3679 Cardinal Wayi, ---' CITY OF EAGAN
? 3830 Pilot Knob Raad
, Eagan, Minnesota 55122-1897
(612) 681-4675
SITEADDRESS• :?.VI- qrw?d•,:? - V;." u?, t:t I
• L $:a -r - Lz x t,.I I . + f, f: rltfNA! bl A Y
? Ic- h ?f4 f! I iir4 F''I F6C f: `.-.0 k) f ti s" N D
? PERMIT SUBTYPE:
: r ?.oi
N RECORD
PERMIT TYPE:
? Permit Number:
Date Issued:
;cis a I, I? j f4f,
433 t :.1.i°t
! _:r J' C) a I
1.?F r?taa;??.?
'4 "i 7 4
TYPE OF WORK:
n c f f PA'r I Ora
i t?!!! C (3 F f] I14 tj f.! Ni 3
INSPECTION
, , . DATE INSPTR. INSPECTION TYPE
?. DA
I k.'NAFt?I;: q`.-;F" N`A #+s? -r v i, E:p m I'? 114 $ p1Ul; " I°C) r, {SR l1NJ Y i :I FkiNitiaJ,ptfib tl#? V- 1f A ".Ckr'if'.Ttt W UE?14'
Permit No. Permlt Holder Date Telephona #
ELECTRIC
PLUMBING
HVAC
?nspectlon Date Insp. Comments
FOOTI NGS
FpUND
FRAMING
ROOFING
AOUGH
PL.UMBING
'
PLBG
AIR TEST
AdUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIfiEPLACE
FIREPLACE
AIR TEST I
FINAL PLBG '
FINAL HTG
ORSAT
TEST
BLDG FINAL I
BSMT R.I. ?
6SMT FINAL
DECK FTG
DECK FINAL
CtTY OF EAGAN 1NATER SERVICE PERMIL
3830 Pilot Knob Road
P. U. Box 21199 PERMIT NO.:
Eagan, KiiV 55121 DATE:
Zpnir?9: . T, •? Na. af Units:
?. .?:; •
OYYfIQr: ,
1,?;.?_:tJL•3iast '
Add1'CSS:
Site Address: `l79 CarG3.n.`?'?A. T-fav l+L: 1°1 _xc`•x9.4:"ton 111. JcF
Ptumber: .:t.lk> .ya•:z?,1:: :a? r -.T,-.?-:?,: '? -
Meter Na.: Cannection Char9e:
.NZe: /-NrCOunt VcpOSit.
Reader IVo.• Permit Fee.
.
I a4no to comFh wNh !he City of Eagnn Surcharge:
, Drdinenow Mtsc. Chorges: ?"'=',()()nd TP
Totol•
BY Dnte Paid:
Date of I nsp.:
Insp.. ,
CITY aF EAGAN SEINER SERVICE PERMIT
3830 Pilot Knob Road -
P. O. Box 21199 PERMIT NQ.:
Eagan, IfAN 55121 DATE:
ZFnirg: ?-` No. of Unita:
Ownar. ?'Tgtt?"'Z.FL' "?s15ae.3f it? ?: r
Addrcss: .-
, :..,
Site Address: ?j :« L:
Plumber: Sta7:'
I pne ft ases* wiM !IN Cilp oF fegow Connectlon Charpe: `+'' '. fi(;tzd
ddilwseee. Acmunt Deposit: 151,. 00 P&
Pennit Fee:
Surchorgs:
By Misc. Clwrpes:
Date of Insp.: Totoi:
Ir?sD.: Dote Poid:
CITIf QF EAGAN
3830 pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N ?
r -
PHONE: 454-8100
? BUlLDING PERMIT Receipt# `
$ 56 nn0 JULY 23
To be used ior Est. Value + oate
iteAdoress ???? CARDYNAL WAY Erect E* Occupancy R3
at 2 Block - I Gec/Sub. LEKINGTOI? PL Remodel ? Zoning PD
srcel No. SO 2j+j,j] Repair ? Type of Const. ?*+
Addition ? No. Stories
Name °-??ET VERNON Move ? Length +? a
W 2a49 90 ?+EXINGTO1a aemolish ? Depth ??
o ?4ddress
E ? ? ??????7? Int. Impr. ? Sq. Ft
City Phone install ?
, o Name FRaNTIER H4VIE+'? ING A pprova ls Fe
;? Address 3908 SIBLEx I?Ei'C3RIAL AWY Assessment Permit
? City ??GAM Phone 452"`0433 Water & Sew. Surcharge
¢ Police Plan Revie
i W Name Fire SAC
? Z
? Address
E
W
t
C
z ng, a
er
on
Coun
I hereby acknowledge that I have read this applicatian and state thatthe gldg.
information is correct and agree to comply with all applicable State of
Minnesota 5tatutes and City of Eagan Ordinances. APC_
Var. .r [
? Signature of Permittee • '? '?` °
< '"'?...a.......
?'RO?ITIER HOMES ZNC
Building Official
23 8 To
Pai
. Co
To1
on the ?
f1d:City of Eagan Ordi
, : ?_..5? , .. .. ?.. _. ?.
?
5?'4
- ?
86
$ 3Q1.Qt'x:
2$.U0'
w ?.5U.5U
575.00
n. 500.00
Meter 0.3 '-D;j
Jnit 290.00
la6.0t7
' . , 064 * 00
ess condition that
ces.
PermR No. Permll Nolder Date Talephone #
, x
I Plumbing
`;){p I
, H.V.,4.C.
lectdc
Sottener
Inspecdon Date Inap. Comments
Footinge I
Footings II
Foundation
Framing ?-?? 04
Roofing
Rough Plbq. )
141
Rough Hty. ?
Inaul. ?
Flreplace
Final Htg.
Final PI69•
Bldg. Final l?v?rg
Cart. Ucc.
Deck Ftg.
Deek Frmg.
weil DeaeH6e Locatlon:
Pr. Disp.
. . - , , • a , ,s ' ,' PERMI?.#
?' * • + MECHANICAL PERMIT RECEIRT #
CIN OF EAGAN -
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: $"?'???
