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4375 Capricorn Ct CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knoh Road -;; ?? P. Q. Box 21199 PERMIT NO.: Eagan, MM. 5512f DATE: Zoning: R: No, of Units: I Owner. E. $ar;i.ow E Sons Address: 5ite Addrcss• 4375 GaQticorn Ict. Lf 112 4,ild. Pl: 3 plumber. :-fatY.iiew Da.niels Iric Nkter No.: Connection Chorge: 500.00pd Sixe: Aaaunt Deposit: 15.00 pcl Reader No.: Permit Fee: 10•00 pd I syroe to aoroplr with the Cky of Eaqa• Surcharge: . 50 pd : Ordinaaaq. Misc. Charges: 1.32.00pa S/C By Dote af Insp.: Total: Date Poid: I nsp.. CITY OF EAGAN , SEWER SERVICE PERMIT 3830 Pilot Knob Road 7500 P. 0, Box 21199 PEFtMiT NO.: Eagan, MN +55127 DATE: Zoninp: r'1 ' No. of Units: 1 Qwner: E. BgXXOW S SOIIB /Wdress: Site Address: 4375 CapricArn Dt. L6 13 d. 171 n Plurnber. n . - G - 1915 85 . Oopil I ogm to eaapy wNb ihe Citr aF laga¦ Connection ChoW: 425 . OOpd Ordlneaas. Hcoourrt Deposit: 15.00 p Permit Fee: p Surcharpe: .57 pd By Misc. Chorpes Dote of Insp.: Totol: Insp.: Dote Paid: _ CITY OF EAGAN '-_ 3830 Pilat Knab Road, P.O. Box 21-199, Eagan, MN 55121 PHOIWIE: 454-8100 BU11.DiNG PERMIT Recelpt # . =3 ? Ta 114. wed fer DW'., ?'' "? ?;AR, Est. Vol ue ` 6, ;? 1 '' ip bate `vx.A"f 19 .? - +,.. --- - Site Address 5i 3 Erect ? Occupancy ?.? 3 ( = ? LOt (It Block d ?eclSub. Remadel ? Zoning Parcel No. Rapair ? Type of Const. S; , Enlarge ? No. Stories ?, Move ? Length ?c h1ame ' ' }'? r }»q p f Demolish ? Depih A ? A?r84S -.f 4't ?S...r' '?l'X??L €?I?_f?EA4JtS JL??7 , x "'46 ' Grade ? Sq. Ft. City 't`Phone 4 5'` . 15 6 1. install ? N8ff18 Appeovals Faas ?? .3 f J ., :.1 Assessment Permit ?; ?.` o? Address ?- City Phone ?'!:: Water 8 Sew. 5urchar? Police Plan Review x `) 9 c' ?W Name ?.W Fira SAC 5 25 Cl t2 Address -3-445 l).K Eng, Woter Conn. ? W City ' '? `.::"k ??? Phone 4 Planner ? Woter Meter Countil Rood Unit I hereby acknowledge that, I hava read this applicotion 4nd stote that gidy, Of{, 13 20 the inlormation is torrect and, pgree to comply wirh oll applicable ?pC Tatal S• k''" StbH of Minntsotn Stotutes qrid Ciy of EqgQn (?r,dj?ances. . .; . ? .'i"'i,?'S'r.., ti/a1'. DAtB Si9nature of Dermi#tee It Building Permlf fs issued M: Z BARj;,(;'sJ Ar F `on tha express conditlon tho+ oil work shall be done iin otoordanca ?vr+th oll applicnble State of iw(inntaoro Statutes ond Ciry of Eagan Ordinonces. Buildiop Official _ ?.. Permit Na. Permit Holdar Dats Tele hone # Plum6ing r 1 7).c ' d 0 v ',.2 -?-?.z : . I H.V.A.C. -16 0 31 _j U_d_(C_??. l??z]( x ? II 1 Electric 1') ?- 9 1 / ?? ? ?? ,? , . ., R ?f l) Insp. , ?A. . I Insulation f CertlOec. ? ?)q(g5-- Water ??ibe Lacation: YYell ?j d ??73t//itf )r Disp. ,4.,. Receipt ? .-? ?i' ? - F??' PLUMBING PERMIT CITY OF EAGAN permit Fee Fi!l in num,bered spaces S/C , Type or Prini legibly Tot - , ' , ?? - 1. Date = s=?> 2, installation Coit 3. Job Address`:;Lot Bikc:---? tract 4, Owner 5. Contractor, ° Phone 6. 7. City ° State Zip 8. 8uilding Type: Residential ;0 9. Work Description: New C.7 10. Describe 11. Commercial ? Institutional ? Add ? Alter O Repair ? No. Fixtures Water Closet No. Fixtures Cesspool/Orainfield e Bath tubs 5e tic Tank Laeatory p Softner ? ' Shower WeII i Kitchen Sink UrinaflBidet Other ' l.aundry Tray 1 Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above informetion is true and correct, and I agree to compty with a11 ordinances and codes gaverning this type of work. Signed: far Rough Final Inspectians: Date Insp. Date tnsp. This is your permit when numbered and appraved. Approved CITY QF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. - CITY OF EAGAN Fee Fill i» numbened spaces SIC 7ype ar Prirrt /egibly Tot 1. Date 2. Installation Cost -" 3. Job Address < - r,?ot Bik. ' Tract 4. Owner ; 5. Contractor ? i f< Phone 6. Address J 7. City State '.f Zip f n'? 8. Building Type: Residential 0 Commercial ? Institutional O 9. Work Description: New ? Add ? Alter ? Repair ? 1 10. Descxibe Fuel Type 11, No. EqilLt HTU - M. Ea. Forced Air No. EQUipment CFM Air Handlin : Mfg. g Boilers Mfg. ' Unit Heater Mech. Exhaust Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CIl"f OF EAGAN 454-8700 CITY OF EAGAN Remarks L't ) 1`?' D ' !*?/? 3C Addition Wilderness Park 3rd Additiem Lot 6 Bik 2 Owner ()Cc rr, - street 4375 Capricorn Court 111i(.;,? nird ?, 4, Improvement Datfl Amount Annual Years 'Payment Receipt Date STREET SURF. L D& 1979 690.40 69.04 10 -8 STREET RESTOR. GRADING SAN SEW TRUNK 1973 168.89 8.44 20 59.17 It it SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA G( 1979 244.44 12.22 20 158.90 go STORM SEW TRK • 1983 505.84 ? 50.58 10 354-10 STORM SEW LAT CURB & GUTTER SIDEWALK STREET I.IGHT 280.00 51935 .