1897 Bear Path Tr
skol RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Requirements RemodoUReoair Requirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks
1 set of Energy Calculations . Indicate if home served by septic system for additions
• 3 copies of Tree Preservation Plan if lot platted after 7/1/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
11 C
/ /
DATE ~C~ VALUATION 16
SITE ADDRESS 11 G1i I MULTI-FAMILY BLDG -Y _N
TYPE OF WORK-kso,C4 Pb Z 9 FIREPLACE(S) _ 0 _ 1 - 2
APPLICANT Renewal By Andersen, Inc.
U
STREET ADDRESS 1920 County Rd. "C" West STATE ZIP
Roseville, MN 55113
TELEPHONE # 651-264-4777 FAX #
License # 20130.983
PROPERTY OWNER ~t TELEPHONE
COMPLETE FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: , Phone #
-
Plumbing system includes: - Water Softener Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: Air Conditioning Fee: $70.00
Heat Recovery System
Sewer/Water Contractor: Phone #
1 hereby acknowledge that I have read this application, state that the infor ation is c ct, and agree t omply
with all applicable State of Minnesota Statutes and City of Eagan Ordin ces.
Signature of Applicant
_
F, D _ -
-
OFFICE USE ONLY a 4~12- C
ertificates of Survey Received _ Tree Preservation Plan Received _ Not Required
Updated 4/02
0
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 ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 06 04-plex ❑ 12 12-plex Plbg_Y or - N ❑ 25 Miscellaneous
I
❑ 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 City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
F
ootin s` new bldg
- g ( g) Final/C.0
- Footings (deck) _ Final/No C.O.
- Footings (addition) _ plumbing
- Foundation _ HVAC
- Drain Tile Other
Roof _ Ice & Water - Final - Pool _ Ftgs _ Air/Gas Tests Final
- Framing _ Siding _ Stucco _ Stone
Fireplace R.I. Air Test - Final - Windows (new/replacement)
Insulation - Retaining Wall
Approved By , Building Inspector
Base = =
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
vv•.,L aity A.&. oV ctt4 / OJ a! 1 ~14OA
'"~rusneu. nr er~unae~ .
out
re -a.
Jura?, 2WI `
MY Of began
3836 Pilot Knob Road
F.&M MN 5.5122
To whom it may Concern:
Elder Jones is authorized to pup building permits for Renews
Elder Jones to prol by AndaxseL pte:aac atUaw
vide this
vxoc for us in until a tewal by And== EaM. Ilk eouthorization i4 valid for any
date beyond 616I01; er
%
to the city_ man= sly revokes it in Wilda.
'request this autho ttion be $coepted.expeffidoualy, as to not delay in die of
our banding Porrnita y fuxdLcr. Pleme can me If there arc my q=Wpns.. II
contacted at ?63-so2-,4706.
- f =
Your immgdiatc Lion to this matter is 14 Pre-a,
Sinoe~aly, -
and R. 'Rau
tistailation Mzmapr
Renewal by Andereen Cmporation
t'.c: KsmA..FJ~}~ Tanee - .
ck
MY
Receives Time Jun. 1,07PM
0- 'r1 063 [0]
Request Date Fire No. gh-Lo. l,,pection R red Inspection Other Than Rough-In
(You must call inspector when ready) ❑ Ready Now O Will Notify Inspector
p Yes ❑ No Date Ready
I licensed contractor ❑ owner hereby request inspection of above electrical work at:
Job Address (Street, Box Route N).) City
t
Section No. Township Name or No. Range No. Co
Ta t (PRINT) Phone No.
Power Supplier ~ Address
Electri I Contractor (Company Name) ] Contractor's License No.
