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3691 Denmark Ave CITY OF EAGAN r 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 • wr PHONE: 454-8100 BUILDING PERMIT " Receipt # To be used for DIMO&OR Value $1t 000 Date JULY It 19 91 Site Address 3695 itl[1IMM A!"= Lot _I Block _ 4 Sec/Sub. TI1t188M 2W OFFICE U SE ONLY Parcel No. Occupancy FEES R0111811111 K? Zoning $25 00 W Name (Actual) Const Bldg Permit * O Address gA? 484-3878 (Allowable) . .50 City Phone 330-52% M ? of Stories Surcharge S Plan Review SANE Length X20_ o Name Depth SAC Cit Z u¢ Address S.F. Total , y '- City Phone S.F. Footprints SAC, MCWCC W On Site Sewage ater Conn } W Name On Site Well F Water Meter Address MWCC System a W City Phone City Water Acct. Deposit PRV Required SM Permit I hereby acknowlege that I have read this application and state that the Booster Pump SrW Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: ROKRT Planner Park Ded. on the express condition that all work shall be done in accordance with all Council 1 00 applicable State of Minnesota tatutes and City of Eagan Ordinances. Bldg. Off dg. Copies . / Building Official /•_ c Variance TOTAL $26.50 s Permit No. Permit Holder Date Telephone rt+ WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Dow Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Orstat Test Final Plbg. Pibg. Inspector- Notify Plumber Const. Meter EngrJPlan Bldg. Final Deck Ftg. 7 g g/ k/? Deck Final ,t q q well Pr. Disp. Receipt MECHANICAL PERMIT CITY OF EAGAN Permit No. Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost L 3. Job Address LotBlk. Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential © Commercial ? Institutional ? 9. Work Description: New ? Add Alter ? Repair ? 10. Describe _ ' Fuel Type 11. No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Ai H i Mfg. r andl ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other T Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed or Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 4548100 ? k14 lKt ? - INSPECTION CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: 141; f NM)WV r1'4'i I I I'Iiil f. .illl l 1111 PERMIT SUBTYPE: ? ? ;ail .II ;CORD PERMIT TYPE: Permit Number: Date Issued: 1 APPLICANT: 1; 14 TYPE OF WORK: K I I l l t1 1 1111 0. I I.'4 X 11/IHJ94 INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR, { I4F PIA F1k 51 SP 11 A14A I t 11 I'M 1 I '. Altl VI ill!) 11,1 11 1 fll< AN',' 1'1 11NIi 1 111, 0 1 I f I I' I1 At I Permft No. Pwmft Holder Date Telephone to S/W PLUMBING HVAC ELECTRI ELECTRIC cj y °O InspeOlon Date Insp. Comments Footings I Foundation Framing t f 2 Roofing Rough Pibg. Pee Rough Htg. [Sul. Fireplace Final Hig. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final 5 Deck Ftg. Deck Final Wall Pr. Disp. CITY OF EAGAN Remarks Adc''•:tion r Lot 2 Blk 4 Parcel 10 76501 020 04 Owner treat 3693 Denmark A-U L State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1974 321. 03 64.20 5 Paid STREET RESTOR. [ GRADING SAN SEW TRUNK * SEWER LATERAL 1973 970.37 64.69 15 Paid WATERMAIN * WATER LATERAL 1973 15 * WATER AREA 1973 15 STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 110.00 6380 9-7-72 BUILDING PER. SAC 240.00 61AD 9-7-72 PARK CITY OF EAGAN Remarks Addition-7- TIMBERSHORE 2nd Lot 3 Blk 9 Owner v bhti f I rrgoL n ?-k Street 3691 Denmark AU E . Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. -421 .()-A 64- 70 C; PA i ti STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 970-17 64 - fig IS PA i rl WATERMAIN # WATER LATERAL yt WATER AREA 197-4 STORMS W TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 110.00 6380 9-7-72 BUILDING PER. SAC 240.00 AIR() 9-7-72 PARK CITY OF EAGAN Remarks Addition TIMBERSILM 2nd Lot L Rik 4 Parcel 10 76501 010 04 Owner be r-t m Street 3695 Denmark /4VL -State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, 1974 321.03 64.20 5 Paid STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 970.37 64.69 15 paiti WATERMAIN • WATER LATERAL 1973 15 * WATER AREA 1973 STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 110.00 6380 9-7-72 BUILDING PER. SAC -740-00 9-7-72 PARK CITY OF EAGAN Remarks Addition TIMBERSH IRE 2nd tot 4 Blk 4 Parcel 10 76501 040 04 Owner LA .