3697 Ashbury RdCITY OF EAGAN Remarks ? /y
AdditionB}aek}-,-;;wk Lot ? eik ? Parcel 1 0-1 43 50-0 2 0-03
Owner
Street 1697 G ?hbury R_g aA State - Eggaa--pN 5.5122
Improvement Date Amount Annual Years Payment Receipt Oace
STREET SURF. 1076 1986 253.48 50.70 5
STREET RESTOR.
GRADING
5AN SEW TRUNK 197 6.70 25 Pd prior division
SEWERLATERAL gn1074 198 112.09 22.42 5
WATERMAIN Bn 1075 198 92.80 18.56
WATER LATERAL
WATER AREA 1072 198 309.40 61.88
Storm w Trk 1073 198 110.91 22.18
STORM SEW TRK 732 198 32.5 7 1
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
9UILDING PER.
SAC
PARK
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Rosd
P. O. Box 21199 PERMIT NO.:
Eagan,. MN 55121 DATE:
ZoninD: No. of Units: -
OWf1lr:
, AddrQSx
Sita Addrcss: 1697 A.ghbur. -_
Plumber. .rY.Yi 3TG3. P; u°ii"_ _
Mebr Na.. Connestion Char9e:
Size: Ilccount Deposit: ? r
Reader No.: Permit Fee:
I yew h aae* rrM6 1w Ciry of Eppe Surcharpe:
OrJiMnor. Mix. Charyes:
Total:
BY Dote Paid:
Date of Insp.: Irup.:
CITY OF EAGAN SEWER SERVlCE PERMIT
3830 Pilot Knoh Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
-. L
zonin0: No. of Units:
Owner. L-a-m= ; ?•• :>? . . _
Address:
Site Addi
Plumber.
1 pne to oae* wUb tIN Cily ef ie'ew
Ordirswau.
By
Date of Irup.:
Conneccia, ChoMs: 47 5. 00rd
AtCOtxlt Deppsit:
Permk Fee:
Surcharpe:
Mise. CFwrpss:
Totol: _
Dob Pafd:
CITY OF EAGAN WATER SERVICE PERMR
3830 Pilot Knob Rosd
P. O. Boz 21199 7770
PERMIT NO.:
Epan. MN 55121 ?ATE: 8-6-86
Zonlrg: Rl
pwn.r; LundQren Bro No. of Unlts: 1
s.
Addnm
Sin Addreu; _3647 Ashbury Road L2 B3 Blackhawk Glen
plun,ber. Lundgren Bro s Plumbine
Meftr No.: _ ?f % ? Sf (o / ? ? CA,w,Kfian Chonpe:
Slze: - 'I Aooount Deposit: _
Reods? No.: - D? Permit Fee:
1 Mm ft ?1 wNU !M Cifp .i l.p. Su.charye; . 50vd
a?....... ? M,x, a„r,,,; 156 . ooPa TP
Tpral; 61_ 5(1pd meter
Dntr Poid:
Date of Insp.: _ f- h' Insq.:
...?.?...t . . .....-- .
CASH RECEIPT -?-
?
, CITY 4F EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
o,nYE 1s
RfiC6IVED
FROM
AMOUNT ?
, } L
? GASH ? CHECK
DOLLARS
100
ROR f
FUND CoC6 pMOUNT
: ? .
?
?
Thank You
BY ?
. .. 5636
J `
White-Payers Copy
Yellow-Posting CopY
Pink-File Copy
CITY OF EAGAN N2 ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 . ??`A
t ?
PHONE• 454 8100
BUILDING PERMIT . Receipt # ?
To be used ior •'JWC/GA- est. value a 96, 004 Date AUGUST 5 19 86
RD
W ?a? LUNDGREttiT SROS CONST
3 Address 95 E WAYZATA BLVD
473-1231
Q City ?Vm?hone
= o Name SA14E
? ? Address
~ City Phone
u a
Name JES IGiJ ETC
W W
Erect L'j
Remodel ? Zoning Hi
Repair ? Type of Const. Vn
Addition ? No. Stories 54
Move ?
