1803 Carnelian Lanecinr oF EAC.AN
3795 Pilot Knob Road Eogan, MN S5122 N! 6326
PHONE: 454-8100
BUILDING PERMIT Receipt _-
To 6e aed far Est. Value Date , 19
Site Addrcss Erect [Q Occupancy
Lot Q ? Block `i Sec/Sub. • -? Alter ? Zoning
parcel # Repcir ? Fire Zone
Enlorge ? Type of Const.
oWC Nome Move ? # Stories
Z Address • Demolish ? Front ff.
? Ci Phone Grnde p Depth h.
m Name APProvab Feea
o .
?
Address Assessment
?
~ Ci p?o,? Woter & Sew.
? Police
?
Name
W Fire
?? Address Eng.
<"?' Ci Phone Plonner
Council
Permit
Surtharge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
I hereby acknowledge that I have reod this epplicotion and stote that gld9. p{f.
the information is correct nnd agree to comply with all applicable APC Totol
Stote of Minnesoto Stotutes and City of Eugan Ordinances.
Signature of Permittee
A Building Permit is issued to: on the express rnndition thot
oll work sholl be done in accordance with all applicable Stote of Minnesota Stetutes and City of Eagon Ordinonces.
Building Officicl
Pwwlt # Dah Im? hrmitFN
Plumbing
Mechanical
INSPECTIONS DATE INSP.
Raph-I n
Finol
Footing5 Q- ? Dote Imp. Date Irnp.
Foundotion Plumbing
Frome/ins. Mechonical
Final
Remarks• 1117 IgC C?f c?e ?.fiiA?? S/rre' C
I
?
CITY OF EAGAN Remarks
Addition CEIaAR GRO VE #7 Lot 21 Blk 9 Parcel 11 16600 210 09
Owner A-, - ^? 4') Street 1803 CarneliaA I,ane State Eag?? MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 58.1$ 2.08 28 Paid
* SEWER LATERAL 1971 20
WATERMAIN
* WATER LATERAL Z 1971 1,615.00 $0.75 20 Paid
WATER AREA
• STORM SEW TRK 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 260.00 3477 4-28-71
BUILDING PER.
sAC 200.00 3477 4-28-71
PARK
INSPECTI
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
` PERNIIT SUBTYPE:
?
I I !"m I IV
ON RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
?c.l. ! • ? 1) i.?. 'i
TYPE 4F WORK:
i , , 1. i i ,
F 1 N A I
?I W. rn'
N ? lJ
1 F WF F', 1 AN(O 1'Nt3 )
Permit No. PermR Holder Date Talephone A
ELECTRIC
PLUMBING
HVAC
InspecUon Dete Insp. Comments
FOOTINGS
FOUND
FRAMINQ
ROOFING
ROUGH
PLUMBING
PIBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FiREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
' CITY OF EAGAN
z 3795 Pile! Knob Raad Eagan, MN 55122 N2 6326
PHONE; 454-8700
BUILDING PERMIT APPLICATION Receiut #
To 6e used fer CHIMNEY Est. Value 1,300 Dme 10-27 1980
Site Address 180 Carnelian Lri. Erect ? Occuponcy
Lot-2 1 Block
Sec/Sub. C- ?' ? Alter ? Zoning _
Parcel # I?
. ?? I??F?0C9 21j0 dO ` Repair ? FlreZone _
E
l T
f C
t
n
arge ? ons
ype o
.
w Name ROnald J8CkE1S Move ? # Stories
z
o
Address 1$03 Carnelian Ln. Demoiish
j]
Front ft.
ci Eagan, NECI. Phane 454-6237 Grode ? Depth ft.
?
0 Narrve Wlll7.8IIL B11M Approrob Fees
?u Address Assessment Permit 5-(1(1
Apple ZIa112y, ?Tl
?' Woter & Sew. SurcFarge - 5(1
o?e
Ci Police Plon check
luw Neme
F?„
Fire
SAC
2
?
Address Eng. Water Conn.
aW Ci Phone Plonner WaterMeter
Council Road Unit
I hereby acknowledge that I have read this application and state thot Bldg. Off.
the information is torreci and agree to comply wlth all cpplicable AP? Total 5.50
State of Minnewta Statutes nd?City Eag
an
O
rd
i
na
nces.
