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4287 Dartmouth Ct Vi 1 For Office, {� ,�i ' i�, i ::: % `,....7 � ; I 't Date 3830 PILOT KNOB ROADrj EAGAN,MN 55122-1810 t. 1 t ..,-rt_,, 1 i (651)675-5675(TDD:(651)-45,4-8535!FAX:(651)675-5694 I Staff: ~ I buildinginspections@cityofeagan.com L 1, APP 04 2011 2018 RESIDENTIAL BUILDING PERMIT APPLICATION �/ '1 �I Date: 1-1/71:77I'S) Sete4d L 7 ► ` v GIT Unit Name: �^.1 0 d Al . c'�' '( f,i ., ftfi'i t� I• Phone: Resident/ 7 , owner Address/City 1 Zip: "?'< J air .rn(rZ t , - _ ";' ! Applicantill is: c it T Weil( Description of work: ' E4c. . 2 . .r1t,_'/1411-7i/,Jl e C. E ]`t.S 4i C tie, t Construction Cost (2-.C. Multi-Family Building:(Yes #No ) Company. •` )e,+ , tte a K C.64,-St: -.L�.r`1(-- Contact -- elk( +'a✓`z C actor Address: -11‘f i'aE' r✓U i['y`L- Gt \k City: 1. - State! .' Zip:-.`s.. --`S i/f : 4 - I -'` l.''if ail: l,t i J( /I)j`c)t irte, ?U I . tC i%vr License#: L°`[tr i 24 lead Cor n- #: / T (Y — r- 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 ofmaster plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Fire Suppression Contractor: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classiffed ir ., . , - . , reasons:hat would, • the to{ first A F are trade Yousubscribeto receive annotification the City of ordi by signing up for an email update on the City's website at www.citvofeacian.comisubscribe. Exterior work authorizedby a builtimg permitissued in accordance with the Minnesota State Butlifing Code must'be canpleted within 180 days of permit issuance. CALL BEFORE YOU DiG. Call Gopher State One Cali at M51) for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.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. ! .� ct)''' ' Applicant's ri n Name •-- ` . - e 7 . Aliz-lin ca O#. / S / + JV NOT VVppITG BELOW TL1D fIIC SUB TYPES _ Foundation Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family), Si !e:FaaMills.. Garage _ Porch(4-Qi soon•�... 4ari r.,41*n„retin+.v.(Mu H'i1 — Multi X Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPESc, New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building Reroof Demolish Interior _ Alteration 'FireRepair _ Windows Demolish'Foundation Replace Repair :Egress Window Water Damage _ Retaining Wall *Demolition of entire building-give PCA handout to applicant I'1F=Ci^_R1PTff1N Valuation ,7f 0 Occupancy MCES System Plan Review Code Edition1 SAC Units (25%_100% X ) Zoning City Water CensusCode Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction a,. Width REQUIRED INSPECTIONS footings (NewBuilding) Meter Size: Footings° c Final i C.O.Required Footings (Addition) Y Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof: i-....: G Water C'......1 rt....1. C..,.+'........ h' I/''.....1".......c.-. C: 1 IloVl. II.G/X VVQIGI I II101 I VVI. I LAMMI IJ llirl VQJ I GJLJ I 111101 Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test Final Siding: Stucco Lath Stone Lalli _Bri-ck EFtS Insulation Windows Sheathing. Retaining Wail:_Footings Backfill Final, Sheetrock Radon Control Fire Walls Fire Suppression: Rough In_Final YrMtAiat..GtalL11V.0714/11 4..4/111.1 0I Shower Pan Other: Reviewed By: ! , Building Inspector RENAL FEES , ;:veti Base Fee °pip.. ;Surcharge Plan Reviewt lui i i ,, ( 7 1 rd) MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Pager of 3 Use BLUE or BLACK Ink For Office Use -7w- Rio City of EaRdfl Permit Fee:' 3830 Pilot Knob Road I I Eagan MN 55122 j Date Deceived: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Sta . ; 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date:,/2--23-/O Site Address: 1121T 7 P /mil a V77/ Gn yA-T': .