1382 Camelback Dr:raft of
ritp of e
6uilding POST IN A
?
?n?prr#inn
tion 306 of the Uniform Building
zr in comnliance with the various
BLbG._ PERMIT N0.
f 01-3210 Bldg. rmit ,
01-3422 Plan Check ?
01-344t •Surch./Adm.
01-3446 SAC/Adm.
01-2155 Sureharge _
111?3860 Road Unit ?
20-2275 SAC
20-3865 Water Conn. o
20-3868 Water Trmt. ?
20-3716 4:ater Meter
20-2252 Acct. Dep. _
20-3713 Water Permit
20-3743 Sewer Perntit
79-3866 5ewer Conn.
,AJ?3555 Park Ded. _
TOTAL lv? --? `
-=?--?
Is
T
CITY OF EAGAN Permit No: 10490'Date:
3830 Pilqt- Knob Road B/P No: 0? l- '? Date, ?f%•
P.O. ka't 21-399 ??
Eagan, MN 55121 1
Owner. ,:i. ns t,
` SiteAddress: 1382 Czm???.":,-- , :_., 10`:
Plumber: Plymauth ? ??' ? ?? ??
MWCG: 550 ,;)i?pd
73 i
?
1° gi,?
cicy cng: 0. kB?fD
? Acct Dep: 15 <
? Permit Fee: %jrfMWpIy With the Ciiy-of Eagan
? Inances ".
Surcharge:
Misc.: By
Cli 'AQAN Permit No: Date:
383 t Knob Road Meter No: Size:
P.O. 8qx 1199 Reader No: Date:
Eagan, MN 55121 "
Owner. °.i. ''er"nanci ":ons t,
Site Address: ->" Ea°melh?ck ?+rive I,.:> :t=+ T'aixway
Plumber. •>'.vr.nuw, in;.r
, •
Conn. Chg: 55Q• 00pd Zoning:
Acct. Dep: 15•00Pd No. of Units: ?
Permit Fee: Itif •20Sy6 °
Surcharge: __ . 5 OF1-11 I agree to comply with the City of Eagan
Tr. Plant 2134• ??OP•'" Drdlnances.
Meter.
Misc.: By
WATER SERVICE PERMtT
CI7 EkGAN PermitNo: 3101190 Date:
38 .t gnob Road B!P fUo: 2,04 9 7 Date:
P.O. t..V1199 ?: . • e:
Eagan, MN 55121
Owner: 6.1 7i33-rtar'17t Cqnst
Site Address: 1132 ?'C''.awgl'^?act Dri.ve T-3 IrWLY
MWCG: - ??:?=3 e 00r.d" Zoning• ?.?
City Ghg: ?011'1 f) 0 ??, d No. of Units: J"
Acct. Dep: i 7„ i:+'!r+t3
Permit Fee: e`y?F r?
- 1 agree to comply with the City of Eagan
Surcharge: Ord'+nances.
Misc.: _ gy
SEWER SERVICE PERMfT
CITY OF EAGAN
3830 Pilat Knob Road, P.O. Box 21-199, Eagan, MN 55121 N
PHU N E: 454-8100
BUILDING PERMIT Receipt #
Tobeusedfor ?? DW(YlGAk EstValue $76?uoo Date J'?NUARY 11 ,19 68
SfteAddress 1.10? ??L15AL;1
Lot ?? BloCk 4 SeGSub.
Parcel
On Site Sewage
MWCC System
On Site Well
City Water
. Name AL iiFRMl1NIN CO1VS'T
Z Address 8723 HIGi'lWOOb? WA7f
o City A.V. Phone 688-069?
°C Name
,o
? Q Addre
? Citv_
Address
I hereby acknowledge that 1 have read t
that the fnformatfon is correct and agree to
. State of Minnesota Statutes and City of E
Signature of Permittee A Buildi+ng Permit is issued to:
all work shall be done in accordance
Building Official
Occupancy "3
y Zoning
_ Type of Const
x (Actuaq
{Allowa6le} ?-
# of Stories
Length 5B
Depth z-?
S.F. Total
Footprint S.F.
APPROVALS FEES
4 ?'?? ? ?
Assessments
Water/Sewer Permit
Surcharge +U?
Police _ Plan Review ??? •??
Fire _ SRC, City 1 0(1. 0
[3
Engr. _ SAC, MWCC 5 5j)- t9l? ..
Pianner _ Water Conn. 4 5() _ 13(1
Council _ WaterMeter
application and state Bldg. Off. _ Road Unit
?
nplywithallapplicable APC - Treatment P1 ?_ r+?
.?
an Ordinances: Variance _ Parks
Copies
TOTAL
2 ?1 • `..'?0
on the express condition that
applicable State of Minnesota Statutes and City of Eagan Ordinances.
'1M REVIawm 10/2 1/ CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-189, Eagan, MN 55121
PHON E: 454•8100
BUILDING PERMIT
To be used for Est. Value °78•000
Receipt *
,'+fOl i
i.
Date A. j. 19 -
Site Address
Lot Block ' Sec/Sub. ' 1.?'`'` :.' •' ' `"L'Y
Parcel No.-
ac Name
W
z Address
a Ciry Phone
°Co Name
.
? a Address
? City Phone
W W Name
F W
? ? Address
e W City Phone
I hereby acknowledge that 1 have read this apptlcation and state
thatthe information iscorrectand agree tocomplywith all appliCable
State of Minnesota Statutes and City of Eagan Ordinancea
Signature of Permittee
OFFICE USE ONLY ?
On 5ite Sewage _ Occupancy ?
MWCC System _ Zoning
qn Site Well _ Type of Const
City Water _ (ActuaD
(Allowable) ,
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
APPROYALS FEES
Assessments _ Permii
Water/Sewer _ Surcharge
Police Plen Review
Fire _ SAC, Ciry
Engr. _ SAC, MWCC
Planner _ WaterConn.
