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1889 Bear Path Tr2005, RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date 3 / Z3 / OS LAWRENCE, MARY 1889 BEAR PATH TRAIL Site Street Address EAGAN, MN 55122 Unit # (651) 688-6385 Property Owner ( Telephone # ) t4IN13 ORBLOM PLUMBING CO, Contractor N(612) 82 ( Telephone # ) i Address City State Zip MINNEAPOLIS, MAN P5408 _ The Applicant is: Owner ontractor Other Alterations to existing dwelling $ 50.00 Add plumbing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). Septic System Abandonment Water Turnaround (add $125.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 - new replacement -Lawn Irrigation _RPZ PVB new __.,repair -rebuild $ 30.00 State Surcharge $ .50 Total $ 157. 50 I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be.. in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a. permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. d p-4 ?)OTWo nn F?m Applicant's Printed Name A I'c s Signature " f MAR 2 8 2005 57 (e9 o RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 %273 . ZS' New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan - Cert of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks -Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date / D??(( U / r J?? L? t /5 S?/ C C t ti Site Address QdA PAM r c on os ons a o U it/St # , n e Description of Work l',C Multi-Family Bldg _ Y `1 N Fiireplace(s 0 1 2 Property Owner ru b? Telephone # ( q) U 6 Contractor MINNESOTA RUSCO, INC. Address Minn a rive ellmko MN 55343 City State Ph. 9524 , 35-9669 Fax 952-915-954 Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category Minnesota Rules 7670 Category 1 • Residential Ventilation Category 1 Worksheet (' submission type) Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor _ Minnesota Rules 7672 . New Energy Code Worksheet #( 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 MN 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 approved plan in the case of work which requires a review and approval of plans. Applic is Printed Name Applicant's ignature OFFICE USE ONLY 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 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 1 0-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const - Footings (new bldg) Footings (deck) - Footings (addition) _ Foundation Drain Tile Roof Ice & Water Final Framing - Fireplace _ R.I. -Air Test -Final Insulation Width REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing HVAC Other Pool _ Ftgs _ Air/Gas Tests - Final Siding _ Stucco - Stone Windows (new/replacement) Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors *Demolition (Entire Bldg) - Give PCA handout to applicant Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Building Inspector This request void L) t{ A.9-51h 7 !?-- Request Date .-- ? Fire No. Rough-in ion Requir []Ready Now dl Notify Inspec- 1''° es ? No tot When Ready Licen Elec ical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address. Box or Rppte No. City INV L en, Seftidfi No. Township ame or N if. Range No. Cozen Occupant(MINT) Phone No. Power uppli Addres C> L'?v ectri 1 ontractor (Company Na trator' License No r MaOinfi dress (Contractor r r Mak, Ins td" ilatien Au or ed gnatu Co ctor/Owner king llati Phone Number 7 j i OTA STA BOARD OF CTRICITY THIS INSPECTION REQUES WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St- Paul. UN 55104 UNLESS PROPER INSPECTION FEE