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1619 Ashbury Pl ` CITY OF EAGAN 1.1P741 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value 4' C00 Date J- 5 i g is Site Address Y PL Lot Block Sec/Sub.P C. WT' N OFFICE USE ONLY Parcel No. Occupancy 7-3 f'- FEES r,_1 Zoning rr Name I' 1 i:Sl RESIDENTIAL ItCF^kS (Actual) Const ~s Bldg. Permit 512.OC Address T-~ dAk®y cA"rt (Allowable) V-N 4I.3C3 Surcharge City'- Phone #ofStories Length 60, Plan Review 30$+ OL` =o Name Depth SAC. City 100, La Address SF. Total ~ SAC, MCWCC 575•QO 0: City Phone S.F. Footprints On Site Sewage Water Conn 560.00 F w W Name On Site Well - Water Meter 40.00 MWCC System - , ~ Address Acct. Deposit 3O•'~ <W City Phone City Water 20.00 PRV Required X;"• S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump &W Surcharge 1.00 information is correct and agree to comply with all applicable State of 228.00 Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit ? 411. ter A Building Permit is issued to:` I:f n 1,;. #4'.. P ti Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official Variance TOTAL ` • Permit No. Permit Holder Date Telephone # ' n WATER~~"~ SEWER PLUMBING H.V.A.C. ELECTRIC L 0 Ou Inspection r7 Date Insp. Comments FootingsI ( ? fl Foundation Framing j -Z~ C41l<Ql' d Roofing / h F C !J !!1 Rough Plbg. Rough Htg. - Isui- u~Palz - Fireplace Final Htg. JCS"~ Final Plbg. X30 Const. Meter Pfbg. Inspector-Notify Plumber Engr./Plan Bldg. Final ~f " 3$ Deck Ftg. Deck Final Well Pr. Disp. INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan; Minnesota 55122-1897 Date Issued: ' (612) 681-4675 SITE ADDRESS: t r► 1,1 11, APPLICANT: WAff"100; Irl 1: 1-t1I { 1AM I r1r ! ;t:,ir, 1 1 rJ .'111f ! PERMIT SUBTYPE: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. i~ r it•. t P1 I'. 1 ~~.II Ifa f'; Ili, I )rJi4! f. II A01 '.f I'r~lrAiF VRHI I'. I.1 0I.11 R1 I r~l' I'I IIMti l hl~. r f f I I Al W! r IF L Permit No. Permit Holder Date Telephone N ELECTRIC PLUMBING a/ HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING GEC) ROUGH PLUMBING ~j PLBG AIR TEST ROUGH j HEATING ~~1 GAS SVC TEST INSUL GYP BOARD FIREPLACE AIRETEST E yr 7(p /n FINAL PLBG y/JUl f FINAL HTG ORSAT TEST BLDG FINAL 71q4 BSMT R.I. BSMT FINAL DECK FTG DECK FINAL (In ifiratr of (Orruvaury citp of (Eagan Mippartmmt of lutldtng iWertion This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following. U., cL..ir.6( SF DWG/GAR Bms. r,.i, No, 16740 Occupancy Type R3 /M 1 Zoning District RI Type Cow, VN Owner of Building FIRST R.CSMENn& HOU Addmm 580 MM IRAIL, EAGAN Buildine Address 1619 ASOM PLAN 7. B4, NAME GLEN ?ND L,~/ n AUGUST 3I,,,1989 f Bi Wing O(Qd POST IN A CONSPICUOUS PLACE SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN PERMIT DATE 3830 Pilot Knob Rd. WATER PERMIT # L",6 SEWER PERMIT # P.O. Box 21199 METER # a `17o l (n U B.P. RECEIPT # Eagan, MN 55121 READER # A- A A 'J B.P. RECEIPT DATE 7/6/89 METER SIZE 54 ISSUE DATE 0-2, 0 -8g •PRV -BOOSTER PUMP SITE ADDRESS PERMIT REOU~STEO LOT -BLOCK SEC/SUB 261d,~~ -Z SEWER WATER TAPS APPLICANT: ! - c%►~'l s.~ Pi~*f>~ ADDRESS: `~_•S F o ?i`i L _ CQAAM/IND RESIDENTIAL CITY, STATE ZIP l y. PHONE: - _i~_f NEW - EXISTING PLUMBER:; - r`h' iil `fz ADDRESS: I AGREE TO COMPLY WITH CITY OF / EAGAN,ORDINAN(;ES: CITY, STATE ZIP a ry PHONE:. OWNER: ADDRESS: SIGl6 U N E ISSUED CITY, STATE ZIP PHONE: PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. CITY OF EAGAN N4 16740 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # C 8 N To be used for SF DWG/GAR Est. Value $94,000 Date JULY 5 , igw- Site Address 1619 ASHBURY PL OFFICE USE ONLY Lot 7 Block 4 Sec/SUb.BLACKHAWK