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3876 Dolomite Dr41111 City of Eap Data: 3830 P11ot Knob Road Eagan MN d8122 Phone: (651) 6756875 Fax: (651) 6754694 Use BLUE or BLACK Ink For oMlos use Penni*: Permit Fee: i ` t 5 Date Received: Lf [4) 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: 3 8') 49 t6'1.°141, rE OR . Unit 8: Reildent/ Owner Name: % 46 4 6 i IK a .v i -.4774" C. Phone: 74,3 - S7 3, — 9 7 7 0 Address / City / Zip: SSo 414-r u R Ay, ,AJ 1./, y /0.4) SS' la 7 Applicant is: Owner ,Contractor TYPO ofwork, Contractor Description of work: I F. -PL r4 C t'.. rr Pc tr LJi,J �c Construction Cost - _ Multi -Family Building: (Yee / No Company: Le- 0 2 /n4-1 Arr. . Co alt Contact bow, a a.r2ai S Address: /o s' w took 17% city: m P4. S sass: IIA Zp: sr /, q prone: lo/ z • X 411- 6021,3 License 8: 'r3 C- 2 V/ / 3 / Lead Certificate if: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) qt -44.s- Q,?itY Post✓ )77r COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUIO In the last 12 months, has tris Cite of Eagan issued a permit for a stiller plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Atlechanicai Contractor: Sewer A Water Contactor. itfbnmitlort:* lief a Phone: Phone: CAj Ly8EFORg 110u DDIIQre alb � Slate One Can at (6611454-0002 for protection against underground utitho damage. Call 48 hours bbeeffoorea Intend dig underground utilities. yeww,goehersmtesriAcau.orsl I hereby acknowledge that the irdormalion Is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan: that 1 undantand this is net permit. but only en application for a permit. and work is not to rated without a permit: tttat the work Rini be in accordance Mtn the approved plan In the twee of work waft requires a review end approval or plans. exterior watt[ authorized by a building permit issued In accordance with the Mlnnasota State completed Builds Code must be within 180 daps of permit issuance,^g- t x �riyr 4 /av12-r2./S Applicant'® Printed Nam ET/TT 39 d Applicant's Slgnsturs Page 1of3 1NItiW 1X3 I38 L9Z9T98Zt9 9T:17T VTOZ/TT/V0 CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N8 6737 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # To W and for 1 of 4 PLEX Est. Value $45,000 Dote Jime 22 19_RL Site Address 3880 Dolomite Drive Erect 2 Occupancy Lot 33 Black 1 Set/Sub. Briarhill 3rd Alter ? Zoning Parcel # 10 14990 330 01 Repair ? Fire Zone _ Enlarge ? Type of Const. V - w Name TollefBon Builders Move ? # Stories 3 nt 44 ft. Address 13816 Holyoke Lne Demolish ? Fro ° City Apple Valley Phone 454-6873 Grade ? Depth 22 ft. Nome Owner Approvals fees 0 Address Name _ Address I hereby acknowledge that I hove 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 Permittee A Building Permit is issued to: Tollefann &AIAe all work shall be done in accordance with all oppli cp1? State of Building Official r1--d" -` Assessment - Water & Sew. Police Fire Eng. Planner - Council - Bldg. Off. APC Permit '` Wsw" Surcharge 22.50 Plan check SAC 525.00 Water Conn. 335. Water Meter 60.00 Road Unit 185.00 Total 41319.50 an the express condition that and City of Eagan Ordinances. CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 N2 6738 BUILDING PERMIT APPLICATION Receipt # c.2'iC To be u{ed for l oP 4 P •F.X Est. Value $45.000 Date June 22 , 19-41- Site Address 3984 Dolomite Drive Erect IN Occupancy H3 Lot 34 Block 1 Sec/Sub. Brlarhill 3rd Alter ? Zoning R 3 Parcel # 10 14990 340 Ol Repair ? Fire Zone NA Enlarge ? Type of Const. V W Name Tollefson Builders Move ? # Stories w 3 Address-1 16 H lynk Tana Demolish ? Front 4t4 ft. ° C; Apple Valley Phone 4544873 Grade ? Depth 22 ft. rc Name _ - Approvals Fees a uU Address 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. Signature of Permittee A Building Permit is issued to: TOl all work shall be done in acct, f/?r th all Building Official 1?t--gip Assessment Water $ Sew Police - Fire Eng. Planner - Council Bldg. Off. - APC Permit i...,'..., Surcharge 22.50 Plan check 64.00 SAC 525.00 Water Conn. 335 Water Meter 60.00 Road Unit 185.00 Total $1319.50 ra an the express condition that Minnesota Statutes and City of Eagan Ordinances. CITY OF EAGAN 3795 Pilot Knob Read Eagan, MN $5121 PHONE: 454-8100 BUILD114G PERMIT APPLICATION N9 6736 Receipt # C-_-2S,3?Z To-be used for 1 of 4 PLEX Est. Value $4 5.000 Date dttnp 22 191_ Site Address 3878 Dolomite Drive _ Erect ® Occupancy R3 Lot _ 2 Block lSec/Sub. Briarhill 3rd Alter ? - Zoning R3 Parcel # 10 14990 320 01 Repair ? Fire Zone NA Enlarge ? Type of Const. V z Name Tolleff;on Builders Move ? # Stories Address 13816 HolyMm Lane_ Demolish ? Front 44 ft. O City Apple Valley Phone 454-6873 Grade ? Depth 22 ft. W rh r Approvals Fees Zo Name e u V Address V Name _ Address I hereby acknowledge that I have read this application and state that the information is coned and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee \. A Building Permit Is issued to: all work shall be done in accordance i h all Building Official Assessment Permit .LLO.UU Water & Sew. Surcharge 22.50 Police Plan check 64.00 Fire SAC 525.00 Eng. Planner Water Conn. 135, 00 Water Meter 60.00 Council Road Unit 185.00 Bldg Off . . APC Total $1419.50 an the express condition that Statutes and City of Eagan Ordinances. CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING `PERMIT APPLICATION N2 6735 Receipt # r??7 To be tied for 1 Of 4 PLEX Est. Value $ 45,000 Date Ttma 22 , 19-S1- Site Address 3876 Dolomite DTIVe Erect 3 Occupancy R'3 Lot 31 Block 1 'Sec/Sub. Brierhill 3rd Alter ? Zoning R3 Parcel # 10 14990 310 01 Repair ? Fire Zone Nile _ _ Enlarge ? Type of Cons,, y w Name Tollefson Builders Move ? # Stories Z Address 13816 Holyoke Dane Demolish ? Front 44 ft. O city hone Grade ? Depth 22 ft. Approvals Fees o Name VJWAr t ou Address 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. Signature of Perrnittee - A Building Permit is issued to: all work shall be done in acco Assessment Permit us°•? Water & Sew, Surcharge 22.50 Police Plan check 64.00 Fire SAC 525.00 Eng. Planner Water Conn. 335.00 Water Meter 60.00 Council Road Unit 185.00 'Bldg Off. . APC Total $1419.50 3 15=16exrs on the express condition that State of Minnesota Statutes and City of Eagan Ordinances. Building Official X/. City/zip code: Phone #: U-737 TD Be Used For Site Address _ a%_33 Block Parcel CITY aF EAGAN Valuation / Sec./Sub. ?ca ,t(`l ?0 330 ??> Owner: Address: CYty/Zip Code: Phone #: - Contractor: lda Address:1JI5616 CitYA4 00 Plane Arc?./b q. Address: • Include 2 sets of plans, 1 site plan w/elevations i 1 set of energy calculatims. Date ?o - p o -,Pl *^ ?. CFFICE USE CNLY Erect v oocupancy Alter Zoning Repair Fire Zane FYtilarge _ 'type of Cont. -r1 MDve # Stories Demolish Front ` t. Grade - Depth ft. Water/Serer Surcharge A :.= Police Plan Check *ire SAC i 6- Eng. Water Conn. 3 _3,s,-- Planner Water Meter , 0 Om-Icil Road Unit 7 s Bldg. Off. APC I? i To Be Used For -;7- - Site Address fflj LDtS 33 Bloch / Parcel t: 0 1 Owner: CITX aF EAGAN Valuation Sec./Sub. `70 N Q U Address: City/%ip Code: Phone f: Cantraebor: Address: /c 'fy' city/zip Oode: Phone X/ Arch./Eng.. Address: • city/zip code- Phone is Include 2 sets of plans, 1 site plan w/elevatirns i 1 set of energy calculations. Date to - -,Pl " of OFFICE USE ONLY Erect x Occupancy Alter zoning Repair Fire Zone AI Enlarge _ Type of Cont. - hove ^ A Stories Dgno11s1' i _ Fxont ft. Grade Depth P 2 ft. APPROVALS FEES Assessments Penitit J Water/Sewer i Surdsarge Police Plan Check _. kre SAC 5 e 014- Erg. Water Conn. 3 3,-'a3L- Planner Water Meter (e p -ev- council Road Unit > g Bldg. Off." APC TOTAL ?z/ ????? .3 5 '?