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3860 Dolomite Dr*My otEta! 3830 Pitot Knob Road Eagan MN 66122 Phone: (661) 676-6676 Fax: (851) 8768894 Use BLUE or BLACK Ink For Oplee Use ` n10 2013 RESIDENTIAL BUILDING PERMIT APPLICATION DMao: /4- 9 -r 4! Sts Address: 3 0 Nmr.o/sl, rr OR . Unit 0: Reeklattl Owner Name: % 4 /%l th3 >? b £ /$( j i - .� � cr Phone: 76 3 • £73 - 97 7 Address / City /Zip: :SO D is C47'CJ 2 4V. J J. .L A 4.046s..1 14t.LI Y /0.c) sr4/A7 Applicant is: Owner XContractor "We.•O(Wotzk, Description of work R C -RL 4 Ct /11 v L 7', PL L (Zha Construction Cost - Multi -Family Building: (Yes / No _J Contractor Company: {S £ 1 Ex- 7- Lei o !L /21 •r-- . 60-P. Contact b4v, Address: IIPS" L toil ¢, - city. PZ State: fYiA__ Zip: 55-'// g Phone: [o/ .Z • e & / - Co 2 V3 License* 4.3 5l/ / 3 / Lead Ceralicaba #: if the proles is exempt from lead certification, please explain why: (see Page 3 for additional information) X4.44)5_ Pas:. is7r 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 bawd on a master plan? Yee _No If yes, dads and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer dr Water Contractor: Phone: NOTE; Piens BEFORE YOU 9IG, CuaGopher State one Call at (851) 484-0002 for protection against underground utWly damage. Call 48 hours You intend to dig to receive locates of underground Mies. www oopher teoneoall.ort I hereby acknowledge that this information is complete and acuate; that the work will be in conformance with the ordinanCee and codes of the Cay of Eagan: that 1 undaratand this is nolo perms, but only an apprcapon for permit. and work is not to smart wit out a Dank: that the mirk 14411 be In accordance wan the approved plan In the case of work welch requin:a a review ane approval of plans. � Perna Issuance. by a building permit issued in accordance with the Minnesota State Build' Code must be completed within 180 A41."- 0 I2v2..Q./s Applicant's Printed Name ET/5O 39 d x Applicants Signature Page 1 of 1NIVW 1X3 I3E L9Z9I98ZI9 9T:bT btOZ/TT/b0 05/22/2009 11:05 6128616267 BEI EXTERIOR MAINT PAGE 03 City of Eaaau /-r t Permit Fee:, 6 3830 Pilot Knob Road a-- i Date Received: Eagan MN $5122 Phone: (651) 675-5675 I Staff: Q Fax: (651) 675-5694 i 2008 RESIDENTIAL BUILDING PERMIT APPLICATION .Date; 5`1/9 1D S Site Address: 3Q6G) - 3 6.7 - 3 3 ~G 6 / ` -IO' / ' Tenant: Suite RESIDENT I OWNER Name: ss W Phone: 7 3'- Vs' s7:77 Address / City / Zip: 7d Z2- .C,fS7 FuSlY _ fGI:4YJ Applicant is: Owner Contractor TYPE OF WORK Description of work: Ame VE ,14/D X&7m-c %a~?F Construction Cost: If/9 o r rd ' $°"c k / Multi-Family Building: (Yes X' / No CONTRACTOR Name- 6XTE7LIOI~ 1;M1/UT COIQ,P. License#: -70Dj339' Address, VUS~ W 60 XLZ&Z7 City; 21 /yA(C?r tu.tI State: RIv Zip: .x5'311 Phane; b!a - g 6 / ° 6'2q3 Contact Person: ()AVID_ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesata_Rul-es7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet _._4_ • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit fora 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 dt~durrr J is that ydu kiirlirrt,r# a la Co`ns,d#rad td bd'' ubtic inforrrlation., portions of. it the City to may e sifr d as i?on pttbl +C'rf yE rr'prowri~~ sp r~rfr eel ~brts that would perm ola the Information Mb orrcl~rde-ill'a#.th. re;tidda'sa re <<' I hereby adknowledge 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 Applicant's Printed Name ,l Applicant's Signature f.lC 0 P Page 1 of 3 CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECRI V ED FROM AMOUNT & DOLLARS 'a, ? CASH ? CHECK FOR C/ ' B Y White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You BUILDING PERMIT To be used for i CITY OF EAGAN 27" Pilot Knob Rood Eagan, MN 55122 PHONEt 05100 Receipt # PTT' Fef v.,iw 45, C±Oi? ri...e Site Address Lot Block Sec/Sub. Parcel # a Name W Address o Name t- u9 Address f- r'l- 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. 7o9 It 1? Enact Q Occupancy Alter ? Zoning Repair ? Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Length Grade ? Depth Sq. Ft. Approvals Fees Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total Signature of Permittee 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. Building Official No. Permiit Permit Holder Misc. Permit No. Holder Plumbing j j H.V.A.C. 2 ?? ?O Fatd hl C?? {? -1 2 - lr Well Water Disp. Sewer Electric Inspection Date Insp. Other Footings Foundation Framing eAM4 Rough Plbg. .l? y t Rough HVAC Awl/ Insulation Final Plb% s Final HVAC Final Water Describe Location: Well Sewer Pr. Div. BUILDING.PERMIT CITY OF EAGAN 37" Pilot Knob !Rood Eeyen, MN 55121 PHONE: 454-8100 I'7{ Est. value , l11^ Site Address Lot Block Sec/Sub. r Parcel # ce I Name Address - - $e Nome 223" u Address I ru.. o? --- Name - Address 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. Receipt # 1 '1 Erect '[3 Occupancy Alter ? Zoning Repair ? Fire Zone Enlarge p Type of Const. Move ? # Stories Demolish p Length Grade fl Depth Sa. Ft. Assessment Permit Water & Sew. Surcharge Police Plan check Fire SAC Eng. Water Conn. Planner Water Meter Council Road Unit Bldg Off. . APC Total Signature of Permittee I A Building Permit Is issued to: on the express condition Thar all work shall be done In accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Misc. Permit No. Holder Plumbing H.V.A.C. 4`43 FrE? `?k q-124z- well water DisP. Sewer Electric 1 Z (ti. 7 ?L(a S ? ? ` (L Inspection Date Insp. Other Footings Foundation Framing Rough Plbg. •Z'? L ?+ Rough HVA Insulation Final Plbg. Final HVAC .Z g yJ Final •?T• 0 Water Describe Location: Well Sewer Pr. Disp. CITY OF EAGAN `y 2705 Pilaf Knob Road Eagan, MH 55122 PHONE: 4544100 BUILDING PERMIT Receipt # To be used for Est. Value Date 19 Site Address Erect ? Occupancy Lot Block Sec/Sub. Alter ? Zoning Parcel # Repair ? Fire Zone Enlarge ? Type of Const. of Name Move ? # Stories = Address Demolish ? Length City Phone Grade ? Depth Sq. Ft. o 0 Nome - Approvals Fees u Address Assessment Permit U F- r... oL ___ Water & Sew. Surcharge Police Fire Eng. Planner Council I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC State of Minnesota Statutes and City of Eagan Ordinances. Plan check SAC Water Conn. Water Meter Road Unit Total Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in occordonce with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Mice. Permit No. Holder Plumbing ?