GLEN 2D D Parcel No. Occupancy R-3 MM1 FEES Zoning RR=1 T Name FIRST RESIDENTIAL HOMES (Actual) Const -Y--N Bldg Permit 612.00 u 4580 SCOTT TR o Address (Allowable) ~VN Surcharge 47.00 City EAGAN Phone 688-6505 Bof Stones Length 60 r Plan Review 306.00 o Name SAME Depth ~ SAC, City 100.0D 0,04 Address SF. Total SAC, MCWCC 575-00 rc City Phone S F. Footprints On Site Sewage Water Conn 580.00 r ww Name On Site Well Water Meter 90.00 uz Address MwCC System X 30.00 Acct Deposit aw City Phone city Water XX PRV Required XX SAV Permit 20.00 1 hereby acknowlege that I have read this application and state that the Booster Pump SfW Surcharge 1.00 information is correct and agree to comply with all applicable State of 22$.00 Minnesota Statutes and City g rdmJance/s.o~ Treatment PI Signature of Permaee ir/ 0g-- -z t.~'-t! APPROVALS Road Unit 340.00 A Building Permit is issued to. FIRST RESIDENTIAL HOMES Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes andy,Cirt{y of Eagan Ordinances. Bldg, On Copies Building Official ANA A I Ij;d' I T1 JJ Variance - TOTAL 2 r 929. C0 11988'BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS 1(0#lqo INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, p 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS III Z B 19E~ To Be Used For: Valuation: wear Date: 26 -PS Site Address Q l1~ ~FlAnoa Y Q. OFFICE USE ONLY Lot Z Block q y.000 Occupancy R--3 M-1 FEES Parcel/Sub Zoning R-1 Actual Const v-N Bldg. Permit 2,oD Owner ~~-,Oe- Allowable Surcharge Af%00 of stories Plan Review .306,00 Address fj'~~O Sa,~¢ TC?aEjL Length (00, SAC, City 100,00 Depth 45, SAC, MWCC 0st Do City/Zip Code S.F. Total Water Cann 50.00 - Footprint S.F. Water Meter 990,00 Phone ~~f-Cp r Acct. Deposit 30.00 On site sewage S/W Permit A0,07 On site well S/W Surcharge 1,00 Contractor rj /3i~1 P MWCC System ✓ Treatment Pl. ZZ3.X) Address City water Road Unit 3,/0, co PRV required Park Ded. City/Zip Code Booster Pump Copies SUBTOTAL Phone APPROVALS Penalty Planner TOTAL a 9-1. 0 Arch./Engr. Council Bldg. Off. ~(2$ Address Variance City/Zip Code Phone # VAL(,lA'T io . . ~9 AR.~yE vZLlx22c SZ~S~CJ$ S5 V4 T rte, ~(~XSv- I1©a 6X3= 2µ ~3zu x ~ 1853 IsT 1=LC~0R- l;smT V121f 1 ~C 7,0 134 x sv= G SURVEYOR'S CERTIFICATE SIENNA CORPORATION X8 ewe ~u n~-•i~'-I ni,n~1-i ~I r-~ I 6 S do i L„~-\rn r!\r'11~v 1"i^I.7L_L=1 V REVISED 6-15- 89 TO SHOWA PROPOSED 2•8) 0/80 2 .00 I J I L/I I Il..ly HOUSE FOR FIRST RESIDENTIAL HOMES, INC. 'y~ S/ ~~\Io (828.1) Z O *~DRAINAGE 9 UTILITY 1 ('V / £ASEMEN r PER PLAT) 40, / 5 I M / LOT 7 I I 0 F-- / I " I J e?2.~ [A f l1 aztaB23,_g) r~2s I usF +f Q O eaa. c o to PRO , 5263 eat? ~ l y PosFp + BEHMgRK ~ry / m _ FUSE li+ 1 EX\S1~Na ni 36 E~F~Oe2POR, n/+ i ~SZ 0 3.O rv{( 11.1 HDUSE 70 RON_ in- i ^ Y _ CV ~Z 7p I It CY e5t4 G4 0 n 4 r o ~~82 1 Ov / wee 4.p N Nf ?o? + o \ 2~v, m W N 2 4° 051111 E~ \ j ~OPOSE 15 1 BENCH MARK t TOP OF IRON K'4 O O ELEV.. 827.16 13.83 Mo B.9 a _ 9 a Be 1 /826.7) : 0 ! R a 2~6 s 43 826.E A 3y 625.6 evR~ ` aza.a p M + pL A C EL~eE6_9 + O DEDENOTES NOTES PROPOSED V° SCALE: ~iNCll a~ R qp 0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 8273 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED L014EST FLOOR - 8p3,L FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 8'Z7•-7 FEET WE IIEREBY CERTIFY TO SIENNA CORPORATION TIIAT TIIIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF TIIE BOUNDARIES OF., Lot 7 Block 4 BLACKHAWK GLEN 2ND ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. IT DOES~ NQT PURPORT TO 511014 IMPROVEMENTS OR ENCROACINIENTS, IF ANY. AS SURVEYED BY ME OR U)4a Y 4 E SIPS :V -SIFO THIS NTH DAY OF DECEMBER 