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1564 Ashbury Pl CITY OF'EAGAN 1 • 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N - 13129 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SF F DkJG/GAR Est. Value $97,000 Date JANUARY 21 19 5 7 Site Address 15b4 ASHBURY 2LACE Erect El Occupancy R3 Lot 19 Block 1 Sec/Sub. BLACKHAWK GLEt4 Remodel ❑ Zoning R1 Parcel No. Repair ❑ Type of Const. V Addition ❑ No. Stories Name LQN:)GRt;N BROS CONST INC Move ❑ Length 54 Depth Address 935 : i;AYZATA BLVD Demolish ❑ . Ft Int. ~ City WAYZATAPhone 473-1231 Installer. a S Sqq. Ft o Name SAME Approvals Fees o< Address Assessment Permit 493.00 City Phone Water 8 Sew. Surcharge 48.50 Police Plan Review 246.50 W Name I)ERT ;IV ETC Fire SAC 625.00 u~ Address S7?c5 ntINKTRK Eng. Water Conn. 525 • 40 iW City 21. L101THone 559-2637 Planner Water Meter 67.00 Council Road Unit 305.00 1 hereby acknowledge that I have read this application and statethatthe Bldg. Off. Tr. Pl. 180.00 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Parks Var. Date Copies Signature of Permittee s' S=>`-F=%-..xt .00 Total A Building Permit is issued to: LU14DGRLN BROS CONST INC on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ' POMR No. Permit Holder Date Telephone M i. Pluhjbing H.V.A.C. Electric it(-ii:'!~ 4n.t.r/~ J !~'f Softener Inspectbn Date Insp. Comments Foofingsl /5/-- -+J Foofings11 Foundation Framing I - ~'f !vi 4• 3 - 7 - X-7 - Roofing Rough Plbg• 3S7 - Rough Htg. ,b-v Insul. /-7z) v Fireplace P . /rf . Final Hill. 'IL-A7 Final Pitrg. t t a • Bldg. Final Cert.Occ. 1, 7 G 1 Deck Fig. Deck Frmg. Well Pr. Disp. PERMIT # PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 7187 CONTRACT PRICE: PHONE: 454-8100 Site Address ~ ' BLDG. TYPE WORK DESCRIPTION Lot 9 Block M ec/Sub Res. k New x - Mult. Add-on m Name ' Comm. Repair 19 Address ' - = - Other c City - ; ? Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOT~L Name --Water Closet - $3.00 Bath Tubs - $3.00 Address Lavatory - $3.00 p City Phone Shower - $3.00 Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 Tray - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE Laundry APT. BLDGS - COMM RATE APPLIES ' Floor Drains - $1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - $1.50 J MINIMUM - RESIDENTIAL FEE -$12.00 Whrlpool - $3.00 MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets - $1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5.00 BEYOND $1,000.00) Well - 510.00 --7pr--Private Disp. - $10.00 +7 Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: :ti _ - - ~ _ - PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN=- ry ri 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE - PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot I Block §e /Sub j v Res. New ® Name ' Mult Add-on Address Comm. Repair c City n~ Phone / / G ( Other Name FEES 3 Address RES. HVAC 0-100 M BTU -$24.00 p City Phone . ' ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. Forced Air L M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) Gas Piping Outlets # Other FEE: S/C: SIGNATURE OF PERMITTEE TOTAL "v FOR: CITY OF EAGAN PERMIT # PLUMBING PERMIT RECEIPT # ! -29 2 CITY OF EAGAN G 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: - ( PHONE: 454-8100 / Site Address BLDG. TYPE WORK DESCRIPTION Lot I Gf Block Sec/Sub Res. New f 7 c. Mult. Add-on $ Name Comm. Repair` f Address Other c City I' Phone 0 RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL nJ j.. x._.. Water Closet - $3.00 $ Name Bath Tubs - $3.00 c Address, I' Lavatory - $3.00 p City