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4777 Beacon Hill Rd Use 13LUE or BLACK Ink For Office Use 1 City of Eajan Permdtr: 1 Pertmt Fee: • I 8630 Pilot Knob Road I l Eagan ANN 85122 1 Date Received: Phone: (551) 675-5675 I Stall Fax: (681) 675.56$4 I 81 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date-. L A" Site Address: 117,77 6g,,4-v -i /-1I R d. . Tenant; Suite M RESIDENT I OWNER Name: KE V ►v% . Phone: 6 1 t f ROW- Gam' $ ~ Address /City 1 Zip: yV ,7 . 141 ! I ~ ~ on. f--"? 2 CONTRACTOR Name; ~atv~.a glu--,0144- ~ C License .._06 45 66 to^ Address, • o , (3,.>J- 1`25 city; "o l Lk kt State; f'i't ✓t , Zip: '5 37 L- Phone: IS 7 C1410- contact _-1&e- 6 ti- z It, - o r1 L Email: TYPE OF WORK -~L New ` Replacement _ Repair Rebuild _ Modify Space Work in R.O,W, Dese tlon of work: PERMIT TYPE RESIDENTIAL. Water Softener Water Heater J Lawn Irrigation RPZ 1 I PV8) Add Plumbing Fixtures Main 1 _ Lower Level) Septic System - Water Turnaround New Abandonment RESIDENTIAL FEES; $55,00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $66.00 Add Plumbing Fixtures, Septic System Abandonment , Water Turnaround* (includes $5.00 State Surcharge) 'Water Turnaround (add $166,00 if a 518" meter Is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc,) (includes $8,00 State Surcharge) TOTAL FEES $ ,;S 06 CALLB.13FORE YOU 010. Gall Gopher State One Call at (651) 454.0602 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www ,yul~tu:i slxle urr~ r,an urea 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 5ppan; that r 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 requirm a review and approval of plans. Applicant's Printed Name A ants Signature FOR OFFICE USE Reviewed By: Data: Required Inspections: Under Ground -Rough-In _Air Test _Gas Test -Final Z/Z d V69S SL6 LS9 « L6ZCOVVZS6 9N19vgn1d DVVA909 8080 OZ-80-01OZ This request void 16 months from x- u ire No. Rough-in Inspection Requited? (Ready Now j6will N"otifv lnspec- r" yes - [QNc tor When Ready Licenaed Electrical Contractor -t hereby request inspection of above Owner : electrical work installed et: Street Address, Box or Route No City Y,7 77 ig eA Cc^ 6ctrori o. Township Name or No. nge No. County -y . Occ ant (PRINT) Phone b. 0/ 1.1 ; Power :Supplier, Address 6fect teal Contractor (Company Name) Contractor's Lic> rYSe No. ~~/T,, ova ,'.1.,~~c© 2- r Mailidg Address (Contractor or Owner Making Installations ~c Autfia ' natare lContsac Owner Making 1 statlation? Phone urnber 4e ~ MINNESOTA STATE BOARD OF E CTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room X.191 BE ACCEPTED BY THE STATE BOARD 1821 Univerelty Ave., St. Paul, MN 55104 U14LESS PROPER INSPECTION FEE IS Phone 1612? 642.0800 ENCLOSED. pt- -7 m CITY Of EAGAN 11 3830 Knob,Road, P.O. Box 214 99," ` , UN $5121 PHONE: 454.810£1 i ` ~ #DiNG PERMIT Receipt ~ Tc,be used for,», SP t)WG/t.Ap Est.Value $103,,1 3 Data APRIL 10 19 k7 d W@ Add _ 4777,B ACON, HILL RfFAtl 2FtCE U&R (Mil fts g Lot 2D Block9 Sec/Sub. BEACON, HILL on site Sewage oocupamv lid WWCC system Zoning Phtrcel Na -on Site Wen Type ofConra3 city water ~t - - - _ RON COR CONST {Alta +e} Name fi.,.. I of Stone. MINIT A 9 '0 029 O~~l i6dcf,~• ~4~n y Phane_ Do 11 ~ ~ - A Name SANE Feotpriflt S F. Address APPROVAL111 WEL 2. City Phone Assessments Permft Water/Sower Suroharge. Name P61ice Plan Review Fire SAC, CitY Address Engr. j SAC, MWCC • tity Ph ne Planner Wab~r Conn Council - Water Motor ' i hwetay s0iwmiefte that 1 have read this application and state Sidg. Off. Plead UOR ' thatth+e' die wWagreetocomplywithalla APC - Treah-iPt State of Minnesota Statute* wW City of Eagan Ordina CO& Variance,_,,_ Peft S turss of Permittse t o ftyf Apt A.