4385 Bear Path Tr
Use BLUE or BLACK Ink
r I
For Office Use
I I
~ Permit#: ~ O I
City of Ea
Ea~ I . I Permit Fee: Gs a C)
3830 Pilot Knob Road
Eagan MN 55122 C~ ` J~Cv
I Date Received: Phone: (651) 675-5675 ✓ I I
Staff:
Fax: (651) 675-5694 L - -
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: Site Address: ~ 3 8S Tenant: Suite
RESIDENT / OWNER Name: h 2 , O A ¢ e-' o VIN Phone:
Address / City / Zip:
it Name: License 0 $ S ! S
CONTRACTOR Address: Hessian Plumbing SprWce%I 1f!r City:
State: 7Et : I? O. Box 22172 2Phone:
Contact: ~ ; X e g c b, -h- Email: y~-, 1(e G h c f ! / a Y, ,9 /h r•.
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
Pe
Description of work: -re
p -
DESCRIPTION
FEES
$55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ S• a G
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeacian.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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.goi)herstateonecall.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 On work will be in accordance with the approved plan in the case of work which requires a review and approval of plans.
x /nI )P, v1 i '1 x z2z~ J3.-I
Applicant's Printed Name Ap icant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In -Final
CITY 14FEAGAN WATER SERVICE -P"MIT
3795 ~ilat Knob Road PERMIT NO.:
EaSpine MN 55122 DATE:. ~ E
Zoning: No. of Units: i -
Owner:
Address: w
Site Address:
Plumber: -
Meter No.: Connection Charge
Size: Account :Deposit:
Reader No.: Permit _Fee:
1 agree to oomPly with the City of Eagan Surchorge,
Ordinances. Mist: Chorges:
Total:
BY Dote Paid: _
Dai of Insp
clry" EAGAN SEWER SERVICE PERM
3: ilot Knob Road PERMIT NO,:
Ea , MN 55122 DATE: r I
Zoning: No. of Units: Y
Owner:
Address:
Site Address: , 1 -
Plumber
- ~t
i agree to comply with the City of Eagan Connection Chargw:
Ordinances. Account Deposit:,
Per"t t=ee: t
Surcharge: r,, F
By Miscr Charges,-
Date of Insp.: v Totalt
I nsp~ tote Poid:
This_bequest void
18 months from,
Date oft equest Fire No.
I, as d Electrical Contractor O Owner, do hereby request inspection of the above electri-
cal wiring installed at:
a
Street Address or Route No. 4,1 S' 9ity
Section Township, Range County
Which is occupied b r, )01 i r l ` Ne,i~_tl
(Name of Occupant)
Is a roughin inspection required on this job? No ❑ Yes ❑ Ready Now 0 Will Call 0
Power Supplier Address
'a 11 tElectrical Contractor Contractor's License .
(Compa ame) _
Mailing Address 62 X-~
(Electrical Co actor o ;t?er Making This inst llation)
Authorized Signature ~ 6CC Phone No.
(Electrical Contractor or wner aking This Installation)
This inspection request will not be accepted by the
3 State Board unless proper inspection fee is enclosed.
Minnesota State Board of Electricity
Griggs Midway Bldg. - Room N191 EB-00001-02
'w~-2A4, University Ave., . Paul. Minn. 55104 - Phone 297 "11
%
AMUEST FORtELECTRICAL INSPECTION-2111 7 4
CHECK BELOW WORK COVERED BY THIS REQUEST 9 5 2 8 5
Type of Building New A4dd. Rep. Check Appliances Wired For Check Equipment Wired For
Home ❑ ❑ Range ❑ Temporary Wiring ❑
Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑
Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑
Commercial Bldg. ❑ ❑ ❑ Furnace ❑ Silo Unloader ❑
Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑
Farm ❑ ❑ ❑ List List
Others ethers
Other ❑ ❑ ❑ Here Here
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders& Sub feeders: # Fee Circuits: # Fee
0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes
dpi
101 to 200 Amps. 81 to 100 Amperes 31 to 100 Amperes
Above 200 Amps. p.v Above 100 Amps. Above 100 Amps.