CONTRACTPRIGE $1500.00 PHONE:454-8100
5ite Address
Lot 1
Block
? Name WE
°-'
?
Address
36
C
;i.
CI?I
?ii
Name Fr
39
c Address
?1
y 1
:?4
O ,
;
? ?y .
TYPE OF WORK
Forced Air
Heater ` -- -
? Air Cond.
Vent.
' Gas Piping Outlets #
Other
iat way gLpG
TYPE WORK DESCRIPTION
- Sec/Su6?_? .
(;
R i'.A
N
-IAIv I GAL es.
M
l ew
Add
3ec Uriv? u
t
C -on
i
omm. r
Repa
Phone 452-15Ei5 Other
Phone
FEES
RES. HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
ADD-ON AIR CONI]. 0-24 BTU
ADDITIONAL 6 M BTU
GAS OUTLETS
COMM/iND FEE - 1% OF CONT
MINIMUM - RESIDENTIAL FEE
- $24.00
- 6.00
- 12.00
- 6.00
- 1.50 EA.
FEE
- 10.00
- 20.00
_-
?$,009n sru
M BTU
= M BTFJ
M BTU
CFM
FEE:
S/C:
TOTAL•
I S/C 1F PERMIT PRICE GOE
$1,000.00)
?5.5U
.50 SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN •
, PLUM8ING PERMIT
CIT1f OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
Site Addre?s
? Lot ?`? Block
m Name
?o Addre
c Ciry 4?
? Name
c Addre
3 ?-
p Cit ""
PERMIT # -
RECEIPT # -
DATE: C=I ?
BLDG. TYPE WORK DESCRIPTION
? Res. New k
Mult Add-on
77Comm. Repair
Phone = /J - ? Other
FEES
COMMfIND FEE - iai6 OF CONTRACT FEE
MINIMiJM - RESIDENTIAL FEE
MINIMUM - COMM/IND FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE GDES
BEYOND $1,000.00)
CITY OF
TURES TOTAL
MO. FIJC
1 .,
j
?'6
Water Closet - $3.00 $
I -
.
? Bath Tubs - $3.00
-4_Lavatory - $3.00 • ? • ?'?
Shower - $3.00
-
TKitchen Sink - $3.00 3 • ??
UrinaVBidet - $3.00
/
Laundry Tray - $3.00
$10.00 ?Floor Drains - $1.50
20 LWater Heater - $1.50 1•,?%
.5? Whirlpaal - $3.00
2
• ? ?
.
Gas Piping Outlets - $7.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
-
?
Rough Openings - $1.50 'L
FEE:
STATE S/C:
GRAND TOTAL•
PERMIT # L/
MECHANICAL PERMIT
GITY OF EAGAN RECEIPT # -
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
oarr onlre. 7 .Z? ^' .w pHONE• 454 8100
Name
? Addre
eiry >
? BLDG. TYPE WORK DESCRIPTION
,etf 5ub Res. New
vG
Mult
Add-on
Comm. Repair
,no?•°:?'•'.i??.r" Other i
? ..v..... 'y C,°4
c Address -?? • ? ??'"`?"?? ? ?f'??
p City Phone
TYPE OF WORK
Fosced Air M STU
Bailer M BTU
Unit Heater ? M BTU
. .: Air Cond. , ...2 ?y- M BTU
'. Vent. - CFM
Gas Piping Outlets # '
Other
FEE:
S/C:
TOTAL:
FEES
HVAC 0-10o M BTU
RES -$24
00
?
. .
A[7DlTIONAL 50 M BTU - 6.00
DES A/C ON NEW
C
ONSTRUC IQN)
GAS OUTLETS (MINIMUM - 1 PER PERiiAiT) - 1.50 EA. ";i
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - C4MAs1. RATE APPLVES
TDWNHOUSE & COND05 - RES. RATE APPLIE5 _
MINIMUM RE5IDENTIAL FEE - ALL ADD-ON &
REMODELS - 12A0
eio MINIMUM CQMMERCIAL FEE - 20.00
- STATE SURCHARGE FER PERMIT - .50-
(ADD $.50 S/C IF PERMIT PRICE GOES '
BE'YOND $1,000)
`
.
6
IGNAT
E OF
P MI EE
1
FOR: CITY OF EAGAN ?
,
,
_" . _ .
.. .„ _ u.,_ _._ . ,_ ?.. .. _._.._u.::....,...?..? =-.. _ . .. . . .
. y: ...,. :..,
/? /?????-?
CITY U EAGAN WATER SERVICE PERMt'E
3830 Pil,nob Road _
' P. O, Box t1199 PERMIT NO.:
Eagarf? MN 55121 OATE: '
Zaninp: No. of Units:
Owner, T"zOn. G : ex ?`izi' :-
Addross:
$ih Add?ess: '+679 f:ard1I131 T7 3:? j_ilr•ior_ ! i
Plumber:
Meter No.:?3 7? /Sa ??
r
?c
' ?(?•,?i -
,
Size:.?•?
`r G
I aprM to a
Qrdiseniw
gy ?/U/'i v
Dote o# Insp.:
?? a?3 "" . 5 ()?.d
bMist. Chorqes: _ 156.00p.1 '
Tofol: Stl! ri mF rar
Dote Paid:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12324
PHONE: 454-8100 /-C? p
BUILDING PERMIT
Receipt #
TobeusedSOr SFDWG/GAR Eslvalue $56,000 oate JULY 23 ?y86
SIteACplress 3679 CARDINAL WAY Erect IN Occupancy R3
LEXING
Lot2 Block I
Sec/sub
Remodel
TON PL
?
Zoning pn
_
.
2N Repair ? Type af Const Vn
D
Percel No. SO Addition ? No. Stories
JANET VERNON Move ? Length-48
W Name
2849 SO LEXINGTON oemolish ? Depth-36
o Address Int. Impr. ? Sq. FL
Ciry EAGAN phone 452-9374 Install ?
o Name FRONTIER HOMES INC pPPfOYF
$a Address 3908 SIBLEY MEMORIAL HWY Assessment_
? ciry EAGAN Phone 452-0433 WaterBSew.
a
r) Police -
W Name Fire
F
? Address Eng
`d 5
0
ciry Phone .