Ma
king Installation)
Mailing Address (ContraPYZ
A orized Signature (Contractor/Owner Making Installation) Phone Number
MINNE OTA STATE BOARD OF ELECTRICI THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-128 I I BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 I` UNLESS PROPER INSPECTION FEE IS
I{( I{(I
Phone 642-0 I II 111 (1l~
(612) 800 111 IIiilllll.~Ii ENCLOSED
EB
-n
.c J !7w - G~ 3 REQUEST FOR ELECTRICAL INSPECTIONC
IIII, See instructions for completing this form on back of yellow copy. 9 $ X' Below !(York Covered by This Request <t
Add R p. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Other (specify) ontr tor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 ps
Transformers Above 200 Amps jAboya-100 Amps
Signs Inspector's Use Only: TAL
s Ce
Irrigation Booms C-1 C-0 `
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has
been made. Final Date Y~
OFFICE USE ONLY
This request void 18 months from
This request void
months from
Request Uate Fire No. Rough- i1spection
Requv Ready Now ill Notify Inspec-
/ es C] No for When Ready
icensed Electrical Contractor 1 hereby request inspection of above
❑ Owner electrical work installed at:
Street Address, Box or Route No. City ~n
to Pi4/ I~-y4
Section No. Township Name or No. Range No. County
P,4 xon4-
Occupant (PRINT) Phone No.
Power Supplier Address
Electrical Contractor (Company Name)
t, Contractor's License No.
° ' C.L.I.S G'.Z:G:~.. (/C !C~'-r , ~~A•~'L.r f r~ ' f ~ Mr raa+
Mailing Addres (Contra or or Owner Making I stailation)
Authoriz ignature (Contra t /Ow r Making Installati n) Phone Number
MINNESOTA STATE BOA OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - oom N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
`hone (612) 297-2111 ENCLOSED.
ES 0"11 04
REQUEST FOR ELECTRICAL INSPECTION S~ZZ
0 See instructions for completing this form on back of yellow copy. 'T'-
2 5 0 6 8 !5--3-jj"'X`' Below Work Covered by This Request .,513,Fce
Nism Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
DUpiex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm - Other peci y Other (Specify)
Other Specify Other Other
ompute Inspection Fee Below
# Fee Service Entrance Size # Fee Feeders /Sub feeders # ee Circuits
0 to 200 Amps 0 to 30 Amps IOIVNPM 0 to 30 Am
Above 200 Amps• 31 to 100 Amps 10, j131 to 100 A
Swimming Pool Above 100 Amps Above 100^A-ps
Transformers Irrigation Booms Partial;"Other Fee
Signs Special Inspection $ TOTAL F
Remarks y ,
Rough-in Date I the Electrical
o
Inspector, hereby
certify that the above
Final D e , inspection has been 42
this request void IS months from
o . oc'
CITY OF EAGAN Remarks- w1 UIS► tin-l5lg5
Addition SUN CLIFF 2nd Lot 1 Bik 1 Parcel 10 72976 010 0
Owners~ 69Street 1897 Bear Path Trail State Eagan, MN 55122
-~o 0, />7N 3
Improvement Date Amount Annual Years " Payment Receipt Date
STREET SURF. 1985 369.37 24.62 15 344.75 ----GQ10401 6- 2 5.--8 5.
STREETRESTOR. o7'g 1986 431.51 5 a2! , ,3 ~UlCB fU-
GRADING dl/75°.S
SAN SEW TRUNK / 1970 48.87 1.95 25 117.60 SEWER LATERAL 8 265-63 53.12 5 2L2 U
SEWER LATERAL 999 1986 829.62 165.92 5 C-/038
WATERMAIN
WATER LATERAL 1000 1986 942.60 188.52 5 a • U - /U /044
WATER AREA 7 17 1 rr 11
WAT LAT BEN +&&2/677 1986 57.88 11.58 5 g' /U38 /U -94-5-
STORM SEW TRK 1971 161.74 8.09 20
STORM SEW LAT 95-4*
S/W SERVICE 1005 1986 808.77 161.75 5 OS. 77 /U 8 /D-
CURB & GUTTER
SIDEWALK
STREET LIGHT
STORM SEW LAT 1006 1986 610.14 122.03 5 40, C -103,y U- -8
Road 11ni t, - 280-00 49987
WATER CONN. n it 500.00
BUILDING PER. it 9953
PAC 525.00
PARK
CITY OF EAGAN N0 9 9 5 3
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receipt #
To be wed for SF DWG/GAR Est. Value $57,000 Date MARCH 8 -,l9-&!i-
Site Address 1897 BEAR PATH TR Erect 0 Occupancy R3
Lot 1 Block 1 S,,/Sub. SUN CLIFF 2 Remodel ❑ Zoning B1
Parcel No. Repair ❑ Type of Const.