--416.4ki sr/Z3 Tenant: Suite RESIDENT / OWNER Name: /4/✓D/ZF~ f-,?af4✓ W44-113, OL-D Phone: 4_r/ !VO J-- 0.3,13 Address/City/Zip: f2~7 A442 ,o-VV-7-7/ GOV-fG 6,44ta, /VA) 11 Applicant is: Owner ✓Contractor TYPE OF WORK Description of work: Ld JOE=* IV /.f hl Construction Cost: n SAO O Multi-Family Building: (Yes / No t/f CONTRACTOR Name: Tl/`1ljE/L~.c/oRLt S 6GDS' S _=XI .icense ~35Z Address: J?2-f City: E¢G~ 41^1 -S-3-112-3 State: /,//j Zip: Phone: 6~~1 ,,387 ^ 0 8}~0 Contact: /l//tf keA-S ( $A42~rrr~i ok COMPLETE THIS AREA ONLY IF CONSTRUCTIN 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 the 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. x/✓/ 4W-0 6#f -s x Applicant's Printed Name Appl cant's Signature age 1 of 2 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 _ 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 ~i Occupancy/?G MCES System Plan Review Code Edition` SAC Units (25%100% V< Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings- Length Fire Sprinklers Type of Construction- Width i REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) JL 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 QV- Fireplace: Rough In -Air Test Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Meter Size: Radon Control Erosion Control Reviewed By: , Building Inspector RESIDENTIAL F ES v y(,~ Zo / fG~O Base Fee 3~ J~► Surcharge Plan Review JO MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2 .. ? CITa( OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: ?•, fi,: I rartt 1 li PERMIT SUBTYPE: N RECORD PERMIT TYPE: Permit Number: Date Issued: APPUCANT: TYPE OF WORK: 0-1/tA/1+ INSPECTION ., . .• 1 0 Al' !l I ? 1 I i' J I.,!??.it t??„I € i i:? r !P!I)) I.I MAf4 F ?:: N!, v ,°i & 1-1 ('I FiR' I:ih M.1' li`fAN ('! ktii Permit No. Permlt Holder Date 7elephone # S/W PLUMBING HVAC c? ELECTRIC 3 rJ ?' ? ? ?,fGcv ELECTRIC Inspectlon Date Insp. Comments Footings i ? Foundation Framing Roofing Rough Plbg. 6- ? Rough Htg. 7- / I5ul. Fireplace Flnal Htg. V? OrsatTest ??;-/Q` ( lI Al/ W!J Final Plbg. Plbg. Inspector - Notity Plumber Const. Meter Engr./Plan Bldg. Final ?Jc/lJ (Z ? Deck Ftg. Deck Final Well Pr. Disp. 0 U ` il \ A./i L V i i V 1 \ i_L V\/ i?i/ CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ' f•? 1 ?i Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: 4 ' r' 1 `' 1' i ? 1? APPLICANT: l.'fMrlllTl{ t:i :?..?il NfsttR'?F Wfi(?p'?; .?IVf? ( t, 1.' ) qF,4-???..tNl? PERMIT SUBTYPE: .,.t TYPE OF WORK: r, 6 :2 1 1 Ii , 1.;nl Permlt No. Permk Holder Dete Telephone N ELECTRIC PLUMBING HVAC Inspectlon Date Inap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPIACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG 42 DECK FINAL +h n n 2 J L 10 97 ?('4 7 R 9u. Oat ?/?. ' ?? Fire No Fou9h-in Inspectlon Reqwretl? s ? No c-` ? ROady Now l??ll Notity Inspector / ZJ?en Ready'+ I? icensed contractor D owner hereby request inspection of above electrical work aT Job Aparess (31r ?, ox or Ro te No City Sec00n No Township Name or No Range No county RlfyYM OccupamlP ? r- Phane No 4?// ? L,? ' . J ^ V ? Pawer Su00lier AOOess Eiecin ai onMal IComp y Name1 " ) Co dors Loense No ? or Mailing Atltlress (COnVacror or Owner Makinq Inslal tionl ? /?? ?/ •?? j??/ry i I Autnonzetl ignawre ICon a onOwn .1.1 ??n 111 yavon Phonmber ? MI ESOTA STATE BOARD OF ELECTHICITV 1{i15 1NSPECTION RWUEST WILL NOT BE ACCEPTEO BY THE 57ATE BOAFD Grigga-Midway Bltlg. - Raom 5-173 UNLESS PROPEF INSPECTION FEE IS 1821 Univemity Av).. 51 Peul. MN 55106 ENCIOSED Phone (612) 642-08D0 REQUEST FOR ELECTRICAL INSPECTION il EBA0001- ? = a?- / See ins[mclmn= lor completing this form on back ol yellow copy ga3- ? n I? _? 111q7 "X" Helow Work Covered by This Request ew Add Rep. TyPeotButldmg Home AppliancesWired Range EquipmentWrted Temporary Serwce Duplex Water Heater Elecinc Heanng Apt 8wlding Dryer Other-(Speafy) Commllndustnal Fumace Parm Air Conddioner Othar (specty) Compute lnspechon Fee Below. Canlredor's RemeMS ? ??/ _?." , ? I! L!/?LJ ? n (Ui. . . . _ ? Ly«?? # Other Fee # S EntranceSize ee 0 CrtcmtslFeeders Fee Swimmmg Pool Transiormers 0 t 200 mps Above 200 _ Amps Onty' k U ?? / to 1 mps Amps TOTA? SignS i se Inspedor ? allon Booms Irn ' / Ly UC' g Special Inspection . Alarm/Communication THIS INSTALLATION RED DISCONNECTED I T Other Fee COMPLETED WITHIN 18 MO S. ( I, the Electricai inspector, hereby AO0gn9° cerhfythaltheaboveinspectionhas been made. F,,al oaie OFFIGE USE ONLV ThiS IKUBSivOid 18 rt100th61lam ? J L LOT fOROLY CBLCICLZBT tOR ItL6IDLHTilIL ? s4=LDTNO tLR1SIT JkYFLICllT2e1N TROPLRTY I,20At,t ? n of a rvsps ? mC .27 .? y? 71?y @??7 D?0 O D • • Registered Lnnd Suzveyer s;qnntuze and coa+pnny Suilding Pezmit !? ' D'"0 D • pplicant 7.eqa1 descziption • 1lddzess D D 0'D 0 L1 • • North arrew and bar •eale 8ousik type (=amblar,, valkout, aplit v/o, split entry D?D D''D O 0 , • , lookout, •tc.) Directional a ?ient !. s a i B''? 