1214 Carlson Lake Lanecirr oF EAGaarr WATER SERVICE PERMIT
3795 I?ilof Knob Road PERMIT NO.:
Eogun, MN 55122 DATE:
Zoning: No. of Units:
Owner;
Address:
Site Address:
Plumber: 0
Meter No.: Connection Charge:
Sixe: - Account De
o
it
p
:
s
Reader No.: Permit Fee:
1 agree to comply with the Cily of Eagon Surcharge:
Ordinoneea. Misc. Charges: - f:i ?--•' :?r t
Total:
BY Dute Paid:
Dote of Insp.: Inso.:
CITY pP' EAGAN
3795 Pilot Knob Roed
•
Eagan, MN 55122
Zoning:
Owner: _
Address:
Site Address:
Plumber.
I
1 agree to eomply wilh the City of Eagan
Connection Charge:
Ordinanees. Acwunt Deposir:
Permit Fee:
Surcharge:
B>' Misc
Chor
es:
.
g
Dote of Insp,: Total:
insp.:- Date Poid:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
CITY OF EAGAN
? 3795 Pilot Knob Road
. Eagae, Minnesotc 55122
Phone: 454.8100
_ PERMIT
Date:
Jnly 20, 1977
Site Address:
Lot , Block ? Sub/Sec.
T'Ont-?:? ---C .
Name
.
m _.
Address ;r.e lli:; :;c.
O
"t. Paul
City Phone:
A. Binder & Sar?
Nome
?
? i:>+) E. Butlnr
? Address
0
C? ,'rF:st St. Faul.
City Phone:
This Permit is issued on the express condition that all work sholl he
Minnesota Statutes and City of Eagan Ordinances.
No. " 3'7
C:=? a'I
Receipt No.:
Single I .
Residential
Multi Res., Comm./ind. I
New/Alter./Repeir. Cost of Instollution
Permit Fee
.50
Surcharge
Tota I
done in accordance with Q!l opplicoble State of
Buildinq Official
r
?
Julz,? 1%: ' ??'77
Date:
CITY OF EAGAN
3795 Pilot Knob Road
Eogan, Minnesota 55122
Phone: 454-8100
PERMIT
Site Address: •.i lSOIl Ldl1E
Lot Blotk Sub/$ec
W Pk
Name
3 Address .;. t , 'xv2. so.
O
_ , P<3•,: ?
City Phone:
Name
.
154 Gran ' T;z:
P Address
s
0
City Phone:
This Permit is issued on the express condition that ull work shall be
Minnesota Statutes and City of Eagon Ordinonces.
No. -
Receipt No.: ?
$ingle I ..
Residential "
Multi Res., Comm./Ind. I
New/Alter. / Repai r
Cost of fnstaifation
Permit Fee -
Surcharge
I Total
done in accordante with all appliwble State of
Building Official
cM oF EAGaN
3745 Pilot Knob Rood Engon, MN 55122 N2 4376
. PHONE: 454-8700
?
BUILDING PERMIT ReceiPt #
To be u:ed fer Date , 19
Site Address Erect ? Occupancy
Lof Block Sec/Sub. s: Alter ? Zoning
Pnrcef # Repair ? Fire Zone
Enlarge ? Type of Const.
w Name
W Move ? # Stories
Z Address -
0 Demolish ? Front {t.
_ City Phone Grade ? Depth ft.
o Neme
?Q Address -
a
=t oL.,,...,
Nume _
Address
I hereby acknowledge thot I have reod this opplicotion and state thot
the informotion is correct and agree to comply with all appiicable
State of Minnesota Stotutes and City of Eagan Ordinonces.
Signature of Permittee
A Building Permit is issued to: -
ail work shall be done in accd'rdance with
8uilding Of€icia!
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bidg. Off.
APC
Fees
Permit
5urcharge r ?z
Plan check
SAC
Water Conn.
Water Meter _`.
.
Total 1;1f,7 Cn
on the express condition that
Minnesota Statutes and City of Eagan Ordinances.
?..
PennM # Dote Iswed PwmkHe
Plumbing 7 7)
Mechonicol ?'t3 7 7-ad - 7 ]
INSPECTIONS DATE INSP. Rougirln Find
Footings Date Insp, pote Irop.