Demolish ? Length ??
Depth
Int. Impr. ? Sq. Ft
Install ?
Assessment
Water & Sew.
Police
Fire
48
Surcharge -21
u' SQ
Plan Review?? o 0
SAC ? 00M
Water Conn.54 .
Water Meter ---2 U 0
Road Unit '
Tr. P I. ? ?
Parks
. Copies ;0Q
Total '
tfie express condition that
Council
Bldg. 01
Signature of
A Building Perrr
all work shail be
Buiiding Official
with all
---- Var.
I I PermN No. I PermR Moldar I neee I Telephone M I
`7 "70
1o?'
Final
Occ.
Frmg.
Dkp.
? 1• j ?' .
?? ^tnt
CONTRACT PRICE
Site Address
Lot ' Block
y Name
9 Address. ;= `+ .
c City
y
Neme
c Address
0 City
-
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond. '
Vent
Gas Piping Outlets #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN r ,-
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
PHONE: 454-8100
r X? r(x M BTU
M BTU
M BTU
M BTU
CFM
BLDG. TYPE
,;.
Res.
Mult
Comm.
Other
WORK DESCRIPTION
New '
?-
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M 8TU - 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 - 146 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
BEYOND $1.000.00)
,.I , _. ; . . , . , . '
PERMIT #
PLUMBING PERMR RECEIPT #
GTY OF EAGAN - •
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTFiACT PRICE PHONE 454-8100
I Site Address ? s • , BLDG. TYPE WORK DESCRIPTION
? Lot Block Sec/Sub
Res. New
,
m Name Mult Add-on
? co Address - ' , • Comm. Repair •
I c City • - Phone Other
f?0. FIXTURES T(;TAL
? Name ? • ? ? ? r Water Closet - $3.00 s 1
I 3 Address -TBath Tubs - $3.00 ?
? O Ciy Phone -? Lavatory -$3.00 T
i ? Shower - $3.00 '
TKitchen Sink - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE -T-UrinallBidet -$3.00 '
Laundry Tray - $3.00
? S i
MINIMi1M - RESIDENTIAL FEE -$10.00 Floor Drains - $1.50
MINIMUM - COMMIIND FEE _ 20,00 _
Water Heater - $1.50
STATE SURCHARGE PER PERMIT - •50 Whiripool -$3.OU =
(ADD $.50 S/C IF PERMIT PRICE GOES _T-Gas Piping Outlets - $1.50
BEYOND $1,000.00) Softener - $5.00
weu - $10.00
Private Disp. - $10.00
?. ' ? ? . , ?'i. ,,'•` ` ? ?-f. ?Rough Openings - $1.50
SIGNATURE OF PERM(TTEE FEE
STATE SlC:
FOR CITY OF EAGAN GRAND TOTAL• °`7 ?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
I I(J 657 -681-4675 t70, 0d
New Constrvclion Renulrements
• 3 registered sile surveys shovring sq. ft. of lol, sq. 8. of house; and II roofed areas
(20% mazimum lot coverage allowed)
• 2 copies of plan showing beam & wiMow s¢es; poured tound desgn, Mc.)
• 1 set of Energy Calculations
. 3 wDies af Tree Preservation Plan ii lot platted aRer 111/93
• Rim Joist Detail Oplions selection sheel (bldgs with 3 or less units)
DATE - vC/
JOB SITE ADDRESS
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNERri j-" d-' /YI?T
TYPE OF WORK? /
APPLICANT 114 ac.?ac(S L
ADDRESS 7/.SS a.Nill eQ al /
PAGER # CELL PHONE #6E2 - 3b6 -412 ye FAX # 952-9ik'1-1166
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Ener9Y Code Cateyory _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet SA
- Energy Envelope Calculations Submitted II n
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Coniractor: _
Plumbing System Includes:
Mechanfcal Conhactor: _
Mechanical System Includes:
Sewer/Water Contractor.
