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4085 Deerwood TrCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4085 Deerwood Tr Lot: 10 Block: 2 Addition: Engstroms Deerwood PID:10- 23900 - 100 -02 Use: Description: Sub Type: e - Furnace Work Type: Replacement Description: Furnace Comments: Fee Summary: Contractor: Air Mechanical 16411 Aberdeen St Ham Lake MN 55304 (763) 434 -7747 Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Elec 952- 445 -2840 DENISE JACKSON 16411 ABERDEEN ST NE ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Owner: Paul A Monson 4085 Deerwood Tr Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 $50.50 Issued By: Signature Mechanical EA080014 09/25/2007 ePermit cal Inspector, I hereby acknowledge that I have read this application and state that the information is correct and agree to comply of Minnesota Statutes and City of Eagan Ordinances. h all applicable State CITY OF EA GAN ,. 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?. PHONE: 681-4675 BUILDING PERMIT Receipt # To be used for FIREPLACE Est. Value Date DEC 2 1 g 91 Site Address 4083 DEERWQOD TR Lot 10 Block 2 Sec/Sub. ENCSTR%i # S ID ERWO , OFFICE USE ONLY FEES E MI Parcel No. Occupancy 00 25 i Z . Bldg. Permit Nagle BRUER CONSTRUCTION on ng (Actual) Const Surcharge • 50 w 11382 190TH CT NW (Allowable) Address Plan Review City ELK RIVER MN 7p 55330 L ofStories g t cere Phone 241-0791 Depth SAC, City cc Name FIRESIDE CORUR S.F. Total SAC, MCWGC o Address 2700 N FAIRVIEW AVE S.F. Footprints S. Site Sewage - Water Conn City RQSEVILLE N!1 Zip SS113 On Site Well Water Meter ~Z Phone 633-2361 MWCC System Acct Deposit O City Water - . U License # PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump SMr Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and Cit of Ea an O di y g r nances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: FIRESIDE CORNER Planner - Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. - Copies 25. 50 Building Official + Variance TOTAL Permit No_ Permit Holder Date Telephone # S/VV PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace N S A/ Ads Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN ° 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH ON E: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value ?12C),0 0 Date D EC 5 ,19 i Site Address '"?' .f•?' OFFICE USE ONLY Lot Block EtiO$TI M Sec/Sub On Site Sewage Occupancy r_3 H . hIEZYWMI MWCC System Y Zoning Parcel No. On Site Well (Actual) Const V- N a Name ` Awn,.: TRiXT1017 City Water ` (Allowable) W Z Address #224 PRV Required * of Stories o City Phone 452-0995 Booster Pump Length Depth 24, ? 0 OQ U¢ F Name*(' S.F. Total Address Footprint S.F, City- Name Addre City 1 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. Signature of Permitlee a - - 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. APPROVALS FEES Engr./Assess. Permit Planner Surcharge Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks TOTAL IS 58.00 63.00 32 .W 100.00 550.00 `T.,J. 00 e7.00 2 . LV Permit No. Permit Holder Date Telephone # Plumbing / H.VA.C. /d ' ,;;2.5 ??rc? rzv / / 9 89 22 / 9 Electric ?C) ? Cf ' ov Softener Inspection Date Insp. Comments Footings I / Footings II Foundation Framing J!?% p !'a f f Chu t>? t 'moo Q Roofing _ 19s7c,4v fs Rough Plbg. lls° Jj _ C_ If 42 Rough Htg. 2 --03 Isul. /? evrrec< Fireplace 1S k Final Htg. Final Plbg. Bldg. Final Cert. Occ. vk? Temp. LP Deck Ftg. Deck Final Well Pc Disp. F? (gerfifirafiP of (Orrupaury Citp of Cagan This Certificale issued pursuant to the requirements of Section 306 of the Uniform Building 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.. Usechwifiction SF DWG?GAR Bldg. PernutNo. 15936 Oa„p--Y TYW R3/M1 Zoning District RI Type Const. VN Owner of Huikling "SME ` MM _Address 2121 = 1Q, F.AGAN Bondi Address 4085-]^EI'?it+lOfA TEAM "li 1 10, B2, EMSUM' S DEEMM Date; ?rMAMI 8, 1989 B g POST IN A CONSPICUOUS PLACE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: " I I I I r Nt tl 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS' ' I H i 0." APPLICANT' ,?.