Planner-
Council
Iherebyacknowledgethatlhavereadthisapplicationandstatethatihe BIdg.Off. ?/Z3/86
. informahon is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinance . AP,
?
Signature of Perminee „? ? ? Var
A•BUildingPermitisissuedto: ONT,IER HOMES INC?J
all work shall be done in accortlance with all applicabiEVqO#of Minnes ta Stat
Permit $ 301.00
Surcharge 28.00
Plan Review 150. 50
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit Z90. 00
7r. PI. 156.00
Date I Copie ,06 .00
Total
- on the express conditlon ihat
of Eagan Ordinances.
Building Official
This request void
18 months trom. ?
C 3'4 791
(i st Dete A
I
U Fire No.
1 qouBh-in Inspec[,on
ReQmred?
eady Nuw QA4i1l Notify Inspec-
?
?
Q [illes ?NO br When ReaOy
[IJeeCensed Electrical Cmnracror 1 hereby repuast inspection of abave
? Owner electrical work Instellad at:
Street AdCress. 8ox or floute No. • C'tv?? (2 4 /0
ection o. Township Neme or No., ange No. County
Oc ant INT) .
?2 rn ? pw?5f Phone No.
?s - 0 3
Pow Suppli Atldress
f
C?Vac r's
ense No.
1 A RAA D?ATATr1!'?V T n wTr! ??
U
Madin A C ilatronl
APPLE VALLEY, M?T 55124
Authorizetl SiBnatwe fCoMractor Owner MakinB Installationl Phone Number
MINNESOTA STATE BOARD OF ELECTqICITY TMIS INSPECTION NEQUEST WILL NOT
Grigga-Mitlwey BIOg. - Room N-197 BE ACCEPTED BY THE STATE BppqD
7821 University Ave., St. Peul. MN 55104 UNLESS PNOPEP INSPECTION FEE IS
pF,,,,e 19121 297_2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION AIMML EB-00001-04
a? ,? ? See instrucfions for comDleti.p fhis torm on baek oi yollow copY-
? 3`F 7 91 "X" Be/ow Work Covered by 7his Request
?AAtl Bap.j Type ot Builtl?ng ApDliancea WireE ' Equ,pment Wiretl I
Mi
N Fee ServiceEntrenee5ize b Fee Feetlers/5ubfeeders k Fee Cucuns
0 to200qms 0 io30qms ?m30Am
Above 200 qmps 37 to 700 Amps 31 to 100 q
41
Swimming Pool
Above 700-Am s
.
I
Above 700_Am s
Transiormers hn ation lboms Partial."Other Fee
Signs Sueciallnspection '
S .- TOTAL E
emurks
-41 u7_,o
the EIAeaI
r.?? Inspector, hereby
.^erLfy thet the nbove
Final ' ? i rrenspection has been
de.
ly
,W/?y
?
? 4 2 3 9,, =°°
Request Date Fire No Rough-n Inspection
qeqmretl? ?I ReaGy Now O WiII Notity Inspectat
? Ves XNo When Reatly?
I[K licensed contractor ? owner hereby request inspection oF a6ove electrical work at:
Job Address (SVeet, Box or Route No.) Qty
3679 C dinal wa Ea an
Section No Township Name or No Renge No COUMy
Dakota
o.cuwM faRwn ahone M.
Barbara Michel 452-9374
Power3upplier Address
Eleqrical CorNecbr (COmpeny Neme) Cant2cror§ Liceree No
040445
Mailmq Mtlresa (Cmirector or Owner Making InstellaUan)
Autho' i ature (C r er ki Inatella0on Phone Number
? 45-2-8886
NINNE3OTA STATE B D ELECTfiICRY 10, 1FIIS INSPECr10N REOUEST WILL NOT
Griggs.Vifdnay Bidg. - poom &173 6E ACCEPTED BY THE STATE BOAF1D
1821 UMVaeslly Ave., 8t Peul, MN 55109 UNLESS PROPER INSPEGTION FEE IS
PM1annw (611) 692-0BOD ENCLOSEO
luls?
F 24 39
REDUEST FOR ELECTRICAL INSPECTION
P? See msNwTens fonpomplebng Nis torm on Cack W yellow tupy.
X' Below Work Covered by This Request
^ EB-00001-07
P,Iev4 Add Rep. 7ypeofeuilding AppliencesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Fumace
Farm g Air Conditioner
Other (speaM Comractor's Remarks.
Compute Inspection Fee Below: JOb # 20883
/f Other Fee # ServiceEntranceSize Fee # Circwls/Feetlers Fee
Swimming Pool 0 to 200 Amps 1 0 to 100 Amps . OO
Transformers Above 200 _ Amps A Amps
Signs inapector5 Use Onry: / TOTAL
trrigation eooms 00 15 . 50
Special Inspection
Alarm/Communicafion
Other Fee
1, the Electrical Inspector, hereby
certify that the above inspection has
been made. Rough-In
F,,,ai oWe
oeta p????
p
OFFICE USE ONLY Thls request wid 10 monihs ham
PERMIT
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, MinnesotziS5122-1897
(612)681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDIN6
031233
12/88/97
SITE ADDRESS:
3679 CARDINAL WAY
LOT: 2 BLOCK: 1
LEXINGTON PLACE SOUTH 2ND
P.I.N.: 10-45061-020-01
DESCRIPTION:
(ONE BEDROOM)
Oilding?-,P?ermit Type BASEMENT FINISH
BGi'7.d'fng ?Jinrk? Type ALTERATION
9C @ rrsv s G ttd.a
--
'?j
434 ALT. RESSDENTIAL
' ,Z??? ?i _?. '
ra ? ?'?F
REMARKS:
A 3EPARA7E PERMIT IS REQUIRED FOR ANY PLUMBING OR ELEC7RICAL WOftK
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
t
$50.00
$.50
$50.50
CONTRACTOR:
Ir hereby,.acknculedge .? h a?T haVe read h T
infeartmata.an ?is ,oor.J'0,c;L .ani? a% r9 Q ,t4 ?t?