_ Air Conditioning
_ Heat Recovery System
Phone #
Phone #
$90.00
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge ihat I have read this application, state that the information is correct, and agree to comply
with ail applicable State of Minnesota Statutes ond City of Eagan Ord' nce?? j?
Signature of Applicant 7 ( _Ie2-Gl
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
. Updated 1101
_ Water Soflener _
_ Water Heater _
_ No. of Baths
RemodeVReoairReauirements ,ry ? r? /n'
. 2 copies W plan ??? ?
11
. 1 setof Eneqy CslcWatlons forheated additbns
• 1 sile survey for ederior additions & decks ?
• Indicate if home served by septic system for addilions
VALUATION 12r cq:20
FIREPLACE(S) x 0 _ 1 _ 2
PHONE# 952 - 31111-98/g
CODE S?S?/30
Phone
Lawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
O 06 04-plex
O 31 New
? 32 Addition
? 33 Alteration
t, A 34 RepiacemeM
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch(screened)
? 24 Storm Damage
? 25 Miscellaneous
?
? 30 Accessory Bldg
? 31 Ex[. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) 0 44 Siding
? 36 Move Bidg. ? 42 Demolish (Foundadon) ? 45 Fire Repair
? 37 Demolish (Bidg)' ? 43 Reroof ? 46 WindowslDoors
•Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation
Census Code
SAC Units
Nbr. of Units l
Nbr. of Bldgs l
Type of Const -?
Occupancy - ? MGES System
Zoning CityWater
Stories Booster Pump
Sq. Ft. PRV
length Fire Sprinklered
W idth
REQUIRED INSPECTIONS
Foatings (new bldg)
? Footings (deck)
0 FinallNo C.O.
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ Air/Gas Tesu _ Fina]
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Smcco Stone
_ Insulation _ Windows (new/replacement)
Approved By 11/z , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 07 05-plex O 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 77 Garage
? 10 08-plex JW 18 Deck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Plbg_Y or _ N
FinaUC.O.
_ Plumbing
HVAC
This request void /? /?, ?1 / ?? (-Y
18 nwnths from 7' 'L ?
o C?' L ,
D 063,450 ?. ?. ?7 J?) n - kSe! G
FequesLg Date
? 1 Fire No.
. Rouan-m Inspeciion
Raired?
Ready Nuw,?Will Nolify Inspec-
?
' ?I??
/ ;aYes ? No [ur When Ready
PiLicenseA ElecVical Convac[or 1 hareby request inspection ol above
? Owner electrical work installed xt:
Street Address, Box or Houle No. City
369 ?shb kd ? ?,J
ecUOn u.
l
t 2 Township Nam or No.
? 3 ar?
B/ R nqe No. '
k Cnu ty
s o? . e
Or,cupant IPflINTI
,C.k h d &pz, ,BcLed eA.a Phone No.
4173 -Iz3
wer Suppl Address
?
1
.Q'- ^-
Elec[ ca Contractor (Compa?ny Name)
E?2 _A/'?.[.;?-r Cun acmr' pLicense No.
2-0 O
Maili Address (Contractor or Owner Making In? {allation) ?
. 2 ,6 27/4
?JASS?, r S53?S
Au o ized Si9nam Con a oJOwner Ma ing Installa[ion? Phone Numbcr
96
MINN OTA STATE BOARD OF EL CTqICITY THIS INSPECTION flEQUEST WILL NOT
Grigys.MitlwaV gidg. - Naom N-191 BE ACCEPTED 9Y THE STATE BOARD
1821 University Ave., St Paul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone (812) 297-2111 ENCIOSED.
REQUEST FOR ELECTRICAL INSPECTION Ee-noooi-oa
C?-/6 ?