•,:?,f ? , i!++„?+ I+,: f ? I:J.11:'.IMt Ni:. i.uPl•.:,f ?f•:'. I I-:??hl I+f J Irk•l+?i+li I ?. 1 ?•) ?I':,4 -tti141 PERMIT SUBTYPE: TYPE OF WORK: [of, "CRIPFJOH foot TNit a tI"At PRAM I Nto FMARKSa SEPARATE PFRMXT5 ARE: HF001NF-D FOR VtfX4 Oft t ItC10iI A Aulr.l I ION c •:t A'.-;()N I•1IIA H Permit No. Permit Holder Date Telephone • ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE AIR TESTCE T FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL !! i?f3?97 Z! ) Need 1:i. s V?e.) 5A y o u ..rvu? BSMT R.I. ?? BSMT FINAL DECK FTG q J / 1 L ??? LZ-, Ui ??iZ DECK FINAL CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: tor: 10 HI (ICK I tN+, r:11•?IM':. UI:'EI?IInuf) PERMIT SUBTYPE: I R0r) 1` 1 NLi F O ;CORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: ;;-a 4 1 , tota) I71°-1032 TYPE OF WORK: 111 .11 11 lit'114 Fitt t 1 1) I N(i H:nlia 07 /01 /elf. R/ PA IF? ( i?onF CNo 1 ?I Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Permit No: 3830 Pil t K l t _fr33 Date: 12113/88 R9Fr)i 12 i o nob Road B/P No: 2/F,< / Date: P.O. Box 21999 Y _ Eagan, MN 551?r1 OT Owner. I - -1 NS:V1 Site Address: -O8 DEER=:70i) TR. r??; .T ;, t El'W(X!D Plumber: OL-BERG 3 5 50.(X) MWCC: .;- Zoning. 100.00 no City Chg: No. of Units: I 15 U Acct Dep: ° " Permit Fee: I agree to comply with the City of Eagan Surcharge: ' Ordinances. Misc.: B y SEWER SERVICE PERMIT CITY OF EAGAN Permit No: 1 i, 4 Date: 12/13/88 3830 Pilot Knob Road Meter No:7 7 9 size: /bf oc P.O. Box 21199 /r L' Ae3der No: Q-0 77 6 2.2 A Date - 3- Eagan, MN 5512'f Y Owner SUNSHINE CONS T Site Address: 4081) DRRRWOOD TR, L10 82 ENGSTROM' S DEERWOOD Plumber nI._RFRr Conn. Chg: t 5 5n _ 00 Pd Zoning: R-1 Acct Dep: 19-00 od No. of Units: 1 Permit Fee: In-()n Pd Surcharge: 5n pa I agree to comply with the City of Eagan Tr. Plant "4.Q4 W 041 Ordiry?ces. Meter. 67:00 pd Misc.: By WATER SERVICE PERMIT PI6J. USE ONLY This request void 18 months from wliclation date printed in this boa IIUI gill U 111 llll?l ??-ozo 9 * 0 4 1 6 1 9 6 4? PLEASE PRINT OR TYPE T RoughW inspecfion required? Yes ? No Inspection Ckher Than Roughen: ? Ready Now Will Call J iYa+ must CoU the insperlor when reodyl °ab Reodr. I, ? licensed contractor owner hereby request inspection of the above electrical work at: lob Address (Street, Box, or Route No.) Zip Code City )ecfton No. Township Name or No. ----- .._ .. t :4D vVll or /A nJ,-4 - 979.2, CZ fYLQ?/ ?,ry l A 11 8/96 STATE BOARD COPY - INSTRIICTKINS ON BACK OF YELLOW COPY REQUEST FOR ELECTRICAL INSPECTION ?°? ..•? . 9 416-196 Minnesota State Board of Electricity 1821 University Ave., Rm. S-128, St. Paul, MN 55104 Phone (612) 642-0800 Home Du lex Apt. Bldg. Other: New Addn Commercial Industrial Farm Q r L Remod Repair Air Cond. H . E uip. Water Htr. Load M mt. Other: D er Range Elec. Heat Tem .Service "X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only. ('4? 6t A u Calculate Inspection Fee - This inspection Request wilt not be accepted without the correct fee: Other Fee # Service Entrance Size Fee It Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Street Ltg./Traffic Sig. Above 200 Amps t Above 100 Amps Transformer/Generator INSPECTOR'S USE ONLY TO ? M- Sign/Outline Ug. Xfmr. Gail AJ07'1(!47 j Alarm/Remote Control Swimming Pool Irri ation B I here certify that I inspected the electrical installation described heroin on the dates s g oom Roughen Date Special Inspection T Investigative Fee HIS INSTALLATION M Y BE O Fm ifto- 2 RDERED DISCONNECTED IF NOT COMPLETED WIT /? f6 D-1 o r _ ... 1R IIA(1NTNC -- - r CITY OF EAGAN i 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?r? 15936 BUILDING PHONE: 454-8100 Receipt # Sl e7?