Foundation _ plumbing -/,.n-1)
Frome/ins. Mechonical
Final
IV
CITY OF EAGAN Remarks
Addition Wilderness Park Lat 19 ?Ik 3 Parcet 10 84254 190 03
Owner?t??: street 1214 Carls on Lake Lane 5tate Eagan,MN 55123
Impravement date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 176.05 8.80 20 132.05 C003512 10-14-77
SEWER LATERAL
WATERMAIN
WATER LATERAL
' wATERAREA _3& 1977 0 66 15 149.34 003512 10-14-77
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 7
8UILDING PER.
SAC 00 -/(? . 77
PAR K
?J. ?t?i zyd?y f? O L g`SD
This request void 18 months from
Ao ; P 10312
Date of this Request 7-13-77
I, as EY9.icensed Electrical Contractor ? Owner, do hereby cequest inspection of the above electri-
cal wiring installed at:
Street es
Se ion owns`?iip psorRo N01214 ? a ?n City Favan
?f" ./ ?} ?- .
Range County Dakota
Which is occupied by Tilsen Homea
(Name oi Occupant)
Is a roughin inspection requiied on this job? No ? Yes E7 Ready Now ? Will Call Rc
PowerSupplier Da.kota Ctv. Address Farm;neton
ElectricalContractor G.B. Thomasoti ElectricCo. Contractor'sLicenseNo.32503
(COmpany Nama)
Mailing Address 12201 P4tka Blvd 3 Ktka 553n3
(Electrical Controctor or 9pr r Making ThIS Installatlon)
Authorized Signature /? 11????., o _ Phone Noc??? ?_
r,?ps (Electfital r`d??tn rkb'?7-6?Jrd?u?akingT islnstallation)
S?? LII? n _
Minnesota State Board of EleMricity '!C-d
?
1 4 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
10312
HECK BELOW WORK COVERED BY THIS REQUEST
Type of Building New Add. Rep. Check Appliancea Wired F Check Equipment Wired For
Home %2 ? [] Range ? Temporary Wiring ?
Duplex ??? Water Heater ? Lighting Fixtures ?t
Apt. Bldg. ??? Dryer ? Electric Heating ?
Commercial Bldg. ??? Furnace XH 2. OC Silo Onloader ?
Industrial Bldg. ?? ? A'u Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List ) List )
COMPUTE INSPECTION FEE BEIAW
Se?vice Entrance Size: # Fee Fcedets&Subfeeders: # Fee Cuwits: dt Fce
0 ro 100 Am s. 0 to 30 Am res ':? ? ?? 0 to 30 Am eres 8 00
101 to 200 Am s. 31 to 1.W A"'.. es y: ?. \ } 31 to 100 Am eres
Above 200 ps. Ab e'I'QQ_L1A7nps. p\? -' Above lO?Am s.
Transformecs Rem' ?°? on -?t "uc ] Partial or othet fee
Si ns 5 ns ion Minimum See 55.00
Remarks
. E811
TOTAL FEE
I, the Elutrical Inspector, hereby c ihat ovE inspection has been made. tfr? ?ate?
(Rough-in) Date Z, R- 7
(Final) _ Date
This request void 18 months from
ciTr oF enGnN ?
3795 Pilof Kno6 Roud Eogan, MN 55722 N2 4376
PHONE: 454-8100
BUILDING PERMIT APPLICATION $599000. Receipt # 6406 _
Te be und for Sing. F8m Dwlg, d Att. Garg. Date .1une 15. 1 9 77
$ife Address 1214 CarlsonLake Ln Erect n Occupancy-?i-L---
Lot -1_9- Block _-3 Sec/Sub. vi: i?ss.rark Aiter ? Zoning
Partel # Repair ? Fire Zone _
Enlarge ? Type of Const. V
rc Name Robert U8S
w Move ? .jF' Stories
Z Address Demolish ? Front ffA ft.
? Ci Phone Grode ? Depth M ft.
Approvols Fe¢s
Nome
o 'Filaeir Homes
Z~
Address 627 Sn Snn11iAg AVe
Assessment 0_
- Permit 1 54_(1
??
r
St
PaUI Water & Sew. Surcharge 29, 50
C?
