1576 Ashbury Pl
s
(Urtifiratt of (Orruvaury
citp of Cagan
wpawtMt of Nuatm , .pertion
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.•
Ubx CLLAirK tion Bldg. Permit No.
Oocupancy Type ' t Zoning District Type roust
Owner of Building UYWX R,` E ,d Address ~w .'a $Li ae 1
Budding Address 1polkY % E i ► B~. i13ti 4
Date:
Building offie l
POST IN A CONSPICUOUS PLACE
CITIf'QF EAGAN Permit No. Date:
3830 Pilot Knob Road Meter No. Size-
P.O. Box 21199 Reader No: Date:
Eagan, MN 55131
_;.u~s rc-~~ Lras.
Owner
Site Address:
I Plumber.
525.00pd
Conn. Chg: Zoning:
Acct Dep: 15. 013pa- No. of Units: ~
Permit Fee:
Surcharge: P I agree to comply with the City of Eagan
Tr. Plant Ordinances.
Meter. '7
Misc.: By
WATER SERVICE PERMIT
CIT1iOF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road 1 i)t)52
P.O. Box 21199 PERMIT NO.:
Eagan, MN 551,21 DATE: 7-20--87 "P 1
I
Zoning. • l No. of Units:
Owner. Lundgren ros.
Address:
Site Address: zhbury Place 2 B1 Blackhavk Glen
Plumber Lundgren 'gyros. Plumbing
5-8-87 73.27 100.00pe
I agree to comply with the City of Eagan Connection Charge: 525.00pd
Ordinances. Account Deposit: 15.00pd
Permit Fee: 10.00Ad
Surcharge: . 50pd
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
BLDG..PERMIT NO.
01-3210 Bldg.'Permit ~i.
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Later Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
t CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454.8100
BUILDING PERMIT Receipt
To be used for Est. Value Date ,19
Site Address OFFICE USE ONLY
Lot Block Sec/Sub. On Site Sewage Occupancy
MWCC System Zoning
Parcel No. On Site Well Type of Const
City Water (Actuaq
Name (Allowable)
W * of Stories
3 Address Length
° City Phone Depth
S.F. Total
p Name Footprint S.F.
z~
0 c Address APPROVALS FEES
0. City Phone Assessments _ Permit
F Water/Sewer Surcharge
F W Name Police Plan Review
Z Fire SAC, City
X'3 Address
v° Engr. SAC, MWCC
a z City Phone Planner Water Conn.
Council Water Meter
I hereby acknowledge that I have read this application and state Bldg. Off. Road Unit
that the information is correct and agree to comply with all applicable APC Treatment P1
State of Minnesota Statutes and City of Eagan Ordinances. Variance Parks
Copies
Signature of Permittee TOTAL
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
Permit No. Permit Holder Date Telephone it
~y
Plumbing FL
r,
HN.A.C.
Electric C
Softener =7C~~(~ 7c LCZ~r c ,J
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing ~a S'~c~ a ~d e .+r.. t 7-/• yC~
Roofing .Uteri -20'ru sS G_
Rough Plbg• .-s k1 d~..q e isGser a rNs< paaY
Rough Htg. ss
[Sul.
Fireplace
Final Htg.
Final Plbg. Ot
Bldg. Final -z-",
Cert.Occ. gyi c «ssa
Temp. LP -&7
Deck Ftg. r
Deck Frmg.
Well
Pr. Disp.
