3644 Ashbury RdCITY OF EAGAN
'- 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PH ON E: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value • ' Date,19
Site Address _
Lot Block
Parcel No.
Sec/Sub. uLl•.( ' , ... & ' 1 .. i,J
OFFICE USE ONLY
On S8e Sewage OCCUpancy
M1NCC System Zoning
On Site WeII (Actual) Const
City Water (Ailowable)
PRV Required # of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
fi- :. ,.- 1
Ii-J
V--?;
-•' -,.
,
rc Name •
W
3 Address
° City Phone
Address
C+ty _
3644 ,?sHr??uY Rr
Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicabie State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
, 1 . ? .
A Buiiding Permit is issued to: q ;,
'
on the express condition that al! work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official_ ?
APPROVALS FEES
'
Engr./Assess. Permit
Planner Surcharge
Council Plan Review
Bldg. Off. SAC, CPty
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
P
arks
TOTAL
? '
Permit No. Permit Holder Date Telephone #
Plumbing
H.V.A.C.
Electric /?/
? S::?Gr?e-
Softener
Inspection Date Insp. Comments
Footings 1
Footings II
Foundation
Framing ?S-
Roofing ?
Rough Pibg. ?-p
Rough Htg. ?
Isul. ?
Fireplace ?s?
Final Htg. ?
Final Plbg. ?
Bldg. Final
Cert.Occ.
Temp. LP
Deck Ftg.
DeCk Final
Well
Pr. Disp.
Cities Digi
itv Control
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from the original page.
• ?
r . , •
CONTRACT PRICE
Site Address
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN 3830 PILOT KNOB ROAO, EAGAN, MN 55122 DATE:
PHONE: 454-9100
- Block Sec/Sub
m Name ?
Address -
c City Phone'
Name
3 Address
O Ciry Phone
FEES
COMM/IND FEE - 1°rb OF CONTRACT FEE
APT. BLDGS - COMM FiATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
Y --?
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DE SCRIPTION
Res. New "
Mult. Add-on
Comm. Repair
Other ?- ,
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
? Bath Tubs - $3.00
?Lavatory - $3.00 '
Shower - $3.00
Kf?chen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - S3.00
Floor Drains - $1.50
Water Heater - $1 50
Whiripool - 53.00 ,
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMM
Softener - $5.00
Well - 510.00
Private Disp. - $10.00
-' Rough Openings - $1.50 ,
FEE:
STATE S/C:
GRAND TOTAL: ?
, PERMIT #
' MECHANICAL PERMIT RECEIPT # ?
• ? ? ?l ? ? _?
,
CITY OF EAGAN
3830 PILOT KNQB RDAD, EA(iAN, MN 55122 DATE
CONTRACT PRICE: - , ; ?; • ?V PHONE: 454-8100 4,
Site Aless -?` -' ??
L
t
Bl
k ?? • T"?
"
/S
S t BLDG. TYPE WORK DESCRIPTION
o
-
oc
' ?
? ec
u
?
?
?
? b
?•".' ,
Res. New
_ }
?
? Name ? • r_ _ Mutt Add-on
Comm. Repair
m Address
c
City .?1
Phone t J
'
Other
.
? _
Name FEES
RES
HVAC 0-100 M BTU - $24
QU
" ?
' .
.
c '?
Addreps ? 1-- •
V '? ADDITIONAL 50 M BTU - 6.00
O City` ` Phone~ (RES. HVAC INCWDES A/C ON NEW
, CONSTRUCTION)
GAS OUTLETS
MINIMUM
• 1
50 EA
1 PER PERiIA111
.
.
(
-
)
. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
; Forced Air M BTU yUV APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
GOES
PERMIT PRICE
Gas Piping Outlets # BEYOND $1 00)
Other
a
FEE:
S/C: -?J SIGNATURE OF PERMITTEE
TOTAL• R
FOR: CITY OF EAGAN ?
? •
? CASH RECEIPT
. ciTV oF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19 nECerveo
FFIOU
AMOUNT
& DOLLARS ?
O CASH ? CHECK ?
,
FM
. ?..,:, •??; ? . f . x . . . W _ :. : ;.