Enlarge ❑ No. Stories
RSM HOMES Move ❑ Length 36
Z Name Demolish ❑ Depth
Address 14486 UPPER GUTHRIE 46
Grade ❑ Sq. Ft.
City APPLE VAL Phone _.435-8868 Install ❑
RSM HOMES Approvals Fees
,o Name
~ Address 14486 UPPER GUTHRIE Assessment Permit . $ 3 0 4 . 0 0
o
uA City APPLE VAL Phone 435-8868 Water &Sew. Surcharge 28.50
Police Plan Review 152.00
FW Name Fire SAC 525_ 00
H Address Eng. Water Conn. 500 00
<W City Phone Planner Water Meter 6 1 - 0 0
Council Rood Unit 9 R u 00
1 hereby acknowledge that I have read this application and state that Bldg. Off. 3 f 8/8 T P . 1jz.00
the information is correct and agree to comply with off applicable APC Total $l, 984. 50
State of Minnesota Statute qty of Eaga rdinances.
Var. Date
Signature of Permitt
A Building Permit is issued to: RSM 110V 'S on the express condition that
all work shall be done in accordance with oil ap 'cable State ~innesota Statutes and City of Eagan Ordinances.
Building Official
W
//f ~ /A41,(4
1985 BUILDING PERMIT APPLICATION -.CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
I SET OF ENERGY CALCULATIONS
To Be Used For: Valuation: 151,COO- Date: ro
Site Address:~ OFFICE USE ONLY
Lot: Block Sect/Sub S Erect Occupancy 2.3
NP Remodel Zoning (2-I
Parcel # Repair Type of Const 17--
5 M Enlarge # of Stories
Owner Move Length
Demolish Depth 4(0
Address N Grade Sq Ft
City/Zip Code S c
Contractor `j C,^- APPROVALS
Address ov
Assessments Permit
Water/Sewer Surcharge 2 Q~.so
City/Zip Code Police Plan Review 15 2.
Fire SAC
Phone # Eur Water Conn
Planner Water Meter (v 3.
Arch./Engr Council oad Unit 28C~,
M Bldg Of, ) Parks
Address APC Treatment PI l3 2.
Variance /
Phone # _ 4 (400 TOTAL ,1-
i
i
C. R. WINDEN & ASSOCIATES, INC.
V LAND SURVEYORS Tot 945-3646
1361 EUSTIS ST., ST. PAUL, MINN. 5510•
For: RSM Homes
6 S 9
6 O' E
O 66 (889.2 )
k 1 O
FQ'
Scale: 1" = 30'
O Denotes Iron
ti lll Monument
' a
`U / a f NOTE:
Z / , PROPOSED N { N o Denotes Wooden Stake
O n~ XDUJE N ID Proposed Garage Floor E1.8744
p ^ / - - (89/./ ) Denotes Proposed
! 4+t 2 Finished Ground E1.
47 ! -1 Denotes Direction
Q / ~B9/• ! Of Sarf ace Drainage
0 27---- 20 Vertical Datum - N.G.V.D. 1929
1
119
o
~2. 17
399,43)
11 !
Lot 1, Block 1, SUN CLIFF SECOND
ADDITION, Dakota County, Minnesota
WE HERESY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION Of A SURVEY OF THE
BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF All BUILDINGS, IF ANY,
THEREON, AND All VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND.