Transformers Remote Control Circ. Partial or other fee
Signs Special Inspection Minimum fee
Remarks
TOTAL F ,34AV
I, the Eat r,pecr,by certify that the above inspection has been
(Rough, Bate 3SD
uest void
ro - -
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N? 6472
PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt #S
To be used for SF DWG/GAR Est. Value 45 , 000 Date 12-22 g 19
Site Address 43$5 Bear Path Tr. Erect Occupancy R3
Lot 100 Block 1 Sec/Sub. Meadowlands Alter ❑ Zoning Rl
Parcel # 10 4$050 100 01 Repair ❑ Fire Zone 3
Enlarge ❑ Type of Const. V
W Name John B. Mahoney Move ❑ # Stories
z Address Rt. 1, BOX 239 Demolish ❑ Front 52= ft.
0
C; Prior Lake ,tV Phone 447-3360 Grade ❑ Depth 39 ft.
W Name Approvals Fees
~0 Q Address same ASS@ssrWt 12-19-8 0 Permit 12$.00
W Water & Sew. Surcharge 22.50
city Phone
Police Plan check 64.00
W W Name Fire SAC 525.00
Address Eng. Water Conn305.00
aW City Phone Planner Water Meter 60.00
Council Road Unit 1$5.00
1 hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable APC Total 1 2$9.50
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: John B. Mahoney on the express condition that
all work shall be done in accordance with a licobleat of Minnesot Statutes nd City of Eagan Ordinances.
Building Official PP `//Z tY
'NNW
3 Y Y at ~ ~r ► Y y a
~Y,i ~Of ~ t L r r L,IS ~ ~1+\`~!^' 1 JhS ,F\% ~.~P\111+_.: rt~\/•S'.: al\,/M ~ 4T/ !
.4a,''7(:.~+~_ ,?S6r'~ i.c~ L .t ra!'r ~_IAr~.r~ '~•'Lf~a.Y~L}Si .;.".~1 4L\
%
~itp of (Eagan
Drpartmrnt of Bnilbing 3noiarrtion
( IF`
s' This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
e Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following: j
> t
SF DG/GAR 6472 I
Use Classifi.,i Bldg. Permit No. j .
Y
R3 3
* L OC<:U C on Fire Zon~...,~ Zq rsIt
i P-y Type -~UU 5-n a aw Rt 1 !"OX o ' ~3`~ t
~ Or Lam
Owner of Building - Address
Building Andreas 4385 Bear Path Tr Locality U001B1, t wlands
By:
z '
z 3-16--81
rX Building Official Date:
~1. POST IN A CONSPICUOUS PLACE +
Yet <J
J
N..: rIO y 'III~N~ orrm tcfr~et tf/.{~~~y:~ !W y. tQS11'' S /~Kt ° rpj•'
~'1~.R ~ .;!Q+` r5 s _ ^ •s '$IC?•sr' wt7ts.'~' .6+ICa :~:a~`' v
LITHOIN U.S.A.
1- C TY OF EAGAN Remarks
Addition Meadowiand 1St Addition Lot 100 Blk 1 Parcel 10 48050 100 01
Owner-('';> Street 4385 Bear Path Trail State Eagan, PAN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR,I mp. 1431.00 AO 00 4-1-81
SAN SEW TRUNK 77.95 3.12 25 40.63 A01005 4-1-81
• SEWER LATERAL 315658 -3-353.65 22840.93 A010051 4-1-81
WATERMAIN
* WATER LATERAL
WATER AREA i 1973 95.27 6.35 15 8 .12 A010051 4-1-81
STORM SEW TRK f- 1971 282.92 14.15 20 127.38 A010051 4-1-81
* STORM SEW LAT 1981 10 1
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road
WATER CONN. 305.00 22522
BUILDING PER. 647
SAC S 00
PARK
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 9 4 3
10/09/97
i
612 681-4675 Date Issued:
SITE ADDRESS:
4385 BEAR PATH TR
LOT: 10 BLOCK: 1
MEADOWLANDS 1ST
P.I.N.: 10-48050-100-01
DESCRIPTION:
(ROOFING)
Building Permit Type SF (MISC.)