t PERMIT # h `v
MECHANICAL PERMIT RECEIPT # r y
a.~• CITY OF EAGAN ~~C ~
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: L
CONTRACT PRICE: PHONE: 454-8100
Site Address + BLDG. TY~E WORK DESCRIPTION
Lot Block I Sec/Sub ' Res. New
r Mutt Add-on
~ Name , it r-ar k L . ,
Address , Comm. Repair
c City i Phone Other
FEES
Name i
RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
p City Phon13 L -1 1 (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air ; M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 t
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU R MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other
FEE
t
S/C: SIGNATURE OF PERMITTEE
TOTAL
FOR: CITY OF EAGAN
PERMIT # ~II 7~
PLUMBING PERMIT RECEIPT # ,t ~I -7 r
CITY OF EAGAN l~
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address 4 40o r" BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub Res. New
"f Mult. Add-on
Name Comm. Repair
Address Other
C City E r r _ - Phone - RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Name -J--Water Closet - $3 00
Bath Tubs - $3.00
3 Address _ v Lavatory - $3.00
O City Phone Shower - $3.00
-LKitchen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE __~__Laundry Tray - $3.00
APT. BLDGS - COMM RATE APPLIES /Floor Drains - $1.50 -
TOWNHOUSE & CONDO - RES. RATE APPLIES __,`_Water Heater - $1.50 /
MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets - $1.50 J
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5.00
BEYOND $1,000.00) Well - $10.00
" Private Disp. - $10.00
t_ .t i' r Rough Openings - $1.50
S~ATURE OF PERMITTEE FEE: `ter . 7
STATE S/C: J
J
FOR: CITY OF EAGAN GRAND TOTAL: ~5
CITY OF EAGAN Remarks # a
Addion~Glen ist Lot ~ Blk Parcel 1 0-1 43 50-9 20_01
[Ot,ackhawk
wner Street 1576 Achh„r:V P1aCP State Eagan MN 5:5t22
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1076 1986 253.48 50.70 5
STREET RESTOR.
GRADING
SAN SEW TRUNK 124 1970 167.44 6.70 25 Pd rior t division
SEWER LATERAL Bn1074 1986 112.09 22.42 5
WATERMAIN Bn 1075 1986 92.80 18.56 5
WATER LATERAL
WATER AREA 1072 1986 309.40 61.88 5
Storm Sew Trk 1073 1986 110.91 22.18 5
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN Permit No: 8898 Date: 7-20-87
3830 Pilot Knob Road Meter No. 3~7 f`f a Size g" klDox
P.O. Box 21199 Reader Na LL6 Date: ~2- y- 9 Z
Eagan, MN 55121 -
Owner. Lundgren Bros.
Site Address: s ury Place L22 B B ac aw Gen
Plumber Lundgren Bros. Plumbing
Conn. Chg: 525.00pd -Zoning: Rl
Acct Dep: 15.00pd No. of Units: 1
Permit Fee: 10.00pd
Surcharge: .50pd I agree to comply with the City of Eagan
Tr. Plant 180.OOpd Ordinances.
Meter. 67 nn
Misc.: By ~.uo
WATER SERVICE PERMIT
This request void
18 months from [414'11'r~ ~7~ss
D 7-9964, All
Fequast Date Fire No. Rough-m Iospecrmn
/ lp~~} Req ed~ ❑Ready Now dl Notify Insp
' er.-
M 7 Oes ❑No lur When Ready
Licensed Electrical Contractor t hereby request inspectipn of above
❑ Owner electrical work installed at:
Street Address, Box or oute No. City.,
/s?4 ,sNBv/eV +L°- 4/(''LIi'G_i_tGA//
ecHoo p- Township Name or No. Range No. C44JJuTT)it, ..~..~1
Y~,?
Occup nt (PRINT) Phone No.
//lE so
Pow Supplier ,p Add .as
o
IJfL r~s CAS F~77e/~ 7'.3r» _ ,Z?~5 °~.S'~ lam//!
Electrical Contractor (Company Name) Contrar. nr's License No.
Standard Electric Co. 40837
Matt mg Address (Contractor or Owner Making Insmil iti n)
267 lewood Dr., Ma a od, Mn 55109
Authorized Lure (Contractor Owner ki al lation) Phone Number
484-8044
MI NNE50T TATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave-. St. Peel. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone 1612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION a-ooool-os
'7 ~5 5
7 ~ See instructions for compete rig this form on back of yellow copy.
996 'X ` Below Work Cot eyed by Ibis Request
Atl Rep. Type of Building Appliance. Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo llnloader
Industrial Bldg Air Conditioner Bulk Milk Tank
Farm Other peu y OthFr (S0,.ifyl
t -r Speorry Othcr Other
Hompute Inspection Fee Below
V Fee Servree Entrance Size # Fee Feeders /Subfeeders # Fe, CI uns
0 to 200 Amps 0 to 30 Amps 0 to 30 Amps
Above 200 Ampsi 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100_Amps Above 100_Amps
Transformers Irrigation Booms p Partial. Other Fee
Signs Special Inspection
Remarks l~ ~ ~~S ~ s~~ TOTAL FE
Hough- n ~i O e I, the Ere
Inspector
, hereby
'!a cerhfy that the above
Final 01=~/ inspection has hewn
f a `G This request Vold 18 months from GL ~_~-y
This request void~/8
months from 6 3 4 as ei ,
Request Date Fire No. Rough-in Ins pectipn
Regwred? ❑Ready Now In Will Notify, tnspec-
G 7 ❑yes ~No for When Ready
Licensed Electrical Contractor 1 hereby request inspection of above
❑ Owner electrical work installed at:
Street Address, Box r Route No. City
/ 5 74 WSA66 Of e-E x`.44 4A/
action No. Township Name or No. Ranee o. C my l
Occy~,anI (PRINT) Phone No.