0 • Froposed/existinq ever ces nd vater •eiv 0 • Street name Driveway sn?v??rzoxe ? 0 0 D • ?xist3ne Sewez •erviee ?? D • • Lot eornezs ?'D 0 • Top of eurb et the dtivevey Elevetions of any exitting adjaeent lsomes ' Zr?D D • pseDeseA Gnrage Sloor ' D 0 • First iloos ?7- D 8? 0 0 D • • Lovect exposed slevation (walkout/vindov) • pzoperty coraezs Fzont ane rear of home at the ioundntion pONDING 71RE71B lit •eel3eBblll D ?D • D 0' D • Tnsement line D ? ? • NwL NwL D D? D • Fcnd t designation n ? D • Lmezqeney pvezflow Llevatien 'f? D 0 • LIlStN8I0N8 Lvt lines ?,,? +i ? 0 D • • Riqht-oi-wey and striet wiAth (to bech of eurb) o prop sed 5ome dimensions ineludinq any proposed deeks, overhan s reete th 1 q q r nn 2 , porches, atc. (i.e. •11 stzuctures tequiziag penennent foetinqs) • Shoa all ensements of seeotd ane eny City utilitie+e vlthin 'D?0 G • those easements Setbaeks of pzoposed structure anG setback of adjecent existinq bomcs , Retaining v re izements, 3i any Reviewed: --- • - - NAm / ete Wo-q3 'f?5?0• or 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCfion Reowremen? 3 registered siM surveys showing sq. N. W lot, sq ft, of house, and all roofed areas (20°k maYimum lot coverage allowed) 1 Soils Report if proposed 6uiWinq is to be placed on disWrbed soil 2 copies of plan showing beam & xnndow s¢es; poured found design, etc. 1 sel of Energy Calculahons 3 copies M Tree Preservafion Plan if lot platted aNer 711/93 Pom Joist Detail Op6ons selectlon sheet (buildings with 3 ar less uni5) Minneqasco medianical ven61a6on fortn RemodeVRenair Reauiremenfs Ql?g? 2 copies of pWn shaving fooungs, heams, joists CeAofSurvzy Reed°,-; _Y _N 1 set of Energy Calculations fa heated addifions Soils Repor't _ _ Y_ N 1 sile survey for addi6ons & decks Ttee Bres Rfad;ReCd?, '_Y. _ N, Addrtion-indmateilon-sitesep6'csystem TrBSPregRequired'=Y _'N On=5iteSepbcSysfem:' _Y _N Plans are considered [aub8ic s'nformatian unless ?ou sta#e theY ars f.rade secret and the raason. Date 'K / J-4-/ 0-7 Construction Cast ??j 1000 Site Address '-{?J DG.,`+ mU?.1-?'h ?'? • eCLC{GCL , m.U.7 UniUSte # Description of Work & M ? 9 ?5'UiirG ?' ST4 O S ,(y<R'Co S77C CC Multi-Family Bldg _ I' ' Y( N Fireplace(s) _ 0 ( 1 _ 2 Lt7r ?y,rC necesSa?? U PropertyOwner Q,y\CA Atl(7.veG, wqW&JO\J Telephoue#(?St ) q05`05l?l Contractor n? C,e./ E-,C< S oiYs-r ??NTR?7e'TeQA- .106 X36 Q? Address / g 3 04? SLa ?nl? /Y/ City ?_` ?4 !r h?/? l D ? State /Al/V Zip_?'Zoo j Telep6one # ($107) 3.27 c?=11 I. SY _ o?p", COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category (q su6mission t e) . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet yp Su6mitted Submitted • Energy Envelope Calculations Submittetl In }he last 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master planZ _ Y _ N If yes, date and address of master plan: Licensed Plumber Teiephone #? J Mechanical Contractor Telephone # ( ) Sewer/Water Contractor Telephone # ( J 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, buY 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. A. ?nf-JK_Gl ?, IAf0.mb0lC%i dv?d? w J. ApplicanYs Printed Name Applicant's Signature PERMIT ?CITY'OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: g U I I. D I G Eagan, Minnesota 55123 Permit Number: 0 2 3 2 9 5 (612) 681-4675 Date Issued: 0 4/ 14 J 9 4 SITE ADDRESS: 4287 DARTMOUTH CT Lp7: 17 BLOCKr 2 HAWTHORNE WOODS 2Nq P.I.N.: 10-32151-170-62 DESCRIPTION: Building:-Permit Type SF DWG Building Wo,rk Type NEW 11BC Occupancy,, R-3 M-1 1 Lonsxruction 7ype V-N Zaning ° R-1 Building I,ength ? 71 ? Building Width ? 40 Buildi,ng stories 2 . F '?`?. S. . .. \ ??l ?`tftr REMARKS: PRV S& W PLBR - GENZ RYAN PLB6 FEE SUMMARY: VALUATION Base Fee Plan Review Surcharge SAC SAC % SHC Units Su6total $944.00 $613.6@ $93.50 $800.00 100 $2,451.10 $18r>e0a MISCELLANEOUS $1,828.50 7ota1 Fee $4,279.60 CONTRACTOR: - SVENO PETERSDN CONS7 10214 PARK VIEW MINNEAPOLIS MN (612) 884-5144 Applicant - ST. LIC 18845144 0001769 CIR 55431 OWNER: 3 PETERSEN CONST INC 10214 PARK VTEW CIR MZNNEAPOLIS MN 55431 (612)884-5144 I her'eby aeknowledge that S have read this intormat3on is co•rrect antl agres to oomply 5tatutes snd/ a? E Ordinances. '- ?_.?'/?Yr-^` / - - APPLICANT/PERMITEE SIGNATURE applfcativn and state t,hat the wa,th all applicable State of Mn. ? n(}?L11 d SUED B. SI NA7U , ., . i ' ? ,i 4W • • ` (? 