- CASH RECEIPT r~>
? CI.TY OF EAGAN
„ 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?
DATE 19 I ?
AMOUNT I $
& DOLIARS
ioo
? CASH \U" CHECK
I ?
Fon
Ll?I
a
<
ki1ND OBJECT AMOUNT
3
Thank You ?
BY
?. a White-PaYers CoPY
Yellow--Postlng CoPY
? Plnk-file Copy
, .
%
CITY OF,EAGAN Permit No: 1)564 Date: 6-14-'88
3830 Pilot Knob Road Meter No: Size:
P.Q. Box 21199 Reader No:
Eagan, MN 55121 '
Date:
Owner. •?ethle Brne. 1
Site Address: ??. _. F .? ".`'• ".-??? / j r? g?3rr'
J
Plumber ?
Conn. Chg:
Acct Dep:
?- ?
Permit Fee:
Surcharge:
Tr. Plant
Meter.
Misc.:
Zoning: _
No. of Units:
1 agree to comply with the City ot Eagan ?
Ordinances. WATER SERVICE PERMIT
CITY bF;EAGAN Permit No: Date: r-1 4 ? s• ?
3830 Pilot Knob Road B/P No: ? f?Date:
P.0. Box 21199
Eagan, MN 55121
^---- -•::?:` _ _ Broe.
Site Address:
MWCC: ?50.00pd
City Chg: 100.00pd
,.?.
Acct Dep: ,
Permit Fee: -
Surcharge:
Zoning•
?
No. of Units:
I agree to comply with the City o1 Eagan
Ordinances.
By
SEWER SERVICE PERMIT
(gextifiratr of Mrrupanry
Citp of qlagan
1Dr;Mrtmrni uf ]Wbing 3wprtwn
This Certifccate issued pursuart 1o the requirements of Section 306 of the Uruform Building
Code certifying that at the tirne of usuance this structure was in compliance with the various
ordiriances of the City reguJaling building consuuction or use. For the foUowing.•
Ute Claraifplioa '7•' DW Bldt. Rmtit No. •?10$
Occ ?, T? ft3/M 1 zo.
"q,abtri.t tM` c°M Vn
'i?1ffZ BEi(ilit:.r'?`=; )N., AVE, BUMINGIUN
o»n« or suddmg naares
I , , 'A?c'r . "? AR? &oldinW Addrese ?+fitY 2ND
.?;Dati:
Bwlding OffieW
POST IN A CONSPICUOUS PLACE
CITY QF EAGAN
3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT '
To be used for S'' ?C
Site Address _
Lot ' Block
Parcel No
2 Sec/Sub. Bl,ACIfIiAWK GI'EN 2r
o? Name nA}1LF B[tOTHERB, INC;
z Address °"304 L1frSnAI.E AVE
o eity ii1,00-41FiGTOf}Phone 888"686c;:
6 Nam??
0
V 4 Address
? City _
a
W Name_
Z Address
cs
W CitY-
I hereby acknowledge that I have read this application and state that the
information is correct and agree to compiy with all appiicable State of
Minnesota 5tatutes and City ofan Ordinances.
, + .
Signature of Permittee - --?1------
A Buiiding Permit is issued to: DAfll.c Bki?'tE{Es+'> , INC
on the express condition that all work shail be done in flccordance with all
applicafble State of Minnesota Statutes and City of Eagan Ordinances.
Est. Value `? 7 + tk't) Date
Receipt
JUNE
i5105
19
ASH.KI RY RD
OFFICE USE ONLY
On Site Sewage Occupancy 11-3 M-1
MWCC System Zoning R-1
On Site well (Actual) Const V-N
City Water X (Allowable) v`N
PRV Required # of Stories
Booster Pump Length 489
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit '12•00
Planner Surcharge ` `•%• 30
Council Plan Review 281,00
BIdg.Off. SAC,Ciry 2W•00
Variance SAC, MWCC 550•00
Water Conn. 5 50• W
WaterMeter 67•00
Road unit 325.00
Treatment P1 04'00
Parks
TOTAL
Building
CITY OF EAGAN Permit No: 9664 Date: F" '- ,` 3830 ?ilot Knob Road Meter No: Z160 /a0 32 g1Ze:
P.O. Box 21199 Reader No: AS P/3?/ I Date:
Eagan, MN 55121
Owner.