~....~.` A Bulk Permit is isauasd to: on the eat +taaetAOW0 -4 Pall work shalt be done in ac cordanae with all applicable State of Minnesota Statutse said City ofEaW tears 8t, kling Offtiai " P*~" omse. t 4"0* 16 ihs Gala Tek*UVM 0' (a 1,27 i €lac iic ~9/g~ S/g ~'00 tnspocom* 00% hop. Footles t r Fob It i Fowidatlon Fnmwn p E Ro©ft c Aough ~ft taut Ftrspia * Final H1% Final Pft Sift Final Cent C?cc. Tamp LP Dock Ft% D"k Fns t~N PEIDWA 75L ~C ter r PtRw"W MECHANICAL PERMIT CITY OF EAGAN RECEIPT F-f~- 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address V77'7 456040U) All~L R BLDG. TYPE . WORK DESCRIPTION Lot Block Sec/Sub t Res. New Name Mult. Add-on S, X c Address ?-f~9o C/tF.S "Ld Comm. Repair c City LL 'IV Afld "Ai Phone Other r Name RM~_-Cvz Comm RES. HVAC 0-100 M BTUEES $2400 c Address 90,2!P Z) L4 PDAIT ADDITIONAL 50 M BTU - 6.00 p City Qlf7Y?mis~/~97a./ Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION)' GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air ZQ0 M BTU Q~ APT. BLDGS. -COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU $ REMODELS - 12,00 4 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent. CFM $ (ADD $:50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) t Other FEE: 1~71 sxy+..~ S/C: SIGNATURE OF PERMITTEE TOTAL: FOR:,CITY OF EAGAN` PERMIT PLUMBING PERMIT RECEIPT # 734 /3 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN $5121 DATE: CONTRACT PRIG: PHONE: 454-8100 Site Address 1-1-77Z ~ 0 14J 42S-- BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub/ r Res. J ' New Name AY 12 C { !tJ Mult Add-on Address Comm. Repair E City IA) e L)S f'C / Phone L ° r Other NO. FIXTURES PTAL Name tJ m --Water Closet - $3.00 3.00 (5 3 0 Cre APhF at Tubs ;30 - .0 ` one _ Lavatory Shower - $3.00 FEES Kitchen Sink - $3.00 Cam COMMAND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00 MINIMUM - RESIDENTIAL FEE - $10.00 Laundry Tray - $3.00` Floor Drains - $1.50 MINIMUM COMM/IND FEE - 20.00-yyater Heater - $1.50 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/CIF PERMIT PRICE GOES Whirlpool - $3.00 Gas Piping Outlets - $1.50 ~ % - BEYOND $1,000.00) Softener - $5.00 Well - $10.00 ! Private Disp. - $10.00 f ,t ..C a Rough Openings - $1.50 s, Si SIGNATURE OF PERMITTE FEE. ~ 6, 6; STATE SIC: 5,C/ i FOR: CITY OF EAGAN GRAND TOTAL:- Vert tr (rrurr at t it ~itp Q~ ~agart { soul um of VOW" # mr This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the tune of issuance this structure was. in compliance with the various ordinances of the City regulating building construction or use. For the folloss in& . , use CIMS fi Ation SP /GAR Ri 13454 iawB. Knit xo.~_ . RI a Owaff of Budding a R ~L'T om Address 5'9 bff(;ff sunns 4777- BF HILL.: 1AMlity~,1O, ~ _ D&W.X 22,' 1987 POST IN A CONSPFCUOUS PLACE 38 kr bte. Metert4o- m P O. tear No. ~3+nrner: : Er~~'"' ~C~Ction & a Hill 8oad A t9 Jim !!ybro Plumbing', co", Chq 525_.!?M_ tl~4 acct oep:- 15.OQpd Permit Fee: 10.00 e 619 Zre S4rharge: , 50rc i GPN44V e0 the City _ of En Tr. #-ant I8d..0f3 d ~ Me* 6T ~p4~ Mfg Y; WATER SERVICE PEA This request void 18 months from CO 7.2 5 Requegt a3 iPe No. Rough-in Inspection Required? LOReady NowXWill Notify. Inspec Yes E]No for When Ready Licensed Electrical Contractor 1 hereby request inspection