Council _ Water Meter
Bldg. Off. _ Road Unit
APC _ Trea[ment Pi
Variance _ Parks
eopies
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 Ordinancea
Building Official
' - Permit No. Permit Holder Date Telaphone it
Plumbing
?
H.V.A.C.
Electric ?,-q d? /af 991 o0
Softener
Inspeetion Date Insp. Comments
Footings I jz
Footings II
Foundation %
/
Framing
Roofing v
Rough Plbg.
Rough Htg.
ISUI. ?! Lt?
Fireplace
?
?? - , s- ?•T ?Lvs' w
Final Htg. ? ,? B?zrcf? ,1S
Final Plbg. ?.? ?v ?_
Bldg. Final
Cert. Occ.
Temp. LP
aeck Ftg. I,? ? 7)W .us
?eck Frmg.
Well
Pr. Disp.
? . . . .. ? : y . ..+ - . . n . . . .
PERMIT #
MECHANICA?,-PERMIT
CITY O RECEIPT #
F'GAN
3830 PILO T KNOB R DAD;; EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE : 404-8100
Site Address
??,DG. TYPE WaRK DESCRIPTION
' Lot 6.
. Block Sec/Sub
? ? New x
; -
A'91u1t Add-on
°-' Name
k 60mm. Repair
? Addre q&j hj ONJUJA << '
4?ther
c Ciry Phone 11 $ yc
Name f ?, FEES
?
?
c
Address ES. HVAC 0-100 M BTU -$24.00
<ADpITIONAL 50 M BTU - 6.00
p City ? Phone?? "?? RES. HVAC INCLUDES A/C ON NEW
. ' ONSTRUCTION)
AS OUTLETS
MINIMUM
1 PER PERMIi
1
50 EA
;,G
) -
(
-
.
. ?
TYPE OF WORK ' ve COMM/IND FEE - ia/o OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CaNDOS - RES. RATE APPLIES
Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU $ ' MINIMUM COMMERCIAL FEE - 20.00
;STATE SURCHARGE PER PERMIT - .50
Vent.
Gas Piping Outlets # CFM
$ {ADD $.50 S/C IF PERMIT PRICE GOES
`±BEYOND $1,000}
Other
FEE: '
Z
_
,
S/G: • a? "SIGNATURE OF PERMITTEE
TOTAL: ?
FOR: CITY OF EAGAN
PERMIT #
PRICE:
Site Address
?
Lot - Block
Name
?s Address ." l 5fG ? :3 ?:_
CitY
Phone
Name
3 Address
p City Phone
FEES
COMM/IND FEE - 1?o OF CONTRACT FEE
APT. BLDGS - CQMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00) ?-
?•?tA.. ?: ? j?, ` , ?iL''Li:"?.w_
?PLUMBING PEHMIT 1
SIG?J,?YU OF E?R[?1?"fEE
CITY OF EAGAN RECEIPT #
3830 PILOT KNQB ROAD, EAGAN, MN 55122 DATE =y??? -?ly
PHONE: 454-8100
BLDG. TYPE WORK DESCRIPTION
SeclSub Res. -\-` New -?
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
ND. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00 ?• ?
2 Lavatory - $3.00 r? • c: r?
' Shower - $3.00 '• ' f'
? Kitchen 5ink -$3.00 ?
Urinal/Bidet - $3.00
?Laundry Tray - $3.00 ?-? -
? Floor Drains - $1.50 ?• " <%
? Water Heater - $1.50
Whirlpool - $3.00
' Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Qisp. - $10.00 a
Rough Openings - $1.50 ?
FEE: .
STATE S/C:
CITY OF EAGAN GRAND TOTAL:
CITY OF EA.?'aAN Permit Na: Date: 1- 2. `: ._,, ?
3830 Pilef-.?Cnab Road Meter No: -3 ?2z 0 9114? Size: P.O. B?chlqq Reader No: '/T &Z?9 Date: 3 Eagan, MN 55121
Qwner; r;l r`F°2`rnann C'nrtG
SiteAddress: 1 :3f;2 LaPnP"hari.: iirizrc
Conn. Chg:
Acct Dep;_
Permit Fee:
Etc,
Surcharge: - fli 1 ? t c with the City of Eagan
Tr. Plant ?04. !l t;?, r nc . -
Meter. ,
. ; ..,., ? ,.
MISC.: By
WATER SERVICE PERMIT
This request voitl , /-2//??
18 mon[hs trom
D? 62429?-?,,p
Renl?est Date
' ire No. Roug n Inspectmn
Pequ ?
oReatly Now ?RI Nn?ity InsDec-
/? (a
(?
?&?V - U(J es ?NO [ur When R¢ady
L] Licensed Elac[ncal ConVactor I hareby raquest inepaction of abova
? Owner electrical work instel led at
Str¢e
t AdAress. 9oa or Route No. Ciry
?
t
.i t
-
cwpant IPNINTI Phone No.
/ 6 91`9
ow upplier Atldress
F5?' -
Elec
a
l Convector (Comp
an
y
Name) Contr
ac
m
r's License No.
/
/?
,
I
?
?F-/ 1`" q
?
/
Mailm?tlJress (Contractor or Owner kine ?t at=on)
?3/ -I?W
S 7s
Authonze i a e IC nhac r/O . kine InstallaLOnl Ph
on
e Num
bcr
/
J
/
?J
?!"/ ?/ $
MINNESOTA STpTE H6SRD OF ELECTRICITY THIS INSPECTION HEQUEST WILL NOT
G"gga-Midwey 8106 floom N•191 BE ACCEPTED BY THE STqTE BOAHD
1821 Universilv Ava.. S4 Paul, MN 65104 UNLESS PNOPEN INSPECTION FEE IS
Phone(6t21 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
, Sae instructions ior wmDleUng this lorm on back o/ yellow copy.