`5tst_utes and Cfty of Eeg,an ?Qrdinandes ?
? .?. . _ _ _. * .. . .? .? . v`.5i? . 4 ..w. .....?... .....r ew.?
// ?/lN?..//???
APPLICANT/PERMITEE SIGNATURE
OWNER: - Appiicant -
VERNpN JANET
3679 CAROSNAL WAY
EAQAN MN 55123
(612)452-9374
1?j 6 at Vrrii <on d state thtiat,the.„
l'CI'I e'll'
i ? '• r
mn. ? ? i_
I'SSUED BY: IG U?iE
? 97 BUILDING PERMIT APPLICATION (RESIDENTIAL) ?-O-ff0
CITY OF EAGAN ^ n(?/'?2
3830 PILOT KNOB RD - 55122 w,f?(/ ?/
681.4675
New Construetion ReauiremeMS $emodeUReoeir Reaviroments
? 3 rogistered sRe surveys ? 2 copies of plan
? 2 copies of plans (inGutle beam 8 window eizes; poured fid. design; etc.) ? 2 ske surveys (exterior addiGons & dedcs)
? t energy calculations ? 7 energy eelculaHons tor heated additions
? 3 wpies of tree vrosenation plan H IM platted after 711/93
required• _Yea _ No -
DATE: ? W/Ap'-/ CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT I BLOCK
`7 17
-1_ SUBD./P.I.D. #:
PROPERTY Name: fl?iQil?4ri? -11qW2-74 Phone #:
owNeR ?„
Street Address:- 3 O ? g ?P PIs?AL W'4 /
City: ?f-Ag /-? i? State: Zip:
CONTRACTOR Company: S=t- F' Phone #:
Street Address: License #:
Cih': State: Zip:
ARCHITECT! Company: Phone
ENGINEER
Name: Registration #:
Street Address:
City: State: Zip:
Sewer 8 water licer^ed plumber (new consWction onty):
and lot change are, equested once permit is issued.
Penalty applies when address change
I hereby acknowledge that 1 have read this application and state that the infortnaGon is correct and agree 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
1 Z
?•. •? ?'
C 2/84
d
CITY Or EAGAN
APPLICATI^vDI FOR PEPUMIT
SEWER AND/OR WATLR CONNECTIODI
(PIEASE PRINT)
1) PROPERT^I ACDRESSc CA2h/NA GUI¢vth l
r.Fr-+L D°...SCRLDTICN: - o 1- z?XQ'I (44002??
(Lot/Bloc}c/Si::,cuvisicn or Tat rarcel I.B. 1NUrZer)
ir -:Iy'=', SI'?.L:C^*:?:. DAT 0F CRTG?AL ISS.
L'S: N R-1 S'?.,:GZ: :?!,IILY .
? R? 2 DUc _.: ('T_:;a L^?I2'S)
? R-3 :C'f.•.??roicg (2?a--- + L:II:'S) ? II.T;73)
? ..-4 Ua+i':'j)
? CCi•n1?CLy.L/RE:r1II?OF.= IC: :
? 7"%Dli51.
? LTSTZ'?"C,^i'IC:IAI./G9vZE?Z,!LN^
2) A'?P:.SC-?T (ALEASc PRlfii)
buV•'?'= Frontier Midwest Homes Corporation
ACDRESS: 3908 Siblev Memorial Hwy. Bldg. E
C1`7L', STATS, ZIP: Eaqan, MN. 55122 -
PHO`E: 454-0433
3)' Pu„:BEF, Star Plumbinq (PIE:,SE PRIYi) FOR CITY USE 041Y
PDDHESS: 1018 Mound Springs TBP. PLU"•BERS LIC;ssF:
CJ Attive
' CITY, STATE, ZIP: Bloomington, MN. 55420 ? Expired
PhC`E: dNaicr.
884-4149 PLUMBEA LFCEYSE N 3329 Q Nat of Retord
' ar int[ia
rm IrLceac rnirilj
'+1 u.?ure,?rria•+r.e-it
?_ ??4??.r -r-
ADoRESs: 'j?q^1 S CLrinir1-,o0
CITY, STATL, ZIP: L&/q",171N
PrDNE: LtSZtt37?L
5) INDICi,TE :aHZCH PERi•lIT IS BEIIvG REQ[TFSTF-.p:
? CC:IIdeCrlOV Tv CITY ScrjM Please mail gold copy to
? CO[vrTExTIQ.1 TO CITY [aATE4 Wenzel Mechanical
3600 Kennebec Dr.
Q Ui[ER (PLG'1..?' DESCP?EE) Eaaan. MN. 55122
,
61 IDZCN::: C:.L:
7) SIC.:-.TLc'iE :
? P=ASE fiOID r1PPP,GUED PgRm3T FOR PICi:-G2 BY ONE OF ABC1yE
°T..EASE tir?SL APP?17t1m PE°.%lIT TJ 1. 2 3, 4 ABOVE
(Circle one)
a6
DP.TE' •
_ .: .
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
xxxxxxrrxxxxxxx.x..F...nxxx?rx?xx M
W
*ATF': PAYM[FNT OF FEE AT N.'IM W
ArPLICATIorr nos Nar CONSrizvrE *
a2rxovAt. oF PERMIx. *
ort oF SEPM arm/OR WAUR
TnSrar.ramrpNS 4d.Qd, NpT BE SCF7ID-
UI FD ONTIL PIItNffT AAS SF.EN
APPR()VID.
P ease Print -
1) PROPERTY ADDRESS:
LEGAL DESCRIpTION:
Lot Block Subdivision or Tax Parcel ID )
IF E7QSTING STRLY-MME, DATE OF ORIGINAL BL?ILDIW. PERMIT ISSL'ANCE: '
Nbn Year)
PRFSIIJP ZODIING/PROPOSID LTSE:
COTMERC2AL/RETAIL/OFFICE
Q IAIDL'STRIAL
f7 INSTITtPfIONAL/GOVII2Nhg,'NT
2) ?