?
?
??
j
?
?
a
'
Signature of Permittee
?%?-"?'-
tiN111i27R BllT1Z1
A Building Pertnit is issued t: on the expreu condition that
oll work shall be done in a ordance Ith a>il app?li le S?ta.?te. of Minnesota Statutes and City of Eagan Ordinances.
BuildingOfficial
• ? CITY OF EFIGAN /?`include 2 sets of plans,
1 site plan w/elevatians &
g[7ILDING PE13?LiT APPLICATION 1 set of energy calculafions•
To Be Used For Valuation ?? 4 O Date ?Q -??-??
site Paaress 1 go3 0-0h-'?,LJ ?a?zzJ oFFicE usE oNLY
?
Lot ? Block ? Sec./Sub. L, Fsect OccuPancy T
A1teY Zoning
Parcel #: Zone
Fi
Repair re
Enlaxge - q'ype of Const.
Owner: mve # Stpries
Aaaress: /?4 3 8 A-/7-J Derolish Fzont
City/Zip Code: ??r ?7"'?li?nm 5? /a ? Grade Depth
Pnone #:
Contractor:
prldress:
City/Zip Code:
Phone #:
Arch. /t1g • • _
pddress:
City/Zip Code:
Phone #:
APPROVAiB
pssessments Pernti.t ?, e 0
taater/Sewer St1Z'ch3Yg2 ti D
Police Plan Check
Fire . SAC
?X3 •
Planner
Council
Bldg. Off.
APC
Water C,onn-
Water Meter
RAad Unit
'it7PAL 6- 6? d
_A
9- 7
c, G ,
TOWN OF EAGAYJ
3795 Pilot Knob Road
S t. Paul, I4inn. 55111
PEP.MIT N0. 103
The Board of Supervisors hereby grants to Cedar Grove Construetian
Co, of 7363 Concord B1vd., So. St.Paul 55075 a
HEATING Permit for; (Owner) Cedar Grove Gonatructionat
1803 Carne11&n, 3990 Cimabar, 1775 Carnelian, 1783 Carnalian,'779-^Carneliang 1807
Carnwl4an21-9*711-9-5s 14-9-7. , pursuant to application dated
16-9-7, 1.5-9-7f 22-9-7
APriJ 220 1971
Fee Paid: 4120.00 Dated this 28th day of Apiil , 1971
^Building Inspector
S
di--9--7
C, G-
TowN oF Eacaii
3795 Pilot i;nob Boad
St. Paul, Minn. 55111
PERMIT R0. ' 109
The Board of Supervisors hereby grants to Cedas Grova Conetiaction
Co of 7343 Concord Blvd. E. South St. Panl 55075 a
pmmMnrxr. Permit for: (Owner) Cedar Grove ConstruCtioa at
1803 Carnalian, 39 ?ianaher, 1775 Casnelian, 1783 Carnelisu,.l'779 Caraelian;
_?21-4-7? 1-9- y 14-9-7,Pursuant to application dated
16-9-7* 15-9-79 22-9-7
Apsil.22. 1971
Fee Paid: $1 n nn Dated this 8th day of $pril , 1971.
_ Building Inspector
J
i
- RESIDENTIAL
19H3-S ????? BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConstruGtion Reuuiremants
• J:-gistered site surveys showing sq. fl. ol b( sq. fl. of house: an0 all roafed areas
(20% mmimum lot coverage allowed)
• ? cooies of plan showug heam 3 window sizes: poured lound desgn, etc.)
• 1 3zt of Energy Calcuiations
. 3 ropies of Tree Preservatbn Plan i( lot Dlatted afler 717J93
. Rim Joist Detail Opuons selection sheet (bldgs with 3 or less unds)
DAiE g[ ? q/o;;k
1-'V1C.