1986. q ek x'GNED: JAId~S 11)LL, INC. av: (GUr.r`t.r.. ,(dam a GA ENGrNEERITvi ' DEP"I-140LD C. PETERSON, LAND SURVEYOR 'MINNESOTA LICENSE NUMBER 12294 PROJECT 110. eoox i PAGE 85618 JAMES R. HILL, INC. (89266) 311/ 71 Planners / Engineers / Surveyors FILE NO. 8200 Humboldt Avenue Soulh .FOLDER Bloominglon, Mn. 66431 012-804-3029 DunEn~ X 1Z, t f~ SITE ADDRESS: y o~ I ~L6zL~ S~-V~J1~ (~~"1~ZtAy~ ~j^J.. CONTRACTOR: DATE PIIOIIE: DETERIMIE. VORY,IIIG SQUARE FOOTAGE OF EACII: I.. TOTAL EXPOSED WALL AREA,,.,,., sq ft x "U'' 7. TOTAL ROOF/CEILING AREA,, . sq ft x "U" 3. TOTAL EXPOSED,14ALL AREA CALCULATIONS' Total exposed wall area above floor' 1~57 sq ft a) Total wall window area: sq ft x "u" glazed sq ft x "U" e b) Total door area sq ft x "U" c) -Total sliding glass door 'area i~' .,r,, glazed..... sq ft x "U" -6 glazed. S4, ft x "U" a d) Total fireplace wall area sq ft x "U" e) Total wall framing area (Average 107)............ ' sq ft x "U" f) Total net wall area above floor (Insulated)....... sq ft x "u" q) Total rim Jolst.area....,.~ G sq ft x 'lull d rj e Total foundation ~ area (Exposed)......,.. f .`Lo v sq.ft I,) Total foundation wlndotr area............ (f). sq ft x "U" 1) Total net foundation" area ahove.graJct sq ft x "U" o TOTAL a) thru 1) [("Item P3 Is the some as, or less than Item PI, you have met the Intent of S,D.C. Section 6006 (c) 2. TOTAL EXPOSED ROor/cEILIHO CALCULATIOUS: Total exposed roof/cellinq area..,..,. . sq ft j) Total skyl l olit. area.'...... sq ft x "U" k) Total roof/ceiling framing area (Average 109), sq ft x "U" ° 1 Total net Insulated roof/telling area - sq ft x "U" TOTAL J) thru 1)161J i. total-of A Is the same as, or less thnn 02, you have met the Intent of I.C. Section 0006 (c) I. ALTERIIATE oUILDIIiG EIIVELOPE DESIGII o Utilize the total envelope system method,, the values.establlshed by the sum f Items 113 and 01 shall not be greater than the sum or Items #1 and N2. 1. + 2. ° C E R T I F ,1 C. A T 1 0 II I hereby certify that I have calculated the "11" factors and "R" values herein and that the hulldinq here described meets or exceeds the State of Hinnesota Enerny'Conservation Act. AS-1111 nature)~- gl// V 0 1111111 Regue Hale Fne N ough-In Inspection Required Ins ecbon Other Th an Rough-In / ; / [~`S (You l ction when ready) 5 candy Now Will -tNobly o Inspector inspector mn Insp O~" 7 Yes ❑ No Date Reatl 1 ❑ licensed contractor L~wner hereby request inspection of above electrical work at: Job Address (Street, Box or Route N ) Qty /(o/ S6kr Section No Township Name or No Range No County Occupant (PRIN 01 No M S~/`ne ee Phone Power Supp4er Address Electrical Contractor (Company Name) Contractor s License No. brut Cv Mailing A ntractor or Owner Making Installation) ✓ A Author's Slgnalu (Contractor Owner mg Insta11aM1 n) Phone Number MINNESOTA STATE BOARD l / e h xeity A m., St. Paul, MNB BE ACCEPTED BY THE STATE FO T 5104 Iry I III II II IIII II II I I I I II (II II I I III rHIS UNLESS PROPER INSPECTION 1821 EE S Phone (612) 642-OBW ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION Ee-00001-09 ` - , See instructions for completing this form on back of yellow copy "X" Below Wo, Wovered by This Request Ne Ad Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractors Remarks Compute Inspection Fee Below. vs /'tj 4 # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 -Amps Signs Inspector's Use Only TOT{ SO Irrigation Booms sf ~!/J Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Roughin ate certify that the above inspection has Final - Date been made. OFFICE USE ONLY o Sn/d ✓iC.