1 R ?* • .._ ?i?f: ? . . W,tl'ttftCRte Of cCC1tvQttC4 Gsittj o? ?agan , Zepnrtmeat oF Zsi[biag anoectian This Certifecafe issued parsuant to the requrrements of the Uniform Building Code .,. ' certifyirsg [hat at the lime of issuance this structure was in comptiance with the variaus ordireances of the City regulatirtg building constnrction or use. For the following: ux cLmirc,um: SF DwG aida. remic No. 23295 oavp-y rya RIMj2 za,,;n8 n;sma RI rype coau ON o..rs,amng S. PE1ER.9C%I 0(7A1ST INC nad.. 10214 PARK {T113a !:IR, MPfS - euiwing naav= 4287 DAR'MIIIi iX1iQtT LocalflyL17. BZ, EIP,WIl0MM GD(1?5 ZID .W POST IN A CONSPICUOUS PIACE ? ;:?i: 7/3 1 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 4 4 -!? ?4.1 ;'.L:,? SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work Site Address: )r„Immjti ?t SiREET SUITE A Tenant Name: (commercial only) /7 ? ? /?-al T D /2.v ar- LOT BLOCK SUBD. A)d00 S ai'!n 4nr P.I,D. # Descri tion of work: The applicant is: ? Owner Contractor ? Other (Describe) Name J" eo<rJS -C"" Phone Property LAST FIRST Owner Address STREET STE # City State Zip Companycf l??T?RS?? eo-W stt- 1'NE- phone Contractor Address/Do2l? P,6PaC 114?41i e(Re License # 1769 Exp. `l17 City State 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 has been approved. I hereby acknowledge that I have read this applfa?'iion and state that the information is correct and agree to comply with all applicabl.e' St'ate of Minnesota Statutes and City of Eagan Ordinances. / ?_---------._? Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging [2 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition 11 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE (a 31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair 0 36 Move GENERAL INFORMATION . ? 16 Basement Finish O 17 Swim Pool El 18 Comm./Ind. ? 19 Comm./Ind. Misc. O 20 Public Facility ? 21 Miscellaneous ? 37 Demolish Const. (Actual) 1141 Basement sq. ft. 111y3 MWCC System X (Allowable) UBC Occupancy VAI lst F1. sq. ft. 2nd F1 s ft City Water ? PRU R i d M-? . q. . 13g/ equ re Zoning -i Sq. Ft. total Baaster Pump # of 5tories 2 Footprint Sq. ft . Fire Sprinkler Length ? / On-site well Census Code p Depth ? o On-site sewage SAC Code ?L Census Bldg APPROVALS Census unit ? Planning Building Assessments Engineering Variance REQUIRED IN SPECTIONS 13 Site [kd Footing ($ Framing Er Insulation ? Wallboard 12 Final ? Draintile 19 Fireplace Permit Fee 5urcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W 5urcharge Treatment P1. Road Unit Park Ded. Trails Ded. cop;es Other Total: SAC % SAC Units v.iuacs«n: $ f S QS.,f d- Isf -? z?k33 =/o9z z?. Sk 32 = 6a00 2Pz,a6 ?. ???- 2? = ss.ya IO?Z : zo ?r//, oyOk?G ??S.FZ = y4 //PGz.vo ?----- 2„ & 3g ? /o9z 1741,e ? z3g Certif.icate of ttouse Locatinn For: r Svend Petersen Construct.ton Inc. 10214 Par.k View Circle Bloomington, MN 55931 DELMAR H. SCHWANZ uno auavEVOns, nrc. MpMNnd Unftr LM el TM l1He el MMrowU 14750 SOUTH ROBERT TRAII ROSEMOUNT, MINNESOTA 630EE y Gj'(l?,?? 1 r'• / Q r .N N : ? b L ? SURVEYOR'S CERTIFICATE 171/50 EfiGP1.SV REVI€'WED e12/42317eeBY ? s - i 1)47E?._..--L--= -- `l?? , - - / 35, ;7o - _ ? qJ _ o ?P N?6 .W ? O.@j/.?A6E 7 urrc?? ?-F4: 5E/7)& YT ?n j N CoT /Z ? I ' I B.Coc?f z `?' I S/ (,er- I \ ? \. "•9j?? ? 9d?a 9aS,4 ? qoAy ' 9oZS' S H i?9Z / v I o: I x 30, 9 ' ? y 2 ln !',PoPC?? m ,,,,? •,,. ? ,a d H f1nu5E v > q c, o. / ` h ? \? ? N - - . qio•u N `? ? q.69 I 5, 33 ?? v ` ?? ?1YA Address: 9287 Dartmouth Court ? Proposed garage floor elev• 7 Proposed ton nf block elev. /?./J?3 -?- - - Proposed lowest level elev. 0 P I-Ws =?5 ; 4i2,4 - q 2S ? Scale: 1 inch = 30 feet • = Iron pipe monument p = Set wood hub xq0l = Rxisting spot elev ralp8 ? C) = Proposed elevation RM = Top of hub on Lnt 16 = 97_2-27 2s Iescription: '^ Lot 17, Dlock 2, ISAWTHORNE WOODS 2ND l1nDITION, accoidiRg t0 th9 recordcd plat thereof, Dakota County, Minne3ota. nF7?\ S-4-r?v Also showing the location of a propoced house staked thereon. '" - ?o?o V o ?EQUtl? _,,?„.tUnumupr„n 1 hero6y certily Ihet Ihla tuney. Dlen. or rapoA was ?'::?'