.. ? ? _.
42 3 'X" Below Work Cavered by Thrs Request
Fdd NBp. TVOe ol Bmltling AOPbancea WireC EqmVmenl Wved
Apt. Bwlding Drye, Electnc Healin
Commercial Bldg. Fumace Silo Unloader
nI Industnal Blda. Air Condrtioner Bulk Milk Tenk
N Fee ServmeEnvanceSize R Fee Fanders/Subtenders K iee Crtcurts
? Q U to 200 Am s 0 to 30 Am s L) 0 tn 30 An s
' Above 200 qmps 31 to 700 Amps 31 to 100'qm s
Swimming Pool Above 100-Amps Above 100_/>inVs
Transiormers IrrigaLOn Booms artial.'Other Fee
Signs SVeclallnspecUOq 5 2-S° OTAL vvyy.y???
ertv?.ks /r7 /J t t ?, i. ?
the Elg£i(yCTil Y I
?nspectoq hereb
cerhfy thet the above
Final ? ?}ie inapecbon has baen
J/,J?? meAe.
Thig redueat
?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681•4675
New Canatruc6on Reauirementa
• 3 registered site surveys showirg sq. ft of lot sq, ft. of trouse; and atl roa(ed areas
(20°k maximum lol coverage allowed)
• 2 copies af plan shawing beam & winAOw srzes; poured fouM desgn, etc.)
• 1 ut of Eneyy Calculatbns
• 3 copies oFTree Preservafion Plan if lot plath.M a%er 711/93
• Rim Jaist OeWd Options selection sheet (bldgs with 3 or less unils)
DATE /U -/ g -d Z-
_ Water Softener
_ Water Heater
_ No. oF Baths
SITE ADDRESS 138,2 ?'Arae? ?RC?? .a? MULTI-FAMILY BLDG _Y _N
TYPE OF WORK AP e 1<0 v P FIREPLACE(S) _ 0_ 1 _ 2
APPUCANT Lcave, Q.vd S?ZJ
STR E ET ADD RESS LoS?&,rDf?/?4f2 Q(vD So/ 7c /3o CITYLz _ce/&w,t•E STATE!'r?ZIP,5i53V?6
TELEPHONE #?Sa•S?y-?035- CELL PHONE # FAx # 9?a -97v- i?8?
PROPERTY OWNER ?Suoew l TELEPHONE #?S/' 40 ?• ° G ZG
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNrSOTA RULFS 7670 CATEGORY 1 MINNESOTA RULFS 7672
(J submission type) . Residentlal Ventllation Category 1 Worksheet Submitted • New EnergyCode Worksheet Submitted
• Energy Envelope CalculaUons Submitted
Plumbing Contractor: -_
Plumbing system includes:
Mechanical Contractor.
Mechaniril system includes:
Air Conditioning
Heat Recovery Syslem
Phone #
Fee: $90.00
Fee: $70.00
Sewer/Water Contractor: Phone #
7 ,
r?T ?i
Y hereby acknowledge that I have read this application, state that the information is correct, and agree to i orpply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ?
Signafure of Applicant "- ???og?-?--K?-
OFFICE USE ONLY
RemodellRaoair Reauiremenb
• 2 wpies of plan
• 1 set of Eneqy Calalations for healed additions
. 7 sAe survey far e:lerior additbns & decks
. Indicate if home served 6y sepGc system for addilions
as
VALUATION _#??L5_0_10 • ?
Phone # .
_ Lawn Sprinkler
_ No. oF R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
S?+os-)
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RC, EAGAN MN 55122
651-681•4875
New Construction ReuuiremeMs
• 3 regisiered site surveys shovnng sq. ft. of IW, sq. R. ot house; and all roofeA areas
(20% mazimum lot coverage allmxed)
• 2 capies of plan shoxing beam & window sizes; poured found design, eta)
• 1 set of Eicergy Calculafioris
• 3 copies of Tree Preservafion Plan if lot platted afler 711/93
• Rim Joist DekY Options selection shcet (Wdgs wifh 3 ar less uniGS)
oare
RemodellReoairReouiremeMS I ' -1) _ --I s
. 2 capies of plan -
• 1 set af Energy Cakulalions for heated additiore
• 7 site survey for exterior additions 8 decks
• Indicate i( twme served by seplic syslem for additions
vaLuarioN UL _bn . 44
SITE ADDRESS _ 1MS2_ MULTI-FAMILY BLDG _ Y?
TYPE OF WORK`???_k ? FIREPLACE(S
APPLICANT
STREET ADDRESS 2489 Rice St Suite 70 CITY Roseviile SiATE MN ZIP55113
TELEPHONE # 651-734-9433 CELL PHONE #
FAX # 651-483-0219
PROPERTYOWNER SL-,Xyj_l bc[?-? TELEPHONE# ??\"9?S'??.'ZSo
---"""-... ____"_""""""'__"_"_"'.-__"-"""""-""'---"_"'_"_--"""'-_"-'
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA R[ILES 7672
(J su6mission type) • Residential Ventllatlon Category 7 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calalations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Conhactor.
Mechanical system includes:
Sewer/Water Gontracfor.
_ Air Conditioning Fee: $70.00
Heat Recovery System FlNn?
Phone #
----°-°°----------------------°------°---------••---------°------°----°-------------- ----------°------°•----
I hereby acknowledge that I have read this application, state ihat the information is co?d;cf,_aod ly
with all applicable State of Minnesota Statutes and City of Eagan Or ' nces ??
Signature of Applica ?