---5,/2 WATER CONN. 500.00 BUILDING PER. 10259 5AC -525.00 PARK . ,.._. cirY aF EaGAN 3830 Pilot Knob Road, P.O. Bax 21-i 99, PH ON E: 454-8100 BUILDING PERMIT Est. Value $7 Lot Btack -? See/Sub. Parcel No. a w Z 3 c r;ARY & CAWLYt% L+DRGAiv °C Name .o - ? q Address 11- City Rhane v¢ WW Name W Address q W City Phone _ Receipt # Date ,1 g OnSiteSewage _ bcoupancy MWCC 5ystem _ Ioning On Site Wel I _ Type of Const City Water (Actual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. APPROVALS Assessments Water/Sewer Police Fire Engr_ Planner Cauncil I hereby acknowledge that I have read this application and state Bldg. pff. thattheinformationi8correctandagreetocomplywithallappliCable aPC 5tate of Minnesota 8iatutes and City of Eagan Ordinances. Variance Signature of Permittee :,. JI.!t'` FEES Permit _ 5uroharge _ Plan Review _ SAC, City _ SAC, MWCC _ Water Conn. _ Water Meter _ Road Unit _ Treatment P1 _ Parks Copies TOTAL i?. condition that all work shall be Building Official Permit No. Permit Holder Date Tefephone # Plumbing H.V.A.C. Electric Softener inspection Date Insp. Gomments Footings I Footings II Foundation Framing Roofing Rough Pibg. Rough Nig. Isui. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. Temp. LP Deck Ftg. DeCk Frmg. &Z L W - Well Pr. Disp. CITY OF EAGAN WATER SERVICE PERMR 3830 Pilot Knob Road P. GYop-ox 2 799 PERMIT NO.: . ? Eagan, N{R11 ?5'?Z7 - ,. .. ., . DATE: . Zoning: lt I „ „ ?'fXilnits: ` Owner: Ba Address: ". „" : „ i ,! ? i ?es 51ce 11rJdrcsa: 17 5 Plumber -' ;: - r xi.z:ls S 3,56 Meter No.: Connection LyhVcroe- 3(?i;).OG?d Size: Aocount Deposit: .09 'IDd Reader No.: 50 7 7 Pertnit Fee: i. •. '. 00 -a c? 1 agree to eompl?r wilh !iN Citp of E.agoa Surchcrge: . 5 Q -? c; Grdinanea. Mist. Chorpes: ??''- ???Opci S/C Totol: .90U d r2et'e1 Dote Paid: Date of I nsp.: ?r ? I nsp.: ? O This reQuestrKiA B '0 ?3 0 o; i & (0 K 3 .o? Request Dale June 7? 198rj I Fire No_ 1 qough-in I7 pection ?a??reA? C]fleady Now OWill Notify. IInspec- Yes ?NO Ior Whgn qradY )(A Licensed Eleclncal Coniractor I herobv renniest ins0eclion of abova ? Owner eleev:fal work imUlled aL Sveet Atldress. Box or Route No. Gity 4375 Capricorn Ct. Eagan ectian Township Name m No; I Ranpe No. Cwn1 . OaCOta Occupant (PRIM) Poone No. mr. Aiorgan E.Barlaw & Sons Const. 452-1561 rowe. suooi+e. nad.ess D.E.A. FArmington Elettrical Con[wctn (CmPanry Name) . Con[rac[or'S License No. Corrigan Electric 60. 0 39549 8 MailinB Atldress (CaMrac[af a Oxnbr Yakim Inslailatian) P.O. Box 475 Rosemount, minn. 55068 Au o Signawre n[r?;lor/Owmer Makinp 1 ttallatiml Ph.e Nvmber ? Aj?tAA'? 423-1131 tlINqESOTp yTpTE 90qpp OF ElEG711VFl/ THIS INSPECTION BEQVEST NILL NOT G?iqps-YitlwraY Bldp. - Ibom N-191 \ I ? ACGEPTED BY 7HE STAIE BOARD 7827 Vniveraity Ave-. St. Paul, YN g1dd UNLESS PROPER INSPECTON FEE IS pbre (61212W2Ill ENCLOSED. IffQUEST FOR HECTWCAL IWECT10N Ee-°°°°?f'?1 ' See i?huetions tor wvpieti,q [bs fam m beek af ?.ellow cnpY- f S(S 129110 ""X"" Be/ow Work Covered by This Request ? 1"c,aal P.o.l rvMoi su;Mino I Applianeas tirW I I E9uipment Wired ? M Fea ServiceEMraMeSixe p Fee Feetlers?5?bleetlers # Fee Gircuits ocozooan oro3on ?to30Am s Above 200 q? 31 m 100 A?s 37 to 100 q Swimming Pool Ahove 700_Amps Above 100_Am ' Transfortners Imgition Booir?c Partial: OThec.E - -I ISpecial Inspection ,S 35.50 I TOTI:C 111-EE Nerterks Rouph-in D.te lV Y Elec ?wl Impector. hereby nify thea the above Final imO?tion Aas been ?de. 1" m4uest roN18nanNisM1an . ? L 09 6a, ? ? ?a.?:?i`"d_ ?j? • Q ? / / .,?,a ?. S <. 7/aL S .4 Request Date Fire No Rough-in Inspecban Repmredi eatly Naw O Will No1tly Insp or U` J YB6 WhOn Reetly? I icensed contractor ? owner hereby request inspection of above electrical work et: Job Atltlress (Sireel Boe or Route No I Gry y 41-15F 1011' SBChan No Township Name or Na Rarga N0. Coun[y Occupam (PRMT) Phone hb. PowerSuppi Atltlress Elecvkal Gonlramo, ICOmOany Name) ComractOrS Lmense No LL L?c° ZE ? ?d!Y Nfailing Atltlress 1 onhactor or Owner king In s`r-o-,-Y, Au[ d Sgnal 1 r/Owner Mak?ng Installetwnl P?ooe NumEar ` ?p MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT Crlggs-MlEway Bltlp. - Room &113 BE ACCEPTED BY THE STATE BOARD 1821 Universiry Ave., SL Poul. MN $5100 UNLES$ PROPEF INSPECTION FEE IS Phone (612) 642-OBOD ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ? See msimdions irn cumpteting this lorm on oeck of yelbw ropy L08966 "X" Below Work Covered by This Request i??a\ EB-00001.08 e i ?y?7r2? 3.. 6 ?"