[vAM:
ADDRESS:
CZTY, STATE, ZIP:
PHONE:
r7 R-1 SINGI,E FAMILY
0 R-2 DLPLEX (1Wo C?nits)
? R-3 ZOWNHOUSE (Three + Units) ( t?nits)
q R-4 APARTN4NT/CObID0MINtUM ( Units)
3) • ?: ?• NAb1E:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
MASTER LICQVSE#
Active
Expired
Not recorded
Starf Initial
4) C?_?w4?f:'i?7• ia?• NAME: ADORESS: '
CITY, STATE, ZIP:
PHONE: •
.5) ,? a. , ?. : a , • . ??
nCONNE(.'TION TO CITY SEWER ? CONNDCTION'TO CITY WATIIt ? OTHER ' .
6) ?? • i- ? pI,F',ASE AOLD APPROVID PERNffT FOR PICK-UP BY ONE OF ABCSVE ---- -
? PLEASE MAIL APPROVID PERMIT TO 1. 2,,3, 4, ABOVE
(Cimle one)
71 r r •
?
"? .
.f
, .. .
FOR CITY USE ONLY .x
PERMIT # ISS[7ED
770? ?
Pd w/Bldg. Permit FEES:
$ xz?• SD $ SEWER PERMIT (INCLUDE SURCHARGE )
$ $ WATER PERMIT (INCLUDE SURCHARGE)
$_ ? 3' S v $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ I5. dv $ ACCOUNT DEPOSIT - SEWER
$ I S. Dzo $ ACCOONT DEPOSIT - WATER
$ S8D 0Z) $ WAC
$ S 7S 1SZ? $
SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ /?I) $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$
?? / SS U $ TOTAL
_
RECEIPT RECEIPT
DOES LTILITY CONNEC TION REQLIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
?
NO ROADWAY" MUST BE
DIVISION
LIS ISSUED BY THE ENGINEERING
.
T AS A CONDITIO[V.
SLBJECT TO THE FOLL OWING CONDITIONS:
APPROVED BY:
TITLE:
DATE ;
' ' ? ?:.
'
VERNON
W'amw `L" ('6')
: ALL COdTBACTORS MOST BB LICENSED iIITH TH6 CTTY OF EAGAN
COFRERCIAL SINGLS FAlII4Y DitSI.I.INGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET'OF ENERGY CALCULATIONS
ENERGY CALCULATIONSJ ? .
$2,000 LANDSCAPE BOND
SGnqep
To Be Used For: SINGLE FAMILY'i Valuation: 05@'989 Date: July 21,1986
Site Address 3679 Cardinal Way OFFICB IISE OPLY
Lot 2 Bloek 7?71--
Parcel/Su S6
Owner uF-P/LS(V\-) IN
9ddress C)- 4.S' ( tiY?
?
City/Zip Code Le-(.ZZ2N4
Phone 452--9?-2/ V
Ereet ? Dccupaney ZI
Remodel Zoning A
Repair Type oF Const Ju/
9ddition # of Stories
Move
? Length ?
Demolish Depth
Int.Impr,. Sq Ft
Install
9PPR09ALS FEES
Contraetorr-si?111ge(L(,LZSL &n?s Assessments Permit
Water/Sewer _ Surcharge
Address Police Plan Review
City/Zip Code Engr Water Conn
?_ ^ ^ ? ? Planner. Water Meter
Phone A_ __? 177- (?{ Couneilf /Road Unit
aiag orf ?Treatment
Areh./En APC Parks
Varianee Copies
Address TpTgi,
City/Zip
Phone #
P1
P
/SSO
S 7T
G3• Sb
Zs0
f
NOTS: 9DDRESSHS FOR CORNSR IA'fS - CONTRACTOR/HOMHOii9SR M03T DESIGNATE ii$ICH
9DDRFSS IS D&SIRBD. NO CHANGBS NILL BE ALLOTdSD ONCE BOILDING PERMIT
IS ISSOED.
,,!1wnOGTaN??e`F'q"? t-' Pzign 1 0 f 1
?CrJt?C?" 11?
c.,Jcrtt^vR E:vELOP_ ,W_'P;;rr ^u^ ::o?•?uT;-t'Md
'?,,,'^.
. ?
OWNER:
_ .a-
SITE AJDRESS: FHOidE:
CONTRACTOR: r_-rC*J3?F=
Determine working squar% e fnot;:e)e of each
1. Total exposed wall area..... 1484; Z S sq. `l. x.11 = ZCS?(, L 9
2. Total roof/ceiling area..... 650 sq. ft. x,pZE
Total exposed wall arca abovc floor=
a. Total wall w4ndow area ..................... ............
<< 3
b. Total door area ....... :......
. -
c.
Total .............
sliding glass door ar>>,,.,,,.,
.. ................ ? 9. ? Z
d.
Total ....
fireplace wall area ............. ......................
4 Z
e.
Total .....
wall framin area avera e 10"
9 ? g } ...... ..........
. .
???????
.....
M
f.
Total
rim joist area ........... ............
?
I 8 S
. 73
•
et .
.. . .
...
wall area ahove floor.?.`E. ...
..
... ... ? . . ......
.. ?
?
---
h. ......
wall area above ftoor ........ . 4S?O
i• ........
wall area above floor .......... ..........
...........
,7.
trame ......
wall arez at `our.aatior ............... ...
..................
.............
Total exposed foundation area=
k. Total foundation window arca ........ •?.-.?._
1. Total ........
net foundation area above grade ....... .......
.....
Determine "u" value of each wall segnient
(e,g. vrindow, door, each separafe wall section)
a._ I! 3 x„u??-?
6._ ??. ip2 X 1-Ull . ?'i s
c. ? ?. y, --u„ A5
d._ x U„
e.?87 X °U" •G = -,?='=
°°
f. ???•'e^`a X ',ul,_0.3 _
9?_..1:? ?• ? _ X „U?? o3
-- Or
--- -
h. X .1ull _
i. x _
j, X
k. `? X ,lull ..?. _ o
1 .__CA. Z S % „U', - ? rJ = f • ?A ?
3 . .................. ............
= •I?Q1,?
If item #3 is the same
as, or less than.item;
X1, you have met,.ttie:":'
intent of SBC 6006l(c)
Lxi-,. io_ Envel;:ue -wernqc IlU" Ccm :urn;:ion ?, ^
n
?
o
1bCn1 cxucsed rooL/^ci;in, r.rca =
? ? ? ?•o
m. 'lot:,l s]:y'_!,i;t arca ............................ ...?.??
n. Totai. _-oo`/cciling fia:,iing e,rra (avc?:ayc 10%) ... ?
o. Total net i.^.snlatew _oof/ceilirg «rea........... . Uctermine "U" valuc for each roo:/ceiiing seament
M. x „Ul. _ ?.
11- x --V--
O. a I. Vii
4 ........................... 7bta1 ° 77,
If tota.l of ;W is .lie same as, or less tnan ;;2, yoU have met tne intent Of
SriC 60UG (c) 1.
Altern;;te 9uildinq E:rve?-oPe Desiqn
To ut:ilize che total envelope'systern method, the valuss established by the s:un of
i.Cems a3 arid #4 shall not be greater than the siun oP items J?1 and 112.
+ z.
3. ---.i? I• 2.?-- + 4. r7. r =_t19,z?
i'
M!,I,
r.. U.r ?yt 1oi nc•??.,?,,n, un:l n:,•r. 01 1"'r-;p
i'c,iir.lr?cilun
?
G,y F' G `p
? ±'1-? -- ? p???: n, ??? •. . ? i ? ? 1 4.
17. CY..?
?:? ?? G. }:>.l?•r?„r .?i? ;?:??? '• U?E?
?
YI?. tll TOPVSFM OF °
FIVd1E IinLT. . ]nlr•'I„r ??ir ';Im ---'---'-`---U:611
'• ?.--.i?±SK-•...??13------.. t?.c+? .
• ' a• muv •- - --- .. __...?,_t?U
??? - ------0 5• At?rm.???r??"'? - ---... .---t-?l
FIG. P2 'iul.nl q?
-`-'-JO
. ? ? • .Q '? tA t'. . (3 ?
? -'r? ? • ' ` . Jt?l...?ri ;ii r nir Cilm
,• .-: ?..--C? z. ?'-s!?'1. . ._ ?-- ?-------;- -?,-??3
..._..___.?
IS?:AtrA
ti,_.:.? ? _O?? :>. E3.t.?m,_4?t?t???----- ---?c?l
?(', il? f ti' 6. }:xCCC(or nic i i Irn il. i'1 `
?{???? ?__. __f ? ?.: ?. - - ? ------ -------?- ---- - -- ---g- --?-{- A
`{--, ?'ll:•..?•?? .? i--?----'_'{}. . Tol.Il G 1•
A • ? _ _''i
1 f J
^.-?----------------ol '. ?„c?•:i?,c nI? rit•., ?,.r,n
, , , • .f?`?_.Cdi.?C.? 8"._ .$5 ?
? ••. , .? ?.°? - e .
,?T.cu .•. - ----••-----(.? ?y. •• , --
P _S'('y C.o . ' •' ---------•-'.
?/ ? tl' • 0? „ ? • ?. . PL.'c.t: ?G_TtyG.. .?iP?F?«?°P.GGP_
?? . U . .FirTn,J? 5.
--'-'----.._..----`-
.. ,
• n . 1 ' ? ? ? " - -- - -- - .. _..,:--------------
? ?
, ?•
• 4d?y °' . 1 S
? si ?,is cm c:tnue
f ? ` •---._...----- / .? .. : . _. .,.- ---. ?- `\ •--._'..?
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•. ?. ? ° ' ?l '??AP? ,II.I'( ? v , • ?T--??
i •? ? ?
(. ` I ? `. ?????_ -? ? ? ? ' •>,17?I =..
4 f ?. . ` • `.
?'} ; • r. ?rr ?•i«. iln rri I } ? -- .? ? ?_ rr!
nnd
• ( \' : ? ?1i,1':r11d'i: q! ??.?:n1.N_inn.
. . ? ? .
? x-v, li, c
. .y?? Cor.stru^:ion
• ?? ? .
Intcrior air filn
??'} ? ?-•- I ? ??? 2• ?'-i ? l-r `( t`? b P . ?
1ti)5Uc.. 44.
??Il?i?l?. , Oa
zxtcrS.or air filn (still) O.G
`:..T Total ? 4sao
1-02
• ? ? ? F R?F+"t 6;7 ' . ' .
s:ted ?ea[ floc? 1- Interi?air Pila?
n
3- ? 4 t?,;suc? 38 3S
• q. .'xLr_:in_ ?ir !:in lsr.zl_1
L?Q.?J
FIG. 95 , .
? . ? . ?:.. ... . ? U=.oZ4..
- - - ' Co.t, sr??cri my? • ' .
r.r??1Vl;.LI_.?? _Y,?.42`.??,j??_F?M1<_1r[n? , .
_ --- - ---_-?•_? 1_ Tnside ?ir fxlm 0.61
% - - ?- -
4.
n `r1 {'•? /? ? ? - $. C?u??ide .?ir. film 0.17
Total
----------- r .
Lo . ? R' ?•w E ? - ' . -
? LJ "2 1 .
1. Tnsidc air Yilm 0.61
2.
eFcnc flou up. j?ventad 3. ' - -
4.
• . ? • ' 5_ Catsidc air f?l:n 0.17
. T'TC_ 96. Totz1
?
v 2. rr.side air film 0.61
2_ .
. '? ;?rr,',:--,. •. _:•.;'-? g_ • . .
•f\.\•",??.+ . •?•.•'•..•-?/ j• ? ? ?
Gt t , i d c a ir f ' : m _ ? • = ?
?r:.. , 1' j J?r_ i!.`?•? TotaL
?/ t? ??? ?,,i • :
tlotc: Use addi_ional sheeLs if morc cFace i:
-.- .. ?? ? .:. .
r.eedecl for cletails ar.d ealeulaticns.
• • ; . - °lov up • - ' ?.