SiteAddress: > Aahhi?r: . ,.? "jI i'.I 3C?"}13WK G1.=ri zI
Plumber. 'i'n- 73171mhinjz
Conn. Chg: 'o- n11nd
Acct Dep:
Permit Fee: in a
Surcharge:
Tr. Plant ?: . Q!Jpi
Zoning: _
No. of Units:
I agree io comply with the City ot Eagan
Ordinances,
Meter.
Misc.:
R1
WATER SERVICE PERMIT
CITY OF EAGAN N° 1510 5
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT
To be used for SF DWG Est. Value $97,000
SiteAddress 3644 ASHBURY RD
Lot 3 Block 2 Sec/Sub. BParcel No
s Name DAHLE BROTHERS. INC
= Address 9304 LYNDALE AVE
3
° City BLOOMINGTON phone 888-6866
a Name
0
?a Addre
a City_
Address
City _
I hereby acknowledge that I have re 7his application and ? that the
inbrmation is correct antl agree cy ? 5[ate of
Minnesota S[atutes and City ol ggfn Ordina ces.
Signature of Permittee r
A Building Permit is issuetl to: DAHLE BROTHERS. INC_
on the express condition that all work Shall be done in accordance with all
applicable State of/?M?in?n?e?so?ta St.aJtutes and City of Eagan Ordinances.
Building OfliciaL?\?l?
Receipt #
Date -
JUNE
1 ,ig 88
OFFICE USE ONLY
On Site Sewage - Occupancy R-3 M-1
MWCC System X Zoning R-1
On Site Well (Actuap Conat v-N
Ciry Water X (Allowable) V-N
PRV Required X # of Storles
Booster Pump _ Length 48,
Depth SS'
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./ASSess. Permit $62.00
Planner Surcharge 48.50
Council Plan Review 281.00
Bldg. Off. SAC, City 100.00
Vadance SAC, MWCC 550.00
WaterConn. -55_0.00
WaterMeter 6.7._0
Q
Road Unit
0
125-0
- Treatment Pi 204.00
Parks
TOTAL 2,687.50
BLDG. PERMIT NO.
01-3210 Bldg. Permit LC)
?
? 01-3422
01-3445 PlanCheck
Surch./Adm, c c-,
ai
01-3446 SAC/Adm. ?7 S L
? 01-2755 Surcharge 1 5 3
? 75-3860 Road Unit
? 20-2275 SAC
20-3865 WaterConn 00
? 20-3868 .
Water Trmt.
? 20-3716 Water Meter L ? Cc-)
? 20-2252 Acct. Dep.
v 20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn. C? O C
28-3855 Park Ded.
TOTAL
Cities Digital Qualitv Control
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Every effort was made to capture the content
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2007 RESIDENTIAL PLUMBING PeRMiT aPPLicarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
I;zl
C?
Please complete for modifications to existing residential dwellings. Do nof combine inside and ouislde
nlumbina nn fhe same annlir.atinnsenarate annli-atinns and necmits are r2ouirec.
?
Date
/ /
y ?
?
Site Street Address Unit #
?•
?1-
`Y?
Owner Telephone #(\?-)l
Pro
ert
p
y
Appliance Cannections Inc
Contractor 1513 Danita Cr Telephone #( ?
Address SheltiDpA@, MN 55379;ity state zip
The Applicant is: _ Owner & Occupant _ Licensed Plumbing Contractor
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
This fee a lies when extensive lumbin re airs are made to a buildin .
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures to main level lower level. This fee includes
installation of a water softener and/or water heater at the same time. !( you are
installing onlv a water so/tener and/or water heafer, do not complete this section;
move to the next section and place a checkmark next to the appliance(s) you are
installing.
_Septic System Abandonment ?
_Water Tumaround (add $136.00 if a 5/8" meter is required)
ther:
_ Water Softener _ Water Heater /?r g ----
?,r
, ,
_ new replacement ?
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge ' $ 50
Total
.
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is corfipfete antl accurate; tnat Ihe worK vnll be
in conformance with the ordinances and codes of the City of Eagan and the'plumbing codes; that I understand this is not a permit, but
only an application for a permit, work is not to start without a pertnit and work will be in accordance with Ihe approved plan in the evenl
a plan is required to be reviewed and approved
4
2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Koad, Eagan MN 55122
- - --- --Telephone # 651-675-5675 FAX # 651-675-5694
't`7().66
New ConsWCtion Reauirements RemodellReoair Reouiremenis
3 registered site surveys showing sq. fl. of lot, sq. ft of house; and ail roofed areas 2 copies of pWn
(20% maximum lot coverege allowed) 1 set of Energy Calculafians for heated additlons
2 coPies of plan sWmg beam & window sizes; poured (ound design, etc. 1 site survey for additions & decks
1 set of Energy Calculations Addition - indicafe ffon-site septic system
3 copies of Tree Preservation Plan if lot platted afler 711/93 mm
Rfm Joist Defail OpGOns selection sheet (61dgs with 3 or less units
Date Construction Cost
Site Address ? '? ??o?{y As?bUru Rd . uo;uste #
Descriptian of Work LA?Ar[SnlA_)s U)[, IIU _lLf1(' -'(lCn 0?9
rJ,
4
Multi-Family Bldg _ Y _ N Fireplace(s) _ 0_ 1 _ 2
Property Owner Telephone #(?$ V)3D5-6'000
RMA HOME SERVICES, INC.
Contractor
- Home Deopt Installed Sales
Address _ 3200 Cobb Galleria Pkwy.5te. #200 city
State Atlanta, GA 30339 Telephane #( )
763-542-8826 BG20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - M'n°esota Rules 7670 Cateeorv 1 ` Minnesota Rules 7672
(J submisslon type) .• Residential Ventllation Category 1 Workshaet , . New Energy Code Worksheet
5ubmitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a buildin<
fee applies. -?-
Licensed Plumber F
Mechanical
Sewer/Water
in Eagan with a similar plan? _ Y
Telephone # (
Telephone #(
Telephone #(
N If so, 25% plan review
I hereby apply for a Residential Building Pemut and acknowledge that the informaUon 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 pemut, and work is not to start without a
pemvt; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval ofplans. ,
?«b-co-So,::)
ApplicanYs Printed Name ApplicanYs Signature
!
OFFTCE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex - O, 13 16-plex ? 20 Pool ---- 0 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-pleac ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demalish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 ROplacement 'Demolition (Entire Bldg ) - GWe PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
? Roof
Ice & W ater Final Pool _ Ftgs _ Air/Gas Tests Final
_
_ Framing _
_ Siding _ Stucco _ Stone _ Br ick
_ Fireplace _ R.I. Air Test _ Final _ W indows
_
_ Insulation _ Retaining Wall
ApproVed By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge .
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
Installed
Siding and Windows ?
LIMITED POWER OF ATTORNEY
CuuN i Y ur c:OBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sales loca?ed at 6E0 Mendelssoh.n Avenue North, Gol.den Valley, rrINT
55427, having a license number of BG 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("AgenY') as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "yVork").
The powers conveyed to the Agent by this Limited Power of Attemey are
limited solely to the express powers delineated herein and apply solely to the Work.
This Limited Power of Attomey shall expire and automatically be revoked on the 21st
day of Tvlay, 2004, which date is one year from the execution hereo£ Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
alry time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
N Wi_"I'NF_SS WHEREOF this Limited Povver efAttorne-y is e.xecirtcd th:s
21st day of May, 2003
David N. Katz
SWORN TO AND SUBSCRIBED BEFOAE ME by David N. Katz on this
21 st day of May, 2003.
Notary P ic in for the State o eorgia
My Commission Expires: Januazy 21, 2006
396816.v3 -
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
,Sq11 I
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete £or: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date?_// (f) J
Site Address Unit #
Property Owner Telephone#(fo?j J ) 3?'? •c1,??n
Contractor y- ?
Street Address h u? City ?
State m? Zip ? Telephone #66) ) 7 O 30
The Applicant is _ Owner ? Conhactor _ Other
Add-on, modification or alteraHon to existiug dwelling unit $ 30.00
furnace replacement
air exchanger
? airconditioner
otner
li.j !':% ; 2 ?cr? ?'?
.
State Surcharge $ .50
Total $ ?
I hereby apply for a Residenrial Mechanical Pernnt and acknowledge that the information is complete and accurate; that the woik 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 applicarion for a pemut, and work is not ro start without a permit; that the ork will be in accordance with the
approved plan in the case of work wMch requires a review and approval of pl ?
n c4u\c?a c? r1 ?? '?
Applicant' inted Name plicant's gnature '.
MECHAIVICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knoh Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: commercial/industrial buildings
multi-family huildings when separate permits aze not required for each dwelling unit
Date
Site Addresa Unit #
Tenant Naroe (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
SYreet Addresa City
State Zip TelepLone # ( )
The Applicant is _ Owner Conhactor Other
Work Type
_ Newconstruction UndergroundTank _Install _Remove
_ Interior Improvement Call for inspection during installation/removal of tank
_ Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fce (inclUdes Siate Surcliarge)
Contract Value $ x .Ol% _ $ Permit Fee
• If permi[ fee is $1,000 or less, add $.50
If permit fee is over $1,000, add $.50 per => $ State Surcharge
$1,000 Permit Fee
$ Total Fee
. uo.ouy nyy,y I- a ?ommerciai rviecnamcai remut and acknowledge that the infbrmation is complete and accurate; [hat [he work
will be in conforntance with the ordinances and codes of the City of Eagan and with the Mechaaical Codes; that I understand this is
not a pemut, but only an application for a pemut, and work is not to start without a pemut; that the work will be in accordance with
ihe approved plan in the case of work wluch requires a review and approval of plans.
ApplicanPs Printed Name ApplicanPs SignaNre
ApproyedBv:_ . . . _.. *......_,..,.r. nntP-_ .
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
, I., .
(::LINGLE FAMILY DWELLINGS 'SI ON
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 7 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTR9CTOR/HOMEOWNER MOST DESIGNATE WfiICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL QNITS FOR SALE UNITS # OF IINITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OE SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OE ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used ror: S•ieLr Daluation: {=a??
Site Address .?:3W
Lot ? Block _? ?? bN hY ? I
Parcel/Sub RLQ(',C 4A49 WWA K I
Owner ha, b 2 'E ZAR? f.() /G.S £
naaress J 5$(0 0 (2o? AW?'cLC "A/?
City/Zip Code ?{E3Se ?/OrG.?y',///n •
Phone
Contractor .2) 4?V/ E 610l05: ?'-
Address ?3?J z ??f'?.o t?t•e
r•-?
City/Zip Code Phone ?JP/
Arch./Engr.
Address
City/Zip Code
RECD MA.Y 2 /6 ?ggg
Date: .J/c?/o g
orrlcb usn VWLI
'
On site sewag
e_ Occupaney 3 M- I
?•
MWCC system Zoning I7-I
On site well Actual Const V•KI
City water ? Allowable V-N
PRV required ? # of stories
Booster Pump Length
_
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit .S 2.00
Planner Surcharge UR ..
Council Plan Review 291.00
Hldg. Off. SAC, City 10o,00
Variance SAC, MWCC 550,00
Water Conn U 1 O
Water Meter 9.OU
Road Unit 5.00
I Treatment Pl 2oy(ou
Parks
Copies
TOTAL ?
SO
Phone #
.- .
VALUAT?oN
GARAGE ? •d ? ?
7,14 X"Z7 - 528 ' ?
?-
y96 x?4 - ??yu
g?m T
3
y x ?4 - z,?
i
g2Bx 1,?= I076y
NOw,t
13Xy2
/I x 32
1( XZ? '
/vK3o '
SU?
. 3s Z
? Zy
?
y?o
__----
1G02 X ?{q ? r)?y98
`J(. 2bG
. , CERTIFICATE OF SURVEY
xiwx?`
T
,...? , IAND SURVEYORS
k?
Survey for:
• z" R. Coutunc, ;)w.
8713 DUPONT AVENUE SOUTH
? BIOOMINGTON, MINN. 56420
888-2084
DAHLE BROS., INC.
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Scale: 1"=30'
s
h DESCRIPTION:
Lot 3, Block 2, BLACKHAWK
GLEN 2ND ADDITION
? \ Y??•
Ro
Dat
Proposed Grades: EA(aAN EItTGI1VEERIIVG DBPT
Top of Blocks Bz0° Garage floor 819S Basement floor 8/6 S
We hereby certify that this is a true and correct representation of a survey of the
boundaries of the land above described and of the location of all buildings, if any, thereon
and all visible encroachments, if any, from or on said?and. Dated this 24th day
of MaY , 1988 . /V
\ ? ,?oy
• ?. ,. , EXTERibR ENYELOPE AVERAGf "U" COMPUTATION
t1WtILR:
SITE aonRess: LOT ?21??' K 2 11???I?lkG1??l
CONTRACTDR: ?a-?,..? ??os -?-?•- DATE : PHONE : S8S-?o8?o(a
DfTERMINE NORKINf, SOUARE FOOTAGE OF fACH:
1. TOTAL EXPOSED uALL AREA, ,,,,,,. Sq ft x"U"
2. TOTAL ROOFICEILING AREA,,,_,,.. 12?p sq ft x"ll" /? ?/ I_ .
_ e l/ 33.z8
3. TOTAL EXPOSED NALL AREA CALCULATIONS:
Total exposed wall
area above floor,,.,,,,, - Zy sq ft
--????-
a) Tota) Nall aindow area:
3
glazed...... sq ft x "U" . S
glazed,,,,,, Sq ft x "U"
b) Total door area ,,,,,,,,, aJ gj sq ft x "U" •?,
c) Total sliding glass door area: '
9lazed...... y0 sq ft x "U" _(oS
Glazed...... sq ft x "U"
d} Total fireplace wall area - sq ft x "U"
e) Tota) wall framing area
{Average )0`!).... ...... . `?02
f) Total net wall area above
floor (Insulated).......
g) Total rim Joist erea......
Total foundatlon .
area (Exposed).......... ?OS
h) Total foundation
window area.............
-
I) Total net foundation
area above grade........ ?D S
sq ft x "U" • 0`1
sq ft x "U" . 0'1
sq ft x "U" • a`A
sq ft
sq ft x "U" -
sq fc x „u"
TOTAL a) thru 1)
• 1?S.So
?
a '-i . 1 g
Q 2? . 00
e
? -
= 50.12
? - .
If ltem N3 is the sane as, or less than item pl , you have met the intent of
2 11CAR 1.16008 A and 0.
Page 1
TOTAL EX705ED RQOF/CEILINf, CALCULATIONS:
Total exposed
`
roof/ceilinq area........ ?(08 sq ft
j) Total skylfoht area....... 8 sq ft x "U" •`? ? ?`,8
k) Total roof/cellinq framing
area (Averaae 1n9,)...... sq ft x "U" . oZ ? 2.3y
1) Total net insulated
roof/cellinq area....... sq ft x "U" -oZ o Z1-oZ
4. 7o7AL j) thru 1) 2-1 •8`I
If total of p4 Is the same as, or less than 02, you have met the intent of
2 MCAR 1 .16008 A and 0.
ALTERNATE BUILDIfIG ENVELOPE AESIr,N
To utilize the total envelope system method, the values established by the sum
of items p3 and N4 shall not be greater than the sum of items Fl and #2.
1. + 2. -
3. . + 4. _
? •
,
?
No
c'
4
rior air
R VALUE
TOTAL R - lo.9 I
U ? 1/R
f1,hR
.A5
t'C l4,oc
2.OL
. b`1
n.i7
OTAL ? 23.05
U - 1/R a .04
RIM J015T SECT10N:
---?) Interlor air film ?
?
D
E
USTRUC? I ON
AMING SECTION:
Interior air f11m
sott
. txterior air
WALL SELTION (INSULATED)
(1 Interlor eTr fl
3 1'Iz" S.rz«+e?c
4 25A1 4F'MS.'1?1t.1L. 4.0(.