SITE ADDRE55 i $? 3 Ccw Yl P A i"t 1-r, . MULTI-FAMILY BLDG _ Y
TYPE OF WORKR IL Si-'dc? lG IZq( 65F fiREPIACE(5) _ 0_ 1
APPLICANT
JI,, N
_ 2
STREET ADDRESS _ 1aa ?I -7' iV. cv`&f cirr 6ulhsu ??- STATE Of y_ZIP 5 S?3
TELEPHONE # C?'I S?) `?D`,? • ELL PHONE # FAX #d 5?8D Ff- 8$'q6
PROPERTYOWNER kocS cJ0.e_ket5 TELEPHONE# (ic-St)yS?/-CR 3 1-
----------------------------------------------------------------------- ------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ y[IVNE:SO'l':1 RGLES 7670 G\"fF.GOI2Y I NII\\ISOT:\ RI'I.L:S itii`l
(v submission rype) . Residential Ventilation Category 7 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbinn sys[em includes:
Mechanical Contractor:
Mcchanic>tl systcm includrs:
Sewer/Water Confractor:
-- Air Condilioning
Heal Rccoven• Systcm
Phone #
Phone #
$70.00
------------------------------------------°---------------------------°----------•-------------------------•----...-----
I hereby acknowledge that I have read this application, state that the information is correct, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eagan Ordinanc
Signafure of Applicant DI(.
?l
---------- ------------- ------- __.------------------- ---__---- ____- ---- _----- ------- ----- ---------------------------
OFFICE USE OtiLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
_ Watcr Softencr
Water Heater
vo. of Baths
14fa. -7S
RemodellReoair Reouirements
• 2 copies of plan
. t sel of Eneigy Caiculatbns for heated additions
• 1 sire survey far ezterior addi6ons 8 decks
. Indicate if home served hy seplic system for addi6ons
VALUATION
Phone #
Lawn Sprinkler
No. oF R.I. Baths ?
AU6 2 1 2002
? CITAF EAGAN PERMIT 3830 Pilot Knob Road PERMITTYPE: BuzLozNG
Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 6 3 5
(612) 681-4675 Date Issued: 0 3/ 2 5/ 9 7
SITE ADDRESS:
1803 CARNELTAN LANE
LOT: 21 BLOCK: 9
CEDAR GROVE #7
P.I.N.: 10-16706-210-09
DESCRIPTION:
^.. (FREESTFlNDING),
k3:6iLding--F'ermi.t Type FIREPLACE
Buildi+ng Wb?k Type NEW
f?Fensus Code 434 ALT. RESIDEN7SAL
?
,
. ??
?. ?
A
'21. f J
2J C" ? ?'
REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: - Applicant - OWNER:
MASTER GAS FITTERS INC 17708691 JACKELS LOIS
2340 SHAWNEE DR 1803 CARNELZAN LN
NjST PAUL MN 55109 EAGAN MN 55122
(612) 770-8691 (612)454-6237
I hereby acknowledge that Z have read this
infor?matiarr4s cor.rect ansl. agrse ta_ comply
Statutes and City of Eagan,Ordinances.
? . _
. APPLICANT/PERMITEE SIGNATURE
application and state that the
witM a11 a?-jppli.cable State of Mn.
(RI74 D?! .? ?
SUE B SI ATUR
_I
? ? ? (
19t CTTY OF EAGAN 4
ig 3830 PILOT KNOB RD - 55122
1997 FII2EPLACE PERMIT APPLICATION
681-4675
DATE: J - -?- I/ _ "i )
DESCRIPTION OF WORK: _ CONSTRUCT NEW FIREPLACE
INSTALL GAS INSERT ONLY
PERMIT FEE: $50.50
_ ALTERATIONS TO EXISTING
INSTALL GAS LINE ONLY
? O'IT3ER: Fzf T ??-5 h.?VL?ce
-t G?s wv2 4f
STREETADDRESS: I gD, 3 ?/?2nJ£G/'*,? L-J -
LOT -J?_ BLOCK ? SUBDJP.I.D. #: 0, UJ&,' ZMN A
APPLICANT: (circle one onty) OWNER CONTRACTOR
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 5tatutes and City of Eagan Ordinances.
