v:1
Copie
Total ? ? ?> • U U
- on the express condition that
Eagan Ordinances.
• PormN No. PrrmM Holder Daft TNphons li
Plumbing
I vs.t ?f -,5
H.KA-C.
EI*ctdc Cyq r ° F-? c.
bf?
sononw
Inspecfion Date Insp. Commenb
Footinys I
Foottngs II
Foundatbn
Framiny
Rootlny
Rouyh Plbq.
Rouph Nly. ?b l
Insul. i ?
FMeplace
Flnsl Hty.
Final Ptby. ? .
Bldp. Final
Cod. occ. ? pn
Dwy;jr ty.
._> 1
Deek Frmy.
WNI
Pr. Dbp.
. PERMIT #
MECHANIGAL PERMIT RECEIPT #
CITY OF EAGAN
r. 3830 PIL07 KNOB ROAD, EAGAN, MN 55121 DATE: ?
CONTRACT PRICE i:? PHONE: 454-8100
Site Address BI.DG. TYPE WORK DESCRIPTION
Lot Block 1 Secf Suh Res. New `
? Name Mult Add-on
m Address Comm. Repair
c City ? Phone - pmer
p I Ciiy
?
. Phone
,
TYPE OF WORK
I
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets # ?._
Other
FEE:
S/C:
TOTAL•
FEES
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1,50 EA.
COMM/IND FEE - 1% aF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - CQMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(Apd $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
FOR CITY OF EAGAN
PERMIT #
. r . . ,
, • PLUMBINGi PERMfT RECEIPT #
CITY OF EACaAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Addr BLDG. TYPE WORK DESCRIPTION
Lot Block .??..?,Sec/Sub
Res. New L
? Name Mult Add-on
,S Address 7 o l? 7 P ` Comm. Repair
c Ciry/ Phone Other
NO. FIXTURES TOTAL
Name ? -? - ? ? ? ? jr • - Water Closet - $3.00
3 Address ?Bath Tubs - $3.00
O Ciiy Phone 3 _Lavatory -$3.00
?Shower - $3.00
FEES / Kitchen Sink - $3.00
COMM/IMD FEE - 146 OF CONTRACT FEE -,-Urinal/Bidet -$3.00
MINIMJM - RESIDENTIAL FEE _$10,00 Laundry Tray -$3.00 ?
? Fioor Drains - $1.50 ? 5
MINIMUM - COMM/IND FEE - 20.00 =yyater Heater -$1.5Q 1150
STATE SURCHARGE PER PERMIT - •50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES ZGas Piping Outlets -$1.50 -
BEYOND $1,000.00) Softener - $5.00
' Well - $10.00
?} Private Disp. - $10.00
??? / =Rough Openings - $1.50 SIGNATURE OF PERMITTEE ?v? > >
FEE
STATE S/C:
.J ?
FOR: CITY OF EAGAN GRAND TOTAL• "? '
CITY OF EAGAN Remarks D 1 V**m 1(o r] -/ 2 -
Addition_D?
?h
wk 6 l
i
t Lot ? Parcel 10_14350-060-01
(o Blk
?
a S
en - _
,,
Owner Street 1676 As hburTFtoad State 'Fa_Dan MN 55199
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1076 1986 253.48 50.70 5
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 6.70 25 Pd rior t division
SEWERLATERAL Bn1074 1986 112.09 22.42 5
WATERMAIN gn 1075 1986 92.80 18.56 5
WATER LATERAL
WATER AREA 1072 1986 309.40 61.88 5
Storm 5ew Trk 1073 1986 110.91 22.18 5
STORM SEW TRK 732 1983 32.57 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
3830 Pilot Knob Roadl P.O. B x 2G-A1 9, Eagan, MN 55121N°- 12639
BUILDING PERMIT PHONE:454-8700 ReceiPt a ?? -
To be used tor SF DWG/GAR Est value $108,000 oate SEPTEMBER 16 1986
SiteAddress 3676 ASHBURY RD
Lot 6 Block 1 SeciSub. BLACKHAWK GLEN
Parcel No.
Name LUNDGREN BROS CONST
Address 935 E WAYZATA BLVD
Ciry WAYZATPPhone 473-1231
? Name SAME
i
? ¢ Adtlress
? CiTy Phone
?w W Name TAOMAS A WHITLOCK
nddress 18402 AVON CT
aw Ciry EDEN P?na 934-0665
I here6y acknowledge that I have read this appl ication and state that the
information is correct and gree to comply with all pplicable State of
Minnesota Statutes and C' f Eaga Ordi ance .
Signature of Permittee
A Building Permit is issued to: LUND EN S CONST
all work shall be done in accordance with all aoolica6fBStattbt MinnesoL
Erect 121 Occupancy R3
Remodel ? 2oning Rr1
Repair U Type of ConstVn -
Addition ? No. Stories
Move ? Length 5 $
Demolish ? Depth 97
Int. Impr. ? Sq. Ft
Install ?
Aoorovals Fees
Assessment
Water & Sew.
Police _
Fire -
Eng.-
Planner
Council
Bldg. Ott. 9/3/86
APC
Var. Date
Permit 9 4?0-vv
Surcharge 54.00
Plan Review 226.50
SAC 575.00
Water Con n. 500. 0 0
Water Meter 63. 50
RoadUnit 290.00
Tr. PI. 156. 00
Copies
Total $2,318.00
on the ezpress condition that
City of Eagan Ordinances.
Building
ihis requesl void
18 mon[hs from Vq
C 47422 Z-6,6c /03?211)-
Repuew Dale
`
?_ Fite NO. PouPh-
in Inspection
Fequrtetl?
?
ReaOy Nuw?ll Noiity InsOec-
?
Wh
R
???
'D _ Aves ?No e9dy
or
en
_
censed Eleclrical ConVactor 1 hareby requeat insPeclion of above wner electricel work installed et:
Street Address, Box or Rouie Na Citv
36 76 -rAG N
ecuon o. Townsni0 Name or No. Range No. County
Occupunl(PRINT) Phone No.
vA/ID 6 r-.,) cotis- Y'7 3 a3
?= rr ss
r
?