Building Work Type REPAIR
Census Code 434 ALT. RESIDENTIAL
REMARKS:
FEE SUMMARY:
VALUATION $3,000
Base Fee $74.75
Surcharge 1.50
Total Fee $76.25
I
Applicant - ST. LIC
CONTRACTOR: OWNER:
DAKOTA ROOFING 16869418 2003641 CANNON HARRY
2105 EGAN AVE 4385 BEAR PATH TR
EAGAN MN 55121 EAGAN MN 55122
(612) 686-9418 (612)686-9418
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
I,
Statutes and City of Eagan Ordinances
LL
APPLICANT/PERMITEE SIGNATURE ISSUED B`. SIGNATURE
997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
30445 f
3830 PILOT KNOB RD • 55122
681-4675
New Construction Reouirements Remodel/Repair Reouirements
3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan if lot platted after 7/1/93
required: _ Yes _ No
DATE: 40 x/97 CONSTRUCTION COST: f'
DESCRIPTION OF WORK: foo~-e)
STREET ADDRESS: g 5 L, PA t Y= Lam-
LOT BLOCK_ SUBD./P.I.D.
PROPERTY Name: C0V71-n on Phone* 6ggv
OWNER l
usT FlRST
Street Address: s Aerxj- Pa,41
City: Stater Zip: CONTRACTOR Company: 0 a~~~U Phone 9y l
Street Address: ~d s Hti~ tce?l e
City: 0"n State:" Zip: s5/' I
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licerned plumber (new construction only): Penalty applies when address change
and lot change are equested once permit is issued.
I hereby acknowledge that I have read this application and state that the informatiolic r ect and a ee to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
❑ 05 SF Misc. ❑ 10 _-plex ❑ 15 Deck
WORK TYPE
❑ 31 New ❑ 33 Alterations ❑ 36 Move
❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ d~ oC
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC 0 J
SAC Units
PERMIT
CITY -OF EAGAN (11 3131 W
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 8 5 5
(612) 681-4675 Date Issued: 06/19/95
SITE ADDRESS:
4385 BEAR PATH TR
LOT: 10 BLOCK: 1
MEADOWLANDS 1ST
P.I.N.: 10-48050-100-01
DESCRIPTION:
(INCL DECK)
Building Permit Type SF PORCH
Building Work Type NEW
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
FEE SUMMARY:
VALUATION $7,000
Base Fee $124.75
Surcharge _ $3.50
Total Fee $128.25
CONTRACTOR: - Applicant - ST. LIC. OWNER:
GRIST CONST INC 14556793 0004099 CANNON HARRY
6875 ATHENA WAY 4385 BEAR PATH TR
INVER GROVE HTS MN 55077 EAGAN MN
(612) 455-6793
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
L Statutes and City of Eagan Ordinances.
EA
APPLICANT/PERMITEE SIGNATURE ISSUED 81: SIGNATURE INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: BUILDING
3830 Pilot Knob Road Permit Number: 0 2 5 8 5 5
Eagan, Minnesota 55122-1897 Date Issued: 06/19/95
(612) 681-4675
SITE ADDRESS: P . I . N 10-48050-100-01 APPLICANT:
LOT: 10 BLOCK: 1
4385 BEAR PATH TR CRIST CONST INC
MEADOWLANDS 1ST (612) 455-6793
PERMIT SUBTYPE: TYPE OF WORK:
SF PORCH NEW
DESCRIPTION (INCL DECK)
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR.
FOOTINGS FINAL
REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
I
CITY OF EAGAN 12~
3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
' 881-4875
* 3 rimed she surveys ♦ 2 coifs of pW
♦ 2 copies of Pans (ftlude beam & wkdow sum; Poured Md. design, eta) ♦ 2 sNe surveys (ems addftm & edw)
I energy coloAftris t erwa caakuleftns for huW addlOws
♦ 3 co0w of bee preservedon plan N bt platted after 711!93
wpdred: _,Yes No
q 5-
BATE:
CONSTRUCTI COST;
n AA
DESCRIPTION OF WORK: oal
STREET ADDRESS: 3 ~J l
LOT BLOCK„ SUBD./P.I.D.