PROPERTY Name: J f!cifEG 5 Lo i 5 Phone #: IOd 3 7
OWNER
Signature:
StreetAddress:
City: ?,4y4.? State: "4,-- Zip:
FIREPLACE Company: (o S -rnvc. Phone #: 720- 162/
INSTALLER
Signature: '
StreetAddress: a?-?o .s Li/?-???f E De- License # :
City: No State: M-v Zip: SS 1 Uf
GAS LINE Company: 4-W P Phone #:
INSTALLER
Name:
.S1gIIfltUiC: r r
Street Address:
City: `I State: Zip:
CITY liSE ONLY ? 11 ti
LOT ? BL I RECEIPT #: ? I
SUBD. CtLl'QIr [97YU?C? ?? RECEIPT DATE: ? I? 1q
1999 M£CHMICAI. PEiMIT (RESIDENTIRIa
crrY oF eAeax
3830 Pu.or [crros gn
eAs,ax MNssiYE
(651) 661-4675
Da[e:
Complete this section onfv if you are installing HVAC in single family, townhomes or condos under
construction and not owner /occupied
• HVAC: 0-100 M B T U $ 30.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets (minimum of one required @$3.00 ea.)
• State Surcharge: .50
• TOTAL:
Complete this section on[v if you aze remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Please indicate if it is a new item, replacement item, or repair.
_ New X Replacement _ Repair _ Other
T?
? Fumace _ Air conditioning
_ Air exchanger, i.e. Vanee system, etc. _ Other
Remiuder: Ca11681-4675 for Inspectioxs. $ 30.00
State Surcharge:
Total: $30.50
SI'tE ADDRESS: 1 D O ( QIr nehan L! J•
ONVNER NAME: LoiS yoGkeIS PHONE #: W`,? -?15y -(na37
NSTALLER NAMEVOh(uS Sa&T/ )J i di- We1 ' PHONE #: "q31--70q-1
STREET ADDRESS: AVX/'
CITY: Aff (X ?/(29? STATE: MK)_ ZIP: 5f)104
441 e, (il)ditl?'?
SIGNATURE OF PERMITTEE
JS. FOR.NS 8LD%MECH PERMIT (RES) - 1999
I . M
EAGFN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERPaT POR WATER SCRVICE CONNECTION
Date: Anril 22, 1971 Number: 586 -
21-9-7
Billing Name:Cedar Grove Const. Co. Site Address: 1803 Carnelian L•an
Owner: Same
Plumber: Stein, Inc,
Meter
4/28/71
Meter No. IPermit Fee 10.00 pd 4/28/71
Meter Reading IMeter Dep.
Meter Sealed: Yes_ lAdd'1 Chg.
NO I Total Chg.
Building is a:
Residence XXX
t4ultiple tio.
Commercial
Industrial
Other
Inspected hy
Date
Remarks:
$25.00 Re-iNsPccTION ,",-I 170;
units IP,9PROPLERL'( fi,ISIALLED Mj-iEPS.
Billing rkldress 7343 Goncord Blvd. B.
South St. Paul, Minn.
55075
In conaideration of the issue and delivery to me of the above permit, I
hereby agree to do ttE proposed work in accordance witn the rules and
regulations of Eagan Tocasiship, Dakota Countq, Minnesota.
By:
Chief Inspector
By: CE?AR GROVE CONSTRUCTION COMPANY
? D O /Y7,CP/ C.. LJ ?i.012'_st
Please notify the above office when ready for inspection aad connection.
. ? ?
EAGtiN TOSJNSHIP
3795 Pilot Knob Road
St, Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATB: An ' 1 22. 7
OWNER;Cerlar Grove .onst_ .o.
TYPE OF PIPE Cast Iron
(Lot 21, Block 9, CedarGrove #7)
AddreBS 1803 a n 1;an .an
PLUMBER Stein. Inc.
DESCRIPTION OF BUITA ING
Industriall Coffiercial[ Residential I Multiple Dwelling I No, of unfCs
Location of Connections:
NOMBER 746
Connection Charge 200.00 4/28/71
Permit Fee 10.00 4/28/71
Street Repairs
Total
Inspected by:
DaCe
Remarka:
By.