{-zl 4z Well Water Disp. Sewer Electric b-)7;2,3-3 J1,V 4t qG- ? Inspection Date Insp. Other Footings Foundation i Framing Rough Plbg. ?Q% Rough HVA Insulation Final Plbg. •23' W Final HVAC • Z 8- Final . Z Water Describe Location: Well Sewer Pr. Disp. CITY OF EAGAN 3796 P1W Knob Read Eagan, MN SS122 ? ti PHONES 454-8100 BUILDING PERMIT Receipt # To 6• used fer Est. Value Date 19 Site Address Erect Cj Occupancy Lot Block Sec/Sub. Alter ? Zoning Parcel # i Repair ? Fire Zone Enlarge ? Type of Const. aa: Name Move ? # Stories Address Demolish ? b ra, tx.- Z 1 _; Grade ? 9 Name wpprovoss ~ Assessment _ Address CY Phone Water & Sew. G? W Police Nome F TO Fire Address Eng . <W city Phone Planner Councl I I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC - State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee Ft. Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Misc. Permit No. Holder Plumbing a`7 -l /Z ?KZ ?le ?1 ?"2?Z H.V.A.C. ? r [_eta r;c,cx, y -f2-.q z Well Water Disp. Sever Electric Inspection Date Insp. Other Footings Foundation Framing Rough Plbg. Rough HVA Insulation Final Plbg. Final HVAC + G /-d4 d Final Water Describe Location: Well Sourer Pr. Disp. . I CITY OF EAGAN M 18483 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 r PHONE: 454-8100 % BUILDI)VG EAMIT Receipt # y ; .i ' J To be used Ibr DECK Est. Value $1 , 000 Date OCT 25 19 90 Site Address 3866 DOLOMITE DR 25 1 Lot Block BRIAR HILL 3RD Sec/Sub. OFFICE USE ONLY Parcel No. Occupancy FEES Zoning W Name (Actual) Const - Bldg. Permit 25.00 R Address (Allowable) • 50 Surcharge City Phone x of Stories to, Plan Review Length o Name DAVID FEIC Depth City SAC o04 Address 8t7 E 51ST ST S.F.Total . u? City MPLS Phone 822-9221 S.F. Footprints SAC, MCWCC Water Conn F On Site Sewage w Name On Site Well Wat M te er e r zZ Address MWCC System <W City Phone City Water Acct. Deposit S/W P it PRV Required erm I hereby acknowlege that I have 4ad this application and state that the Booster Pump S/W Surcharge information is correct and agree -fo comply with,-eB applicable State of Minnesota Statutes and City of f;a gan Ordinances. Treatment PI Si t f P it - APPROVALS gna ure o erm ee Road Unit A Building Permit is issued to: DAVID FEIG 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 Building Official ? Variance TOTAL 56 Z S. Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plhg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. CITY OF EA GAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 `I 103i BUILDING PERI91IT. Receipt # To be used fofv; DECK Est. Value $1.000 Date OCT 25 19 3860 DDL0 DR Site Add( ss Lot ` BRIAR !TILL RD Block . Sec/Sub. OFFICE USE ONLY Parcel No. Occupancy FEES W Name Zoning (Actual) Const Bldg. Permit 25.00 3 Address IAltowable) h 50 o Surc arge • City Phone # of Stones 10' Plan Review Length o Name DAVID Ir'EIG Depth 10' SAC City 8? Address 817 E 51ST ST S.F. Total , U~ City MPLS Phone 822-9221 S.F. Footprints SAC, MCWCC Water Conn On Site Sewage W w Name On Site Well W t t M er a e er _a' Address MWCC System z 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 S/W Surcharge information is correct and agree -to comply with,all applicable State of Minnesota Statutes and City of EAgan Ordinancttic 74---- Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: DAVID FEW 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 Building Official Variance TOTAL 25 • Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings[ Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber EngrJPlan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date - 2. Installation Cost 3. Job Address, Lot Blk. 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 ? I 10. Describe Fuel Type 1 11. No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Air Handlin : Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other 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 : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt 3 MECHANICAL PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly 1. Date 2. Installation Cost 3. Job Address Lot Blk. 4. Owner 5. Contrac 6. Address 7. City _ Permit No. Fee S/C Tot. Tract =? I Phone State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 1 10. Describe 1 11. Type No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and 1 agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. - 1. Date - r, <- 2. Installation Cost 3. Job Address Lot Blk. 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 ? 1 10. Describe 11. Fuel Type No. Equipment BTU - M. Ea. Forced Air ' No. Equipment CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other 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 : - for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date - 2. Installation Cost 3. Job Address -_ Lot Bilk. Tract 4. Owner 5. Phone 6. Address - , 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? I 10. Describe Fuel Type 1 11. No. Equipment BTU - M. Ea. Forced Air - y' No. Equipment CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other 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: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 • ? uT -r -, PERMIT # Z7 6&K, MECHAAICAL PERMIT Ilk' RECEIPT # CITY OF EAG ,AN e O 3830 PILOT KNOB Rood, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION G Lot s Block SPC/S_db Res. ? New ` Mult. Add-on ? Name !471 A) COND Comm. Repair . Address Other c City Phone - .., L J' , FEES Name RES HVAC 0 100 M BTU . - -$24.00 3 Address ADDITIONAL 50 M BTU - 6.