IS Phone 1612) 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-0000104 , See instructions for completing this form on back of yellow copy. B 313394 ""X" 861ow Work Covered by This Request-, Mew 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 other pecify Other !spec_ityk Other (Specify) Other Other ompute Inspection Fee Below # Fee Service Entrance Size # Fee Feeders/Subfeeders Fee Circuits 0to200Am 0 to 30 As 0to30Amps Above 200 Amps 31 to 100 Amps 31 to 100 Arni)s Swinming Pool Above 100 _Amps Above 100_Amps Transformers Irrigation Booms j Partial Other Fee Signs SpecialIns pec*_ion Remarks TOTAL Ff1 1 Final if nrtify that hereby rtify that the above t o inspection has been ,w(? made. This request void 18 months This request void mon from 7 4 /. 3.4 ?-/ I , C? Lj Request Da a ^ Fire No. Hough-in In ion Re uire Ready Now X11 Noiify Inspec f Wh es [] No or en Ready r Licensed tectric Contractor 1 hereby request inspection of above ? Owner electrical work installed at: Streef Address, Box or Route No. City ect n No. Township Name or No. Range No. County Occupant (PRIN Phone No. Power S tier - Addres ' f - El tri I ontractor (Company Na e) racto s License No A -Address Address (Contractor or Owne Making stailation) Au rized ign re (Co a r Owner a g nstall tion) Phone umber - 1? PIXY t 1 tMINNES STATE B_ RD OF LE E FICITY THIS, INSPECTION REQUEST WILL NOT Griggs- dway BId Room N.1 1 BE ACCEPTED BY THE STATE BOARD 1821 University ve., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612} 297-2111 ENCLOSED. p/ REQUEST FOR ELECTRICAL INSPECTION EB-00001-ii QtY , See instructions for completing this form on back of yellow copy. 318 4 ,,X" Below Work Covered by This Request 3-= ?"5 Miim Add ReO-. Type of Building Appliances Wired Equipment Wired Nome nge 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 Other (Specify) ther (Specify) Other (Specify) Other Other Compute Inspection Fee Below R e Service Entrance Size # Fee Feeders/Subfeeders it Fee Circuits ,U 0 to 200 Ams 0 to 30 Ams iC9 Oto30Am Above 200 Amps 31 to 100 Amps ^?L1 31 to 100 Amps Swimming Pool Above 100___Amps Above 100 ____Amps Transformers Irrigation Booms [71 Partial, Other Fee Signs Special Inspection $ TOTAL E Remarks i Rough-in Date ".Spector. Elecirical^ (paJ &i Inspector, hereby Jertify that the above Final Da a - inspection has been made. This mouest void 18 months from CITY OF EAGAN Addition SUN CLIFF 2nd Owner Remarks Lot 4 Blk 1 Parcel 10 72976 040 01 Street 1889 Bear Path Trail State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, ?2 q, 369-37 24.62 15 344.75 C010402 5-25-8.5 STREETRESTOR. 1/d18 1986 -rrr ?i 431.51 5 6217,5-53 C'- /0.39/ f0 Y5 GRADING /7-r' SAN SEW TRUNK 1970 48.64 1.95 25 17.60 " " SEWER LATERAL . 212.51 11 11 SEWER LATERAL 999 1986 829.62 165.92 5 24, a - 1o3 9/ o 5 WATERMAIN WATER LATERAL 1000 1986 942.60 188.52 5 4-), v - o -/1 /0-tr 4-5 WATER AREA 40V 1973 62.34 4.16 15 8.39 WAT AT BEN +98 1986 57.88 11.58 5 7- _F C'- STORM SEW TRK o,' 1971 161.72 8.09 20 140.52 STORM SEW LAT 4 S/W SERVICE 1005 1986 808.77 161.75 5 off, 77 0-10-371 jU .f- CURB & GUTTER SIDEWALK STREET LIGHT STORM SEW LAT 1006 1986 610.14 122.03 5 6210,tq C'- /Oj /U d' Road Unit 280.00 52683 6/13/85 WATER CONN. 500.00 tt " BUILDING PER. 1 n it SAC S15 CIO n n PARK - 1 CITY OF EAGAN ?