Chief Inspector
In consideration of the issue arnd deliverp to me of the above permit, I
hereby agree to do tfie proposed work in accordance with the rules and
regulations of Eagan Toirc?ship, Dakota CounCy, Nlianesota
gy CEDAR Grove CONSTRUCTION COMPANY
/,?l J f//1 rn i r? ?' Please notify whea ready for.inspection and connection and hefore any portion
of the work is covered.
EAGAN TOWNSHIP
BUILDING PERMIT
Ownei "".?y...?':'T:7?Q:.......L'.v..°.?:'r?
Addrese (Pzeseni) ...f..'.b..----:?..-Y...........
Suild,z .................... :.........Q??..............................................
....
Addrere .......................................................... ....................................
DESCAIPTION
N° 2425
Eagan Townahip
Town Ha11
ne:e r ...................
Siorie' To Be Uced For Froni Deplh Heigh! Eei. Cost P ermiY Fee Ramarka
/ ? I ?'J
This permif does not au2horise the use of slreels, roeds, alleyt or eidewalks noz does if giva the awnes or hia agent
the righffo ereate any sifuation which is a nuisanee or which presents a hazard !o the healih, sefety, eonveaience end
genesal welfare !o anpone in the cammunify. .
THIS PERMIT MUST BE KEPT ON TFIE PREMISE WHILE THE WOAK IS IN PROGRESS.
T6is is !o eariifY, that.4S..rr,....c-?.....t.-¢...-..-?cC....... hespermission !o arect a...... +...:.------ - ._,:?C_ . ............._upon
the above descri6ed pramise subjaci fo the provisions of the Building Ordinance for Eagawnship dopled April 11,
1955. ?
....................... ( . .. .... F/...^ ... ............. Per .................... ' ?......0:`.?Q : °?---?............................
l Chairn of Tvwn Baard ? Buildin Im ector
MASTER CARD
•
LOCATION
OWNER `CVA R G.ML ClfA/1?
STRUCTURE AND
LAND USED AS
Permit
No. I
Issued Issued To
Coniractor - , Owner
BUILDING -I I I
PLUMBING
CESSPOOL - SEPTIC TANK
N?ELL
ELECTRICAL I
HEATING ? V s . y?s ?7/
GAS INSTALLWG I
SANITARY SEWER ? y 6 .- ?
OTHER
W
OTHER
?
I I
•
7
?
Items ? Approved
(Initial) '
Daie
Remarks
Distance From Well
FGOTING y ??, ??II SEPTIC _
FOUNDATION
FRAMING
`• Y. CESSPOOL
TILE FIELD FT.
FINAL
ELECTRICAI
HEATING
T?
y ? DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK I
CESSPOOL
DRAINFlELD
PWMBING jl
op-
WELL
SANITARY SEWER d, -o
Violations Noted
on Back
COMMENTS:
? 2005 RESIDENTIAL BUII.DING PERMIT APPLICATION
? City Of Eagan
3830 Pilot Knob Raad, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reouirements RemodeVReoair ReauiremenGa OFwe Use Onlv
3 2gisle2d sile surveys showing sq. IL of lot sq. fL of hause; and ail roofed areas 2 wpies of plan CeR of Survey Recd _Y _ N
(2VI. maximum lot coverage allowed) 7 set of Eneyy Calculatbns for heeted addftians Tree Pres Pian Recd _Y _ N_
2 copies of plan showing beam 8 window sizes; poured found design, etc. 7 sRe survey for additlons & decks Tree Pres Required" _ Y_ N
lsetofEnergyCalculations Addition - indicateHOnsiTeseptksysfem On-siteSepficSystem _Y _N
3 copies of Tree Preservation Plan'rf IM DlaGed afler 7/1/93
Rim Joist DetalOptbns selearon sheet (buldings with 3 or less units)
Date 7 / ?`?/ 6 S Co struction Cost l? , t!? R? '-
Site Address Ip
p 03 ??-e, (;0.YA QP
I?_. Unit/Ste #
S
i
Description of Work ?v_
=h?