Phon ;SITS- tiCOo 6 Shower - $3.00 Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 ` COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains - $1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - $1.50 MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool - $3.00 MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets - $1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES ~softener - $5.00 r BEYOND $1,000.W Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: CITY OF EAGAN Permit No: E 51, r) Date: 1 1 -E 7 3630 Pilot Knob Road Meter No. Size: P.O. Box 21199 Reader No: Date. Eagan, MN 55121 Owner t .n ro-i 73ros. Site Address: 15(A ` ah ury ace L19 P1 S ac awk C. en Plumber Lun f ren Bros. P ur-bia - Conn. Chg: 525.00pd Zoning: s Acct Dep: ^ ' ,n~.t No. of Units: Permit Fee: In Surcharge: I agree to comply with the City of Eagan Tr. Plant Ordinances. Meter. Misc.: By WATER SERVICE PERMIT CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P.O. Box 21199 PERMIT NO.: r? 64 0 Eagan, MN 55121 DATE Zoning: '1 No. of Units: 1 Owner. L nd e Bros. Address: Site Addre~s'~ 1564 Ashbury place L19 n1 7,1ackhawk Glen Plumber Lundy-ren Bros P1t.mbin_Z 1-26-87 702+"9 100.00pd I agree to comply with the City of Eagan Connection Charge: 525 QQPd - Ordinances. Account Deposit: 1~.00PA Permit Fee: 1nn._ Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 10 - BATE 19 RECEIVED FROM AMOUNT $ I & _DOLLARS loo CASH ❑ CHECK FUND CODE AMOUNT Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy BLDG. PERMIT NO. 01-321 Bldg. Permit C 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge S 17-3860 Road Unit 20-2275 SAC ~ 20-3865 Water Conn. S 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. y f 11-3855 Park Ded. TOTAL, . I' 1 (grrfifirafr of (Orrupaury 4Citp of (Eagan ]ot,pw tr ww of luring jMwerti m This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following. . Use clalsifintion BWg. PErmir No. OccuW-Y "'Pe t Zomng D;stria 'type cone. Owner of Building 1 ti i~; = > Q F l i? l ,Add,= 235 1", y?S\".t L Binding Address c~-t n,; ,1~' Iac,lity 131. L`ti•G Date: Busldw$ Officud POST IN A CONSPICUOUS PLACE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: , 3830 Pilot Knob Road Permit Number: , Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS:' t t ' " ` ' • ,I( kti iii E APPLICANT: I tll:ttt.Y I•I i; PERMIT SUBTYPE: TYPE OF WORK: INSPECT I ON I YPE DATE INSPTR. INSPECTION TYPE DATE INSPTR I I i IL Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC inspection Dab Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG 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 ~S AVII, DECK FINAL CITY OF EAGAN Remarks 0k V -j=:b / (,.a 4 9 Addition RT arkhawk Cl An 1 nt Lot I9 Blk Parcel 10-14350-190-01 Owner street- 1564 Ashbury Place State Eagan., MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1076 1986 2d3,~LB- 50.70 5 STREET RESTOR. GRADING SAN SEW TRUNK 1 6.70 25 Pd prior tc division SEWER LATERAL gnj ()74 112,09' 99-49 WATERMAIN Bn 1075 1986 92.80 18.56 5 WATER LATERAL WATER AREA 1072 1986 309.40 61.88 5 Storm Sew Trk 1073 1986 110.91 99-19 5 STORM SEW TRK 732 19 32.57 151 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER, SAC PARK CITY OF EAGAN Permit No: 8549 Date: 3-13-87 3830 Pilot Knob Road Meter No. e Size: t~ " fdA P.O. Box 21199 Reader Ntx o 7 a 7 9(3 9 `,-L Date:' / 9 p Eagan, MN 55121 Owner. Lundgren Bros. Site Address: _ 1564 Ashbury Place L19 Bl Blackhawk Glen Plumber Lundgren Bros. Plumbing Conn. Chg:" 525.00pd Zoning R1 Acct Dept' 15.00pd No. of Units: 1 ' Permit Fee:' 10.00pd Surcharge: . 