1563 Ashbury CtCITY OF EAGAN Permit No: 9162 Date: 10- ^ C-F; 7
3830 Pilof "ob Road Meter No: Size:
P.O. Box 21199 Reader No: Date:
Eagas, MN 55121
Owner. f???and Const.
Site Address: 1563 Ashbury Court L10 B2 31a.ckhawlc G1en TI
Pliimhnr rt11Z"-rVfl31
Conn. Chg: 5:' 5. s'k7?d
Acct Dep: IS : 00nd
Permit Fee: 10 _ Q0pd
Surcharge: - So, 'l
Tr. Plant V?o _ nn.,d
Meter. []?QQ;Q
Misc : 42 3''? ?Tf?bi? W;PUIr;,D-
Zoning: Fs
No. of Units: ? -
I agree to comply with the Ctly of Eagan
Ordinancea.
WATER SERVICE PERMIT
CITI( OF EAGAN
3830 Pilot Knob Road
P.O. Box 21199
Eag5p,dNIN 55121
Site Addi
Plumber:
Permit No: Date: I
B/PNo: ' Date:
MWCC:
Ciry Chg: a'.,.
`
Acct Dep:
Permit Fee: ?' .
: ''Orr±
Surcharge:
Misc.:
Zoning• ?
No. of Units:
I agree io comply wiih the CFty oi Eagan
Ordinances.
SEWER SERVICE PERMIT
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value Date ,19
Site Address OFFI CE USE ONLY
On Site Sewage Occupancy
Lot Blo ck Sec/Sub.
MWCC System Zoning
Parcel No. On Site Well (Actual) Const
T Ciry water (Allowable)
¢ Na
Address PRV Required # of Storles
3
? City •?-
php?e • ??ter Pump Length
Depth
o Name ??/' lJ7sf S.F.Totai
,
? ` Address Footprint S.F.
? City Phone APPROVALS FEES
? ¢
y? W
Name Engr./Assess. Permit
_ z Address Pianner Surcharge
u
? W
Ciry
Phone Council Plan Review
Bidg. Off. SAC, City
I hereby acknowladge that I have read this application and stafe that the
information is corr ct and agree to comply with all applicable State of Variance SAC, MWCC
Wa1er Conn.
Minnesota Statut and City of Eagan Ordinances. Water Meter
Signature of P ttee _ ? _ _- ?
Road Unit
"
A Building Per is issued¢o:_ Treatment P1
on the exprec
applicable St dition that al I work shall bpdone in accordance with all
?Minnesota Statutes and 4y of Eagan Ordinances.
Parkg
` TOTAL
- Permit No. Permit Holder Dste Telephons #
Plum4ing
?-? ?-
--'?
?
e ? -
H.V°'AC. '
Electric
c.
Softener
Inspection Date Insp. Comments
Footinga I
Footings II
Foundation ?
Framfng
Roofing }tqp J?,SG ?'Si • ? - 2aor-? .? s
Rough Plbg. ov3-
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg. - - ? , `-f
Bldg. Final
Cert. Occ.
Te m p. L P
Deck Ftg.
Deck Final
Weli
Pr. Disp.
4," ' ' - -,
PERMIT #
. , . MECHANICAL PERMIT RECElPT #
- CITY OF EAGAN
3830 PILOT KNOB ROAD, EACiAN, MN 55122 DATE: ?? ?? -? ?1 !'J 'r,?
tACT PRICE: PHONE: 454-8100
y? v .. --
i
m Name _
? Address
c City _
Name _
c Address
0 CiN -A
E OF WORK
ed Air BTU
?r M BTU
Heater M BTU
;ond. M 8TU
, CFM
Piping Outlets #
FEE:
S/C:
TOTAL•
BLDG. TYPE / WOAK DESCRIPpON
Res. New
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M 8TU -$24.00
AODITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
VVIYIIYI! IIYU r c? -I ? vr vvfv i nnv i rcc
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADO-ON $
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000) .
SIGNATURE OF F RKiIITTEE
1.50 EA. 1
j?,'?" FOR: CITY OF EAGAN
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: ' ''
t +r t
PERMIT SUBTYPE:
PERMIT TYPE:
Permit Number: , ; . .
Date Issued: V 6 /.K K
14'`!i1 . 114) `' APPLICANT:
to Hi fo,
TYPE OF WORK: -
INSPECTION .. . .•
?
f l;; ???,?.i r ,; ? i,.?, i? i! ?? t:r? i I ..,; ???? ? i? t, ?„f• ??i?'? f'I F f i'i? 1!'/?t. I1??kf,
7 X ?4? ?
'
. ,. . ? . . , ... "
? ? . , . , .. , . .
?. :
, ' . . .. `, , . , .. .. ..
------_ _ _ _ _ _ _ _ _ _ _ _ _ -_ ? ? ?? ? ----' --' ----?
Permit No. Permit Holder Date Telephone M
ELECTRIC DOIoI 9'33 ?Q,?; S? 9 ?
PLUMBING
HVAC
Inspectlon Data Insp. Commenta
FOOTiNGS ?
FOUND
FRAMING
f. N
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLUG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG -
DECK FINAL
' ' . PERMIT # :'-
• ' PWMBING PERMIT RECEIPT # -?
CITY OF EAGAN
3830 PILOT KN08 ROAD, EAGAN, MN 55122 DATE Oc tO'"eY 1 ?, =''
CONTRACT PRICE: PHONE: 454-8100
Site Address
1,,. 21 't)
Name "a?.?-nyar? can
Address 1.4745 South Robert
City Rcspmount, MN Phone 4
Address
City ''1
FEES
COMM/IND FEE - 1°rb OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
FlEYOND S1 _00I_(X)1 . 1
ttt
BLDG. TYPE WORK DESCRIPTION
Res. New 7
Mult. Add-on
Comm. Repair
Other
RES. PLBC. ONLY - COMPLETE THE FOLLOWING:
FIXTURES _ TOTAL
-N--Water Closet - $3.00 $ '_?6_113ath Tubs - $3.00
_1--Lavatory - $3.00
Shower - $3.00
/_Kitchen Sink - $3.00 4- ?