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS MINIMUM E P ( - 1 P R ERMIT) - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES Boil TOWNHOUSE & CONDOS - RES. RATE APPLIES er M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS _ -.12.00 Air Cond_! M BTU _ MINIMUM COMMERCIAL-FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent. CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # . BEYOND $1,000) FEE S/C: TOTAL- ff ) PERMIT # PLUMBING PERMIT RECEIPT # CITY OF EAGAN E - : 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DAT CONTRACT PRICE: PHONE: 454-8100 Site Address -S ) 6 7 /'' - BLDG. TYPE WORK DESCRIPTION Lot Z Block Sec/Sub 'n ' > Y ? Res. New S WATER CONDITIONING Must Add-on Ad?2 Excelsior Ave. E. Comm. Repair U) City inn o hone Other o 7;7 NO. FIXTURES TOTAL )'? r 1 c Name Water Closet - $3 00 $ Address . Bath Tubs - $3.00 p City Phone G Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00 MINIMUM - RESIDENTIAL FEE -$10.00 Floor Drains - $1.50 MINIMUM - COMM/IND FEE - 2000 Water Heater - $1.50 STATE SURCHARGE PER PERMIT - .50 Whirlpool - $3.00 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets - $1.50 BEYOND $1,000.00) =Softener - $5.00 well - $10 00 . Private Disp. - $10.00 Rough Openings - $1.50 SIG URtE OF PERMI E FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL PERMIT # PLUMBING PERMIT RECEIPT q CITY OF EAGAN .3 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PRICE: PHONE: 454-8100 ' LoJ Ire` Site Adore 706 'y Lot Block ? Ser/9ub Name ca Addres GD r ' F <" C City Phone Name O L < ` ' C Addres O City Phone" /' O - FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE -$12.00 MINIMUM - COMM/IND FEE -$20.00 STATE SURCHARGE PER PERMIT - .50 (ADD .50 S/C IF PERMIT PRICE GOES BEY N $1,000.00) SIGNATURE OF PERMITTEE CITY OF EAGAN BLDG. TYPE, WORK DESCRIPTION Res. f New Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1 50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 k (MINIMUM - 1 PER PERMIT) „Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: _ GRAND TOTAL J ' .?() Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. 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 11. No. Fixtures Water Closet No. Fixtures Cesspool /Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink 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 : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot. Blk. Tract 4. Owner 5. Contractor . , i Phone 6. Address 7. City State Zip 8. Building Type: Residential fft- Commercial O Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cess ool/Dr infield Bath tubs p a Se tic T nk Lavatory p a Softner Shower Well Kitchen Sink , Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink 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 : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly T ot. 1. Date c - G L 2. Installation Cost 3. Job Address Lot ? / BIk. Tract 4. Owner ?/ %? - i? 5. Contractor Phone 6. Address 7. City State "L Av Zip 8. Building Type: Residential $' Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool /Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink 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 : for - Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN J Fee fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor - ; ;, ? Phone - 6. Address 7. City State Zip 8. Building Type: Residential O Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool /Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink 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 : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 ,. E ADDRESS: i1 01141 11 061 PERMIT SUBTYPE: fiUI111fNH 0311,+11 AF 1-2A /q[i APPLICANT: TYPE OF WORK: I()INl. IN( r VAIk t INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. 0-vw. 7e. 1.r inFoR . 1HNV. I)UI !!PI I 1 I 1?Ir 1 VI- L Permit No. Permit Holder Date Telephone N 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 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date issued: (612) 681-4675 SITE ADDRESS: i wt1ow 1111k wo PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: "111I DIN++ 0'?v60rg 1NINf Iv6 CAV01 YN Al It 14A I ION ( [?A'? [ hSl; R T 14 1 I NF) INSPECTION TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR. Permit No. Pernik Holder Dab Telephone 8 ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPSOARD FIREPLACE 3`6.97 FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL - T r CITY OF EAGAN Remarks rr.! / f,yi j Z Addition PRIM HILL 3rd ADDITION ot 23 Rlk _ Owner 17I? ft' ,..?, 1 Street 3890 Dolo>site Drive Improvement Date mo Annual Years Payment Receipt Date STREET SURF. 10 L 1 1 el IQ=!C 2000 0110-2? STREET RESTOR. Z41 1975 P 8.0 10 1 • 11 A011272 7-19-82 GRADING 1982 24.61 5 98.44 11 11 Street Surf ^C 1982 600.76 120.15 5 480.61 " SAN SEW TRUNK 1968 33.61 1.12 O 16.81 SEWER LATERAL WATERMAIN WATER LATERAL 1971 36-81 1.84 20 14.73 WATER AREA 19 6T. 21 4.48 15 40.33 ** S /W Lat Stm Lit% 1982 1431.44 286.29 5 1145.16 STORM SEW TRK 7 1982 402.83 80.55 5 322.19 11 " STORM SEW LAT 1971 20 CURB & GUTTER SIDEWALK STREET LIGHT Road nit 185.00 #28869 2-16-82 WATER CONN. 335.00 " " OUILDING PER. 7089 SAC 1;21; Qf) PARK CITY OF EAGAN Addition BRIJU ? r Owner Remarks b L,? - Z ' HILL 3rd ADDITION Lot 2$ Blk 1 Parcel 10;Z4998-240-01 Street 3862 Dolomite Drive Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. (OZ 1971 Paid trade parcel 10 000 10-25 STREET RESTOR. 7 1975 0.27 .03 10 16.11 A011280 7-23-82 GRADING 1982 123.04 24.6 5 98.44 of " Street Surf 00 1982 600.76 1201.5 480.61 of " SAN SEW TRUNK 40 11968 33.1 1.12 30 16.81 it " SEWER LATERAL WATERMAIN WATER LATERAL JD7 1971 36.81 1.84 20 14.73 it " WATER AREA 4 1977 7.21 15 40.33 *'* S/W Lat Stm 1982 1431.44 286.29 5 1145.16 STORM SEW TRK 1982 402.73 80055 5 322.19 STORM SEW LAT 1971 20 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 185.00 #2R869 9-16-R9 WATER CONN. 335.00 BUILDING PER. 7090 SAC 525.00 n PARK CITY OF EAGAN Remarks f )- Z Addition BRIAR HILL 3rd ADDITION Lot 25 Rik 1 Parcel 10-14992-250-01 Owndr lief'_ i)! Street 3864 Dolomite Drive State Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, Ip2 1971 Paid under Parcel 10 000 1.0, 2 STREET RESTOR. L-11 I 80.27 8.03 10 16.11 A011307 8-3-82 GRADING 1982 123.04 24.61 5 98.44 Street Surf (g(??> 1982 600.76. 120.15 5 480.61 IT IT SAN SEW TRUNK -10 1968 33.61 1.12 30 16.81 " SEWER LATERAL WATERMAIN * WATER LATERAL 101 1971 36.81 1.84 20 14.73 A011307 8-3-82 WATER AREA 3 h ? 19TT 6T.21 14.48 1 40.33 ++ ++ ** S/W Lat Stm L( 1982 1431.44 286.29 5 1145.16 STORM SEW TRK 1982 402.73 80.55 5 322.19 e STORM SEW LAT 1971 20 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit lAr, f)() #78869 9-16-89 WATER CONN. 335.00 _ " it BUILDING PER. 7091 SAC 525-00 ++ ?