50pd I agree to comply with the City of Eagan Tr. Plant 180.00pd Ordinances. Meter 67.A0 Mis B~~( WATER SERVICE PERMIT This request void ,8h8'r4 7 4 Request Oa to c ire No. Nay Bh-idn?lnspection []Ready Now ill Notify Inspec- 3- 0 Yes ❑ NO or When Ready Licensed Electrical Contractor I hereby request inspection of above ❑ Owner electrical work installed at: Street Address, Bozo Route No. Cif is4 WW5Dzy A4~ ~,J action n. Towns hip Name or No. Range No. County ,Qko~4- OccZn1 1PRINTI Phone No. Power Supplier Address Q VS/0 .tom 3o4ao /Ylarrvsac c .t,,~,2r Electrical Contractor (Company Namel Conti ctor's License No. Standard Electric Co. 40837 Mailing Address (Contractor or Owner Making Installation) Dr., Maplewood, Mn 55109 2672 Maple"o Authorized Si tur o /Owner ng Installation) 1 Phone Number 484-8044 MINNESOTA STATE BOAR VF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Gr.gge-Mldwev Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD PROPER INSPECTION FEE IS 1821 University Ave.. St. Paul. MN 55704 UNLESS ENCLOSED. Phone (6 1672121 642-0600 3/9/87 REQUEST FOR ELECTRICAL INSPECTION *Vk EeB--00001-0e 0 See instructions for completing this form on beck of yellow copy. RAA7A '"X- Below Work Covered by This Request Narri'Addl Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other peu v Cher IS neu fyl [ ar you y Other . Other Compute rispection fee Below g 'Fee Service Entrance Size o Fee Feeders/Subfeeders a Fee Circuits _ i 0to 200 Am 0to 30 Amps j 0to 30 Am Above 200 gmps 31 to 100 Amps 31 to 100 Amps Swimmin Pool Above 100_Amps Above 100_Am s Transformers Irrigation Booms Q Partial.'Other Fee Signs Special Inspection $ p Remarks slier TOTA A6a Rough-on Opte 1. the E Cal 3~f Inspector, hereby certify that the above Final t ;%te .y inspect... has bean j ~yZ} / 0 made. Ybis request vale 18 months from I CIT11 OF EAGAN _ 13129 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 Np BUILDING PERMIT PHONE: 454-8100 Receipt q 2a)'D CY Tobeusedfor SF DWG/GAR Est. value $97,000 Date JANUARY 21 tg 87 Site Address 1564 ASHBURY PLACE Erect & Occupancy R3 Lot 19 Block 1 Sec/Sub. BLACKHAWK GLEN Remodel ❑ Zoning R1 Parcel No. Repair ❑ Type of Const V Addition ❑ No. Stories Name LUNDGREN BROS CONST INC Move ❑ Length 54 3 Address 935 E WAYZATA BLVD Demolish ❑ Depths( ° WAYZAT 473-1231 In , ❑ Sq. Ft Ciry APhone Install tall ❑ O Name SAME Approvals Fees 0< Address Assessment Permit $ 493.00 City Phone Water &Sew. Surcharge 48.50 Police Plan Review 246.50 FW Name DESIGN ETC Fire SAC 625.00 Q1 Address 5735 DUNKIRK Eng. Water Conn. 525.00 aw city PT~?THone_ 559-2637 Planner Water Meter 67.00 Council Road Unit 305.00 I hereby acknowledge that l have read this application and state that the Bldg. Off. Tr. PI. 180.00 information is correct and agree to comply with all applicable State of Minnesota Statutes an City Eagan rQinances. APC Parks Var. Date Copies Signature of Permittee Total $ 2, 490 . 00 A Building Permit is issued t : LUNDGREN BROS CONST INC on the express condition that all work shall be done in acc rdance with all applicable a of Minnesota Lutes and Ciry of Eagan Ordinances. Building Official \ q 1986 BUILDING PEBIIIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL: INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND Q To Be Used For: Quation: ©0 Date: / Site Address OFFICE USE ONLY Lot A Block Erect y/ Occupancy R-3 Remodel Zoning 9.1 Parcel/Sub Repair Type of Const 3T Addition # of Stories Owner' u„a /o~J w, ( o~y Move Length S4 Address 9 5 A _ J ~Il Depth 3O Q~-. 