729 Caribou Lane
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA086672
Eagan, MN 55122 . Date Issued: 10/06/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 729 Caribou Lane
Lot: 11 Block: 4 Addition: Fawn Ridge 2nd
PID 10-25801-110-04
Use
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are
required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Renewal Andersen Thomas M Brown
1920 County Road C West 729 Caribou Lane
Roseville MN 55113 Eagan MN 55123
(651) 264-4777
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.
Applicant/Permitee: Signature Issued By: Signature
BLDG. PERMIT NO.
y'
r ter, `'rte -.lr'r
01-3210 Bdg. hermit
_ S
01-3422 Plan Check f`'? A,&
F 01-3445 Surch./Adm.
01-3446 SAC/Adm.'s
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter 20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded,
TOTAL t
: Date: `126/`"7
CITY OF EAGAN Permit No: J-A~ 8846
3830 Pilot Knob RYoad Meter No: Size:
P.O. Sox 21199 Reader No: Date:
Eagan, MN 55121
r._.l d Tomes
Owner.
~
Site Address: 729 C4ril~o~+ .14
Plumber. ,ecl:~
i ~
Conn. Chg:1'15 - "1( )Pd Zoning: T~
-d
Acct. Dep: 1 ii
s r- No. of Units:
t,z 01)Pd
Permit Fee:
Surcharge: ~r,(-)pd I agree to comply with the City of Eagan
Tr. Plant 1.8t2 , nnPd Ordinances.
Meter. or-pu,
Misc.: By
WATER SERVICE PERMIT
CITY ®F FAGAN, SEWER SERVICE PERMIT
3830, Pilot Knob Road
P.Q'. Box 21199 PERMIT NO.: I1 X01
Eigan, MN 55121 DATE: ;,j2' js?7
Zoning: Y. 4 r. I No. of Units: I
Owner. -Vip,j ao. Tdnrnag
Address:
Site Address: f arihin,1 Ts»e ? 1 1 *p, T"-;P n#Qra 11
Plumber. DC 1„ curb jD--nn;z (,;,i ; h
5/20/87 873743 1t~0.rJOpc=
i I agree to comply with the City of Eagan Connection Charge: 525.00 d
Account Deposit: 15.00pc
Ordinances.
Permit Fee: 10 `00pe
_
Surcharge: .50P(1
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
CITY OF tAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value G 7 Date ,1
Site Address OFFICE USE ONLY
Lot I Block " Sec/sub. I) On Site Sewage Occupancy T_
MWCC System Zoning
Parcel No. On Site Well x Type of Const
City Water (Actual)
Name (Allowable)
_ of Stories
3 Address " C Length
O City Phone `'4-•~r,3'° Depth
S.F. Total
q Name Footprint S.F_
0 a Address APPROVALS FEES
P City Phone Assessments Permit
Water/Sewer Surcharge ?
W I :I I
W m Name Police Plan Review T
EE Fire SAC, City
E E Address -
U O Engr. SAC, MWCC ?
s m City Phone I I Planner Water Conn.
Council Water Meter -13
I hereby acknowledge that I have read this application and state Bldg. Off. Road Unit
that the information is correct and agree to comply with all applicable APC Treatment Pi i6 f
State of Minnesota Statutes and City of Eagan Ordinances. Variance Parks
Copies
Signature of PermitteeTOTAL
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( 9, v
H.v.A.C.
Electric
Softener
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing L71-
ci `fu
C° Nt'~cf ~..S-fiar-~ o•~ /.~t d,
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg. p 6 t7 /f
Final Plbg. _
Bldg. Final F ,,P
Cert. Occ. 9'4,4 A . Jf.
Tl
D~0of ~fw-s dv- G-J-+7
DWP"•rr• r Uo ' or
ly I -A
f G i t ~7 r 1/ . /Z /tea 7
s .