OFFICE USE ONLY
? Water Softener
_ Water Heater
_ No. of Baths
Fee: $90.00
Phone #
lawn Sprinkler
No. of R.I. Baths
Phone #
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
CITY OF EAGAN No 14 5 4 6
3830 Pilot Ksiob Robd, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE:454-8100 Receipt # q?(:H Cl--?
0
Tobeusedfor SF DWG/GAR EstValue $78,000 Date 1ANUARY 11 1988
SiteAddress 1382 CAMELBACK ?RIVE
Lot 3 Block 4 Sec/Suh. FAIRWAY HILLS
Parcel No.
a Name AL HERMANN CONST
z Address $723 HIGHWOOD WAY
° City A• V• Phone 688-0696
,p Name SAMF
? a Address
P City phone
City
OFFICE USE ONLY
On Site Sewage _ Occupancy R3
MWCC Sys[em x Zoning R 1
On Site Well _ Type of Conffi Vn
Ciry Water x (Adual) -V_
(Allowable)
# of Stories
Length S$
DeOth 4.8...33_
S.F. Total
Footprinl S.F.
APPROVALS FEE3
Aaseasments _ Permit ? 486.00
Waier/Sewer _ Surcharge 39.00
,
Police ? _ PlanRevlew 243.0
0
Fire - SAC, City 1 nn _ nn
Engr. _ SAC, MWCC 550,,.00
Planner _ Water Conn.
Council _ Water Meter ?w? nn
I hereby acknowledge that 1 have read thia application and atate Bldg. Ofl. _ Road Unrt 325.0
thattheinformationfsconectendagreetocomptywithallapplicable I A? - TreatmentPl ?0
State oT Minnesota Statutea d C' of an Ordinances. Variance _ Perks
Copies
Signature of Permlttee To7aL $.2,,, 564_0
0
A? ERMAN COP]ST
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with allAplicable State of "nespta Statutps and Ciry of Eagan Ordinances
Building
,. . _ ' -• . •
198$ BUILDING PERMIT APPLICATION - CITY OF EAGAN •
SINGLE FAMILY DWELLING3
?
?
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SUEtVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOA/HOMEOWNER M[JST DESTGNATE WfiICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS !l OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
7 SET OF ENERGY CALCULATIONS
COIA7ERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
SM JAf?
To Be Used For: RESIpENTlAL Valuation: ? Date:
-T
Site Address 087- CAMELBAcK -DP-
Lot 3 Block _14
Parcel/Sub ?A\QwAy H?« 5
Owner AL V1eStnctiu Cousi
Address
City/Zip Code
Phone
Contractor A L LAe.ah.eN Cou5-r
Address 8 7 Z'3 Hi F..w.ov t,,.iAY
City/Zip Code APpiF Ve«Ey? MH SSi Zy
Phone (, 8$ - 0 69f,
Arch./Engr. `{zME E n&-
Address IbD t 140? Si
City/Zip Code BuRNSVr«E 55331
Phone # L132- 3oop
78 od a -
On sfte sewage_
Occupancy ?_
M47CC system ? Zoning R' f
On site well Actual Const V-N
City water ? Allowable V -PJ
PRV required # of stories
_
Booster Pump Length 56,60
?
` Depth y9,33
S.F. Total
Footprint S.F.
APPROVALS FEES I
Engr/Assess Permit y86.00
Planner Sureharge , 00
Council Plan Review 2$O
Bldg. Off. (f=1 5 SAC, City ! 00 , 00
Variance SAC, MFICC 350.Op
Water Conn 5 0.00
Water Meter OD
Road Unit
00
250
Treatment P1 1-?00
Parks
Copies
TOTAL .J s (e kL
*VALii^-T'1o1.t
GA;_
z?X z2? 4sy
?.o X
6 64 X 12:-, 82 0 8
, .
DgMZ'
yH u ?L' ? ???uy X?yr ??bo'lL
H.._ E
Rs+v?"ti' =
lly?l
.t-
f 20o Xy`1-? 52?00
?-?-----
? q Oty
.. _- ,
Addres?. e1;,:oT
?. •,.,:; ?? ,' ., .
BASED OV.GIIAPTBR 5 GF TNE .' MOucj, L;,IERf,Y CODE - L963 ED[?i0N
Aduptlun B[Ehetlve l/L( 4
,., . U
' cation:,, Type Al (Single Fa:ntly S Ouptex
I?::? a ? ,: m! N .... .. ... . . ... ..._ . . . ..
- ' ,
-(Other)
, . •=: :? ,.. ??? . _ ,
? _?•:_ _?:
0.l ?[NFaRMATION
FF
Phone ?T
?. "rhone
:, ., .
R2 (Residential
(3 stories or? ess -
(0•rer 3 stories) '
uilding `Pe'rimeter.4? 11, Wp?k-!4b?ft.,,
all height•(ground to eave) ? ft. '•
x- 2•..('above);9r.oss Na11,d.C'.€A. $17 ft.?
€'?, . ,•, ?:.a:. ?r -- .
2
ailding dimensions (L) -- x(N) "' ¦'Iz4? ft. roof b fl.aor area .
.:? .
oist si
,quare Fcot area of rim jolst ATOr.,
ze (2 x Ot ' Perimeter = Rim o st area ¦ 7?r4A?ftZ
Y loor9?._Arga r..?.? ..? .1 ?? ... . . . . . _ • _
Thickness", n: actor .m 4t-47 F
Tlpe of,Construct oo . . Perimeter 'ft.• '
= Flanufacturer .
fotal door°'0eirimeter ft . ,' • .
._'pen' _. . ? . ? ? •
aindoris: .