Urinal/9idet - $3.00
? Laundry Tray - $3.00
? Floor Drains - $1.50
=Water Heater - $1.50
Whirlpool - $3.00
:7-Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Soltener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
11
STATE S/C:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt
To be used for Est. Value ' i • '- . ?l' ? Date - - ,19
Site Address OFFICE USE ONLY
Lot { Block SeC/Sub. $LAC" "' '" ' ' ••• " %- On Site Sewage dccupency '
MWCC System x Zoning
Parcel No. ?
'
On Site Well (Actual) Const
oc Name t l n •' -? ?' '' ' ?•` ?' ; j• yC City Water (Allowable) v
_
7 L 34
Address
PRV Required
of Stories
0 Cit PhOne .,`' .•• 7 7
y Booster Pump Length S?'
Depth 34
, p Name S.F. Total
O Q Addre?ss Footprint S.F.
U
?
City Phone
APPROVALS
FEES
1- cc
W W
Name
Engr./Assess. _
Permit
?z AddreSS Planner Surcharge 52.00
Qz
City Phone
Council
Plan Review 257.75
W
4
Bldg
Off
SAC
City
00' 00
I hereby acknowledge that I have read this application and state that the .
.
Variance
- .
SAC,MWCC
-- 525.`1U
information is correct and agree to comply with all applicable State of WaterConn. 525.00
Minnesota Statutes and City of Eagan Ordinances.
?
Water Meter ?? ??
SignatLre of Permittee
-
Road Unit
305,00?
A Building Permit is issued to: ?'? iNc Treatment P1 l8U•?
on the exprqss condition that ail work shall be done in accordance with atl
applicable State of Minnesota Statutes and City of Eagan Ordinances. pyrks
?2 7 . 2 5.
Building OffiCial TOTAL
. CASH RECEIPT •
CITY OF EAGAN
3830 PILQrTf<NOB ROAD
EAGAN, MINNESOTA 55122
--
DATE ? 19
. %
wccarvca ?/ •? , / ;
AMOUNT $ ?
•,
& DOLLAHS
+oo
? CASH [] CMECK
• .. - - _
s
PUND CODE AMOUNT
L
Thank
e,r
White-Payera Copy
? Yeilow-Postin9 Copy
Pink-File Copy
BLDG. PERMIT N0.
- , , . ' • = l', _ , . K.
01-3210 Bldg. Permii
01-3422 Plan Check
01-3445 5urch./Adm.
01-3446 SAC/Adm.
01r2155 Surcharge
17-3860 Road Unit
2d-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Fater Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
• CASH RECEIPT ?.
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
,DATE
19
RECHIVfiD
FROM
AMOUNT $ I
[-] CASH
8c DOLLARf
?oo
? CHECK
POR /J ? •
FUND CODE AMOUNT
Thank You BY, j
t White-Payers Copy
Yellow-Posting COpy
Pink-File Copy
Ct1rY OF fAGAN Permit No: !'1f'2 Date: i`)-' 20'"`' ?
38?0 Pilot Knob Road Meter No: a S d Size:
P.b. Box 21198 Reader No: Date: .:r??2_ 6?Sl?
Eagan, MN 55121
Owner.
SiteAddress: :'?,3 Asiiburv t;ourt I10 II' 51ael:112Wn TT
?.._,.__ ,?.?__r.,?„ • --
Conn. Chg: ?? 5 0L)pd
ACCt Dep: '? tt-3 •
Permit Fee:
Surcharge: ??e?t??ply wlth the City of Esgan
Tr. Plant I 3'? AAGUIKEPP nances.
Meter. e7:?±??= B ?? p
Misc.:
WATER SERVICE PERMIT
This requesl void
18 months from yl ??
D 6176811o. go
Renucst'bate' " Fire No. qo
Reqoph-, n,Insoer,UOnA
uired
?
Ready Now [BWill Nouly InSDec-
Nw. 3. 1987 IRves ?No mr When Pead?
aLi1ensed Elec[ncal ConVactor 1 hereby request inspaction of above
? Own¢r eiectrcal work installed at:
Street AdAress, Bot or Route No. Qty
1563 Ashbury Eagan
ecUOn o. Township Name or No. Fange No. Counly
Dakota
Occupant (PflINTi Phone No.
Kirkland Construction 869-2477
Power Suppher Atldress
DEA Farmington
Electrical Con[racmr (COmpany Ndme)
Convactor's License No.
Corrigan Electric Company 039549 8
Maiimp Address IConiractor or Owner Making Instailavonl
P.O. Box 475, Rosemount, MN 55068
Authorit¢d Signature ContractodOwner Makiny Ins[allaUOn)
?l Phone Number
.ci ipra, 423-1131
MINNESOTA STATE BOAYiD OF ELECTNI6ITY THIS INSPECTION REQUEST WILL NOT
GriB9s-Midwey BldB. - poom N•191 BE ACCEPTEO BY THE STATE BOARD
7921 Universitv Ave.. St. Peul, MN 55104 UNLESS PPOPEfl INSPECTION FEE IS
Phonel6721642-0800 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION EB-00001- 6
` ? See instructions tor comOlBlin9 lhis IOrm On beck of Vellow copY.
? ?,-V 17 6 8 "X" B, low Work Covered by lhis Reqirest
iii. AddI A.P.1 Tvpe ol BmlJina ACPboncea Wired Equivment Wved
X Home ], Range Temporary Service
Duplex Water Heater Lighuny F?xtures
Apt BwlAmg Dryer Electnc HeaLn
Commercial Bidg Fumace Silu UnloaJer
Industrial BIAg. j Air Condrtioner Bulk Milk Tank
Farm 1 Oth, Soeci v DW DISP n1hcr ISncutv?
T nr Sucuty ther Othur
om?ute lnsoecUan Fer. Belaw
M Fee Service EnfrenceSiie Y Fee Faxders/SObiexders Fee Circw[s
1 15.00 0 to 200 qm 0 to 30 qm 5 0 tn 30 An cs
Above 200
Amps 31 to 700 Amps 31 to 100'Am s
q
Swimmn Above 100-Amps Above 100_Amps
Transiormers 1rngaLOn Boort?s Purtial.bther Fee
Signs Speaal Inspection S
(2
$?
TOT EE
Pe.rks . O
"
Nough-m ?
t
? Date
4/4? I. the n
Insaectoq hereby
cerL-y thxt IDe abova
Final ? ^le
_?.i
V ms0ecfion hes Eeen
mae.
(h1E request voitl 18 montlie irom
.S (i?9s ' pn? .SGo??'/.,?`
061 493 3.l?n. A„2 A,a
Request Date Frte No Fou -In Inspectmn Reqmretl Inspeclwn Other Than Rough-In
?? s._? ?
5 (VOU must call inspeclor
wnen reatly) ? Reatly Now ? Wtll NotRy Inspecror
?
Ves No Dale Reatl
IIq licensed contractor ?owner hereby request inspechon of above electrical work at:
Job Atldress (Stree? Box or Rome No ) Ciry
15-13 4-5 H13?Ry <54 A.I
Secnon No, Tovunsnip Nama ar No Ranqe No Counry
_PR/6or9
Occupan[(?NT) Phona N.
Power Suppher
? Atltlress
Eleemcfll Conllacror (COmpany Namal ContmctoYs Lwense No
Standard Electric Co., Inc. CA01715
lAatling AtlUress IConVaclor or Owner PAakmg Installation)
2672 Map ew d Drive, Ma lewood MN 55109
Amhonzotl Signatur o ctor/Owner Makmg Ins ati n) / Phone Num?er
484-8044
MINNESOTA
ICITV
?
T
j
Gr
o
m S
9
M
8
? yj? 11 111 1111 11 11 111 111 11 BOA
PTED
R
S
P
2
Un
e s?
ve,
MN
5510Q
St OPER MSP C ION EE
UNLES
PR
Phone (61I) 642-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION ?6
5?4 95 ? : "; ?.o?o, -09
c Po Sae instmctions lor enmpleVng fiis Fotm on back of yellaw copy i?K`•P"`F ? J/ .1
0 " 0 U.1. 493 "X" Befoui Worh Covered by This Request ?"??•a?
Nev Add Rep. Type of Building Appliances Wired Equipment Wired
? Home Range Temporary Service
Duplex Water Heater Electnc Heating
Apt. Building Dryer load Management
Comm./Indusinal Furnace Other (Specify)
Farm Air Condrtioner
Other (spealy) Contracl 's Remarks
Compute fnspection Fee Below.
# Other Fee # Service Entrance Size Fee # Circuits/Feetlers Fee
Swimming Pool 0 to 200 Amps 0 t Sg Amps
Transformers Above 200 Amps Above 100 -Amps
Si ns irsPecto:s use omy. TOTA
Irrigation Booms
Special Inspection 44l Q
AlarmlCommunication THIS INSTALLATION MAY, UER D NNECTED IF NOT
Other Fee COMPLETED WITHIN 18`MO
I, the Electrical Inspector, hereby Rou9n-in 1?
certfy that the above inspection has
been made. Finai
? ?
oa
?_i
OFFICE USE ONLV
ThiS ra,que91 vaitl 18 mOnihS fmm
CITY OF EAGAN N°_ 14 215
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT
Receipt#
To be used for S^ i1WG/GAR Est. Value $104,000 Date SEPTEMBER 24 19 87
Site Address 1563 ASHBURY COliRT OFFICE USE ONIY
BLACKHAWK GLEN 2
Lot 10 Block Z Sec/Sub OnSiteSewage Occupancy
R3
. MWCCSystem X Zoning Rl
ParcelNo. V
OnSiteWell (ACtuaqConst
w Name KIRKLAND CONST INC Ciry Water X (Allowable) V
z AddfCSS 7634 KNOX AVE SO PRVReqwred X #ofStories
° City MPLS phone 869-2477 Boosteraump _ Length 50
Dapth 34
, p Name SAME S.F.TOtal
oa Address FootpiintS.F.
? City Phone APPROVALS FEES
?a
W w
Name Engr./ASSess. Permit 515.50
_= Address Planner Surcharge 52.00
aw City Phone Council PlanReview 257.75
Bldg Off SAC, Ciry 100.04
IherebyacknowledgeMatlhavereadthisapplicationandstatet e _
Variance SAC,MWCC 525.OC
information is cotrect and agree to comply
h all pplic Sta[e f WaterConn. SZS.OC
?
Minnesota Statutes an ( gan Ordin c 67
OC
Water Meter .
Signature of Permittee " Road Unit 305.OC
A Building Permit is issu d to KIRKLAND NST INC Treatment Pt 180.OC
ontheexpresscontlition allworkshallbedoneinaccordancewithall
apph
cable
5ta[eofMinnesot StatutesantlCity otEaganOrdmances parks
?2-52?-25
C21?1
Bud
ding
Official TOTAL '
CITY OF EAGAfV
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NYl'F: PA7049Kf OF kM AT TIME OF
rPPLIcaTTON ooFS Nom oOtezTUTE
APPROVAL OF PFRNSIT.
I1,k%ncrioN oF sEWM raro/OR MTEz
TTiSTATTdTTON$ wnL Mj` $E $CHED-
ULF9 UNPIL PERTffT AAS BEEN
APPROVID.
- ---- - ---- ---- -
P ease Print
1) PROPERTY ADDRESS: 1563 Asbury court ••
LEGAL DESCRIPTION: Lot 10, Block 2, &$ffifi Black Hawk Glen - 2nd Addition ?
Lo* B ock Subdivision or Tax Parcel ID )
IF EXISTING STRL'CZSJRE, DATE OF ORIGINAL BUILDING PERMIT ISSL'ANCE: '
PRFSE[Jf 7ANING/PROPOSEp L'SE: 14an Year
C] COMPIERCIAL/REfAIL/OFFICE
Q IbIDL'STRIAL
n INSTIZ[?TIONAL/GOVERNIENr
IMX R-1 SINGLE FAMILY
Q R-2 DLPLEX (1t„o Dnits)
? R-3 1qWNH0USE (Three + Units) ( Onits)
p R-4 APARTMEN'P/CONIDUUMiNt[,T1 ( Units)
2) ? -
NAMEt KIRKLAND CONSTRUCTION
ADDRESS: 7634 Rnox Avenue South-
. CZTY. STATE, zIP: Minneapolis, MN 55423,
PHONE: 869-2477
3) • i: ?• For City Use .
- NAME: GENZ-RYAN PLUMBING & HEATING P
IIIIfIbEI'S LICERSe:
ADDRFSS: 14745 South Robert Trail ^
Act1?
?
ExpirEd
CZTY, STATE, ZIP:
PHONE: Roseinount; MN 55068
423=1144 MASTIIt LICENSE# 1849M Not r2cord2d
St?=al
4) •. • i?•
NAME:
ADDRFSS: '
CITY, STATE, ZIP:
L r;ONE: •
5) '? a• ?• : a • ?? -- -
? CONNECTION 7O' CITY SEWII2 ? CpNNECTION M CZTY WATER ? OPAER
6) ?? • • r ? pLEA,gE HOLD APPROVID PERMIT FOR PIQC-L?P BY ONE OF ABOVE
• ? PLEASE MAIL ApPROVID PERMIT TO 1, 2,jo 4. ABOVE
(Circle one)
F'OR -CITY USE ONLY
PERMIT # ISSUED
%/? ?-?
Pd w/Bldg. Permit
S
S
$ ?7,? -
$
FEES:
$ /O • S?
$
s
e
?
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SLRCHARGE)
WATER N?ETER/COPFliRHORN/OUTSIDE READER
WATER TAP (INCLODE CORPORATION STOP)
$ $ SEWER TAP
$ $ /Gi •/; r7 ACCOUNT DEPOSIT - SEWER
$ $ ??•? U ACCOUNT DEPOSIT - WATER
$ $
WAC
$ $ SAC
$ $ TR[)NK'' WATER ASSESSMEIVT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRDNK WATER
$ IS6 'U U $ WATER TREATMENT PLANT SURCHARGE
$ $ -OTHER:
$ ?3 9 $ h ? O U TOTAL
-77 7 ? ? Vl,-?
RECEIPT RECEIPT
DOES UTILITY CO NNECTION REQUIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
F-1 YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST BE
DIVISION
LIS ISSUED BY THE ENGINEERING
.
T AS A COIVDITION.
SUBJECT TO THE FOLLOWING CpNDITIONS:
APPROVED BY:
?
TITLE:
DATE:
0
•
/ Yr
1987 BQILDING PERMIT APPLICATION - CITY OF EAG9N
SINGLE FAMILY DWELLINGS
INCLIIDE 2 SETS OF PLANS, 3
OF SORVEY, 1 SfiT OF ENERGY CALCOLATI08S
NOTE: ADDRESSES FOR CORNER LOTS - CONTR9CTOR/HOME01iNER MIIST DESIGiYATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCS BQILDING PEAMIT IS ISSIIED.
MULTIPLE DiiELLINGS - RFSIDENTIAL
INCLUDE 2 SETS OF PLANS, CEA
1 SET OF ENERGY CALCULATIONS
COLMMRCIAL
RENTAL iJP1ITS FOR SALE D9ITS
OF SORVEY - CHECB HITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
?? ?`? To Be Used For: ft.4! d,&cI'$,Ualuation: ?
Site Address ?SID filyauQ%OFFI,
Lot/v- Block .71 On Site Sewage_
MWCC System
Parcel/Sub 84e*oK4?? ,ZA)? On Site Well _
City Water ?
Owner ?111 _
Address 7637 1<?yn,x,?! ,?.
City/Zip Code /?}?/?riv,6yqpDy5 ?`jW3
Phone ?9-??177 I 6PPROV9LS
Contractor
Address 145 yympyif-
City/Zip Code __<< 4'
Phone /WlT-
Arch./Engr. 717.
Address !.-a-13 / (o a PW. ND ,
vate: 9ld//87
Occupancy
Zoning fZ ?
Type of Const
(Aetual) ?.
(Allowable) SC
6 of Stories
Length SO
Depth 34-
S.F. Total
Footprint S.F.
FEFS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off 9 Z¢
722-
APC
Variance
Permit 51 S '
Sureharge 5 2.
Plan Review '5r
SAC, City
.
100
SAC, MWCC S2S•
Water Conn 525
Water Meter 0"7.
Road Unit 30?--
Treatment P1 180.