PERMIT # F'
PLUMBING PERMIT RECEIPT # CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: f 4 7 q
CONTRACT PRICE PHONE: 454-8100 u,
Site Address BLDG. TYPE . WORK DESCRIPTION
LotBlock s` Sec/Subs" =
Res. New
Name 42 C er- )?wt- , c,* _ Mult Add-on
m
Address ` e- Comm. Repair
c City Phone Other
{ NO. FIXTURES TOTAL
` Name °S Water Closet - $3.00 `
3 Address / Bath Tubs - $3.00 ' C
p City Phone Lavatory - $3.00 0 0
Shower - $3.00
_ Kitchen Sink - $3.00 7:• d
FEES
COMM/IND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00 ~ v
MINIMUM - RESIDENTIAL FEE -$10.00 1-Laundry Tray - $3.00 . C)
Floor Drains - $1.50 4 71
MINIMUM - COMM/IND FEE - 20.00 --L-Water Heater - $1.50
STATE SURCHARGE PER PERMIT - .50 Whirlpool - $3.00
(ADD $.50 SIC IF PERMIT PRICE GOES -1-Gas Piping Outlets - $1.50
BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL:
PERMIT # 75 X5,7[
MECHANICAL PERMIT RECEIPT # 75
1 CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ///67
CONTRACT PRICE: PHONE: 454-8100 a
Site Address ar~ 6au -a Al C_
BLDG. TYPE WORK DESCRIPTION
Lot Block Seq/Sub
Res.- New X
Mult Add-on
Name
Comm. Repair
Address Other
c City AA 1r.~. Phone 1 - /
~j
FEES
Name RES. HVAC 0-100 M BTU -$24.00
c Address I/ qK4-S-D lbw ADDITIONAL 50 M BTU - 6.00
p Ciry A~,lPhone (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 M BTU V W APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU g REMODELS - 12.00
Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
$ (ADD $.50 S/C IF PERMIT
PRICE GOES
Gas Piping Outlets # $Si BEYOND $1,000)
•'gi
Other $
FEE:
e'1 ;ka
S/C: SIGNATURE OF PERMITTEE r
TOTAL:
FOR: CITY OF EAGAN
PERMIT # .f2 F(( a
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN /
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 11F,2
CONTRACT PRICE: PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot ~L- Block Sec/Sub Res. New
• ~2'17 Mult. Add-on T
Name ' t a Comm. Repair
4 Address Other
C city t.' Pht~iAe ^ ? - RES. PLBG. ONLY -COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Name LAI, Water Closet - $3.00 $
Bath Tubs -$3.00
3 Address Lavatory - $3.00
p City Phone' n Shower - $3.00
r' Kitchen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains - $1.50
:
TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - $1.50
MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets - $1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) tit
(ADD $.50 SIC IF PERMIT.PRICE GOES I Softener - $5.00 C.
BEYOND $1,000.00) Well - $10.00
Private Disp. - $10.00
i r eRough Openings - $1.50
SIGNATURE OF PERMITTEE FEE: `Yr
STATE SIC:'
FOR: CITY OF EAGAN GRAND TOTAL: s`
Date: 6/26/'-
CITY Of EAGAN' Permit No: I~-~`(
3830 3830 Pilot Knob Road Meter No~5EZ Z4
~f Size:
P.O. Box 21199 Reader No: ~D 7 o Date: 7=
Eagan, MN 55121
Owner. ;Tomes
Site Address: 'fig Caribou Lana L1.1. B-4 Fawn Ridge II
Plumber. ; cc , >enny (i >
ry
Conn. Chg:i"' r)t{„'i ~R1 i
Acct. Der:
Permit Fee: Tld Refnre j j(1$ 0211 1iC~~"°
Surcharge: r`2,:i -7G a4~(7NF tit 5 Eft.
`~rr~~, ~ ee o comply with the City of Eagan
Tr. Plant Q v t)+- a W
Meter. r,
REQUIR
Misc.: By
WATER SERVICE PERMIT
Terttftrafr of (Orrttputtry
4Citp of (Eagan
h ' arvartmrnt of suiohlo insprdimt
~ y 4
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
i
z.
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.•
Use Classification Bldg. Permit No.
s y
y Oxapancy Type Zoning District Type Const.
s r ^ ! OwnerotBtulding i 47 AA, gddresy...' k ( ,afily `;~i;1:. ~;4sf. is s r'
Building nadtess Locality L1 ! s '?4, FAWN RL-E,
6, 198"?
Date:
Building Official
~ ~l
' POST IN A CONSPICUOUS PLACE
y
F
` r'
Renewal By Andersen RESIDENTIAL --I
35'0-73rd Ave. NE WING PERMIT APPLICATION
Fridley, MN 55432 CITY OF EAGAN )
763-502-4777 U ~-C
#MN20130983 I i 3830 PILOT KNOB RD - 55122
7Lf~ 651-681-4675
Newconatruodon Requirements RemodelfReoair Requirements
. 3 registered site surveys showing sq. ft. of lot, sq. ft. or house; and all mofed arm . 2 ooples of plan
(20% madmum lot coverage allowed) . 1 set of Energy Calculations for heated additions
. 2 copies of plan showing beam & window saes; 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 d lot platted after 711193
. Rim Joist Detail Options selection sheet (IRdgs with 3 or less units)
DATE VALUATION a~ I`JO`
JOB SITE ADDRESS 019 CO.( *rbau LOXl
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNERTOYrm
ne.a10. a ._":%hnc% FIREPLACE(S) _ 0 _ 1 _ 2
TYPE OF WORK?
APPLICANT r ."r PHONE#
ADDRESS ZIPCODEzl~
PAGER # CELL PHONE # FAX #
VIEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) Residential Ventilation Category 1 Worksheet Submitted
Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone
Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor. Phone #
Mechanical System Includes: Air Conditioning Fee: $70.00
Heat Recovery System
Sewer/Water Contractor. Phone #
All above information must be submitted prior to processing of application.
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 Or ' antes.
Signature of Applicants 3OJY1LC6 1
Certificates of Survey Received Tree Preservation Plan Received - Not Required
Updated 1101
INSPECTION RECORD Control No. 0875
CITY OF EAGAN PERMIT TYPE: e111111>«7a241111
3830 Pilot Knob Road Permit Number: 0#11*9
Eagan, Minnesota 55123 Date Issued: 01991#2
(612) 681-4675
SITE ADDRESS: LOT j 11 91 ocls , 4 APPLICANT:
139 CAR1110V LAN& FIREPLACC •PECYALIV?
CFA" RXOSE ?NO (612) 441^•12'7!