, See instructions far completing this torm on beek of Yellow copy.
o ?191?1 "1
X" Be/ow Work Covered by 7his Request
+ewAAdd flep. Type oi BuilEing Aooliances Wrred Equipment Wired
Duplex Water Heater Lightinp Fixtures
" -Apt. Building Dryer - Electric Heatin
Commercial 81dg. Furnace Silo Unloader
Industrial 81Aq. Air Conditioner Bulk Milk Tank
w
p- Fee ServiceEntranceSixe k Fee+ Fneders/Subfeatle,s k Fee Circuits
U to 200 qm s 0 to 30 qm s ! ,3.O+u 0 to 30 Am s
Ahove 200 qinpy 31 to 100 qmps , QO 31 to 100 A s
Swimming Pool A6ove 700_Amps Above 100_AmPs
Transrormers Irrigation Booms Partial-'Other Fee
Signs Special Inspection S ?_isO
Hemarks 5R
i
Final
n
r
(a 11f'aU
I, the Elec ri
Inapectar, hereby
certify that the above
insDection has been
This
. ,.
f 'CERTIFICATE LUNDGREN BROS. CONST.. INC.
(THIS LEGAL DESCRIPTION WILL BE VALID UPON TIIE FILING OF 7NE PLA7, 6LACKfIAWK GLEN
1ST ADDITION.) N I
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(b m J
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22.00
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? q33s I.?, gio,G . - 26.00 " ?i'32,13
134.41 S89046'21"E? MI I Q
Li .? I
DENOTES PROPOSED SURFACE DRAINAGE
T O DENOTES 1RON MUNUMENT SET SCALE: 1 INCH = '30 FEET
• DENOTES IRON MONUMENT FOUND fROPOSED GARAGE FLOOR = 9 3-1•Y FEE7
X000.0 DENOTES EXISTING ELEVATION PRDPOSED LOIJEST FLOOR = 930.1 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP. Of 6LOCK =FEET.
I 11EREDY CERTIFY TO LUNDGREN BROS. CONST. Till1T TIi15 IS A TRUE AND CORRECT
REPRESENTATIUN OF A SURVEY OF TIIE aOU14UAf21ES OF:
Lot 2, Block 3, BLACKHAWK GLEN 1ST AODITIDN, according to the
recorded plat thereof, Dakota County, t4innesota.
11FlD OF TIIE LOCATION OF A PROP05Ef) 4UILUING. 1T DOES NOT PURPURT TO SIIU4f IhIPROVEMEtJTS
OR ENCROACHh1ENT5, IF ANY, THEREUtI. AS SURVEYED [3Y ME, OR UI4UER h1Y UIRECT SUPCRV1510N,
TIIIS Z17H DAY OFAouc1usT , 1985.
REVISED 7- II - B6 .
SIGNEU: J M . HILL, INC.
[3 Y :
IAROLD C. PETER5014, LAIID SURVEYUR
P11NtJE50TA LICENSE PIO. 12294
PROJECT N0. BOOK / Pl1GE JAMES R. H1LL9 INC.
85808 (%p(o)
Planners / Engineers / Surveyors
FILE NO,
8200 Humbofdt Avenue Soulh
FOLDER BbotnlnBloti,Mi?. 65431 612-864-3029
.
CITY QF EAGAN Np
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 12 4 0 Z
PHONE:454-8100
BUILDING PERMIT Receiptu ?p
iobeusedfor SF DWG/GAR Estvawe $96,000 pate AUGUST 5 1986
SiteAddress 3697 ASHBURY RD Erect N Occupancy R3
Lot 2 Block 3 Sec/Sub. $LACKHAWK GLEN qemodel ? Zaning Rl
Parcel No Repair ? Type of Const. Vn
. Addition ? No. Stories
?
LUNDGREN BROS CONST
Move
?
Length 54
Name 26
= 935 E WAYZATA BLVD Demolish ? Depth
o Address I ? Ft
S
473-1231
WAYZATAI
Cit mpr.
Int.
? .
q.
P ha.e
y Install
a Aoorerals Fees
i o Name SAME
$ a Address
a
? Ciry Phone
?