/ PERMIT To be used for SF DWG/GAR Est. Value $126,000 Date DEC 5 ,19 88 Site Address 4085 DEERWOOD TR OFFICE USE ONLY Lot 10 Block 2 Sec/Sub. ENGSTROM' S On Site Sewage Occupancy R-3 M-1 DEERWQGD MWCC System X Zoning R-1 Parcel No. V N On Site Well (Actual) Const - a SUNSHINE CONSTRUCTION Name city water X (Allowable) V-N z Address 2121 CLIFF DR #224 PRV Required # of Stories City EAGAN Phone 452-0995 Booster Pump Length 58, Depth 24' o Name SAME S.F. Total u< Address Footprint S.F. City Phone APPROVALS FEES r¢ mw Name Engr/Assess. Permit 658.00 F i Planner Surcharge 63.00 z- Address U z Council Plan Review 329.00 4 W City Phone Bldg Off. SAC, City X00.90 I hereby acknowledgeVhat I have read t application an tate that the variance SAC, M WCC 550.0D information is correct o agr to com ly with all applhble State of Water Conn. n 550.0 Minnesota Statutes and of atrOr ans. Water Meter ?jZ..00 Signature of Permitlee __ `?tJ,_--_ Road Unit _3_2ar, ? A Building Permit is issued to -SUNSHINE-CONSTRUCTION- Treatment P1 204.00 I on the express condition that all work shall be done in accordance with al Parks applicable State of Minnesota Statutes and City of Eagan Ordinances. 846 00 2 yy?? Building Ofhaal?,?.?e?1?i_L1_C TOTAL . , CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199. Eagan, MN 55121 9929 PHONE: 681 n -4675 ' 1 BUILDING PERMIT l o Receipt # l 1(0 ttl7c Y To be used for FIREPLACE Est. Value Date DEC 2 , tg 91 Site Address 4085 DEERWOOD TR Lot 10 Block 2 Sec/Sub. ENGSTROM' S OFFICE USE ONLY FEES Parcel No. rERW Occupancy n n Z Bldg. Permit 2 5 _ 00 i g o Name BRUER CONSTRUCTION (Actual) Const Surcharge .50 W Address 11382 190TH CT NW (Allowable) Plan Review City ELK RIVER NN Zjp 55330 Lnghtories License O - Phone 241-0791 Depth SAC, City Name FIRESIDE CORNER S.F. Total SAC, MCWCC cc r- Address 2700 N FAIRVIEW AVE S F. Footprints On Site Sewage water Conn C4 ROSEVILLE MN Zip 55113 On Site Well water Meter Phone 633-2561 MWCC System Acct. Deposit O City Water - U License # PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump SfW Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permltee APPROVALS Road Unit A Building Permit is issued to: FIRESIDE CORNER Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances Bldg, Off. Copies y 25. $0 III Building Official 7r?M1A R 4i Vanance TOTAL ,.---------------- _._ ? Permit #: I Permit Fee: G ?. S V Date Reoeived:D(o Staff: L--------------- C{2 08 RESIDENTIAL nP?L?UMBING PERMIT. APPLICATION Date: 4 0 Site Address: ` a, ? " -r- et S o -""-'c V Tenant: Paul Monson 4085 Deerwood Trail RESIDENT 1 OWNER Name: Eagan, MN 55422 9529368821 Address I City I Zip: CONTRACTOR TYPE OF WORK Name: Adores Suite #: phone: City: 1 ''t^^V?/1/ I //? State: y Zip: ? D Phone) LP I (al - 70322 3 Contact Person: Jess _ New Replacement _Repair _Rebuild _ Modify Space _ Work in R.O.W. of PERMIT TYPE RESIDENTIAL X Water Heater Lawn Irrigation (_ RPZ 1 _ PVB) Septic System _ New Abandonment Water Softener Add Plumbing Fixtures Main _ Lower Level) Water Turnaround RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround* (includes $.50 State Surcharge) *Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) CJ O TOTAL FEES $ 50 I hereby acknowledge that this information is complete and accurate; that the work will n onfornance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, fiidd wo ' t to start withoy/t a permit, that the work will be in accordance with the approved plan in the case of work which requires a review and pproval f pl "? // / /? X)Pfi? L N Orb) 6YYL Applir anVs Printe me Signature . J 0 ? ? o 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot sq ft of house; and all roofed areas (20% maximum lot coverage allowed) 1 Soils Report if proposed building is to be placed on disturbed soil 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy calculations 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail options selection sheet (buidings with 3 or less units) lAnnegasco mechanical ventilation form RemodellReoair Requirements 2 copies of plan showing footings, beams, joists 1 set of Energy calculations for heated additions 1 site survey for additions & decks Adddim - indicate if on-09 septic system W 