® O 3 8 66 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be and for SF DWG/GAR Est. Value $61, 000 Date JUNE 13 19 85 Site Address 1889 BEAR PATH TR Erect ® Occupancy R3 SUN CLIFF 2ND Lot 4 Block 1 Sec/Sub Remodel ? Zoning R1 . Parcel No Repair ? Type of Const. V . . Addition ? No. Stories KEYLAND HOMES Name Move ? li h ? D Length 42 Z Address 3471 W 173RD ST emo s I t i ? Depth 4 8 z n . mpr. Sq. Ft. City JORDAN Phone 435-3323 Install ? o Name SAME Approvals Fees pu Address Assessment . 0 0 Permit ?- City Phone Water & Sew. Surcharge 30 . 5 0 Police Plan Review 158.00 FW Name DENNIS HALLOUIST Fire SAC 525.00 u? Address 5001 W 80TH ST Eng. Water Conn. 500.00 W City BLMTN Phone 831-1875 Planner Water Meter 63.00 Council Road Unit 280.00 1 hereby acknowledge that I have read this application and state that Bldg. Off. 6/ 13/85 Tr. pl. 132.00 the information is correct o gree to compl with all applicable APC Parks State of Minnesota Stotut City E s. = Var. Date Copies 1 Signature of Perrnittes - $2,004.50 Total A Building Permit is issued to: KEYLAND HO S g - on the express condition tha+ all work shall be done in accordance witV/alj applicablx rdts} of4yliooesoto Statutes and City of Eagan Ordinances. Building Official 0010- 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 1 SET OF ENERGY CALCULATIONS To Be Used For:Y/4.e /V luation: Date: --/d -f-S Site Address: `Rd ' / u N P 7P-91(- Lot: _`' OFFICE USE ONLY Block Sect/Sub Erect Parcel I e Owner 2 h? Lss Address L,f `23 5f City/Zip Code -` , J " z Phone ;33 7 -3 Contractor Address City/Zip Codes Remodel Repair Enlarge Move Demolish Grade APPROVALS ?C Occupancy Zoning (2- I Type of Const II of Stories Length Depth Sq Ft Assessments Permit Water/Sewer _ Surcharge Police Plan Review Fire SAC Engr Water Conn P1 W t M anner a er eter Phoneme Council ,,Road Unit Bldg Off y17"j?.' Parks 3©..m 158.°= 525. °= 5co• (0? bn -L E>a Arch./Engr. APC Treatment Pl (32. - !? oO l Variance Address 613 36 TOTAL City/Zip Code Phone # //,P9 Ben7t- >^Lx?A p4 "? FOR: KEY-LAND-HOMES N 89°30'31" E .r89O.7 ?s.oo (e914) 0 Scale: 1" = 30' ~ I 4 ',Denotes Iron Monument Q ? (893.9) Ll 40 N C,N 'S L:) NOTE: c Denotes Wooden Stake N lllj f-1ousC cv f M Cti Proposed Garage Floor E1.= &970 (896.7 ) Denotes Proposed h - (8 6 7) 2 Finished Ground El. 'vv. Z r -f- Denotes Di ection N r Of Surface Drainage Vertical Datum - N.G.V.D. 1929 &93 29 Z5. 00 r8 9" ! l) ?1 F TL-11 TRP! Lot 4, Block 1, SUN CLIFF SECOND ADDITION, Dakota County, Minnesota WE HERESY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND Of THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND Doted this day of ,J Ar A D D. ± C. R. WINDEN d ASSOCIATES, INC. -?`..,d.: t "rte "^!.•' ? •....f ` 14 by Surveyor. mimn*soto Registration No -3.;u Facie 1 of 4 EXTERIOR, ENVELOPE AVERAGE "II" COMPUTATION 3 OWNER: --- - fATr ------ --? 9 SITE ADDRESS: PHONE ; CONTRACTOR: Determine working square footage of each 1. Total exposed wall area ....-7 16 ---1114-_ _sq. ft. x .11 2. Total roof/ceiling area.... = Z 040 _s y 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...... e. Total wall framing area (average 10%) ............................ f. ............. . . . . . . . .. . . . . . . Total rim joist area.......... --- ??2? 9• net wall area above floor ............................ ;--?? h. wall area above floor .... /-?-rls i. wall area above floor. .. ...`... . j. frame wall area at foundation.. .................. Total exposed foundation area= _ _Q_ 4 k. Total foundation window area .Total net foundation area above grade ............. Determine "u" value of each wall segment (e.g. window, door, each separate wall section) a. X 1U., b. 3 X I,U„ , 31 _ l f 1 c 4o X „U" d. X ""Ulu e. X I'u" of, f . ,37, _ X "u' , Q4 _? 