-;,Manqfacturer_ •?/?,??,UL? ?"? 5tate approved 1 factor."-t,
x TY,P? ° ?. ?.SIZE ,;. .r . AREA (Ft.2) lIUMEER pF'°; T07AL FEET Z
t f? ' ' v1 i EACH UN1T5
.06 57F
?
fj? v•l=:ap,je ?._. ?? ,
? ,. .
otal;-,ft. .? ... . ... . .. _
Sreplace?i,areas Width x heiaht ¦ ? x "- a -' FE.2
xposed;foundation: Height x Perlmeter xt„?"`?? . 001,05- Ft.2
TION OF TH15 fORM t5 REQUIRED FOR ALL IIEII CONSTRUCTIUl1t MAJOR REI•IOOELING AHD BUII.OINGS BEING
WNERE ENERGY, OTHER TtUAY iHE ldlN[MAL CODE AL1041A11CE. IS USED. .
•?CO
rnml,ng area ¦ 10% of gross trall areat ' • .• Grnss xall?area 2?j??J/ rJ ft.Z "
• . Vx,, ??:t_. . ?{? .
Nindow'ered A!??-i-I ft.z U qindow
s ' U x A ¦' !. ?l.
'i?. ..1rYMM?'A ??:. . . . _-F--
;'. Rim Jolslarea'A {t?2 • U rim Jolst ¦ %4 'Jr U x A ¦A2E
' . ., . y., , ..., . .
ooo:i
r; ar.ea
" Y?•t.. , U door area ¦ . ??T U x A¦(Dj'PX?n
areC? f 2. .
t. U ftagtaEe ¦ ? ? U x A ¦ ????''
`Expos
Framed foundatlon.A 0,p?' Z ' OSZ
;4 ft. U faundatian ¦? U x A¦ ,.a,-:. 9 ...? area A ? tt.2 .
U framing area •+?2 U x A¦ I(0.
Net?irail area I -?j ft. ?U Ha11 ¦' ? C??a?l U x A'¦5591?
='.,'_ ? • , . . '
(138) TOTAL . . . . . . . . . ." U x ?"•.
>'d"?..? 'r•'tt : .:. •_ . .• . 14.. Gross,xatt°"area Y .
A=1 single famlly 8 duplex ¦ allowable U x A/Code
? (13. above) -- ..._ . . . , • " ?' ? ?x 0:23 (A-2 ather'resldentlal)
X. .23 (Other bulldings) X.-'.29 ?Over 3 storles) '
. ,, .. ..M . .
A ,-7 atuH Must ee larger t
.., x 10-7 --Q
, .? ?. 138 above
15. Ce111ng framing'area (A() equals•lOx af ce111ng area' ? 01' tha same as)
15A. Gros,s`cetling'area •'A)• i- x(y) ¦ ?1 Z??- . ft.2
158 ..Jo1st area (Af) ¦ 10% celling area • ?z-,4' ft.Z
15C. flet'-: ca111ng". area (Ac) (15A - 158) •ZD
U Ce;1llpgaX A-t?• 0.7i2 x• I? ¦ ?? fl.Z
? ,. .k.. - 1:(p • •
U 02? t5 Z .
?ST ,
1'• . ti q
150. TOTAI. U x"A ..::'...a ...:::....:...r:........:.......• I Z
ii• ti
il ' . • •
16. Ce11;1ng area (15A) x 0.026 (A=1 Single'famlly 8 duplex - code allowable U x A .
• x 0.033 (A-2 other resldenNal) , . '
x 0.06 (olher) • ? . .
,
:A (15A) I ?. ?9aUll Must be larger than 15D (above
, x?_(codels F, (or the aame as ).
$?.i`y : ; i e, ???;; ;;?: : • / . . ; , .
. _,.?{ ' '' . •
:'NOTE: Use U arid'Avalues obtalaed from nps 1. J and 4.
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?N?,qYN INC,
r^` ?
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'$.j.uD!l.::,
A.
rt 2HD^WALL3.._,?r._ .,_ ;., y?...
` SECTION
? i. ? ? ? ? •
,
v rNUt l.Al6uLAI1uNb
nLuE u vaLue
? -
Insida alr Eilm . ° :68 • , ,
Idteeloe vall .?j (pall) •U . ? .
[nsulation , (? pp
,
Shea'thing
Slding . 1&7 ..:..z,.. ? .'r'.
Ouulda alt Ellm .17 R TOTAL ?j R 7 . _ _. . . .
Iaatda atr film .68
Intetior vall .?S'
411 stud R¦ 4M 6,5*0 (Framing)U. & .
Sheathin6 . (p,Lb . ',. . ........ _ .. .
Sldln6
r.?
Ouhlde atr fllrr,, ' :1
Instda air [!im
Intarlor vall
C10n
R¦ .68
Sheath ,
? • ?.•r '?,,,;,,,,.,:,.. ,',_ ' Extesior vall eo ng
Extariae ilr fLlm: a ..
wil
,.? ...___. . . _
,. v:. (Wall '
zU .R `
. ' A TOTAL
. - :'. ; ?? • interlor alr film _ R??.68.,.?. ?.._ .. . ?... _..
AIH Inaulation . ?• (1
Qp
?OLJTkl.34??i?1 •+?•.
?1
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a ?si>4r?
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?? • l? tn<h soEt ,
wond. R•1..88
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aat
ing i?3S
Exterfor wal l eovering t(o'l
---
i's'
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? • Extertoe air film Ra
11
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- R
TOTAL Z$,40 •
.
? A 1:?,f {?y?" ?f? ??ii?J ?[ ` a , ? ? . . ? ' ? . •
.Inteclor alr film R¦'.68
.: Insula
tlon
.'
•
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D o0
Eoundatlon
. •
:
(Fdn.) U
¦ A'.
Extarlor ale ,
,
Ellm R• .17
R Torec
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xposid_
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... C.[L[PIA 'aliH 9EIIT E(1 ATTIC SpACE A
80
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? ? . . ?''s ? ? .;-.?.....?...,?.... . _._._.. _ . FRAHIHG ? CEiI (HG
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• FLAT AQOF 0_R CATIIt AAi CElLiN6
R''IAIUE , .