r Supplier 14Address
4~77e14:1. 3W- 4.20 "77
rfoz~
X
Electrical Contractor (Company Name) Contractor's License No.
Standard Electric Co. 40837
Mailing Address (Contractor or Owner Making Installation)
2672, Maplewood Dr., Maplewood, Mn 55109
Amhor a lanature (Convac Ow Making Installation) Phone Number
484-8044
INNESOTA STATE BOAR OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-181 BE ACCEPTED BY THE STATE BOARD
1821 University Ave.. St. Paul, MN 65104 UNLESS PROPER INSPECTION FEE IS
Phnne (9191 R49.I1A0O ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EEB-0/00001-05
r I/ See instructions for completing this form on back of yellow copy.
"X" Below Work Covered by This Request
I-qAddIflop.1 Type of 8ulld,ng Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heater
Commercial Bldg. Furnace Sl Ia Un loader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm other pear v other Isoeufyl
Vine' Gem y Other other
ompute Inspection Fee Below
k Fee Service Entrance Size k Fee Feeders/Subfeeders a Fee circunts
0 to 200 Amps 0 to 30 Amps / 0 to 30 Am
Above 200 Amps 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100-Amps Above 100_Am
Transformers Irrigation Booffs , p Partlal.'Other Fee
Signs Special Inspection ~J C TOTAL
Remarks S~_3 s
/3 .
Rough, Deta 1. the Electrical
Inspector" hereby
certify that the above
Final bete mspection has been
made.
This request mid 18 months from
CITY OF EAGAN NO 13 5 9 6
3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 454.8100
BUILDING PERMIT Receipt#
To be used for SF DWG/GAR Est Value $104,000 Date mAY 8 ,19 87
Site Address 1576 ASHBDRY PLACE OFFICE USE ONLY
Lot 22 Block 1 Sec/Sub. BLACKHAWK GLEN On Site Sewage Occupancy R3
MWCC System X Zoning RI
Parcel No. On Site Well Type of Const V
City Water (Actuall
a Name LUNDGREN BROS CONST (Allowable) V
w # of Stories
T Address 935 E WAYZATA BLVD -56
~ Length
o City WAYZATA Phone 473-1231 Depth 75
S F. Total
,p Name- SAME Footprint S.F.
o< Address APPROVALS FEES
City Phone Assessments _ Permit $ 515.50
Water/Sewer Surcharge 52.00
W m Name Police _ Plan Review 297- 7 5
ti Fire SAC, City 1nn_n0
ug Address Engr. SAC, MWCC 525, 0
aw City Phone Planner Water Conn. 525- 0
Council Water Meter 67-00
I hereby acknowledge that I ava reaNEP, pplicatio a d state Bldg. Off. Road Unit "305.00
thatthe informationiscorrec a agreelywith Ila plicable APC Treatment Pl 1R0_n0
State of Minnesota Statute ity o Ord1 no s. Variance Parks
Copies
Signatureof Permittee TOTAL 2 527.25
A Building Permit is issued to: LUNDGREN BROS ST on the express condition that
all work shall be done in accordance with all p' able State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
61 P
1987 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
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 - RESIDENTIAL RENTAL UNITS FOR SALE UNITS r!
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Valuation: Date: S G`
Site Address OFFICE USE ONLY
Lot e~s4 Block On Site Sewage_ Occupancy 3
~~AA
/Y~bet~✓f MWCC System ✓ Zoning
Parcel/Sub (~'•I
On Site Well Type of Const
City Water ✓ (Actual)
Owner (Allowable) 3Z
p # of Stories
Address / 3 j Ae-- Length
Depth 35
City/Zip Code y/+ S.F. Total
SJ 3 47~1~ 3 Footprint S.F.
Phone APPROVALS FEES
Contractor Assessments Permit 515.x°
Water/Sewer Surcharge 521
Address Police Plan Review 25,7
Fire SAC, City ID 0.