?? ' Sa l ?53 e Atltl ep. TypeoBmldmg AppliancesWired EquipmentWlred Home Ran9e Temporary Service Duplea Water Heater Electric Haating Apt. Building Dryer O[her-(Specity) Comm./Industnal Pumace Farm Air Conditionar Other (speclry) Coniracror5 Remarks Compute fnspechon Fee Be/ow, ?j? # Other Fee # ServicaEnirancaSae Fee # CirouitsiFeeders Fee Swimming Pool 0 to 200 Amps 0 io 700 Amps 7ransformers Above 200 _ Amps Above 100 _ Amps Siqns InsPectorS use OnN: / TOTAL Imgatwn8ooms Special Inspection AlermiCommunicaLOn THIS INSTALLATION MAV BE OR IF NOT Other Fee COMPLETED WITHIN t8 MONTHS. I, the Elactrical Inspector, hereby certify that the above inspecUOn has been made. Rouqn-in F,,,ai oeie oWe OFFICE USE ONLY This request voitl 18 monihs Imm ' 1 IL I 2/84 m r CITY OF EAG??V ' / APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTIODI (PLEASE PRINr) P°OP= ?DRESS: _4L 75 C?Piz«o?z?? cr LEG.'vL D:.,??P'I';C:I: RQ ) d U l CPa'255 3drl?- ? ` (Lot/Block/Sinciivisicn or TZi rarcet I.D_ 'F sIT.LC^:Z, naTZ oF cRIc^raL uzLDr:c .==1T ls a::-`c._ ,: - =_•, ?_, PPESm.^_ :. ,..TT,/??0PC5= L'S: 2-1 SL= FF?trLv ? R-? LU:= (7:'0 C'?:=S) ? R-3 ?C:.?zrr?cr (?2?? - L?i:S1 ? S) ?-? ? ,;: C Q CCinL?"?C==i?.%2?';?T_?C:'`'Tcm ? TM-%r,/cc=.?.r.;r 2) APPLI;__;: (PLEasz rai;jr) E (Gwz[,tXw -i- Soti.ls ACnREss: 3tN ashin??-r CI'I"l, S_^r.TE, ZIP: _ l? !!lnij,cl ' PHG-NE: 3) pumLa fOR CLiY IJSE 04LY NP.1L: l PDD.nESS:-% ?l? C ??fl. =-UJA ? ? ' PLUMBERS L1&:.45E: CITY,..STIITE, ZIP; -. . , ttive Ezpi d . PHOVE: 1.? L ^ PLUMBER LILEVSE N of R ord Lld ,i1 UC,C'.,'PPS]T/CT.?'ER NA lrLca4L rninr) [?: ADDRESS: CIT"l, STATE, ZIP: PfiO.`IE: 5) IIVDICi.TE :'7[IICH PERi-1LT IS BEI\C REOUESTED: to CC:.ICy 'IO CITY SES^IER EA GC :':`IEC:IC:I 'Ib CITY S1ATt.?t ? amER (PI.r'LcE DESCRIHE) 6) L":DiC:,i.., C:.c,: • • Q_ T.?.+SE FOID r1PP?UVID pERMUT FOR PZCs-L? SY C.'?IE OF A£C?7E APP.ROVED P&F-'•LIT TJ Z, -Z.6,-'4' e'4G(JVE. 7) SIa7,'iuR: : DATE: ?o ? ?? ? RR?.iR/Y.iO! l? ? lS??l?f! t/YA??? af i i?Si?a a a??!!ala?O?i? fl ?f !lRi??,y F O R PF?".IT '-` ISSUED E:?__= I T Y U S E O N L Y : S ?a.Su $ « ?3 . $ S S f) =?? $ l ? . ?.?{ $ S S S $ $ . S ? 3A , uL S SU°C.°.?RGE) waTSa pFITtTm (yr:cL?;nE_ sURcuaacL) WAT°R METER/COPPEF:-IORN/OUTSID : REi,DER WATE.°. TAP (INCL'JDE CORPORATZON STOP) 5:.;•7 ER :?,? ACCpuNT DEPOSIT - i•IAmER wac sac TRli:;K S•]AT°R ASSESS::=T TBli:1{ SE:-iER ;,SSESS::E?iT L'nTE?.nL HE:vErIT/TRUJIK Sc LATcRaL BENEFIT/TP,U:IK S•JAT°n SdATER TREATMEh7 PLANT SURCHARGE OTHER: TOTAL A.`lOli`:T PAIJ,%REC°i?T ,'1, ???? DOES UTILITY CON:]ECTION REQUIP,E EXCaVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PE.^Z;fIT FOR 'r70RK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE r__7_116_?ENGINEERIDIG DIVISION. LIST AS A CONDI- TION. SliEJECT TO THE FOLLOWING CONDITIONS: APPROVED BY; TI:LE: DAT°: IN sw ?as ?? s? ?w rc ? w f? ? w? w ssf w? Ra w?? w?w? ss? wE++4 ? se ?.i.?r w? w? w?i+ ?? BUILDING PERMIT t CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21•799, Eagan, MN 55121 PHONE: 4548100 Reeeipt SF DWC;'GAR Est. Value $62.000 Date MAY 22 19 85 Siteqdnren 4375 CAPRICORN CT Lot 6 Blxk Z ?clsub. WILD PARK III PuoN No. ? Name E. BARLOW & SONS CONST pdd,on 3445 WASHINGTON LN cny EAGAN phone 452-1561 Nama SAME e, Addreat ? City Phone Qrj?-],$?9 91 I Name AR -HTT . T R T. CRAPHT S _? q?? 3445 WASHTN(:TnN DR ?W City F.AGAN phone 452-1 Sfid 1 Mieby ackrawledge t have ad fhfs opDliwrion ond store that the inlormation is corr nd ree to comply with oll opDlicabla Stote of Minnesota SWt t f a i p nus. Slpnotum of PermiMas A Buildinq Parmir Is iss to: W ONS ( dl work shotl 6e doro iaecordanee wlth all a bb State of i BWldinp OfflGal Erect [l Ompsncy R3 Remodel ? Zoning RI Repeir ? Type of Conit. V Enlarge ? No. Storiee Move ? Lengtn 44 oemol+ah ? Depth 48 Grede ? Sq. Ft. Inrtell ? Aoorarnab F.a. Assessment Woter 3 Sew. Polica Firo En0• Planner Couneil BIdg.OH. rJ 22 $ APC Var. Date pemit ? 31 y. V v S,,,ch,,a, 31.00 Plan Review 159.50 SAC 525. 0 Water Conn. 500- 0 Woter MePor _63-4 0 Road Unir 280- n p T.P. 132.00 Total S2,009, 5 X on the exproY canditlon Ihot Stotutes ond City of Eopan Ordinoncaa N_ 10259 s`'1W _?' S7 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS 19(IST BE LICENSED WITH THE CITY OF EAG6N INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF S URVEY tdoM?,ey 7 SET OF ENERGY CALCULA TIONS To Be Used For: ?tesr?e?+ri.v4? Valuation: ?4hause S Date. Site Address: ¢-37J ?f?-?-?w? ??• (v Z.,C?O.? OFFICE USE ONLY W ?7d/ticari.?/! Lot: ? Block ? Sect/Sub Pa+./?.c Erect )C Occupancy ? ?j Parcel S io- fel"2S7-- 060-0z- Remodel Zoning R-I Repair _ Type of Const Owner F4A,ICF?Id ,_ so?/S sT Enlarge # of Stories Move _ Length 44- zI / Address 7i??(,f AShr.vq,?r.?q Demolish Depth Grade Sq Ft - ? c City/Zip Code -ag?.d ILI i.u,f) SS/1? ---------------------------- ------ Phone ?{5 Z-lS6 / APPROVALS Contractor ?j6 a?Ar? dfe-iss CrWSI?Assessments _ Permit 3 ?q, °-° Address Water/Sewer 72?t{?? /NRStW??r?t D?• police Surcharge Plan Review 31 00 5q,5° 7 City/Zip Code A/ iLA) Fire 6-S-1;L ? Engr SAC Water Conn °° 525. - 500. s- Phone 'V5 Z- Planner Water Meter rc3 °= Council Road Un1t 2.gp, 99 A h /E /-Id1 ' / -/ Bldg Off Parks rc . ngr. .c??rECx ?a APC Treatment Pl ?3Z.