FR,It•itNG *, CEIi.[PIG
?_ -? ?? ? /?,z; •{ ,, .
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' >?. .77 7
?- . '=? ?, 0.61 Inside air. .film ' 0.61
?' ? Jai?e ?scu
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Ir ipacs '
,! . Naot
docktng
..::__, • (n:ulaNan -
?^ : • ' Built-up roof
I • 0•17 Ouislde air film 0.17 .
• ...._..... .?:?;s?t?:?,.;t.??? .,,. .
_ ?`?. ????: •: M:; . ?._.._.__..?.... ...,.. . _. ,_. _. . Total R? r ' - ._ _,. ._ . . _ ._ ..
indow. inflltration r:5cfm/11nen1' fbot of crack I ? esidential door`-lnfittratl6o"4.5 cfm/square faot or door and minlmum code•raquirement
'an-residential doar inNltratian 11.0 9fr/11nea1 foot of crack
. . .,...,..W.. ,. • _ . .. .... , . , . . . . .
lb 12" cancrete biock no lnsulaNan a :47• R 2.1 . ?
lb _12"..concreta.block lnsulated cores ¦ .26 R 3.8 ` • ,.
lb _12" 1 iglit??etght black ' ¦ .32 B 3.1 , . Ib- 12" lfgh`tweight block insulatad cores s.12 R 8.3
• '•
? .............? ..
I single.glass. a 1.13; with starm,tirinda,?'.54 '•
I dauble gla;s ¦ :55 • • . : • . . •
1 'trlpl"e' glass'• 0' 641 .,::"°.'__:...'? •`... . .:..._. . .
' .;:4J. :a^? 1X? :. .. ... ' ."':' . , •' • , • . - •
ill''exterior walls and ceillngs must have a vapar barrler (0.10'perm max.)... . •
;apor,barr.ier.must_he on the inslde (heated slde) af wall. •• '
raaor'.barrier's af7;th'e palyethelene thin Nlm havg, na A value,' ,_,.,.,,,,. ,
. •
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IROBE.
ENGINEfRING
COMPANY, INC.
1000 EJ157 1461n 57RE:T,
# /D7¢,oI
C13NSUlTIH6 EH61HfEfl5
pIANHEAS ond LAHG ?URVEYOQS
BURNSVILLE, YIHNE30Tx 5_337 PH 4212-3000
ZeS:at .De.icr4,o2ion: LQT 3 pt..OCK 4, FAIRwAY NIUS,
4qKOTA CAUt41Y, MINNESoTA
(io2_'i,'o ) pENOTES EXISTING ELEVATION
(/022,0 ) pENpTES PROpOSED ELEVA710N
INDICATES DIRECTION OF SURFACE DPAINAGE
/o2z.33 = FINISNED GARAf3E FI..DOR ELF-Va110N
30' FRONT BUILDING
SFtBAGK LINE -1
qM??
6?a
? R,4
5r O
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SCAl E • I '= 3d
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DRAINAGE AND U1lLffY
?
E4SEMENT
NJn p - ?ezr, o?
. 6>OJr6 98 ?
. `?2
?
I hereby caMity that thia ia a t:ue and corrnct rnprzaantttion ot a tract oC
land as tho+rn' and deacribed hernon.• Ae prepared by ma on thia /? 77'! ' d+Y o!
•
DEee»Bax ? 19 67.
?,,? Ninn, ltods Ho. /608r
_?--
? Av;?- l
»1?y? ?
,,
o?
?.<o,
s?
?
, w
PRESENP 7ANING/PROPOSID t?SE:
(Mbnth/Year)
..
-
? CU41ERCIALAZETAIL/OFFICE [eR-1 SINGI,E FAMILY '
Q IIS)PSTRIAL ? R-2 DDPLEX (1wo Onits)
0 INSTITUTIONAL/GpVTRNMENT ? R-3 7UWWOUSE (Three + Units) ( Units)
. [] R-4 APARZMENT/CObIDOMINi[M ( Units )
*RY!'S: PAYMF'nT!`' OF FEE AT 1'IME pF
nPPLscazioN DOEs Nom oCNs2ITUTE
APPROVAL OF PERNIIT.
P ease Print
^
"1) PROPERTY ADDRESS: 13 g? #"4A BItQ, D?- •.
LEGAL DESCRIPTION: _ 3 y A°?i f. W p aJ Alot;T 4J ,f
IF EXISTING S"PRL'L'MME, DATE pF ORIGINAL BDIIDING PERMIT ISSL'ANCE:
2)
PHONE:
3) ' i:a?• NAME. ---
Pjyvlltoul-(.1- plS ?vv
ADDRFSS:
CITY. STATE, 2IP:
.?
PHoNE:_ rAsrm r.IcaasE#
ActiVe
Expired
Not recorded
stTr "Initial
4) w• ?
ru?r?: 3,odn? 45
AMxEss: CITY, STATE, ZIP:
PHONE: .
'5? " «' • ?• : ? a? - ??
?CONBIDCPION 10 CITY SEWER N[d9C,TION TO CITY WATER OTfM '. .
6) as • • i [ErPLEASE IiOLD APPROVFU PERMIT F'nR PICK-L?P BY ONE OF ABC)VE ----- ---
? PLEASE MAIL APPROVID PERMIT TO 1, 2, 3. 4. ABdVE
' • (Circle one) 7) .e?s ? e/wi._ / n ?_. .? ?n
CITY OF EAGAfV
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NAM: ef -L //c rrm .t t.V
ADDRESS:
CITY. STATEr 2IP:
nCrnMoN oF sSM Arro/OR kMM
Tnlcmnr.raTrONS WIIS, NOT BE SCfED-
tnM vNM PERruT HAs EM
APPRdVFD.