+ PARK CITY OF EAGAN Addition ERM Owngr- Remarks Street 26--------B I k 1 Parcel Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1971 Paid und@ parcel 10-0 2000- )10-25 STREET R ESTOR. l 7 0. 7 3 8.09 A011773 1-3-83 GRADING 5 2 123 4 24.61 5 73.84 120.15 5 360.46 SAN SEW TRUNK CI 1968 33.61 1.12 30 15.69 SEWER LATERAL WATERMAIN WATER LATERAL Q 19 TI 36.81 1.84 12.89 A011773 1-3-83 WATER AREA 1 6T.21 4.48 19 35.85 it ri ** 05" 286:29 5 858.88 it " STORM SEW TRK 1989 402.73 80.55 5 241.65 STORM SEW LAT 19?I 20 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 185.00 #28869 2-16-82 WATER CONN. 335.00 +r 11 BUILDING PER. 7092 SAO 525.00 " " PARK CITY OF EAGAN WATER SERVICE. PERMIT 3795 Pilot Knob Rood PERMIT NO.: gon, MN $5122 DATE: Zoning: No. of Units: Owner: Address: Site Address: r Plumber: Meter No.: Connection Charge: - Size: Reader No.: 1 agree to comply with the City of Eagan Ordinances. By Date of Insp.: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: . (,Ilcfson inc Address: Site Add Plumber: 1 agree to comply with the City of Eagan Ordinances. By CITY OF EAGAN Paid: 3795 Pilot Knob Rood PERMIT NO.: (A Eagan, MN 55122 DATE: i Zoning: No. of Units: - lr t ?;r Owner:.. - Address: ?.c.. L" ', zi?r ?all I'T Site Address: Plumber: h Meter No.: arge: Connection C Size: Account Deposit: Reader No.: Permit Fee: f E Ci l i h h Surchar e: ty o agan y w e agree to comp t t g Ordinances. Misc. Charges: Total: 100.00 pd Connection Charge: Account Deposit: Permit Fee: Surcharge: 4 Misc. Charges: SEWER SERVICE PERMIT CITY OF EAGAN 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: L r Address: Site Address. 1.0:nite r!r T" 'riar z'ill 17 ? Plumber: agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Dote of Ins : Total: p. In Dote Paid: sp.: OF EAGAN WATER SERVICE PERMIT Pilot Knob Road PERMIT NO.: MN 55122 DATE: No. of Units: Address: -'olor?ite z ;,_ TT fiber: ?r No.: Connection Charge: Account De osit: p ler No.: Permit Fee: ee to eompy with the City of Eagan Surcharge- pnces• Misc. Charges: Total: Date Paid: of Insp.: Insp : . CITY Or EAGAN 3795 Pilot Knob Road Eagan, MN 55122 Zoning: Owner: °vr• '.,;c Address: Site Address: Plumber: I agree to comply with the City of Eagan Ordinances. SEWER SERVICE PERMIT PERMIT NO.: DATE: - No. of Units: Connection Charge: Account Deposit: _ Permit Fee: Surcharge: By Misc. Charges: - Date of Insp.: Total: Insp.: Dote Paid: 100.00 pd .ender No.: agree to Comply With the City of Eagan WATER SERVICE PERMIT PERMIT NO.: DATE: Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: _ Total: Date Paid: SEWER SERVICE PERMIT CITY OF EAGAN 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: F-t._ '?L'ivi: _ i Plumber: I agree to comply with the City of Eagan Ordinances. By Date of Insp.: Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: CITY OF EAGAN `' r 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 t'0 18483 BUILDING PE"RMIT PHONE: 454-8100 Receipt # 7p i,r?C? l i l/ U To be used for DECK Est. Value $1,000 Date OCT 25 . 19 90 Site Address 3864 DOLOMITE DR Lot 25 Block 1 Sec/Sub. BRIAR HILL 3RD Parcel No. Name W z 3.. Address City Phone ,o Name DAVID FF Address _ 817 E 51ST ST ¢ City MPI.S Phone R22-9221 r wW Name 13 Address aw City Phone I hereby acknowlege that I hav read this application and state that the information is correct and a to comply N-a cable State of Minnesota Statutes and City f agan Ordin ce . Signature of Permite A Building Permit is issued to: DAVID FEIG on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Occupancy Zoning (Actual) Const (Allowable) # of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off. Variance OFFICE USE ONLY FEES O Bldg. Permit 99-() O Surcharge .5 10, Plan Review 10, SAC. City - SAC, MCWCC Water Conn Water Meter Acct. Deposit SNd Permit SNd Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL 25.50 BUILDING PERMIT. To be used fpr DECK CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt # $1,000 199.Q Site Address 3860 DOLOMITE DR Lot 23 Block 1 See/Sub. HILL 3RD OFFICE USE ONLY Parcel No. Occupancy FEES Zoning _ W Name (Actual) Const Permit 25.00 Bldg 3 Address (Allowable) . _ S p rt Surcharge - City Phone # of Stories 10, Plan Review Length Name DAVID FEIG Depth 10! SAC Cit zR o Address 817 E 51ST ST S.F. Total . y ? City MPLS Phone 822-9221 S.F. Footprints SAC, MCWCC C W On Site Sewage ater onn ow Name On Site Well ?w Water Meter Address MWCC System aw City Phone City Water Acq. Deposit PRV Required S/W Permit I hereby acknowlege that I h read this applic n and state that the Booster Pump SiW Surcharge information is correct and a r to comply wit applicable State of Minnesota Statutes and City f agent OrdiRa Treatment PI Signature of Permit" APPROVALS Road Unit A Building Permit is issued to: DAVID FEIG Planner Park Dad. on the express condition that a ll work shall be done in accordance with all Council _. applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg, Off. Copies Building Official ( Variance TOTAL 25.50 N/2 18 1 ?10?? CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN $5122 PHONEt 454.8100 N° 7089 '- 'b BUILDING PERMIT Receipt To be used for 1 of 4 PIEX Est value $45,000 Date rebriaery 12, 198?9 . Site Address 3860 Dolomite Drive Erect XX Occupancy R-3 Briarhill 3rd 23 b k 1 S /S Alter (j (R-3) Zoning Pfd u . ec Bloc Lot NA 10 14992 230 01 Repair ? Fire Zone Parcel # Enlarge ? Type of Const. V W Name Tbllefson Builders Move ? # Stories z i 1655 NDTF700d Drive Demolish ? Lengthy ,_ Address cily M=n 55122 Phone 454-6873 Grade ? Depth 22 -Sq. Ft.- Name Owner 0? Address r n•.. Phone Name _ Address 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 Ordmonces. Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit 117111 22. Surcharge Plan check 130' SAC 525. Water Conn. 335. Water Meter 60. Road Unit 185. Total $1518.25 ` Signature of Pennittee ' on the express A Building Permit is issued to: r condition thin all work shall be done in accordance i all oppl' Stare of Minnesota Statutes and City of Eagan Ordinances. Building Official BUILDING PERMIT 4 00 N: 7090 Receipt * ' 2Yf69 3 R Site Address 3867 m101[Lfa Drive d Erect XX - Occupancy PD (R-3) i Z Briarhill 3r Lot 24 Black 1 Sec/ Alter ? ng on NA 10 14992 2440 0 Ol Repair E) Fire Zone - - V # Parcel Enlarge ? Type of Gonst. T1011RPson Builders Move ? * Stories o: Name i = Demolish ? length 44 ve 1655 P10Z4100d Dr 6 Address 454-6873 Grade E) Depth 22 Sq. Ft.