?' ?? ZE R ? prepered Dy me or under my dirse! supenislon end thst 1 sm e duly ReglatareE lend Surveyor unAar the Iewa ol 1M Steta o1 Minnesots. AR H" a : SCHWANZ ` ' F DNm?r M. Btlnnnz - Datsd 04-04-94 862$ - ?Q? MMnwM? R?qMrtlbn No. l62S ? 04-07-94 Additions 2.75 ? m N I IO 2/.5 .py //,3 0 ? DEPT. w.nv:.Yr..+u?..._...._.......?._..?.?...?_....??_ ?.? 15 14 1+23 0 . ,. \ \ \ / 6-I/16 & I/32 BENDS GqTE VALVE _ 24 \ , , 23 16 SEE SHEE7 N0.9 17 1$ \ M.H.19 M'H .18 • Ct P.O.T ? 3+ 88' 3+23 ' ? v <=? 6" 22 C.O. 21 \ 19 - HYDRANT C.O. 20 s"GATE VALVE , It 24 23 ?, ? 22 7 , \ \ C.O. ... . .... .. . ................... ................................................. .... . ....................................... ..................................................................................... ... ... . .. ........... .................................................................................................................... ... .................................... ....... ................................. . ....... ........................ . ........................ .......................... .......... ................... ..... ... . ..... . ... .... ... .................................... . . . .... ... .. ? . ............................... ................... ? ................................ . . . 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"::::.::::":`::::::: ::::.:.::::::: ........_........................ .. ::::::::::... ...................... ? ............... ......._? :p?................... N 4? ............... _....... ,F,.. :::?::::.::::::":::?::.:r7i Ki,-.. ? _............... .............. ...... .., . .:?::..:........................................... ............ ................................... .__.... ............._ . ? .. ......................... ..... ..............................I.........?.?.?...?.. 21 \ %'? ? -- - - ? g 1 EXIST I TREE ? oi 0 ?o? i -? " ? - - - m Sn m I ? I ?I o I I I I o ? I I I ?, ? EXI T. TR ES , CIRCLE I NAVJ SBURY CIRC E Ea GRADE t i ? i LOTS !O B I I i FpOTING ? _ - ?-- I -- - ' _ cana SED 6 ? L2 , . ,15 , M.1- i 0 25 ESM T ol 17 0? I / DARTMOUTH COUR ----?-- ___-r-- - M.H. {8 FILL TO MIN.5.0 ;OVtR DVER SEW R LINE PEP GRRUfNG PI _A SHEET N0. If 7 -- f? 1 R E 904 5 I ? L.OT 18 17 _? ? -----? OTING EL _ L 350?? $„?'.V.C. SDR 35 }-0.40% I G,ree#ra4€rr S_ €'efersett Cas?3t_ inc_ Jrsb Lot 17 Blsck 2Haw#hcrne 2nd Enera q caicula#ion 4/ti94 t Ta:ai exspased wall area 3195 _. 5=1 .45 2 T:ttnl ft}DftiCN3l39Sg dr-f*3 I -%?#? r' .026 41 ?'a Total 392.94 A fiit3l wiS#i$9d`s" dr£°3 462 li.i= 14,e'::4 $ 'lOtsil D4Gr -aGR-a 38 I_:.12.°i 43f_. C Total s17d7B!g Glaas5 3Yga 4[) iD j' i 21.80 D Total ffisep3ace ar-ea SC _F.ry:; E Total framinq ar-ea (ar_50%) 319 111 19 ?, an f T4t_ 75a#'ffA&l nTe? abeAva }Z.3i'sP 2081 ii.il4.c ,i= 'r,.i (j Total S'i9Lk j635t 3rEd 166 iJ i747 . _' * 5'ata8 f4und7t7ari'g`i7aduw aer2a 7$ j_..-:' 5.7b t Tu#. net foundaisxtrs abnre yrade 51 0.14 ? 114 Total $t 320_37 J Total sky79gh# area 0 0.32 0.&1 '? Tot. rnarlceiiing framing (10%} 159.2 3, 0454 ?.c:u L Total aet 9nsuia#eci ross#/cei3ang arra 1432_8 0.0, 7 9 3 a;.c..`• Total 152 35_45 TO$d{ of i delfd 2 3-?_'.5_83 PERMIT ? CITY OF EAGAN 3830 Pilot Knob Road Eadan, iNinnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number, Date Issued: WA1511W' BUILDING 026010 07/14/95 SITE ADDRESS: 4287 DAR7MOUTH CT LOT: 17 6LOCK: 2 HAW7HORNE WOODS 2ND P.I.N.: 10-32151-179-02 DESCRIPTION: ;?":?,,- BpY!Ylding?!.?Permit Type DECK Buildirrg Wii,rk Type RDDYTION LYl ?? } n vxs ? e'?s's?w F ,f3 E'. `FC'g' W `x14( iypy? fli ?'GjPq A -531IE UP. REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: OWNER: - flpRlicant - SCHIILING DTE7ER 4257 DAR7MOUTH CT EAGAN MN (812)454--9300 ? ?- Z hereby ac`kmota.lQSfqe that hav-e? read,?thxs ap?'plica?t.;kQrjiir,c[ state ? that e _. : ?irrfbr±rra•tivrt .is. c?orrect ar?il a'grpe c?or?p?y't?ith `o'f' Mn ° ?-statates a.nd. rity o1r Eagatr 0.rd3riati?c?s.? ? ?_ . ' ' . . _ ..,...._ v . ._ . ._ _ . ... . c? .....6 _ ........».. . _ ?J APPLICANTlPERMITEE SIGN URE ISSUED BV: NATURE , CITY OF EAGAN ?? D• S CJ C;?(00' ? 3830 PILOT KNOB RD - 55722 1995 BUILDING PERMIT APPLICATIOlV (RESIDENTIAL) ????5 B81-4675 New Construetion Reouirements RemodellReoair ReauiremeMs ? 3 registered site surveYg ? 2 eoPies of plan ? 2 eopies of plans (inclutle beam & window sizes; poured fid. design; etc.) ? 