.
phone Police Plan check
Fw Name Fire SAC 465,00
_?0 Address Eng. Water Conn. _230...0.0
4W Ci Phone Planner W terfyle?r60.?0
?8i
on 120
0
CounCil ic
v
.
I hereby acknowledge that I have reod this aDPlicotian and state that Bldg. Off.
the information is correct ond agree to comply with all applica6le
State of Minnesoto Statutes and City of Eegan Ordinances.
APC 7()F7 _ 5f1
Totol
Signature of Permittee
A Building Permit is issued co: Tilsen Homes _ on the express condition that
te o/f?Minnesata Statutes and City of Eagan Ordinances.
oll work shall be done in ac ance with pplicable Sto
o
_
Buildir
Officiol
v
g
.
s
??? ?? ???
Date c ?P 'J3- ??
BUILDIiS('i PERttiIIi P.PPLICATZ057
7.,OT J ?_ S:,OCK ,-.3 FIDDITIQrd ???; /V? _
'?_::CET, & SPCTIOP3 PNISDER IF Ui3PLATTED
':1:.';L"::;v:; Gr 'r:":;S.:EL f 02?'? ?,(i n!//?a?Y? %A ? ??/ .._ . ...
, '--,T?=-- ?OCCUPARICY d? USE S? /L.C/?GsJ? ?' ???
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Ji•'I?.1r,R ??{?.P2/(- L??ta?.2? '?.?+PH?T??' SV?.
y[: !}..C;S:?
COC??:R?.CT??S? ,? ? ??O^ TELEPHONE fTO.
f_})L)?ESS
?P?XS.?
t?lote? Include site plan, building plans, and energy calculations ?^?th ih9.r.
a?plication
Signed
OFFICE USE
?.12?I,UATIOid
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_'TJIT?DEIdG PERI:3IT FE$ ? ??
q.30
^;iItrHl.P.GE FE£ O? / i..
PLf1PT Ci_FCA F?i .....
?P.FtK DEDIC.'?TION FEE Ia? ?
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' `.i>?;SEn'Ir^.?'T CLERK?SUILDIiQG DEPT. POLICE DEPT. _ ,
..'.'^???2 E SEi?7ER DEPT. EI12? DEPT. PA,?IC DEPT.
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Tilsen Homes,--Inq.
627 SOUTH SNELLING AVENUE
ST. PAUL, MINNESQTA 55116
PHONE:698-5501 $UbJBCY a ? Date
MessaSe jke- 0'tt Ca&.C? Ql/ ?
CiL&10-2V CI1G2'?&C
,
PLEASE REPLY TO 14') /9-l1 ?
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Reply
Signed Date
Form No. QL3 SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETl1RNED WITH REPLY
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y?..µ. - -. . ? . .
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(TO N fmbodlted. iritk ti111?
t "?t" ca?lsr?r?~
Ma?lt ?}plie?ei?ay
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Site Address.?_..
Cmlnctor -h ,_eFm 4Adj.AE7t6 1 ?c- Dau 01- 9,,-r1(a }IrM
LIUAL !T. dF
? RALL ?+!?JCZ+(4?¢+L :?+?+?+? ± to abow sndo- ! 5t1. c -n
- fe4 TOTAL Ea06ED MALL AREA SQ. !T.
x 8 g? 2
aAQUE wALi. GoN STRi1CTI0N: "U" valae E aru ;612-
Z
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'b" ? t. ?- (D) (w;
P,7???, LQ?yyyE_ WA?I.. "0" • D: sq. ft. ? Plfob` . ' Ilh (A;
,ttail seferenee ••p" z sq. ft. • (!) (A?
fi0a ('r?Lr o ?? t?... "U" .?'7 zsq. ft. 1 1 'rl m
?jGi, 8 (? (l4
iteaeded ohNte "U" z sq, _
ft, n (O) (A;
"U" z sq. ft. ' (V) (A;
"U" z sq. ft. ' (V) (A;
Wama+s: 'v^ vai.ve x arsa
? (P Au+N xt5 gq, cT,
.? 1 @14 a 1 '11 r?,c Su ' 1541 . f t.
r- @ zaxad ? .?.. ?q.fc.
1- @ cz? 24<44 ` 1q.3 ?q.ft.
I @ Gzi ?nx44a sq.ft.
'L @. G I 1 inx4A ? ¦q.ft,
? @ c1? Zexaa- .q.fe.
IhscA4 - 4.9 _?sq.ft,
haln 6 ty" : sq. [t.
sq. ft. 11 2.9 ? l02. I (A)
sq. ft. (e. 2 ? '. 4. (U) (e)
?'x sq. ft. 7..0 (11) (A)
MORSt "0" nlue ! aree popQSt QE,qS£
0k6 3 t]p/ 1(P %1,°_ Y fo8 "U" j 13 zsq. ft. 2Cn (0) '(U
"b" _ j2 zsq, ft. M(N
. „ - - -
fouls q. . ' M W
?.U?? .I sq. ft.? . o ??-M Ua
IOLL M(A) VAI.UES 36 2,rnl • •!3 Taru.s -12
?. ?.q. fc. 30?•5 (tnU
SI?ID? bY 1'OTAL fiALL AREA?.`z10. I AVG. "U"
MMACE "U" .17 or lese for 1 6 2 faaily dre111nge
.22 or less for all o[her buildinge
MM/CBILnIG:
!'0'rAL ARSA: sq. ft. . .
Deull reforenee "U" x eq, ft, ? ({) (A)
!e'm "U" .ea3 x sq. ft. 1 '74Z'7'7. / (W) (A)
ottl06od sheets "U" x sq. ft. ' ({) (A)
DeIetiDe opeaings "U" z sq. ft. ' (ln (A)
Ln roof "U" x sq. Et. ' (!M (A)
r0Y'AL (if) (A) VALUES
>IYIDED M 1VTAL ROOF/
ssa,nic naM
-17 . 1 O ¢ Tni.S / 7"? 'Z .9. f t. (v) (A)
/ '7 9 -.. . .
l^ i h
OM os Rno fnily doellieg_2. oreer _?t, •^'+?,? _..?..
A11' other ° ..-"
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i
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. l •
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RLAGE "U" .OS for venciaLated roofs
.LO for •11 other oouatructioa
D!/C6ILING: R= value
1.
2. l[?" IIaSVLAT?n4,1 7.2.?0
3. 9,5,,ut6
.0.?
. 4.
5• _ . 043
05,
fISTRUCTION FRAMINC: R- value
2.
3, 1'?2 Su? sa },A I wUn . D b
4,
5. ?
6. ?ti4?o _ ??Q •e ??,q..9? ` .07
1 --
TE: If average "ll" valuae aa calculated abmre do not ssat the Enargy Code raquireoan[e,
the "Alternate Euvelope Design" a• wtlined in SBC 6006 (g) mey ba ussd. Additiowl
sheecs may bn ueed co show calculations,
.
BEA BLOMq115T
MnYOR
THOMAS EGAN
MAqK FARFANTO
JAMES A SMITH
THEDppRE WACHTER
COUNLIL MEM8EF5
June 17, 1980
Mr. Robert E. Haas
1214 Carlson Lake Lane
Eagan, MN 55123
?-
.
CITY OF jEAGAN
??PILOT KNOB ROAD ,
EAGAN. MINNESOTA
-
55122
PMONE 454? tOO :,•RY'?,...
3 h.=.
+r
?i
1MOMRS MEDGES
CRY ADMINISTAAiOP
ALYCE 80LKE
CITY CIERN
RE: Driveway Construction
Dear Mr. Haas;
During an inspection by our Engineerin,e Department, it was discovered that
during the_construction of your driveway at the above referenced address,
a portion of the asphalt was construeted beyond the back of the eoncrete
curb and gutter section. This excess asphalt covering the concrete eurb
and gutter section adversely effects the drainage of the streets.As you
vrill notice, two new cateh basins have been installed in front o£ your
property. This installation was necessary to aid in the interception of
storm water £low in the gutter portion of the street. With your "asphalt
ramp" in the gutter section, it diverts the water around the catch basin
and renders it less effective than is required to be. Consequently, this
asphalt apron must be removed. The City o£ Eagan can make arrangements
to have this removed by the contractor performing the work.on the catch
basins or by our maintenance department. However, we will not be liable
for any disruption to your existing driveway that may occur during this
removal process. It would be advisable if you would make arrangements
to have this removed on your own. Please contact me indicating how:you
wish to proceed with this apron remaval. Your anticipated cooperation
and response prior to June 25, would be appreciated.