Doted this f' doy aiFe .-ua A D. IggS` C. R. WINpEN d, ASSOCIATES, INC.
byS'Jrveyor, Minnesota Registration No ._22_-L, s
Nl3',io
7 7-
e 3830 Pilot Knob Road 5985
d. Box-21199 PERMIT NO.:
VN 95121- DATE:
orung: R1 No. of Units: 1
Owner: RSM
Address:
Site Address: 4 Sun Cliff 2
umber: e'limis in
r No.: ~nnec~onharge: _
blosir:
Sim,
10.00
ermit Fee:
P. av F%&
f agree to aonwly With the City of Eegae Surchorge:
4 ~G X07 94 Misc. gorges: 132.00 Rd
* Totol Pd meter
BY Date Paid:
Date of Imp.: ~ 2 4 9 C'^ insp.:
~A a a: W►ttLi itA tCt 9i 60117
3830 Pilot Knob Road 5915
P. O. Box 21199 : PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: Rl No. of Units: 1
Owner: t RSM Homes
Address:
Site Address: 1397 Bear Path Trail Ll B1 Sun Cliff 2
Plumber: 1,a eside Fllunh in
Meter No.: Connection Charge: 1-1) of)
Size: Account Deposit;
Reader No.: Permit Fee: 10.00 P
I aieree to comply with the City of Eagan Surcharge: P
Or~naoae. Misc. Charges: 132.00 pd
Total: 63-00 ad meter
By
Date Paid:
Date of Insp.: Insp.:
r T .R
77
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Rdad 7173
P. O. Box 21199 PERMIT NO.: ~ Eagan, MN 55121 DATE:
Zoning: R1 No. of Units: 1
Owner. RSM Homes
Address:
r site Address: 1897 Bear Path Trail 1.1 B1 Sun Cliff Z
Plumber. Lks!gi_ eP?},g1na
3-8-83 49987 100.00 pd
I agree to eanpy with the City of Eagan Connection Charge: 425.00 Rd
Ordinances. Account Deposit: 15.00 pd
Permit Fee: ].0.00- Pd
Surcharge: , 50 P41
By Misc. Charges:
Dote of Insp.: Total:
Insp.: Dote Paid:
s
i 2/84
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINT)
1) PROPERTY ADDRESS: Pc? ,
LEGAL, DESCRIPTICN: ~ d
(Lot/Block/Subdivision or Tax Parcel I.D. Number)
IF E`;ISI':iJ STRUCTURE, DATE. OF ORIG IAL EUILDI::G _ IT ISS~A~C_::
_
PRES= ::^`'M. TVPT?OPOSED USE--• V-1R-1 SINGLE FAMILY
❑ R-2 DUP= (TLtiI) UNITS)
❑ R-3 TOP-T~FOUSE (TI C= + UNTITS) ( UNIT'S)
❑ R-4 APARhIEENI/COQ INITJi I ( UNITS)
CCi 1','iZCI.AL/RE'P ~AT
~ FFI
O I,/OCE
❑ I\:DUS-L
p INSTI TL'TIONAL/GOVEFN,-1E2,NT
2) APPLI= ,.(PLEASE PRINT)
NAME l '
C,
ADDRESS: 1
CITY, STATE, ZIP:,,,
PHONE : V ' C3
3) P=1BE: I PLE E RI NT) j FOR CITY USE ONLY
NAME:
PLUMBERS LICENSE:
ADDRESS: _ Active
CITY, STATE, ZIP: Expired
MASTER--- Not of Record
PHONE: PLUMBER LICENSE
a r nitia
4) OCCUPANT/Orq~TER PEASE PRINT)
NAME: t
ADDRESS: ~ 1
CITY, STATE, ZIP: '
PHONE: s- - .
5) INDICATE WHICH PERMIT IS BEING REQUESTED:
CONNECTION TO CITY SEVIER
CONNECTION TO CITY WATER
❑ 071ER (PLEASE DESCRIBE)
6) INDICT ATE ONE :
❑ PLEASE HOLD APPROVED PERXIT FOR PICK-UP BY ONE OF ABOVE
❑ PLEASE rVUL APPROVED PER:"11 TO 1 .2, 3, 4 ABOVE
r- ' (Circle one)
7) SIG:,~TURE: DATE:
II~
r
F O R C I T Y U S E O N L Y ~
i
PERMIT ISSUED
FEES: $ / a a SE'r7ER PERMIT (I`ICL DE SURCHARGE)
$ WATER PERMIT (INCLUDE SURCHARGE )
$ WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
$ ACCOUNT DEPOSIT - WATER
$ s WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER
$ TOTAL
$ AMOUNT PAID/RECEIPT S 4 o'
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A "PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: TITLE:
-7 _
DATE : ...3r d ~JS.