- CI 55122 phone ? Approvals Fees owrex t 260.50 Permit Assessmen Address Ph Water 6 Sew. Surcharge k 130-25 h Pl one city Police ec an c SAC 525.00 Nome Z Eng. Water Conn. 319-(M- Add Addr Address Planner Water Meter 60.0n iW city Phone Road Unit 1$5 nn Council I hereby acknowledge that I have read this application and state that ree to comply with all applicab d a t In Bldg. Off. $1518.25 Total g an the information is correc State of Minnesota Statutes and City of Eagan Ordinances. APC Signature of Permittee A Building Permit is issued to: _ rrO11RfSOn Bui.lde on the express inances. Char all work shall be done in accordance with/bli opplicabll Sta Minnesota Statutes and City of Eagan Ordinances. Building Official ;14 CITY OF EAGAN 1795 Pilot Knob Rood Eagan, MN 55122 PHONE% 454-8100 CITY OF EAGAN 9793 Pilat Knob Road Eagan, MN 33122 PHONE: 434-8100 BUILDING PERMIT Receipt # N9 7091 FP rv 12 b 1982 To be used for 1 of 4 PLEX Est Value $45,000 Date nk , 'i ' N cu anc O R-3 M 1Rt,4 Mlrnnit-e TT Site Address ? -- Erect I p c y PD (R-3) Briarhill 3rd c/Sub k 1 S 25 Bl Alter ? Zoning e . oc Lot 01 Repair ? Fire Zone NA 10 14992 250 P l # V arce Enlarge ? Type of Const. Tollefson Builders Move ? # Stories rc z Name 1655 t`brwood T1riy Demolish ? Length 44 , Address _.. ? 551 ,),) 454-F873 Grade ? Depth 22 sq. Ft.- Name tlS rrer Assessment o uSa Address Water & Sew. Cit Phone Police Ww Name Fire Eng. x? Address City Phone Planner Council 1 hereby acknowledge that 1 have read this application and state that Bldg. Off. the information is correct and agree to comply with oil applicable APC State of Minnesota Statutes and City of Eagan Ordinances. Fees Permit - Surcharge 22-50 Plan check 130.25 SAC 525.00 Water Conn. 335, Water Meter 60.00 Road Unit 185-00 Total . S1S1 R-2S Signature of Permittee _ ' A Building Permit is issued to: Tol 1 afcnn on the express condition that all work shall be done in accordance J oil applicable State f M pesoto tatutes and City of Eagan Ordinances. Building Official ^ V J ` e-- CITY jF EAGAN N° 7092 5795 Pilot Knob Read Eagan, MN 55722 - • PHONE: 454.8100 ?3 0 ?J O BUILDING PERMIT Receipt # To be used for 1 of 4 PL>X Est. Value $45, 000 Date Fe bruary 12 19 82 Site Address 3866 Dolomite Drive Erect XR Occupancy R-3 Lot 26 Block 1 Sec/Sub. Briarhill 3rd Alter ? Zoning PD (R-3) Parcel # 10 14992 26n nl Repair ? Fire Zone NA Enlarge ? Type of Const. V w Name 'lbllefson Builders Move ? # Stories z Address 1655 N02:9 O Drive, Demolish ? Length _44_ CI ]La 55122 phone 454-6873 Grade ? Depth 29 Sq. Ft.- Approvals Fees °oC Name Owner Ou Address Assessment Permit 260.50 ?? Water 8 Sew. Surcharge 22.50 City Phone Police Plan check 31 0.25 Wes Name Fire SAC 525.00 xZ Address Eng. Water Conn. 335_nn Phone iW cit Planner Water Meter 60...0-0- y Council Road Unit 1 RS nn I hereby acknowledge that 1 have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total M Sl R _ 2S State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: M-111PfROn $uy1 R on the express condition that all work sholl be done in accordance wi II applies Stdtte Minnesota Statutes and City of Eagan Ordinances. Official Jet, 1 et.n Buildin Cf7 i? g n????vr?rn1 W APR 1 6 2008 U ----------------- ffice tJ(se? / _ I j .#: n U! l? j Permit I Permit Fee: 13c)• i- I I I Date Received: -y r j Staff: I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Tenant: Site Address: 412'.91Z Ny G L in <., ,,; boa,. C Suite #: RESIDENT/OWNER Name: 0/0 Asse a, w--, j F ,v Jc,,i i,Lr unvc c -Phone: -7 L3-Y9 v- 377- Address/City/Zip: 38641 60L-0. r'r'L 6R, Applicant is: Owner X Contractor TYPE OF WORK Description of work: fL £ - fE v i e , A E e Construction Cost: N? U J Multi-Family Building: (Yes X / No CONTRACTOR Name: Q f / £x r z z/ 0 P 199A 1,4 r. C-2 P. License #: ZC R q11 3 1 Address: i" - & c ?c S; ,, City: M P L S' State: /))a Zip: S .S 411 5 Phone: 45it-8u?' 4,X V3 Contact Person: D:??t uRr1rS COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 _ Energy Code . Residential Ventilation Category i Worksheet New Energy Code Worksheet Category Submitted Submitted (4 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 documents that you submit are considered to be public information., Portions of the information may be classified as non=public if you provide spectric reasons that would permit the City to 'conclude that they are tmde.secrets:. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and wor! is not to sta out a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approv of p ans. x btgu/ ?u/L,2{S x- Applicant's Printed Name Applicant's Signature Page 1 of 3 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 - Multi ? 01 of-Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? 08-plex ® Deck ? Porch (screen/gazebo/pergola) ? 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 Bui lding ? Reroof ? Demolish Interior ? Alteration ? Fire Repair ? Windows ? Demolish Foundation t0> Replacement ? Egress Window ? Water Damage Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation 3/ooo • - Occupancy yTLL - MCES System Plan Review Code Edition -29°, SAC Units (25%_ 100% Zoning City Water Census Code L4 3L4 Stories Booster Pump # of Units Square Feet PRV # of Buildings Length l? Fire Sprinklers Type of Const. Width / a 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 -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick _ Fireplace:_R.I. _AirTest -Final Windows Insulation Retaining Wall Reviewed By: Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies - z Total Page 2 of 3 F. C. JACKSON LAND SURVEYOR REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MIMN[APOLIS 9616 EAST 55TH STREET 55417 7 -34 Ourbtper'm? !Certificate or . 1 t 2•40 :x,3_71 ooc.a Exrs/,tea ?/r`v. T ,''/N d _ N N moo, r . 3 i. \t v . Pr»jseci Crr-se Fli.,r Llev. tU_.n . Fr D,se:3 Easerarra F1?ar ilr., ifi3. Yr:;,_>:cd Flr?+E F:t?:,r Eiev. 1L', „ I HEREBY CERTIFY THAT THE ABOVE IS A TRUE AND CORRECT PLAT OF A SURVEY OF briar, :iiil 3rd. :.dd>.tiaa, Dakota Count.,Minnesz)ta. ' 4tn. FeLruary As SURVEYED BY ME THIS -DAY OF--- 3 EAGAN REVIEWED alf. DATE, / ! /. / l?U BUILDING INSPECTIONS DIVISION 19d2 F. C. JA F. C. JACKSON. MIMM? REGISTRATION. NO. 1600 70 0 °( CITY OF FAGkN TO Be Used For -Z/- Site Addxmws?'/vO??fG ?a3,/IA asa Block Parei'f: IG Sec./Sub. A :2 30 0 Owner: ?d ® asn 1rr7 Address: 14e CLty/Zip code:'-fix S'1 J ?/ _ j a Phone is i?5 - E 8 7 3 Contractor: i Address: City/Zip Code: Phone Arrh./Eng.. Address: • City/zip Code: Phcne #: Include 2 sets of plans, 1 site plan w/elevations 6 BUnDING PE 4 T APPLICATION 1 set of energy calculations. _ valuations o°t7 pate 5y?oG OFFICE [IC, rWrV - Erect a Occupancy I Alter -- -c -- Zoning Aepair Fire Zone Enlarge _ Type of Const. Move N Stories De olist' i _ Front FE. Grade Depth ft. APPFC VALE Egs Assessments Pemit :7 Water/Sewer surcharge as sl Police Plan Check /30 Fire SAC 5aS °' Eng. Water Conn. 3 3,5- 0 Planner Water Meter Council Poad Unit ?53T Bldg. Off. APC TOPAZ 1si? 8` T?jtleteDn ::uiltle.rs Inc. F. C. JACKSON LAND SURVEYOR RSOISTERED UNDER LAWS OF STATE OF MIMNSSOTA LICENSED !Y ORDINANCE OF CCTV OF YINNSAFOLIB i F ?2e hN Yro,ose, Car46v F1 7.,,r Liev. 1t 0 . ProrasL { bas •mtii t FI7,o .:lc•., a 3.2? ??? ,?„ ?r• PT o,,osca First F1 »r 1.lav. 11t, i7 • t' T;- N d %hN f ,? ?. hry. 0 or. 11290 1i 3-7 1 YYY 9616 EAST 86TH STREET 35417 72 '-34H' • 1"?nvi ?_` .?`_. ?urbcp6r'sf ?ertituate ooc,o . Exlsf.+g ,??ev. a 7P2.0_j I HERESY CERTIFY THAT THE ABOVE 16 A TRUE AND OORRECT PLAT OF A SURVEY OF L,t a: 23 ;,25 a::.i 2i ,1'11 ac briar Hill 3rd. Add itian, Dakota Count,Hinnesot*. 4tn. February 1982 AS sueve o BY NS THIS____..-_-_ _-DAY OF___- A.D. r SIONE - F. C. JACKSON. Me"N O REGISTRATION. NO, .81100 r . 17 r gyp' r CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: BUILDING Permit Number: 031941 Date Issued: 05/20/98 SITE ADDRESS: P.S.N.: 10-14992-230-01 DESCRIPTION: ff - " 4 a&9' Y n REMAMgbDES: FEE SUMMARY: Base Fee Surcharge Total Fee 3862, 3864, 3866 DOLOMITE DRIVE L24 L25 L26 3860 DOLOMITE DR LOT: 23 BLOCK: 1 BRIAR HILL 3RD SIDING & SHUTTERS Permit Type MULTI. (MISC.) irk Type REPAIR de''sl. 434 ALT. RESIDENTIAL VALUATION $22,000 $312.25 $11.00 $323.25 CWT Wl TWi S. SIDING INCly12816363 000$077 B MR- ILL ASSOCIATION 11 P 0 BOX 5937 3800 HEATHER DR RO{CHESTER MN 55903 EAGAN MN 55122 (642) 281-6363 (612)683-9659 APPLICANT/PERMITEE SIGNATURE PERMIT COQ ISSUED B S NATURE ?- ?lil I;': rv!•I,l iln l CITY UP EARM i I ... 05/20/90 1 JiC:: 10 PRIO 9001 987A UGLOMTTE 1) 274,75 2155 00 76 111 MITY ft .... AM 900i 1859 OOLOMITE 1) W.2!-- MY 901 i STAN pohomITE 0 9.&0 9P r I i t u ma .f.. l l' I m. ': r Ki .. .., . W ; .. H I "q 1 wk, j °: ?1'9!•I ?."ill[; .:1 ' .,i. :i .1, i{{Icl'I t1'; „ ,. ; I II ? 1..: ?? .r ,. . I.L., ,?';-.? i_ I .Ili. it'. L'•,I 3 ( GU 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) 3a3 a`S? / CITY OF ZAOAN 3830 PILOT KNOB RD - 55122 681-4675 New Construction Requirements Remodel/Repair Requirements ? 3 registered site surveys ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? I energy calculations ? 3 copies of tree preservation plan If lot platted after 711/93 required: _ Yes _ No d DATE: /X-3D -QJ ? 2 copies of plan ? 2 she surveys (exterior additions & decks) ? 1 energy calculations for heated additions CONSTRUCTION COST; DESCRIPTION OF WORK: _ ;&/; f. v STREET ADDRESS: 36'60 - 3e6'Z V - rc /ta y caY "a . Q?? ??-3 -Z J LOT: BLOCK: / SUBD./P.I.D. M /a Name: Phone #: l0/? - lor?3" ?6s1? PROPERTY Last First OWNER Street Address: 9a7,eV`- ; rLe- !, lfin State: 1)1 !lJ Zip: SS/Z ? City 10-a! 61 Company: L/dns !.tBCa7S 1,7 Phone #: 507-, W/-636-7 CONTRACTOR Street Address: .O. 13ok 553 7 License # D 7S ?O 77 city KocAeSA State: MA ) Zip: 5.5963 ARCHITECT/ ENGINEER Phone #: Name: Registration #: Street City State: Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. Zip: Penalty applies when address Chang I hereby acknowledge that I have read this application and state that the Information is rtact and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN 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.) I SET OF SPECIFICATIONS I 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. /? "'P?' ? " ??xi S "N T B U d F D -/'70 ) o e se or: Valuat ate: ion: S /o/ Site Address -3YK0 p/BL c,-,17,' 11f OFFICE USE ONLY o00 3 Lot ? Block I FEES Occupancy R,Asp, u 3Rp Parcel/Sub lil?L Ai)gjN Zoning Actual Const .°?:oD Bldg. Permit z_ Allowable Surcharge 45J Owner # of stories Plan Review Length 10 SAC, City Address Depth /o SAC, MWCC S.F. Total Water Conn City/Zip Code Footprint S.F. Water Meter Acct. Deposit Phone On site sewage- S/W Permit On site well S/W Surcharge Contractor Q?u: ti ziG- MWCC System _ Treatment Pl. City water Road Unit Address PRV Park Ded. Booster Pump Copies City/Zip Code 47 /?'4j Zo w _ SUBTOTAL APPROVALS Penalty Phone Planner TOTAL •S.5" Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # 'CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: BUILDING Permit Number: 0 2 9 0 0 8 Date Issued: 10/07/96 SITE ADDRESS: P.I.N.: 10-14992-250-01 3864 DOLOMITE OR LOT: 25 BLOCK: 1 BRIAR HILL 3RD DESCRIPTION: (GAS INSERT & Biaz,lding Permit Type Building Wprk Type -Census Code` „ 434 e" LINE) FIREPLACE ALTERATION ALT. RESIDENTIAL REMARKS: FEE SUMMARY., Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: .C ????RR -- MpplXQOFI . - OSUN-1TS1'120M CAROLYN 3864 DOLOMITE DR EAGAN MN 55122-1617 (612)686-6213 I hereby acknowledge that I have read this application and state tha-t the information is correct and agree to comply,w•ith,all applicable -State of M:n. Statutes and City-of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE ISSUED BY: SIGNATURE 1'. ll . CITY fO ,`;AE.,NJ •..•.;.;:, .I::.Ra ..-: TERMINAL NOs 35() DATEN 10/08/96 TIME; 004231. [P p„• ... •. L:e114:;:?A,. Y7d f{ . r.J FJjI!3?1 f•'f ;r5 TWO 9001 3864 DOLOMITE D R5.00 n%sniq WEP TD, NANCY ,tq 006 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 FIREPLACE PERMIT APPLICATION 681-4675 DATE: /0 - 7- Z? DESCRIPTION OF WORK: CONSTRUCT NEW FIREPLACE: WOOD BURNING GAS INSTALL GAS INSERT ONLY IN EXISTING FIREPLACE _ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE _ OTHER: ROOM TO BE INSTALLED IN: / y mn y Qgqa? - Lng) r? - 11FL STREETADDRESS: l-2o?m/n5 J),g. 9 pp LOT ? BLOCK SUBD./P.I.D. #: ILL k P?, _ l P?j APPLICANT: (circle one only) OWNER CONTRACTOR 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. PROPERTY Name: u/ OWNER Signature: Street Address: FIREPLACE INSTALLER City: Fa,,,,,4n/ Company: Signature: _ Street Address: City: GAS LINE Company: INSTALLER Name: Signature: _ Street Address: City: State: Phone #: License #: Zip: Phone #: Phone #: ?