2/J Int.Impr. Impr. Sq Ft Install _ City/Zip Code .~53 Phone y273 - /a 31 APPROVALS FEES Contractor Assessments Permit 413. Water/Sewer Surcharge 4o, sO Address ~3S u/ Police Plan Review 'L4s° ~/99qq Fire SAC X25, City/Zip Code/ Engr Water Conn :-2Z S, Planner Water Meter (0'7. Phone - a 3 Council Road Unit °JOS, Bldg Off Treatment Pl f oo. Arch./Engr. APC Parks Variance Copies Address S7 TOTAL City/Zip Code ~Ai~yyj~jy S~y~l~ Phone # NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. 7~ox 34 e2&q-x. s - SIZ-7 P i 2d x 22- - 4-4a >c (2 = ~2go `~5~48 s -SURVEYOR'S CERTIFICATE' SIENNA CORPORATION . DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET _ • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 545.3 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 5 ,bS•3 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = S 4-s.'7FEET WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 19. Block 1• BLACKHAWK GLEN 15T ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW'IMPROVEMENTS OR ENCROACHMENTS, IF ANY. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 13TH DAY OF No V. 1996. SIGNED: 7LI , INCREV ISED 1-9-87 TO SHOW PROPOSED HOUSE BY LUNDGREN BROS. CONST., INC. 0 BY: HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 SHEET I OF 2 SHEETS PROJECT NO. BOOK i PAGE JAMES' R. HILL, INC. 85618 (87012) 132 / 58 Planners / Engineers / Surveyors FILE NO. 8200 Humbotdt Avenue South FOLDER Bloomington, Mn. 55431 812-884-3029 SURVEYOR'S CERTIFICATE SIENNA CORPORATION z s 0°19.19" E 112.28 5 l DRAINAGE Q UT/L/TY E45EmDff J PER PLAT m I x Q) c y 0 ~j 4 m i } 1-07- .19 x^ ti h rP ~ b EX TING OUSE 0 o N /9 GT n 3q r~).,~0 y. P/ai0 0 •~s2 k e / N G 4,y m V HO SSFD e4e.73 "/`3q• / E o 0,5 0 % /N. k m / m" ~~q 0 M , 3350 h o ~ ~~iy"•:I ~ pk \ ea ~ dl,j ~.CJ4' q E 4 : 2 4 M/ ,R y I1 . 9 eae,x / e+s.o 1r4 4/50 2 C stg \ S' B ease 9,p) \ Feae a REVISED 1-9-87 SHEET 2 OF 2 SHEETS PROJECT NO, BOOK / PAGE JAMES R. HILL, INC. 85618(87012) 132/58 Planners / Engineers / Surveyors FILE NO, 0200 Humboldt Avenue South FOLDER Sloomington, ?An. 55431 012-004-3029 WHO H C H I CTRUCTION BROS~935 EAST WAYZATA BOULEVARD • WAYZATA, MINNESOTA 55391 • (612) 473-1231 EXTERIOR ENVELOPE AVERAGE U ,OMPUTATION Site Address J7woi;~20 Lot Block R a U Factors R U Opaque IdalIs y5$ Wall Framing Areas Ceiling Insulation Area "003 Ceiling Framing Area 0 a 7 Rim Joist 0 Y Masonry Mall/ P;i ndows 3 S Doors 3/ Skylights 5 S 1) Lower Level (Basement) Total exposed wall area a6 Opaque Wall Area ~x (U) ,OSB= p~•/o2 ;flood Frame Area Z(n x (U) Rini Joist - x (U) , 6Y _ Excosed block x (U) Window Area j~ x (U) 2 Sliding Glass Door - x (U) _ Door Area x M 31 Total 07.3 LU )GREn Page 2 DROSN CTRUCTION 935 EAST WAYZATA BOULEVARD • WAYZATA, MINNESOTA 55391 • (612) 473-1231 2) 1st or main floor Total exposed wall area Opaque wall area =X (U) Wood frame area ~x (U) L/? = 9, /T Rim joist Z2 -ox (U) ,D` _ Window area /x (U) , 3-5- Sliding glass door (U) ,3S'= lass Door area ~x (U)~ _ -&-2Z Total 3) 2nd floor if 2 story Total exposed wall area Opaque wall area 0 Zx (U) Wood frame area x (U) Window area Z2 LX (U) Sliding glass door x (U) Door area ~x (LI) _ Total 4) Total ceiling area r Wood frame area ~eq x (U) Opaque ceiling area -2 ~6.x (U) Skylight , x (U) - 5 Total 07', 6 q .1 L U h G PE n Page 3 BROSC INC. CTION 935 EAST WAYZATA BOULEVARD • WAYZATA. MINNESOTA 55391 • (612) 473-1231 Minn. U Factors Total exposed wall area o? /a? X c Minn. U Factors Total exposed ceiling area x .o , (A) Total = ~9~• 0(v a,3q + Item 2 06,3 Item 3Z9,3o+ Item 4,20 Item 12 If total