= Address 7 ? iance TOTAL a o 050 City/Zip Code Phone 0 2Cp x?? i o 4o x S 4" 5c9 t co 0 Z2 n 2z - 4-g4 x 11 - 532? " (151 iqe:l 4 ROBE CONSULTiNd EHGtNEENS NGINEEAING PLpNNEAS und LAND 3URVEYOAS COMPANY, INC. 1000 EAST 1461h STREET, BURNSYILLE, YINNESOTA 53337 PH 432-3000 ?OQt .UC.lCf'L ?07'Ll -oT (e J&.oCK Z.1 Wit-DG.RNESS A>RK 5' AD??TioN? OaKoT4 Go?u'rY? MIiJNE.SaTA. ? - - ? i i? v I ? S ?'(•° lI ` Y? , I" ? ?-- g $ I 2v: Z a o I? n ? 45c?7? z3 S6A vylawabE? urturv 6". 4 9.s) N 54aa1 (9 ,c 10.0 r -0 ? ?p9/ ?•'ri 9w oj r ? izo.4A- N 84°s7'28"E LC'f" i 6 ,a ? 1 l?4iRp IJOfZTH SGOLEt 1"=3a? , \\ / •' \ o. ? ?I ( • Mo ran 954P.45 Q .n ? ru.J 945.e0 oo r$ l ?zrc, 53•4y? ?953 •?j \ F??_°iDErJCrfES ?iC?ST?NV EI??/e-Ronl ?9so.o)r?p?S PearosED ?va-r?a.l FIAII?jHED ?A&E FtO?¢. ELE?/ATtAJ =?ba 1 R_ lhlDlcpES DIKEx.?iAJ oF SNRFAG? . p¢n1wlAb? - I her*by certity that this ie a true and earreet raprneenlatioa of a tract of land as sham'and described l?ereon.. As preparad by me on this zzNo day of 19 8? . ?0 /? ?EK IAF?ICCKr.i LouRT ? -??1? 12.L,444._Hian. 1te6. llo. i".0*s EXTERIOR EDIVFLC?E AVERAGE "U' COPl?UTATI04"1 041NER STTE ADDRESS Z497- ?-&-4qCK- 2 lUrcP6z,VE'S5 3-°AP'CY77oxj CONTRACTOR_ ? aae"rc> ?v Sculs DATE PHOPJE Determine rrorking square Pootage oF eaCh. 1. Total exposed wall area ..., 1798 eq. Pt, x,11 = 197 8 2. Totsl roof/ceiling area .... 1040 sq, ft, x.02`6 ? 27 Total exposed xall area above floor a 1-709 a. Tota2 wall mindo:•r area ..............,,, 132 b. Total door 2xea ......... 20 c. Total s1131n ????????? B Elassarea ...... .? ........ I5.7 d. Total fireplace vrall area - e. Total wall fraQing area (average-l0$)... So f. Total net vrall area above floor ........ 1 Ia1 S. Total rir, Joist area ...................109 Total exposed foundation area = h. Total foundation r:indow area .......... i. Total net foundation asea above grade . Determine "U' value of each wall segment. a. 132 X flut: 72.6 ^ b. 2o X"U° , 13 a 20 • c. I5•?_ X "U°t I0.2 D• - X "p" e. I SO JG ?. U" .22 a 39• (o f. 13&( g uU" 7o4/v = b2•!o h . ?- g l?U "U' 1. g r.Uii ? 3 ............................................Tota1 o 197,4 If item q3 is the same as, or less than item al, you have met the intent of SBC 6006(c)2. , . Total exposed roof/ceiling area ? 10140 J. Total skylight area . . ,,,,, _ k• Total roof/ceiling frar.:ing ?2rea?(average 10Z - 1• iotal net insulated roo:/ceilina area ,...... to4o Determine "U` value Por each roof/ceiling sep_ment. ?, g k. X 6 U?: s 1. to XU u ,_ 02?a = 7i'j 4 .........................................Total ? 2 7 If total of Y'-I is the same as, or less than #2, you have met the intent of SBC 6006(c)1. Alternate Buiid3rig Envelope Desli,n To utilize the total envelope systera method, the values estab2lshed by the sun of items !f3 and N4 shall not be greater than the su,-.1.oF itens and 92, - 1. I 9"7. is + 2. 27 = 22?F. Sf ' -1 ---.---,. 3. ?9=r +4. 2 7 CITY OF EAGAN N! 13 4 7 5 ;s Nf} 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE:454•8100 Receipt # ?a 53? 7o be used for DECK Est. Value $750 Date APRIL 17 19 87 SiteAddress 4375 CAPRICORN CT Lot 6 Block z Sec/Sub. WILDERNESS PK 3R Parcel No 3lName GARY & CAROLYN MORGAN I = Address 0 City Phone 454-0739 p Name_ ?Q Address ? City_ w Name_ Z Address u w City_ OFFICE USE ONLY OnSiteSewage _ Occupancy MWCCSystem _ 2onmg On Site Well _ Type of Conat Ciry Water _ (Actual) (Allowable) # of Stories Lengih Depth S.F.TOtal Footprint S.F. APPHOVALS Assessments Water/Sewer Police Fire Engr. Planner Council I hereby acknowled9e that I have read this application antl state Bldg. Off. thattheinformatloniscortectandagreetocamplywithellappliCable I APC State of Minnesota Statutes a i of Ea9en Ordinancea Variance Signature of Permittee evzia A Building Permit is issued to: GARY ; CAROLYN MORGAN all work shall be done In accordance with all applicable St e of Minnesota Statu BuildingOfficlal 41? FEES _ Permi[ _ Surcharge _ Plan Review _ SAC, City _ SAC, MWCC _ waterConn. _ WaterMeter _ RoeA Unil _ Trea[ment Pt _ Parks Copies TOTAL 17.10 .50 •??! _ on the exDress condition that and Ciry of Eagan Ordinances. 1987 BQILDING PERMI2 9PPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLDDE 2 SETS OF PLANS9 3 CERTIFICATSS OF Si1RVEYO 1 SET OF SNBRGY HOTE: 9DDRESSES FOE COEAER LOTS - COHTEACTOR/HOtiEOWNSR lIIIST DESIGHASB i1HICH ADDRfiSS IS DESIRED. NO CHANGES iiILL HS ALLOWED OACE BOILDIPG PERMIT IS ISSDED. MOLYIPLE DSiE[,LINGS - E&SIDSNTIAL SBNTAL DAIY3 FOR SALS OHITS INCLUDE 2 SETS OF PLANS, CERTIFICAi6 OF SIIRVEY - CHECg iTIYH BLDG. DEPT.9 1 SET OF BNERGY CALCULATIONS - COP4M6RCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANSt 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: D ?LK Valuation: ??•"-" Date: T ? ?/ 5 ?9? 