W W nlame DESIGN ETC
.
ox ; Address 5735 DUNKIRK
aw City P r•YMOIT'RHione 559-2637
Iherebyacknowledgethatlhav readthisap iicationands f thatthe
information is correct antl a to comply Vit - all appli bl State of
Minnesota Statutes and Ci of an Or n es.
Signature of Permittee -?
Assessment
Water 8 Sew.
Police
Fire
Eng.
Planner
Council
eid9.Ott. 7/24/86
APC
Var. Date
? \ LUNbGkEN BR CONST
A Building Permit is issue to:
all work shall be done in accordance with all appiicable State? f esota S1
Building Official
Permit -
?
Surcharge 00
Plan Review 210.50
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290.00
Tr. PI. 156.00
Copies?0 0
Total '
on the ezpress condition that
an Ordinances.
1046
1985 BUILDING PERHIT APPLICATIUN - CITY OF EAGAN
NOTE: ALL CONTRACTORS KUST BE LICENSED NITN THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
51Fp,n;l ? ?
To Be Used For: ?esrnlPnr.?? Valuation: , Date:
Site Address: u??v 97 45AL r- a/ OEFICE USE ONLY
Lot: B1ock ? Sect/Sub d/etCKhC1cJt Erect ? Occupancy ?
Parcel II C 12n Remad?l _ T ning
p _ ype of Const U/
Enlarge I! of Stories
owner Lundgren Bros. Construction, Inc. rtove _ Length 561
Demolish Depth ece_
address 935 East Wayzata Boulevard Grade Sq Ft
City/Zip Code Wayzata, Minnesota 55391 ___________________________________
Phone 473-1231 APPROYALS
Contractor Lundgren Bros. ConStruction, InCAssessments Permit
Water/Sewer Surcharge
Address 935 Edst Wdyzdtd Boulevard Police Pla.n Review
Fire SAC
City/Zip Code Wayzata, Minne50td 55391 Engr Water Conn
Phone
Planner Water Meter
473-1231 Council R ad Unit
Bldg Off ?rks
Arch,/Engr, ne Sicn .?P APC Treatment Pl
Variance
Address 6- 73.1- n<<n Kir ? TOTAL
? City/Zip Cade PIury)ni,zth 550(o
Phone # 559-
1?v
5-D
.??
.50
93. r6
S
aa ? y%
Zoa`33.?
VA gtYl % S/Z 7Z-
??Ma? Wq ?4A%`w 3,589r,
--Of 9s-S/vs. 00
1
SURVEYORrS CERTIFICAT? LUNDGREN BROS. CONST.. INC.
(THIS LEGAL DESCRIPTION WILL BE VALID UPON THE FILING OF TFIE PLAT, BLACKHAWK GLEN
1ST ADQITIQN.)
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DENOTES PROPOSED SURFACE DRAINAGE 30
O
DENOTES
IRON MQNUMENT SE7
SCALE: 1 _
INCH -
Y
-7 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 9 3
- FEET
X000.0 DENDTES EXISTING ELEVATION PROPOSED LOIJEST FLOOR = 930.1 FEET
(000.0) DENOTES PROPOSED ELEVFlTION PROPOSED TOP OF 6LOCK = 1 3g,-L FEE7
I NEREDY CERTIFY TO LUNDGREN BROS. CONST. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE 60UNUARIES OF:
Lot 2, 81ock 3, BLACKHAWK GLEN 1ST ADDITION, according to the
recorded plat thereof, Dakota County, tlinnesota.
AhID OF THE LOCATION OF !1 PROPOSED 4UILUING. IT DOES NOT PURPORT TO SIiDII 1PiPROVEMENTS
OR ENCRUACHMENTS, If ANY, THEREUId, R5 SURVEYEU dY ME, UR UNUER MY DIRECT SUPERY1510N,
TH15 Z17H DAY OFA-uclus-c , 1985.
REVISED 7- II - 86 " -
, SIGNEU: ?A1E?S f? HILL, 1NC.