9' X flu" h. j. k. X "U" X "U" X "U" X "U" X U ----5. .................................Total = If item #3 is the saw as. or less than item #1, you have met-the Intent of SBC-6006 (o 4 - - EXTERIOR ENVELOPE AVERAGE h COMFIITAL OWNER • ..: SITE ADDRESS: PI IONE : CONTRACTOR: . ki64 S 4csi..f Determine working square footage of each 1. Total exposed wall area ..... 1)4`_sq. ft. x .11 2 . Total roof/ceiling area ....L Q p s q . It. x .026 = Z Total exposed wall area alabve floor= ?# .7 a. Total wall window area ........................................... b. Total door area .................................................. c. Total sliding glass door area .................................... d. Total fireplace wall area ........................................ e. Total wall framing area (average 10%) ............................ ( 77_ f. Total rim joist area ............................................ g. net wall area above floor ..................................... h. wall area above floor ..................................... i. wall area above floor.... ............................... j. frame'wall area at foundation .................... ............. Total exposed foundation area= _??J k. Total foundation window area ...................... 1. Total net foundation area above grade .............. tirbe Determine "u" value of each wall segment (e.g. window, door, each separate wall section) a. X „ U dp =-:7 b 3'8 X ,U, -31 C.- 4o X ,IU" d. X „U„ e. I72- _ X "U„- f._ 137, X „U„ s P I S X ?„ • oS =??et? ____ h. X "U" i • X I, U,l j• X „U„ k. X fU„ ? • X 11U11 5.3 .................................Total If item #3 is the sam as, or less-than item #1, you have met, the intent of SDC.6006 (c Ir rior. Envelopo Average "U" Computation Page 2 of 4 ThLal exposed roof/ceiling area = LAO M. Total skylight area n. 'Total roof/ceiling framing area (average 10%)... -?04 o. Total net insulated roof/ceiling area ........... 3,TOL Determine "U" value for each roof/coiling segment M. X "lull 0- X gluts OZ, 4. .......... Total = 2? •Z. If. total 'of 114 is the same as, or less than #2, you have met the intent of SIC .6006 .(c) 1. Alternate Buildin 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. + 2. Z.71 37. 3- + 4. Z? •2 - ?_? (p 1• . • I WAI.t, f,Cr;'I';c S UGc ?51...of ?? rjlur wall Arc/ (or frnm,t coIlc;trucI ion SIC A1.I, FIG. M] 11011V1111.1 OF FItAt'IE WALL FIG. 112 i:i)-5r A LEA 4. a1 K-? ?\ p Ii•rn0 !'.u1c ':'S?Ir (ow:tI'llull?ik,l?n 1t-Vf1IIw, 1 . nlt i Im U (,I? 2. .r?.?.$A_ •. ?• 3 "?IUi:III"/ .rJ(I, h"I..--°.•.__....... ..... .. . .5I•D.!?-j.(p. .(02. 6. xlcr iur 'i.r: (i :m U. 17 1•,11,ll 1z,Z7 u- 'as s INSut• 1. Intc'rinY air ilm 0.611 G. Ext.hHor air film V=oS 1. 1lit 1-.I ior,11.1' I ll171 0.(111 2. JJ? J,R._....3.. '& .. _ _..._... J .P._ 3. J.Sq 6. Exterior nir film 11.1.7 _. To t a 1. Zi . V?.o9 LIL. 1, In 17I c-?c a I r f i 1!n U. On 2. __._.»_.__ ._.._...... _ ........._ ..___ .._ 3. I Z"..__tic2NG Et.. . _....... _..... /?.ZZ 4. . _.2. _5 4.va._... _...--- /.2.x..0 1).17 'tb1:11 - /Z,13 U 'it-All ON !;RADE 13 v, ?I 1. -...??.. 11-1 . ' ... . ? 1 rtt ? ' , !l! l i t . FIG. 114 1(t << :> / v /?! fit! t 11rl'1.': Indi1_nt.. t.y're, "R" valull, depth And pIacerwnt of irl^,uI., .ion. PLAQ * 33z!. ® L i i EA L FT, F-XpOSED L.oG k..)i 7-40+9 o -t 2!0 -?- q-O = / 3 Z ULL1?j,; 132 uLL 2 iz. l t?t : ?, i f 3 2 WALL c . art', EKPo ,E WALL AREA 1 32- X NEE ?•, 13 Z._. X. S = G (oo Vet o PuLLil , /3z k g = !off FU LO L k F, K.i M . ?I 3 K ^ 3 -o1 L = fill-- 11 ¦ Sq.,Ft. EKPoSED GEILIIJq L(oxtta. logo ?o(fo 11, W Dwi5 3(, Z it ® D oo rzs z 39 3zS PA"T"IO D2.S Z __1 S M-? U LJ i -f-5 t?l d • WOOF/CEILING L r y canrir i (on A-VAWO 1• interior air film 0.61 • ` (`? (? I`J,}IL 4. Exterior air film(st:ill /.11? (?-TSi1?t?l1iI111I -? Total ( . :.Hied Heat flow 1• Interior aiirr film 0.61 2- 5f up • 4. Exterior air ti.ln (st"iiT GT- Total r q P. IS ric. 15 A) .0241 COA- rV-ie r eay`,_ ...1,- ._ _.r_•__:1" - _--r-__? I. Inside air filth 0.61 tom. 2. (1 (? .j? S. Outside air filth U. 17 'y I1 1/ i? t Total 2 3 . LG 1. Inside air film 0.61 2. Hect f lou up vented 3- 4_ • S. outside air f ilia _ 0. 17 .TIG. Q6. ... - : Total. ro v 3._ Inside air filth • . __.0.61 .•'_,f .1 =-' ?- ,l .?.;--?i ?"? 4. Out :idc air PiLn 0, 17 Total. • K0:7-VII:IZD . Vote: Use additional sheets if more space is jucedcd for details and calculations. Neat flow up •. VIG. •?7 s. •. CITY OF EAGAN IUJ *Wj *4Wb Ro - P. o, "x 21 in 6343 trr No,: Eagan, MN 55121 , bATE:. ]"' oni»9:. RI tea of Urdu: 1 Cam: ____ _ -_Ho> sc Mdrem- Stte Address: 1 $ 'tail L4 B1 .G t't+ tuber: Meter No.: f18' A* y RAd&r No,: Fee:. QQ ageaw to go** r-w;tfi ow C.iry of $"on S nct ge. SQ *0 r A+MIsc, Ci o 13200 p4 fl/ ; Totot: b4 p f?etrt By Dote taxed' Date of Insp.: 2-az P 5 ; CI*Y OF EAGAN WATER SERVICE PERMIT 3830 Pilot Kiwb Road P. O. *0* 11J9 PERMIT NO.. t3 Pagan, MN 55121 DATE: f' '"tea Zoning: ry,i I No. of Units: Owner: eylafld Hom4t: Address: Site Address: ]:fit; .F .:ax 'OU'l ".`tail. L4 B1 Spin Cliff 2dd Plumber: = ?`Iilw Meter No.: Connection Charge: 500-02" Ed Size: Account Deposit: a • ti0 Reader No.: Permit Fee: I agree to comply with the city of Eegen Surcharge: 10 Ordhmecss. Misc. Charges: 132.00 Total: 63-M Pd m9 t er By Dote of Insp.: Date Paid: Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: 7531 Eagan, MN 55121 DATE: 7`1'85 Zoning: L(i- No. of Units: Owner. Keyland U :t Address: Site Address: 1 889 year P Plumber, f' '-" chanica --I3.,-85 52 I agree to comply with the City of Bosom ordiaeness. By Date of Insp.: Insp.: Connection Charge: 425. Of) ad Account Deposit: .. Ct Permit Fee: L0.00 Surcharge: Misc. Charges: Total: Dote Paid: 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS : =66Tr LEGAL DESCRIPTION: /C'" I (Lot/Block/Subdivision or Tax Parcel I.D. NLmiber) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUI=11G =nMIT ISSUANCE: _ _ _ '.£ Tenth fe a r ) PRESENT ^'1lir,/PROPOSED 'SE: ,R-1 SINGLE FAMILY O R-2 DUPLc MO UNITS) O R-3 TOWNHOUSE (THREE + UNITS)( UNITS) O R-4 APARTi ENT/CONDOM NIUM ( UNITS) O COMMERCIAL/RETAIL/OFFICE Q INDUSTRIAL Q INSTITUTIONAL/GOVERNT 2) APPLICANT (PLEASE PRINT) NAME: ts7- ?JTY;?t ADDRESS: ?'7'?/! ? CITY, STATE, ZIP: PHONE: ?f r 3) PLUMBER PLEASE PRINT) NAM FOR CITY USE ONLY E: ADDRESS : PLUMBERS LICENSE: Active CITY, STATE, ZIP: Pl-LY _ Expired __ r?? ASTER PHONE 7 56 ) Not of Record : PLUMBER LICENSE # ? J f Staff nitia (PLEASE t PRINT) / 4) OCCUPANT/OWNER NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 5) INDICATE WHICH PERMIT IS BEING REQUESTED: CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER (PLEASE DESCRIBE) 6) INDICATE ONE: PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APP PERMIT TO 1, 2, `3, 4 ABOVE (Circle "n e) 7) SIQIATG'RE : \lss DATE lp FOR CITY USE ON-LY PERMIT # ISSUED FEES: $ $ $ $ j-?., f=v $ 3c J $ SEWER PERMIT (INCLUDE' SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER C 'rr,L r -,?y1l '$t 7C 1? TOTAL AMOUNT PAID/RECEIPT # 3z >-L/ 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 NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE : ;7// ley -a w:mw ON-me eawwt sk" **woww:mmwrlwiv?w v*wflrtw"w womwmvewl-ft !' `!! wl* w- CITY OF ELAN CASHIER: JS TERMINAL NO: 007 DATE: 07/15/99 TIM i0:342 M. ID NiAM SE:L.A ROOFING & REMODELING '.3':10 9001 089 B'E:AR PATH 0505 205 900± 1889 BEAR PATH 3.00 Total Receipt Amount % :128. i CR 1.:13437 USER TD: JAN 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681.4675 New Construction Requirements > 3 registered site surveys showing sq. ft. of lot, sq. ft. of house and all roofed areas (20% maximum lot coverage allowed) > 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) > 1 set of energy calculations > 3 copies of tree preservation plan if lot platted after 7/1/93 DATE: -7 1 4- -q q Remodel/Repair Requirements 2 copies of plan 1 set of energy calculations for heated additions 1 site survey for exterior additions & decks CONSTRUCTION COST: 5'?r0 0 DESCRIPTION OF WORK: -t-e? r°J?C 61?Qvv?"°?SP p?v/?cl? STREET ADDRESS: _ 91 7 , A th ral LOT: '- BLOCK: I_ SUBD./P.I.D. #: PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Name: wA ?C C S(" 'y- Z.- ce ? Phone #: Last First Street Address: ,50i-I G' City State: Zip: SELA ROOFING & REMODELING, INC. 4100 EXCELSIOR BLVD. Phone #: g'2- ? `.'a Company: ST. kel:118 PARK, fullm o,-)416 ID #0001050 (area code) Street Address: License # Exp. 3 31 " Q o City Company:. State: Zip: Name: Telephone #: area code ( ) Street Address: Registration #: City Sewer & water licensed plumber (required for new construction only): State: Penalty applies when address change and lot change Is requested once permit Is Issued Zip: I hereby acknowledge that I have read this application, state that the Information Is correct, and agree to comply with all applicable Stc)te 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 3 OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 02 SF Dwelling ? 07 5-plex ? 03 1 of_ plex ? 08 6-plex ? 04 2-plex ? 09 7-plex ? 05 3-plex ? 10 8-plex WORK TYPE ? 11 10-plex ? 12 12-plex ? 13 16-plex ? 14 Apartments ? 15 Lodging ? 16 Fireplace ? 17 Garage ? 18 Deck ? 19 Lower Level ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning _ Basement sq. ft. Census Code _ Main level sq. ft. SAC Code _ sq. ft. No. of Units _ sq. ft. No, of Bldgs _ sq. ft. MC/ES System' sq. ft. City Water _ Footprint sq. ft. Booster Pump PRV Fire Sprinklered Building Engineering Variance Permit Fee - a1 Surcharge 3. otj Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: ka .?-? SAC Units Valuation: $600OO 1 % SAC CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be uad for Est. Value Date I q ; ` Site Address t « is `_. w T`°- Erect ? Occupancy Lot ilJ LIFE sLI Block • Sec/Sub Remodel ? Zoning . Repair ? Type of Const. Parcel No. Addition ? No. Stories W Name ,,?,)!^ ,)^r ?{ z Move ? li D h ? Length z 3471 , 4.73 is ST Address emo s Int.lmpr. ? Depth Sq1=t Sq City J _ OROi i Phone , 3 s .-3 3 Install El . . Name MM,s s Approvals Fees Zt Assessment w, Permit *?' ?> . -' - Address Water & Sew. Surcharge 30.56 City y Phone Police Plan Review -- 0 w Name «> i',I ?, J Firs SAC ..,' o i- Address k4 Eng. Water Conn. '. City ' r st',: Phone Planner Water Meter « t.t # Council I hereby acknowledge that I have read this application and state that Bldg Off f, j/ the information is correct an ' agree to comply with oil, applicable APC State of Minnesota Statutes and City ,of Eagan Ordinances. V D Road Unit k i5 =3 « U U Tr. Pl. Parks ar. ate Co ies Signature of Permittee _ , t p Ta1' ;,-2, Total ? A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Date Telephone Plumbing S y C'. HM A.C. 17 y , f F?-C 7 - c Electric 3 3 L J o Softener Inspection Date Insp. Other Footings I Footings 11 Foundation 7 (J Framing Roofing Rough Plbg. .? ° Rough Htg. Insui. '7J Fireplace Final Htg. Final Plbg. Final CertfOcc. Water Describe Location: Well Sewer Pr. Disp. Receipt MECHANICAL PERMIT Permit No, 5 CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 7 _ t$ 2. Installation Cost 17G_o 3. Job Address /889 Lot, Blk. ) Tract 4. Owner k-W 5. Contractor Ph one 41f17 ?Ia c? 6. Address i9 ?? rho { A'o\'1U 6 7. City ,cat` --a k-e.._ State Zip ' 7Z 8. Building Type: Residential -.. Commercial ? Institutional ? 9. Work Description: New Add ? Alter ? Repair ? 10. Describe ' Fuel Type of _ 11. No. fl Equipment BTU - M. Ea. Forced Air Si 00 No. Equipment CFM Air Handlin : Mfg. C.u r t ? e. K" g Boilers 5 O Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. _ Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply all ina s n codes governing this type of work. f Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT. Permit No. r CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address f' • ; ? A=V, ;-'/ Lot' BIk. Tract r," r,xF M c. 4. Owner 5. Contractor l.r ! #d {:r Phone 6. Address a z: ;' t" T< 7. City State ''_i Zip "wJ 8. Building Type: Residential , Commercial ? Institutional ? 9. Work Description: New,. 10. Describe 11. Add ? Alter ? Repair ? No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I 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 6 -DOLLARS f00 I ? CASH CK' f r ( , FUND CODE AMOUNT , j4 7 7' Thaak You 52 83 White-Payers Copy Yellow-Posting Copy Pink-File Copy city of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: wy cG Date Received: SID -o/13 Staff: 2013 RESIDENTIAL PLUMBIN PERMIT APPLICATION Date 1/1_2P13_ Site Address: 188 Tenant: Resident/Owner Contractor Type of Work Permit Type Address / City / Zip: _ Suite #: klr _ _____ Phone: IA: g W ®'lW O I Name: tqw____ License #: Address: _____12850 Chestnut Blvd. Shakopee,City: MN 553/9 State: __-- Zip: _952,4454803 Phone: -- Contact:_ Email: 1 Replacement __ Repair Rebuild a le i RESIDENTIAL b( Water Heater ___ Lawn Irrigation (__ RPZ /___ PVB) _—_ Septic System 1 RESIDENTIAL FEES: 1 $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) 1 $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) u $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ j AL CALL BEFORE YOU DIG. CaII 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.orq 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 Eaga; 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 accortlance with the apprd plan in the case of work which requires a review and approI of plans. ' r Mil& New Water Softener —__ Add Plumbing Fixtures (___ Main / _— Lower Level) _ Water Turnaround Modify Space __ Work in R.O.W. Abandonment ea - xC Applicant's Printed Name FOR OFFICE USE Required Inspections Reviewed By: icant's Signature _ Under Ground Rough -In Air Test Gas Test Final