of Items 1 -4 is less than Item (A), building complies with SSC 6006 (C)s YMENT EFL AT TIM OF CONSTITUTE CITY OF EAGAN ~CATI APPROVAL OF PERMIT. APPLICATION FOR PERMIT * INSPECTION OF SEWER AND/OR WATER r* TTiS'1'Am mrONB WILL NDT BE SCHEO- SEWER AND/OR WATER CONNECTION ULED UNTIL PERMIT HAS BEEN APPROVED. * (Please Print) 1) PROPERTY ADDRESS: 1 S 6 14 SiiiV Y v pL a P LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parcel ID IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED LSE: (Mon Year) COI`P'IERCIAL/RETAIL/OFFICE ® R-1 SINGLE FAMILY Q INDUSTRIAL Q R-2 DUPLEX (Two Units) Q INSTITUTIONAL/GOVMW= Q R-3 TOWNHOUSE (Three + Units) ( Units) q R-4 APARTMENT/CONDOMINIUM ( Units) 2)v Lr~ / NAME: i./P~ YeC ra E~7~ ADDRESS: ~3~ Ul ~J r 7 76Z- m CITY, STATE, ZIP: (Al C , ) ~Cft-2- r h_S ~3 l PHONE:-!2x3 Z. 3) u I::• / 64 a, At, /0 For City Use G Plumbers License: RLActive ADDRESS:~.3~6 q~-T'3cZ~t1 Expired CITY, STATE, ZIP: d- 2-a a~ JIA 1'44 4 ~3je Not recorded PHONE :Y~ ~f^ /2~ / MASTE LICENSE# ;~tlal 4) • I: ~'I NAME: ADDRESS: CITY, STATE, ZIP: PHONE: •5) • r 1 r: •:I• :o •o• a• CONNECTION TO CITY SEWER 6-1 CONNECTION TO CITY WATER Q 011W 6) • • i' EM-PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) o 7) IMF] • r. • 1~ • f : i M:/• ly.~l 1 1 1 :1' • :1• Y Y -FOR CITY USE ONLY PERMIIT~~# ISSUED ~7 J y C Pd w/Bldg. Permit FEES: $ $ //l4 S SEWER PERMIT (INCLUDE SURCHARGE) $ $ /C)•7 WATER PERMIT (INCLUDE SURCHARGE) $ 7,o o $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ~j a-a ACCOUNT DEPOSIT - SEWER $ $ ~S U d ACCOUNT DEPOSIT -WATER $ a Z S Cr tJ $ WAC $ Cy Z S U U $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ l ' D C~ $ /r U 21 TOTAL 2-0 RECEIPT f- RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: ..tea TITLE: DATE : 1, PERMIT cR-, qq I q CITY OF EAGAN 41100 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 4 6 3 (612) 681-4675 Date Issued: 04/26/95 SITE ADDRESS: 1564 ASHBURY PL LOT: 19 BLOCK: 1 BLACKHAWK GLEN P.T.N.: 10-14350-190-01 DESCRIPTION: Bu lding-~Permit Type DECK Building Wo'rk Type NEW REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: OWNER: - Applicant - CHAMBERLAIN MARTY 1564 ASHBURY PL EAGAN MN 55122 (612)681-5174 I hereby acknowledge that 1 have read this,application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan ordinances. L _ F N APPLICANT/PERMITEE SIGNATURE ISSUED : SI TURE CITY OF EAGAN~~ 3830 PILOT KNOB RD - 55122 ff4is O 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction Requirements RemodeUReoair Recuirements ♦ 3 registered she surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ t energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan if lot platted after 7/1/93 required: _Yes No DATE: 4Pk21C 2D, ! 99S CONSTRUCTION COST: ~2, d00 DESCRIPTION OF WORK: 1^7CG1G STREET ADDRESS: /:56 4 4 s 913 u P- y PLAC a LOT 15 BLOCK / SUBD./P.I.D. 3G4dX9j1WK C«N (W) G8i-si-7q PROPERTY Name: (fW4 MaeRC4IAI e~v Phone IAd 45"4'400G OWNER uar "rtsr Street Address- /,5-64 Ac.4c d- City: Lei -C,,4 A4 State: NAI Zip: S~122 CONTRACTOR Company: Phone Street Address: License City: State: Zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration # Street Address* City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. 