/
dY:
({/1f?OLD C. PETERSON, IANU SURYEYUR
PIINIVESOTA LICENSE PIO. 12294
PAOJECT NO. BOOK / PAGE JAMES R. HILL, INC.
85808Cg(,?
Planners / En9ineers / Surveyors
FILE NQ. ? 8200 Humboldt Avenue Sbuth
FOLDER Bborriington,Mrt 55431 012-E384-3029
_ -,
LUNDGREH
BRO cC0 CTRUCTION
J
935 EAST WavZATA BOUlEV.4FD • WAYZATA. MINNESOTA 55391 0 (612) 473-1237
EXTERiOR PIVELOPE Ab'ERAGE U C0t"?UTATION
Si te Addr-ess ;'%:. ?j? Lot a_ 31ock ?97 TlS?bttirc?_ 7COC,?O
/
R& U Factors R U
Opaque 4!alls . ().5$
41a11 Framing Areas . // ';1
Ceiling Insulation Area .0 a3
Ceiling Framinn Area
Rim Joist , O 7
Fiasonry 41a11 • y? ?
I•;indows , 3?
Doors , 3/
Skyiiahts ,5 S
1) loaier Level (Basement)
Total e:<posed wal l area
Opaque blall Area ?x (U) GSF= ?-/a
ldood Frame Area -Z(,--x (U)
Rim Joist - x (U) . G?
Excosed bloc'< x (U) /A c2
'n'indo,4 F,rea x (U) ,3J = ?
Sliding Glass Door - x (U)
Coor Area -- x (U)
=
31
-
Total ??-.?
A
LtJ 11 D G RE H Paye 2
13 ? ?CO CTRUCTION
935 EAST 1NAYZnTA BOULEVARD • WAYZATA. MINNESOTA 55391 0 (612) 473-7237
2) lst or rnain flcor
7otal exposed wa11 area
Opaque wall area x (U) ,0S7, =
ldood frame area ?x (U) . // % _
Rim joist Ox (U)
k'indow area x (U) -E
Sliding glass door 3; x (U)
Door area x (U)
Total ?
3) 2nd floor if 2 story
Tota' exposed wall area 1t? (? <??7
Opaque wall area 2zx (U)
Wood frame area ?x (U) .//
4lindcw area
7 i X (U) ?
a
Sliding glass door -- x (U)
Door area `-x (L,)
Total
4) Total ceiling area
'rtood frarre area S?rQ x (U)
Opaque ceiling area ?X (u) _G> ° /2•-?/
Skylight t. x (U) --
Total <,?6
?
. -,
W h D G RE n Page 3
CO CTRUCTION
BROS435 e%ST bb'AYZATA BOULEVARO • WF,YZATA, MINNESOTA 55397 9 (612) 473-1231
/ , ; ,
Minn. U Factors Total exposed arall area ?V X.// - -
Piinn. U Factors Total exposed ceiling area x.G?? - •?=
(A) Total -
Item 1??,?„=?+ Item 2 Iter? 3'?- Item 4?D.(c
?` to?al of Items 1- Q is less than Item (A), buildina
comolies a+ith S6C 6006 (C)s
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*TOTF: PAYMRNr OF FEE AT TIME OF
APPLICATZON DOFS N[7P COIISTII[flL
APPROVAL OF PERNIIT.
... . _°_°__°___....
P ease Pr1nt)
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF EXISTING STRCCZS.'RE, DATE OF ORIGINAL BfJZLDING PERMiT ISSL'ANCE: 719P6
? Fbn ear
PRESEUP ZONING/PROPOSID L'SE:
Q CAtiVEtCIAL/REPAII,/OFFICE
Q IDIDCSTRZAL
[I INSTI2L'TIONAL/GOVERAAg,'NT
2) $ R-1 SINGLE FAMILY
r-i R-2 DL`PLEX (1two Units)
? R-3 70WNHOLSE (Three + Units) ( L?nits)
Q R-4 APARTMEDIT/COPIDOMINIUM ( Units )
NAME:
ADDRESS:
CITY, $TATEr 2IP:
PHorE: y!? 3- i z 3 i
3) u i: ?•
NAME:
i
? /6 -) ? - v s,
ADDRESS:
CITY, STATE, ZIP:
PHONE: MASTER I.ICEDISE#
4) ??r • ? ia?• ?j „?