90 .00 Office Use Only Cert of Survey Recd _Y _N Soils Report _Y _N Tree Pres Plan Recd _ Y - N. Tree Pres Required _ Y _ N On-site Septic System _Y _N Date Feb. / 03 Site Address /2007 Construction Cost $ 26,00Q.00 4085 Deerwood Trail Unit/Ste # Description of Work Lower level finish Multi-Family Bldg - Y X N Fireplace(s) g 0 - 1 - 2 Property Owner Paul & Nancy Monson Telephone#(651)994-0396 Contractor Carlton Builders #7416 Address 438 4th State Minnesota Avenue City Newport zip 55055 Telephone #(651) 552-1110 COMPLETE THIS'AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category I _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • 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 plane - Y - N If yes, date and address of master plan: Licensed Plumber fF' Telephone #( --?? may(}- - ? u ?, I U echanical Contractor J Telephone #( M rto 111 a Out Sewer/Water Contractor / Telephone # I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex Work Types ? 31 New ? 32 Addition 33 Alteration ? 34 Replacement ? 13 16-plex ? 16 Fireplace ? 17 Garage ? 18 Deck 1K 19 Lower Level ? 20 Pool ? 30 Accessory Bldg ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc. ? 24 Storm Damage ? 25 Miscellaneous ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage _ Yes Valuation lJt??i Occupancy MCES System Plan Review 100% or 25% s Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Sheetrock - Footings (deck) Final/C.O. - Footings (addition) Final/No C.O. Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Figs _ Air/Gas Tests _ Final Final _ Pool Framing _ Stucco Lath _ Stone Lath -Brick Siding Fireplace - R.I. -Air Test _ _ -Final _ Windows Insulation _ Retaining Wall Approved By:Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? 07 05-plex ? 08 06-plex ? 09 07-plex ? 10 08-plex ? 11 10-plex ? 12 12-plex ?G ?! O? v / ??i72 a 7 k??? [X7 -D-fUJ'7 ?-?O rc •c 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION 3 S 0 ?f City Of Eagan Ck. Ka 0 30339 ?t 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date Site Address g? D-er- o z) 1 Unit # Property Owner 0 ?( l' M/J6, '11 0)1 SnAf_ Telephone # ((pPj )qq (')39 Contractor Q L) m eC 61 a n ( C. Ci Street Address W41( Q b O f l Pe n 5+ 1\(f' City /7 (m r?TQ ?CP? ?? State Zip i5nq( 94 Telephone# (17h3 )4-3q-77,1-1"7 Bond #: Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 3000 furnace -Additional -Replacement _ air exchanger air conditioner _New Replacement other State Surcharge $ .50 Total ?? ?- $ 30, -?0 0 I hereby apply for a Residential Mechanical 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 with the Mechanical Codes, 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 app d plan in the case of work which requires a review and approval of pi ve Applicant's Printed Name Applicant's Signature ? l APR 0 1 2005 ;_ I rj RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681.4675 New construction Requirements - 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) - 2 copies of plan showing beam & wmdow sizes; poured found design, etc) 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711193 - Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE 66? SITE ADDRESS TYPE OF APPLICANT GAM`` STREET ADDRESS) V' TELEPHONE CELL PHONE # _ J-6 RemodelfRegau Reguirements , ? 2 copies of plan - 1 set of Energy Calculations for heated additions - 1 site survey for extenor additions & decks - Indicate if home served by septic system for additions VALUATION MULTI-FAMILY BLDG _Y _N FIREPLACE(S) _ 0 _ 1 _ 2 STATE/W/" ZIP Jf? FAX #? M.01S (5w PROPERTYOWNER In "5 TELEPHONE 416?1 '9911-09(1 ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RIJI.ES 7670 CATEGORY 1 672 submission type) - Residential Ventilation Category 1 Worksheet Submitted Fe-F eet Sub mitted - Energy Envelope Calculabons Submitted 2 7 2002 Plumbing Contractor: PhonPlumbing system includes: Water Softener fawn Spr""--ree: $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 is ect, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Or . n es. Signature of Applicant ........ ------------ ------------- -_------- --- - -------- --------- -_------- - OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 CITY OF EAGAN PERMIT U,M12- 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 029681 (612) 681-4675 Date Issued: 04/0 7/97 SITE ADDRESS: 4085 DEERW00D TR LOT: 10 BLOCK: 2 ENGST,ROMS DEERWOOD P.I.N.: 10-23900-100-02 DESCRIPTION: 3-SEASON PORCH Permit Type SF PORCH 'Eu??dg Work Type ADDITION _':enatE'S=-ptlge 434 ALT. RESIDENTIAL nth r . F at :gypp ?h { .'-?F 3 P&YL5 xel# n Tgg9{FA ^-0S -l REMARKS: SEPARATE PERMITS ARE REQUIRED FOR PLBG OR ELECTRICAL WORK FEE SUMMARY, Base Fee Plan Review Surcharge Total Fee VALUATION $124.75 $81.09 $3.50 $209.34 $7,000 CONTRACTOR: - Applicant - ST. QWNER: VALLEY INVESTMENTS CONST 14645191 000 241 QUACKENBUSCH HAROLD 2401 LEXINGTON AVE S 4085 DEERWOOD TR MENDOTA HTS MN 55120 EAGAN MN 55123 (612) 454-5191 (612)686-9792 r*erebY ae1kh6wlad e.''tfa-t, irifpt'4r?c??a`ad3 ?`?. Eorr??t r0_rt APPLIC RMITEE SIGNATURE a` "r, t lc t t £SS1 x 3 F p$t Ld 1,011 Ahd, etdt9 th the x 1" t?" ,_ ik' tijifi t7 ?! W d tLl , ?- +^3 ' !'?. J.<4. ;d±bl"o +S. t0t'#" b f, M"l r{t? Y6s?gt1C:?5 ? '; ? , v ISSUED ' SIGNATURE PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 028114 (612) 681-4675 Date Issued: 07/01/96 SITE ADDRESS: 4085 DEERWOOD TR LOT: 10 BLOCK: 2 ENGSTROM'S DEERWOOD P.I.N.: 10-23900-100-02 DESCRIPTION: (ROOFING) Ruilding.,.,Permit Type /.Building Work Type Cen.9,us Co4a ?i STORM DAMAGE REPAIR 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: CONTRACTOR: - Applicant - ST. LIC.OWNER: HABLE'S CONST, A S 17712032 0006330 QUACKENBUSH HAROLD 1050 HYACINTH AVE 4085 DEERWOOD TR ST PAUL MN 55106 EAGAN MN 55122 (612) 771-2032 (612)686-9792 I hereby acknowledge that I have read this information is correct and agree to comply Statutes and City of Eagan Ordinances. L APPLIC M E SIGNATURE application and state that the with all applicable State of Mn. ISSUED YISI? OTU Er m_ CITY OF EAGAN 3830 PILOT KNOB RD 55122 1996 BUILDING NG PERMIT APPLICATION (RESIDENTIAL) IIP114 681-4676 New Construction Reauirements Remodel/Repair Reouirements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ? 7 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan it lot platted after 7/1193 required: -Yes _ No DATE: 2"/- 9G CONSTRUCTION COST: 3 ??'-- DESCRIPTION OF WORK: A?;;tc OFF a- /'e f oo E 4 a ?7 STREET ADDRESS: _ZQ 9_5?-42e_e rw 6o a 22,+;L (? n LOT Q_ BLOCK SUBD./P.I.D. #: (?_h;m'? ?' / UApilm , PROPERTY Name: Q eA)h u fk -A/) Phone #: OWNER u.. `"`T ' Street Address: y0 ?5 re A, city: a?w.? State: 91N?. Zip: 5-3-1-2 2 < ??oo Phone #: L 3 ( Dysl CONTRACTOR Company: , /, Street Address: A( A4;n.h &ue. License #: City: 5-rield/ State: dk/. Zip:!?_-f66_ ARCHITECT/ Company: Phone #: ENGINEER Name: Registration #: Street Address* City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot f hereby acknowledge that I have read this application and state that the informatio/,srect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received Yes No Yes No 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) Y? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 wt cux?r .? r ? 6814675 New Construction Reouiremems Bemodel/Reoair Reculrements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (Include beam & window sizes; poured Ind. design; etc.) e 2 site surveys (exterior additions & decks) e 1 energy calculations e 1 energy calculations for heated additions ? 3 copies of tree preservation plan it lot platted after 711/93 required: _Yes _ No p? DATE: 3 -?J - CONSTRUCTION COST: /Food DESCRIPTION OF WORK: STREET ADDRESS: LOT /0 BLOCK PROPERTY Name?7tfl9CJ) ??LfRFN??fSCFiL Phone#: OWNER Street Address: Y?gS?-,2 Gyo©? ?? City:8 State: (41"V Zip: CONTRACTOR Company: vae7fTEl?i?S Phone #: ?{S//-k?? g Street Address:c;?VO/ License #:? City: Ae1062? 77? S State: M AI Zip: SSA ARCHITECT/ Company: ENGINEER Name: Phone #: Registration #: Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the info on is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: U ie" Received _ Yes _ No MALI 1 IKSY OFFICE USE ONLY RECEIVED an Received Yes No Not Required B : Certificates of Survey Tree Preservation PI 14- SUBD./P.I.D.#: OFFICE USE ONLY * b BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? ? 03 in SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? ? 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE 3 - Sec ?o? 4 ?? ? 31 New ? 33 Alterations ? 36 Move X32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building AAO 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. -,4,S,4 SAC Code Census Bldg f Census Unit o Engineering Variance Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ 7, o00, - 4 utL = zz<(npd(3v = Cm-7 zo % SAC SAC Units 1" 29 1991 BUILDING PERMIT APPLICATION CITY OF RAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS _# OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED, PERMIT MUST SHOW A LICENSED PLUMBER. / To Be Used For: Valuation: 1fWiO v Date: A41 Site Address ( T OFFICE USE ONLY Lot 10 Block FEES _ Occupancy Bldg. Permit rr) Zoning Surcharge n Parcel/Sub "hun; Actual Const Plan Review Allowable SAC, City Owner ' # of stories SAC, MWCC Length Water Conn. Address Depth Water Meter _ S.F. Total Acct. Deposit City/Zip Code m Al 5 S33 Footprint S.F. S/w Permit ?4/ Surcharge S/W Phone On site sewage- Treatment P1. On site well Road Unit Contractor r/? Si( IXJ!/?^ ? ? MWCC System Park Ded. City water Trail Ded. nn?W //\\,? Addressc? /V 744-?L-1y??Wl1C r?_ PRV Copies I,,K City/Zip Code 1205-2U1 (P1 ?01 _ Booster Pump SUBTOTAL '' nn _1 APPROVALS Penalty Phone lS? Planner Lot Change Council TOTAL Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # 40 ?,?(3LG-?,, agrees that all work shall be done in accordance with (Signature of Contractor all applicable State of Minnesota Statutes and City of Eagan Ordinances. 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS 15 q 5 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 RENTAL UNITS FOR SALE UNITS # OF 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 PU 0 21988 To Be Used For: SA,& ti_rAml?$e Valuation: 126,000' Date: ?.2//T Site Address y02S U£Ekw1bD /2!t/L OFFICE USE ONLY I Lot A? Block Parcel/Sub Owner . >'.nIC.-Aln/Ar- C:: iPM<T- Address . /t2/r tiFF &dE 40 -Wy City/Zip Code ' R- "A/ S77.2.2- Phone SLS.2 -Uflrs' Contractor ??giy? /?S ACiadE Address City/Zip Code Phone Arch./Engr. .TAjoL,g_? Q, 9/-/ Address Sy0 / ?fhh? i '0" .So City/Zip Code AEbh„:1(s7Z7A1 .xfYJ/ Phone # ffF31/-30?J On site sewage_ MWCC system k?- On site well _ City water PRV required Booster Pump _ APPROVALS Engr/Assess Planner Council Bldg. Off. Variance Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. FEES R-3 M-I R-1 V-N V-N 5r?. 50 Permit 650, Surcharge 3,0 0 Plan Review 329,00 SAC, City 100 ,00 SAC, MWCC 550.00 Water Conn 550,00 Water Meter &I, Do Road Unit 3251 00 Treatment Pl ZoL4,00 Parks Copies TOTAL . VA, L uA-TIC) N G aRac ?. ID'A X22= (060 X1 y = 92yo ?s mr IY k IS ? 32? Io53x i3= 13689 fStA - = 1053 aX /9 ax7 = 1y 1081 X y9 Zug ?wr? 12Y, i3 = 1S(. 33x26= ASS ION X 49 = L19 6 O le (2 SSg N e? t _Y CITY OF - Cg,e,,g fJ BUILDING DEPARTMENT EXTERIOR ENVELOPE AVERAGE "U" COI•IPUTATIO14 (To be submitted with building permit application) One or Two Family Dwelling Owner -S1??1?Ef-dl? .6o1r All Other Contractor . #g5 -- 3ZZ LINEAL FEET OF tI-r EXPOSED WALL ?_I ?Le1oR!< s???T» ft. above grade 245I79.$8 1}-? TOTAL EXPOSED WALL AREA SQ. FT. OPAQUE WALL CONSTRUCTION: nUrt Value x Area Detail s 1"? null ' O$3 x SQ. reference ?'° e' - fluff. . 0140 x sq. from X11y) truff .040 x SQ. attached fluff x sq. sheets fluff x sq. nUu x SQ. 'VIRDOwS: nUrf Value x Area FT. 20. I- . y?7.$7 (U)(A) FT._ 11515.12.= I(o ! (U) (A) FT. Z37.oJ1=_tt q.,B (U) (A) FT. _ (U)(A) FT. _ (U) (A) FT. _ (U)(A) Make & Type -M501-- &wl'r 'full .$'L x SQ. FT. 20.00. 07.(0 (U) (A) n u nun x SQ. FT. - (U)(A) n n nUu x sq. FT. - (U)(A) n n fluff x SQ. FT. - (U)(A) DOORS: "U'f Value x Area Make & Type yTt.r )40L nun .14- x SQ. it " Xlr>zl??n1 fluff .47 x SQ. ff u fluff x SQ. n n _ ttuu x SQ. TOTALS 94P79. s?a SQ. AVERAGE ffU" TOTAL (U) (A) VALUES Z44 dg _ ,'DIVIDED BY TOTAL WALL AREA AP79.S$ AVERAGE "U" . 15 r less for 1&2 family dwellings TOTALOAREA: 1194.00 'Y FT. 49,00 =!t M (A) FT. 35.oo = I(o.45 (U) (A) FT. _ (U) (A) FT. _ (U) (A) FT. Z4Q 0A (U) (A) Detail reference fluff .l7Z3 x SQ. FT. )19+ = 2 7-,VP(U)(A) from dull x SQ. FT. = (U)(A) attached sheets. nU" x SQ. _ FT. - (U)(A) Describe oneninga fluff x SQ. FT. - (U)(A) in roof. ffUir x SQ. FT. - (U)(A) TOTAL M(A) VALUES DIVIDED BY Z74(p - 7o7l?LS 114 gq.fr Z7.9Lc' C?rA?? TOTAL ROOF/CEIL 7O AREA M+00 ' c7Z 3 AVERAGE ''U' . 2$ or ventilated roofs. 21 Site Address S?08i lIEf2 %2• D oT /0 8A X .Z 4de"AZV,6 Date /,{// Phone !Kr2-095;S • ?o1Z>L `?1??ET &Fop?y sx?oscl? wn?? 18.33X C4Z+4Z+z?+z?? 9•soX (,Co-?(?? - 4•0o x Iz 4, oo X (o = 6040 , (o7 X ( 9-Z+-9-Z+ 2 to +2(,) 4.od X (v - riri1 ?ols7 ?.Cn7 x C,4z-F-4Z.+z(o-I-z1n? = 110X3lo = 4,0 X ,Z =' ZvX3(o = 5.o X 3 = Z4x 3(0 = (v. o X 4 Z4X48 = 8•o K' i1 = Z4-x (00 = 10. o x 3 _ zo x ?00 = 8.4 X S - Doo ;E.5 3° yT?, wf 5,?. zg sr?• sE? 5 ° ATyal Urrl - ooF Z69,0z =- & X )7 = Z49z.$s 114:00 48. ov Z4, 00 Z (D78.88 4 91.12 MOO I l s.1z_ ?. Z &7. 1z 9.7(0 Z37.og -)?- A 00 15.00 24.00 g8.oo 30, o0 9z?oo Zo7, co 28.00 Z1. o0 -35,00 84. oc> logZ loZ IAI-04 Ne r EXycs? WALL 6gL4Le. w 4t-'-- 2(n7g.gg G?45 C'odo-, 115.IZ Ii P-1"1 • Z3Zo$ W?w'S .o Zo 7 o - (043. z o it wvR? S 8 ¢ 0 0 2o3$.m8? qL, (17 6- 3 2007 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existinq residential dwellings. Date 3 1 2 12607 Site Street Address V095' DeL`FZWODp TP-}I - Unit # Property Owner f}Lt ¢ N Telephone# ((orll) 95Ll- 039(P ((p¢1) SS2 - 111 D Contractor f D S Telephone # Address t.VD Sc.iT6 (( City .q.0N ST J94kL State /w,?) Zip SSo75` The Applicant is: ?Owner & Occupant _ Licensed Plumbing Contractor Refurbished Submit 2 sets of plans and MPC license Septic System _ New includes County fee _ $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee applies when extensive lumbin repairs are made to a buildin . Alterations to existing dwelling $ 50.00 Add plumbing fixtures to _ main level ? lower level. This fee includes installation of a water softener and/or water heater at the same time. If you are installing onlv a water softener and/or water heater, do not complete this section; move to the next section and place a checkmark next to the appliance(s) you are installing. -Septic System Abandonment -Water Turnaround (add $136.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 new _ replacement Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $ Q SO I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is re Ida ?tG Mow5onl =K== Applicant's Printed Name Applicant's Signature SURVEYOR'S CERTIFICATE EeV ae9. eeO%0 3.28 -9°24'28" / 886.6 Qy\&1 ! 997.2 PROPOSED g I DRIVEWAY m ? 30.17 GARAGE N $ t m m/ m / IV a a 11.50 _ OD w ? I all o J -_- w O 0 w rn w M I'l = 30 (703.2 \ `? 6- K NIk cn a: m -r1 -n - M O co N O ? - N r r m O CD 0)n U X v to 61> M z z O =? " 0 p z i m W co N O m < SUNSHINE CONSTRUCTION ,aes:a Z15 m I N I ? eea, ? P A 1` ? ° C889,G) ' 'ilI / : 2733 o a 0 NO IH m 0. W T i LOT 10 I r 1 1 i 0 rn Im g w I ° fl-M , n. ,A f r ?1 DRAINAGE 6 UTlL'TY 1 EASEMENT PER PLAT 5? 5 ?------ 0 °- °- 72.59 S 89° 23'34" W James R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 SURVEYOR'S CERTIFICATE PROPOSED GRADES SHOWN WERE TAKEN FROM THE DEVELOPMENT PLAN FOR ENGSTROMS DEERWOOD ADDITION, PREPARED BY BRW, INC. AND LAST DATED 6-28-88. • DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET ® DENOTES IRON MONUMENT FOUND XOOO.O DENOTES EXISTING ELEVATION (000.0) DENOTES PROPOSED ELEVATION SUNSHINE CONSTRUCTION L . F ? -? SCALE: 1 INCH - 30 FEET PROPOSED GARAGE FLOOR - 889.9 FEET PROPOSED LOWEST FLOOR - 882, z FEET PROPOSED TOP OF BLOCK- 890,3 FEET WE HEREBY CERTIFY TO SUNSHINE CONSTRUCTION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: LOT 10, BLOCK 2, ENGSTROMS DEERWOOD ADDITION, ACCORDING TO THE RECORDED PLAT THEREOF, DAKOTA COUNTY, MINNESOTA. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 17TH DAY OF NOVEMBER , 1988. SIGNED: JAME_Q fLL, INC. 'BY: / e? HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 mo? L 0 ? ; ° m tD o c- r O MOD m -' (A ;r \' Fn - D ? m Z v p m z M N j N James R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 App - INFLOW & INFILTRATION.pdf http://www.cityofeagan.com/upload/images/CommunityDevelopment/... Use BLUE or BLACK Ink 1 of 1 41' Gity of Eaaail 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 For Office Use Permit #: Perm Fee: Date Received: Staff INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: Site Address: /_ 0 S 7 Tr - Tenant: r Tenant: Resident/Owner Contractor Type of Work Suite #: Name: Address Name: 414A— %( t (' Ai -CO") Phone: % 57- 99 7 6396, City / Zip: YO 85 761,1 W Th L, 6647J, &i s' f22— Al A - License #: Address: City. State: Contact: Zip: Phone: Email: Description PLUMBING (within the budding envelope) Sump Pump Repair Other. Description of work: f' -C i r SEWER & WATER (Outside the biild'ng envelope) Repair Other. FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.comlinflow, or City Hall at 3830 Pilot Knob Rd. 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.gopherstateonecallorq 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 1 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 wor which rehires a review and approval of plans. Applicant's Printed Name x Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required inspections: Under Ground _Rough -In _Final 3/11/2013 8:33 AM Date: City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 1- Use BLUE or BLACK Ink r —, For Office Use Q� Permit #: I 1 / Q� 0 Permit Fee: M5°5 Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION l-5 Site Address: y. &lir ./0-e ef-v/ t L Unit #: Type of Work Name: _ le (7/ v�v' r /� //S h., r h Phone:15 F / V—'/,% ,97 Address / City / Zip: "C) Z9c r1-- 1Jp,-/ - ter" ` 6 ( y Applicant is: Owner //C Contractor Contractor Description of work: �7 Construction Cost: ,/ PO 0 Multi - Family Building: (Yes / No ) Company: • V I /Pee? ,/ ! Y 1 / 7 . c 47Contact: c,-5-1- 2 ‘ Address: / 77 City: Jr;/r) State: iXC License #: Phone: ‘X/— 21"°- 7�3j 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE. Plans and supporting documents that y the information may' be,classified as anon pub concical`e:' submit are con you provi-` at they are`°tra• ered to be public information Portions of ecific reasons that would permit the City to e 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.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 issuance. ✓c'"le Applicant's Printed Nano, App cant's SignatuAll/Pr Page 1 of 3 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use ^ �j Permit #: Permit Fee: 1 0 5:D 5 a5 Date Received: 9. 11Y Staff: 2014 RESIDENTIAL�BUILDING PERMIT APPLICATION Date: 342:7' Site Address: / /b t) 1)e / %A4-0, 1 Unit #: Resident/ Owner Name: 0-J cJ Ai , . G! _50 t\ Phone: 1 —®-3 9 /� / / Address / City / Zip: � ��+'�_ / �/`�,N' 5 -57;2 -2 - ` -57 ,Applicant Applicantis: Owner X Contractor Type of Work r Description of work: kd^ ie 5,-J /k �_' . / .SG " 5 Construction Cost:I, 0 0 0 P Multi -Family Buildi g: (Yes / No Contractor Company: ` er/ _ A Contact: /c`,/ .l / a N. r J( 0 -17 Address 2/c f 22,J.Ci r e, City: ../A,c- '` State:A Zip: 56 7 C Phone: 57 /F---/ 7 V .6 License #: t0 -y} 0 / 9' t Lead Certificate #: /41 // If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, _Yes _No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents thatyou 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.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 S Byjlding Code ust be completwithin 180 days ofQermit issuance. x .� /ir:J Applicant's Printed Name x Applicant's Signature Page 1 of 3