Elec[ncal Conhaclor IComDany Nnme) Con?rar.tor's License No.
Standard Electric Co. 40837 .
Mailing Address IConvactor or Owner MekinB Instailalionl
2 a lewood Mn 55109
Authori d i0nature (ConVac r Making Installation) -
Phone Numbar
1 484-8044
MINNESOTA STATE 80ARD OF ELECTRICITY THIS CINSPECTION REQVEST WILL NOT
Griqgs-Midwav Blda. - Room N.191 BE ACEPTEO BY THE STATE BOANO
1821 UniversitV Ava.. St. iaul, MN 65104 UNLESS PNOPEN INSPECTtON FEE IS
Phon. 16121 2972117 ENC LOSEO.
REQUEST FOR ELECTRICAL INSPECTION E8-OUW7-04
See inetruclions for completinQ this lorm on beck oi yellow copy.
C(F 74 22 "'X" ilelow Wark Covered by This Request
Ravi AAd fleD. TYOB of euildinB ADDlioncee WiraA Equiymenl Wired
Home Range Temporery Service
Duplex Water Heater Lightinq Fixtures
Apt. Building Dryer Electrie HeaUn
Commercial Bldy. Fumace Sito Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tank
Farm th.r oer.i v Oiner Isnecifvl
Tt . uecify Other 01h?r
Compute Inspection Fee Below
p Fee Servica EnVenceSiza a Fee Feetlers/Subteede,s C Fee Circuits
z, to 30 qm s to Am s
I 31 to 700 Amps 31 to 100 A s
E M Above 700_Am s Above 100_Amps
Irrigation t3ooms so Partial..Other
Speciat Inspection T
Nemerks OTAL FE
; C?l. GC J
RouBh-in D:?te ' ?-?
o. ??i//'r,v?^ I, the Elect?ical
Q`? Inspectoq hereby
certi(v that the nbova
Final P. ?J < imgpection hes bean
?
? erede.
Tltls rpueal voiA iB montRS tmm
Thls revuest void CW51o b
iB rtwnih's Irom .
- C 49128
lib 0 7q
Reques Uate Fire No, qough-in InsyecIion
Nequrted?
?Heady Now Q Will Nolily InsOec-
h
Dyes No lor W
en Peady
[ZLicenseC E ecbical Conireclor 1 hareby request inspection of e0ove
? Owner alaelrical work installed at:
Sveet Address, Box ar Route No.
3& , Ash butc Pd Citv
ecLOn o. To nshi0 Name o No.
?I
(?
K flanBe No. County
ae.
-
T &u
Occuoant (PqINT)
W4C? 05. ?en-?-f12L?m%z Phone No.
q73 -/231
Power SuDV? er
V
? Atldress
t_
.o ao
l
Convacfor (CO
m
pa
nyNamel
E
lec
/
nca License No.
Comractor's
,/
?
,/
?
J
/ ? ?'-l?- ..
-?
-
G/C?G°?'LCCr p
ZO O ? .
MaJljnp AdJres
F-r 2 s (c,ynttactor or Owner Mak'?ra Ins?alla_??oP I
CSOx 271N
Au o ized SiO nat e Co t actor/Owner Mkine lnstallation) Phone Nwnber
t ?U ? u
MINNESOTA STpTE BOAHD Of ELECTNICITY TMIS INSPECTION HEQUEST WILL NOT
Gripgs-Midwey BId9. - paam N-191 BE ACCEPTED eY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PflOVEN INSPECTION FEE IS
Phone (8721 297.2711 ENCLOSED.
9I,2,51Rqc REQUEST FOR ELECTRICAL INSPECTION ? E9-OU001-M
1 See inslruelions lor completinp this form on beck of Vellow copy. ?(.
" .7` e
?49128 ""X" 8elow Wak Covered by This Request v d Y
AAn Reo. Tvae ot Builaina Applianeea WireA Enuiymem Wi.an
Home Range Temporary Service
Duplax Water Heater Lightiny Fixtures
Apt. Bu,ildinc
g
Dryer
Electric HoaUn
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm me, oeu y omnr isuec,fvl
t er SPeci y Olher Othor
Cnmuute Insoection Fee Below
p Fee Sarvice EnvaneaSize p iee Feeders/5ubfeeders N Fee Grcults
/7400 0 to 200 qm s 0 to 30 qm s -°` 0 to 30 Am>s
Above 20 _qmps 37 to 100 qmps 37 to 100 Am
Swinming Pool Above 100_Amps Above 100_Amps
Transtormers Irrigation l3ooms PdrtiaL?Other Fee
Signs Speciallnspection
5
TOTALF
1
Nem3rks /0
1
n
RouBh-in Da, I,the Elactricel
Inspectoq hereby ceriily Ihet the above I
Final . we/? "nspection hes been
de.
This reousst voiC 18 moniM Irom J
a -.. • -a
Ter#i#iratr uf (Orrupanry
Citp of Olagan
iprwdn"t of iutlding 3wrrtian
This Certificate issued pursuant to tke requiiements ojSection 306 of the Uniform Building
Code certifyrng that at the dme of issuance this sttucture was in complrance with the wrious
ordinances of tlte City regulating building construction or use. For the following.•
v: cwmismdm ;39
Hldg. Rrmit No.
Occum)7 TYm Zuaios Disvid r' ! .type Coost
BW7ditp Addrm Locahry i.b , $ ? , MAX"& M&
DeIC: J?.?r?!?
BuBding Official
POST IN A CONSPICUDUS PLACE
/C; ?
?