of above Owner electrical work installed at: Street Address, Box or Route No. City 1-1777 13 ,eA ,-V.. / .ed - - 164 6 Section o. Township Name or No. Range No. County Occ ant (PRINT Phone No, (0/1 Cox yet [Power Supplier Address C -zctf"(, -,-"4 C/o n:~~ hA El aI Contractor (Company Name) Contractor's License No. ectt tr Mail i g Address (Contractor or Owner Making Instailation) AuM'zd nature (Contrac /Owner Making I stallation) Phone Number MINNESOTA STATE BOARD OF E CTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. JIM EB-00001-05 REQUEST FOR ELECTRICAL INSPECTION T~ 1 See instructions for completing. this form on back of yellow copy. C "X" Below Work Covered by This Request Now Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm then peel y, Other tSpecity) Other pecity ther Other 7-f- o Compute Inspection Fee Below p Fee Service Entrance Size # Fee Feeders/Subfeeders # Fee Circuits Q 0 to 200 Amps 0 to 30 Amps a" 0 to 30 Amos -3( 6 Above 200 Amps 31 to 100 Amps yr 31 to 100 Amps Swimming Pool Above 100____Amps Above 100_Am s Transformers Irrigation Booms Partial-'Other Fee Signs Special Inspection TOTAL Remarks Rough-in r Date 1, the Ele I ~i~' Inspector, hereby r certify that the above Final to inspection has been made. This request void 18 months from CITY OF EAGAN NO 13 4 54 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # .-1 -'73' 4 To be used for SF DWG/GAR Est. Value $103 9000 Date APRIL 10 -'19_87 Site Address 4777 BEACON HILL ROAD OFFICE USE ONLY 10 9 BEACON HILL On Site Sewage Occupancy R3 Lot Block Sec/Sub. MWCC System Zoning B1 Parcel No. On Site Well Type of Const V City Water X (Actual) V ac Name RON COR CONST (Allowable) w # of Stories z Address 9029 DUPONT AVE SO Length --46- o City BLMGTN Phone 888-5578 Depth 59 S.F. Total p Name SAME Footprint S.F. o a Address APPROVALS FEES $ City Phone Assessments Permit 512.50 Water/Sewer Surcharge 3T-.-5O F ww Name Police Plan Review 256.25 Address Fire SAC, City --J-OD--GO Engr. SAC, MWCC 525.00 aW City Phone Planner - Water Conn. 525.00 Council Water Meter 67.00 1 hereby acknowledge that I have read this application and state Bldg. Off. Road Unit 305.00 thatthe information is correct and agree to comply with allapplicable APC - Treatment P1 180. State of Minnesota Statute d City of Eagan Ordinances. Variance j _ Parks Copies g $2,522.25 Signature of Permittee TOTAL A Building Permit is issued to: RON COR CONST on the express condition that all work shall be done in accordance with all applicab State of Min ota Statutes and City of Eagan Ordinances Building Official 1 CITY OF EAGAN Remarks Addition BEACON HILL ADDITION Lot 10 Blk 9 Parcel 10 13500 100 09 Owner ~j qulCa- Street 4777 Reacon Hill Road State Fagan, MN 55122 To h,-t Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1848.67 205.41 9 1,94 . 117 STREET RESTOR. GRADING 1982 537.84 59.76 9 a dD SAN SEW TRUNK 04 1976 135,97 9.06 15 7 * SEWER LATERAL 66, 1982 3182.83 353.65 9 g WATERMAIN * WATER LATERAL 1982 9 WATER AREA V 1982 202.00 22.44 9 a * Stubs 1982 9 STORM SEW TRK 1982 367.77 0.86 9 33 * STORM SEW LAT 1982 9 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK 1987 BUILDING PERMIT APPLICA YON CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND i SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND 03 cNnn To Be Used For: 15&171 1-1-1 Valuation: Date: Site Address 1-17 7 7 OFFICE USE ONLY Lot W-- Block On Site Sewage Occupancy J MWCC System ✓ Zoning (2.1 Parcel/Sub rU" kf