Sineerel}r i'/
G
omas A. Colbert, P.E.
Director of Publie Works
TAC/jlr
TME LONE OAK TREE ... THE SYMBOL OF STRENGTH ANO GROWTH IN OUR COMMUNITY.
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN i
3830 PILOT KNOB RD, EAGAN MN 55122
851-881-4875
NewConaVUCtbnBeaulrements RemodeVReoehBeguhemeMe ?
• 3 registered stte suneys showeng sq. fl. of bt, sq. A. o( house; anU all roofetl areas • 2 copies of plen j 3
(20% maximum lot coverage allowed) . 1 set ot Energy Ca?ulations tor neated additbns
• 2 copies of plan showtrp beam & wlndow slzes; poured tounC design, etc.) • 1 SBe survey lor extetwr addilbns 8 decks
• 1 set o1 Erre[gy Calculations . InEicale H home served Gy sepik system lor etltlitions
• 3 copies of Tree Preservatbn Plan N bl platted after 7/7/93
• Pim ,bist Detail Options seleclbn sheet (bl0gs wMh 3 or less unRs)
DATE S / GIO I VALUATION S)Z/" ?3 -71
SITE ADDRESS _ I 0 , I"1 Cai"I SO n Lak? Ltn MULTI-FAMILY BLDG _ Y ? N
TYPE OF WORK + ?_Uy-cSr-F J r?_I'an(- 0
FIREPLACE(S) 11. _ 1_ 2
,
APPLICANT
STREET ADDRESS IqeO PaT Il C) CIN C?na h Hus S+, STATE ?'? 11T ZIP S S 317
TELEPHONE #(95? 00 -d(VJI CELL PHONE #
FAX #
PROPERTYOWNER 70Yn n'lYh$I TELEPHONEdk??
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNFSOTA RULES 7672
0 submission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submiped
• Energy Envelope Calculations Su6mitted
Plumbing Coniractor:
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Conhactor:
Phone #
Phone #
Fee: $90.00
1T ? ?? vu?l?
p? MAY 13 2002
I hereby acknowledge That I have read this application, sTate that the Information is corre&T,=endvg o comply
with all applicable StaTe of Minnesota StatuTes and City of Eagan OrdJrag??es. /
Signature of Applicant
..................................................... OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Water Softener _
_ Water Heater _
_ No. of Baths
_ Phone #
L,awn Sprinkler
No. of RI. Baths
_ Air Conditioning
_ Heat Recovery System
uPaatea a/o2
,
LA e
Oil
For Office Use {�// /
� , ::::
,,,•,,,_,,,
:
♦ l
i� - ce
7 y' Date Received: / (�0'"/
3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 91,vv z z Nd('
(651)675-56751 TDD: (651)454-8535 I FAX:(651)675-5694 Staff: •� i
G
buildinginspections@cityofeagan.com A3102 1 L
,�7 2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: It / -. t ii a.
Site Address: tZ (4 iS -‹ LC-s%ft... Unit#:
Name: 1 L® 4 ICJ"vine t Phone: le:3 1 - 7,40 11-17b
Address/City/Zip: 12. I1 \�H,Cl I S[''� Lt tti Lit N: p......., i
C3, % ''' Applicant is: Owner J� Contractor
Description of work: Fir-tr., 1"C f44 c - -1"(- -14-'1- 1'\ i Pry w�-I1t t ba-1(1'16/"Nb-3 ,j 4
Construction Cost: IZai Kit ‘ -7 Z Multi-Family Building: (Yes /No Y )
Company: iY(F a$h �L. Contact: <. (.)-t,<. (.)-t, , vs-N-tit-►2'-2
CEif11 t:tor - Address:
P3bh JC, fv. PtI' - Al. city: --r/I d<v\ ' VI,�
;'%;/,-,,,, State: 11.4W Zip: �J 1-4�,Eo Phone: �-7 � b mail: JOC Cglt.4ts�.CE'- :ccpk-,
License#: P��'� 6 Lead Certificate#: A/4T" (.&?3� Z
;-i w
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor: Phone:
NOTE:Plans s documents that you submit are considered - r'i,,,, f 'fir may b � a
classified as no ' lick :� ... .'at . Id.• fheC ` to c' the `'�
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for l'"an email update on the City's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
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.cooherstateonecall.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 isno t 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 pl-
�p f, /."
x c iJ�. �"V Ra� x /. !�
Applicant's Printed Name Appl' ant's i s •,
1„_;I1„_;Izi C (s0L14c: Ln /L176 (e,
. '
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
4 Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
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 zt Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation /30 God) Occupancy IRR _/ MCES System
Plan Review Code Edition )01( SAC Units
(25%_100% ) Zoning /i,-.) City Water ..
Census Code 434 Stories Booster Pump —
#of Units / Square Feet PRV
#of Buildings 1 Length " Fire Suppression Required "-'
Type of Construction Width ,--
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) 4 Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice ,Water _Final Pool: Footings _Air/Gas Tests _Final
Framing t,30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
.. Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
S 4
Reviewed By: fl V , Building Inspector
RESIDENTIAL FEES
Base Fee /2. 3C -
Surcharge
Plan Review 9'03 V-
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
For Office Use j�Q
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t %. EAGAN
: bOa
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspections(a�cityofeagan.com L
2018 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2)sets of plans with all commercial applications.
`' (ckMa! LLSOU M(Date: "`i^ � �O S��i//teAddress: 117- I.6nll=
Tenant: —CNA()rtat.S K nn r L. Suite#:
Name: 1\
*e Reei Owvner
d Phone:
Address/City/Zip: \a1\-\ co-A.t.5eN L.
Name: CA-1cv•‘ License#: Q'^ 6603 C"
p
Contractor,
Address: r.a . ,&t3,7C S`t\ City: CL It (L s t L
State: ' Zip: SS 3.30 Phone: 6 b.3-
i 0
Contact: Email: —1 oFe �+9�+cTc�h r Th•LU.'\
New Replacement Additional Alteration Demolition
Type Of Work Description of work: G6\-t fro.�.a t�I ti - l I-Av
ROTE Roof mountedend ground ti unto e q lntcal equ pment is r a to be; creene` iy City
Co lPlease contact t e anit:al a on on mitted screening� s-t � ry .".. . er
r a., p.,. .wr nA�Oods
t RESIDENTIAL COMMERCIAL
aft:
Furnace New Construction Interior Improvement
\ Air Conditioner Install Piping Processed
Permit Type
x Air Exchanger 1\ 9 Gas Exterior HVAC Unit
Heat Pump Under/Above ground Tank ( Install/ Remove)
Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge =$ 43,d= TOTAL FEE
COMMERCIAL FEES
$60.00 Permit Fee Minimum Contract Value$ x.01
$75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee
Surcharge=Contract Value x$0.0005 =$ Surcharge
If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
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 n to s rt 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
Applicant's Printed Name Applicant' gnatur
<:r
FOR OFFICE:1JSE
Required Inspections „,""''''""e",,,
'" Reviewed S : • #
. Underground Iugh In :i Air Test :-- Gas Servr Test )n fl t F�`;..rte : Scr rr $ yet
For Office Use !1(
P:: L.
EAGAN
P
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinoinspectionsna..citvofeaoan.com L
i' 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
4
Date: " 17-1g Site Address: al \ Coi-X S or.1 L./W.. L. 1i
Tenant: To L. Suite#:
Resident/Owner Name: Tv -. Ir"�•� t Phone:
Address/City/Zip: I `I C &LS'oN L$�L LnJ
1 ^
Name: "PPA,�1-. r. Chvtwa t:44-L License#:
P`'‘6603
Contractor
Address: �`0‘ Qd X sex\ City: ELK
State: v‘i1/41 Zip: SS33O Phone: 6)a:
Contact: -�='c" OL----E-'( Email: -.1v,r .co,
_.
New _eplacement —Repair —Rebuild —Modify Space Work in R.O.W.
Type of Work — —
Description of work: NE's ..�.�T "T° LE`1\ (.4v 4 Flo��L'ter,
RESIDENTIAL
1 Water Heater
Lawn Irrigation(_RPZ/—PVB) l Water Softener
Permit Type
Add Plumbing Fixtures( Main/ Lower Level)
Septic System —
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
ao
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ ®�
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.ciooherstateonecall.orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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 i n.t 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 pl s/
x 16-4-A&E x
Applicant's Printed Name Applicant's • I-
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff;