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4623 Penkwe Way for-Oice_Us Permit Permit Fee: 3S-7, OCO 3830 Pilot Knob Road IOU I Eagan MN 55122 . Date Recei 46 v*h ' = -1- Phone: (651) 675-5675 start: Fax: (651) 675-5694 - 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: l Tenant Suite RESIDENT / OWNER Name: * /747 ,C 'hone: Address / City 1 Zip: Applicant is: Owner X Contractor TYPE OF WORK Description of work: 49 ' l5 Construction Cost: 50 0 Multi-Family Building: (Yes / No CONTRACTOR Name: ?t~b~L °7/~GC7r1~?'y¢c Tars Gam- License It. 2<71 5'Q 73 Address: p C~°T^ 3,Z G: mayT 'l1_ A- City: State: 1141-04-- Zip: 53T "l Phone: Contact Person: J 7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • ° New Energy Code Worksheet Category Submitted Submitted (I submission type) • Energy Envelope Calculations Submitted 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 Plaits and supporting documents that you: submi't' `siilered to be public informat,on. Portions of the information may be;c/ ssifier as non-public if yo p> pacific reasons that would permit the City to cotrclude tha#: re secrets. I hereby acknowledge that this information is complete and accurate; that vtwk be in'corifo p anee with the ordinances and codes of the City of Eagan; that l understand this is not a permit, but only an application foC work is notAo start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a r w I of pla x x Applicants Printed Name 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/GazebolPergola) _ Exterior Alteration (Multi) 01 of Plex _ Lower Level Pool Miscellaneous Accessory Building .J !1 C eS •7?d A S WORK TYPES New _ Interior Improvement Siding _ Demolish Building* Addition _ 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 / 1 006 • - Occupancy MCES System Plan Review Code Edition y/4_41 oy"'j SAC Units (25%_ 100%_) Zoning 9." City Water Census Code ~j Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Cf Sheetrock Footings (Deck)-( Final / C.O. Required Footings (Addition Final / No C.O. Required Foundation HVAC 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 Meter Size: Erosion Control Reviewed By:7_29 , Building Inspector RESIDENTIAL FEES Base Fee 12 DO& 1kn -.cvieL..7 Surcharge .d 0 t(f ona - jJt J3 n~ L)!4l(s PI" Qevief? Plan Review • 1 r MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 For OfficeU_se L City of E (f (t n Permit b I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 staff: 2009 RESIDENTIAL BUILDING PERMIT APPLIC ION Date: Site Address: Tenant: Suite RESIDENT/ OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY I CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 ate o 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation C tegory 1 Worksheet • New Energy Code Worksheet Submitted Category Submitted submission type) • Energy Envelope Calc6lations Submitted 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. 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. X x Applicant's Printed Name Applicant's Signature Page 1 of 3 "A47k • (~Q C. R. WINDEN & ASSOCIATES, INC. t1 LAND SURVEYORS T.L $45-3646 For: 1381 EUSTIS ST., ST. PAUL, MINN. 55109 U. S. Home Corporation N EAGAN REVIEWED BY: ('/q l fl g wd~~s DATE: BUILDING INSPECTIONS DIVISION Scale: 1" = 50' A ti l 't• J F 2 ~y~ 6i p 16 acs ri -7 O- 'i 0 4 z~3 ryli cs 3ti X01 ! - d Lots 1 through 4 inclusive, Block 8, Johnny Cake Ridge Third Addition, Dakota County, Minnesota. WE HEREBY 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 L"C4h doy of Ma rc h A. o. 19,S/ C. R W ASSOCIATES. INC. by Surveyor, Mini seta Rogistrotioa Ne. '7?Z6 4 N . . ` W# SERV : 3tlt . ° iMU ;Root P�Gh� m -NO 38 � 7 ' . . jot" M N , 15132 DATE: El 1 Q/ 1 - 'R TI - I. unit tithe n it s: Owrnsr Orrin `Thp ps ©n 1oune4 .. Sies rein 4623 Pend i Way T.4 1 s 1".. .'` .I ITT r Pi 'en4a pltsnih'fItQ , 4iAliiiiiiiir No., Cowhaction Charge: 335-00 p' M t: r I4b.: Permit per 10.00 pd tilow‘vitisaptif vo10. 146 City et lags* Surcharge: 50 pd Www. Misc. Charges: 60 . on p suet-et Total: s° RY _ Dote Paid: ., Dat* of i . 6 C{ 2r insp.: CITY 0' 1 ; ~ - siRrce-PERMIT 3I9S "K•ar tow PERMIT NQ: £� • MN 55122 DATE: n0, i ITT No. of Unit8: 1 trait to %se 'rriia- . Thompson . o es Address: Site Add ress: 4(23 Penkwe Way J4 T J C PidCe III mother. ��rF Plumbing 4/20/x'1 24292 100,00 pd 1 eyes ite esrelti► dA Hie City et tepee CanAiction Charge: 4 7 5 .Mf pr? _reweee. Amt Deposit: Perrni! 10.00 pd Surcharge: • 50 pd BY Misc. Total: i ce;; (7 Date Paid: �I C��I, �(�7� `)�� W C���. ���-� 'la Use�Bl.UE or BLACK Ink �-----=----------� 1 For Off'ice tJse � / � l �-�`j I Co + � �!� � Permit#: ! �1�� 0�����Il � ' � ��.S� � � Permit Fee:' � 3830 Pilot Knob Road v Eagan MN 55122 1 Date Received: j Phone:{651)675-5675 � � Fax:(651)675-5694 1 Staff: i 1 � . . ... . �.. . . . V.�.� � ���..�J . 2414 RE5IQENTIAL BUILDING PERM13 A�PLiCAT10N Date: �'..!�'"j e.f Site Address: �O�'1 ` (��i �'3 l��-- ��ii���`'�'�(- 4''� ;Unit#• Name: C/��""�l;?� Gr!�I�� !e�t:�,�/)�'1��r t..._ �Phone: Residentf Owner adaress�ciry tzi�: ,�'���- �� � Applicant is: Owner � Gontractor Description of wrork: �'G� r��� � ��" ���'�i � TYpe o�W+�tk � Construction Co&t� ��'f��� Mu�i-Famity Building:(Yes .� /No„+,� � / .�"��' ` Company:/VC�YZrJ�5� t'e'7�'!`t fs�-G��[7i'S Contact r�r� �G,�t�'�y ad�«ss:��il l Z�v��.����- L„�-,�� � c►ty:�1�'�- �tz r���-- contractor : G �� ` State:��Zip: ��.1�3,�tj Phone:�'�J�l"p''Email:���rw� �3v"t.�l S`T�'�r9yJ�i/��-7e�v � 'z y1 e� C��_.�-� ��� �� � � ucense#.�� I.�� � 7� �d cer�ca�a#:N�.-�°��=��r 1 c�3 —I' if the project is-exempt#rom lead certification,please explain why: (see Pag�3 for additionai information) COMPLETE THlS AREA ONLY IF CONSTRUCTfiNG A NEW BUiC.DtNG la the last 12 moM , tl�Gity ot Eagan i�sued a permit far a simFlar pEan based on a master pian? Yes No if yes,date and addr f master plan: Licensed Plumber: Phone: Mechanical Gontractor: . Sev�r 8�:Water-Corrt r. Phone: =/�i�T�•« and suppdr�i,�g cts�cttmet�t��ttat�c�t�sub»t�t a�e corr5iderea���a he ptrbli�c ii�'c►r�a�4� l���s;�f.`.. r�rirna��rrt r»a�Lte+���s�i�it.as nQn�tublic i�yro�t pr�rri�e sp�ct�'s�r�so#�s�fiaf�rptr�����e��i to cc�nc/i�d�th�rf tlr� ar e#ra�de sc�r�ets:: Cl4LL B�fORE YOU DIG. Gali Gopher State Or�e Cati at(654)454-0002 for protection against undetgrcnuid ut�ity damage. Cai!48 hours before you 1n2enci fo dig ta receive locates af underground utilides. wnvw.aosherstateo�il:ort� l hereby acknowiedge that this informatian is c�mp(ete and aa:urate;that the woric will be in cronformance With the ordinances and codes of#he C+ty of Eagan;that i understand th+s+s not a pema't#, buf a�nly an app4icatwrf for a petmit,and worfc is not to start w+thout a perinit; thaf the wt;rk witi �in accordance with the approv�ed'ptan in the c�se of wortc which fequires a t�view arfd aPProval of ptans. ExLerior work au�orized by a building pernrft�sued in accordance w�th the Miqnesota Stafis Fiding Gade m�t be compte�bed witt�in 180 days of per�mit i�uance. : , "�,r d I x tf' 1'� �G��t��� x ��_' Apqtican�'s Prirrted i+iame ' ctt's 5ignature , Page 1 of 3