L Z- On Site Well Type of Const City Water r/ (Actual) Owner ,Q t,' j jji ~b-1-7 -er 5 e, (Allowable) ~Z- # of Stories Address ~j Length _ Depth City/Zip Code S.F. Total _ Footprint S.F. Phone, -J APPROVALS FEES t~ Contractor ®JY { ' r/~,- , Assessments Permit E4 2- Address Surcharge Address Police Plan Review Z Fire SAC, City 00. City/Zip Code Gt~d (1,~ /L 9 y,;~Lcy Engr SAC, MWCC 525, Planner Water Conn 25• Phone Council Water Meter (n`I_ Bldg Off Road Unit c>5. Arch./Engr. APC Treatment Pl IE42- Variance Parks Address Copies TOTAL City/Zip Code Phone # F7 b Z(o 12- L 51.5U+ 256 2")+ 625.0,0-1- 525'00+ ` a i~ 5 • t1 U / 16o` + F W. imrown Land Surveyin , Inc. WOODROW A. BROWN, R.LS. 7701 Harriet Ave. So. 938.4 T.C. President Richfield, Minnesota 55423 (612) 866-4580 \39 942.5 SURVEY FOR: RON COR BUILDERS BEACON \o O ROAD 42.9 TG .0 SCALE: I"= 30 a „ S?~ Q~ p 8 O DENOTES IRON MONUMENT o f / .\.=y~'• 943.6 NOTE M \ (945.3) denotes proposed elev. -2s9 Off 944.7 denotes existi 15 ng elev. N Proposed front entry elev.= 947.0 ADJOINING 0 Proposed top of block DWELLING p elev.= 946.1 u `;TOP OF BLOCK Proposed garage floor elev.= 945.6 (\j t'>M ELEV=946.1 Proposed basement floor elev.= 938.1 (94,54 The pr oposed elevations and house .4 location are=subject to review 21 and change by the City Engineer, Building Dept. , Developer L19453 and Owner. 9343 ~ i 933.3 LOT T~ of 10 M DRAINAGE AND \ UTILITY EASEMENT 933.8 15 ~ \ r - - - 110.00 _ 930.8 PROPERTY DESCRIPTION Lot 10, Block 9, BEACON HILL according to the recorded plat thereof, Dakota County, Minnesota. I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. Date April 2, 1987 Reg. No. 15230 33-87 21117 WUPIWIIEETS FOR EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER lk'IEV i 6 AJ SITE ADDRESS CONTRACTOR DATE PHONE Determine working square footage of each. 1. Total exposed wall area C~,a~ sq. ft. x .11 = 2. Total roof/ceiling area sq. ft. x .026 Total exposed wall area above floor a. Total wall window area b. Total door area c. Total sliding glass door area d. Total fireplace wall area... o e. total wall framing area (average In%' Qt #,abomnl f. Total net wall area above floor k Ann%( • tlmn.(e) g. Total rim Joist area Total exposed foundation area h. Total foundation window area,,9.....,....•••.•••• 1. Tdal net foundation area above.grade o44 AQg110(M Determine "U" value of each wall segment. This is 1/R U. R is the total of all R values for all segments of wall(or ceiling , including interior and exterior air film R factors. Divide total o R C SC, X nu" , ~5 into l for 11 Ulf . Total Wall Window Area a. - Total Door Area b. X "U i DO X nuff Total Sliding Door Area Co Total Fireplace Wall Ared• 50 42* X fluff a6/ Total Wall Framing area e. ~ i X "U" 0 0~ , (area a) stud) Total Net Wall Area f • `"0 X "U" Total Rim Joist area. 9•_X "U" ate d Foundation Window Area. h• X fluff - Net found. Area less f. ~ X "U" windows. 3• •(•Tota41, jJ• MAP of .e poseda wa-. .a"o TotaI If item 03 is the same as, or less than item 01, you have met the intent of SBC 6006(02. If not include answer. above into Alternate Building Envelope Desigr along with answer for ceding in A, to see if.average of both is same or less than of #1 and #2 above. Total exposed roof/ceiling area - J. Total skylight area.......... k. Total roof/ceiling framing area (average ~9~)... 1. Total vet insulated roof/ceili pg area........... , total less J. and k.) - Determine "U" value for each roof/ceiling segment. Y1.ight Area J. X $full oiling framing k.