.. ??-
. FOR :CITY USE ONLY PERMIT # ISSUED
L 3 FaZ.
Pd w/Bldg. Permit FEES:
$ $ /O - S--D SEWER PERMIT (INCLLDE SURCHARGE)
$ $ -S a WATER PERMIT (INCLUDE SORCHARGE)
$ ? -7`0 ? $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLDDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ? 5G t? ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ o D $ WAC
$ ?S D •C9 0 $ SAC
$ $` TRDNK WATER ASSESSMENT
$ $ TRDNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRLNK SEWER
$ $ LATERAL BENEFIT/TRIINK WATER
$ $
WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$- 0--D $ TOTAL
7 .': 9 6
RECEIPT RECEIPT
DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST BE
DIVIS ISSUED B?.' THE ENGIIVEERING
ION. LIST AS A COIVDITION.
SO BJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: A,,J &,?
TITLE:
DATE:
i cirr use oNLr ?
L BL RECEIPT N: ?? ?`T a g
SUBD. ? ? 1111 RECEIPT DATE:
? PERMIT # 7)9 -7 J3
I
? 2000 PLUbIDING PERMIT (RESIDENTIAL)
j czTr os EAcnx
? 3830 PILOT IQiOH RD
EAGAN, 1+A7 55122
I 651-681-66?5
i
Please cortjpiete for: ? single family dwellings
? ? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
i
Alterationsl
Describe: ?
to existing dwelling - minimum fee
$ 30.00
Bath tub . $ 3.00 x = a
Floor drein 3.00 x. _ $
Gas ipin ; outlet ' minimum - t 3.00 x = $
Hot tub/s 3.00 x = $
Kitchen si k 3.00 x = $
Laund tr 3.00 X. _ $
Laveto 3.00 x = $
Se Uc S s em newlretumianea ' requlres MPC lic. 75.00 xi = $
Septic S s em abendonment 30.00 x = $
RPZ I newinstallaUoNrepaidrebuild 30.00 X = $
Rou h o enin 1.50 x, _ $
Shower ; 3.00 x, _ $
Under rouhd s rinkler M dweiling is under consWetion 3.00 x = $
Under rou ds rinkler Hexlslingdwelling 30.00 x = $
Water clos t 3.00 x = $
Water heater 3.00 x = $
Water softner Ii dWelling under eonsWCtlon 5.00 x = $
Water sokener i} exlsting dwalling 30.00 x = $
Watertumaround 30.00 x $
State 5urchar e .50 -> -> -> 8 .50
Total -> -> ---? ----s . 50
Reminde?: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
•---•-••--•--'----••••••-----•--...-----•._._...---••----------•---•-----••••• ...................•••• •••----•----...----•---------•••••••---•
f hereby ackn?vrledge that I heve read thfs applicetion, staM that the Informetion b corted, and e9? to compy wkh all appliwbk City oi Eagan ordinances.
k is the applicenYa responsibility to notify the property owner that the City oT Eapan ecsumes no Ilability for eny damages ceuaed 6y the Ciry during 8s
normal opereiional end meintenance activities to the fadlities constructed under this pertnlt wkhin Cily property/right-of-way/easement.
SITEADD?ESS: ?WALRAVEN,MORRIS
I 1382 CAMELBACK DRIVE i ,
EAGAN, MN 55123
OWNER NpME: : ?(?i) Qoa-iess TELEPHONE
! I (AREA CODE) '
INSTALLER NAME: WOIZf1iL-OW1 F 1_LJM 51134 l_o TELEPHONE #: 61Z_ B27' qn_3
i 0- ?L G (AREA CODE)
STREETAPDRESS: Z.i/D J'r ?tFQ.F= 1?. LIS I7J? JO
cirr: SAJ ?J e-i4po?? S sr ziP: 5.c-)J08
? SIGN E OF PERMITTEE
;
"e , ^..
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRE33ES FOR CORNER LOTS - CONTR9CTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BOILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENT9L IINITS FOR SALE UNITS 9 OF ONITS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SURVEY - CHECR WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTUR9L & STRUCTURAL PLANS,
1 SET OF SPECIFZCATIONS AND 1 SET OF ENERGY CALCULATZONS
'55,0(- 10570 Al - Z-l -,PIP
To Be Used For: beC/f ? Valuation:` & Date: ?
Site Address
Lot ? Bloek h?
Pareel/Sub =/c:a,v .? / G ?
Owner
Address J,3 5, 2 4 ,a????
City/Zip Code ea2ti 1. ?,If f'SYp1,?
Phone
Contraetor
9ddress
City/Zip Code,ffj'/?ap
Phone ????
Areh./Engr.
Address -
City/Zip Code ?
Phone # -
On site sewage_
MWCC system _
On site well _
City water _
PRV required _
Booster Pump _
9PPROVALS
Oecupaney
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Engr/Assess
Planner
Couneil
Bldg. Off. lo Z1
Variance
Permit ? 6.
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
,.
A? //E?,?a?? ?oNSr
e tr ?o7¢,ni
R Ol?E ?OHSUlT1H0 EN4tNEfR1
- ENGINEEAING PIANNEAS ond LAHO ,llAVEY0?5
` COMnf?NYi INC.
1000 EAST f46N 57REET, BURHSVILLE, i11NHE50Ta 6-337 PH 132-5000
C?TZ?Z?Z C?CLze D? c?L7"'7l'e y
Le? al .?e.scr?P?'iort• L07 3 U.OCK 4, FAIRWAY NILLS,
L1AK0T"A CoUMY, MINNESOTA
(i_oz'i. a ) DENOTES EXISTING ELEVATION
(1027-0) [)MNoTFS PROpo$ED ELEVA710N
?-? INUICA'i'ES DlREC't1CN OF StJRFAC6 DRAINAGE
1022,33 = FIN{SHEB GARAf9E FLGOR ELEVli1lON
3
?z ?a4C ?