NOTE: ALL
M[TST BE LICENSBD 1dITH THE CITY OF EAGAN
SIBGLE F9lIILY DiiELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SORVEY, 1 SET OF ENERGY CALCULATIONS
MULTIPLE DiiE[.LING3 - EfiSIDENTIAL
INCLUDE 2 SETS OF PLANS, CER
1 SET OF ENERGY CALCULATIONS
RENTAL @lIT3 FOR S9LS IINITS
OF SQRVEY - CHEC% iJITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SE'f OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
f=nlyAvaluation: ?/
To Be Used For: Date: ?7' Z91e)?4
Site Address OFFICE DSE ONLY
Lot lo Block /
Parcel/Sub
Owner 4
Address 4
City/Zip C
Phone y ?,3 - ja3? Address
Ctty/Zip Code
Phone 51?73 - i„; 3[__?
Arch./Engr. /?if,?•,??I,<? /?, /./l?
Address Z9!Zaa2
/ fq/-?ra?1 ( "_,y ,,,,?Xf
City/Zip
i ?
Phone # ?`?,3:Z -el? 65
Erect A
Remodel _
Repair _
Addition _
Move _
Demolish _
Int.Impr. _
Install _
APPROPALS
Oceupancy
Zoning
Type of Constmi_
# of Stories
Length COM-
Depth T7
Sq Ft
Assessments Permit a'?i3
Water/Sewer Sureharge 64
Police Plan Review =6
,1
Fire SAC _
?7"j
Engr Water Conn 6b0
Planner Water Meter
Couneil Road IInit Z O
Bldg Off_ -? Treatment Pl
APC Parks
Variance Copies
YOTAL --? .?
NOTfi: ADDHESSSS FOR CORNER LOTS - CONTR6CTOR/HOFIEOWNER MIIST DfiSIG9AT8 NAICH ADDRESS
IS DSSIRED. NO CHANGSS SiILL BE ALLOfi6D ONCE BOILDING PERPIIT IS ISSIIED.
zo x zz . wO .<<zz sZ60
38%* -Z7 : /oz(0k 56• 57UZ
z7 4 5oft -o Cozrak4A? vr/tIq A&
/a 7660, 0-0
Cities Dijzital Qualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
. Y. ? / ¦ [(? /? G
• L=3 V r? V ?? V??
'
COflS1RUC1101J
S. IIJC. -- --- -
. I?JNWESOTA 55391 • (o"i2) 47;1231
935 El+S7 vJl;YZNTP. POULEVARD %',r%YZATk.
Ey,1ER]OP, ERVELOPE P,VEP.kGE U CO"?PUTA710N
Lot ? Block?
Site Nddress
R U
'-?74 '26
-
Factors
.OSS
ppaoue b7alls -
.117
Ylall Framing Areas -
' _023
Ceiling Insulation Area -
.027
Ceiling Framing Area -
OG
Rin Joist , - -
.14
liasonry Wall -
- ??
!-lindows Double Hung .26
Casements --
.18
Doors -
. --- : _ 46
: Patio Doors ; ; -
.47
Sidelites , -
1) Lower Level (Basement)
t
Total exposed wall area _ --
?x (u) .058 =
Opaque Wall Area -
-?x (U) -117 = ?_.
IJood Frame Area
- x (U) -04 = -
Rim Joist --
14
?x (U) -
Exposed block
Casement
Window Area
' - x
_ X (U)
(U) -46
.26 = ?-
= -
'--'
Double Hung
- _ -
Sliding Glass Door -- x (U) •46
Door Area - F,
? 7otal
k
_•f y
2)
a 0:Kil
DO (CCOhJSTRUC110N _--
? I(JC.
_---- I?II.NESOTA SS391 • (6?2) 573-1231
,- v T%-. BOULEVARD • VJAYZATk.
lst or r-,,cin floor
Total er,oosed wall area
Opaaue ::z11 area
Wood frame area
Rim joist
? 1.`indow P.rea ;
? 5liding Glass Door
Door area
Sidelites
Casements
Dauble Hung
: 3) 2nd Tloor ir 2 s'Lory
' Iotal exoosed wall area
` Ooaque wall area '
Wood frame area
l!i ndow area
Casements
Double Hung
Sliding glass door
Door area
4) Total ceiling area
Wood frame area
Opaque ceiling area
Sky]ight
?
-.
/?-? ?_-
26 P
?
(U)
.058 =
??-
?X (u) -117 _ ?
( U ) . 04 = J! ?--
-x
2jx ?U)
(U) -46
-26 = ?-
= /? 5
?x (U) .46
F-X (u) .ia = Ic?
4LX (U) .47 = l /? --
7otal ?
?1?2
94aX
1222X
/Lx 6
(u)
(u)
?U?
.058
-117
-26
= %-
= ?2
- x (U ) .46
=
? X ( U ) .18
= ?--
Total 9 ?
?iOa &
(U) .027 = ??-
9a.3X (u) _023 = a ,a
_ X (U) .55 = ?---
Total °??
. _ . _.._. . _ -- .. .. . . i., j„ .:
?COf Cl RUCI ION -
E -,
?
-- , , Mit.,wcsora ss?y? • cb,z> 473-1231
935 EHST V.'AYZATl. BOULEVF,PD ?lHYZH.TA.
Total er.posed viall area -;;? Z?2? X -11 = v??n?.92
11inn. U Factors
r. .020
11inn. U Factors Total er.posed ceiling area /??lo -??
(A) Total
Item +, Item 2//q ?+ Item 3 71+ Item 42,jo
L?
1 ?./ ..
If total of I-Lems 1- 4 is less tnan Item (A), building
complies witn SBC 6006 (C)s
= S? ?
C. __.
-SURVEYOR'a' CERTIFICATE
SIENNA CORPORATIDN
I \
I EX/\/N6 .
? HOUS
,? lo L?
a1?030 g?i _ ni.3 x
Q c?? o)) X- g31.94 xd
2B6 31?4
? 3 S
G=
fo
D ! N ' -z?.so _ u8S23 1 559
(A F' 02
?? ? Q??? 93f.7 ????
C ? 27.0 ? ? 77 ?
?
N
w r
<
?O tD m\°\
? m ?
W °
w
o (C O?