--a,~ X #fDll = oist or bottom chor sulated area 1. / X "U" _ - q.•Total,U,valuesi•roof/ceiling.•,.Tota1 f If total of #4 is the same as, or less than #2, you have met the intent of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2. Permissible ,falls 1 Lung + 2 3r ti119 3, 4.. • a . ieet. its total is less than the line above~.-you have met the intent of sBC W06(c)l. Average "U" is .17 or less for*1 & 2 family dwellings, for exposed wall surfaces. it if of .22 or less for all other buildings# n n n n Average "U"'is .05 for ventilated roofs. .10 for all other construction. 7~ WALL SECTIONS 0c° j5%, of opaque wall area for framerconstiuction Construction R-Value n 1. Anterior it film 0 6 2 . r7~' • 3. ~inches soft wood 5• 6e Exterior air film 0.17 'L Total, /2 - 14 VI • 05. FIG. #1 TOPVIEW OF i FRAHE WALL 1. Interior air film 0.68 2. ,Z O 3• ' 4."~0"f~l ► wv I r1 5. !~V L-A A e) 6.' Exterior air film 0.17 FIG. #2 Total= a 3 . 1. Interior air film 0.68 •~i 2 3. ral 5: 6. Exterior air film 0.17 Total. .04- I. Interior air film 0.68 ION A b 2. 6. Exterior air film 0.17 j` Total SLAB ON GRADE A . r • • 6 L!l l r FIG. #4 3 _ • NOTE: Indicate type, "•R" value, depth and plar.!ment of insulation. -`ROOF/CEILING ' Construction (Use for Item L) K-Value 1. Interior air film 0.61 . O ~ ~r 2 z 3. /7- Ai g2, 4. Exterior air film (st111) 0.(iI VMIT Total „ ~ ~-'T ~ ' 2 Or 0 2 CIG. FRAMING(Use for Item K) 'ented Heat flow up 1: Interior Air film. 0..61 2. /20 o 3. Inches soft wood 3 d FIG. #5 4. Inches insul above framing L ,J 3,7,S ' S. Air Film 0.61 v~~! !yttu~t.r"►•l].~~"~ia1~::~'~,Rt+i~9,_'~F'.RQ~R1{Fft 1..JUiterior air film 0.61 2. I 3. _ 4. Exterior air film (still) 0.61 ° Total Heat f lo'.i up :.v ented ..FIG. #6 1. Inside air film 0.61 3. 5. Outside air film 0.17 Total 1 1 2 14041-VENTED Note: Use additional sheets if more space to needed for details and calculations. Neat flow up ' PTO. A7 CITY OF EAGAN Permit No. 8775 Date: 5-23-87 i 3830 P*#-#(nWrfload "Meter No Site: P.O. Box 21199 Reader No Elate: Eagan, MN 55121 Owner ran Cor, Construction Site Address: 4777 ]~e-acon a-1, d L1011 l j cu H Plumber vid s W /Jim Ny to Plimbift t Conn. Chg: S2Sad Zoning: Acct Der:- 25-1+9 No. of Units: 1 Permit Fee: 10 * OOV t Surcharge: - .500d ! agree to comply with the City of Eagan Tr. Plant:_ 180-~ Ordinances. Meter. 67 Qpp„ Misc.: By WATER SERVICE PERMIT 830 P~lot,kb~'Road -30 99, P.O. Box 21189 PERMIT NO.: Eagan, MN 55121 DATE: 5-2F-87 Zoning: Pi - No. of Units: - Owner: Pon Cor Conet Address: Site Address: 4777 Beagpn Hill Road L10 B9 Beacon. Bill Plumber: DaAd'4 & W/Mro Plumbing_ 4.-14--87 72463- 100.00pd 1 agree to comply with the City of Eagan Connection Charge: 52 5 iiapd - Ordinances. Account Deposit: 1 5 ()():Pd Permit Fee: -it?nd Surcharge: 50: Pd By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: ' • CITY OF. E A G A f~ MOTE. PAYMKTS OF FEE AT TIME OF x* x* APPLICATION DOES NOT CONSTITUTE x* APPROVAL OF PERMIT. x* APPLICATION FOR PERMIT * INSPECTION OF SEWER AND/OR WATER INSTALLATIONS WILL NOT BE SCHED- SEWER AND/OR WATER CONNECTION UIED UNTIL PERMIT HAS BEEN * APPROVED * * * * Please Print) 1) PROPERTY ADDRESS: ~Z f17 LEGAL DESCRIPTION: - Lot Block Subdivision or Tax Parcel ID ) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: ont Year PRESNT ZONINIG/PROPOSED USE: (M Q COMMERCIAL/RETAIL/OFFICE ~ R-1 SINGLE FAMILY Q INDUSTRIAL R-2 DUPLEX (Twe Units) INSTITUTIONAL/GOVERnMiT R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2)76~•Ti. NAME: r1 e_d ADDRESS: C J 2t~ra CITY, STATE, ZIP: PHONE :~r~~--•? a 3) is NAME: For City Use l~ Plumbers License: ADDRESS:- Active r Expired CITY, STATE, ZIP: Not recorded PHONE:44 1. h 'MASTER LICENSE# p Staff In teal 4) • oN T-1 NAME: ADDRESS:- 4 12 ~ ~ ✓ 27 7` .fit 1/,~ CITY, STATE, ZIP: 12 1r" %u ~ d PHONE: fQ r` - S.l -5) 0-P! D) ~V 03FROVENZ CONNECTION TO CITY SEWER ® CONNECTION TO CITY WATER Q OTHER 6) Q PLEASE HOLD APPROVED PERMIT FOR PICK-LIP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2,3' 4, ABOVE /m (Circeone) 7) WNFRY ~i 't 16 /P/-/ L-4 I sla ' • `f: • Y' I: • • • • • • 1' ' • ' 5 151• is ! Yal' • • • • • • r 1 FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SURCHARGE) $ WATER PERMIT (INCLUDE SURCHARGE) $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /5-'r C` ACCOUNT DEPOSIT - SEWER $ C^ ACCOUNT DEPOSIT - WATER $ S h° $ WAC $ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ I TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: ,c~ 1 S 7 RESIDENTIAL BUILDING PERMIT APPLICATION 5~ CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements Remodelfftair Requirements • 3 registered site surveys showing sq. ft. of 'ot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam a window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks 1 set of Energy Calculations . Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if tot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) n c DATE 2a1 - Z VALUATION SITE ADDRESS -7 &0- Cen-) C t t ~~1 MULTI-FAMILY BLDG - Y _ N TYPE OF WORK e ,,-6# j~ &a2SC e-C FIREPLACE(S) 0 _ 1 - 2 SELA ROOFING & REMODELING, IN(, APPLICANT 4100 EXCELSIOR BLVD. MN 55416 STREET ADDRESS ST. LOUIS PARK , IRQ1050 CITY. STATE ZIP TELEPHONE -9'Ry(,Q CELL PHONE # FAX # PROPERTY OWNER T Cki A TELEPHONE # r0 W 133 COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category tiIINtiF:SO'I`a RULES 7670 CA"I'F.GOI2I' I _ M1NNES0'I':1. RULES 7672 (4 submission type) • Residential Ventilation Category I Worksheet Submitted New Energ sl `~e u~itf • Energy Envelope Calculations Submitted I l! L~ AUG 2 9 2002 Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener Lawn Sprinkler B Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Meet' nical system includes: :fir Conditioning Fee: ,x,70.00 Hcat Recovery System Sewer/Water Contractor: Phone # 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 ---~-_~-----_-----------------------------------------------.__.._w__--_ OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received Not Required Updated 4/02 nswewi& LUMBtNG PERMIT At LIcAT Ai ! CITY OF EAG 38PILOT'KNOB ROAD, EA13AN WIN 11 - 66'1-675-5675 fttkse c"ete for modifications to existing residential dings. a V9f ft a _ mar c~+►r~ ~-~t.,~.c..~rn... ~,0,~„,►~ ~ ~1~~, 4 city Tho Appel nt is. r ° tamer - - Mimi- to rooms, exuding w waft and ~r neater Sept 9Wtem- AbWtdowe nt Water T rrd (mod $121.00 If a 514": is regL*ad . Comer: atsr Water Weat6ri 5.ti0 rot.. adnai ,ts Surc#targe ` I borvby apply for a ResidenU Plumbing Permit and acknoWedge` Q* k*mT*# cQr --and curate; that the work will be in conformance with the ordinates and 1 co Of only so* EaW ahd the plumbing codes; that l understand this is not a perrrni#,`bi,ct art n for ,perh*, voo* is not to s#ad without a permt and worts will be in With t# plan the event a plan is required to be reviewed and approved. u . s Printed P9a Applicard, s Si nature 9 h19Ai7 1..7 2104