City/Zip Code Engr SAC, MWCC 5Z5.
Planner Water Conn 2-5
.
Phone Council Water Meter (0 7.
Bldg Off Road Unit 3oS
Arch./Engr. APC Treatment P1 180,
Variance Parks
Address Copies
TOTAL dd 5 Q
City/Zip Code
Phone #
Z A
2(o x 24- 2 x 5b 5 co I t9
Z n 3o 3&0 S-6 ~ ' ZoB~c~
x~2
z
2O X22=
3C) x 26 X 44 34320
(e~5 720
I
'SURVEYOR'S. CERTIFICATE' SIENNA CORPORATION
az„s.y
M
o ASyBURY LACE .
823. r
S0 azzz eza.z M
d- 9 °
682~ pj 30 q.s
r x826 r 74.96
0
x p
l1 S L 82381 CO 19 •o~
~l~r "r 1 5
M ° ARAZ N~ 1
3 1
(E)-
1. vot 20,33 - 830.36 ` V
h N 23,6) 612,0 o
^ N o
r7 oz / I GAR.
PROPOSED N
W
!1. I N HOUSE' O B.O vi e3 B E%ISTING
••17.43-. O i I m k HOUSE
m h M/ 823.3 48.0 I
^ N
L1590. C)
r.~ ro za:sx
l m O
LOT 22
1 5 ~ PFR /'L4T ~ ~/</TY I
169SF,H~yT I I-_
g3/.off x63o.r
r
/ s cos e o ~ I
/ r
REVISED 5-4-BT TO SHOW PROPOSED HOUSE
BY LUNDGREN BROS.
DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 830.8 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED L014EST FLOOR = 813.8 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK =8 3).L FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF T11E BOUNDARIES OF:
Lot 22,Block I, BLACKHAWK GLEN 1ST ADDITION, according to the recorded plat
thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOb! IMPROVEMENTS OR ENCROACHMENTS, IF ANY. AS SURVEYED BY
ME OR UNDER MY DIRECT SUPERVISION THIS 13TH DAY OF Nov. 1985.
SIGNED: JAMR I ILL, INC.
v
iG~w(~l
BY:
HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12294
PROJECT NO. BOOK / PAGE JAMES R. HILL, INC.
85618(87264) 203/ 15 Planners / Engineers / Surveyors
FILE NO,
8200 Humboldt Avanuo South
FOLDER Bloomington, Mn, 55431 812-884-3029
~ CC)JCIRUClION -
935 EAST \NF YZNTP. BOIJLEV/+.RD \':hYZ/+T A, ILI;JIJLSO TA 5'91 {c'2) 4i 1%31
EY.lEP,iOP. ENVELOPE P.VEP.AGE U CO"IUTATIOI
DLoto?ABIock
siteAddre s _ i - -
R U
R I rs
-058
Opaque Walls `
.117
Wall Framing Areas
.023
Ceiling Insulation Area -
.027
Ceiling Framing Area
04
Rim Joist
le
Masonry Wall `
.26
Windows Double Hung .46
Casements
.18
Doors
46
Patio Doors
.47
Sidelites
1) Lower Level (Basement)
Total exposed wall area
- x (U) .058 =
Opaque Wall Area
(U) -117 = -
Wood Frame Area
- x ( U ) 04 =
Rim Joist
Exposed block
46
bJindow Area casement ~x (U) .26 =
Double Hung
Sliding Glass Door
Door Area 2
- Total
N D 6REH
~COIJS1aUC1101J -
573-1231
935 EAST WAYZATL. BOULEVARD VdAYZATA, IJII:NESp7A 5S391 (F12)
2) ist or main floor
Total exposed tall area _
Opooue %;all area
/Clox (U) .117 =
Wood `came area
-
/ x (U) 04
,
Rim joist x (u) -46
Casements ~x (U) 26 =~f
b!indo.~ Area Double Hung
~/O x (U) 46
sliding Glass Door
3 x (U) .18
Door area Lx (U) 47
Sidelites
To tal
3) 2nd door if 2 story
Total exposed wall area /7
g~yx (U) .058
Opaque wall area
(U) .117
Wood frame area
Zx (U) . 41 = 6
Window area Casements Lax ( ) .26 = 3
Double Hung
Sliding glass door
Door area
To -Ial
y~
4) Total ceiling area /x (U) -027 = 3
Wood. frame area ZIL
Opaque ceiling area _
x (U) .55 =
Skylight
Total
0 1COI NCSI RUCI IO14
N. - -
!It::,,FSOTA 55351 (672) :73-7Z3t
935 EAST WAYZATA BOULEVARD • WAYZATA,
11inn. U Factors Total exposed wall area x 11 = ~
area x .026 =
Factors Total exposed ceiling
[-!inn. U
(A) Total
Item Z/ Item 2/-} Item 3 J ✓ Item 4 ~ - °6
o? +
L
If total of Items 1 - 4 is less than Item (A), building
complies with SBC 6006 (C)s
C
GOLD COPY-PERMIT RELEASE FORM
PERMIT # ~J C1 ~S
ADDRESS
PICKED UP BY
L Z L G~
CITY OF E A G A I~ PAYMF]T1 OF FEE AT TIME of
*APPLICATION DOES NOT CONSTIT[TJE x*
* APPROVAL OF PERMIT.