•m w"m MAN m mils .&s. .s`= @a N446 =us sE m sE.:P* s"m spa sum w NP-Am W"" mum sE w m wzpq mcm s*m m* a am=
r - - - - - - - - - - - - - - - - -
I
For Office Use
Permit 7 t~ G
City of Ea oa~ I
J F I Permit Fee.
3830 Pilot Knob Road I _ 2 j
Eagan MN 55122 Date Received: 67
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 2 2 4 Site Address: \$q I~
Tenant: 1 Suite M
RESIDENT / OWNER Name: _Phonee:\-
Address/ City/Zip: N) Q4V Inc 2
Applicant is: -4- Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR. Name: y V bc&u u-¢4 - _ License
Address: 'N-Q~
State: Zip:
City:
Phone: 01 ,0622 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you;submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets. .
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.
X x
Applic is Printed Name Applicant's Signature
Page 1 of 3
CITY OF EAGAN 9953
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for 3 _ n fA7 :',r`GX,1 Est. Value ~,5 7 , 0 0 0 Date VAP 12 19. _
Site Address Erect Occupancy R-
Lot I. Block •l. Sec/Sub. ' SUN Remodel C1 Zoning
Parcel No. Repair ❑ Type of Const._
Enlarge ❑ No. Stories
} v Move ❑ Length 36
19 W Name Demolish ❑ Depth - 46,
z 4 8, `3
Address t P° FV3 11`3.;,RI Grade ❑ Sq. Ft.
b City' PhoneI Install ❑
' Approvals Fees
Name
`T it r Assessment Permit
zou .,a ; i' ;R „g'
Address
4 3 - ti 6 Water & Sew. Surcharge
u~ City i ' lr Phone
Police Plan Review_
tW Name Fire SACS
u1 Address Eng. Water Conn. S12101 0 00
<W City Phone Planner Water Metes ris s 64
Council Road Unit Sao -
I here by ockrwwtedgIa that i hove read this application and state that Bldg. Off. 19
?the information is-correct and. agree to comply with all applicable APC Total w
State of Minnesptit Statutes and City of Eagan Ordinances.
Var. Date
Signature of Perrnittee
M4 ROM
4 Building Permit is issued to: IR on the express condition that
all work shall be done in accordance with all o cable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
I
7
Permit No. Permit Holder Dete Telephone #
PlOmbing L~/~ l y-//lCvbU
HMA.C.
Electric as o b g s 3 ~'J 7 3 7l1
Softener
Inspection Date Insp. Other
Footings `)2y
Foundation
Framing
Roofing
j Rough Pibg.
e
Rough HVAC
Insulation lB
Final Plbg.
Final HVAC
Final
Cert/Occ. 1
Water Describe Location: ~)g
Well
Sewer
Pr: Disp.
Receipt MECHANICAL PERMIT Permit No. f
CITY OF FEAGAN Fee 20.00
Fill in numbered spaces S/C . 5
Type or Print legibly Tot. c
1. Date 2. Installation Cost 2300.00 j
i
3. Job Address!',L f trig " r~ Lot Blk. Tract
4. Owner
i
5. Contractor Phone'
6. Address
7. City State , zip
f
8. Building Type: Residential 0 Commercial ❑ Institutional ❑
r 9. Work Description: New 0 Add, ❑ Alter O Repair O
10. Describe lgk a 1? r~r `'.Yrc F f+DICI Type : n
6 11. No. Equjpment BTU - M. Ea. No. Equipment CFM
' Forced Air '+f0
Air Handling:
Mfg.