7 Site Address ya;s- '41 Lot Bloek ? Parcel/Sub Owner 9ddress City/Zip Code Phone t( s Contraetor Address City/Zip Code Phone Arch./Engr. _ Address On Site Sewage_ MWCC System _ On Site Well _ City Water _ 9PPROV9I.S Assessments Water/Sewer Police Fire Engr Planner Couneil Bldg Off APC Variance City/Zip Code Phone # Oecupancy Zoning Type of Const (Aetual) (Allowable) 0 of Stories Length ' Depth I S.F. Total Footprint S.F. FEBS Permit (-7. L" I Sureharge yo ' Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOT9L C? P)dt ? F Vo czc1gan 3830 PILOT KNOB ROAD, P.O. BOX 21799 eeA BLOrn9UiST EAGAN, MINNESOTA 55121 ^AO+'? PHONE: (612) 454$700 iHOMAS EGAN JAME$ A. SMITH DATE: MaY 1> 1985 JERRV THOMAS THEODORE WACHTER CouncY Members iHOMAS HEDGES Ciry Atlmimitmror COVERBEKE EUGENE V SPECIAL ASSESSMENT 'V O SEARCH Requested by: DAKOTA COUNTY ABSTRACT C0. RE: Wilderness Park 3rd, Lot 6, Block 2 1250 Highway #55 4375 Capricorn Court, Eagan, PM1 55123 Parcel # 10 84252 060 02 Hastings, MN 55033 Enclosed herein is the seaxch which you requested made on the above described property. Kind of Improvement yPars, Beginning Original Amount Balance Due Street 10 1979 $690.40 $207.12 Sewer Trunk zo 1973 168.$9 59.17 Water Area 20 1979 244.44 158•90 Storm Sewer Trunk 10 1983 505•84 354.10 I further certify that according to the records of said office, the following improve- ments are contemplated or pending after having been approved and are now in the process of planning or completion. Kind of Zmprovement Approximate Date of Completion Approximate Cost NONE WAIVER: Neither the City of Eagan nor its employees guarantees the accuracy of the above infor- mation which was requested by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly waived. Levied assessments to be paid to the CITY OF EAGAN, 3830 Pilot Knob Road, P.O. Box 21199, Eagan, MN 55121. Very truly yours, SPECIAL ASSESSMENT DIVISION Azw THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROV?fH IN OUR COMMUNIN oritl F li acigal yo t 3830 PILOT KNOB ROAD, P.O. BOX 27799 sEA BLOMBUIST EAGAN, MINNESOTA 55121 tibw PHONE: (612) 454-8100 THOMAS EGAN JAMES A SMITH DATE: May g, 1985 JERRY THOMAS THEODORE WACHiER Counnl Membars TFiOMAS HEDGES CRy ADnimsfrofor SPECIAL ASSESSMENT SEARCH EUGENECVACOkERBEKE Requested by: Chicago Title Insurance CgE; Wilderness Park 3rd, Lot 6, Blo 4$20 West 77th Street 4375 Capricorn Court Edina, MN 55435 Eagan, MN 55123 Parcel # 10 $4252 060 02 Enclosed herein is the search which you requested made on the above described property. Kind of Improvement yBeginning Original Amount Balance Due Street 10 1979 690.40 207.12 Sewer Trunk 20 1973 168.89 59.17 Water Area 20 1979 244•44 158•90 Storm Sew Trunk 10 1983 505•84 354.10 I further certify that according to the records of said office, the following improve- ments are contemplated or pending after having b een approved and are now in the process of planning or completion. Kind of_Improvement ApproXimate Date of Completion Approximate Cost None WAIVER• Neither the City of Eagan nor its employees guar antees the accuracy of the above infor- mation which was requested by the person or pers ons indicated. Nor does the City or its employees assume any liability for the correctne ss thereof. In consideration for the supplying of the indicated information in the ab ove form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly waived. Levied assessments to be paid to the CITY OF EAGAN, 3830 Pilot Knob Road, P.O. Box 21199, Eagan, MN 55121. Very truly yours, SPECIAL ASSESSMENT DIVISION Aw ??---? THE LONE OAK TREE...THE SYMBOI OF STRENGTH AND GROWTH IN OUR COMMUNIN oF 3830 PILOT KNOB ROAD. P.O BOX 21199 EAGAN. MINNESOTA 55121 PHONE' (612) 454-8100 Special Assessment Search Date: pugust 19, 1986 Requested by• DAKOTA COUNTY AHSTRACT CC 1250 IiWY 55, P 0 BOX ASG BASTINGS MIII 55033 ?FA BLOM9UIST Mayor THONYIS :GAN JPMES A SMIiH V1C ELLISON iHEODORE WACHTER Courcu MemUers THOMAS HEDGES QN mmimshotw EUGENE YPN OVERBEKE Cily Cleik Re5Wilderness Park 3rd ( 10-84252-060-07 ? On the attached form is the City's response to your search request on the identified property. The information includes the original amount of the assessments and the payoff amounts of the assessments on the parcel. In addition, pending assessments are included for improvement projects that have been ordered to be installed by the City Council if there are any on this parcel. The City's policy is to levy assessments based upon the current or existing use of the parcel, as reflected in the above assessments. if, and when, the parcel is rezoned or developed to a higher use, that parcel shall assume an additional assessment obligation as a condition of development approval. The City Engineering Division can provide further clarification of this policy if you desire. WAIVER: Neither the City of Eagan nor its employees guarantees the accuracy of the information which was requested by the person or persons indicated. Nor does the City or its employees asswae any liability for the correctness thereof. In consideration for the supplying of the indicated information on the attached form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly waived. Levied assessments can be paid to the CITY OF EAGAN. Very truly yours, 010 SPECIAL ASSESSMENTS Attachment iHE LONE OAK TREE ..THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIN I/ ? -, TrANSACTIDN ZD: R768 SPECIAL ASSESSMEN7S SPEC IAL ASBESSMENTS SERRCH SUMMflRY RROF' E(17'Y I.D. T ODAYS DATE: OS/YS186 ---SP£CIAL FLAGS---- 1-2-3-4-5- 6-7-5'-9-I0 10-84 25-`?