. ..? • . .. •
' 1"I ._ 27 • ' " r ' ' • •' ,
. , , . . • ? •
i
•; r?n;.i. r,r,crrt?,as ?
C:. ?ir•r ??,t? of un vnl: .n, rcr,
(:il(11q GVi1;ilTVC?:L.'fl
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Flo..a1 n,rvi::d oe
FN1i.' IIALT,'
fICl? ?11?..• C •
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h ?
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i• U?.41 '.'?.J?1 i I ? 1? l),Qir? ', -
'• _IFlFZE5...$f-UGK S"Mt1?4_ . . .?.11 . -
G. }.>:lt^.i?,r' ?i? •ilin Il ?.. .
1. TnLr'In:' ??i:' In
-- -•-- -- -. _ . ._ -----'-
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BLOG k.. ; 7 Z,-+ 4v . ? ?- Fo = r Z ig-S
-774 ?'f?• 5'i _' id ?• ?
?
-----,.-_._
rUI..L! ? Z?t 48 +s= r??
--
r-??, ?.. ?. ? _
S? . rT, ??.t? o5c? VQAE L..L_.
t3Lock14 k , S = 64, Z7S
• 5
_.
1::uLL
?r- , ? ? ? • ? , -_-
_?_
=
?
To 7-A L = r 5 , -?. -pw S
r???? '
?,y ;? 4G? v?IS ?
.
?...Q( -6: 1-
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4 = 3?
ZAIr.°'
AZE.A
? 7`._„` ?
?.?.?4?' !?•G Z -
? ?i4cTl o D?.S ? ?1 4 Z.6
?
?-F ?--?-----?
? cirr usE' oHLr •
L ?. BL,' RECEIP-O#;•-'_ *7 5.0 ?I.€ . ._
SUBD. ` --?-..' ?• - ' ? .. '^ f 'RECEIP7,?DATE: ..o7?S?j?,
> d
• ;? 1997 PLUMBING PER:MIT'(RESIDENTIAL?)
CITYO'F:EAGAN
. 383(l PI11.00KNOB RD
FJIGANON 55122
(812?'?B'8j1:.4675
?
Please completehfor - : "single famity dwellings t
. townhomes and condos when permits are required)fertach unit
d?:?• ??'=-'.,;
backflow preventer for untlePground sprinldeF, sysfem
--
FIXTURES EACL'!
3.00 x
Shower
WaterCloset? 3.00 x,
" BathTu 3.00 x•
Lavato 3.00 k
,-
Kitchen ? 3.00 x
Laundry ? 3.00 x ;?:`.
Hot Tub 3 3.00 x ::";
. ? WaterH 3.00 4x
2
FIO& Dr ?.. ?J 3.00 x
Gas^Pipi • 3.00 x
,? - ..
Rough Q ? 1.50 x, . ?. 07?._?'._,:_
ener ' for dwellings under construction 5.00 X . • ? } '. ? - '" -. ,?ai':?"
Water'S a"
oftene -'ti?rextanogdxremng 20.00 z.
y .°Sprink e " ror, dwe?l%pg under const 3.00
U.G. Spnrikler, ' forezfstirig dwelling " 20.00 p ?' ?•
? • - A'? • '. ;a= t T '?,J,_+??.. , ?
.
ARetations to existlng residence 20.00 , ?!4 "Si PX .?,_
_ .. ..?,. ' .
? Water TumAround 20.00
Private Disposal;Sys4em ' oak cty iic. 75.00 ? `? -; ? :' _ ? ?a-TM"??. •?. ' : -
? (newandrefurbished=systems) PrivateDisposalSystems.' -nuendonment 20.00 '?tl •?? _?:'''`_ ?j'" ' : `
r. r
,- .
STATEfrSURCHARGE
?- ' ?;?•...,.
TOTAL
.:? . ? ' ?, ' ?;??•-,> ?.-:'-?? s _
,..,.:?
y.`wh'rellfeppliceble
I hereby ecknowledge Nst?l9have•?eed'thistapplicaHon, stete.thatdheginom?etion ia correct, ?antl?agrae,to? compl it
M Eagarf ortlinencestt is?the?applicaM's?responslbNity M nMify the'property owner that thOiGity,rbf1Eagan;aspumes,no;lie?b'?iliet ?y,fbr`an
n;y;?; ?
damages ceused by the Crity; during its normal,operational entl mainfehance'acWities to Cie faalitiesicbnshucted'undecitild
CitY GroPertYlrlghtof-wayleasement. ' ' . ' _ ? . ?,?`,' z:; . ? •. .
MIJJ4
SITE ADDRESS: M
? OWNER NAME: ? , ;
P NE #: • ° ""'?, ? _?? 1
? INSTALLER;NAME: TELE
STREET(? D S5:
CITY: cJ, ?.? ST,4TE: ? Y IP: • ??`':'??.
????
SIGNATURE 05PE
.=i' F•'az, ,T.
_?
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY CF EAOAN
5830 PILOT KNOB RD • 55122
3 (o C) 0 1 651•881•4675
New Conshuction Reaulremenh Remodel/ReoaLReauirements
? 3 regislered sile surveys showing sq. R. of lot, sq. k. W house 2 copief of plan
and g( roWed areas (20% maximum lot eoveroae allowed) 1 sef of energy calculaffons for heafed addXlons
? 2 coples ot pians (show beam t window sizes; poured Ind. design; etc.) 1 stle survey for exterlor addRions a decks
? 7 set M energy calculations
D 3 copies ot hee presenaNon plan 8 bt pIWMd atter 7/1/93
DATE: S ` a1- q n
00
CONSTRUCTION CO$'L CY'7C`) _
DESCRIPTION OF WORK: l«-
STREET ADDRESS:
LO7: a BLOCK: ? SUBD./P.I.D. #:
?
Name: (-Icet? 730? Phone #:
PROPERTY Lan f6st
OWNER Street Address: C-P?Q1@JP? w4u
City State: Zip:
Company: Phone#:
(area eode)
CONTRACTOR
SfreetAddress: ucense? 1b173?31*p. CO?