~ This request void 18 months from CITY OF EAGAN PERMIT Geo 6,11o ~ - 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 8 7 7 (612) 681-4675 Date Issued: 12/21/95 SITE ADDRESS: 1619 ASHBURY PL LOT: 7 BLOCK: 4 BLACKHAWK GLEN 2ND P.I.N.: 10-14351-070-04 DESCRIPTION: Building-.Permit Type BASEMENT FINISH Building Wb-k Type ALTERATION `Census Code 0434 ALT. RESIDENTIAL i r' ~r REMARKS: SEPARATE PERMITS REQUIRED FOR PLUMBING & ELECTRICAL WORK r FEE SUMMARY: Base Fee $35.00 Surcharge $.50 Total Fee $35.50 CONTRACTOR: OWNER: - Applicant - SCHROEDER WILLIAM 1619 ASHBURY PL EAGAN MN (612)681-1394 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 Mn. Statutes and Cit ~gan Ordinances. L- J AP LICANT/PE MITE ATURE ISSUED B . GNA REE - 1 CITY OF EAGAN J 5 S~ b 3830 PILOT KNOB RD - 55122 111 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) C~Qn:/~ ~Z 1 681.4675 New Construction Reouirements Remodel/Repair Reouirements ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window-sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ 1 et+etgy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan N lot platted after 711/93 required: _Yes, _ No / DATE: :!o2 -/rte `Dl S CONSTRUCTION COST: DESCRIPTION OF WORK:: II SS u e, d Lev At L, STREET ADDRESS: l 9 I ~~6 u r`v1 ~~Nyy LOT BLOCK SUBD./P.I.D.#: PROPERTY Name: S~ ft/2c~n~2 Wl f 1 b,Qm Phone Pon OWNER 1' Street Address:)/, .15 A SWIL, ,,,r City: e~-nCAr\1- State: M Al Zip: <-1a .CONTRACTOR Company: Phone Street Address: License City: State: Zip! ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address- City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is corre r"ree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. r Signature of Applicant: OFFICE USE ONLY C El 12 1995 Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex 0 ::1 I_,' Qpt /Lodging; • ,r'~16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex~ ; .R•::12. •°Multi.t3~p~ir/Rem. o' 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plett.~3;.,t:atrt+mr,.93:~G`saegei~(CCessory- t 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 = piex ❑ 15 Deck WORK TYPE ❑ 31 New ` 3 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCJWS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sgwfl. ; s: PRV # of Stories sq. ft=: ; Booster Pump Length sq,:ft:; c:?, • ; Census Code. Y3~ Depth Footprint sq. ft. SAC Code Census Bldg i Census Unit APPROVALS Planning Building Engineering Variance Permit Fee ''VAlu~ation:`;`'' „rS?R•.:•_: Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pi. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units CITY USE ONLY L ~ q 131- 10/ RECEIPT ~ SUBDaIQ~UW ~'i DATE:/ r7.1 1995 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► single family dwellings townhomes and condos when permits are required for each unit FIXTURES _ EACH NO. TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet * minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal * Dakota Cty. license 20.00 = U.G. Sprinkler * home under const. 3.00 = Alterations * to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL O O SITE ADDRESS: )QsAllry OWNER NAME: INSTALLER NAME J i m ~P LI i2vEoE~ STREET ADDRESS: CITY: ca STATE: P/) 7V ZIP: PHONE i OFFICE USE ONLY L _ BL RECEIPT SUBD. DATE: 1995 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for. ► all commerciallindustrial buildings. ► multi-family buildings when separate permits are = required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: _ NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? - YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS To BE INSTALLED? _ YES _ NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract. price, whichever