Parks
Copies
TOTAL ? Sq 7 a S`
City/Zip Code 1A1%JL 6j4{/#,i IIX/V
2hone a ?-oy77 ??'9
2so X ?
(2?2? = 2¢6
Lo x Zz -
a4O x `?z r
?Sz?o
I 3 c? za
?2?0
Io3?q c?
.
?SURVEYOR'S CERTIFICATE SIENNA CORPORATION
r?r?l I i1.11V 1 0
r i ?'li \ve1i\ r,L L _ N
224.? ?
i
0 W
S 89° 37' 29E I--- -' -? w -T
-? ---???\---' ^'
ORNNAGE 6 UTfLfTY ?I
EASEM£NT PER PLAT
? - - ? LOT 10 °
1 v
? 1o
?
,
I ?. 43 9e ?1 / / n/?'/ • .
p/S00
, M 'OR
?qo°PSe Fo 5J } ?
APPROVED FOR SIENNA
BY: `-r
? ??- ? 2• ?5I QQf `°yOf ,! N DATE:
--
? ° O
?--
i 'rpsO??SJ??
OO \T
ASHBURY \
; COURT ?
! -4--- DENOTES PROPOSED SURFACE DRAINAGE SCALE: 1 INCIi ? 30 FEET
O .pEN07ES lRON MONl1MENT SET pROPOSED GARAGE FLOOR • 848,3 FEET
• DENOTES IRON MONUMENT FOUt?D
X000,0 DEN07E5 EXISTING ELEVATION pROPOSED LOWE57 FLOOR -041.3 FEET (000.0) OEti0TE5 PROPOSED ELEVATION pROPOSED TOP OF ULOCK - $49.'I FEET
j 41E IIEREBY CERTIFY TO SiENNA CORPORATION THAT THJS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF TIiE BOUNDARIES OF:
Lot io 81ock Z BLACKHAWK GLEN 2ND ADpITION, according to the recorded plat
tliereof, Dakota County, Mlnnesota.
EROVh115 T30?H pAY R OF C'iDECEMBER F ANjg 86 S SURVEYED BY
h1E OR WNDER MY DIRECT SUPERVISION T
SIGNED: JAM?S . Hll.l, INC.
W d"'?•-.?
UY:
Z3s&F-ars3-7 T02 HA OLO C. PE7ERSON, LAND SURVEYOR
,i7_y_LA.yIp }??,,,ES MINNESOTA L]CENSE NUI•fUER 12294
PROJECT N0. aoo,c / PAGq JAMES R. HiLL, INC,.
C sisz v) Planners / Englneers / Surveyors
FILE N0. 8200 Humbotdt Avenue 6oulh
FOLDER B1oomington,Mn. 65431 512-ee4-3029
CITY OF EAGAN
EXTERIOR ENVELOPE AVERAGE 'U' CONPUTATION
ONNER: 412KG-A9VD
COIL)
SITE ADDRESS:
/
CONTRACiOR: /e/XK4?4?i CQ'U?! •? y?, DATE: 9l3/ lb Z PHONE: ?9 - 497 77
Determine xorking square footage of each:
1. Tota1 exposed wall area .. ?7c;25 sq, ft. x.t1 = o? jg', `7,T-
2. Total roof/ceiling area .. 105?O sq. ft, x.026 - C?-F .6 V ,
Total exposed wall area above floor = C95707D 5i'
a. Total wall window area ............................ /39- 9
b. Total door area .................................. 4ro• a
?
c. Total sliding glass area .......................... 5?'
=
d. Total fireplace wall area ......................... .?/D,O
e. Total wall framing area (average 10%) ............. . 2,5,p• 0
f, Total net wall area above floor ................... 0-00 7,7
g. Total rim joist area .............................. ?. a-
Total exposed foundation area = 72 sr
h. Total foundation window area ....................... /d.s
i. Total net foundation area above grade .............. /nR. 3
Determine 'U' value of each wall segment:
a.
b.
c.
d.
e.
f.
6•
h.
- i,
x ' U'
x ' U'
x 'U'
x 'U'
x 'U'
x 'U'
x 'u'
x +u!
x ' U'
3 . ................................................... Total = o2?(-, 3Z
Zf item #3 is the same as or less than item 111, you have met the intent of SBC
6006(c) 2. ?
Total exposed roof/ceiling area = /dq,r
3. Total skylight area ...................... .....•.... , 0
k. Total roof/ceiling framing area (average 10%).... . /09,
1. Total net insulated roof/ceiling area..............
OVER
Determine 'U' value for each roof/ceiling segment:
J. ? x 'U' N A = Q
k. fn XIuI
x'us C?•DaS? _ . 64?
4 . ...................................................... Total
If total of 114 is the same as or less than 112, you have met the intent of SBC
6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum
of Items #3 and !t4 shall not be greater than the sum of Items #1 and 112.
1. c? / % • ?? + 2. ? . '`f t1 = -39 $T„_c?-7
3. ? ?• -3 -7 + 4. 4. /L - ;197 1t7
2
SINGLE & DOUBLE FAMILY HOMES
1984 ENERGY CODE REQUIREMENTS
On or about March 1, 1984, the following energy code requirements
should be calculated and included with a building permit application.
1. Roof - ceiling assemblies - R-38 U= 0.025 Average
2. Exterior walls & rim joists - R-20 U= 0.11 Average
3. Floors over unheated spaces - R-20 U= 0.05 Average
4. Exterior overhanqs will be considered as exterior wall.
5. Foundations (all exterior walls) - Minimum of R-5 insulation. ?
6. All insulated areas must be separated from the heated space
by a well-lapped or sealed vapor barrier with a minimum perm
rating of 0.1. A 4 mil. polyethlene sheet or equivalent meets
this requirement.
A Kraft face R-19 type insulation will be accepted in the rim joist
areas. Air chute baffles are to be placed in every rafter space.
, tuio[Line io (a) Vncruas reon rsua,;c nnnunt,
o v Trr icr,LLr usco rr.ouucTs
(R) (R)
In[erlar Air Fi1m (llalls) 0.68 Gypsum or plaster board 316" 0.31
Eaterior pir iitm (tlalls) 0.I7 Lypsum or ylascer boar0 1/2" 0.45
1-[etlor (.ir Film (Vented Ceilinq) 0.61 Gypsum or pl..stcr Eaard 5/8" 0.56
Ealeri,.r Air Fllm (Vented Ccilin9) 0.61 PlwooA j/B" 0.47
- Inecrlar Alr Filn (tten YrnceA) 0.61 Ptywaod 1/2" 0.62
Fxterior Air Film (Ilon Vented) 0.17 Flyvood 3/4" 0.97
Sheathinq, reg. density 1/2" I.32
Rluminum Sidina 0.61 Sheathinq, req. aensity 25/37" 2.06
Aluminum .,ith Backer 1.82 Nail-hase she.:thinq 1/2" 1.14
Alvminum wi[h Backer L Foiled 2.96
I/2 n 8 LaD Sidinn (Wootl) 0.81 Builc-un Poofs 0.73
7/16 n 12 IlatdboarE $idinq 0.67 Asbestoz-cement shinql,s 0.21
xsLestos SiAinns 1/4 Lapped 0.21 Asphalt roll roofing 0.15
Stucco (Oro.m and Finlsh Coat) - Aspahlt Shingles O.44
3:4" Vood Subfloor or Sheathinq 0.94 Insulation: 2-2 3/4" Fiberqiuss 7.00
' 1/3" Plywoad .i.ca[hinq 0.62 losulation: } 1/2^ fiberqlass Ih00
- 1/I" Particlc tlwrd 0.66 Insulation: 6" iIb<rglasz 19.00
t100D5: BlDL1111C v00L5
•
Flr, pinc t slmilar soft kloeds 1 I/2" 1.89 - Approx. J" 9.00
2 1/2" 7.12 APProx. 4 1/2" 13.00
3 1/2" 4•75 Avvrox. 6 I/4" 19.00
5 1/2" 6.87 Avvrox. J 1/4" 24.00
' Approz. 14" - 30.00
Approx. IB" 40.00
All o[her insula[lon materials mu5[ be
Fil)ed verified (R Fac[or)
(A) Vermiculit c
8" Conerete elock (5 t G R¢q,) I.-11 1.9; •
12^ Cancrete elock (5 L G Re9.) 1.28 3.15 .
8° Liync uctgnc 2.16 5.03
12° Liqnt Weignt 2.46 5.82
RA?t?.^..1lRYft.C L1..:?n??t?nt..:?f!
NOTE: (11) z Area Square iect
Al l IJInAOUS '
(w/SCOrns V to 4" Spocc) .56
Reraval OoaEle Glazing (RDG) .5$
Therma or welded 3/16" air snace .69
1/4" air .pace .65
1/2" air space .58
(Other windows specificalty testce can use be[ter ratin9s)
1 3/4 Solid corc door .46
w/storm, wnod .31
w/storm, metal .26
Pease SceelDOOr Ins Ve/GL 7.65R .13
ziidi,a cia:s ooar, uaod .65
Metal .)1$
' . . . CITY OF F.AGAN •
PIINItNM "U" VALUE AND R-FACTOR AT ROOF, WALL, RIPI tV\D CO\CRETE BLOCI:
f . . • • .
P ? RooF ? CEiL(NG
(Y) VAL
Q It?TE?lo? ? NR FI?M o.mr
. O S?s" G`cP P-D, ' o • ST(e?
QO lNSUTA ?IO? 3%, no
C?41 .
O of? A
(?
?`
EXjE
;
IR FI?
1 -
' t5-CiLI? '
_
u" = tltz = _oZs -roTAL. (cZ)= ?;.2
?
? WALL G?. _ ,o:?:. •..
(1Z? VALL
Q INtc(=lot= AIR FlLM 0.4'/
Q '12` GYQ' 8?
? :
?
.
. c
•yS
LN
?i , lor _kM Fl
1
To-rPI- Cr?? _?, y
..
? =
C
,
3
- u ?
'
?
Y
,
Z1M
• - ' ? _?R? ?lr1l?=
it It?TEI'-loc? Ati? FI?t1 . 0.!c/
D 5 1/,!' INSULA71o,a . .. l9- 0
(ID 2 F4fz- Rt1'1 ?oleq . ./;SG
?5 ??;z"
gviL 7
-?iT?
-
I .
,
.
.. . . :2( odo
AI N?f;cr"CCE sto1NG 0
17
.
p ex
tz??c?
i
?
T?
AM f
LM
- -
. ToTP1- (n)= ?. y
?.
. ? .
?"oJrADAT1oO
.
? Ciz) VALUZ?
?
?? tN ?et7l?t? Atrc F«.t?t ? .?
? . -
• C
I ,? . .
IG
"AX?C[
L j?
.
I
9-5
o
17
.
EXjE(1o2 Altt FiCM .
G( = . /,5738
Floors ot•e; unhezted spaces must have mininum R-factor'of R-20 (tuck-under garages),
Floors ocer outdoor air (overhangs) aust tiave a mininum P,-f actor of R-33. , ?.
? CiTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT ?'k4Q2Q ?
PERMIT TYPE:
PermitNumber: BUILDIN6
025540
Date Issued: 0 5/ 0 8/ 9 5
SITE ADDRESS:
P.I.N.: 10-14351-100-02
1563 ASHBURY CT
LOT: 10 BLOCK: 2
BLACKHAWK GIEN 2ND
DESCRIPTION:
- (IMCL pECK)
Building}Permit Type SP AODITION
Building Wor.k,,Type NEW
i
r
.
i
5°.fa
-
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
FEE SUMMARY:
VALUATION $15,000
Base Fee $162.00
Plan Review $105.30
Surch arge $7.50
Lic. Search Fee $5.00
Total Fee $279.80
CONTRACTOR: - Applicant - sT. Lxc. OWNER:
BRASK CONST, KEITH 18927047 20006119 BURK DAN
9650 161ST W 1563 ASHBURY CT
LAKEVILLE MN 55044 EAGAN MN
(612) 892-7047 (612)668-6547
?
I hereby acknowledge thaC T have read this applicat,ion and stata that Che
information is correct and agree to camply with all applicable StaCe of Mn.
Statutes and City of Eagen ordinaaces. i ?
APPLICANT/PERMITEE ? ISS IttI?I1l.SURE?.I/1ASJ
MAy-• 4-95 THU 2:31 PM tAMPERTS APP1E VAILEY FA% ND, 6124320694 P. 2
oS1tlC R S
SITE ADhRE55:
I
2
3•
3.
CifTEVtIOR
ZOHTRfiCTOR: `P??DATE: PHONEt ?po1 " 7d??
DETERMINE WORKINf SOUARE FOOTAGE OF EALH:
'M7Al EXPDSED 1fIlLL AREA,,,,,, ,, Sq ft x"U" •11 _ 3O .33
TO7 L ROOF/CEILING AIIEA ., r+sq f[ x"U'? OZ6 • 3Y.??
?ep?Ek+' qia
( o
TOTAL FXPOSE
NALI, AREA CALCU LATIONS:
?
/ry
,
Total exposed wall
area a6ave floor,,,,,,,, /r-, sq ft (9G49 -jlVE? ??1F-
a) Total wa11 wlndow area:
giezed......
a4
ft x
"U"
s
.
L /
..L
9laxed..... r--+ Sq ft x "U" •-- ? '"
b) To[a rea,,,,,,, Sq ft x "U" .()`7 ?P,?(L
c) Total sllding giass door area: CPati?j l7,pm,. 4 'T`A=.,?
. ,r
? glazad......
3/? ??¢
Sq
ft % q-
??U"
?as? /
¦ ?? ?
._. ?.=L.Y.LG ,. W
4laxad...... "."
sq
ft x ?
"U" •.-.--.
.
d) Total ftrepleca wall ares ?? sq ft x "U" o y7 a 7. JO
e). Total wall fram{n7 nrea
(Averaac }5X)..... rp
3? C7 S
f! X"U" • Q Q? ? 22
JJ
?
.... q r
f) Total nnt uall area above
flaOf (Ineulatcd).....,. I[{/ ? g sq f[ x"U" • ? 7 W ?OC.f?
q) Total rIm Jolst area...... _ O-LQg sq ft x"U" •QaZ ? p.?
Total foundatlon
E
d) /
4? •
?
0
?
,
;e
,,,,,,,.,,
xpose
erea ( Sq ft •
?
O +erJ
h) Total foundatlon
f
d
?
f
"
" ?/
'
3
M
n
ow area ............. U
t x
5q * • •
?O
I) 7ota1 net foundatlon D?J r l/d 9• / -2j,
area above grade........ 30 __ sq ft x"U" o b71 Ar ?
7UTAL a) thru 1)
IF Item p) Is ehe same as, ar less
than item . `'
dl, you have mee tha Intcnt
of
2 FSCAR 1.16008 A and 0. .
Page 1 "-
/
EN]IELOPE AVER0.GE "U" LtlHPUTATION
'.' MAY-• 4-95 TflD 2:32 PM IAMPERTS APPIE YAI,I.E-Y FAx N0. 6124320694 P. 3
?
,`'TOrnt EXPa5E0 RoaF/cEillrIr CnLCUtnrlotIs:
11
Tqtal exposed ?
roof/cellinp area......,. 1335,4 _sq ft///O
J) Total skyllaht area....... /V IQ- sq it x"U"
k) Total roof/cclllnq ftaming ZZ '
atea (AvereOe 10$).... /// - sq ft x "U"
1) 'Total net insuie[cd 7, 0 ?
roof/catllnq erea.....,. 9 p'9 sq ft H"U"
4.-
NMW Rlof
o1,p R38
• D?$ w ?10??
+033 - • ?o/v
I Q IL7 '?7• 98
To7AL J1 thru 1) ?3. 70
If total of l4 Is tha same as, or less than fT, you have met the Intent of
2 MCaR 1.1600$ A and 0.
ALTMIATE BUIl.DING ENVELOPE DESIf.N
To util{te the totel envelope system inethod, the values estaaltshed by the sum
of items 03 and R4 sha11 noC be greater than the sum of Items pl and 02.
r. 308, 33 + z.
3. a 72-%2 +a.
?
?/•/d0 w
3 I 70 -
C E R T 1 F 1 C A T 1 ll N
3V3.01
3 13,66
( harahy certifY,that I hava caTeulated the "ll^ faetars and "R"
values herefn and that the Aufldinn here described meets or exceeds the State
of lflnnesote Enerpy Conservaeion Act.
?