-060-02 ' --------- ------- ------------- T -------- ------- --- - ------ S.A.# ------------ HSSE5SMENT --- ---==---- DESCR. --- --- YR -- ------- --------------- Yr5 RATE TOTAL --- --------- ANN.FRIN. -------- PAYOFF -- - COMMENT 100221 SEWER TRk: 7:7 20 3. vt)"/. 168.89 .00 .00 PRERAY 1004p6 ST1ifET5 78 YO 3.00% 690.40 .00 .CtU PREPAY 100408 WATCR pREA 79 20 s'. Ud% 244.44 .00 .00 F(iEPAY iW'i 17 SS/TR 82 10 1 0. 4G"f. 505. 84 .00 .00 PRfFAY a?•rtx:k3r SUMMAh'Y OF AC:TTVE .00 . oo .00 THIS YEAr'S TQT F'&I •00 F'ress FI or F2 (Header Form) or F7 (Restart tr'763) HOUSE HEATING TEST RECORD ADDRESS 4?'_? ? ? ?C1at `-'? APT._FLOOR GTY ?SUBURB OCNPANT OWNER HEAT LO55 DATE HTG. INST. ;'J - O/ SOLD BY e ' r?/G T n.c INSTALLED BY Elemrieal Wo k By C y ??' E,ye?t. ?? C Gua Line By Sou-?+S.?e. y Y7 Q-.V?. TYPE OF HEAT GA _79- FA -?6_NW _STEAM _SPACE HTR. _UNIT HTR. _ OTHER n n GAS DESIGN , CONVERSION MAKE (? wMDL MAKE OF BURNER Model tLG Pk- 07 a U'E Abdel s..iai ? x50 30? F?-999aS1r?? M,.. sru ea,in9 INPUT -ZCCO Tt,,- MAKE OF FURNACE Modai ' _. - .. CONTROLS ? ` K SHERYOSTAT ' " tMat Alup Yont Slat . Yafw W ft Ki2iD OF LfNER SIZp HOMF Llmis ?i ,?c?.M, o??. omh • HYOd .? Llml!$?MIaY b Flk?fi Fas S?nlaa /O ° mlmwy Plbt TYN 1'r_ GJmmy Ca?siNCilaa ° 1 Pllot YoW i ruse iw" . 3?. eo.? wr? ? PUw Tldna Arati T.st Tay. L.W. Cw Off Dca AMswrO LIp6tloQ 7?'. ' r..,.?. 35 P.rc.m coz •?_ ooo. tapw CFIi pwqw. p Y. G? ca?m =w? - a 2 StcrJc Tiay. l0 2 F Axaot CO 0 Nam at Tuar - Forms 23S CITY USE ONLY PERMIT #: G RECEIPT DATE: fiESID£NTIAL MECRARICAI. PERMIT ?PPLICATIOR crrYoF $wsm 3$30 fILOT KNOB RD £AHAR bIN 5S18E 6:51-6$1-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: 3-1" 0I SITE ADDRESS: 17.3 7S- OWNER NAME: TELEPHONE #: GS?` ySa' ??Y? (AREA CODE) INSTALLER NAME: ??p7rt.Glt??, Uu2q i' A/b TELEPHONE #: (AREA CODE) STREET ADDRESS: ?D ??'" /G9Z?'rL(?+^-eCttYt? ?JW?, CITY: STATE: AtJ ZIP: Place a check mark neYt to the oermit work tvee New residential dwelling unit under constructionand not owner/occupied $ 70.00 Y Add-on, modification or alteration to existinq dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other Nature of work: -,7 sRu.,?ie zG3 State Surchar e $ .50 Total $ ??y? Reminder: Ca11 far inspections. I_S SIGNATUREOF?PF? ITy_EE 2 2001 1 F2 ll Updamd , �> > Use BLUE or BLACK Ink �----------------- � For Office Use � ' j Permit#: / ��/� � I �1�� Q� ��I�II ��c��o � �� . s3 � � Permit Fee: � 3830 Pilot Knob Road S�� (� � rt^*� I �� I Eagan MN 55122 * � Date Received: � Phone:(651)675-5675 I �(�i I Fax:(651)675-5694 I Staff: � I I I ��_______��J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION „n �� Date: Site Address: Unit#: d ' � Name. �alfl� rlCJh, SUSQtq, �A/'.�r'l Phone:l�Jf �71 ��°� Resident/ �./ /l � � Owner Address/City/Zip: "7 3 �J'f L�U i"1 CO✓�Y� �� Applicant is: �Owner Contractor Type of Work Description of work: Qf'' `��-✓�" �.r �` �o%6�v>"� U/V�� S I h� e Construction Cost: �e�� Multi-Family Building:(Yes /No�) Company: Contact: Contractor Address: City: ' State: Zip: Phone: Email: ` License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additi��nformati�) ' � 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 tratle secrets. ' CALL BEFORE YOU DIG. Call Gopher State One Cali 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.aopherstateonecall.orp I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota St e Building Code must be completed within 180 days of permit issuance. X �C3l.V►� � . �6 J �AvG� x G�� ApplicanYs Printed Name App icant's Signature Page 1 of 3 4_ �375 �� . . e� DO NOT WRITE BELOW THIS LINE J� 7/�� SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) X Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) T Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES _ New _ interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation _ Replace _ Repair _ Egress Window �(, Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation t�T�_ Occupancy ' ��- MCES System Plan Review Code Edition � SAC Units (25%_100%�) Zoning ��°'__ City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction �_�� Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings(Addition) � Final/No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick � Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control ,�r Braced Walls Y Other:��A��l'Ns�� M�'7� 7"'� Reviewed By: , Building Inspector RESIDENTIAL FEES � -- Base Fee ,/} ��Dr�, � � �� n,��A,� , af�� ► � ,r�� ., Surcharge ��/ � � Plan Review �r'! ,/"r ��''�•��' ��' MCES SAC �'�� City SAC �� Utility Connection Charge S8�W Permit& Surcharge ��.1 �� .