5 Na.abe:?d S ?a;
i 6 fxterior atr ftl ?.17
TOTAL R s 24 .4 Iv
FOUNDATION INSULATIOtI REQUIRED:
Min. R-5 on entire wall DR U- 1/R e .Uy
p.;•
a• Min. R-10 down to frost depth
Q
,
A,• FOUNDATION SECTION:
°%?"• 1 interior air fllm n,fi8
'P . ? • Z
.? b ?
s?,a• =• 3 y?' tor:c• ^, lK
"'-"A 4 fxterinr air film Q.17
'a-
.•
p ' '•
(5
a 0;
a• ::.e 4 ? TOTAL R° 1325
SLAR ON GRADE
`? °?:?L;, •°? ?a? :> , q ? ?
•' '? Heated Slabs:
Minimum R = 8:5
Unheated Slabs:
,•'Q 'v . mum R = 6.2
'?•, ! o ',. . q` ,:, A
?"• '• . j ° :' .. Q'••a'Q,1
?q
Ll , d' ? . `'•q.?..4? . rc'
Yq; ,q? • '? . ??; ,
, 44:, ? Q;V''•9•
q . .' ,
. 4 , a ., ; •,
. , . . ??
Page •3
.
u
G
H
VENTED
CONSTRUCTION A VALUC ? tEILINf, SECTION (INSULATED):`•
1 Interior alr fttm ft.hl
2 f.L :?
4r.' . o0
4 Exterior air film stili n.F1
TOTAL R ? 45?t
- U?
\
CEILINf FRAMING SELTION: a
1 Intertor air film 0.61
2 Vt-'r `' F r. L V
3 Ct.F. lrk, b?-e-a 4d-.o'J
4 Intertor air fi m still O.F+1
S 51/2 inches soft wood gG.
TOTAL R = 51•bb
U a 1/R . D?L /
CEILING SEf,TIUN (INSULATED):. , .
1' Intertor air film 0•61
2 SI ° G. ov..A .5.
3 C? ??Js 6tewr? ?4 oc
4 F.xterior air film stillj 0.61
TOTAL R = l15: I g
U - 1/R = -?'Z \
CEILINr, FRAMINn SECTIOtl: ?
1 Interior air film 1 0.61
2 Sfs" S?n ? Oh/4 .CJ?O
3 1..1G t,.r-N _
4 Exterlor air filn still ?• I
5 11I2, inches soft wood I.f9
TOTAL R
U = 1/R = .02-
Inside alr film o•Al
2
3
4
5 Outside air film n,17
TOTAL R
U- I/Ra_
Page 4
APFLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
oF eagcan
1) PROPII2TSt ADDRESS:
T,FY:Ai• DESCRIPTIONS.
? ............................. .. -:
iN(7PE: PAYhIINf OF FfE AT TIME OF
? APPLICATiON DOFS NDT CON- :
? STIN1'E APPRUJAL OF PIIthIIT.
?
? INSPt7CPION OF SEFIIR APD/OR WATIIt
:.
i IIISTALiATZO[5 WILL Npf BE SCSDIR,FD ?
? L'Nl'LL PII7hffT HAS BFEN APPROVED. i*.
ff.e??faratff?rtx?a+frf?,?a++????fw+i+3wx
IF EXISTING STRL'CTURE, DATE OF ORIGINAL HUILDING PERMIT ISSLANCE:
Nbnt Year
PRESENT ZONING/PROPOSID OSE:
Q .CONMERCIAL/RETAIL/OFFICE
Q INDL?STRIAL
Q INSTITUTIONAL/GOVERNNENT
2) NANIE:
ADDFtESS:
CIT3t, STATE, ZIP:
PHONE:
3) NarE: ?
ADDRESS: _0,/'e '..tq
CITY, STATE, ZIP:
PHoNE: .??
4) Wlkn?'f? F31? e ?•
I_ R-1 SINGLE FAMILY
DUPLEX ('IWO T-inits )
? R-3 TOWN-IOOSE (Three + Units) ( Lnits)
Q R-4 APARTMENT/COPIDOMINILM ( Units)
` "0L, .?_ r
l
r
-MASTER LICENSE a
N11ME: _ ? 12P-Fn ?
ADDRESS:
CITY, STATE, ZIP:
PHONE:
P1 rum es License:
Active
Expired
ij Not recorded
Sta InF__ - ...
5) ?- o d?' :a •o'o- ??e
CONNECfION TO CITY SEWER Dg-1?6NNECTION TO CITY WATER a OTfER
6)
**t****x?***********?**?rz?***??**?*?*?***++*????*******?,r********+r*,r***,r*,rx***,e*****??,e**??**?**????
* THE GOID COPY OF 1HE PERNIIT WILL BE SENf DIRECPLY TD PLm,IC WORKS TO FACILITATE METER PIQC-UP. *
,,*t PLF,ASE ALI,OW TWU WpRKING DAYS FOR PROCFSSING. SOMIDONE EROM TfIE CITY WILL CONfAGT YOU IF TfIERE *
* P.RE ANY PROBLII•1S. ;
FOR CITY USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit FEES: •
$ $ SEWER PERMIT (INCLUDE SURCHARGE )
$ $ /o• S-2) WATER PERMIT (INCLUDE SURCHARGE)
$ ? 7'0 n $ WATER METER/COPPERHORN/OOTSIDE READER
$ $ WATER TAP (INCLLDE CORPORATION STOP)
$ $ SEWER TAP
$ $ Ly ? ACCOUNT DEPOSIT - SEWER
$ $ L-e ACCOUNT DEPOSIT - WATER
$ $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSME[VT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERA L BENEFIT/TRCNK WATER'
$-- 6? C) $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ X711 on $ ,S/• O U TOTAL
,yy?, 7 D 1. Pl(l V ?
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQDIRE EXCAVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : (G / / ?/ ?J
UNDERGROUND SPRINKLER SYSTEM
PLUMBING PERMIT
Date: Permit #
Date 7a5/9/
Receipt #
_ Commercial: $25.50 + water tap if required. (City installs all taps up to 1"). If
adding new service, a water permit will be required, as well.
? EbstinQ residential: $15.50 (Plumbing permit not required if bacldlow preventor was
previously installed).
_ Residential developments: Fee to be determined by building inspections department.
May require payment of water permit, plumbi g permit, WAC, and water treatment
plant fees. ? ,316„21 ??? ,i
(Address to be sp ' ered)
Homeowner/Plumber: ?cc •7 r?..., /??K sef'v
Phone #: 213^
Street Address: 17 GU e,
Ciry, State, Zip: Y 3
Owner Name: ?l?U1 j l< e GJ e, tj',s
Street Address: 310 `lY Wd M"
Phone #: v v c U' ° r(<?
Irrigation Contractor: 14 e?? a %ry
Phone #: Li / y l
I hereby acknowledge that I have read this application and state that the information is
correct an ee to comply with all applicable City of Eagan Ordinances
cc: Engineering Department
7
-2r-9r
? ?
? s3as
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
? ? sa
Date 07 ? 07 / 04
Site Street Address 3644 ASHBURY RoAD
Unit #
Property Owner JOY PICCOLINO -R6AB Telephone #( 651) 365-0200
Contractor RICHFIELD PLUMSING COMPANY Telephone #e52 ?
Address 8640 HARRIET AVE.S. Ii100 City HLOOMINGTON State Mn' 881-3355
Zip 55420
The Applicant is: _ Owner XContractor _Other
Alterations to existing dwelling
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other: $ 50.00
Water Softener _ Water Heater
_ replacement _ additional $ 15.00
Lawn Irrigation System RPZ_ new _ repair X rebuild $ 30.00
State Surcharge $ .50
Total $ 30.50
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
DAVID F. ADELMANN
ApplicanYs Printed Name
?r/ t( . AdaY-r?c?L2't._.
ApplicanYs Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119096
Date Issued:11/14/2013
Permit Category:ePermit
Site Address: 3644 Ashbury Rd
Lot:3 Block: 2 Addition: Blackhawk Glen 2nd
PID:10-14351-02-030
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required by law in ALL single family homes .
Marcial Obregon
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 -
Sirathy T Ky
3644 Ashbury Rd
Eagan MN 55122
(651) 454-8791
Taylor Brock Corp
6565 City West Pkwy
Eden Prairie MN 55344
(952) 888-2000
Applicant/Permitee: Signature Issued By: Signature