1 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. Signature of Applicant: Lr OFFICE USE ONLY rl~ 2C E V Certificates of Survey Received Yes No APR 2 0 1995 Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool 0 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory o 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex o 14 Fireplace o 21 Miscellaneous 0 05 SF Misc. ❑ 10 _ plex c:E~ 15 Deck WORK TYPE 31 New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37, Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. yly Depth Footprint sq. ft. SAC Code 6L Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ 1.7-0o Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units SIENNR CORPORATION SURVEYOR'S, CERTIFICATE ' S 0°19'19" E ~ DAAINAGE d UTILITY EASEMENT PFIt PLAT / of m , k / r~ f b b ~1 W k 0 II k 1-07- 19 3 . o• mn ti ~ nnh/~Q ~ kA k .V `i/ EXH 7fNG co x use. 1 ~ 84S;o 0 8 a ' N G pH~ SFD USE N //k// zp $D h /N Vii b 1I11,Vl/f^ 1,51• 1 h.J 1 , ' 4 k E` Y1.IV/ M da e2. 49 ee~ 9 1 ask / e'''0 AS'H 45 502„ W39,0) \ BURY °3B.a ~~~°Cgccc ,,o e`ie. e REVISED 1-9-87 ` SHEET 2 OF 2 SHEETS PROJECT 110. BOOK PAGE JAMES R. HILL, INC. 85618 (87012) 132 / 58 Planners / Engineers / Surveyors FILE NO, 0200 Humboldt Avenue Goulh FOLDER Bloomington, Mn. 55431 012-004-3029 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commerciallindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond Expires: The Applicant is Owner Contractor Other Work Type _ New Construction _ Underground Tank _ Install -Remove **see below Interior Improvement - Install Piping -Processed -Gas Nature of Work: "When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal $50.50 Minimum (includes State Surcharge) or Contract Value $ x 1% = $ Permit Fee • If ep rmit fee is $1,000 or less, add $.50 $ State Surcharge If ep rmit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; 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 r a review and approval of plans. • Applic dName' \ Applicant's Signature Approved By: Inspector Date: l I For CRlce Uysn~el I City of Eap Permit # v Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 I Date Received: j I I Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: n 20 8 RESIDENTIAL BUILDING PERMIT APPLICATION Date: / 1r 08 Site Address: 1-56 V XS#lTa/Z K 1-2 4 G~ ~4 e Tenant: p / Suite RESIDENT / OWNER Name: c 74-e-v tC ~Te r SJ N Phone: erl/Z -"4600- 299 Address/City/Zip: ~S6 sl,~/4u Y ~LACc L ~6A/t~ Applicant is: Owner ,t-contractor TYPE OF WORK Description of work: 1410 u s e~ Construction Cost: _Si Apo ao Multi-Family Building: (Yes No CONTRACTOR Name: /Ve-f, License 020.2 19`706 Address: 02 cf ~2c? /'✓!L/ i~~CJD ~91e•_4j7- p City: 1014,4 /°L z 40 y 0 State: /1)/V Zip: S S~ I / 8 99a Phone: L;p~ Contact Person: L I 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 the 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 4 -,Y /i--mEi of Applicant's Printed Name Appli ant's 'nature Paga 1 of 3 Use BLUE or BLACK Ink For Office Use i - j City I Permit of Eap I i Pe ' 3830 Pilot Knob Road I rmaFee: Eagan MN 55122 i Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: i 2010 RESIDENTIAL BUILDING PERMIT APPLICATION y Date: Site Address: Tenant: Suite RESIDENT / OWNER Name: Phone: Cp's~-Mb Address / City / Zip: P Applicant is: Owner Contractor TYPE OF WORK P f Description of work: Construction Cost: Multi-Family Building: (Yes / No ) CONTRACTOR Name: P cense Address: Ci yl h StaterA)Zip; / Phone: Co l L Contact: V efO17~ Email; 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 conclude that the 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.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 Cif 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 ~h accordance with the approved plan in the case of work which requires a review and ap plans. 1 X x Applicant's Printed Name p a s Signature Page 1 of 2