PROPERTY Name: Phone
OWNER L"T
f 5- 8g&gj2A -N. i L
Street Address,
City: 0 P'r'f State: zip. - 1b CONTRACTOR Company: r ► :~?-T C02 ~ Phone
Street Address: License
City:~SU.e State: Zip. `77 -A AV; ARCHITECT/ Company: Phone
ENGINEER
Name: Registration
Street Address*
City: State: Zip:
Sewer & water licensed plumber. Penalty applies when address change and lot
change are requested otoe permit is issued.
I hereby aoknowiedge that I have read this application and state that the ' is corript and agrA to Comply with all
qpplioabte State of Minnesota Statutes and City of Eagan Ordinances. '
Signature of Applicant:
OFFICE USE ONLY RECEWED
Certificates of Survey Received Yes No JUN 0 8 1995
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
a 01 Foundation a 08 Duplex o 11 Apt./Lodging a 16 Basement Finish
a 02 SF Dwelling o 07 4-piex a 12 Multi Repair/Rem. a 17 Swim Pool
a 03 SF Addition o 08 8-plex a 13 GaragefAcomory o 20 Pubes Facilityr
Cp-,'04 SF Porch b 09 12-plex • o 14 Fireplace a 21 Ilaneous
a 05 SF Misc. a 10 -plex X15 Deck
WORK TYPE
Rs iAcl", rof"4A I -
A( 31 New a 33 Alterations a 36 Move
a 32 Addition a 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCNYS System ~.._._..r._
(Allowable) Main level sq. ft. City wow
USC Occupancy sq. ft. Fire Spri Wered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. Utz
Depth Footprint sq. ft.SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Corm.
Water Meter -N
Aect. Deposit
SNV Permit y l Z'
j SM Surcharge / X t l Z o-d sc~-
Treatment Pl.
Road Unit/ Z 4yd
Park Dad.
Trails Dad.
Other
Copies
Total:
% SAC
SAC Units
SALES REPRESENTATIVE
npe Mse-
STEVE SHEROD ;
5084 GRAFTON AVENUE RESIDENCE
OAKDALE, MN 55109 (612) 770-6183
ws•c,~~a~~ nos Come home to quality. . OFFICE
Come home to Andersen. (612) 439-5150
Q
DATE 41 JOB 3 C_.'
l
<Zj
y ~
75
a
ANDERSEN@ PERMA-SHIELD® WINDOWS & GLIDING DOORS FOR COMMERCIAL & INSTITUTIONAL: USE
CITY OF EAGAN Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set of energy calculations.
Be Used r t valuation ~ Date
Site Address 5~S/ti,, C u OFFICE USE ONLY
Lot e, , Block Sec./Sub. Erect Occupancy
'l
Parcel T Alter Zoning
Repair Fire Zone
Owner: Enlarge Type of Const. y~
Move # Stories
Address/ l ~~,':3f Demolish Front ft.
City/Zip Code: Grade Depth 3 ft.
Phone 3 3 ~r
APPROVALS FEES
Contractor: Assessments ermit > 2 S. d
Water/Sewer urcharge 2 2,re
Address: Police Plan Check G y, C.8
City/Zip Code: Fire SAC S247.06
Phone Eng. Water Conn. .30S.00
Planner Water Meter 60,60
Council Road Unit
.
Bldg. Bldg. Off.
Address : APC
City/Zip Code:
TOTAL -
Phone
9Z
DELMAR H. SCHWANZ
LAND SUAVE VOA
R.prstua Under Laws of 7M Stat* of Minnesota
2975 - 145TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 56066 PHONE 612 423-1169
SURVEYOR'S CERTIFICATE
g9° t9 te` W IZ1.99 (3 J
M - Its L j
G n~
t1l ► ( Z t j
/ d
v,
AL -j
~Tr
I C
►J H9' t9' 16, w 1-tt. gq v
Ihereby certify that this is a true and correct Scale
representation of Lot 100, Block 1, ME-ADOWLAND FIRST
ADDITION, according to the recorded plat thereof, Dal4ta County,
Minnesota.
Dated: June 18, 1980
Approved for Dunn 8e Curry Real Estate Management, Inc
AIM-
by
AML
rJu~ w "
1' I
S10
16r 01. ,
• o
i
'Otr
tiAtNNE5 _4T^ REGISTRATION NO 6625
Iyinn ~5c Curry
sDELMAR H. SCHWANZ
LAND SURVEYOR
Registered Under Laws of The State of Minnesota
2978-- 145TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 612 423-1769
SURVEYOR'S CERTIFICATE ~G
15
0 p
10
IT 16" w 111.99 0
T hereby certify that this is a -true and correct
representation of Lot 10,02 Block 1, M! ADCwLAND FIRST
ADDITION, according to the recorded plat thereof, Dakta Cc>unty,
Minnesota.
Dated June 18, 1980
Approved for Duran Curry Real Estate Management, Inc.
by
r-
~s 1 l
MINNESOTA REGISTRATION 40 6626
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pers et~id l~ x en'' he,~h e `
For Office Use I
an I 1
Cit of Ea ~ jl j Permit 173 __3 I
I I
I Permit Fee: , e I
1
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff:
1 1
- - - - - - - - - - - - - - - - - J
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: rid L / 7 -0 9 Site Address: 2, k~
Tenant: Suite
RESIDENT/ OWNER Name: Phone:
Address / City / Zip. 4395
Applicant is: Owner Contractor
TYPE OF WORK Description of work: cL ~ 1 4
Construction Cost: Multi-Family Building: (Yes / No 24~1
CONTRACTOR Name: 1 LC4icense 45
Address:
City: V_ State: /I~ Zip: X15 01"7Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • 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?
-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.
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 1 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 pr I of plans.
s
App cant's Printed ame Applicant's Sig u
Page 1 of 3
r
r________.________ i
i~
f I For Office Use
City of Permit I ~
I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
- - - - - - - - - - - - - - - -
Date: I '0 Site Address: O J' t
Tenant: Suite
RESIDENT / OWNER Name: uvtilt~ Phone: to,, - poo - 1009 ;;L--
Address /City ' DAA -
Applicant is: /`Owner Contractor
TYPE OF WORK Description of work: fle,
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: License A OS$ 3 Z 7 Y
Address: O~ dA.
City: w State: ftl 1J Zip: 7L
Phone: 1051 3 6 5 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • 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?
_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 maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that the 'are trade secrets.
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 rk 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 appr al f plans.
X ►,QjT x
Applicant's Printed me Applicant's Sig cl` ure
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
❑ Foundation ❑ 05-plex ❑ 16-plex ❑ Accessory Building ❑ Pool
❑ Single Family ❑ 06-plex ❑ Fireplace ❑ Porch (3-season) ❑ Ext. Alt. - Multi
❑ 01 of - Plex ❑ 07-plex ❑ Garage ❑ Porch (4-season) ❑ Ext. Alt. - SF
❑ 02-Plex ❑ 08-plex ❑ Deck ❑ Porch (screen/gazebo/pergola) ❑ Multi Misc.
❑ 03-Plex ❑ 10-plex ❑ Lower Level ❑ Storm Damage
❑ 04-Plex ❑ 12-plex ❑ Miscellaneous
WORK TYPES
❑ New ❑ Interior Improvement ❑ Siding ❑ Demolish Building*
❑ Addition ❑ Move Building ❑ Reroof ❑ Demolish Interior
❑ Alteration ❑ Fire Repair ❑ Windows ❑ Demolish Foundation
❑ Replacement ❑ Egress Window ❑ Water Damage
Demolition (entire building) - give PCA handout to applicant
DESCRIPTION:
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%100% ) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
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: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Pireplace: _R.I. _AirTest -Final Windows
Insulation Retaining Wall
Reviewed By: , Building Inspector
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Page 2of3
}
C ITY '01:7, EAC: V
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I~NI"l1 I)AKOTA RGlQF**.:NIG INC,
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21"55 9001 4.'3 5 . BEAR PATH, 50
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crTy oF, EAGAN PERWT TYPE; 80
:3=1 Pilot Knob Road Permit Number: 0
Eagan, Minnesota 55122-1897 p,
(612} 681-4675
ESS: t APPLICANT:
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Crr*f OF EAGAN PERMIT TYPE: .a 041
W Pi{bt Knob Road Permit Number: t /
Egan„ Minnesota 55122-1897 Date Issued:
(612) 681-4675.