- L - /, 2/S State: RN Zip: .567/Z2--/L7 State: Zip: 4t IS Y83 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN 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. lrc2- ??'G? To Be Used For: Valuation: 44 Date: ?? 9U Site Address )j/uyr, Lot Block Parcel/Sub _1 1KI"t A 1 / I LL 51 D A'bn- , Owner Address City/Zip Code Phone Contractor /)X o//) Address '5?71 -) l S S %Z City/Zip Code 0 Phone 'K2 2- 9 z z i Arch./Engr. Address City/Zip Code pc?o OFFICE USE ONLY l FEES Occupancy Zoning Actual Const Bldg. Permit ZS,o? Allowable Surcharge # of stories Plan Review Length SAC, City Depth lo` SAC, MWCC S.F. Total Water Conn Footprint S.F. Water Meter Acct. Deposit On site sewage- S/W Permit On site well S/W Surcharge MWCC System Treatment Pl. City water Road Unit PRV Park Ded. Booster Pump - Copies SUBTOTAL APPROVALS Penalty Planner TOTAL ?S,Sb Council Bldg. Off Variance Phone # f -- ----_---_- i I For?Office. t!$g ////,?,, .Permit#: Permit Fee: 130, d I ? I Date Received: Oto "01b I ?? I I Staff: I I ------------------ RESIDENTIAL BUILDING PERMIT APPLICATION C -0rl Date: Site Address: 42, /1 /Z f? « T w b. e S C f? 1 1 Tenant: Suite #: RESIDENT / OWNER 7 Name: e/b 04550 c w- , f f,f Oc ,3 L i044„6z z - Phone: 74-1 -Y1 v- s 7 ,7 Address / City / Zip: 3 IF &- 7- ?) a L n? i' T L Q R, Applicant is: _ Owner X Contractor TYPE OF WORK Description of work: £- r L , 6t c Construction Cost: 7 /?? • 6 o Multi-Family Building: (Yes X / No CONTRACTOR Name: 13 £ / E'x rc2i o 2 lrlp;„r r. Gc2 P. License #: 1C Z y// 3 1 Address: i/°-t" LJ. (cc City: /7y PL 5, State: m,? Zip: SS,// Phone: 6,iR-F6 62 V3 Contact Person: I?.w?L ?c'/I ?ZrS 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 (d 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 documents that you submit are considered to'be public information. Portions of; the information may be classified as'non-public f you provide spec ?c`reasons that would permit the City,o " conclude that they are trade secrets.: I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of work will be in d t a permit; that the Eagan: that I understand this is not a permit, but only an application for a permit, rw: accordance with the approved plan in the case of work which requires a review and apxtr9UID n3a&J2iS X Applicant's Printed Name Applicants Signature Page 1 of 3 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. - Multi ? olof - Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? 08-plex FP Deck ? Porch (screen/gazebo/pergola) ? 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 91 Replacement ? Egress Window ? Water Damage Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation J?-, a aa, -- Occupancy MCES System Plan Review Code Edition AAA SAC Units (25%_ 100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Const. Width REQUIRED INSPECTIONS Footings (new bldg) Sheetrock Footings (deck) Final/C.O. _ Footings (addition) )d Final/No C.O. _ Foundation HVAC Drain Tile Other: _ _ Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: _R.I. _A irTest -Final Windows Insulation Retaining Wall Reviewed By: 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 Page 2 of 3 ? l "M. I I ? u'_ . VT. 1 t t:f , 1:3-71 F. C. JACKSON LAND SURVEYOR REGISTERED UNDER LAWS OF STATE OR MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIa P ////// 8618 EAST 55TH STREET 55417 cC fHUrbcpor'g Certificate ooc.o , Ex/ fra 'elf V. JI ? 14 1 i :. `Y?iN ,ty N y //NN ,,t?YNN 1 0. , l I 'a Jr ' r Yrz:,ose.! Gcr. 6e }lo.,r Liev lu3.n , YrD e.d Ease scut Fi?ar i lr:, r+. 3. Y7:%Jf E,a F1 r8t ?I JJT 1.1Ct'. 11t'. 1 HEREBY CERTIFY THAT THE ABOVE IB A TRUE AND CORRECT PLAT OF A SURVEY OF L: 231_S R::,1 2t ,11:,',k 1, briar hill 3rd. Addition, Dakota Czt:int,,Yinnes?ta. 401. February 19d2 AS SURVEYED MY ME THIS--------- -DAY OF-----A.D. Rap F. C. JACKSON. m c r i Z q V\ 0? No. 2600 *City oisaaau 3630 Pilot Knob Road Eagan MN 55122 Phone; (651) 6754675 Fax: (651) 67515694 Use BLUE or BLACK Ink R For OMee Use Parma • • 1 1 ic8(a Permit Fes: c' � as Date Received: I / / y 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: - /� S- J V , Site Address: 3 iff 4'Q 1 U6 v Inca Qo co w 7 AL. unit #: Typm lVgt'k Cantractor Name: o c A t' 7- M A ".3 A 4 Z /tit Address, City 1 Zip: 'SO Ib e- a 4 ' ' Q 19v ,!) Applicant is: Owner Contractor Phony 74 5-S3 - ' z,q Iziaz,1 V44 m. s $Th'27 Description of work: -7-5A-4 ■fi iN QE - 14v0� � Construction Cost , /) 90 0 Multi- Family Building: (Yes X / No __) Company: CIE / Etc r Ede ioR /1147....1-;-. contact krAi.i d ilo,0 ZR r 5 Address: V o s 1.3 61,13 h . C *,: m PL. $ State: // 9 Phone: r6,-- G X q3 License #: I C .j Y11 s / Lead Certificate #: If the project is exempt *cm lead certification, please explain why: (see Page 3 for additional information) Q:4_l�s i.JEQE- 7- Po.s. J 97 COMPLETE THIS AREA ONLY IF CONSTRUCTING A JEW BUILDING In the last 12 months, has the City of Eagan issued a permit fora similar plan based on a master pan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: �Wr "" 57:41 � �.4i3 "`t."1tk. '>°t{f�AZ'�- r'?►'}�Y•,..r, ,n�' " • PALL aEFORe YQu DIG. call Gophsrstate One Call at (651) 4644o02 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities. aww.cooke starteunecalkorrt hereby ad t this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; with understand v. permit but only an application for a permit, and work is not to start without a perms that the work win be in approved plan In the case of wont welch requires a review and approval claims. Exterior work authorized by a building permit issued In accordance with the Minnesota State Sanding Code must be completed within 180 days of permit issuance. x bow r p g v 22 rS Applicant" s printed Name 80/80 39 d 1NItiW 1x3 I3$ `77r Applicant's Signature Page 1 of 3 L9Z9I98ZI9 LO:OT PTOZ /80/T0 dily of Eaaall 3830 Pilot Knob Road Eagan MN 56122 Phone: (661) 675-5675 Fax: (651) 676.6684 RECEIVED MAR 2 8 2O1b Use BLUE or BLACK ink 1 For Mee Use Pernik a: 1'' Permit Fee: Dote Received: 3 / a 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Data; 3 -II- `/ Site Address: 'IA D 3704, 3 - Md-rE DL- units: Reeiidentl Owner Name: eh. 4e /1i41...S 4 bZ14 L.41 -A-% c. Address / City / Zip: :so 1st C icru Q til✓, sJ , Applicant is: Owner Contractor J Phone: 763 - s ,' 1-- 9 7 740 Type •ot:WOric Contractor Description of work: £d...0 a` 1 Pt..f-c.L. S 6 a i-4-40 a /Yl &, 4 l - Construction Cost: / y< V tr0 Multi -Family Building: (Yes c / No Company: a E ? 