PERNffRSypaY f E: TYPE OF WORK: 049W
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR.
FlorPI ACF
Permit No. Permit Holder Date Telephone Of
SNd
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Commends
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Mg.
Isul.
Fireplace
Final Mg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Deck Ftg.
Deck Final
Well I
Pr. Disp.
1 8 his
fro to O void ~/s/p 7
months request
1
D 4 8 5 4 ~r r endue-y
Request Dn to Fire No. Rough-in InsV -non
` ~i Regwred~ Ready Naw ~Y0>71-MOnfY Inspec-
V^ p ' es ❑NO for When Ready
Electr cal Contractor I hereby request inspection of above
❑ Owner electrical work installed at.
Street Address, Be. or Re to No. city
RJ
ecnon o. Towns ip Name or No. Range No. CoupX
v1 r
Oecupdnt 1 NTI Phone Nn.
L ir/ Q
Power uppl Address
L'
Electrcal C tractor (Company Name) Contractor's License No. leel
Mail` ddr ss (Contractor or wner akmg 1 taflanoN /
Author,z Si eater ontractor Ow r Makui Insta non) Phone Number
MI SOTA S E BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
QriggsMidway Bldg. -Room N-t 91 BE ACCEPTED BY THE STATE BOARD
1921 Universit Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612)fi4 -0800 ENCLOSED.
6,151 ;2 REQUEST FOR ELECTRICAL INSPECTION E/B)-00001.06/y
'See instructions for completing this form on back of yellow copy.
D. 4 *9 5 4 " X" Below Work Covered by 7hts Request
rdtl' - `Type of Building Appliances Wired Equipment Wired
Home ange Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Electric Healing if, --onrel Commercial Bldg. nu ce Silo Unloader
Industrial Bldg. it Conditioner Bulk Milk Tank
Farm Other peo y Other ISpwufy)
[ er specify Other Other
Compute Inspection Fee Below
e Fee Service Entrance Size tt Fee Feeders/Subfeeders a Fee Cvcwts
„7,Od 0 to 200 Amps 0 to 30 AM DS 0 to 30 Am
Above 200 Amps 31 to 100 Amps If;< 31 to 100 Am
Swimming Pool Above 100 Amps Above 100 _Am s
Transformers Irrigation Booms t1 O Partial-Other
fi~
Signs Special Inspection $Remarks t,S"~;,.J - TOTAL F 51'0)
4 '01, J. Rough-in DnM the Electr
o' o "'spec tar. hereby
certtly that the above
F mal Dale q7 spec U On has been
de.
This request void 1S months from
This request voitl
18 months from / O
D 2605b Z//
Request Date Fire No. Rough- n Inspection
Re~quu~ed? - gR23CPT7uw Omit Nolily Inspec-
t-Pros IJ'yo for Mo RReady
ense lectric Contractor 1 hereby request inspection of above
❑ Owner electrical work installed at:
Street Ad ss, Box or flou No. C,ty
Ize
echo o. Townsh me or No. flange No. Cour
O
Occupant ( 1 Phone No.
N
Power Suppber Address
Electrical C actor (Company Name) Con trat...1 s icense o
Mailm d ss ( ontractor or Own & Making Inst.ilanon)
Authorized S1 n re (Contr r Owner Ma Installatinn) one Num r
NNE O STATE ARO OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
MI
NNE- itlwST Bldg. -Room LE BE ACCEPTED BY THE STATE BOARD
MN 66104 UNLESS PROPER INSPECTION FEE IS
1821 University Ave.. St. Paul. ENCLOSED-
Phone (612) 642-0800
6/M? REQUEST FOR ELECTRICAL INSPECTION ~EJB-0000011-06
/
/Sae instructions for completing this form on back of yellow copy.
2605 5 .X: ' Below Work Covered by This Request
Add Reii. - Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Flxtlties
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
4 Farm they peel Y Other ISprtrify) ofi- t pe ter Other
Compute lnspe ion fee Below
ft Fee Service EnhanceSae b Fee Feeders/Subfeeders a Fee Circuits
0 to 200 qm s Oto 30 Amps Otn 30 Am S
Above 200 Amps 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Am s Above 100-Am s
Transtormers Irrigation Booms ,J Partial.'Other Fee
Signs Special Inspection s .G. TOTAL O
emarks
0
Bough-m Date 1, the Ere Inspecfor trice
tor, Hereby
certify that the above
Final r Date inspection has been
/
7he de.
This request cold 18 months from
~~~i~•.i auu ice. uv rm rov 0r1 4400 1tC,1v15RAl. tSY°AnUCK.7C1Y r81UUZ/UUL
Y
re al
BYANDBBSEW
June 7, 2001
City of Eagan
3836 Pilot Knob Road
Eagan, MN 55122
To Whom It May Concern:
Elder Jones is authorized to pull building permits for Renewal by Andersen- Please allow
Elder Jones to provide this service for us in Eagan. This authorization is valid for any
date beyond 616101; until a renewal by Andersen manager expressly revokes it in writing
to the City.