2 site surveya (ezlerior eddlUons 8 dadcs) ? t energy calculations ? 1 energy calwlatfons for heated addRions ? 3 copies of tree presenation plen H IM plat[ed after 7I1193 required: _ Yes _ No DATE: CONSTRUCTION COST: ?3 ?? SOeo DESCRIPTION OF WORK: - DZck G'oxS1P?+?7`?O?a STREET ADDRESS: ' ?'287 Dc?r'rh+ok';`A lpa r f ?4q4ih LOT /I BLOCK 2 SUBD./P.I.D.#: 8aW4l?°"ne Uoad5 Zhd AoUi4-1oN 4 SN -93oox3y2 Cw? PROPERTY Name: -!?rd d&q OWNER Street Address y?87 Q4rtn"04fAl Cc City: ??94H State: Alil CONTRACTOR Company: Se Ac-? Phane #: Street Address: City; Phone #: #s1-e73? ?H,? Y-t-- zip: 9.5--/2 3 State: ARCHITECT! Company: SB?F ENGINEER Name: License #• Zip. Phone #* Registration #- Street Address• City: State: Zip: Sewer & water licensed plumber: &4L4 Penalty applies when address change and lot change are requested once permit is issued. 1 hereby acknowledge that I have read this appiication and state that the information is correct and agree to comply with all applicable State of Minnesota Stawtes and City of Eagan Ordinances. P QJ/ U ? Signature of Applicant: OFFICE USE ONLY ???ENET Certificates of Survey Received _ Yss _ No J U L 0 5 1995 Tree Preservation Plan Received _ Yes _ Na OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex 0 02 SF Dwelling ? 07 4-plex ? 03 SF Addition o 08 8-plex 0 04 SF Porch ? 09 12-plex ? 05 SF Misc. 0 10 _ plex WORK TYPE -fT?31 New o 33 Afterations 0 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) tJBC Occupancy Zoning # of 5tories Length Depth APPROVALS Pianning 0 11 Apt./Lodging ? ? 12 Multi Repair/Rem. o ? 13 Garage/Accessory ? ? 14 Fireplace ? 5 Deck 0 36 Move 0 37 Demolition Basement sq. ft. Main Ievel sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building f .? 18 Basement Finish 17 Swim Pool ao Public Facility 21 Misceilaneous MCNVS 5ystem City Water Fire Sprinklered PRV Booster Pump Census Code. 193 Y SAC Code Census Bldg i Census Unit v Engineering Variance Permit Fee Surcharge Plan Review License MGNVS 5AC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit S!W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Totai: w Valuation: $ 12B9 % SAC SAC Units Certtfic,ate of E1011Se LocTtion For: Svend Petersen Constniction Inc. 10:14 Qark View Circle ajncimington, MN 55431 DELMAR H. SCHWANZ uno aunvevona n+e. MW?twb Vnhr Lnn a1 TMl? at MM~a 14750 SOUTH ROBERT TRAII ROSEMOUNT, MINNESOTA b506e SURVEYOR'S CERTIFICATE .,\ rn / ? , N??f °?8 SS 4J ? ?i.?asE = 9ae , ?D ?uriu N E95E/71E?T ? ?I ? ?.p ?B.os ?- N ? niBB°-1;8'13"15 rF?l u 27.9ZI'l-?? T I ? ? /OT /2, I f310Cif Z ? ? 0 y M ? a \ Z?n:?O• s.?s \ ? T ? I N 171/50 !12/4231788 90?0 ? - 9oS,Q /?lroPo??D "' ' ? ?a a NauS& ` Nv . " ? q,o.o q , 2.x T N I /D m 327 ? ? i 7 3 7 9e ? Proyosed garage floor elev. Proposed top o£ block elev. p? - ? =-- Proyo .ed lowest 1evc1 elev. 2S ? Scale: 1 inch = - 30 feet /? . • = Iron pipe monumen ti ?• O= Set vood hiib F.xisting spot ele q7rp9 ? Q = Proposed elevation RM = Top o£ hub on Lot 1 = 912.27 2S nescription: Lot 17, Block 2, I1nWTNORNE WOODS 2ND N)DITION, accordinq to the recorded plat thereof, Dakota County, Minnesota- Also showing the location of a yroposed house staked thereon. 1 here6y certi}y thet Ihis ourvey, pien, or repoA wee prepered by me or under my direct aupervielon and thet I am e duty Regiatered Lend Survayw under Ihe lews ot Ihe Stale of MfnneeoU, poted 04-04-94 CELM,;R N. SCHL'atli'dZ - &523._ H.BeMrtnt . x8 nwwnmm Ho. srls ? /(/,? j?. • iA PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNFiOIvIES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT. NO. FIXTURES EACH TOTAL SHOWER 3.00 ?? .?_ WATER CLOSET 3.00 ., . . . •`? ?? -_ BATH TUS 3.00 _1a.po LAVATORY 3.00 1 KITCHEN SINK 3.00 0 [a0 LAUNDRY TRAY 3.00 ?r.A? HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum • 1 ROUGH OPENINGS 3.00 1.50 ? WATER SOFI'ENER 5.00 PRIVATE DISP. • Dek.cry. lic. 20.00 U.G. SPRINKLER • nome uneer mn:i. 3.00 ALTERATIONS • to odsting 20.00 WATER TURN AROUNI3 20.00 STATE SURCHARGB TOTAL: SITE ADDRESS:_ '4287) ? Q?