is greater. State surcharge of $.50 per $1,000 of RgLnII fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: APPLICANT OFFICE USE ONLY METER SIZE: DATE: INSPECTOR: A-4) HOUSE HEATING TEST RECORD n n ADDRESS _ I jq 'J U r ~ O APT FLOOR C CITY ~l ~'"t r pA] OCCUPANOWNER N-da r V n~N HEAT LOSS DATE HTG. INST. SOLD BY HOME ENERGY CENTER INSTALLED BY HOME ENERGY CENTER Electrical Work By HARRISON ELECTRIC Gas Line By TYPE OF HEAT GA FA X HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE C MAKE OF BURNER Model C~ V- Model Serial - O c1 C.r s Max. BTU Rating INPUT OLL MAKE OF FURNACE CONTROLS THERMOSTAT Heat nKeINDIOF ize Valve v< le', co 0A LINER SIZE NONE Limit e ~f Draft Hood Regulator Limit Setting Filters Size Number Fan Setting Chimney Location Inside Outside Pilot Type - Chimney Construction Pilot Make O l Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L W Cut Off Door Pressure Lighting Inst. Pressure Percent CO, Date Tested Input CFH Percent OZ Company Testing HOM I Stack Temp y Percent CO Name of Tester Form 235 ~ 292 ~3o,so 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone hl 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit DateRY1{' 1 / 12 12666 Site Address Unit # Property Owner A111YSA A) Q Telephone # (45~51 ) 3 36! , 19Z7 Contractor Le_(c, y /e~s~,p~ifAf(1 J I(~ Street A/ d~dress ls2 o D z~ /-fx IV- ~Sw-k_ ia~ City ~I+V u jj ~,4 I State (~..t Zip 5x447 Telephone ( jb j )4'1b . i R`1O Bond W -I `7 U Lj Expires: 2 Lf zoo (O The Applicant is Owner v1 Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional Replacement _ air exchanger air conditioner -New X Replacement other on EC ~ APR 4 ZUU6 State Surcharge $ .50 Total $ 0 D. 5 I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the aaproved qql//an in the case of work which requires a review and approval of plans. Applicant's Printed Name pp icant's Signature 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commerciallindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond Expires: The Applicant is Owner Contractor Other Work Type New Construction - Underground Tank _ Install -Remove *"see below Interior Improvement - Install Piping -Processed -Gas Nature of Work: *"When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal $50.50 Minimum (includes State Surcharge) or Contract Value $ x 1% = $ Permit Fee • If ep rmit fee is $1,000 or less, add $.50 $ State Surcharge If ep imit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: Inspector Date: qO C 2006 RESIDENTIAL BUILDING PERAuT APPLIcAmN 0 3 C, 3, City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Tz~ Telephone # 651-675-5675 FAX # 651-675-5694 aN/pY'' J New Construction Requirements Remodel11 air Requirements Ortxedise dnN 3 registered site surveys showing sq. ft. of lot, sq. R of house; and all roofed areas 2 copies of in showing footings, beams, joists CPrfor6drva ;._Y=.-'!Y (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Rat _Y 1 Soils Report A proposed building is to be placed on disturbed soil 1 site survey for additions & decks Trpa,Pria j, eqd- ° -Y,= "N 2 copies of plan showing beam & window sizes; poured found design, etc. Addition - indicate if ons8e septic system Trbd'PreiaRegplred: r~x . =",A`; 1 set of Energy Calculations 0"n ,lte'Sep'~tS~stepf~;' i'''s" N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Mmnegasm -echanical ventilation form~q(~ ~a Date "I / 10 / OQ Construction Cost e) Ts Site Address 1 6~ Iq t 1~✓lht )C ~y o~ Unit/Ste # Description of Work - e~4- l~ I 4- 1~~1 Multi-Family Bldg _ Y v' N Fireplace(s) 2 Property Owner ;rt n n Telephone #44-1) 330, Contractor N a-41ei-Caapei