APPLICATION FOR PERMIT * INSPECTION OF SEWER AND/OR WATER
* iLA7.r mms WILL NOT BE Sao>-
SEWER AND/OR WATER CONNECTION ULED UNTIL PERMIT HAS BEEN
* ApPRl7VED.
(Please Print
1) PROPERTY ADDRESS: jae
LEGAL DESCRIPTION:
(Lot/Block/Subdivision or Tax Parcel ID
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: %
(Mon Year
PRESENT ZONING/PROPOSED USE:
Q COMMERCIAL/RETAIL/OFFICE P~f. R-1 SINGLE FAMILY
❑ INDUSTRIAL ❑ R-2 DUPLEX (Two Units)
❑ INSTITUTIONAL/COVE NMENr ❑ R-3 TOWNHOUSE (Three + Units) ( Units)
❑ R-4 APARTbff=/CONDOMINIUM ( Units)
NAME: l/!✓_ ~~^J.ro ,(~.rra4.,
ADDRESS: IR%!~L 7rx~??•y/
CITY, STATE, ZIP: jf(fgg r?~f
PHONE:'7'j,
3) NAME: For Tity Use
P~lll--u~::SSSmbers License:
ADDRESS: Active
Expired
CITY, STATE, ZIP: Not recorded
PHONE: 473-173 ) MASTER LICENSE# Std Initial
4) • a • i:+
NAME: 7c'1e
ADDRESS: b
CITY, STATE, ZIP:
PHONE: '
CONNECTION TO CITY SEWER CONNECTION TO CITY WATER ❑ OTHER '
6) • • PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE -
LPTEAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one) 7
• n • a. • r•r, • ea• r • r a a• a• •
'FOR ,CITY USE ONLY
PERMITp # ISSUED
Pd w/Bldg. Permit FEES:
$ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLUDE SURCHARGE)
$ lo--o- $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ h-, 11T7 ACCOUNT DEPOSIT - SEWER
$ $ O 7~ ACCOUNT DEPOSIT - WATER
$ ri ZS CTO $ WAC
$ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ p $ LATERAL BENEFIT/TRUNK WATER
$ ~a U D $ WATER TREATMENT PLANT SURCHARGE
$ q $ OTHER:
$ / 0 O $ J-7, Cj-t TOTAL
7,3' 2- -7 x.57> 7 ~
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF .YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
Q
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: ~iC ayc y~
TITLE:
DATE: ~/Z
PROBLEM RIPAIR~'
c
NESS 4-9 AND 5-9 WERE BROKEN AND REPLACED IN THEFiIEU(++)A 4'xB' SHEET 1.) WE3S 4-9 AND 5-9 MUST BE HEN-FIR 03 OF. BETTER AND CUT TO FIT TIG IT.
of 112' PLYWOOD WAS GLUED AND NAILED AS SHOW. PLUS-1/2' PLYWOOD WAS
GLUED AND NAILED AT JOINTS 4 AND 5_ 2.) THE 5x12 ALPINE CONNECTOR PLATE AT JOINT 9 MUST BE INTACT ON SOTTOM
CNIROS.
AFTER COMPLEf10N OF REPAIRS, TRUSSES MUST BE INSPECT-.D BY THE TRUSS
MANUFACTUREt OR LOCAL BUILDING DEPARTMENT TO ASSURE COMPLIANCE WITH 3.) 112" PLYWOOD MIST BE APA EXPOSURE I OF. BETTER
ALPINE DESIGAS AND SPECIFICATIONS.