(D ? -nLIT CU 0 RAINAGN7 P F PWr `._,r
PRQPOSED .:,rm G?. VyW. ?J15EME
ORfVEWAY ?\
? O ? 22.0 V?`?L> ?1 ? N k f
X833-5 \ /
D
a 10
? _ ,? g 53 . 70 I
V340) - 28.12 ?839327.10 83q,789ol???5?? w ?7
?7J 5 g?i ? __ S g3RG f I
? 30
Lb?
l w z
REVISEO 8-.19-86 TO SHOW PROPOSED HOUSE REVISED 8-22-86
FOR LUNDCJ?EN.9ROS. CONST. . ,
'
I
r-
i
?
•° v
i ?
Z.W
N6? ri\
Ay
Cn
-- DENOTES PROPOSED SURFACE DRAIIJAGE SCALE: 1 INCH = 30 FE[T
O UENOTES
DENOTES IRON MONUMENT SET
IRON MONUMENT FOUtJU
PROPOSED GARAGE
FLOOR =
&'3y,8
-
FEET
•
X000.0 DENOTES EXISTING ELEVATION
PROPOSED LOWEST
OP OF
FLOOR =
BLOCY
=
e2-
1•e
835
2
FEET
FEET
(000.0) DEfIOTES PROPOSED ELEVATION PROPOSED T . .
l-lE IiERE6Y CERTIFY TO SIENNA CORPORFlTION 7NAT 7HIS IS A TRUE AND CORRECT
REPRESENTA7I0N OF A SURVEY OF TFIE 40UNDARIES OF:
Lot 6.Block I, 4LACKHAWK GLEN 1S7 AUDITION, according to the recorded plat
thereof, Dakota.County, MinnesoCa.
IT l)OES NOT PURPORT TO SHOW IMPRDVEr9ENT5 Dft ENCROACHMENTS, IF AN1985 S SURU[YED DY
ME OR UNDER MY UIRECT SUPERVISIOP? TH1513T N UAY OF NoY. ,
SIGPI[D: JAME R HILL, INC
DY: ? " C,.
? 'r?
, 3
HAROLD C. PETERSON, LAPID SURVEYOR
h11NN[507A LICENSE NUh1aER 12294
PROJECT H0. a00K / PAGE JAMES R. HILL, INC.
85618(F69?G) Pfanners / Engineers / Surveyors
FiLE rio. 0200 Humboldt Avonuo soutn
FOLQER Bbominalon, Mn. 55431 012-034-3029
.
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*ATE: PAYMFNf OF kEE AT TIME OF
APPLICATION DOES NM CONMTM
APPROVAL OF PERNIIT.
_._ --____°----- - --- - - _
P ease Print)
1) PROPERTY ADDRESS; 3076 &4/Mry •-
LEGAL DESCRIPTION: Ge?- G /J. [wa4t-,1 -1,44f??((?y,y,?
sion
IF E7QSTIW. STRL'Ct[]RE, DATE OF ORIGINAL BL'ILDIM PERMIT ISSL'ANCE:
(Mont Yearl
PRESEN77P ZONING/PROPpSID L'SE: `
? Ca1MERCIAI./RL7AIL/OFFICE ? R-1 SINGLE FAMILY .
r7 IN]I-'STRIAL ? R-2 DL'PLEX (Ttoo Units)
n INSTITL'TIONAL/GOVERtZ= ? R-3 70WNEi0USE (Three + Units) ( Units)
. p R-4 APARTMEN'p/CODIDOMINIIINI ( Units)
2) ? , • /
NAME:_
aMREss:_ 93s- ? w?as. i?f+. 1•-.-d.
CITY. STATE, ZIP:
PxoNE:_ y73 • /x 3 !
3) • u ?: ?• '?" For City Use .
- NAME: Lv.v Crcrrn /?s'e f' Plunbers License:
ADDRESS:_ '735- E. 6*?4si ZW44? Active
CITY. STATE, ZIP:_ 6"¢*z4A 3 ?ExP1Ied
i IttN J.1"?77 / Not recorded
PxoNE:_ y 73 - i z? i mr,sTm r.2cE[vss# 11 y 3- M
- st Initial
4) ?• ? ??-
NAME:
ADDRESS: •
CZTY, STATE, ZZP:
PHONE:
•5) ? vi a• • ?• : ? • o? - ?,
ODNNECTION 10 CITY SE?RaIIt ? CONNECI'ION TO CITY WATEFt n
6) ? •' • r (T75 PLEASE HOLD APPROVID PERMIT FY)R PICK-DP BY ONE OF ABOVE -: -- -- .-
? PLFASE MAIL APPROVID PERMIT TCl 1. 2, 3. 4, AHOVE
Ar A. & I - /1 (circle one) '
nusrFx-rioN oF sEKM aND/OR MM
nSt'AL? .a'r10NS V7IIM DiOT FE SCig9-
UI,ID [J[TfIL PERMIT AAS BEEESI
APPFtOVED.
FOR CITY USE ONLY
PERMIT # ISSL'ED
7 ;7
Pd w/Bldg. Permit
$
?
$
FEES:
$ SEWER PERMIT (INCLUDE SURCHARGE)
$ IZ?• ?j-? WATER PERMIT (INCLUDE SL`RCHARGE) ..
$ WATER METER/COPPERHORN/OC'TSIDE READER
$ WATER TAP {INCL['DE CORPORATION STOP)
$ $ SEWE° TAP
$ $ ACCODNT DEPOSIT - SEWER
$ $ /?? ? c/ d ACCOONT DEPOSIT - WATER
-?
$ Sd G- c--c) $ wAc
$ 5 7.5--L-U $ SAC
$ $ TRL'NK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMEI3T
$ $ LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ I 2- ,-~j /• U-ZD TOTAL
2- 7 ???S
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUEA BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CO[VDITIONS:
APPROVED BY:
TITLE:
DATE: 9)2-,? /Q (,
, HEAT LOSS CAtCUTATIO
CuNOmf NsnN ?? .rO?n ?Yr35
Cny -
Orlw Name.
Strq1 -----
City
f lwwrn 38 wieen a-I w,.
Win}fows and Doon-Gxka" snd y
Ar
wmh Mo. a Lwx n. w.
we
e? ?M M l U NtAtt .?.
? l?
-
.
.
,.
? 1
I D$ C.1et1
co.i. stu
Intdtrauon 70 ? 6
GNu
fxp. wall- -:30 X 10
Not eap. wall 9 3900
Im. wdl •
Giling ? X yLl
I
2
i
j
OSeI.,
Fl°°r I'a - D
Toui Bm. i V
) y F I.- Room I Lann wwen i 4 Msi t
wineoW aw -,c?,auo. " ?...
. Me. W'MM Wq^» `e. N UMM".4 -A h
?- 3 W 2 i b
3? 3
_
atu
IMihration lib
; - ws S s;
. ?
wall
,
, t .uc. wall / i-
''.,Ant wau
toihng 19 k / Z fo
= ?.
stu.
Doora-trae*as rd Arr
w
t-Ink M U N
.
Afo
Otu
lnf ilt/ibon -
Gwa ' 00
?
f rp. vwll 2?+ S'
Nw oap. wall I B
im.wan
1
Coi
-li^9 U-S X 1
1 jb
2
z
!=!
F?Of' ?50 ? a
z
Ioni sw. I 32/e 0
?,i?r I - * 3
N .-5o ° TEMP. DIFF.
Typm CoMhuRbn 'Ri n+on L a 54*w.nl :
MIiMOw? St0?111 .yh
Walb . Irta.
Gilirq Ins.
floa
9 f? RoomI lwwth Wideh ( IMi t
winaows aw ooon-c..ck.O.wW rv« ?.
?. N MM Iyl?l?? IN. M I~ h. • M .
1 8 bb
? !w .
In}ikralion (p
GIM
E.c. w.ir k
No KP. will
Int. wall
Gilinp X
floor p-
rotd Btu.
I ?Fi.l araa kF°?*Aaom? Lrqt?f]. ? Wideh 13 INidit
wineow. me ooo..-0,auo: «ie Ar..
Me. N NM No M Na ` 4MY K A"g
(o-
Ce?l. hu
Ineikrnion O b9
.Gbr 3
F.o...?? x
No ezn. wNl 3
Int. wall
Giliny ?t 1
• Z
plear / a'
obl Stu. -A- "
19rol i f--_•7- n? limamh 12 wd*h i%l- be.AkeR
Windoirt d Ooas-8ad?a wd Am
w. M.TM
M w Mn/?? IN. M ??? 11.
Z1
3l. Z? 2
itu
Inlih?atwn O
Grr ? 4b0
Eap. "ll Y p
K
M.t ..a. wall r
Int. wall
???ro I 3 x I u m.
Z
Fbor 3 to
Tobl etu. I Sa(c[)
, ?R?e Z o F? 3 I
HEAT LOSS CALCULATION -2jL--* TEMP. DIFF.
Tro. Conw.uajon P44hQf0n ?54o=L
,r1er Nimt. Window &am SM 4f/?
81nN YWIb . Irr. -
ChY `Gilieq IrM.
Flop FI.I floomll D WidM '
Win}fows Doort-Guk ? t 1.1 #oom?L ry? a ?=,
+p and Arw 1Ni t
Ne -wMr?^y ..a•?Mm ?e. ?? i N me?i. •,?ry. wiAdDwi and OoorfMM A?M .
? 02
Erp. wall
Net e?p. will
Int. wall
Tottl Btu.
f I.?'?v Room I
wllldf /Ild D001{•
Ms ?'°t? ?MN^I
. wall
eKp. wall
wall
Mn
i/MI
IlIt1l11i1 WII
ti?iyj l
wall
F?p. ?b x
? oKP. wall
Int. wall
Me.
y?t
W
^
IN. M IMMN h.
? e ?
ary?
h
_
i?nn..cb? Za
o
G4o
---
- f 1v 0 !7
??
Exp. wra
Met nxp, wU
Q
Int. wall
Gilinp ? ??
floor /`?f ?- ??'g
• wYIY.
+ I.?
wllldpm pw
Me. YII?!i? M
Old AIN
. ._.. ??• ?StV
(oU Inf ikration
A tl0 '`; Ghr
..
Eap. wNl
a- ` l b Nw ap. wNl
.. ? Int. wall
336 , c.a„q
7+ ' 3ro " Paa
? 00 n?,Btu.
1
?
H
s
4
ind A?M .
/?
r
r
wkmiom
•?rM h. w
N 077YE
V
ww
I
? ..
?
°"" I/O IcutiI ftmf2- ,
fXp.well ?
NN ucP. well
im. rsii
t I-?I
f'q ?,e S °-'r ?? \
1.
HEAT LOSS CALCUlAT10N -20-0 TEMP. DIFF. .nw I?iMn. ?-u ?rCn c? ros '
•r
OMbr Nue» .
?
YUNidowt tEOrn?l?A?.-?- •>
Gi1Np
fber
wiMerA
.ne A...
? MAtn ?-vhl `e. M N q. n_w
3 0
CoM. /tu
- Int??dat?pn
460-
1 ov
G4a .
' Eso• wall' 3 I x 8
NR *xP. wall .Ip .
Int. wall . E
c.?u? 1 3 x 18
Fba I;L-
Btu.
rd Du*rs-Gackas and Arr
N N w h
co.e. WU
>R'`lnlinnsioe v o 0
?.?`,t;f¦p. w?N ' ? K .
taP. wNl
= . ,,ML wNl
as
2,sZ
1 -2-4
?
6041
BIU.
wW4*WA sm
-? W M?n .
M w? Mryn1
M M' b. M
L =L ?.
-aY
?p?llf?iflOfi
G4;a
Ump. wsll
IWt nmD. wall
IM. rwll
CN?np
flar
FI.I AOOn1I L?h . ? , 71N - ;;,?
wWW&M.ne ooo?.-a.*w .na ?.
wo
«.. 'M""'" .
T
-
M?
Mfik??tlon
Gls
Esp.,rmn
Nae ..p. .?rou
f
Int. wNl
c.?ling
fber
ToplBro.
il.l 11oanIL?Mh ? INi t
Window and Doon-OadaM Wd ArM
w. M YM M K .
.
a»r.
w
Ow :
MliKntbn
G4s
Eap. wNl . . . ? . . . . .
fUt esR wW
Mt. wll
Giliig
floor ?
Totd Stu.
F1.) Noeni ? - Wf0
MfN?dawt ?nd Oeott-Cn
I • wd M ?
?
l11f d11at1D11 ..
Gw?
EMp. wNl
Not ertP, wNl
IM. wNl
CNlfn?
Fbor
Toul Bw. N Tonl Stu.
(0?? (c(O ? Connlc-F?
?-
? ,,
(09,-?'
_. ,yi
?f RESIDENTIAL
S / ?O ' BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New ConaWdlon Reauiremenh
. 3 regatered site suNeys showing sq. ft. of lot sq. N. of house; and all roofed areas
(20°k macimum bt cove2ge allowed)
• 2 copies of plan showing beam 8 window saes; pnured found design, etc.)
• 7setotEnerqyCalculations
• 3 capies of Tree Preservation Plan if lot platted after 1/1/93
• Rim Jaist Detail Optians selection sheet (Wdgs with 3 or less unils)
DATE
SITE ADDRESS
TYPE OF WORI
ULTI-FAMILY BLDG _Y SN
FIREPLACE(S) -Y0 _ 1 _ 2
APPLICANT C'atastmphP RPCtoratinn SPryirPC Inr
STREETADDRESS PAR9 Rice St Ciiita 7Q CITY Rnep??i,,,a-ill STATE nANZIP 5511
TELEPHONE # 651_734_9424 CELL PHONE #
FAx #
PROPERTY OWNER TELEPHONE # toS 1`U5 U' 90
................. --------------- --------------------------------------------- -----------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category VIINNESO"CA RULES 7670 CATEGORY 1 MINNESO'1'A RU"LES 7672
- 'f
(J submission type) • Residentlal Ventifation Category 1 Worksheet Submitted • Ne ae{gy ipde F9dricsfiui"cetlLS 5iiti i[p
? In i
• Energy Envelope Calculations Submitted ? i
AUG 2 1 2002
I
Plumbing Contraetor: Phone #
Plumbing system includes: ? Water Softener Lawn Sprinkler By_ -Eee:-$9I1.00-
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Confractor:
Mechanical system includes:
Sewer/Water Contractor:
_ Air Conditioning
Heat Remvery System
Phone #
Phone #
Pee: $70.00
-----°---------------°-•---------°--------°---------------°°---°------•--------------------------------------------
I hereby acknowledge ihat I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eag rdinances.
Signature of AppUca
---- - - ---------------- - -
---------_._.....-----•---°__-----------_____ ___.._---------------------..._.. _»
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
RemodellReoairReauiremants /? ? ??
. 2 cropies of plan
• 1 set of Energy Calculations forheated additions
• 1 site survey for ezterior additbns & decks
• Indicale if Iwme sened by septic system for additions
VALUATION ,?. ?-F`-i ,&5`7
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 71 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning Ciry Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Foorings(new bldg) FinaUC.O.
_ Footings (deck) FinaVNo C.O.
_ Footings (addirion) _ plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs
Air/Gas Tesu Final
_ Framing _ _
Siding Stucco Stone _
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
-4-zs( (z)
2006 RESIDENTIAL MECHANICAL rEUnuT nrrLicATioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
s'1
I
?I
?
Please complete for. single family dwellings & townhomeslcondos when permits are required for each unit
s o
Date C_J / a / ?0
SiteAddress Unit#
Property Owner Telephone #((oGj I) a 05 - GCoV)C)
Contractor CONTRf1t 1 CA elA INl!
21210 EATON AVE
Street Address City
State Zip Telephoue# (6a5l ) [.-S(o[?-CoE?2?
Bond tt: Z 2 p? 0d:7-1> Expires: Od
The Applicant is _ Owner y/ Confractor _ Other
Add-on or alteration to existing dwelling unit
? furnace _Additional _ Replac n? ?New ?
? $ 30.00
airexchanger ? ?A? G 3 7?n6
? air conditioner
heat pump
other
State Surcharge $ .50
TOtAI $ ?.)(J -?!)-/
I hereby apply for a Residential Mechanical PeRnit and acknowledge that the information is complete and accurate; that the work willbe in conformance with the ordinances and codes of
the Ciry of Eagan and with the Mechanical Codes; that I undexstand 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
ap roved plan in the case of work which requires a review and approval o ar sI I
I ?i?sG?
L1 I I En "1 Yl C I l,v1r•? P ? ZApplicant's ri ted Name plicanYs S gn t
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3676 Ashbury Rd
Lot: 6 Block: 1 Addition: Blackhawk Glen
PID:10- 14350- 060 -01
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Capstone Bros Contracting Inc
216 North River Ridge Cirle
Burnsville MN 55337
(952) 882 -8888
Applicant/Permitee: Signature
PERMIT
City of Eaan
Construction Type:
Occupancy:
If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
$88.50
$1.50
Total: $90.00
Owner:
Clay A Stejskal
3676 Ashbury Rd
Eagan MN 55122- -125
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
Issued By: Signature
Building
EA090202
07/15/2009
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117050
Date Issued:10/15/2013
Permit Category:ePermit
Site Address: 3676 Ashbury Rd
Lot:6 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-060
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Windows/Doors: If altering the opening size, a framing inspection is required.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
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.
Contractor:Owner:- Applicant -
Clay A Stejskal
3676 Ashbury Rd
Eagan MN 55122--125
Smart Builders Inc
7001 Garland Ln N
Maple Grove MN 55311
(763) 691-5021
Applicant/Permitee: Signature Issued By: Signature
Jan 30 14 12:01p
AA Garage Door
City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
651-702-0838 p.2
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
L
2014 RESIDENTIAL/BUILDING PERMIT APPLICATION
Date: 6 . Site Address: 3(61 `+� o I vChb(
Resident/
Owner
Unit #:
1I52 -0.61-.5.5-e '7
Name: Nab!
l/(/t bI S-6. � g / Phone: ,!
Address i City Z p: 31L 7(G P5h � j RdRd,. E ajar i4 J `c1
i
Applicant is: Owner l Contractor
Description of work: ��1(.t �
e.� A i n U Q vorht .cI 9u'�rCi &terTypeofWork •
Multi -Family Building: (Yes t No
Contractor
Construction Cost: VI A 6)
Company: i iq C..(1-7.fiqL, Door
Address: l 0 i 1#1
State: H!" Zip: 'JS L 7
Phone: l4?�
Contact b.h
city: tS-E- pit L ( Pog,
k
License #: Lead Certificate #:
LS-1g7gq?
if the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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 masterIplan:
Licensed Plumber:
Mechanical Contractor.
i Sewer & Water Contractor: I Phone: s
NOTE: Plans and supporting documents tlit you submit are considered to be public information. Portions of i
the information may be classified as non-public if you provide specific reasons that would permit the City to 1
• conclude that they are trade secrets. _
CALL BEFORE YOU DIG. Call Gopher State One Call et (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. ,:.-tv.00cherstareonecall.ora
I hereby acknowledge that this inforrnation 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 must be completed within 180
days of permit issuance.
A
x ofc�h r�l� a x `�' �?- " r'i
Applicant's Printed Named Applicant's Signature
Phone:
Phone:
Page 1 of 3
!"
#$%&'()' *+*,
-./$%'"&0-1N3$2>$,+
-./$%'53/4-.1 67879C9
<*%-'!==3->1?9@?Q@:?7A
-./$%'#*%-+(.&1- -./$%
B$%-'6>>.-==1''9;A;''6=J43.&' >''
K"# $% &&8)**+ + , &&"#0$%.0Q%&\\#2,
567 8'98V(;'9'89'K'&
=12
<-=D.$0%$(,1
>?@&-AB2 C2E HN ,1 E?$ + ,&-AB2
D E%&-AB2 C2B#0$2
721$E+B + , 7 21&, &+,$#?*2&1%A#+4. J1L
N2,1?1&N *2 V(V&9&Z$$?B0,$A
_ ,+,4
>P?0E2&R22 '
5#2012&BE+, &B+$ ?E21& H&+$2&0,*&Q0 2E&BE 2$ + ,&0,*X2& ,&1+ 2M
#(//-,%=1
N0E@ ,&/ , O+*2&*2 2$ E1&0E2&E2P?+E2*&Q+ .+,&8'&H22 & H&0##&1#22B+,4&E /& B2,+,41&+,&E21+*2, +0#&. /21&JF+,,21 0&> 0 2&
"?+#*+,4&N *2LM
" &9&"012&R22&UVaU8'(MW;&'!'8MV'!;
E--'B3//*.&1
>?E$.0E42&9&"012*& ,&`0#?0 + ,&UVaUWM''&<''8MW8<;
`0#?0 + , &&V^'''M''
"(%*21F7?CG:C'
#(,%.*D%(.1HI,-.1
9&&)BB#+$0, &&9
240$A&C21 E0 + ,& #$N#0A&)&> 2d1%0#
8V'''&W; .&)X2&I(K:K&)1.@?EA&C*
>?+ 2&88'Y040,&FI&&;;8WW998W;
5#A/ ? .&FI&&;;VV:JK8WL&V(:98K<!
J:K(L&(;V9:KK'
6&.2E2@A&0$%, Q#2*42& .0 &6&.0X2&E20*& .+1&0BB#+$0 + ,&0,*&1 0 2& .0 & .2&+,H E/0 + ,&+1&$ EE2$ &0,*&04E22& &$ /B#A&Q+ .&0##&0BB#+$0@#2&> 0 2&
H&F+,,21 0&> 0 ? 21&0,*&N+ A& H&Y040,&ZE*+,0,$21M
)BB#+$0, T52E/+ 22 &>+4,0 ?E2611?2*&"A &>+4,0 ?E2
r
ivi
cPr- ,e
For Office Use I i'v`
%%% i 1 ; :::t:e:' ,
..•- � E 1
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RECEIVED
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 JUN 21 2018L Staff:
buildinginspectionsacityofeagan.com J
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10—'1 q—it Site Address: 3‘,,A) 1k46.1&vj I c - Unit#:
CA c D L Ski 5 LI Phone: (o51" Z(01 '9332
'r Name: tlr i n 1
E'Slf�:tr ASIV)ry Ra. Ear 5jS122
Dg I Address/City/Zip. 1� 0
N 4 ,1 �� Applicant is: Owner
' Contractor
' 41,t Description of work: � �"thS It Wk5� S t mai i ted V!/ /1 (1het PizI
:rmsthpea� �
, Construction Cost: 2.410 cc Multi-Family Building: (Yes_/No '^j)
47-0*-1V714,r4
Y d
V�'�tl�z.y �0�- Contact: e, a NAc""�"�r
Company: 1
* ' ,r� r ---4,-; Address: 36i a. C k1P � City: EU r+R3 rl l�l�-
r()•ClfrclCtor r
/ Zip:03
.1 (012.723 916 3I y '� UG-114Y pod er,
�� 6 �= State: �IV Phone: Email: d. Cr�c) n"
I
" License#: OA Lead Certificate#:
If the project is exempt from lead certification, please explain why:
?.9
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:
Fire Suppression Contractor: Phone:
NOTE:Plans d supp ortfn l'acume a tm re on eyed the u - fir► rma a , y-e LL
T
q assif ied a n public rf*0 rrovi = ecirc s t oul€1 e r e City cone ui' .th , Y. ..„4 ,r 1ts.� ,
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.comisubscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
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.aooherstateonecall.orq
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 wo ' not to start without a permit; that tthe work will be in
accordance with th approved plan in the case of work which requires a review and approva f pl ns.
x J 4:/i M Moi o xj� -IA i
Applic nt s Pri ed Name Applic n s Y.nature
. , 6,,, 7‘ ,i)--__<-4 bc(wy A2c1 ,....
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) Exterior Alteration(Multi)
Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex _ Lower Level �( Pool _ Accessory Building
WORK TYPES ®®
.New _ Interior Improvement Siding _ Demolish Building*
Addition _ Move Building Reroof Demolish Interior
_
_ Alteration _ Fire Repair _ Windows Demolish Foundation
_
Replace Repair _ Egress Window Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTIONs/
Valuation 9 9 o Occupancy / MCES System
Plan Review Code Edition SAC Units
(25%_100%\i) Zoning 1 City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
Roof: Ice&Water _Final X Pool: )(,Footings X Air/Gas Tests y Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: 1 , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge 11/9(.9 0 1°°#'
Plan Review
MCES SAC
City SAC
Utility Connection Charge 2 ilif 0 (2°
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
• POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS
Address: b74o 'LanRd
Applicant Name: e-ict z Sari - 451(.•1
GENERAL INFORMATION
• ¢
o z
j I ❑ ❑ Applicant name and contact information
JZI ❑ ❑ Property owner name
A ❑ ❑ Address of property
•� ❑ ❑ North arrow, scale (1" = 30' or 40')
A ❑ ❑ Site Plan, drawn to scale showing location of house,pool, and other existing or proposed
structures, including retaining walls and fences.
❑ ❑ Location and name of all streets adjacent to property
X ❑ ❑ Directional drainage arrows (existing and proposed)
❑ J ❑ Lot Square Footage
❑ ❑ Lot Coverage
ELEVATIONS
Existing
O ❑ ❑ House corners
O ❑ ❑ Property corners
A ❑ ❑ If applicable, ground elevation at each end of retaining walls and at wall's greatest height
Proposed
,® ❑ ❑ Finished pool deck corners
0 ❑ ❑ Top of proposed retaining walls (if any) and at each different elevation(if it changes)
❑ ❑ Pool bottom(or max. depth)
DIMENSIONS
Existing
.1 ❑ ❑ All property/lot lines
4' ❑ ❑ All Easements on the property
Proposed
AE( ❑ ❑ Pool
, I ❑ ❑ Pool plus integrated deck/patio
,J� ❑ ❑ Shortest distance from outside edge of••of deck to lot lines and house
Reviewed: ‘h7//3
Nave Date
G:FORMS/Pool Permit Checklist/11-20-12
. 7( , A _ , (ay.,/(ay.,/R P1(: :e
EC;,._ ;, . ,
AUG 032010 . SURVEYOR'S. CERTIFICATE SIENNA CORPORATION • • .
= / -s()c .e'E
t6 A
•
_� R ir,.;, \1
tt4V'i 1__,
\ -- :.
\ 1 ..
HOVS' p
X� 30 i3I•Q) �_ _ 9 a' x�1r.4 t � .
28 63 0r' ' S I
�► r'
or
-27:6o ._ i.,1
,co " ., 8323 3�5s '59 �, I .
J) la (--� - � — 165. O 1 I
. i I
27.0 ,' . '.�" - cn :: Cia25
C Q QO w (�� w _.-L"'5-1";('- ,°- 0
70 I( k
'�1-a O � � � ; �,� i �` CO
�ii O i�r� w V)41 13 s-,
9:1)',f,---') r_ o ~~I
(11
Q W W o._ _ .x „sll i 4 p V
AL1 c,--�5.0 1 TY ; O��
1. (71
4} •y °, / ��\zr Ra1fJAGr & iv. Li
•�- I
�0�
PR POSED 1� -4\AR. y� f CM N � )• cd
'� DR 1}lEWAY ., 1 N�r �.-ti ,-,-7-=-_, .. .tom :•�y.o
I '!
t (� • . 22.0x" -�- - a
f33-.)1.3%5
p.X833.5 -- I/ •,,r•
10 ---1-4-94 ------ , r x.12
Q3�10) ` 28.12 -839 3 .10 SOq•7 9 0 10 , 0541
y _7 / •n;,,,, �., .
r
30 IL
\J "T47° aL.
+o I PI,L~ o
O.\
\ M 0
REVISED 8-.19-86 TO SHOW PROPOSED HOUSE REVISED 8-22-86
FOR LUNDGREN.BROS. CONST. •
4 DENOTES PROPOSED SURFACE DRAINAGE •
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 03,-/.1 FEET
X000.0 DENOTES EXISTING ELEVATION • PROPOSED LOWEST FLOOR = 62.1 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = s.35s2. FEET
• WE HEREBY CERTIFY TO •SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 6, Block I, BLACKHAWK GLEN 1ST ADDITION, according to the recorded plat
thereof , Dakota .County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, IF ANY. AS SURVEYED BY
ME OR UNDER MY DIRECT SUPERVISION THIS 13TH DAY OF NOY. , 1985.
1 / ' VVE®_41 SIGNED: JAMS R HILL, INC. ,
A. �:. `..
DBs :_
' � BY: �. 4.)- (,/1C' 1Qiry^'
Date
EAGAN ENGINEERING DEPT, • HAROLD C. PETERSON, LAND SURVEYOR
• MINNESOTA LICENSE NUMBER 12294
Pi3OJECT NO. BOOK / PAGE • JAMES R. HILL, INC.
8561806g1 •
Planners / Engineers / Surveyors
•
FILE NO. 8200 Humboldt Avenue South
FOLDER Bloomington, Mn. 55431 012-584-3029
-
• ` • • •
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA161693
Date Issued:06/09/2020
Permit Category:ePermit
Site Address: 3676 Ashbury Rd
Lot:6 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
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.
Contractor:Owner:- Applicant -
Clay A Stejskal
3676 Ashbury Rd
Eagan MN 55122--125
(612) 437-1698
Heating & Cooling Two
18550 Cty Rd 81
Maple Grove MN 55369
(763) 428-3677
Applicant/Permitee: Signature Issued By: Signature