I request this authorization be accepted expeditiously, as to not delay in the processing of
our building permits any further. Please call me if there are any questions. I can be
contacted at 763-502-4706.
Your immediate attention to this matter is appreciated.
Sincerely,
ymond R. Rau
nstallation Manager
Renewal by Andersen Corporation
C:c: Kara-F.lder Jnnea
GHADA OR ~i GAMAL
Notary Public
Minnesota -
MY C01" °0^raavat,Jan. ef2Op5
Received Time Jun. 1• NA
PERMIT Control 0875
38f0Y OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: BUILDING
Eagan, Minnesota 55123 Permit Number: 001169
(612) 681-4675 Date Issued: 07/29/92
SITE ADDRESS:
729 CARIBOU LANE
LOT: 11 BLOCK: 4
FAWN RIDGE 2ND
DESCRIPTION:
:~Build'ing Permit Type FIREPLACE
Buildinq,~Work Type NEW
t
REMARKS:
13D
FEE SUMMARY-
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR: - Applicant - -ST- LICOWNER:
FIREPLACE SPECIALIST 14511970 0003924 LANGWORTHY JOHN
1200 9TH AVE 729 CARIBOU LN
S ST PAUL NN 55075 EAGAN NN
(612) 451-1970 (612)688-8648
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.
Statutes and City of Eagan Ordinances.
L 9 - I
APPLICANT/PERMITEE SIGI URE SUED Y IGNA RE
INSPECTION RECORD Control No. 0875
CITY OF EAGAN PERMIT TYPE: BUILDING
3830 Pilot Knob Road Permit Number: 001169
Eagan, Minnesota 55123 Date Issued- 07/29/92
(612) 681-4675
SITE ADDRESS: LOT: 11 BLOCK: 4 APPLICANT:
729 CARIBOU LANE FIREPLACE SPECIALIST
FAWN RIDGE 2ND (612) 451-1970
PERMIT SUBTYPE: TYPE OF WORK:
FIREPLACE NEW
DATE INSPTR. INSPECTION TYPE DATE INSPTR.
INSPECTION TYPE FIREPLACE
L-
PERMIT B CITY OF EAGAN
REACTIVATE _ 1992 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys,, I copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans; I set of
specifications, I copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up°,by last working day
of month in which re guest is made or lot change is re guested once permit is issued.
Date 7 Valuation of work 3 D oy
Site Address: 5 a i 100 U ~n
STREET SUITE /
Tenant Name: (commercial only)
LOT BLOCK SUBD.
P.I.D.
Description of work: )7 W S l`~ 44
The applicant is: ❑ Owner ❑ Contractor ❑ Other (Describe)
Name _ L A ■i G Lyn 2 7~i. i/ d v vV Phone Property LAST ~ FIRST °
Owner Address bo U
STREET STE R
City a Y/ State Zip
Company Q? t 4 C e See Q-.,' c,L s -t Phone; W E / 2> a
Contractor Address License # oo0-31~l Exp.
City State YYl 1?/ Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area as been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all a licable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
CITY OF EAGAN N2 13 6 4 2
3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN.55121
` PHONE: 454.8100
BUILDING PERMIT * Receipt # r-7 3"1y3
Tobeusedfor SF DWG/GAR Est.Value $67,000 Date MAY 19 t~7
Site Address 729 CARIBOU LN OFFICE USE ONLY
R3
Lot 11 Block 4 Sec/Sub. FAWN RIDGE 2ND MOn Site WCC system Zoning
Parcel No. On Site Well Type of Const X
City Water (Actual)
a Name KEYLAND HOMES (Allowable)
w * of Stories
Z Address 14450 BURNSVILLE PKWY Length T+~
o City B'VILLE Phone 894-2636 Depth 1+$
S.F. Total
,o Name SAME FootprintS.F.
0` Address APPROVALS FEES
P City Phone Assessments Permit $ 388.00
Water/Sewer Surcharge 33.50
0
W W Name HALLOUIST Police Plan Review 194.0
0
z Fire
Address SAC, City 100.0
Engr. _ SAC, MWCC 595.00
aw City BLMGTN Phone 831-1875 Planner _ Water Conn. ~
Council Water Meter h / .UU
I hereby acknowledge that I have read this application and state Bldg. Off. Road Unit 305.00
that the information is comect agree to comp) with allapplicable APC _ Treatment Pt 7R0_no
State of Minnesota Statute Id 'of ances. Variance _ Parks
Copies
Signature of Permittee TOTAL $T 50
A Building Permit is Issued to: KEYLAIK HOMES on the express condition that
all work shall be done in accordance with all applicable St a of Minnesot Statutes and City of Eagan Ordinances.