4_) PLIWOOD MUST EXTEND THE MINIMUM DISTANCE ON EACH MEMBER, AS SHOWt.
SEE LITTFIN'> DRAWING FOR ORIGINAL INFORMATION NOT SIOWN HERE.
5.) C11CLED NUMBER INDICATES MINIMUM NUMBER OF 6d NAILS REQUIRED, ON BOTH
• FACES THROUGH THE PLYWOOD INT@ THAT MEMBER.
All fie -d added members must Je cut prereice to bear solid. 4. 2 8
18' Direction of face 9-ain
7.00
3. 8
12" 6 5.
e
7.UU
G~
2. 3
6.
6
^ 2 E3
1.
/ 10`x -
-_3_50 3.50
12 t2
9. 6d NAI-S 40 O.C. ~8.
_ THESE MEMBERS
R-1795A Y^ 6-30 - - B-O-O R-15951 N- S.00-
_ 15.0.0 I -IU E 0
PLATE TYPE--ALPINE 5EON-- 15582 FwMI9i R COPY OF THIS yMSIGNT TO E"TION CONTRRCTER wr MIA SOLE - I.ZW
RIDE Im:INE"mo Mmm n' IA[- IYF..'L9 AELJT9f rNTIDx rnAF
+NIMPORTRNT1tSWRLNm W9F9v:mE1111 w WARNT_MG IN Im9R1NG, osE~TaN R91 - DESIGN TRITT REF R116--1)06
THIS
rIrIMOR F 51'F:CI 0 MW NIEW[a M PJ![IIE."1E •m 81-EH', mAICIK INmiIIFgH=~ ramor,uwr IC LL Q,O PSF DATE OBIMIN
ITV [ IN W INJIM m111D IN 1WJ I
N CI1 MTM THM 1 167
I WITH 91Ifl91119NiW11M:+ml- SFE IrOFI • Illy
NEWT THE T1E `U01 idRI E11 FMN 0FNVV IHN ME119q' W OMI. F ILIN W Rim 1:A, IKEq ,,j M
WR. M nxx rlQil SRCIi TERM- ~'1•r o T1'. OL 10.0 P$F DRUG 569,828
l~ c:J u I , NNE. m911nY:lUE.E Fpl IN SALImI T& HWEFIIFLTA %M , IImUII.TIMH- UII.LB YM9916E 17t»Qs
I nIRtNISF'9FJNJ, EFT11F: 1 FWX5InnsRTE XIFqpi TE A VI Im~tl9ilp !loll ff I milN ? m9o a.K+~N. DL 10.0 F" IL-ENG JNW SWMW
o nFrLT EIDIItC1m1H m Fp I W 91M W 99V
mFOM
smJN1x9, .LO. 60. 0 PSF O/R LEN- 25-6-0
9 @ anw, 9ENIInR0
: rrAlle RIE v- Np111R M.LIK 19Em waNI9E 91Y9N. 90TTpl P af-0 'm "Rip au1N MAIM !tone a m9C
RUW ° MISS SUMM B Iyilxm VIM R IcmmE ~Inmw 6 as WECIFM w 291M. WWI WE MICC ^ OUR.F~FIC. 1 .15 PITCH: 7/12
Li r=1 wm6 9t nnl .V1.11 W >CT+II, NEGIM 911- FITS 9E1 ONON TAFWM LUMBER. plt ilsr~
...rrl-rx9G RNR Erannne ry,-11PII1>sE R91GI {yeelFroiloeMw9a wc*werw „'-M- SPACING 24,D' TYPE REPAII
•Ie91r~i~Nw•t♦
2007 RESIDENTIAL BUILDING PERMIT APPLICATION ~a
City Of Eagan l C/
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reeuirementu Remodel(Reoair Requirements Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Ced of Survey Recd Y _ N
(20% maximum lot coverage allowed) l set of Energy Calculations for heated additions Soils Report _Y _N
1 Soils Report 9 proposed building is to be placed on disturbed soil 1 site survey for additions & decks Tree Pres Plan Recd _Y _ N,
2 copies of plan showing beam & window sizes; poured found design, at. Addition - indicate if on-site septic system Tree Pres Required _ Y _ N
I set of Energy calculations On-site Septic System _Y - N
3 copies of Tree Presemabon Plan Slot platted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Mnnegasco mechanical ventilation form
Plans are considered public information unless you state the are trade secret and the reason.
Date _'O / / 0_7 Cstruction Cost
Site Address 15 -7 A G1 r-~ I I 0 < C Unit/Ste #
p /-q A/ 55 1~a
kJ I
Description of Work cc)ci+ ~G Se C cA ro~2e
Multi-Family Bldg / Y /N Fireplace(s) _ 0 _i 1 - 2
Property Owner (9 L-ar lei Telephone # (650 YL 16
Contractor M 5 e 4 -
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential ventilation Category 1 Worksheel New Energy Code 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 )
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.
r g fG o r S
Applicant' rinte Name icant's Si at
DO NOT WRITE BELOW THIS LINE
Sub Types
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg
❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi
❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF
❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo/pergola) ❑ 36 Multi Misc.
❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 06 04-plex ❑ 12 12-plex ❑ 25 Miscellaneous
Work Types
❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding
❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair
❑ 33 Alteration ❑ 37 Demolish Building' ❑ 43 Reroof ❑ 46 Windows/Doors
❑ 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant
Description: Water Damage _ Yes
Valuation Occupancy VICES System
Plan Review _ 100% or _ 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg) _ Sheetrock
Footings (deck) _ Final/C.O.
- Footings (addition) _ Final/No C.O.
_ Foundation _ HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests _ Final
Framing - Siding -Stucco Lath _ Stone Lath -Brick
Fireplace _ R.I. Air Test -Final _ Windows
- Insulation _ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MIC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA075942
Eagan, MN 55122 . Date Issued: 11/21/2006
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1576 Ashbury Pl
Lot: 22 Block: 1 Addition: Blackhawk Glen
PID 10-14350-220-01
Use
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If altering the opening size, a framing inspection is required. Smoke detec tors are required in all sleeping rooms prior to
final inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required Bat tery operated types
are acceptable if the wall/ceiling finish (i.e. sheetroc k) has to be removed to install a smoke detector. Tim Schenk
Elder-Jon es Building Permit Service 1120 East 80th Street, Ste. #211 Bloomington, M N 55420 952-345-6040
Fee Summary: BL - Base Fee $2K $69.00 0801.4085
Surcharge - Based on Valuation $2K $1.00 9001.2195
Valuation: 2,000.00
Total: $70.00
Contractor: -Applicant - Owner:
Renewal Andersen Gregory J Earley
1920 County Road C West 1576 Ashbury PI
Roseville MN 55113 Eagan MN 55122
(651) 264-4777
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA101074
Date Issued: 09/20/2011
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 1576 Ashbury P1
Lot: 22 Block: I Addition: Blackhawk Glen
PID: 10-14350-01-220
Use:
Description:
Sub Type: e-Windows iDoors Construction Type:
Work Type: Windows Doors-New ; Replacement
Description: House
Census Code: 434- Occupancy-:
Zonin,:
Square Feet: 0
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 S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Renewal Andersen Gregory- J Earley"
1920 County Road C West 176 Ashburn Pl
Roseville NIN 55113 Eagan NIN 55122
(61)264-4777
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117140
Date Issued:10/15/2013
Permit Category:ePermit
Site Address: 1576 Ashbury Pl
Lot:22 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-220
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Windows/Doors: If altering the opening size, a framing inspection is required.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Gregory J Earley
1576 Ashbury Pl
Eagan MN 55122
Cedar Custom Builders & Remodelers
1501 Keller Lake Rd
Burnsville MN 55306
(952) 215-5141
Applicant/Permitee: Signature Issued By: Signature
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
MAY 152013
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
/D 300y
Permit Fee: ! of .
Date Received: //i
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #: v
esiden'
Owner'
Name: C N)1e/ rfrizz/
Address / City / Zip: / 5-76 4518d/21,7
Applicant is: Owner X Contractor
Description of work:
Construction Cosi:';
Phone:( -. V65 - 7)0.6,
Address: /0(0
Multi -Family Building: (Yes / No/�. )
Contact:974/3$7r57
City:i4{"1-,.)
State: r%Al Zip: 5503 Phone: C23( -3i(7 -/if V Email: 2inr,� "'V @ 002.4 5T. Nom%
License #: fle ? j ? Lead Certificate #:
/V
If the project is exempt from lead certification, please explain why: (see Page 3 for ad Itional information)
(Gm D
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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 Building Code must be completed within 180
days of permit issuance.
x,
App ant's Sign-,/ re
Page 1 of 3
/57 (ei ,4Mh h'
DO NOT WRITE BELOW HIS LINE
/x3005 4
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
WORK TYPES
New _ Interior Improvement
Move Building
Fire Repair
Repair
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Addition
, Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
alb
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: Ice & Water Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Siding
Reroof
Windows
•Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building"
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests Final
Drain Tile
Siding: _Stucco Lath Stone Lath Brick
4_ Windows knekh,55 tett, f1
Retaining Wall: Footings _ Backfill _ Final
Radon Control
Erosion Control
Other:
Reviewed By: ' t-/, 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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124880
Date Issued:07/14/2014
Permit Category:ePermit
Site Address: 1576 Ashbury Pl
Lot:22 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-220
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Gregory J Earley
1576 Ashbury Pl
Eagan MN 55122
Hearth And Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 638-3309
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA139555
Date Issued:10/27/2016
Permit Category:ePermit
Site Address: 1576 Ashbury Pl
Lot:22 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-220
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
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 -
Gregory J Earley
1576 Ashbury Pl
Eagan MN 55122
All Craftsmen Exteriors Llc
1020 East 146th St
Ste 226
Burnsville MN 55337
(952) 898-4680
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA154296
Date Issued:03/11/2019
Permit Category:ePermit
Site Address: 1576 Ashbury Pl
Lot:22 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-220
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$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 -
Gregory J Earley
1576 Ashbury Pl
Eagan MN 55122
Sieben Plumbing
18605 Fischer Ave
Hastings MN 55033
(651) 343-6298
Applicant/Permitee: Signature Issued By: Signature
CEIVE'
O For Office Use ,
2019
BAR ya 59
• ::::e2
EAAN
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:
J
buildinginspections@cityofeagan.com L
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name:(9(-G� d �e nc� � ar•(�y Phone: CA(oSt• '�l& 73.0GResident/ Q
Owner Address/City/zip: IS1 to b•-',c•-/ P 1 G cr
Applicant is: Owner X Contractor
Type of Work Description of work: �;�-e �.�, / L2,,�U ,eJ
Construction Cost: `k Multi-Family Building: (Yes /No )
Company: 2c U. gn C �e :'. g.,r'b4 Contact: h^,5
Contractor Address: ,q City: 1. 0.Lam..`((2
State:M rZip: `E'4 Phone:(90-8'4 moa(o Email: C-11.•-"N•6 @ eo Icy
b t•1-)
License#: a-c`{3(.7 Lead Certificate#:/Nii-i- '2>00.4 —/
If the project is exempt from lead certification, please explain why:
-7 g
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 and supporting documents that you submit are considered to be public information. Portions of the information maybe
classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets.
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.citvofeaqan.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 for a permit, and ork is not to start without a permit; that the work will be in
acc ance with the approved plan in the case of work which requires a review and app I of plans.
x r1.s 0\9_4.,%4Nx e
Applicant's Printed Name Applicant's Signature
/S ,cP S
46w/ 6 •
DO NOT WRITE BELOW THIS LINE /5 76 A-
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 .�./ I MCES System
-121-4e0
Plan Review ii
Code Edition y ` ! 5d. SAC Units
(25% 100% Zoning s 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 Service Test Gas Line Air Test Hood
Roof:_Ice&Water _Final Pool: Footings _Air/Gas Tests _Final
Framing 7( 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In 4Air Test 1[ Final Siding:_Stucco Lath Stone Lath _Brick_EFIS
i
Insulation 4Air
C Windows -U-f
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control a
Shower Pan _11' Other: pa r,p(riNs
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee 1t�
Surcharge Y " I'1
Plan Review f 1 OOtellill
MCES SAC IVIVIV
City SAC
Utility Connection Charge
( C. (?,(2/0 .-..,
SSW Permit 8 Surcharge q)3 �
Treatment Plant / '
Radio Meter Read Iwo:� /
Copies il / .l�f/:/` :-A 20 c,- ,
TOTAL .2 CI ("4?
",,,,.----,.—" a'lr g rof r
f7 , VO
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA154321
Date Issued:03/13/2019
Permit Category:ePermit
Site Address: 1576 Ashbury Pl
Lot:22 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-220
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Gregory J Earley
1576 Ashbury Pl
Eagan MN 55122
Glowing Hearth And Home Llc
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature