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1573 Ashbury Pl Use BLUE or BLACK Ink j Fbr / -7 / Permit q6 ~ / (,o City Of EaEdn I o. I cc, Permit Fee. 3830 Pilot Knob Road I i Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 I star Fax: (651)675-694 I 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 10-05-10 Site Address; 1 IBS t t 1Z~( Tenant. Suits RESIDENT I OWNER Name:-r0(-"1 I I4-t-tT-C- M t. ll<~eiZ Phone: l6 I --334 0158 Address J City f Zip: 1513 1SiAUjP L 1 EF`681-i 555 VL - Applicant is: Owner Contractor TYPE OF WORK Description of work: P'e I? U',(-E- FIIONT =IZ Construction Cost: , `1®a 00 Multi-Family ;wilding: (Yes / No CONTRACTOR Name: (%c, license -2-05 W (,p" Address: Cif 121q Ci 8A L1r DlZ City: CM6 1Zk-NPt8S, State: MH Zip: 5 4 4'IE> Phone: -1 L03 - Z29 --7 20(Q Contact: 11Z~ Email: y?1[L1 Iq COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _,,,_No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the Information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are 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.gooherstateonecall.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 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 appro al plans. Applicants Printed Name Applicant's Signature Page 1 of 2 CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 E 19 RECEIVED FR ! y~,. AMOUN $ 1 e1 DOLLARS Boa ❑ CASH CHECK FOR j G7 FUND CbDE AMOUNT J Thank You 61677 ' BY White-Payers Copy Yellow-Posting COPY Pink-File Copy CITY OF EAGAN WATER SERVICE PERMIT 3830 Pildt Knob Road P. O: Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: _ No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 elm to Comply With the City of Eeyen Surcharge: ordiwaaem Misc. Charges: Total: By Dote Paid: Date of Insp.: Insp.: CITY OF EAGAN SMR SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: 1{1 No. of Units: Owner: Lundgren Bros . Address: Site Address: ? Ashbur, aC~' } Plumber: I eta to eewPyr Wkh tb Chy of Mgerr Connection Charge: ^5.0ope 0ammences. Account Deposit: ? Permit Foe: Surcharge: BY Misc. Charges: Dote of Insp.: Total: Insp.: Dab Paid: Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered waces S/C Type of Prim legibly Tot. 1. Data 2. Installation Cost 3. Job Address Lot I _ 8lk. Tract 4. Owner i i 5. Contractor Phone ' 6. Address 7. City State Zip 8. Building Type: Residential 12 Commercial ❑ Institutional ❑ 9. Work Description: New ❑ Add ❑ Alter ❑ Repair ❑ 10. Describe i Fuel Type 11. No. Equipment BTU - M. Ea. No. Equipment CFM Forced Air z P 3 Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other r~ Air Cond. Mfg. 1 Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 11. _1 13 A` PHONE: 454-8100 BUILzING PERMIT Receipt # - To be used for SY DWG/GAR Est Value $96,000 Date NOVEMBER 19 tg 85 Site Add 1573 ASHBURY PI, Erect 1~ Occupancy R3 jje s Lot 1 Block Sec/Sub. BLACKHAWK GLEN Remodel ❑ Zoning R1 Parcel No. 1ST Repair ❑ Type of Const V Addition ❑ No. Stories Name LUNDGREN BROS CONST Move O Length ;A W 935 P. WAYZATA VD Demolish ❑ Depth 26 o CdyressWAYZ ne 473-1231 Install 11 Int er" 11 Sq. Ft = o Name SAME Approvals Fees Address Assessment Permit 4 2 ' 0 0 48 . 0 0 F City Phone Water & Sew. Surcharge Police Plan Review 210.50 W Name INSPIRATIONS INC ~ Fire SAC -x'00 =Z Address 232'0 QUEENWOOD LN NO 500.00 <W city PLYMOU~;ne 559-1542 Eng. Water Conn. 63. i14, Planner Water Meter Council Road Unit ~ 00 , 1 hereby acknowledge that I have read this application and state that the. Bldg. Off. 11/19/ 8 5Tr. PI. 132.00 information is correct and agree'~to comply with, all applicable State of Minnesota Statutes and City of Cagan, Ordinances. APC Parks L- ' Var. Date Copies Signature of Permittee- - Total $2,179.50 A Building Permit is issued to: LUNDGREN BROS CONST 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 fl Plumbing rt Gt r~ i 1-~~ I LI / HN.A.C. _ Electric 7463 . r (M Softener inspection Date Insp. Comments Footings 1 r W Footings 11 Foundation Framing Rooling Rough Plbg. Rough Hill. 144.r Insul. Fireplace Final Hig. Final Plbg. Bldg. Final Cert. Oct. Deck Fig. Deck Frmg. Describe Location: Well Pr. Dlsp. PERMIT # C CITY OF EAGAN FEE y S'U PLUMBING PERMIT RECEIPT # 454-8100 SIC ' MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL -3S QU DATE S MINIMUM COMMERCIAL FEE - $20.00 + $.50 1. Bldg. Type: Res Comm Inst 2. New X Add Alter Repair 3. Total Bid Price 4. Job Address I_5_73 A4- Lott (Z~ Block / Sece~ ~A 5. Owner 6. Contractor N D (Name) (Street) (City) (Zip) 7. Contractor Phone # y 3- NO. FIXTURES NO. FIXTURES NO. FIXTURES Water Closet - $3.00 Laundry Tray - $3.00 -Well - $10.00 / Bath Tubs - $3.00 Floor Drains - $1.50 -Private Disp Syst - $10.00 Lavatory - $3.00 -Water Heater - $1.50 -Rough Openings w/o Shower - $3.00 Whirlpool - $3.00 Fixtures - $1.50 Kitchen Sink - $3.00 -,(--Gas Piping Outlets - $1.50 _ -Uririal/Bidet - $3.00 -Softener - $5.00 COMM./IND RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE. Signed: for j Approved Inspections: Date Rough Insp. Date Final Insp. ' P9RM,IT # z ~ITY OF EAGAN FEE s• MECHANICAL PERMIT SD RECEIPT # J 454- 1 S/C MINIMUM RESIDENTIA $10.00 + $.50 TOTAL ✓J DATE y I ' I S - 4 MINIMUM COMMERCIAL FEE - $20.00 + $.50 1. Bldg. Type: Res Comm Inst 2. New X, Add Alter Repair 3. Total Bid Price o~0UOp +'iU 4. Job Address 157 7? ASh b" ry Fl i c e Lot - Block Sec 5. Owner L-u;r+nGve r. 2~vo . 6. Contractor F Ir(yt Rest I t,&-i M ~•cc~CIS ~c ~t ~i (:c.ld e,, Vg IiE~vt If- (Name) y 1 (Street) (City) (Zip) 7. Contractor Phone # S T . RESIDENTIAL HEATING- 01-100,000 BTU's - $24.00. Each additional 50,000 BTU's or fraction - $6.00 RESIDENTIAL COOLING - 01-24,000 BTU's - $12.00. Each additional 6,000 BTU's or fraction - $6.00 MODIFICATIONS/ALTERATIONS -$10.00 minimum fee _ HEATING - - VENTILATING HOT WATER STEAM AIR COND. AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG. RES. GAS PIPING OUTLETS - $1.50 - TANKS: ZSL.P. UNDERGROUND OTHER U COMM./IN .RATE 1%OFJ(j70T L BID PRICE PLUS $.50 STATE SURCHA" FOR EACH $1,000 OF FEE. Signed: for && - Approved Inspections: Date1'~3~ Rough Insp Date Final Insp. I-73-5 PERMIT# - c- MECHANICAL PERMIT RECEIPT # S4722 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address s u ' BLD9. TYPE ~ WORK DESCRIPTION Lot Block Sec/Sub + a nn ¢ r3 5 C O Res. x New x m Name r Mutt Add-on k)U Linden -.1 rz Address Comm. Repair c City VN Is. 55403 42-53J/ phone Other Name ~Rpd;ren f r o s. 99nkt. FEES c Address V RES. HVAC 0-100 M BTU -$24.00 9F, 47 1 p City 8 y Z Phone - ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU , MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) Gas Piping Outlets # Other Install do^¢ FEE: S/C: SIGNATURE OF PERMITT TOTAL ' FOR: CITY OF EAGAN CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot *nob Road P. 0`8ox 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning:. No. of Units: 1 Owner: Lundgren Bros. Address: Site Address 7.5risTl-bury n ace L_,• P, B ac:.- aw.z en st Plumber: Meter No.: 24-`i , .1.. z. p c _ -~3 ion Size: r! a c Reader No.: 1 esr•e ib ee.Ply with the City a ~10 'Sur+cF,o _r BY Dots Paid: Date of Insp.: Insp.: CITY OF EAGAN Remarks D I V # 1 6 a 4 r5 Addition Blackhawk Glen 1st Lot ► 0 Rik If Parcel 10-14350-100-01 Owner Street 1573 Ashbury Place State Eagan MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1076 1986 253.48 50.70 5 STREET RESTOR. GRADING SAN SEW TRUNK 1970 6.70 25 Pd prior 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 St-nrm Spw Trk 1071 1,986 11121,91 22.19 STORM SEW TRK 732 1983 32.57 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 280.00 57658 11/19 gr, WATER CONN. 500.00 BUILDING PER. [L13110 1411 SAC PARK This request void /j Jet 4 o, a 16 months months from / le (J1p 0750371, L d l Revues Fre No. Rough-ii lnspecuon Runwred> ~R Now ill Novfy InsPec- Yes ❑No for When Ready Licensed Electrical Contractor I hereby leg uest mspecinin of above Owner electrical work installed at: Street Address, Box or Route No City ecUOn o. TownshIP Name or No. Range No. C tly ig~ Oc ant IPRI T Phone No. ewer Sup ie Address Ele- -al Con actor ICo amel Contractors License No. J o t7 Mai mg Address Contractor or Owner Making Inst. ilatmnl Auih ne d Signature n or Owner Making Insi latwnl Phone Number 6 3 33 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Gr,ggs-Midway Bldg. - Roam N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55100 UNLESS PROPER INSPECTION FEE IS Phone 16121 297-2111 ENCLOSED REQUEST FOR ELECTRICAL INSPECTION EB-00001-04 v u Sea instructions for completing this form on back of yellow copy. ME) a 75 0 3 7 -1- Below Work Covered by This Request Add y. Type of Scolding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Liyhtmg Fixtures Apt. Building Dryer Electric Heating Commercial Bldg Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Othei peci y Other (Speniyl the, Speo y thcr Other Compute Inspection Fee Below p Fee Service Entrance Size it Fee Feeders/Subfeeders n Fee c - rcuits 0 to 200 Amps 0 to 30 Amps 0 to 30 Am s Above 200 Amps, 31 to 100 Amps 31 to 100 Amps Swimming Pool Above 100Amps Above 100_Am s Transtormers Irrigation Booms Partial,'01her Fee Signs Special Inspection s Remarks TOTA E f 0 Rough-in 42 al A3-4,p~ct tha Final pec t the above pection has been de- Thisrequestvoidtomonthsfrom CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 