0 2 Mlit7 1-1-r . Cn aA contact _DA '1' t3 Q1,' S Address: 4/P -S, 100 /:6' 1. city: /7/ pL S State: /410 Zip: SS's,// rj Phone: lv/ A • g to /- eo 21/3 License #: L 2 Y/ / 3 / Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 1�t•l,los- QuIL," Pos 11-71r COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BOLDING In the last 12 months. has the City of Eagan issued a permit fora similar plan based on a matter plan? _Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor. Phone: NOTE;Plans and , 'rOrta%d',iF _ . > class**, tan r�a lrhw at 0010! CAIS BEFORE YOU DIG. Call Gopher Stats One Call at (661) 454-0002 for protection against underground utility damage. CaU 48 hours before you Intend to dig to receive bcatee of underground utilities. www_aoohetstateonecall.onI 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 umdarsaand this is not permit, but only an application for a permit. and work is net to start without a permit: Mat the Mark be in accordance with the approved plan In the rase of work which requiros a review and approval of plans. Exterior work authorized by a bullding permit issued in actiordance with the Minnesota State Building Code must be completed within 180 daysofpermit ieauanca. x 4" Applicant's Printed Name VO/TO 39vd Applicant's Signature Page 1 of 3 1NIVW 1X3 I3S L9Z9T98ZT9 00:60 t'TOZ/8Z/E0 Use = or BLACK Ink � r.���__�__.._�.�����_�' ( For Office Use � I Q ( �� v ��� �` � Permit#: � `��� a���� , �� � � Permit Fee:��O� I I 3$30 Pilot Knob Road -_ `� ` � �i ��jr � Eagan MN 55122 �'�� ' � Date Received: � /I I Phone: (651)675-5675 � � i Staff: , : I Fax: (651)675-5694 �--------- ------� 2014 RESlDENTU4L PLUMBING PERMtT APPLICA►Tl�N Date:�d"Z7����� Site Address:���� �JO lo�,,,, � �/'`I t�`e Tenant: Suite#: �Name: /` Phone: '7s a �� ��q�! ResidenUOwner Address/City/Zip: 3 d O /ti. � t Name: License#: � Contractor Address: City: State: Zip: PMone: Contact: Email: Type O�WOI'k —New _,Reptacement _Repair _Rebuild �Modify Space �Work in R.O.W. Description of work: w — ! RESIDENTIAL � Water Heater � Lawn Irrigation�RPZ/_PVB) Water Softener Pet'Ittit Type � �Add plumbing Fixtures(_„Main/_Lower Level) Septic Systern � � _New � Water 7umaround Abandonment f RESIDENTIAL FEES: �60.OU Water Heater,Water Softener, or Water Heater and 5oftener(indudes$5.0o State Surcharge) $60.00 Lawn Irrigatian{includes$5.00 mi�imum State Surcharge) $60.00 Add Plumbing Fi7ttures,Septic System Abandonment,Water Tumaround"(includes$5.00 State Surcharge) �Water Tumaround(add$2Q0.00 if a 518"meter is required) �115.00 Septic System New($10.00 per as built}(indudes County fee and$5.00 State Surchargej TOTAL FEES$ CALL BEFURE YOU DIG. Call Gopher State One CaN at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend#o dig to receive locates of underground utilities.www.c,�opherstateonecall.org I hereby acknowledge that this irfformation 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 applic:atian 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 �.�«�nl�r , , r�-� X�..��-�,�-��,�-� �s--_ ApplicanYs rinted Na e Ap�n s Si ' ature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-ln Air Test ; Gas 7est Final ' Meter Related Items: Meter Size Radio Read Staff: Use BLUE or BLACK Ink � � � r�----------------� I For Office Use I � � Permit#: /�����J � City of ����� � �.,j fr x,� ; �- � � ���,.. � Permit Fee: I 3830 Pilot Knob Road ,� PRhr-. Eagan MN 55122 ��� L � o;�. 4 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: � � ----��,1-' 2014 RESIDENTIAL BUILDING PERMIT APPLICATION ����� / ./�., �� Date: L(� °`�-2.�(�{' Site Address: �r( Q1 J��'T� �� �a c�y1 /�/.551 Z�. Unit#: Name: C�rt���t�� �.��-l''l�- Phone: -I-S� �15� �%Z j Residentl /�� Owner. . ` Address/City/Zip: ���Q �����Mp i,I� D,/ � �. , �. ': Applicant is: �Owner Contractor �� � � ��� Descriptionofwork: �'�tP�'iG,� ��?�UC".��� � }�f��G�,�,�� Type of�Work � � Construction Cost: Multi-Family Building: (Yes� /No_) : Company: Contact: C011tl'1CtOC ;` Address: City: .' State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) .Z3a/��"/�% �'� 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: NOTE:.Plans and supporting documents that you submit are considered fo be public'information. !Portions of fhe 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.qopherstateonecall.ora 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 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. X l.r�;''i�f1�?ht!fr ��11� X � ��r(/ ApplicanYs rinted Name ApplicanYs Si nature Page 1 of 3 ���G' ,��-�Yr,� 1��� DO NOT WRITE BELOW THIS LINE � ����� SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) _ Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) Multi Deck Porch (Screen/GazebolPergola) Miscellaneous � 01 of�Plex _ Lower Level _ Pool _ 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 3a� � Occupancy �� MCES System — Plan Review Code Edition ` C��. SAC Units — (25%_100% 1/ ) Zoning �i� City Water Census Code l/:�Y Stories Booster Pump -- #of Units 1 Square Feet PRV — #of Buildings � Length -- Fire Sprinklers --- Type of Construction � Width __-- REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) � Final/ No C.O. Required Foundation � HVAC_Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick � Insulation Windows Sheathing Retaining Wall: _Footings_ Backfill_Final � Sheetrock Radon Control � Fire Walls Erosion Control Braced Walls Other: Reviewed By: , Building Inspector RESIDENTIAL FEES // � j�/ � `gl ' �, ��iC/a;Z.2 'i ���� ���G� Base Fee g$ �- Surcharge Plan Review �7 �,�- MCES SAC City SAC Utility Connection Charge S&W Permit& Surcha�ge Treatment Plant Copies TOTAL Page 2 of 3