(Date)
& g3Z0
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
$ 99. 2s
New Canstrucfion Reauirements RemodellReoair Reauirements ONke Use OnN
3 registered stte surveys shmving sq. ft. of lot, sq. ft. of house; and all raofed areas 2 copies o( plan CeR of Survey Re€d _ Y _ N
(20%maximum lot coverage allmved) 7 set of Energy Calalations forheated additions Tree Pres Plan Recd _Y _ N,
2 mpies of pian showing 6eam 8 window sizes; poured found desgn, etc. 1 site survey for additbns & decks T2e P2s Required _ Y _ N
1 setofEnergyCalcula6ons AddiHon - iiMicate'rfonsifesepfksysfem OnsiteSepticSystem _Y _N
3 copies of Tree Presarvation Plan if lot platted afier 711193
Rim Jolsl Delail Options selection sheet (buildings with 3 or less uniLS)
Date 3 /?
I /0 (T
Construction Cost
_
SiteAddress PiSH RoA-( /+ l.i UnidSte #
Description of Work l?M l./}7 OVFPL J=L-+? TFiPt'EZ-GF?p
Multi-Family Bldg _ Y Fireplace(s) 2??.
'
a
PropertyOwner I.LSA FbND AORM ?tl ) ?Sl I?SS 5^
SENP1M u) Telephone#((??
Contractor
Address jei.GE si City I
State ?N Zip ?1 aC_ Telephone #(45l ) Uk 1
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catenorv 1 Minnesota Rules 7672
Energy COde Category . Residential Ventilation Category 7 Worksheel • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submilted
• Energy Envelope Calculations Submitted
Have you previously consiructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances
Statutes; I understand this is not a permit, but only an applic
permit; that the work will be in accordance with the approved
approv of plans.
NR'RC w I???t(J(YV ?
APPlicant's Printed Name APP l1
and codes of the City of Eagan and the State of MN
ation for a petmit, and work is not to start without a
the casg of wQrk which requires a review and
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 18 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 (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellane0u5
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• 0 43 Reroof ? 46 WindowsfDoors
? 34 Replacement •Demolition (Entire Bld g) - Give PCA handout to appliwnt
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# af Units Sq. Ft. PRV
# af Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
_ Footings (deck) FinalMo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ A'u/Gas Tests Final
_ Framing Siding
Stucco
Stone Brick
_ Fireplace _ R.I. _ Air Test _
_ Final _
_
_
Windows
_ Insulation _
_ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
CITY OF EAGAN 41
3830 PILOT KNOB RD - 55122
14,640 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
? 3 registered site surveys
? 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.)
? t energy celculetions
? 3 copies of tree preservation plan H lot plalted aRer 7/1/93
required: _ Yes _ No
DATE: «/ Z CONSTRUCTION COST: ? OG
DESCRIPTION OF WORK:
L- Y?6rC,?- ° '?/ (-_??-Y-?- ? y 0 WP1,- ?`
? 2 oopies of plan
? 2 site surveys (exterior edditions & decks)
? 1 energy calwlatlons for heated additbns
STREET ADDRESS: I s63
LOT hI BLOCK Z _ SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
G
Name: ,e u r ?C, h Phone #: ?U
N6i iN6T
Street
c 3
C+'
City: State: Zip:
Company: Phone #: g,?Z-70V 7
Street Address: ,?6SD / 6 ?S-/ -/ License #: z°°o G l( -?
City: ???cdtc State: Zip? ?
ARCHITECT/ Company:
ENGINEER
Name:
Phone #•
Registration #-
Street Address-
City:
State:
Zip:
Sewer & water licensed plumber: . Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the informatian is carrect and agree to comply with all
applicable State of Minnesota StaWtes and City of Eagan Ordinances.
Signature of Applicant: ?
OFFICE USE ONLY RECEN'?,.' LD)
Certificates of Survey Received _ Yes _ No ?AY 0 2 1995
Tree Preservation Plan Received _ Yes _ No
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch o 09 12-plex
? 05 SF Misc. 0 10 _-plex
WORK TYPE
cE;C- 31 New ? 33 Afterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
OFFICE USE ONLY
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory o
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
.. ? n r
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
MClWS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
Engineering
Variance
y3 ?
.?2L
0
- ,.
n. .Yt
Permit Fee
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:
Valuation:
P02 c ff
$ /S evO
I? ° z yy 5-( °
2
pLro1:L
G'z+rw? SPA?c
2zyy G =
l, 3 yy
% SAC G yo
SAC Units
6 5(?Sa_ \,
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
E,;"u
15•sa
Date / I 1?? I .G4
Site Street Address Unit #
Property Owner l Telephone #?)
contractoY,!±????? ' Telepnone #t`?)
:?L Zip01
Address LH-L,I-IiWA ,?4 JatCity A!?State_Lt
The Applicant is: _ Owner Contractor _Other
Alterations to existing dweiling
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other: $ 50.00
Water Softener _ Water Heater
_11? replacement _ additional $ 15.00
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
Total $ ?1
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and z
ApplicanYs Printed Name
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118933
Date Issued:11/12/2013
Permit Category:ePermit
Site Address: 1563 Ashbury Ct
Lot:10 Block: 2 Addition: Blackhawk Glen 2nd
PID:10-14351-02-100
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Adam D Rosenfield
1563 Ashbury Ct
Eagan MN 55122
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177646
Date Issued:07/12/2022
Permit Category:ePermit
Site Address: 1563 Ashbury Ct
Lot:10 Block: 2 Addition: Blackhawk Glen 2nd
PID:10-14351-02-100
Use:
Description:
Sub Type:Reroof & Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic.
Valuation: 15,000.00
Fee Summary:BL - Base Fee $15K $265.50 0801.4085
Surcharge - Based on Valuation $15K $7.50 9001.2195
$273.00 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 -
Adam D & Lisa A Rosenfield
1563 Ashbury Ct
Saint Paul MN 55122--220
Minnesota Window Siding
8609 Lyndale Ave S #207
Bloomington MN 55420
(952) 888-9904
Applicant/Permitee: Signature Issued By: Signature