LrG/JS u~~U~? / Address J IP fir/ ~m0/ i'r~ A/ /1, City S712 ~~CJGt TFJ State /2) Al Zip ~35Z P 2 Telephone # (/l S7) 3 y 3 ;'Lo COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Cade Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y _ N If yes, date and address of master plan: Licensed Plumber Telephone J Mechanical Contractor Telephone ) Sewer/Water Contractor 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 and codes of the City of Eagan and the State of MN Statutes; 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. II A f) f 1 I ct , cam 1~1x~ Applicant's Printed Name Applicant's Signature Use BLUE or BLACK Ink r For Office Use I / I City of Ea ~n I Permit Io OD I Permit Fee: _ I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 L Staff: 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: 1("1 !n C Tenant: Suite C©tM , RESIDENT / OWNER Name: I - ~Q Phone: Address/ City / Zip: Name: pe, pen R'La V1_1 LicenZ! CONTRACTOR Address: 7~,so 1 1~~ City: State: R0 0 Zip: Phone: (o I f L~ -~4 6 ~ n Contact: Email: t (/(.j 1 t~ TYPE OF WORK - New replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL Water Heater Water Softener PERMIT TYPE Lawn Irrigation RPZ / PVB Add Plumbing Fixtures Main Lower Level) / Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge) `Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be i conform 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 k is n to tart ' ut a permit; that the work will be in Xcco dancth the approved p the case of work which requires a review and z prov I f pla Applicant's Printed Name App icant's S' nature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In _Air Test Gas Test Final PERMIT City of Eagan Permit Type:Building Permit Number:EA112662 Date Issued:08/21/2013 Permit Category:ePermit Site Address: 1619 Ashbury Pl Lot:7 Block: 4 Addition: Blackhawk Glen 2nd PID:10-14351-04-070 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, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Thomas Johnson Po Box 351 Afton MN 55001 Applicant/Permitee: Signature Issued By: Signature 41,11/ City of hp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Pemiit#: /✓g0� Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: dent! caner Name: 6\)citM Gres how ok K Phone: l/ ' (-4-6 7 --Li 3 3 1 Address / City / Zip: / 6 ! 1R 'kill U if (2I . Applicant is: Owner Contractor ©rk Description of work: 're =' (00-r , Construction Cost 41 "( 006 Multi -Family Building: (Yes / No v ) Con#ra gi Company: WDV'-i-Ut 0 L„Iik&I IU((,. Contact: .J466IA yet/ Address: (o677 /' 4 t^ Q/ p�� 1 / 1-6, S City: (b -rage C9 rave 0' State: Zip: 550/4 Phone: 69 3t-'163Email:s00' coya'vcto git a"t(. L6atA License #: '-86., 297()l % Lead Certificate #: If the project is exempt from lead certification, please explain why: In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: N©TE: flans and io is @ o ument at you submit ire :. Bred to be u ilrc info �e tr fi ®n. f' nformation it y b 'ssifled a public if s g �� r t wo s'` e Cl That CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the 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 Minpesota $gate Building de must be completed within 180 days of permit issuance. x Applicant's Printed Name x� M4 -07A Ap icant's Signature Page 1 of 3 Use BLUE or BLACK Ink For Office Us(e �::: #: /4�9(/ CCCity of Eaal6 Fee: 6 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 buildinginspections(a.cityofeagan.com Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: /Vti +/ t�O��a 6707 -2 - $3 CY Phone: psi , OWtle) -4,1 ' Address/City/Zip: 621 ACh' P ' Applicant is: ' Owner Contractor Type of Work. Description of work: u' cL(,\7 Construction Cost: Multi-Family Building:(Yes /No ) Company: %- 'l Contact: ContractorAddress: City: State: Zip: Phone: Email: License#: Lead Certificate#: 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:3 lans andI upp r#og,alocuments fl u submit pare ons#rid toKK # ubfic information. Portions�the information may be classified as non public if you provide specific reasons that ou rmit the: • • ,lodet rat they are traadesecrets: 442 to f, 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.cityofeagan.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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work ' ••t to start without a permit; that t the work will be in accorda ce wi the approved plan in the case of work which requires a review and approv- • plan-. —Cs 1 �1 X Applicant's Printed Name Ap• cant's ignature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SU B TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration (Single Family) K 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 BuildingReroof Demolish Interior XWindows Alteration Fire Repair Demolish Foundation Replace Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION !, Valuation �.✓C� 6) 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 Suppression Required 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 Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test Roof: Ice &Water _Final Pool: Footings _Air/Gas Tests Final Framing 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: Reviewed By: ,G"; ,` ", I i _ i , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Use BLUE or BLACK Ink r -� For Office Use City of Eaali ::::e: leJ'a?J 3830 Pilot Knob Road ti—.1 i 7 Eagan MN 55122 Date Received: 1 - / Phone: (651)675-5675 buildinginspections(a cityofeagan.com Staff: . 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: a Site Address: i 6 / c I �� I r.-cam 0MA ,S� Unit#: Name: ./ C, ._G2u ,i- - �v V-D 'L I esldefg/ , Phone: '' Owner -v Address/City/Zip: 1 I AS�\o,., , <� ,! t65/-476)- , Applicant is: V Owner Contractor q33, of Work Description of work: a %..L.0,Z )1. tic CL i re p -e ; >vz<Z 11 e_� r4 �7{=r� �c7�C' {zj✓ Type; of Construction Cost: S s �C C) Multi-Family Building:(Yes /No ✓ ) Company: S' E..-(.- Contact: Contractor Address: City: x State: Zip: Phone: Email: y ': License#: Lead Certificate#: 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: 11i©7F Plans and supporting documents that you submit are`considered to be public nfr ation. Pox n� f. information abbe classified as no lic f you p vide s��reasons t would •e: h;C �o,c e � ey ms_ are it/' e�seC �'s r, , ,�_ 4-1, ... � 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.cityofeagan.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.gopherstateonecall.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 fora permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x x Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) _ 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 _ Fire Repair _ Windows _ Demolish Foundation _ Replace — Repair _ Egress Window __ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation 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 Suppression Required 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 Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test Roof: _Ice &Water Final Pool: Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile , Fireplace: _Rough In _Air Test Final Siding: Stucco Lath _J( 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: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3