Boilers
Mech. Exhaust
r_ Mfg.
Unit Heater
Mfg. Other.
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454.8100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGA
Fee
fill in numbered spaces S/C'
Type or Print legibly Tot.'
1. Date 2. Installation Cost
3. Job Address t;' Lot Blk. ~r Tract
4. Owner
'>r' ~fii
5. Contractor Phone
6. Address
7. City State Zip 'j 2
8. Building Type: Residential Commercial ❑ Institutional ❑
9. Work Description: New,0 Add ❑ Alter ❑ Repair ❑
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
' Bath tubs
Septic Tank
Lavatory Softner
` Shower Well
Kitchen Sink
Urinal/Bidet Other
f Laundry Tray.
Floor Drains
Drinking Ftn.
Slop Sink
ej Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
CASH RECEIPT
CITY OF EAGAN
P. 0. BOX 21-199
EAGAN, MINNES _ 55121
DATE 19
i
Y
AMOUNT
8e DOLLARS
+oo
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11/07/2011 23:17 6519948701 JANECKVPLUMBING PAGE 01
PAa 01
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11/07/2011 29:10 6519946701 JAhIECKYPLUMBxN6
Use 9l.UE or BLACK Ink
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Rap i Permlrf2e: ` ~ t
I O~fte Raatked: _
2830 pilot Knot) ROM
I ~
Ea0litn M% 66122
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Phone; (651) 8764679
pax: (661),1370-694
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
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New Rep►=oemenll ~ Repair Rebuild Modify SpaCa Was* In R.O.W.
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Add pl61mbing Fixtums L_ Maio I Low e4
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Now
dt'"~~•1'y ~4?1~ +1a., y~<;(: le!' a AbQI1dOfN'ttarlt ur ~
' tR69IDE M, q F ,PEES:
SKIN Mil p~q 1Natar HwW, Water Sa ftner, or Water Heater Ed Softener (includes 96,00 Sme sumharge)
$38.00 Lawn Innngeban pnsueea Saw stm Sumhmp)
SA&M Add Plumbing Fvturse, Wo9ystem 1ftC!Lr VVa%rTutt wwnd* (mcluarta 36M 6tV Surcharge)
'Water Tuntttrbund (add $106.00 if a 6V meter is roquhed)
$1 MAO Septic ISystem (51 0,00 per as built) (MaladM County fee and 8800 State Surcharge)
596,00 Fire Repair (replace, burned out applINOM, ducNraatG Oro,) pncludeo $6.00 State Sttroharge)
TOTAL PEST
C,~1&6 E9W0 V~. 00 OWarSfafia am Call #A(w1) 464.0042for p+etec6w aplainsl utrttt and uNilty damage.
Cell 48 hOun beibm you W Mnd bo dig m Melva locates of underiraund NI N08, mmago maned,=
I hereby avwMedga theft this IrltCrr wW is cmplete and =100: that the work vde be in carhmwme wAh the cr: t ream and codes of the city of
Winr, that t wters~riq }tile b not a PN^R bit Only an NINIft tlon for A ptxmlt. end wont Is rO to oft *00w a poft that the wM VIII be In
eceordanee-v O ttte approved p" M the inert df warir which Mquiflle a evlen and approval or p1B
Applicarife PRtltaa Writi AppllmriVs
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Use BLUE or BLACK Ink
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I For Office Use Z, 1
Permit / I
non
City of Ea Permit Fee:
3830 Pilot Knob Road } 1 (3
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
1 44
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Za> Site Address: Unit
Name:
lR~ Phone: 12~1 ®
Resident/ \Owner Address / City / Zip:
i
1 Applicant is: Owner Contractor
Type of Work Description of work: 11
a.,...
Construction Cost: Multi-Family Building: (Yes /No Company: Contact:
Contractor Address: City:
State: Zip: Phone:
License Lead Certificate
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:
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 i
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.gopherstateonecall.ora
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.
x V~_ ka A~ aw C-,
Applicant's Printed Name Applicant's Signature
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