, 8?? 65 9? ?3 0? ?
•?.,
30' FRONT BU!!.DlNG SS90
S[T'HACK LINE
. ? 40 ` 220? 'o / ? ??\
I
. v`?
If
ff 00
^ f C? 4?j ?Itll. ?r2 R ? /
` ? ? ` ??..• ,?°2j ro R? oa
___? , ? ?;4 ?,f
? ? ??o ?` °?'•?
/. ?
e4,?
.-_rI I
DAAINAGE ANO tJ11LfiY
SCAI..E = I"= 30' EASEMEMT
o ?
w
I heraby cnrtify that thin ia a t:ue and correct rnpreaent:tion of a tracL of
land as ahoxn'and dcacribed herem• Aa preparad by me on this /`;day ot
DeWwMv- , 19 67 . .
_;;? . ? Hina. leE. No. 108s
f
Use BLUE or BLACK Ink
F---ffi--ce -Use-----------
~ For O I
j Permit j
City of Eapn I
Permit Fee: '
3830 Pilot Knob Road ` A 1
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I~
Fax: (651) 675-5694 1 Staff:
--i
1 `7
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
C~
Date: 49 13113 Site^ Address: ~ ;~7 SA Ca m e- 16eA c k- D t" Unit
_....w _ _ Name: u r► I j So M CL Yl t Phone: ~O GJ 1 ' ~J9®' 9-711
Resident/
Owner Address/ City/ Zip: 4 W ? ' " e. r i n Et g et 5151
Ili f I/
Applicant is: Owner Contractor
Type of Work ' Description of work: ! C Ti° ry /T1Cdr r' F= l~
~ ~7~1 S~'"1 n ~✓i.Lrr1 b~ C' Lt-1^ ~ i o0 r"
` Construction Cost: $c~Q.~ ~ Multi-Family Building: (Yes / No
Company: M Cyric-re-l` 0)&+er ontact: ma t'~-' ' j" roe_Je-r
Address:
1 2 5 -3~1>ncW OCvd city: D
Contractor ~ /nl~lt 1'1'~
State: Zip: 65150 b q Phone: & P- -:7 -7
License* qRe(_06dN&n+r 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
g In the last 12-,months, has the City of Eagan issued a permit for a similar plan based on a master plan?
I _Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and su ortin documents that ou sub~~~~~~~~~~~~~~'_.. _ .u._ .
pp g y 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. "
Applicant's Printed Name App1F ant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
_ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
_ 01 of _ Plex _ Lower Level _ Pool _ Miscellaneous
_ Accessory Building
WORK TYPES
- New _ Interior Improvement _ Siding - Demolish Building*
- Addition e Move Building _ Reroof _ Demolish Interior
_ Alteration Fire Repair _ Windows _ Demolish Foundation
Replace Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition 00 SAC Units
(25%_ 100% Zoning n "I City Water
Census Code Stories Booster Pump
# of Units / Square Feet PRV
# of Buildings 7 Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/ C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In Air Test -Final Windows
Insulation Retaining Wall: - Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FE
Base Fee
Surcharge
Plan Review 30 3
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies TOTAL
Page 2 of 3
TLCC5S-.' C41- 1 ct-'1/' IS- Use BLUE or BLACK Ink
4k.i.. 35 77 e‘1 =949.°I 5For Office Use
.
••:r,..i,;*0.V.::,. 7CP 3" 5/5
.•••• Permit#: /
17 City of Eaian -CC, r CC. -64
Permit Fee:
3830 Pilot Knob Road RECEIVED
Eagan MN 55122 Date Received:
Phone:(651)675-5675 JUL 0 6 2017 Staff:
Fax: (651)675-5694
2017 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: ra&c: ea_tn,el bell_c_e_ov
Tenant:.,............ ,,•_.,.,...... ........ ,,,....,,,...„, ........ .., ....„,, ,,__...., Suite#:
C-4—$ 41jajPhone: &SY—965—66a
Resident/Owner Name:!
/City/Ztr.,,I.-5.494C , M.... :e1....b.‹1. .4.-.Alr.. .... . ............ ...,........... .,...._ _,..,-,,•• ., • :
• Name:1tvilD 1ZCO4e tr License It: Prno(0 illo I •
Contractor :! Address: 1463C) al "-- tn_ iv, City: P Nov"....A-IN • .
state:JAN_zip: 56Y1-17 Phone: 16,5 qi co 3' -7 7
.:. „„ .„.... .., .... „„,„„, .... ,..:.' 9. .c.t.:„..,..1..N. ..1.....: t .
. ,
.. .
, .
Type of Work —New K Replacement Repair Rebuild Modify Space Work in R.O.W.
. : Description of work:
' RESIDENTIAL
. .
. .
Water Heater • ..
• Water Softener
Lawn Irrigation(_RPZ/ PVB)
Permit Type —Septic System —
Add Plumbing Fixtures( Main/ Lower Level) •
!
•
Water Turnaround
: • New —
. •
: .
.• . Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(Includes 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)
$115.00 Septic System New(includes County fee and State Surcharge)
TOTAL FEES$ •
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. .',:,..".;:vz,,!:.!,. .4. :
I hereby acknowledge that this information is complete and accurate:that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit,and -rk Is f• to s,rt without a permit;that the work will be in
acco nce wilt the proved plan in the case of work which requires a review and app . I . /7
?sr
xoll Ire--- -
Ap licant's P 'nted Name s teant's • . a ure
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test ........_..Final
Meter Related Items: Meter Size Radio Read Manometer Staff: