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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 ❑ CASH ❑ C1 tEC`K ~ ~•`r' ~ ate- r- ,S ~ D ~r d r ~ f F.' " FUND • CODE - AM OU 42, Thanl'' R.:~, BY 51 t 1 tl White-Payers Copy Yellow-Posting Copy Pink-File Copy 11/07/2011 23:17 6519948701 JANECKVPLUMBING PAGE 01 PAa 01 . . 11/07/2011 29:10 6519946701 JAhIECKYPLUMBxN6 Use 9l.UE or BLACK Ink t For Otltc'e use t P~err+k ~ ~ it C Rap i Permlrf2e: ` ~ t I O~fte Raatked: _ 2830 pilot Knot) ROM I ~ Ea0litn M% 66122 I SfaA' Phone; (651) 8764679 pax: (661),1370-694 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Oahe: Suit. k Tanart~ ~ W Npwrrte' ~l Addre s '!1 pbitiG,la, " ,iR'!t; tvw Il ~~D P tw ;,to' r o i,; *1 rai F v 1( f~f~Y t mom &V War S'f' ~ti~ sus,, 7 t~.•ttl,) ) ~t1mII; New Rep►=oemenll ~ Repair Rebuild Modify SpaCa Was* In R.O.W. f.' ^j Water elid er voor Heater SP ~4,1`L1yyy, fl "'0:41•! _ Ink Add pl61mbing Fixtums L_ Maio I Low e4 ':3.• t i;~~y, r.~'~,tia'~~~;d • a lrswrm Irrigation RPZ! PV9) ~;t;~ w'. ;r ri.;.. Water Tumaraund SYS" 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 vr.. .Ctp: rr ..'r g M31W , St=V~' 1 4 "1:,. Y' Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - 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 Page 1 of 3