-f ?? a. OWNER N 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3$30 PIIAT KNOB RD EAGAN MN 55122 (612) 6814675 CITY: QzeRukn+ STATE: ZIP CODE: ? J PHONE #: ((?Z ) ?Z,5' I I q PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ? NEW CONSTRUCTION , ADD-ON A/C ADD-ON FURNACE FIREPLACE INSERT DATE FEES HVAC: 0-100 M BTU $ 24.00 ADDITIONAL 50 M BTU 6 GAS OUTLETS (MINIMUM 1 Qa $3.00 EACH) `7•w ADD-ON/REMODEL (ExISTING CoNSTizUCTION) $ 20.00 STATE SURCHARGE .50 TOTAL 20 -4?_o SITE OWNER NAME: "?J • P64r)r ??o11 IIVSTALLER: GENZ-RYAN PLVrmrNG & xEAZING COr[PANY ADDRESS: 14745 South Robert Trail CITY: Rosemount STATE: m ZIP CODE: 55068 TELEPHONE #: 423-1144 ? t SICF RE O P RMITTEE 1994 MECHANICAL PERMIT (RESIDENTIAI,) CITY OF EAGAN 3830 PILOT KNOB RD ' EAGAN MN 55122 (612) 6814675 ??78, ?- 2004 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. Date0 IV //V /04/ ? Site Street Address ?e? ? 7 A?.JA.L?'/Vrk? ?.? Unit # PropertyOwner .nnw0 A? ?4422DL. z Telephone# (65J) irDS-D?l3 Contractor '76 Telephorte # ((5! ) -34S -43 SUJ Address20 6t.nU tpu City State- Zip.,J?? The Applicant is: _ Owner If-6ontractor _ Other Alterations to existing dwelling $ 50.00 _Add fixtures to rooms, excluding water softener and water h eater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) Other: Water Softener ? Water Heater $ 15.00 ie? replacement _ additional Lawn Irrigation System RPZ- new _ repair _ rebuild $ 30.00 r State Surcharge T9 $ .50 Total 23 APR ?SO I hereby apply for a Residential Plumbing Permit an&ec nl?owledge that the information is complete and aceurate; 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 wiil be in accordance with the approved plan in the event a plan is required to be reviewed and approved. loeA wc rd?n.o L?? Ww?? Applicant's Printed Name ApplicanYs Signatur *. City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use j (� Permit #: 1 1 t I 0 5 Permit Fee: (4° u ') Date Received: V( I I I 13 Staff: 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans withiall commercialrcapplications. Date: 6'_ it- (� Site Address: `Y' 2-c t-,r^C ` Tenant:��N_w C``'&'0Q j Suite #: Phone: Address / City / Zip: Name: ACCk' QS 14- License #: Address: ? GC) Ccctn a tt `'t , City: L v'-'/�� C.. M - State: Wk. Zip: Phone: Email: New /Replacement Additional Description of work: rQUJ (sL Alteration Demolition NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL /Furnace tr-kr Conditioner Air Exchanger Heat Pump Other ICOMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1% $60.00 Minimum (includes State Surcharge) = $ Permit Fee COMMERCIAL New Construction Interior Improvement Install Piping Processed Gas Exterior HVAC Unit Under / Above ground Tank ( Install / Remove) RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE *If the project valuation is over $1 million, please call for Surcharge =$ _$ 5.00 Surcharge* TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One CaII 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.bopherstateonecall.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. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Required Inspections: Underground Rough In Air Test Reviewed By: Date: Final HVAC Screening _ Gas Service Test In -floor Heat PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA124276 Date Issued:06/26/2014 Permit Category:ePermit Site Address: 4287 Dartmouth Ct Lot:17 Block: 2 Addition: Hawthorne Woods 2nd PID:10-32151-02-170 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Troy Good 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: 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. Contractor:Owner:- Applicant - John D Wambold 4287 Dartmouth Ct Eagan MN 55123 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature 3830 Pliot knob Roan Eagan MN 55122 Phone, (851) 6154675 Fax' ($51) 615-5694 L016 RESIDENTIAL PLUItit4 G PERMIT AP 9/2 /2018 soe Addt 4287 Dartrnou Use UE BLACK nk CATI N bold Oartn American hnr o box 205 . rett 2.-750-M278 cher ,cern shower drain and ve n master bath :t FEES: O Water Heater, Water ater Su . ar ` WI, r and 0 # ,.,� 0.00 end Plumbing r t rs ,a , .. � � r,;} ' ;' 3 2€ larnamand dada y CALL BEFORE YOU 0 eOrr* Call a002 r:*- r r,; appOcancw- Re tared Inspections: c. t Ai Test ...a Read - Man , RF7F- _ Use BLUE or BLACK Ink {ai,N � `' FEB 1 2011 For office Use , si City of FIIII Prmit#: f_ 3830 Pilot Knob Road Permit Fee: ' �r Eagan MN 55122 Date Received; i-13 17 Phone: (651) 675-5675 Fax: (651) 675-5694 staff: • 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION O Date: , 3-1 Site Address: —t'� � C.4 Tenant: '� r^j r Yi 131 tii r r 4 ,��...- uite#: 30.114.44? 4 F ::ss/Cty . 1 iit I � �� 9F�v`' i �1 ` Name' 'Milbert Con�pan Inc dba Culligan Water. License#. 3J.tinI ) ,. Y'. •S WC641376. ', £1r 44,o trr t' °'',.L' s r ;�''`%'s" . ikik,; Address: 1801. 50th St East City. Inver Grove Hgts. 0.144,01,:i447,:>.41, Mn R � State Zip: 55077 651-451-224:1' Ukl�><t t'r;;,Efa , P` Phone: a � rata ;;' ,ti�55�+le, William R Milbert i,, 1Sti a`�vts!'a'�")�VNI''d Contact: Email: -1,,.F , • {C,t,„,,,+i,, �i. t< I ,,,,,,,„,,,,,,,,,,,,,,,,,„ , `qo m ,,,, * _New .__._Replacement _Repair Rebuild _Modify Space _Work In R.O.W. • e0,111 '' 1ulft Description of work: •'{__ �,F' at �%,�r 't` k RESIDENTIAL • f 4 `?f,; ;` it, Water Heater Uf, ' tt ' ` ti 4�. X Water Softener ,K.0`1/44 k a kaf�. i a l{ ; i _Lawn Irrigation(____RPZ/_PVB) ' )'1'r!` � e j`. Septic System Add Plumbing Fixtures(_Main/_Lower Level) ' s Y 13V111'4,11,ppi•.5.4tosi P ! t2�m1� �q!¢tr+�} ,t New _„Waterl•umaround ifli,Wks, 4,„ t.U> _Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) $60.00 Lawn Irrigation (includes$5.00 minimum 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) $115.00 Septic System New($10.00 per as btUllt)(includes County fee and $5.00 State Surcharge)' 0 0 TOTAL FEES$ 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: www,00pherstateonecall.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 I.th the approved Ian in a e of work hlch requires a review and approvai.o plans. x i\( x , ,....191(--1-6/.4- , Applicant's Printed Name Applicant's Signature T 2i t t , yi'`�q�" !y z. ti`; `' r! l Vi t 2r: t, r ;a-' t �,i n�+,()' t`r ':hl Oa,i• ,t,, r� erAn , i.h t t t \-' l i.i," t 1i Cl t ff ,.t' ir14 61 !y ,f, rilk:.S1 i tee`k f }.n1i 'i { f !deer,,} p ;5< ti F r) l Y r t �q T4 „a z. L 4., '! ,.. tt o: (1: �v P) r f 44F.'s!t lth �' t,' r) r��rr Itj i.7 e'(' t�:aFa,Ot';s6,FF. •.,i ��tlil`,3`+ ('Ff *� ..� ' id � naFZBV.��" ,� t_Sv.11�ra�tla : �.t Vsa� �Cc �-wtit �s -;'i-tt E r 4 Hs v hFTrr`�f1,,y,„ Mkt flv�'Ir Fw _; f, ,3^ ,. a t>v.�T`s;a --.xi.„.00i tt� �1A �r ii �}`.i7,,y r�'�l!t 14w5 +��t9 S t�yc¢ r � ty .#�.�}�'�tl T",� ,ig.r). K bl. id t { i l r J t r �i„ ,,'-jct�t2}t'`fl yrr �S�.0, , C . ,9 t 37 y�t'.'7t ; a ai.OPVi 1 t ,- : 1 (' ,, fr}'t:. AF,,,t`' �� 11)-;,-) fl y ��}� � q t a x Cy�;{d� �{{ �/ �t ��l � �p ,�j Rho I.:e • �`n GR7 ti+sq�F t o= ? rcU"(�vr4F ..orf$ to t":¢ 1 na�i , T iht;r41en ,, �Ptt�'FS1�4� �fitN 1}F? ' f e ,D �t r n --�. t f,. ,. J Y C t + 3. �(C �{fa ,gs. p ` '((f31.,S n'�`�y � �{te, � tS}�',' >•Y�A i�'t ,�t�; 5.�+. -.rl•f'':�.�+,��"',5,t�1'?}ti3 5,�'(AsSi4:{.�j� �'�:�,t`S��6r�1e C i,,�t 'SsA, ('tt, Y tr,,,Y � �. � • �,,r h iii,{.^�� a Y� k�2u. lit +!''�11 �y. < ,nI t;a. i�t�f�irl3�k� � 4?E{T-J " p��`�It E7v�y� i.yr7r,o.� � �✓r9� �1� r M B r to• t' t f ti17 .t. f T.Rr-0'0 , aa 0 .? 4= .5tii0 pwp ' 'Ig,. .ta G r,��e' p�pjfs4 tt said`..,, Y i fly l.{'�{rx i t5 +,l•.'A -'. .Yfa• -t@. .. ar 'r� ratio &au.n yes mem. .e..,3e oa''i,e.>e t,Y::.�L ,Jfa '3� S2`>.�:,m:•.„ •.a..�, mau- : r Use BLUE or BLACK Ink For Office Use ) 1...{ y6.3 4Ib6 City of aaa Permit#: Permit Fee: (.� c ) 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#: t Ahclr Gtr l� 6,5—y— '/O5 03 1_1 r Name: B a'1 Phone: Rest:entl L(] R 7 I . finer A• ddress/City/Zip: l 0(`' C '�q ��jdct,� C Applicant is: g Owner Contractor X 4,41 444D• escription of work: 'C_G9 I � Tyev4tp ®f Wo 3'7" 333.. > Construction Cost: lg, Multi-Family Building:(Yes /No ) ��` Company: B�,wtan�t el—U2f� Loci 7�/d •`YpCtaL<t: ontrctor Address: (7 3 k60ct Cf. City: r r^'` :fl,q iP� 4 CSO State: Zip: Phone: Email: 3.33 33z,k' L• icense#: C (7 e06 `f Lead Certificate#: N kf `0 0 3 77' --( 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: NOT flan yid 'p i, g ocuments thatyou subm f areeFco a e Abe.®' a �in for ® i "®/tions Of t£ inform ion aay be classified sno • blic r ®`u pro ® pecirfic real at 11.Y;14,' s rmit the ty►, f" c e x zx eob.: ale f ey a rF le seer* 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.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 nota 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. 5f"erk VI x Applicant's Printed Name Applicant's Signature Page 1 of 3