% S' Street 3697 DeMark A4 ?- , State Eagan, MN 551247 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1974 321.03 64.20 5 Paid STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 11-1 1973 970.37 64.69 15 Paid WATERMAIN * WATER LATERAL 1973 15 * WATER AREA 1973 15 STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 110.00 6380 9-7-72 BUILDING PER. SAC 240-00 6380 9-:77 PARK y EAGAN TOWNSHIP -y BUILDING PERMIT Owner .. /.4.Sr?,:c.. ?----...... ................. Address (present) ....?r.3 6...../?%k e6-[- 9--l Builder .......... ..._...... -?!e _.......... --......_......_. Address .............. .....-- .........................------....---- nERC}iiPTinN N° 2772 Eagan Township Town Hall Date -_7. .// -. ?'- Stories --------- To Be Used For --------- Front ---- --- Depth I. Hugh! Est. Cos! Permit Fee Remarks l Street, Road or other Description of Location Lo! Bloch Addition or Trac 346 9, 4 q / q--4 This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent She right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that.....*.'t" ..... . ?......... t??-!^?....... has permission to erect a....2?':'M_.._:;?`?^-?- -t--. .. ' ........................ upon the above described premise subject "to the provisions of the Building Ordinance for Eagan Township adopted April 11, 1955 ----.......---- .................. ' n_-... ... . 0 ... . / ................... .. .. ..[3..... .. ctor.. Chairman of Tnwn Board Building Inspe.. A ID 7&50/ 0/D 0? 7i`mbPrSvr an // TONN OF FAGAN 3795 Pilot Knob Road Eagan, Minnesota 55121 PERMIT NO. 247-248-249-250 The Board of Supervisors hereby grants to Thompson Plumbing 00. of 12201 ^Unnetonka Blvd. M? nnatonka 55343 a PLUIMING Permit for: (Owner) New Horizon Homes 91-93- . Denmark, 1292-94 Kola .a. ?c OMW , 13 2 12 -967' Kolstad at La., 1304 -W-1, Kolstad Tane pursuant to application dated 7/31/72 Fee Paid: $320.00 Dated this 7th day of August , 19 72 Building InspE:c*_or F TU.. "N OF EAGAN 3795 Pilot Knob I:oad Eagan, Minnesota 55111 PERMIT NO. 250 The Board of Supervisors hereby grants to Geo. Sedgwiak Heaing & Air Cond. Co. of 1001 Xenia Ave. So., Ntpla. 55416 a HFATING Permit for: (Owner) New Horizon limes at 6 -0-0-97 Denmark Ave. , pursuant to application dated 9l13Z72 Fee Paid: *ftxft $86.00 Dated this 15th day of September 19 72. 2.00 a/c Building Inspector 3 F ? ? i TOWN OF EAGAN 3795 Pilot Knob road Eagan, Minnesota 55121 )6 2 , 5 6 l eW v ?L Ti.??llShC:/"? C14 PMI1T No. 247-248-249-250 The Board of Supervisors hereby grants to Thompson Plumbing 00. of 12201 nUnnetonka Blvd, Minnetonka 55343 a PLUM-MLiG permit for: (Owner) New Horizon Homes Mor M- - Kalstad ?1-93 Deannarl., 1292-94 Kols .a. zt 368'My Do , 13V-4- 'Z70 at La., 13 .06--o8-I0 Kolsttad Lane pursuant to application dated 7./31/72 Fee Paid: x320.00 Dated this 7th day of Augaat MUC 37-6 1972 Building lnspector [5 TO`,N OF EAGAN 3795 Pilot Knob road Eagan, Minnesota 55121 PERMIT NO. 250 The Board of Supervisors hereby grants to Geo. 9edgwiak Heafing & Air Cond. Co. of 1001 Xenia Ave. 3o., Mple. 55416 a HEATING Permit for: (Owner) New Horizon flames at 2Y1`9-95-10'Denmark Ave. , pursuant to application dated 9/13(72 Fee Paid: *OEM $88.00 Dated this 15th day of SeptQ1W-W- , 19 72. 2. o Building Inspector 3 TO' .N OF EAGAI4 3795 Pilot Knob Road Eagan, Minnesota 55121 PERMIT NO. 250 The Board of Supervisors hereby grants to Geo. Sedgwiak HeAng & Air Cond. Co. of 1001 Xenia Ave. So., Mp2e. 516 a HEATING Permit for: ((wner) New Horizon Hoses at 3001-93-9-9Z"Denmark Ave. , pursuant to application dated 2/13Z72 Fee Paid: *MM $86.00 Dated this 15th day of September 19 72. 2.00 o Building Inspector 3 TOWN OF EAGAN 3795 Pilot Knob road Eagan, Minnesota 55121 PERMIT NO. 247-248-249-250 The Board of Supervisors hereby g_-ants to Thompson Plumbing Co. of 12201 nU=etamka :11vd, Minnetonka 55343 a PUJIff3Ii1G Permit for: (Owner) New Horizon Hobe 39-91--? -9- Denmark, 1292-94 Kola enmar p -9b7' Kolstad at Vii., 1304-o6-08-110 Kolstad Lme pursuant to application dated 7/31/72 Fee Paid: $320.00 Dated this 7th day of August 19 72 Building Inspector ) 5 10 7?ff?_)7 036 6¢ TOWN OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55121 PERMIT NO. 247-249-249-250 The Board of Supervisors hereby grants to Thompson Plumbing Co. of 12201 m=wtmka Blvd, mi=etonka 55343 a PIMING Permit for: (Owner) NaW Horizon Home 0521-A-93-95-97 Denmwk, 1292-94 Kola , KOl? at Is„ 1304-o6-W^10 Kolatad lane , pursuant to application dated 7/31/72 Fee Paid: $320.00 Dated this 7th day of August 8.W M 1972 . Building Inspector /S /D ?b5 L/ 036 04- %, r b c>r" 3 `xl// TORN OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55121 PERMIT NO. The Board of Supervisors hereby grants to G80- Sedgwick He4ng & Air Cond. Co. of 1001 %enia Ave. So., Mpl.s. 55416 a HEATING Permit for: (Owner) New Horizon Homes at 3691-9-2-95-7 Denmark Ave. , pursuant to application dated 9!13/72 Fee Paid: *MKM $80.00 Dated this 15th day of September , 19 72. 2. s o Building Inspector 3 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: August 7, 1972 F+ a OWNER:New Horizon Homes a Address 3691-93-95-97 Denmark Ave. e. PLUMBERThcmpson Plumbing Co, TYPE OF PIPE Heavy Cast Iron DESCRIPTION OF BUILDING Industriall Commerciall Residential Multiple Dwelling No. of units 1 I I xx 1 a Location of Connections: NUMBER 1086 Connection Charge 960.00 pd 9/7/72 Permit Fee 10,00 pd 8/7/72 .Du PU U/(/If Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota By Thompson Plumbing Co. Please notify when ready for inspection and connection and before any portion of the work is covered. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 419- . . PEM-11T FOR WATER SERVICE CONNECTION Date: 8/7/72 Billing Name: New Horizon Homes Ouner: same Plumber: Thompson Plumbing Co. Location of Connectio 3691 - 22220663 324367 3693 - 2222o664 324668 3695 - 22220665 324369 3697 - 22220666 324370 Assn.- 22220667 324371 Number: R24 924 Site Address: 3691-93-95-()Denmark Ave. Billing Address (billed add'l $10.) Meter Size Connection Chg. 30,00 pd 9/7/72 Meter No. Permit Fee 10,00 pd 8/7/72 Meter Reading Meter Dep. .50 pd 8/7/72 5 meters Meter Sealed: Yes lAdd'l Chg. 300,00 pd 8/7/72 NO Total Chg. Inspected by Building is a: Residence Multiple roc No, units 4 Commercial Industrial Other Date Remarks: $25.0"0 IMPROPERLY iil:;(4ii By: ^ Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: Thompson Plumkine Co. Pleaae notify the above office when ready for inspection and connection. 4 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PER11IT FOR WATER SERVICE CONNECTION Date: 8/7/72 Number: aE24 924 Billing Name: Iyew Horizon Homes Site Address: 3691-93 95, 97 Denmark Ave. Owner: same Plumber: Thompson Plumbing Co. Location of Connection 3691 - 22220663 324367 3693 - 22220664 324668 3695 - 22220665 324369 3697 - 22220666 324370 Assn.- 2222o667 324371 Billing Address (billed add'1 $10.) Meter Size Connection Chg. 30,00 pd 9/7/72 Meter No. Permit Fee 10.00 pd 8/7/72 Meter Reading Meter Dep. .50 fd 8/7/72 5 meters Meter Sealed: Yes 1Add'l chg. 300.00 pd 8/7/72 NO I Total Chg. Building is a: Residence Multiple Xx No. Units 4 Commercial Industrial Other Inspected by Date Remarks: By: Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: Thompson PlumLinc= Co. Pleaae notify the above office when ready for inspection and connection. COMMERCIAL 2002 BUILDING PERMIT APPLICATION CITY OF EAGAN 651-681-4675 3 .-r5 Foundation Only New Construction Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) " • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp.& Testing Schedule " • Certificate of Survey (1) • Energy Calculations (1) not always- • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always- • Meter size must be established • Meter size must be established • Meter size must be established - if applicable • Project Specs (1) 1 • Energy Calculations (1) 1 • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1)" 1 1 • Soils Report (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details. p p 2 DATE: Zv O ` WORK TYPE: _ NEW _ REMODEL CONSTRUCTION COST: I D I -/ SITE ADDRESS: 3(e I alp '1 1?; 34 ?QMYV?G: Jj P\yQ TENANT NAME: FORMER TENANT NAME, IF APPLICABLE: DESCRIPTION OF WORK Name: 1 1 rn r;m S?t? ftp? l Phone #: ( tcl) / PROPERTY Last First OWNER ? Street Address: ?• ?0 // I C) lP ` c City: State: r-J Zip: J? I r? I Company:l LAG t" 11 ?> M W 1 t t DSLJ ?+ J1 b t `? Phone #: (?SoZ ) 6 - I ? " J L CONTRACTOR J Street Address: 4 k 6b City Yn U y(JVL?GYn??( State: t? Zip: ARCHITECT/ ENGINEER Company: Name: Street Address: City: Licensed plumber installing new sewerlwater SUITE #: Phone #: I hereby acknowledge that I have read this application, state that the information is correct, Ic! agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. /' / `lam ( ' Signature of Applicant: Updated 1/02 ?S TIMBERSHORE 2ND PERMIT DATE & TYPE LOT BL ADDRESS 7172 4-PLEX 010 01 020 01 030 01 040 01 7/72 4-PLEX 010 02 020 02 030 02 040 02 7/72 4-PLEX 010 03 020 03 030 03 7/72 4-PLEX 010 04 020 04 030 04 040 04 76501 1304/ KOLSTAD LN 1306/ 1308/ 1310 1296/ KOLSTAD LN 1298/ 1300/ 1302 3687 DENMARK AVE 1292/ KOLSTAD LN 1294 3689 DENMARK AVE 3695/ DENMARK AVE 3693/ 3691/ 3697 4 /?7,??/CSyOI?Es MASTER CARD LOCA OWN STRUM LANE Permit No. Issued Issued To Contractor Owner BUILDING PLUMBING CESSPOOL - SEPTIC TANK oU7 _ WELL =ELECTRICAL HEATING SAS INSTALLING iANITARY SEWER -/ R- DTHER - DTHER Approved Items (Initial) OOTING FOUNDATION Date Remarks Distance From Well SEPTIC CESSPOOL FRAMING TILE FIELD FT. -INAL LECTRICAL__ HEATING SAS INSTALLATION / ! - -- DEPTH OF WELL SEPTIC TANK :ESSPOOL IRAINFIELD 'LUMBING YELL ANITARY SEWER + C i F Violations Noted on Back COMMENTS: 7-1-1 ' )-N ' --- l ' l I-?7 1991 BIIILDIN P T L TION y LD EAMI CITY OF EAGAN SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (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 Site Address ]bC& qt 'r/5 %Awaluation: 3695 beNmyric Ave I- Lot / Block Parcel/Sub-flJNbefsboro 2'JAJJjrl0a Owner gherr Damber&- Address 5 l emmorte ove City/Zip Code N SSl23 or/ Phone '?S? • 3 7 g 330-5W6 Contractor .Self Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Date: 6 - I2 o - ( 1 OFFICE USE ONLY FEES Occupancy Bldg. Permit Jr,?J Zoning Surcharge . SO Actual Const Plan Review Allowable SAC, City # of stories SAC, MWCC Length AO Water Conn. Depth Water Meter S.F. Total Acct. Deposit Footprint S.F. S/w Permit S/W Surcharge On site sewage- Treatment Pl. On site well Road Unit MWCC System Park Ded. City water Trail Ded. PRV Copies , 00 Booster Pump _ SUBTOTAL APPROVALS Penalty Planner Lot Change Council TOTAL Bldg. Off. Variance Phone # 12 agrees that all work shall be done in accordance with Signature of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. '"" o . ,! S 1 , CITY OF EAGAN ' N4 19385 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 C BUILDING PERMIT PHONE: 454-8100 I CI -3 81 Receipt # To be used for DECK/DOOR Est Value TrIlow JULY 9 91 . Date t s Site Address 3695 DENMARK AVENUE Lot 1 Block 4 Sec/Sub. TIMBERSHORE 2ND OFFICE USE ONLY Parcel No. Occupancy FE ES Name ROBERT BLOMBERG Zoning $25.00 SAME 454-3878 Address (Actual) Const Bldg. Permit o City Phone 330-5296 (W) (Allowable) aofStories Surcharge • 50 SAME Length WO Plan Review o fF Name Deplh SAC, City up Address S.F. Total • City Phone - S.F. Footprints SAC, MCWCC On Site Sewage Water Conn W ?i Name on site well Water Meter u? Address MWCC System - aw City Phone City Water Acct. Deposit PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump information is correct and gre comply wit plica le State of t S/W Surcharge Minnesota Statutes and try of o Ordi t? Treatment PI Signature of Permitee r , r APPROVALS Road Unit A Building Permit is issued to: ROBERT Ill on the express condition that all work shall be done in accordance with all Planner Council Park Dad. applicable State of Minnesota( atu?tes? and CiryQp?fj?Eagan Ordinances. Building Official ??"`-^?'? Bldg. Ofl Variance Copies 1.00 $ 26' S0 TOTAL 2-0 L-1 A? Vil ?56 95 ' ? yr? #rlc 4 uc I CITY USE ONLY SUBD. - 1 ?t'? b-el?Ss ?((Lt.. ?""1' RECEIPT #: \\ RECEIPT DATE: o I c-yC? - U PERMIT # )- t `''??? O t-+ <? 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 651-681-4675 Please complete for: > single family dwellings > townhomes and condos when penults are required for each unit >- backflow preventer for underground sprinkler system FIXTURES FACH !t TnTet Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet 'minimum-1 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavatory 3.00 x = $ Septic System new/refurbished • requires MPC lie. 75.00 x = $ Septic System abandonment 30.00 x = $ RPZ new installationlrepair/rebuild 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground sprinkler if dwelling is under construction 3.00 x = $ Underground sprinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener If dwelling under construction 5.00 x = $ Water softener if existing dwelling 30.00 x = $ Water turnaround 30.00 x $ p_ co State Surcharge .50 -> -> -> $ .50 Total $ 9 Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. I hereby atlcnowledge that 1 have read this application, state that the informatiod is corned, and agree to mmply with 211 applicable CRY off Eagan ordinances. it is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-wayleasement. SITEADDRESS: `s n OWNER NAME:: f7d.?r?p> ?Dh?lf?G°6 TELEPHONE ULU (AREA ODE) ""' ` INSTALLER NAME: pT?? TELEPHONE #: FG3/ / STREET ADDRESS: Z111126k9 (AREA COD CITY: 24(d&29/ y STATE: dl/? X/ ZIP: SS?Sl? SIGNATURE OF PE ITTEE 42 47JO CITY USE ONLY L BL d SUBD. RECEIPT #: . /,;2//// DATE: 7 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: single family dwellings ? townhomes and condos when permits are required for each unit New construction ? Add-on furnace 7a Dpa ,(if yf?.rL? v? Add-q- fit 'co i 1 i Add-on air exchanger, i.e. Vanee system, etc. ? Minimum Fee: Add-on/Remodel (existing residence only) $20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 Gas Outlets (minimum of 1 required @ $3.00 each) ? State Surcharge .50 TOTAL b SU SITE ADDRESS: 3b,5 '/ pz"n'?rn4,1Z1, 4i4.t, OWNER NAME: (rv?1G? ??(i??il PHONE M INSTALLER NAME: 8EDGWtCK!Ar,:M?0` r' "'o CfJimr, r i M Weapolis, MN 55xM STREET ADDRESS: 881-AOt)0 CITY: STATE: ZIP: PHONE #: ( )'?(- ClDaU -?lGlu . Date: Id -1 U -1?7 '? PERMIT ?qJ y CrTY OF E A G A N y-/a -9 `f 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 023324 (612) 681-4675 Date Issued: 04/18/94 SITE ADDRESS: 3693 DENMARK AVE LOT: 2 BLOCK: 4 TIMBERSHORE 2ND P.I.N.: 10-76501-020-04 DESCRIPTION: BUilding:_Permit Type Building Work Type i BASEMENT FINISH ALTERATION REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: Base Fee $35.00 Surcharge $.50 Lic. Search Fee $5.00 Total Fee $40.50 CONTRACTOR: CHUCK'S CARPENTRY 4135 WENTWORTH MINNEAPOLIS MN (612) 851-5505 - Applicant - ST. LIC 18515505 0009394 AVE S 55409 OWNER: SHAWL SUE 3693 DENMARK AVE EAGAN MN 55123 (612)688-2074 I hereby acknowledge that I have read this information is correct and agree to comply Statutes and City of,Eagan Ordinances. APP T/PERMITEE SIGNATURE application and state that the with all applicable State of Mn. J &Fj. m? S]Nu SUED B)f SI NATURE-`' 2332 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 .s 14...,P/ n ---___ - - -_.___ _ SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy talcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy talcs. 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 VfK Valuat on of work i 343 G' 1 ? 6 Site Address: Y1W1Gr N 1 yel STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. ,n 1 la r p ^ f? ??7 J?I P.I.D. # ? Descri tion of work: VV The applicant is: ? Owner L%YContractor ? Other (Describe) Name Shzq l? Phone ?gS-zo Property LAST FIRST Owner Address 3 9 3 0Cy'\YhC \r STREET STE # CityCIGr-"' State ?n_ Zip Company ?l ,?KS f v Phone Contractor Address I3S ?)? `??S1T ?? License #L6093? Exp. city l 1??5 State Zip 5-5V6 /' 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 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 Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ? Site ? Wallboard Basement sq. ft. 1st F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing ? Final ? Framing ? Draintile v ? Insulation ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pg. Road Unit Park Ded. Trails Ded. Copies Other Total: valuetim: $ ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments SAC % SAC Units 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122._ (612) 681-4675 PLEASE ' PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWIT OMF.S AN WHEN PERMITS ARE REQUIRED FOR EACH UNIT. _._--------- NO. . FIXTURES EACH TOTAL t SHOWER 3.00 - WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 5,?4 7- 3.00 LAUNDRY TRAY HOT TUB/SPA d r rl 3.00 WATER HEATER 3.00 - FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum - t 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. • osk.ay. Tic. 20.00 U.G. SPRINKLER • home under cunt. 3.00 ALTERATIONS -to existing 20.00 WATER TURN AROUND 20.00 STATE SURCHARGE 30 . TOTAL: ap s SITE ADDRESS: 3(o9 ?e.nw\O v OWNER NAME: i 3a_Q Sctco?c?A INSTALLER: ADDRESS: R 3 e v? vwa ? F? v CITY:a c? + J STATE: n^1 ZIP CODE, ,1'a 3 PHONE # (fie/a)- Gf#N ao?c/ CLAIM VOUCHER - REFUND REQUEST CITY OF EAGAN CLAIMANT_ SUE ADDRESS_3693 DENI4RK AVENUE ___ __-_---- _ EAGAN. M13-Jj 1_-------------- Location S2gIIT193K BYF------- ],2. Receipt No./Date 12112-04(1;0_-_------ Reason for Refund ?OMEOWN$R - of Refund Electrical Permit #N02534 3211-9220 $_?Q•n0 Plumbing Permit 3212-9220 $ Mechanical Permit 3213-8220 $ Surcharge 2155-9220 $ Water Connection Permit 3713-9220 $ Sewer Connection Permit 3743-9220 $ Account Deposit 2252-9220 $ Utility Account Over-payment 2250-9220 $ Other: $ - - - --- - -------- TOTAL $ I declare under penalties of law that this account, claim or demand is just and that no part of it has been paid. N TURE J _7 7 4F DATE ;r . , EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454.5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: August 7, 1972 OWNER: New Horizon Hanes PLUMBERThanpson Plumbing Co. NUMBER 1086 Addres 369 -93-95-97 Denmark Ave. TYPE OF PIPE Heavy Cast Iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: xx 1 4 Connection Charge 960.00 pd 9/7/72 Permit Fee 10.00 pd 8/7/72 Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota By Thompson Plumbing Co. Please notify when ready for inspection and connection and before any portion of the work is covered. EAGAN TOWNSHIP '7 N ?'- ? 3795 Pilot Knob Road St. Paul, Minnesota 55111 _ Telephone 454-5242 + PERMIT FOR WATER SERVICE CONNECTION Date: 8/7/72 Number: tic 9211 Billing Name: New Horizon Hones Site Address: 3691-'93-95-97 Denmark Ave. Owner: same Billing Address Plumber: Thompson Plumbing Co. (billed add'1 $10.) Location of Connection Meter Size Connection Chg. 30.7 pd 9/7/72 3691 - 22220663 3211367 Meter No. Permit Fee 10.00 pd 8/7/72 3693 - 2222o664 321068 Meter Reading Meter Dep. •50 pd 8/7/72 3695 - 2222o665 3211369 5 meters 3697 - 22220666 3211370 Meter Sealed: Yes Add'1 Chg. 300.00 pd 8/7/72 Assn.- 2222o667 3211371 NO Total Chg. Inspected by Date Building is a: Remarks: Residence Multiple ? No. units ?+ $25.00 RE-INSPECTION FEE FOR IMPROPERLY INSTALLED METERS. Commercial Industrial By: Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: Thompson Plum}n;no Co. Please notify the above office when ready for inspection and connection. EAGAN T014NSHIP U 3795 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: August 7, 1972 NUMBER 1086 OWNER:New Horizon Homes Address3691 9395-97 Denmark Ave. PLUMBERThompson Plumbing Co. TYPE OF PIPE Heavy Cast Iran DESCRIPTION OF BUILDING Industriall Commerciail Residential I Multiple Dwelling I No. of units I xx 1 Location of Connections: Connection Charge 960.00 pd 9/7/72 Permit Fee 10.00 pd 8/7/72 .50 p Street Repairs Tots Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota By Thompson Plumbing Co. Please notify when ready for inspection and connection and before any portion of the work is covered. EAGAN T014NSHIP 3195 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: August 7, 1972 OWNER: New Horizon Homes NUMBER 1086 F Address3691-9344 x97 Denmark Ave. PLUMBERThompson Plumbing Co. TYPE OF PIPE Heavy Cast Iron DESCRIPTION OF BUILDING Industrial Commercial] Residential I Multiple Dwelling I No. of units I I i xx 1 Location of Connections: Connection Charge 960.00 pd 9/7/72 Permit Fee 10.00 pd 8/7/72 p Street Repairs Total Inspected by: Date Remarks By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota By. Thompson Plumbing Co. Please notify when ready for inspection and connection and before any portion of the work is covered. City of Eap Fn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 q, TR JUL 1 7 2008 - - - - - - - - - - - - - - - - - - For OIFrs use?j j Permit#: ?4s j Permit Fee: l I?c Date Received: ba? I I I Staff: I I ---------------- 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Tenant: Suite #: RESIDENT/OWNER ?)S) • T?9 .14lS? Name: DY Ll?- Phone: I / Address/City/Zip: f? 9+., u 1IL S`? is Applicant is: -&-owner Conbactor TYPE OF WORK Description ofwodc: ew FXW_ Construction Cost: 0. Multi-Family Building: (Yes / No CONTRACTOR Name: SQ ?Yl -C aS D W Y) 2'y- License #: Address: City: State: Zip: Phone: Contact Person: 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: Plans and supporting doctiments that you submit are considered to be public information. Portions of the information may be classified as non-public d you provide speciric reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codas of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and wok 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 plans. x 1-4Sa ?W1ICA x l akAjL? She Address: 3W I DeAi rnm l _ ue-. e4 I DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool ? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Muhl ? 01 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? 06-plex 1?( Deck ? Porch (screen/gazebolpergda) ? Multi Misc. ? 03-Plex ? 10-plex ? Lower Level ? Storm Damage ? 04-Plex ? 12-plex ? Miscellaneous WORK TYPES ? New ? Interior Improvement ? Siding ? Demolish Building` * Addition ? Move Building ? Reroof ? Demolish Interior ? Alteration ? Fire Repair ? Windows ? Demolish Foundation ? Replacement ? Egress Window ? Water Damage ' Demolition (entire building) - give PGA handout to applicant DESCRIPTION: Valuation A? Occupancy r?i) MCES System Plan Review Code Edition SAC Units (25%100%_YJ Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRY # of Buildings Length Fire Sprinklers Type of Const. 4)b- Width REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) Footings (addition) Foundation _ Drain Tile Roof: -Ice&Water -Final Framing _ Fireplace:-R-1- _Air Test -Final Insulation Sheetrock Final/C.O. Final/No C.O. HVAC Pool:-Footings _Air/Gas Tests -Final Siding:-Stucco Lath -Stone Lath -Brick _ Windows Retaining Wall Reviewed By: 11- z . Building Inspector RESIDENTIAL FEES. Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total owt- 31 o a X'?, I NORTH 1 11) I f) Vj i 1W C. C StAIt 00metts Iron Monument Marked "R.L.S. 772G" eearinga on Aeevm40 N JUNE 1972 a I , to CP 00 I In W z Q J 0 Ww SCALE I Inch - 40 feet o saoa ? n feel idd ?? fLC1li?l rIL?GLI ??(Jli 1. , flip! I?I0 i• A I'. It t; .s ,\J KOLJTi.:! s 3?•e a'3i• •. t , °a ' qm? i q t? ? p FO y I v 7 It D; U KNOW ATA M ' PY PRF:Sr. YNr;SFSTgt hot yew Ilop Ann po"' inn., a Mlo""tn ,.n.parntinn, nuncr eat Anpnrrlma property aituAtti to the fmtnty Of dhkota, State of Minnesota to wit: 7hpt part or Ic Final MdMilm, AcearAing to 91e plat tharrnf on 1114 end of reoerd In thn Virile of tin; Rogtst. and State, Iymg South of a llnn MRerlbed pa beidinning At a point nn the '+ast lira of eelid yet from the NorthuM.1 corner of Aaid Lot 1; thnnen. Ynaterly and at right angleo in nald went lion 1 a tannvatial cure to the rtght, gild enrve having a rndIoR Al 194.99 feet sad A enntenl angie t 100,0;q tent f.n A paint or ravaraa evrve; then[! F.anterly aladg acid revnrpe CWve to thn tuft, hn Arc dunna, of 113,1a feet more or leas to a point on the Feet find d1 paid Cot 141vtrtnt 597.! Alai ears a, spin In, I amt thorn tertofnRtins, hen ..... 4 the epee to he all,"'Aa PAd platted emI do Ilerebr donate. Add dedlcatt to the Pllnllc ror the pnhllt ut4 ratev4r, }be ?raja.;. and oil flat. TO nit"" "'reef Sold New Met pan a... Ina, hag Conned then. ..... ota to he nt mad !n' earparal.a Real to tie h.... l". afflAe4 thin .4f 1q of Slut A.D. 1172, In P"Annre ptl MVe• IR MTT.Ry umY 1 An in Po he 1,t L. purger n9 1 i. f I.I v// end ynp Y, YnnAn rv'n 1,t State of nlnnnantA - rant. ar kMe• on ttq: M da.- of Sept, ,t.n, 1472, 1••,fnrx Ian, n so", ruellc. wit J Pp 1,p noel l, pnlrp arm knhprt t, hvgor And W.ve.ea n, vpa .1VArt, she being, rprl : nl a- 4101, F afn IIf president and Snr.1,n tnrv or Few 1larlson Morph Inc., the rerPOr.ttan dep.d In the fnrpgnlep ineinl .11 "10 in laid iuetnlennt Ip tbn norpuralb .Al Bof $414 cnrporatlell . ^ and IW paid IoNtIol nt Von 1"'n .4 a") '.Tied In hPhfllf Or A65d f 117 t b t f 11 h ? e 4 i < y en t n 1,l o o oer o cOrpdre i all s ru"m and -aid HOW L. nnrAAr nhd Y'rtvP9 A, Vanderrnrt aeknnrlodgell UAW inatroment to he, the y .e RIY II I', r"" pit and 0..4 Of said pnrpn rarinn. N. rnanisslan I.'aplr 1 le In' ...Ni that 1 1". avs lpl+d Ado platted tic r urty Anerleed on [pia Mat A IInnnnKl r- plat 1, A [. e.t I", ... ot.lida It nand Al that p11 lint.PCAP are narreetly ahoia no anld 0; fear, then all n 4A Pn nnrMi pia A to the r[ IIpA ft? t ft% t A 10 n no /•I lint, th T IY np T ]Joel p TCC11S el j / n 71 s d_alrn I nn AAtd plat And and that 'here Are an etl A6 or p,blic I? ? q„tl CliJ? III AhP At'PIR t0 t de ll Rna}ad On aA74 MAt OtfiPT t11nn 89 phnM tePro pTOnn. 4111VB\Oi - lnnte0l, ?tat. of %lioneaola Cnuhty or Irennepln The sin"evdr'a rertiflaete 1011e1,rlbnd and Imorn m before re. A 9otan' rut And stern tMA LCdpv of 're", 4,11. "". . . oVl, GIla w•<.: ..?. r +.I... ?. ors pn nn 1,y 411 m, lennq ._ Yy rOnnteaian rnplr l Tots PI&L at TrMFRRhpnRF SFCnyn :1DDITIM VAR epprnved and Title Plat of TIMAIFPSIndIF eeeeptad by Ihp planning And main; Cpno lli(NI at F,nn, rtCCnptAd h, tha harm d1 e Alnnasatn At A rngulAr anetinq th,.".f hn!d ult._ji_ del AL rednier one td np Iner, m of A„?. n, n. lrna. 1?,Wn.16 w7z. z FIANN14i ANn IOYING CNg11 SWIM (IF M N, S11NNf^.!0't.1 Irmil n1, SPPF:IR'[$OPF, rill b.' 4? rhet tram IN r iaL IN4 C 60 fl a9t-?rl: ;;?a Thin pint was APPradAnI 0114 Accepted by ulp rlllmh ram]lsslannra or neknta Cnuntq, IlInn RRota, at e thief nnvnf_<'?. A,11, IQi a, Cmm rowir11S51nNphS, n.1r9TA rn1YT1' - _:,Slat rmRn 1 . ..'.,,.. -kKUiA C010dsY 64.82' GREG AND LISA HARNED 3697 DENMARK AVE. 82.17' SITE PLAN 651-488-9415 PROPERTY LINE EASEMENT LINE Jul 10 13 07:32a Gates General Contractors 7634387710 p.4 Use BLUE or BLACK Ink -------e---------- I For Office Use I Permit 9: Clay of Ea EaIl ~ Permit Fee: ~ 3830 Pilot Knob Road vi~ I Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: 1 1 I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: O / Site Address 3 3 ~3G 9 3(i -7 ~ Unit : Narne:_F1 ~'GJ~~ ~~y~ L 014 Phone: It 1y~0 7~~"/ / Z_ Resident/ Owner Address I City / Zip: Applicant is: Owner A/ Contractor Type of Work Description of work: 7 I G o.cp Construction Cost: Multi-Family Building: (YesNom Companyt:~;enT s rV C,ert Contact: L e- Addre-3-S2Py 9, 4✓ 57-1-' 949,0-S-~_Xcity: Contractor ,r State: A4,6~ Zip: T 7 -7 Phone: 72- 7>_l 5 License k Lead Certificate Z 3 f-~ l If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) qua COMPLETE THIS AREA ONLY 1 CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE-- Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets CALL BEFORE YOU DIG. Call Gopher State One Call at 651 4540002 for rot2gion against underground utility damage. Call 48 hours before you intend to dig to receive locales of underground utilities. : Tjv,,_oooherstateonecall or, 1 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 or authorized by a buildin permit issued in accordance with the Minnesota Building Code sl be completed within 180 day pe it issuance. / x )~j{/Gt/ tw rte/ x Applicant's Printed Name Applicant's Signatu Page 1 of 3