NAPE:_.?/.??1?. [?7'm.C? ?x/= '•
ADDRFSS:
CITY, STATE, 2IP:
PHONE:
reLS 11C2iI5E:
ACt1172
F?cpired
Not recorded
St Irutial
5) ? :? r ? a: • ?• : ? • os • ?? -
? CONNECI'ION T0 CITY SEWEE2 )?6 CO[VNECrION M CITY WATER El OTfM '
6) PLEASE HOLD APPROVED PERh1IT FY)R PICK-UP BY ONE OF ABOVE
PLFASq MAIL APPR PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one)
7) r i. u: • 1??? j?ei? _ 1? ,.J?L- w:sr..-,.. e/r `£1 >
INSPF]CTION OF SEWIIt ArID/OR F7A1Qt
IWI4LLATTONS WIId, NOT SE SQ3m-
ULID [7N7.RI. PII2NffT.AAS BM
APPIK7VF9.
FOR CITY USE ONLY
PERMIT # ISSL'ED
? 7 7 L2
Pd w/Bldg. Permit FEES:
$ S /6-.S O
$ $ /Lo • 5?
$_ (3 $
$ $
$ $
$ $ l5? t Z)
$ $
$ 06 $
$ S75.1}U $
$ $
$ $
$ ? .
$ $
S l' S?o • f5 Z? $
SEWER PERMIT (INCLDDE SURCHARGE)
WATER PERMIT (INCLUDE SL'RCHARGE)
WATER METER/COPPERHOR[V/OL'TSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIT - WATER
WAC
SAC
TRL'NK WATER ASSESSMENT
TRUNK SEWER ASSESSMENT
LATERAL BENEFIT/TRCIVK SEWER
LATERAL BENSFIT/TRONK WATER
WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ /,? / `7 S U $ TOTAL
RE EIPT RECEIPT
DOES UTILITY CONNECTION REQOIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
71 YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" ML?ST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : ? _ ? ? ?
? ??,?L.???_??...,-F.. _?E?,? • "
HEAT LOSS CALCULATION qe) ° fEMP. DIFF,
?
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HEAT LOSS CAICUlAT10N LO O1lEMP. DIFF,
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RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
110??
ce,? qlz?/?
Neri Construction Reouirements RertadeVReoair Reaui2menls Olfice Use OnN
3 registered site surveys showirg sq. k. of lot, sq. ft. of house; and all roofed areas 2 oopies of plan CeA of Survey Recd
(20°/a maximum lot coverage albwed) t set of Energy Calalallons for heated additions Tree Pres Plan Reed
2 copies of plan showing beam 8 wiMow sizes; poured found design, etc. 1 site survey for additbns & decks Tree Pres Not Reqd
isetofEnergyCalculations Add'rtion-indicafeifon-sifeseptksystem _Dn-siteSepticSystem
3 copies of Tree Preservation Plan if bt platted after 7/1/93
Rim Joist Detail Oplions selection sheet (bldgs wiN 3 or less unifs
Date - _? l 1,f l ??/J
Site Address 52?12 f'/SB? /J Cons[ruction Cost e??o
,CpfpU?? ?71? Unif/Ste #
Description of Work
Property Owner ? Telephone # ?Ti?{oI?-rJ
Contractor
Address ?
State City
Telephone # ( %77}
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy Code Category . , Residential Ventllation Category 7 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone
I hereby apply for a Residential Building Permit and acknowledge that e i:
that the work will be in conformance with the ordinances and codes o the
Statutes; I understand tliis is not a permit, but only an application for a e
perxnit; that the work will be in accordance with the approved plan in th?j asi
approval of plans.