Building Official
Y
1987 BUILDING PERMIT APPLICATION - 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 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
- ~ b-710--x7
To Be Used For:c~/]~jaluation: ~Jl/ Date:cJ ZZ
Site Address ! C~14~1c ep, OFFICE USE ONLY
Lot ( ( Block On Site Sewage_ Occupancy 3
l MWCC System ✓ Zoning fz l
Parcel/Sub /`d'-` On Site Well Type of Const
/ City Water ✓ (Actual)
Owner (Allowable)
n n S of Stories
Address / / V-V--o ~ cXy( Lm Length
n n Depth 48
City/Zip Code' llt4 a ve/~ S-R37 S.F. Total
APPROVALS FooFEEpFSrint S.F.
Phone
Contractor Assessments Permit
Water/Sewer Surcharge '33 -
Address y Police Plan Review
Fire SAC, City 100
City/Zip Code Engr SAC, MWCC 5Z5
Planner Water Conn 52-5.
Phone Council Water Meter (O1,
Bldg Off Road Unit 507 -
Arch./Engr. APC Treatment P1 18D•
Variance Parks
Address Copies
TOTAL
City/Zip Cod I
Phone # / l df'7 S
Z~ ~O 104- k Sb X320
Zo x22 = ~4d x ~z. _ ~z~o
`~x~ - (cx~ X8 r coo
ROBE KEAAMD)
CONSULTlHO ENOINEEAS
ENGINEE[IING PLANNERS and LANG illRVEYOftS H0ME"'>
CompnNyl INC. psa'°~
1000 EAST 146th 57REET, BURNSVILLE, MINNESOTA 5337 PH 412-3000
UsQ~l I7"C7-L'02 iort; LOT. 11, BLOCK -4, FAWN RIDGe 2ND ADDITION)
DAKOTA CC)UNTY, MINNESOTA
X2,8 DENOTES' EXISTING ELEVATION
(945,5) P NOTI=S PROPOSED ELEVATION
INDICATES DIRECTION OF
SURFACE DRAINAGE
9¢5.83 FINIS!-IEP GARAGE F=LOOR
ELEVATION
A
i ,tip Ig DRAINAGE AND SCALE: I 'z3()
` -
aoh~O,\O UTILITY EASEMENT
~ hd
J \ 4 SR o ~ .
S
1> F 30' BUILDING
`ay,~ SETBACK LINE
O U1 ~iSi D[~i~
00
r'ay.~ qk ~ ~ CY
0
p 0
(94+0
N
~O
I hertby certify that this is a true and correct representation of a tract of
land as shorn'and described hereon,. As prepared by me on this ,&f day of
_A?;y , 198-1.
Minn. Fag- NO- 160rr
v (i
rage i or v
EX RIOR_CNVELOPL AURAGC "H" COMPUTATION
OWNER.,_ _ nnir: . ~q•as
SITE ADDRESS: PHONE
CONTRACTOR: Kell a 6% D
Determine working square footage of each
1. Total exposed wall area _ 4--sq. ft. x -.11_= ziD.S
i
i 2. Total roof/ceiling area..... tQAD_sq. ft. x .026 = 7:1
Total exposed wall area alinvc 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 are,a (average 10%)
f.- Total rim joist area.
g. net wall area above floor 1385
h. wall area above floor
j i. wall area above floor ....HR _
J. frame wall area at foLuulation
Total exposed foundation area=
j k. Total foundation window area
1. Total net foundation area above grade
Determine "u" value of each wall segment
(e.g. window, door, each separate wall section)
I a._~ X „U Ldp
3~-IF-- I1 1
b. 3z - X V.
r. _
d. X U.,
f l 3 z X U„
i
g• 1315 X "U" dS =
_ rer~
h. X U.. _
i. X ,.U1. _
j. X .U.,
! if item R3 is the sam
k. X as, or less than item
U. you have met,the
1• X "U" $•_3 Intent of SDC 6006 (c
3 . .................................Total
/n. Envelope Average "U" computation Page 2 of 4
Total exposed roof/ceiling area
tal skylight area
tal roof/ceiling framing area (average 102)...
o. Total net insulated roof/ceiling area...........
Determine "U" value for each roof/ceiling segment
X „U,.
M.
e.~ X .,D,, OZL = rE 7
4 'Ibtal - ZLL
If. total of 114 is the same as, or less than 112, you have met the intent of
SBC 6006 (c) 1.
Alternate Building Envelope Design
To (utilize the total envelope 'system method, the values established by the stun of
items 03 and 64 shall not be greater than the sum of items !tl and 112.
1. - 71 O. S i• 2. Z7 237. S
4: at
- WA. T-1, l-,rrT,0W1 Two
.•r• ~,1 or Pp9(!urI wall areA for
from': const rust inn C'on:l rui: t it'll
I:-Vr(Iua
;Ai i__
- 4 ` DI
SIC ^ 6. F:r.l'_rior air: (iLn > U.17
ALL - -U,
Tot„1 1z,z7
FIG. 11 1Gt'VII-11 OF ~NSUI.•
FIIAIIE WALL 1. InCruiou aic `.ilm _ 0.('111
5. law
6. Ext.crior ,(ir CiL,(
FIG. 42 C - '_-"-_~L+' ToLaI - ZO.q
l)=~oS
~rA EA
,l~ f~ l ~ 6. ExCr.•rfor nit' f.iJm - -_p,17
TO La 1
III
L V- -o_._.__- •-Oj 1, In rt tpr alt file:, U, 6R
c1• ' - - -
ATIC11 2.