--� � �/� a Treatment Plant � `� � � Copies TOTAL Page 2 of 3 � ' . � _ _ _ _ _ /�-��'� . $�-��.�� -��,��.�� S�fore cornpdeii�g and ser�ning this fcrm, t�e principr�l r.�ust recad ancf initial the IMPORTAfVT Ps1flT1CF TC3 i Hc Pfi#,`�CPPAL�htrt crppec�rs t�ft2r t�he si�raa�ure fines in this f�rr.n. Se}ore acting on i�ef�r�;f of�he prir,ciprzl, th�r,rttorr�ey�.�;-in-�r�ct musr sig�a�his��rtr�ackno�ariecfgi�g hcr�in�rer�d r�n�unde;stoc�the ffVtf�f�RTAfYT#�fC177C�T�3 THE'ATTQ�NEY(5�-ft1t-�ACT ihat Q�pe�rrs€x�ter#}�e notice to the princip�xl � . , _..r° - `� /`° ��''��tiTn� � �� 'R!�!��€��9.{Name artd address rsf person gra�tir�g t�e power) , �r ; , ��.s ti5�?e �-J c Z�:�� °��;+ , . �S ;��%'C��-��l� �`� � -� f /'/ ! �l�2�� _� �� t/�.�� Arro��v��{�}-�;�-��cr su�c�sso��o��r�s;-��v-��e� (�Iarn�s and Acfdress�s} (Optior�a!)To act if any named attorne�-in-fac�dies, � resi�ns or is c�therwise unal�le�o serve. r-.. � ��,��__��'�_-_1�E'_:t€� (i�ame and Address} ��:� ��e,L�`v'�R .`�� 'd�tti��t,:`:�CC� ��a'�- 4°�� IfSC�UCCP_SSOi' � . _ _'lT �•�f�� -a3��.Yh�,__._�'� ; �:�f`.i�'t, \ , � ,� _._._ ��i �:%i1i� L,.z.V(�....iC�il� .. -T .,t� �� n --- �N'--L�=§?GW(1 &"+t� � ,^s J�'ta �J`1/�- ,�. SeconclSuccessor �O�iC�_ If rnore ihan on2 aitorra�y-in-fact Es d�sig��ed to act�t the same t�rne,r�ake�check -_____._____, or•,x„on the iine in fro�t of c�ne of the foilgwing — s�a�e�nents "� �� _--�'� �ach af�ocrsey-in-�ac'c r�ay inr��e�der�tly EXPIRATIflf��AT�{C�ptiar�ai} EX2sC15°the po�vers granteti, Use s�ecifc rnonfih,da�a�d year onfy _.___..----. A!i attc�r`�,e�ysara-€act m�st jaintly�x��cise the nov�iers grar��ec1. � `� �� - �d;� ��'a� �,�I 1:�� ;� (,�Ci i V� � �� ---..._.� ��„�,»„�.�- ..........-..-.,-..�-' ...r-4--.--�"'"�� _ y _ � 7 . . . �.� i� ? ��N��o� s�r��ru��s z�� sz�.�� I, (the�bave-named Prinwi�ai) �ere�_y ap�int the above�aamed 1-�tt�rs�ey�s�-i�s-�'$ct t�acs �s��r�ttomey(s}-iz�-fact: �IRS�`: �'o act fcr m�iit s�y��ay�hat I eQ�ild a�t��i�a respect tc�the f��Iowin�mat�ers, as each c�f them is de�aned ir��vla�tnes€�ta Staiufes, section 523_24_ (To�ran�t�tl�e�ttomey-in-fact�ny€�f t�e ft�tl€su<ia��we�,�aice a chcck€�r:+x"��t[ic li��. ' - �n fr4r�t of each�wer bein��ranted.You�nay,but need not,cr�ss out eae�Z pc�wer not granted. �aili.are tc�rt�ake a check or"x"c�n i�e Ii�e in frc�nt o�the�c�wer wit�haE��t�e ef�ect csf delefu��the � �*cs;�er ur�iess the l�ne in front c�f�€��ver trf�t'�T)is chee�C� or x-ec�.) � ! ..�------. (!�} real �araper�y transs.ctia�zs; I � I choose ta limit�?s p�wcr to real prc�gerty in ...................•--..........,:.........��unty, � ivlinnesota, describec�as fallc�ws: ° � �.Tse legai ciescrip�io��I)€�nc�t a�.se sfreet acldress-} i .........................................................�--•---.......--•---.........................._........._..._..-•------.. ............................................................................................................................°•--� � ..........................................................................................•••--..._.,................,_....•--.... � (IFrnc�re spaee is nee�ed,continue an th�b�c�t�r an�n attachment_) � _....----. {8 j �tangible�ersonal pro��,rty irans�c�ic�ns, . � ! ..... (�} hond, sh�rre, and ca�m�dity tran�cti�ns; � _....._... (�} b�kin�lransacticanL; � ...._...._ �E} €�usiness operatan�transactic��s; ! _......... !�') i�s�ua.nce iransactit�ns; ; ---------- (E`s� ben;:f ciary transactiot�; [ � ..�_�..... tH} gift teasnsaciicans; i ` - -•- (�3 ficiuciaf-yy i�actic�ns; r ---_. . ` .......... (3�, el�i�s ��d?ati�a#i€��; �3s.3��.�'t f ......_.._ (K; fa�i��maintenance; ,, C��`;��`�1.9� ; ; �€��t ' ` ---------- ��.) be�tef'�Ls frt�m�it:�r}� �e�-vice; ' i ---------, L�I) r�cc�rds, repgrts, a�c�s��te�t�tenis; 4 ; ...�r� (�� att of��t��c��vers listc�in{��ta�-augh�I�)�bove�-�c��.1}c�t�er matt��rs,t�ther t�an ` � �eait�c�e decis�c��s tzn��r a h�,a�th care direciive t�at complies with It�ii�nesc�ta ; Statu#�s, cha�ter ��5�. � ! 5��?�II�:��'ou r��st indaca�e belg�whether�r n4t�is�wer ai atta�ney v�-ill bc e#�ecti�e if yc�u becc�me incapacstated c��incQ�npe�e�t. �1ake a check or"x" an#he Iine in fi-c�nt c�f ihe sta-te.nent that espresses your int�t.� Cc��syrir�i ti;2013 0�=the€3�ce oi thc Rerri��=af Statut�,State o#�iV(ign�sc�ta_A'sl iti�hts I2eserve.d. , . . � ��.