Applicant` Printed Name ApplicanYs
S E 2003 On is complete and accurate;
Eaean-and-theSYatie of MN
work is not to start without a
k which requires a review and
Sub Types
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 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 (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ?
? 32 Addition ?
?K 33 Alteration ?
? 34 Replacement
Valuation 0 J
Census Code p ti
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
35 lnt Improvement ? 38 Demolish (Interior) ? 44 Siding
36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing -
Fireplace _ R.I. Air Test Final
? Insulation
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (newheplacement)
_ Retaining Wall
Approved ByT -2-
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
ToWI
Building Inspector
? 7c?
. ? q)eef cdrA
-T?v
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telcphone # 651-675-5675 FAX # 651-675-5694
96, &?)
New Conshudion Reouirements RemotlellReoair Reauirements DKce Use.OnlV
3 registered site surveys showinq sq. R. of lot, sq. il. oi house; antl ?II roofed areas
2 copies of plan showing foo6ngs, 6eams, joisis
Cedof Survey Recd
' .
Y
_ N
(20% mmimum bt coverage allowed) 1 set of Energy Calcula6ons for heated additions Tree Pres?Plan Recd _Y _ N
2 copies of plan showing beam & window sizes; poured found tlesign, etc. 1 site wrveyfor atlditions & decks Tree Pres Reguired:. .i ?:Y _ N
isetofEnergyCalculaUons Addifion -indicateilon-sifesepficsystem On-SiteSeptlcSystem _Y _N
3 copies M Tree PreservaGon Plan iF lot platted afler 711193
Rim Joist Oetaii OpUOns selection sheet (buildings with 3 or less units)
Minnegasco mechanical ventila[ion fortn
Date C.J /(o / U 1 Construction Cost
Site Address '3(0q1 UniUSte #
Description of Work AfL..1 Q1v 1 lm roo F
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
PropeMy Owner Telephone #( )
Contractor IJICWI ???UrS
nddress CityFO(r
-M11'UG,1UN
State M i N Zip 56Uo 4 TelepNOne #(iD61 ) 4 (p0'(o 18 1
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minneso[a Rules 7670 Cateeor_y1
Residential Ventilation Category 1 Worksheet
(J submission rype) Submittetl
• Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Ru(es 7672
. New Energy Code Worksheet
Submdted
In ihe lasi 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residentiaf Building Pennit and acknowledge that the information is complete and accurate;
tliat the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes, l understand this is not a permit, but only an application for a pennit, and work is not to start without a
pennit that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
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Applicant's Printed Name Applicant's Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118398
Date Issued:10/31/2013
Permit Category:ePermit
Site Address: 3697 Ashbury Rd
Lot:2 Block: 3 Addition: Blackhawk Glen
PID:10-14350-03-020
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required by law in ALL single family homes .
Eric Brehe
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Sean M Burns
3697 Ashbury Rd
Eagan MN 55122--122
Aspen Contracting/asi
4651 Nicols Rd
Eagan MN 55122
(952) 583-2641
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127559
Date Issued:10/06/2014
Permit Category:ePermit
Site Address: 3597 Ashbury Rd
Lot:26 Block: 3 Addition: Blackhawk Glen 2nd
PID:10-14351-03-260
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required by law in ALL single family homes .
Amy Jilk
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Jeffrey L Dosh
3597 Ashbury Rd
Eagan MN 55122
Lindus Construction
879 Hwy 63
Baldwin WI 54002
(715) 684-4647
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA169610
Date Issued:06/03/2021
Permit Category:ePermit
Site Address: 3697 Ashbury Rd
Lot:2 Block: 3 Addition: Blackhawk Glen
PID:10-14350-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Jason & Kristin Narverud
3697 Ashbury Rd
Eagan MN 55122
A & A Heating And Air Inc
1206 5th Avenue S
Buffalo MN 55313
(763) 999-1872
Applicant/Permitee: Signature Issued By: Signature