S~ 11313 BUILDING PERMIT PHONE: 454-8100 Receiptil c / a 716 Tobeusedfor SF DWG/GAR Est value $96,000 Date NOVEMBER 19 1985 Site Address 1573 ASHBURY PL Erect 8 Occupancy R3 Lot 10 Block 1 Sec/Sub BLACKHAWK GLEN Remodel ❑ Zoning R1 Parcel No. 1ST Repair ❑ Type of Const ~1 Addition ❑ No. Stories Q Name LUNDGREN BROS CONST Move ❑ Length se E WAYZATA BLVD Demolish El Depth 26 o Address Int. Impr. El Sq. Ft Ciry WAYZATAone 473-1231 Install ❑ ¢ SAME Approvals Fees o Name $ 421.00 $ a Address Assessment Permit City Phone Water & Sew. Surcharge 4 8.00 Police Plan Review 210.50 w W Name INSPIRATIONS INC 525.00 Fire SAC Address 2320 QUEENWOOD LN NO SOO.DO ¢z PLYMOUT 559-1542 Eng. Water Conn. 63.00 R. City Bone Planner Water Meter Council Road Unit 280.00 I hereby acknowledge that l hav ead this application and state that the Bldg. Off. 11/19/8 Tr. PI. 132.00 information is correct and agre to co ply wi all applicable State of Minnesota Statutes and City o Eaga fin 6's. APC Parks Jl(,Q Var. Date Copies Signature of Perm... Total $2,179.50 A Building Permit is issued to LUNDGREN BR OS C on the express condition that all work shall be done in accordance with all apple le State of It to tatutes and Ciry of Eagan Ordinances. Building Official 11312 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY y 1 SET OF ENERGY CALCULATIONS 7-~ Cf t~ a'~o To Be Used For: z 'Paluation: Date: Site Address: /S7 dam' dd OFFICE USE ONLY Lot: I Block Sect/Sub O Erect Occupancy Remodel _ Zoning R'I Parcel 11 Repair Type of Const V Enlarge 11 of Stories Owner ~ Move Length Demolish Depth Z(o Address Grade - Sq Ft City/Zip Code a&,,5-.53V Phone APPROVALS Contractor L Assessments Permit ater/Sewer Surcharge 4& Address de Police Plan Review Z Q -2 Z Fire SAC 525, City/Zip Code Engr Water Conn S~ _ Planner Water Meter (03, Phone Y-:7 3 Council Road Unit 2W Bldg Off Parks Arch./Engr. APC Treatment P1 Variance Address o13oj~ ('/tC¢~i,LGcryyytrj/ `Jiry AV , TOTAL y. S City/Zip Code Phone N S J - /J f~v7 2CP x~~ - 084 K ~8 s ~ z-~2 a t, 44U c2_ Sz&v 2X22 _ ZCo~34' ~ 0~4 X44- ` ~~'g7'ro 15 44~ SI -SURVEYOR'S. CERTIFICATE SIENNA CORPORATION . ` • A2' 5a g2yzx \ \ N 22 63 a9 i o 1 r - / ~ 5 I / .xgZg9 ~ o GEB UP~t .J 75 SEAF~ Pfp 1 I I (Jf 62rgx . I %929.7 ~A 3 I LOT .1o w ~w o~ l q ~ ("I (v M I / w W CD 5) Q _ _ ~B Zp ~8 30.6 o N 630.9 9.5 R1 540 ` X633.6 N o PROPOSED HOUSE o 1 X N / N N ONi GAR~ `J 6zear _ 17-- 34,0 '0/20,0, x630.6 aio.9xC83o b) 630.3 .~gT oV4L 16.77_ 635.02 a ~r,rdm I N 75 8 y azs.r 1~%~t!o~ o r~ 94.90 x 630.9 0 M 6x3,5 Q'°1.9 'S3 '201Ie2r.9 HYO.Q 930.2 0 391.50 826,8 `ASHBURY _ PL AC E630_3- 'DENOTES PROPOSED SURFACE DRAINAGE SCALE: 1 INCH = 30 FEET O DENOTES IRON MONUMENT SET 0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 83o.9 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR =8Z5.2 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 8313 FEET WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot IO,Block I, BLACKHAWK GLEN 1st ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, IF ANY. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 4S,A DAY OF NovEO13eIL, 1985• SIGNED: JAMES HILL, INC. REVISED 10-04-85 TO SHOW PROPOSED BY HOUSE PoRLUNDGREH BROS. HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. 85618 (85950) 151 X25 Planners /Engineers /Surveyors FILE NO. 8200 Humboldt Avenue South FOLDER Bloomington, Mn. 55431 612-084-3029 B R osC I CTRUCTION 935 EAST WAYZATA BOULEVARD • WAYZATA, MINNESOTA 55391 • (612) 473-1231 EXTERIOR ENVELOPE AVERAGE U COMPUTATION /j Site Address cp Loth Block a- R & U Factors R U Opaque Walls dS$ Wall Framing Areas Ceiling Insulation Area ,Q a3 Ceiling Framing Area p a Rim Joist j _r Masonry Wall o ~ Windows Doors Skylights S5 1) Lower Level (Basement) Total exposed wall area Opaque 'r!a 1 Area x (U) ldood Frame Area /-Ln x (U) Rim Joist -x (U) Exposed block x (U) Windo;1 Area p x (U) ,~5= 14 i Sliding Glass Door - x (U) _ Door Area - x (U) 3 1 = - Total o~• 3 -f. LU WGREn Page 2 I CTRUCTION 935 S~935 EAST WAYZATA BOULEVARD • WAYZATA. MINNESOTA 55391 • (612) 473-1231 2) 1st or main floor Total exposed wall area /l~ g0 Opaque wall area =X (U) , a5? = a S. Wood frame area ~x (U) Rim joist Z2 -0x (U) , O` _ • ~ Window area -7- j x (U) Sliding glass door j x (U) Door area j _x (U)L = 7~ Total /O 3) 2nd floor if 2 story Total exposed wall area Opaque wall area 07x (U) , oSt' = to Wood frame area Ix (U) Window area 22--x (U) Sliding glass door x (U) 5 = Door area ` x (U) _ Total 4) Total ceiling area Wood frame area x (U) Opaque ceiling area ax (U) ,Gti = 8• Skylight , x (U) 5 Total a0, q t. LU 'D(j P, En Page 3 R S: I CTRUCTION 13 0 . 93S EAST WAYZATA BOULEVARD • WAYZATA, MINNESOTA 55391 • (612) 473-1231 Minn. U Factors Total exposed wall area x rr Minn. U Factors Total exposed ceiling area x Gyp (A) Total = ~9D• DSO Item 13a,9 + Item 2 QG,3 + Item 39.1 ~j+ Item 4,~Q,(~ = o?~i~/,G If total of Items 1 - 4 is less than Item (A), building complies with 58C 6006 (C)s w CITY OF E A G A i1I MDIV,: "M AT ME [`nmArpoOF TINmOF *t APPROVAL OF PERMIT. APPLICATION FOR PERMIT INSPECTION OF SEWER AND/OR WATER *t rr , L m ms WILL NOT BE SCHEO- SEWER AND/OR WATER CONNECTION ULED UNTIL PERMIT HAS BEEN *r APPROVED. * w w * w P ease Print 1) PROPERTY ADDRESS: /S75 .44j`p 0-n e- LEGAL DESCRIPTION: ~o¢ /p Lot Block Subdivision or Tax Parcel ID ) IF EXISTING SPRUCIU'RE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPQSED USE: (Month/Year) 0. Ca4,ERCIAL/RET&IL/0FFICE P.-l SINGLE FAMILY Q INDUSTRIAL Q R-2 DUPLEX (Tv Units) In INSTITUTIONAL/GMTRNMEM R-3 TOWNHOUSE (Three + Units) ( Units) ❑ R-4 APARTMENT/CONDOMINIUM ( Units) 2) • • • i~ NAME: vrp~j• wc4 ADDRESS: / CITY, STATE, ZIP:_ d f-ySG MLN Sr36 3 PHONE: (0 75'- 3 z eg 3) Nom:- For City Use Plumbers License: ADDRESS: 93S GN,4,y s.ef•~ Bz~ryQ, i ed CITY, STATE, ZIP:_ (i(/ ~qf Atw cT.r3 f Not recorded PHONE: 975-1-A-31 MASTER LICENSE# StaTF Initial 4) •ea s / ~ / NAME: ~w e eo t &W , C.0•m ADDRESS: 2 ti✓~ CITY, STATE, ZIP:_ Sri,/ PHONE: T73 /L3 CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER 6) • • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE - PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) 7) ® l~ 1. . 'j~~/(-f8(o -FOR -CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ /l 5 n SEWER PERMIT (INCLUDE SURCHARGE) $ $ /C S T WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ f,S ! n ACCOUNT DEPOSIT - WATER $ ~J 2 D . clZ~ $ WAC $ 7 a $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ 7 $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ / $ OTHER: $ f ~U • U $ J 7? TOTAL RECEIPT RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE: G 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date /b / / lots Site Address 157.3 /4 Sit 6 m• r ~@ c Unit # Property Owner /JQ ~h G ~ y n Telephone # (Grl) 693-191J_ Contractor 14 nq 0-1 /4 f c Street Address 111.S"3 N%ce1'~~f /4,j4 se. City 64~^su. State /Yk 0 Zip SS 3 3 ~ Telephone # ( q S:.) ? V G.- S1 0 0 Bond Expires: The Applicant is Owner Contractor Other Add-0n or alteration to existing dwelling unit $ 30.00 furnace -Additional K Replacement _ New air exchanger _ air conditioner 1G heat pump other State Surcharge $ .50 Total $ 30. br0 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 approved plan in the case of work which requires a review and approval of plans. A-rRJ( 4'Nr--~Xnc Applic nt's Printed Name Applicant's Signature 1 2579 $ 10. co 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 New Construction Requirements Remodel Reoar Requirements mice use Only _ 3 registered site surveys showng sq 8 of lot, sc, If 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) Iset of Energy Calculations for heated adddians Tree Pres Plan Redd _Y _N, 2 copies of plan showing beam & window sizes, poured found design, etc t site survey for addhons & decks Tree Pres Required -Y _ N1 set of Energy Calculations Addition- inchoate if onsde septic system On-she-Septic System'___Y__N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Jost Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form 2 9 Z Callcd 31 to - Date J / / y Construction Cost Site Address 73 Ask6 Lu~ P14ce- UnitlSte.#~, Description of Work ( J t,~'^i S l C3~^'' Q ~}SeM°"l t^' 1 S "tt""q Sys 7y-C'n/ 'y - 1 . Multi-Family Bldg _ Y N Fireplace(s) g 1 2 V, - - 1 -k Property Darner Telephone # (6S/ ) Contractor C_72-e-tf1 L-Ak s ,/(f," Address i~dsV 6lurJ14- h(L J City /'4rypk UAile1 State MAJ Zip S Sl2-4( Telephone # (R 1 z) ~c! l yvd 9 j e~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Ivtirnesota Rules 7670 Category 1 _ ]V m csota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet 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 # ( 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 NIN 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 approv tan in the case of work which requires a review and approval of plans. Applicant's Printed Name Ap t s ign t ~1~-~+ Last-_) J 4- 51)~)G 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 ExtAlt - SF ❑ 04 02-plex ❑ 10 08-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-p1ex ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 IntImprovement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair A 33 Alteration ❑ 37 Demolish Building' ❑ 43 Reroof ❑ 46 Wndows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage_Yes Ci r Valuation J Occupancy MCES System Plan Review 100% or _ 25% Census Code G/~Y Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV _ # of Bldgs Length Fire Sprinklered Type of Const Width --TT 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 _ Fool _ Ftgs _ Air/Gas Tests -Final Framing - Siding _ Stucco Lath _ Stone Lath -Brick Fireplace - R.I _Air Test -Final - Windows _ Insulation _ Retaining Wall Approved By: Z, Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA108325 Date Issued:11/30/2012 Permit Category:ePermit Site Address: 1573 Ashbury Pl Lot:10 Block: 1 Addition: Blackhawk Glen PID:10-14350-01-100 Use: Description: Sub Type:e - Water Heater Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Kris Oien 3670 Dodd Rd Eagan, mn 55123 651-365-1340 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Thomas Mercer 1573 Ashbury Pl Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature d.." ) Use BLUE or BLACK Ink i-----------------, i For Office Use I Permit -31 1 of Eajan i o I 1 I I Permit Fee: - I 3830 Pilot Knob Road 1 I 1 Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 I Staff: I I_----------------~ / 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 14)-7 -5 /'~5~ `~v~•~ 1 ~4c~. UnitM Date: Site Address: F Name: o ~t~ct~ Phone: 051- -73(j - it 7H Resident/ Owner Address / City / Zip: K) 3 ~ 1-,bv. ~ (arc - ~a Applicant is: Owner Contractor II Type of Work Description of work: w;ndaw 5 3 Construction Cost: A'07)0 Multi-Family Building: (Yes / No K Company: ~LI'lO~n~rt l (r yw r n n S Contact: tJea C!% I 'JTe C) -,e )1,)L C."C(A. City: ~.e- k,nkA Contractor Address: (Poa,~ _ T State: /n aJ Zip: 553 N 3 Phone: q%1-3,45- a.9oo d 7 3 • a ag - 5 ~+o License X_ Sl (y b,-I 5 Lead Certificate M /V,4-r- Doan -7-1 t If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: _ Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to ( conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.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 Minnesota State Building Code must be completed within 180 days of permit issuance. - i7 xst, x ~ Name Applicant's Signature Page 1 of 3 7 Y Use BLUE or BLACK Ink q,y "•'��/C i ForOfficeUse ---------� ` '"��'' ,t v � ' �a��9 ' C1Ly of 1Ca�� ; Permit#: �� JUN 2 4 2014 ' c.t � �D •� ' r � Permit Fee; � 3830 Pilot Knob Road � Eagan MN 55122 BY: I Date Received: ��'�� Phone: (651)675-5675 � �,,�/f � Staff: /% � Fax: (651)675-5694 � � I _��_��__�__J 201 `RESIDENTIAL PLl11V�BING PERMIT APPLICATION � 3 � � � Date: — � Site Address: —� Tenant: �` Suite#: �` �a+�� '��,,�a��e ��; a a 'v�?,Sr`i��++�s�s� y„�� / [� '� ��"��" ` � Name: � '1 �/l Phone: � ' �tes��n�/�Owr�'e'��" ! �v�-- " �'-�' �i r '�E�`� � l`/ �1� �../v�- +��:fk s`��_ � �� Ai+dragg/��;ty!Z;p: 7' !/�� * � ��'�� 'F� Milbert Company Inc dba Culiig Water r � `"�'�� r�� WC643176 f��""� � �� Name: ucense#: �� '� �'� ��z 180150t Street East ,� �� hv� tt � `� ' Aaaress: c;ty: Inver Grove Hgts. ��ontractor A � ��' �� a� � 55077 651-451-2241 � �4�TM��"��; � � state:. �M N zip: Phone: '�,��,�°'k�� , � ' .�!`�"�� .t �� 1�h . . �;�� ;�ss� t,.a�� ' Contact: wI��I�t11� R�'MI�EJe1't EmaiL• � 4 - $ ,l� k � ��`��, a � . . . ��r�*3��9�b��`%Y �� . . . . . . " _Mew _�eplacement _Repair _Rebuild _Modify Space Work in R.O.W. ', r�TYpe of�Wo �� — ��si� �r ��4 �"y.. . . � h� i �, "��,�4 . �� °� �! Descrtption ofwork: � � � � ra � ��F�.,�k�' ,"��'��` RESIDENTIAL ��^� �� , � . � � 'e�,> � ��p��s� Wafer Heater �?��'��s.,�� Water Softener� 1 �� ' r�� '+ Lawn Irrigation(_RPZ/_PVB) �'"��PermitkzT�yp�ri � �f' �- � � Add Plumbin Fixtures � � ;��t x>��. �'�`�� •: Se tic S stem 9 �Main/_Lower Level) , ,� �� a �, � � p Y � '��X�;� "�� r �" e � WaterTumaround ��a° � ' z �`�' �: New � ��'e��•'��'"��: �_ -- � � r�� ,,��4;.� � � . Abandonment RESIDENTIAL FEES: ' ' $60.OD Wefer Heater,;Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) � $60:00 Cawn'Jrridation(�ncludes$5.QQ minim�im StatQ c��mhamp! $60.00 Add Plumbing Fixtures; Septic Svstem Abandonment,Water Tumaround*(includes$5.00 State Surcharge) , "Water Turnaround(add$200.00 if a 5/8"meter is required) $115 00 Septic Svstem New($1�.00 per as built)(includes County fee and$5.00 State Surcharge) �(�(� TOTAL FEES S � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. , Call.48 hQUrs before you intend to dig to receive'locates of underground utilities. vwvw.4opherstateonecall.or4 • I hereby acknowiedge fhat this informa:ion is complete and accurate;that the work will be in conformance with the ordinances and codes of the City oi Eagan; thaY 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 wlll be In , accordance with.t e approved pla 'n the case of work which requires a review and approval of plan l� � X / � .� �— �� y � ��'1� � � x Applicant's Printed Name ApplicanYs Signature 3 §�� `f�'� `'f 9 Y yN4 'i+� . . . � �� .��z �° � �� , ��!� �9��Pb��,}f�°M r r'�'. �F(?R�O Fi�� US �Z � � � ��+,�.�,"��,,�i�R"+�'`r , � � ,: ��,�p,,x,7..," r�,�. a# .�@ � . � 6 � � 9 a, �a.tBY^'�u�P��.. rl ii �c �R e q u i r e d I r� p e C�� r 'n r o y '� rj es ��,. � � �' ��'��>� b � � E , '� � { .. �' �. '�� i �G. r ��• L� I'�i . ��Meter ela ecl�it te��i� , a_:�" fi �� 3� >,f,.,:w ., ,k��,. ��,� � �r,� � � � �..,.. �.�,>� Use BLUE or BLACK Ink r For Office Use 46. City Of nn�nn Permit#:11+JQ Q111 Perm /Ill(,° 1 it Fee: /05 a� 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: / Unit#: Name: f d/'i.�f S 't�' ��u7'�'Le�/� �C.v'CP�- Phone: �.�,, �d.,�_�_ Resident/ I 4-s44_0,--7 /� (.4_9 Oowner Address/City/Zip: 157 3 ° I , Applicant is: Owner Contractor Description of work:ky`d O Type of Work Construction Cost: 5O0 0 Multi Family Building: (Yes /No ) Company.,.. „- clP.a". r oe,g_T o' Cont ct: (J' Ie /fri Contractor 3 Address: ( %ZZ � J c_f c �i'' City: 1/110/ / 11-C State: v/`// Zip: s5`i3 Phone: 6/2'WV '9 I Email: (J"etc°C:_C h 1�keef-cor&As• License#: £CSq D SGl c 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: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.00pherstateonecall.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 Minnesota State Buildin• ode must be completed within 180 days of permit issuance. p `` x (eele /cs7ei. x,/fi Applicant's Printed Name Applicant's Signature Page 1 of 3