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Street
City
Sewer R water Ilcensed plumber (reaulred for new conslruction onlvl:
State:
Penatty applles when address change and lot change is requested once permR Is issued.
Zip:
I hereby ackrwwledge that I have read ihis applicotion, slafe that the inf rrrpHan is rtect, and agree to
State of Minnesota Statutes and Cify of Eagan Ordinances. \ t
Signature of Applkant.
OFFlCE USE ONLY
Registration 1k:
with all applicabl
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
81GMA
S UP'f
Y
SE
3908 Sible
Eagan.
Phone
I
EYINO
FtVICEB
y Memorial H'rghway
Minnesota 55122
(612) 452•3077
t
5 pj4a '22, 1,7*? _ .
- -ZOi.g?
3-OC.
l?
V
?
Q
?
00 ??
?
I
\1
iz
MonW- NAaTr-*oa+S -L-
?
v
?? ?
.
?ry ^ ?
ID?o
?
Lf GENQ _
0 LLnotes lron Monunent
m Aenotes Wad Hub Set
x9o9.9 Opnotes Existirg Spot Elevation
( , i4efwN) Denotes Proposed Spot Elevation
'.-?Denotes Ora inage Directiao
.PADPERTY DESCRIPffON-
LOT? &GCK 1
? cxi iwoN PI.AGL-6OtYfkf ?'
accordirg to the recorded plat thereof,
DAKO'(A County, Mimesota
?k
t?-
?
nouSE LERTIFICATE FOR:
NpME BUILOERS
LAMD DE VE WPC h5
NFALTIMS
F COMP??NtES
r
aoa'??
of /
/41"t/
? IV.
?,. ??
o'
. ry?7
hr)
?
?a/ N ?Q
? o
1N? ./
? ni 2Q
'US cJ'<
•
v
?
?
1
WAYNF D.
GpRpES
/j 94675
?
no - ??
a ?.,,? 't? ???.
? ??????????uSn m??p??`i?•
PROPOSED GARA6E FLOOR EtEVATlON= '108-0
PRtlFOSED Top of 8lock ELEVATlON- 91583
PROPOSED BASEYENT FLOQR ELEVATION- 905,3 W1p
NOTE. Verify alf ffoor herghts wrth Final Hane Pfaru.
ar? MIFICArIpV-
I hereby certify thet this survey, plan or report
wtrs prepared bY ms a' uAder my direct supervisiar
ard thaf I am a duly Registsrad Lard 5urveyor
und the laws of the State of Minnesota.
ba,i.-O- 6 rk Date: & 186
Wayne D. ordes. Ninn. Reg. No. 14575
RESIDENTIAL
o
?o BUILDINC PERMIT APPLICATION
CITY OF EAGAN
" 3830 PILOT KNOB RD, EAGAN MN 55122
851-681•9675
New Conetruction Raaulrementa
• 3 reg"stered site surveys showing sq. N. of lot, sq. R of house; and ?II raofed areas
(ZO% maximum lot coverage allowed)
• 2 copies of plan showing beam 8 window saes; poured fouM design, etc.)
. 1 set of Energy Calculatbns
• 3 copias of Tree Presenation Plan'rf lot platted after 711193
• Rim Joist Dehail Options seleclion sheet (hldgs wilh 3 or less units)
VI ? O
DATE 011.14
SITE ADDRESS ?::?lfl' l LI l1IC1.dl fNi I (A 1(11
TYPE OF WORK4eQn ?l-r' A e -
APPLICANT
STREET ADDRESS ^I I'`f I111(1f1P nan,0. FH
TELEPHONE #101M ?`b3r CELL PHONE #
?STATEfflQ.ZIPF55411g
FAX#Inla ?a C)';))()?j
PROPERTYOWNER.?Qflet ?, 4M TELEPHONE#loRi-LIsc'qmy
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RiJLFS 7670 CATEGORY 1 MINNFSOTA RUI.ES 7672
(4 submission type) • Residential Ventilatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing CoMractor: ___
Plumbing system includes:
Mechanical Contrador:
Mechanical system includes:
Sewer/Water Contrador:
MULTI-FAMILY BLDG _Y L"k-
FIREPLACE(S) _ 0 _ 1 _ 2
Phone #
Phone #
Fee: $90.00
Fee: $70.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
Water Softener _
_ Water Heater _
No. of Baths
Phone #
Lawn Sprinkler
No. of R.I. Baths
_ Air Conditioning
_ Heat Recovery System
113 ?s-
?
RemodeYReoalr Reauirements
. 2 copies of plan
• 1 aet of Energy Calculations for heated additions
• 1 stte survey (or exlerior additions & dacks
• Indicate'rfhameservedbysepticsystemforaddilions
VALUATION '13 08 , k/a
MAY 13 200Z
Certificates of Survey Received - Tree Preservation Plan Received - Not
7-3ac( a
2006 RESIDENTIAL PLUMBING PeRnnir APPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
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Conuactor 3670 DODD ROAD Telephone #( )
Address EAGAN, MN 55123 City State Zip
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1 The Applicant is: _ Owner )(- Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
I Alterations to existing dwelling $ 50.00
_ Add plumbing fxtures. This fee includes installation of a water softener and/or water
! heater at the same time. If you are instaNing onlv a water sofrener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment -
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i _ Water Turnaround (add $130.00 if a 5!8" meter is required)
Other:
,
I Water Softener ? Water Heater ' $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild
' $ 30.00
State Surcharge $ 50
$
Totai
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is compiete ana accurate; [na[ cne
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 rt out a permit and work will be in
cordan?e wit th? roved plap? event a plan is re ' e to be revie d and ro ed. '
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pplicanYs Printed Name Ap canYs i re
??so?
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164555
Date Issued:10/01/2020
Permit Category:ePermit
Site Address: 3679 Cardinal Way
Lot:2 Block: 1 Addition: Lexington Place South 2nd
PID:10-45061-01-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Elizabeth A Guzior
3679 Cardinal Way
Eagan MN 55123
(651) 210-4262
Tacheny Exteriors
49 S Owasso Blvd W
Little Canada MN 55117
(651) 481-1466
Applicant/Permitee: Signature Issued By: Signature