ADDRESS: t: Al F to t, c r t I APPLICANT:
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C ' CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 Np 6472
PHONE: 454-8100
BUILDING PERMIT Receipt #
Ta be used far , T ! 0~( t1s Est. Value Date 19 '
Site Address ' ?t'i t2'• Erect Qc Occupancy
Lot Block Sec/Sub. Alter ❑ Zoning
n
l # ~ 1, 1f70 01 Repair ❑ Fire Zone
Enlarge ❑ Type of Const.
w Name Jahn 7 ' `ahone y
Move ❑ # Stories
2?
3 Address U. , c Demolish ❑ Front ft.
o City T v P °e , ~ Phone 4,47-3360 Grade ❑ Depth ft,
W Name Approvals Fees
8V Address -f . Assessrt2rt Permit '
f' city Phone Water & Sew. Surcharge
Police Pion check
a Name
Fire SAC
Address Eng. Water Conn,
city Phone Planner Water Meter ` •
Council Road Unit
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable APC Total "I
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
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.
Ouilding Official /
Pere4lt # Date Issued Penn#tee
Plumbing .2.2,30 ?-,2G - e
Mechanical. 35,3
INSPECTIONS DATE INSP. Rough-in Final
Footings Date + Imp Date Insp.,
Pjumbjjf ~ r
F
C rome/ins. Mechanical
Final _ r
f.
Remarks:
f
• CITY OF EAGAN
3745 Pilot Knob Road
No Eagan, Minnesota 55122 INSPECTOR NOTIFICATION
Phone: 454-8100 REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
_Zz;°~'l ?
Dates Receipt No.:
Single
Site Address; Residential
tot("() Black Sub/Sec. iE3i'C'C4J~r2t:S Multi Res., Comm./Ind.
Name New/Alter./Repair. Address ~kf-• r Cost of Installation
City, Phone: 447-3360 Permit Fee r,
NameL F T-i.t t s
l ~ - Surcharge
Address
City T10sE2"amt Phone: 4 Total 1
This Permit is issued 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
CITY OF EAGAN
3795 Pilot Knob Road
NoEagan, Minnesota 55122 INSPECTOR NOTIFICATION
Phone: 454-8100 REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
Dote: 2()---Q,l Receipt No.: 23r 26
Single
43 'S l°?x Path 11t r
Site Address: Residential
Lot Block Sub/Sec.=`~Clls2~ Multi Res., Comm./Ind.
Name
New/Alter./Repair
Address 1r = rt39 Cost of Installation
City Prior IAI-.r Phone: 447-33f-,Ci ~ 20.00
Permit Fee
Name ar tori lTea - i 7 Surcharge • 50
Address
i Prior lake ?0.50
City Phone. Total
This Permit is issued on the express condition that all work shall be done in accordance with oil applicable State of
pp' Minnesota Statutes and City of Eagan Ordinances.
f
Building Official
Use BLUE or BLACK Ink
r
For I Office Use
2 ~3
a 4`. Permit ! 3 ! I
City of Ealian as
I Permit Fee: 105,
3830 Pilot Knob Road I c I
Eagan MN 55122 Date Received: 0
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: M113 Site Address: Unit
Name: Phone: (!s I 0!~Q
Resident/ h
Owner Address/ City/Zip: `1 3565 6LA
'i Applicant is: Owner Contractor
.
Description of work: LT
Type of Work
Construction Cost: Multi-Family Building: (Yes / No
Company: ~~Contact: i-- _ a lL2_ (a 3Q%3
~~--ksS
q/~C
Contractor Address: City:
State: M,&J Zip: -Phone: c~l dQ Lf s1
License C_IC a,5 Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I
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
da s of pe~r/mit issuance.
x '``a M - - k~'
Applicant's Printed Name Applica Vs Si
Page 1 of 3