A
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner Tm s ' Telephone # ( ?5() KS?I ^ (P
Renewal By Andersen
Conaacror 1920 County Rd. "C" West
Address Roseville, MN 55113 C?ty
State 651-264-4777 _ Telephone # ( )
License #20130983
''
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy COde Category . Residentiai Ventilation Category 1 Worksheet • New Energy Code WoAcsheet
(Jsubmissionlype) Submitted Submitted
. Energy Envelope Calculetions Submitted
Have you previously constrvcted a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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
appro al of plans.
A plicant's Printed Name Applic t's Signature ?
?"•"•,"'•? ?uu ?c.ov rrin. roa o!1 440D L(?tSiTlll. BYkttUtSit7tSLY .
re
rune ?, zaal -
. City of Eapn .
3836 RiIuE Snob Road '
EAM MN 55122 To Whom It May Canoerrr.
EIder Tones is aathodzed to ptM buildfilg pftmits forRenewal bY Andeasen. Please aIIow
Eider Jones to pi+ovide this
date bcyond 616101; Acrvicc forns in Eagan, 'ihia enthorizetien is valid Pvr any
to theCity- watil a?'enanvaj bY Andcrsen manapt exPcessIY revokes it in wiiHng
I rcqueat tGis authodzafion be ecc,epted-°xpeffidously. as to uot deIay in the .
our bniidinS Pcnmiti anY fi?ez. Plcaic
contacbed at 763-502-4746_ caII mc If tficm arc nnp qucstfona.. I?ng of
,
.. _ ?.
Your imm9diats mttcntion to Wis metterls 111DtdargL 9 -
Sincarely,
4XYm ond R &-Rau
dstalIation Managor
Ranowal bY Andcrsen CorPotativn
C'r.: TCarn-F.IcIPr 7nnea . - .
y oH o. !?
??
?
_ `°^??.?.?
?
Y •
,
+Gluu
Received Tihe Jun. ]. 1-07Pld
-----------------
I Far?f.?tice Ils_e` ?
? Permit # j
i Pertnit Fee:
? Date Received: ?
I I
? Stafr: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ? - 11 - Site Address. k60 Tenant: Suite #:
RESIDENT! OWNER Name: L_ffl-? Phone: 411l-'l5H -46 Z51
Address / CRy / Zip: \b° 3 (c.r ( ?., ?.7c??1
i
Applicant is: _ Owner _X Contractor
TYPE OF WORK Description ofwork: 1cn+" cDW k te,c*r+? Ywu,a,
,A Avr+xqP.
-
Construction Cost: Zac7' Multi-Family Building: (Yes No ?
CONTRACTOR Name: ? ah F}clin 44 License #: 7.017-b66a
Address: ?q ?J 2,76 Sf•
City: 5t • l..oA.?s i? State: N'LN Zip: 554Z-B
Phone:46s'9z5, 1,156 ContactPerson:U?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Su6mitted Su6mitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan hased on a master plan7
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contrector: Phone:
Sewer & Water Contractor: Phone:
NOTE,` Plans and supporting documents thaf you submit are considered. to be public information. Portions of >
the information may be cfassified as `non-public if you provide specific reasons-that would permit the City fo
conclude that the are irade secrets. . =
I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance 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 permik that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
?
x ? x -
ApplicanYs Printed Name canf", a
Page 1 of 3
Use BLUE or BLACK Ink
r
For Office Use -
I
rP~ I l 31
City of Emu I Permit
I b 1C
I Permit Fee: I
3830 Pilot Knob Road I
Eagan MN 55122 Date Received: 1
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
t Name: Lk, S )iCcctakw, Phone: 3-7
Resident/
Owner Address / City I Zip: caf^eA[._~ Lot. _ our..
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Applicant is: Owner Contractor
Description of work: Lotcf'' oR
Type of Work
Construction Cost: OC7 Multi-Family Building: (Yes / No
Company: ~Y- Contact: Address: MP~A City:-15
Contractor
State: Zip: .~.3 Phone: !7S 7_ " 7Z56( 5 (CD
License BL (2 ~88o Lead Certificate
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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 master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
i NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that 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.aor)herstateonecall.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 must be completed within 180
days of permit issuance.
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Applicant's Printed Name Appli ant' n ure
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