.
!7-fJjC V, -5
•n• r' - - - - -
lul.rl I Z l3
i
U =191
S LnH ON iAWAI,
ill itt / lit 3
~ (l~ ~ ~ lilt
etc: 114
lit,
II /1~ r - ltr'
❑OI'C: Indlca(c l}"nc, '!t value, JePth and - A
_ ` ( placement of insulation. '
"'+`o V'P9W d W "iRf %S'Q'$904jPPp'yT'0+^"
PLAQ # 3325"
® LI Iv E 4 L FT, EXPOSED WALL
~LOGk.II; zCo+9o-f Z~4p~ 13Z
III
lil
=ULL(32
=ULL ! ; -
I R-E~LA,c.E '
l~L. l M : f ,3 z .
Sc . ~-r, ~1~r~o5ED WALL Az EA
13Lac ik'~ 3Z K cece
Km EE Ir /73 Z X T
Vv.o, x 6 = r~/~
~uLLli) / 3z K, g . rosy,
FU LLB jZ ; _
k ~
~~M r 3L K /3i
To 7-A L. = fill
SGT F-f F-KP05E--D GE.ILtkjq LGx4o l ogo
® WDwtS I Doot2S L1
zf3(o e 1~N~ i c,v Z r 39
Zq4 n s
?at~a 1+ ZS PATIO T-).
I~ ZBgQ tee I 40
~ SSMC U+~i+S ~ ;
~1
!i I
a
ROOF/CEILING
Lry/' Construction R-Vahlo
1. Interior air film 0.61
I ~~li, I (11 It!•,~ IIII II~I~ 4. Exterior air file (still) 0C, IC
4E>Z j Total (z 4s po
i I FIIrR+~'t e~
! Heat flow 1. Interior air film _ 0.61
sted 2' G
up 3. 1 SUL 38.35
4. F.xtet'ior air film (sttl .61
Total
2 C~O.IS..
PIG. QS _ '
I1 .Co.1~1rR ✓CTI myt.,~.
Inside air film 0.61
r 2.
4.
I~ 1l 1/ ! 5. outside air. film 0.17
'fI I t~1lll~~ 11~ ti Total
3 4 1. Inside air film 0:61-
; 2-
t 3.
Y.cat floe up- vented 4.
l 5. outside air filin 0.17
rIG_ Q6. . Total
3 4 05 v 1. Inside air film
• 2
3-
4.
. . 0.17
;-Ji}••..::;.•:~::'~-•~"/'• / / y. putsi.dc air film
Total
MO:7-VII:37~ laotc: Use additional sheets if more "Paco !
- meedcd for details and calculations.
I Hcat
flow UP
71G. P7 '
CITY O F E A G A N * NOTE: PAYMM NT OF FEE AT TIME OF
* APPLICATION DOES NOT CONsTrium
• * APPROVAL OF PERMIT.
APPLICATION FOR PERMIT
* INSPECTION OF SEWER AND/OR WATER *1
y* INSTALLATIONS WILL NOT BE SCHED-
SEWER AND/OR WATER CONNECTION * ULED UNTIL PERMIT HAS BEEN »
,*1 APPROVED.
*
*
(Please Prin
1) PROPERTY ADDRESS: C
LEGAL DESCRIPTION: E~wezRdq
Lot Block Subdivision o ax Parcel ID )
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
(Month/Year)
PRESENT ZCNING/PROPOSED USE:
COMMERCIAL/ EEL/OFFICE R-1 SINGLE FAMILY
Q INDUSTRIAL 0 R-2 DUPLEX (Two Units)
INSTITUTIONAL/GOVERNMENT R-3 TOWNHOUSE (Three + Units) ( Units)
11
R-4 APARTMENT/CONDOMINIUM ( Units)
2).~!
NAME: i •G
ADDRESS: 1,9 Lw
CITY, STATE, ZIP:
PHONE:~~
3) For City Use
NAME: Plumbers License:
ADDRESS: Active
Expired
CITY, STATE, ZIP: j C Not recorded
PHONE: MASTER LICENSE#~ 3751,44 7
Stoma f Initial
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE: _l y
04 DID
CONNECTION TO CITY SEWER CONNECTION TO CITY WATER ❑ OTHER
6) • 1" ri P HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE
L APP P T TO 1, 2,~11) 4, ABOVE
(Circle one)
7) r. r• y~ • %1
• 7• • Y• I: • • • • • a• • • • a i:~• u r way xT • a• • 6• 137901"1".