�� 7 '�9€��:i�y a�Qrney�s)-in-fact 1fi�Y iV��m�Ice gif�s tg t�e a��-ney{s}-iri-fact,or an�ane the ates��ney-in- �acf is iegally fl�ligated tc�sup�flrt,U�1LE5�!hav�rnarie a check a�an"x"on the Pine in frar�t oa the second sta�.ement�efov�.r a�?d i nave�+rri�en is��he r,ame{s}of the attQr�?ey�s}-irs-fact. TF�e secar�d apti�n al6�uus you�0 4i�ait th�giSiing�aov�e�to o�fv€he atLc�r�sey�s}-i�-�ac#you cta�e irt th�statemenf_ h�inneso�a S�atu�es,s�ctiar�523.Z�,sssbdiVision S,cl�use{2j,4imi`�s the�nr�aat g'rft(s}r�act�to m�at�Qrr�ey(s)-�r►-fac�, or to a�3yone t�e ai�o€�neyfs)-in-�=act are�egaliy cr�[igated�a sup�o�,io art amount,in the aggr�gate,ii�at do�s not�xceed th��ec�erai anr�ua!gift tax exclusion arr►out��ar�the y�ar o€�he g;ft. r � t��a��u��a�rize an aF in att�rn� s tr� ract ta r�a�e :fES to thems2tves or t�an one€�e �� Y �1 Y� )= -� � ` Y a�tcrney{s}in fact have a legai c;b{��a�ion t�support. 1 authflraze ��rrite in nam�s). as my a«ors�ey4s}-in-fact,to make gi�i�t�themseives or Lo anyone�hn attorney{s}-in-fa��ve� 6eaa1 obligai��n L4 St�pprrt. �(3€��€�:�yt�U may indicat�bel�v�vvi�2t�e�r�r not the atiQrney-is�-�act ss rea�uireoi ta make an aecos�att"sng. Make a chec�C csr"�„on�F�e Iine in front�f the s�a�ement tha�expresses your in�ec�t_} � ftt�y attorney-in-fact n�ed not��nder a�a�counting unfess t r�que�t�or the accounting is othenrvise rgQ�l��E3�1!'V�li93�l�Sfl��il1�?5,secii��t 523_21. �lf�r a�tarn�v-it�-fa�rnus�r�rae4er (f�e�nt�ly,�uar�eal�r,fi�s�rtual} a�ca��atirgs tc��,�� (t�'ame�nd Add,�ss) � �L��ng r��r ii�etir:se,anc�a fiic;a;acc�un�is�g'€a i'�e persona! represen:ative of my estate, if any is � aP�ointecl,after rny��ath. ��'�1��5��E��,1�a�e heseant�signed rn�r nar�e this r�ay o� :,��. �� 2t�3� � 5 � � I ignature of Principaf) � I (Rc,:nowiedgrn�n�oi�rircipa#j �`i'A,�OF tVilA33�LSdT�"' };;:._ � ..-.:,.__..t.. _._�_•... c. ..-- �: . ,.� �� y__ �.�:�SSst> ,�. C�}Ut�T�'�f _�. _� .=..� � �::a ; � The fiare�oing insirume�t wras ac��+r6�dgec�b�FCare r+1e this ____ da�� ,��, j; ; �,#,,, ,. .�-7�;,. 2tl , �}� �{.f�c=;:� 1��.�� `��-se==yF _ (lr,sert name of principat j� 1 �;� � �;�.S�Ji�� Sig�aa�re�f l�o�ar�Pt�blic o dot�r o �cial 1 �9{��c��i§� E�6�{t84� � �;�x-Caesat rE€L.+ae U te€3 S�t . rs�3:tneeSca Gu�d>t3tta#ed f�b€trtdra v.� _ _ _ _. _ Use BLUE or BLACK Ink . . . . �-----------------� I For Office Use � I I Clt of E� a� j Permit#:�?L��5� j Y � � 5� � � Permit Fee: + � 3830 Pilot Knob Road i �� Eagan MN 55122 � Date Received: � Phone: (651)675-5675 � � Fax: (651)675-5694 I Staff: � � I � I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: �P? C:�°I �U.�Cf�t�' L,C 1�S��1 Phone: �� D � 7 �/ Z g Resident/ �/ OwneC ':' Address I City/Zip: �1�7.S �V�� C,c�✓'n � , ' Applicant is: �Owner Contractor _. Description of work: r v�c�v.� `�-«!h�l� ��N �� Type of Work r--- c�c�; � Construction Cost: �bC�, -- Multi-Family Building: (Yes /No_) ' Company: Contact: COt1tCaCtOC '` Address: City: '` State: Zip: Phone: Email: ` License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be:public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State ilding Code must be completed within 180 days of permit issuance. X �CL V�>� � � �C�J�GL� X . ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA131056 Date Issued:05/29/2015 Permit Category:ePermit Site Address: 4375 Capricorn Ct Lot:006 Block: 002 Addition: Wilderness Park 3rd PID:10-84252-02-060 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Ryan Cairns 4375 Capricorn Ct Eagan MN 55123 (651) 353-1128 Window World Aka Probuilt America 2211 11th Ave E, #130 N St. Paul MN 55109 (651) 770-5570 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA149843 Date Issued:06/12/2018 Permit Category:ePermit Site Address: 4375 Capricorn Ct Lot:006 Block: 002 Addition: Wilderness Park 3rd PID:10-84252-02-060 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Ryan Cairns 4375 Capricorn Ct Eagan MN 55123 (952) 891-6020 Elysian Construction Inc 301 Thomas Ave N Minneapolis MN 55405 (612) 310-6723 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA161199 Date Issued:05/12/2020 Permit Category:ePermit Site Address: 4375 Capricorn Ct Lot:006 Block: 002 Addition: Wilderness Park 3rd PID:10-84252-02-060 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Ryan Cairns 4375 Capricorn Ct Eagan MN 55123 (651) 353-1128 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA174426 Date Issued:01/26/2022 Permit Category:ePermit Site Address: 4375 Capricorn Ct Lot:006 Block: 002 Addition: Wilderness Park 3rd PID:10-84252-02-060 Use: Description: Sub Type:Furnace Work Type:Replace Description: 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 - Ryan & Salley Cairns 4375 Capricorn Ct Eagan MN 55123 (651) 353-1128 One Hour Heating & Air 11825 Point Douglas Rd S Hastings MN 55033 (651) 437-4177 Applicant/Permitee: Signature Issued By: Signature