.FOR CITY USE ONLY'
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ / D S SEWER PERMIT (INCLUDE SURCHARGE)
$ / $ /D 5 WATER PERMIT (INCLUDE SURCHARGE)
$ Z7. 00 $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ /S O U ACCOUNT DEPOSIT - SEWER
$ Q O ACCOUNT DEPOSIT - 'WATER
$ J a~ S• O o $ WAC
$ o to $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ ry $ LATERAL BENEFIT/TRUNK WATER
$ Id U $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ O U TOTAL
73 74/5 7 y9 -7
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: l
RESIDENTIAL
BUILDING PERMIT APPLICATION zs
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
Z-1 851.881-4875 ,
t RemotleV1110i Reaufrements
• 3 registered site surveys showing sq. tt of lot, sq. ft. of house; and air roofed areas 2 copies of plan
(20% ma)umum lot coverage allowed) . 1 set of Energy Calculations for heated additions
• 2 copies of plan slowing beam & window sizes; poured found design, eta) • 1 site survey for exterior additions & decks
• 1 set of Energy Calculations . indicate r home served by septk system for addabns
• 3 copies of Tree Preservation Plan If lot platted after 711/93
• Rlm Joist Detail Optic c select7-9 (bldgs with 3 or less units)
DATE VALUATION U 3
off/ ~~rI'be tA and
SITE ADDRESS MULTI-FAMILY BLDG _ Y °S N
TYPE OF WORK AkJeVur FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT 4Z- C61,IE- yfoof`- /^j 51011V
- II
STREET ADDRESS G~~~ lac. t/t~ Lfz CITY t P. STrAT A ZIP_SS3
TELEPHONE # ~LLZZy-- 03.!CCELL PHONE # FAX
YY'la S 't ~^ov~ -rte
66
PROPERTY OWNER _ TELEPHONE #
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MIN 56 ' ~ `i
(J submission type) • Residential Ventilation Category 7 Worksheet Submitted New rgy Code Wo heat Sub H'ed
• Energy Envelope Calculations Submitted MAY 2 4 21JU2~
Plumbing Contractor. _ Phone # Bs y
Plumbing system includes: _ Water Softener Lawn Sprinkler Fee: $90.00
Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: - Air Conditioning Fee: $70.00
- Heat Recovery System
Sewer/Water Contractor: Phone #
I hereby acknowledge that I have read this application, state that the Information 's-e Irect, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. -
Signature of Applicant
ll
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Rlred _
Updated 4102
PERMIT
City of Eagan Permit Type: Plumbing
Eaaan, Permit Number: EA099745
Date Issued: 06/23/2011
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 729 Caribou Lane
Lot: I I Block: 4 Addition: Fawn Ridge 2nd
PID: 10-25801-04-110
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: Kris Oien
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087
Valuation: 848.00 Surcharge-Fixed $5.00 9001.2195
Total: $55.00
Contractor: - Applicant - Owner:
Champion Plumbing Thomas 1\1 Brown
3670 Dodd Rd., =100 729 Caribou Lane
Eagan NIN 55123 Eagan MN 55123
(651) 365-1340
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 Cite of Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
Use BLUE or BLACK Ink
r
I For Office Use I
Ea~ ; Permit#:~~I~~ S S ;
City of Ea
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: [ 2 13
Phone: (651) 675-5675 I Gy`3 I
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: J Unit M
Name: Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Type of Work Description of work: ~l51L
~-7~ '
Construction Cost:. V d Multi-Family Building: (Yes /No
v )
Company: o z Contact: ~vK P
Contractor- Address: /,,/S l City:
State: Zip: 3/
Phone: l~ 1,;2
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to }
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ,17t (/G' G / oZ~ x lei
Applicant's P inted Name App icant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use 1 �v
*. City of Eaan Permit#:
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675
Fax: (651)675-5694 Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: 6(2.0e...,2_ / Phone:
Resident/
Owner Address/City/Zip: 9 2' (cc eLl i jc X.f C OA-
'
Applicant is: Owner ) Contractor
Description of work: Ye.of Work
Construction Cost: Multi-Family Building:(Yes /No )
Company: gL/)4 `'l Contact:
Contractor Address: /U �} J Z City: / ( ' /� 4 c Ce�
State: "141-'Zip: � ( Phone: L- (2-2 ��mail: , 't(56;1(',_x'3
License#: Lead Certificate#: t:
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
-NOTE Plans and supporting documents that you submit are considered-to be public information. Portions of
the information maybe 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.qopherstateonecall.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
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit iss an . r�
;_' x fr'2 '
Applicant's Printed Name Applicant's Signature
Page 1 of 3
*el§ For Office.Use
Permit#:. /5/ `7
Permit Fee: 6t/
•
3830 PILOT KNOB ROAD EAS. Date Received:
AN,MN 55122-18.10
(651)675,5675 I TDD:(651)45;-8535 I FAX: (651)675-5694
bulldinglnspectione a(�,cltyofeacm corn Staff:
L
2018 E.'o IDENTIAL PLUMBING PERMIT AP LICATION
Date: Cs // k
Sit: Address:
Tenant: 1,49‘ ,.
(1" w
-r!`_ r0 4 ` w Suite#:
t `
rd t ,�` r L° 'i. Nk4,1arne t o _40
Phone: � �
}
li';.,:it ., .4, Addre s/City/Zip:
i ' I �. t
PS
to
•
�, t 41 ' •(rt Name: MILBERT COMPANY dba CULLIGAN WATER f
, Y31 (r;; s License#: WC641376
" „'TOMO�• tAs;T,,A Addre s; 1801 50TH STREET EAST
4,„6.06:%16,',.'clhk,,..
�9't' City: INVER GROVE HEIGHTS
` ht '<W I, �,`,, State: MN . zip: 55077
�, ill- R,d,Yla p Phone: 651-451 2241
„ri�S,`<. iref w Conta.t: BILL MILBERT
1"`„ , ?- 4.41 : Email; gloria,abasl�culligan4water.com
`f -(��1y�� �•p.1 i New Replacement Repair Rebuild Modify Space Work in R.O.W.
t > `�lfirt��i t< ,, {, Descri.tlon of work:
•stet 41:x ,,,Oxsviiki k)tf4, REST ENTIAL — _ .
,, ,. ry • _
igg t r''3'',zi,y�`}, , _ ater Heater
e, 1 r t+ 61 _L=wn Irrigation( RpZ/ pig) Water Softener
` � y rgelt;;/Ts li I�
iL��^ ii:N1r... V::;k, 0 S:ptic System Add Plumbing Fixtures ( Maln.
f�f '14,)i}4�k�sl)�j,�j�,,,i�; / Lower Level)
,11,40 , 3 r \(1Sf d New Water Turnaround
• 3, st , + f {i/c
Abandonment
xif -- __ _
$60,00 Water Heater,Water Softener, or Water Heater and Softener(Includes State•Surcharge) —_~
RESIDENTIAL FEES:
--
$60,00 Lawn Irrigation (Include. State Surcharge)
$60.00 Add Plumbing Fixtures Septic System Abandonment,Water Turnaround*(includes State Surcharge)
'Water Turnaround (add ',280,00 If a 3/4"meter Is required)
$115.00 Septic System New(I eludes County fee and State Surcharge) TOTAL FEES $ 60.00
CALL BEFORE YOU DIG. Call G.oph.r State One Call at(651)454.0002 for protection against underground utility damage. Cat 4E hours before you
Intend to dig to receive locates of unde,.round utilities. www,gopherstateonecall,orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
websito at www,cltyofeagan,com/su,scribe.
I hereby acknowledge that this Inform:tion is complete and accurate; that the work will be in conformance with the ordinances anc codes of the City of
Eagan; that I understand this Is no . permit, but only en application for a permit, and work is not to start without a p rmlt; that the work will be In
ac rdaancee Mtn h-approved plan I e ;a e of`wbr4 which requ es a review and approval of plans,
6
•Applicant's Printed Name x lc is'
Ap:llcant s Signature
iriPt',Y i1C,l�<v�S'i�kY(r�Y4g,it.} h iii! h/�� '' t
ay a USE t< IWV(01, kiaJ�IM ( ai.i s 1�1 �a+I;i1CAW.��`rl�Wit I ,44:1�,1 E'l'i�x s� I r�• ;��: ,e.r,' .. .:r 1-
CiR.y r y;{FRIG l .Ext AA / ( .C fess , 'it,; 1 OUte a i Vit{ 1 r£h t. .�4, p. �4 d' 4? 'ti�Pk A4,:ci R
fY �r � 3 � r� (. �<?, x wed, BV0,1,.;:,,,;„+ 45, . r w �;,,:.
;��.� ��s a , �a f' n; uS'rt �� r€ G tt ) y, �ai�frx m '. � t i c §� ��v .�-rah+.f .4 v �>' k.+rv�:=�:.
ROgU1;ed ins ' ppt ',''`r;>t.`�'p�- i,M•.^.kcS..Y, i 1 : ,, §#1?4(t{ ,,t4,4 rtta ,.g is yr,,,,
�•• t ��} � � �' z'hZr4 r vDate �i�
�{.t�'�.,�C `; y :a�� � � $�o_ ��.r..h• zt�.de,%ppm ���z�&�c�'�ti x sr1,?r3•� � its-•-st ° rht`,,��Ktiy;��-{>f��)�,t�i�t x �`_t -icy .iY�•4,41,1,,,c,04- .,,,ice
?r w z t, �, :. H: .: 9 x;Y;41 (t, R h ! r. t"3 . tr r`% ,r Iti,p pm, ? �
�'1.tt�* 011 + ,,.''''';' "Ti.''''”
wits 1 r,, 1 q�r..t,�r --o.V4 .''f .hkv.,4 v� t 4.,,, .i....o T: l 4,.f.,,i, Itv S� (( t S : , %rte .,1
YI�@� Y la e � ,�� .1�' F {:•az�St n,r�a ( � ,�tri std +p'�ftii,� .e<�r-SGr,`�t � c. ���'' � �� est r��r;t�{ p K
... -1 f, 1'' '75ki Mete `Sieh' 1. ZNI�?tat'Sla 4a9-! ' IZIk14,9 �p� 40,5 i .t'ist�korf-. yfigk�'+}`�'..ARfr,I` l+t� r i tic .
:.•fR..._.,.� � $;,M:anorn6r�rt �?_ �Sta t`,� ��x"E �y� ,� �`r t.