-- CIT'l OF EAGAN BUILDING PERMIT APPLICATION TO Be Used Site Address _ Lot_3 ?-3c/Block Parcel t: Owner: 11?C, i Valuation pr Sec. /Sub. (070 GI Address: Clty/zip Code: Phone /: Contractor: Address: /C City/Zip code: A/ Phase 1: '7 J ?f - Arc:./mrrg.: Address: City/Zip Code: Phone !: Include 2 sets of plans, 1 site plan w/elevations i I set of energy calculations. Date - a - ?? OFFICE USE ONLY Erect Y Occupancy IK,7? Alter Zoning Repair Fire Zone 'k, Enlarge ^ Type of Const. 7 '" Move # Stories DemollsF- Front Grade - Depth .a ? ft. APP%7VAIS _ FE ES Assessments Permit Water/sewer Surcharge " ..: Police Plan Check i ? Fire SAC to 5 Eng. Water Corm. Planner Water Meter Council n3m unit F s -- Bldg. Off. APC : 7DTAL CITY OF EAGAN BUIIDING PERMIT APPL 1b Be Used For'd` - ?r_ e- _/ valuation site Address 3$?y (? , ??., c 3i, 32 Ivt 3 :I "Block / Sec./Sub. Parcae, t = /D t? l0 t(O c? Owner: Address: City/%ip Code: Phone t: - Contractor: /&& Address: A5YX6 City/Zip Phne t: 75 - Arch./brig.: Adduce: • City/Zip Code: Phone 1: Include 2 sets of plans, 1 site plan w/elevations i f set of energy calculations. Date - d - ?? ?. OFFICE USE ONLY v Occupancy Erect Alter Zoning Repair Fire Zone / +U Enlarge _ Type of Oonst. Moue A Stories Demoiu Front r t. Grade - Depth ft. APPROVALS FE ES Assessments Permit 77 7 Water/Sewer Surcharge Polioe Plan Check . !o -1 . Fire SAC g` s- Eng. water Conn. r ; 3,7- Planner water meter Council Road Unit .? = Bldg. Off. APC MrAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 BUILDING 025442 04/24/95 SITEADDRESS:P. I. N. : 10-14992-330-01 APPLICANT: LOT: 33 BLOCK: 1 3880 DOLOMITE DR STEVENSON BRIAR HILL 3RD (612) 688-6997 PERMIT SUBTYPE: TYPE OF WORK: DECK GREGORY ADDITION CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEIVED FROM AMOUNT & DOLLARS goo ? CASH ? CHECK FOR FUND CODE AMOUNT Thank You 1? BY White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 6738 PHONE: 434-8100 BUILDING PERMIT Receipt # To be tied for Est. Value Date 19 Site Address Erect Q Occupancy Lot Block Sec/Sub. - -- Alter ? Zoning -' ' Parcel # 11.. Repair ? Fire Zone Enlarge ? Type of Const. W Name Move ? # Stories z Address 3 Demolish ? Front ft. city Phone 52 Grade ? Depth ft. w Name Approvals Fees ,o 0' Address Assessment Permit ~ City Phone Water & Sew. Surcharge Police Plan check F W Name Fire SAC uZ Address Eng. Water Conn. <W city Phone Planner Water Meter Council Rood Unit 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 State of Minnesota Statutes and City of Eagan Ordinances. APC 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 t owdl # Dole low" lOwn"t . Plumbing -?2sco ?- i3- 7Y- a Mechanical 7?3-7z? INSPECTIONS DATE INSP. Rough-In Final Footings - Dote Inw. Date Insp. Foundation Plumbing 1 Frame/ins. Mechanical -2 753 ef Final - .Z Remarks: • CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55143 N2 6736 PHONE. 4548100 BUILDING PERMIT Receipt To'be wad for Est. Value Date 19 Site Address Erect ? Occupancy Lot Block Sec/Sub. `rlf_rFii. l I' Alter ? Zoning Parcel # Repair ? Fire Zone Enlarge p Type of Const. W Name Move p .# Stories Address rlP Demolish ? Front ft. Grade ? Depth ft. ec Name _ z° ou Address u I- ni- 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. Signature of Permittee ?l A Building Permit is issued to: all work shall be done in accordance with oil Building Official Assessment - Water & Sew. Police Fire Eng. Planner Council Bldg. Off. _ APC Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total - on the express condition that Statutes and City of Eagan Ordinances. Mrralt # pate hued hralttee Plumbing of 4 $^ - (3 F5 ti/l'? - Q Mechanical a4c t -( CE. h INSPECTIONS DATE INSP. Rough-In Final Footings Date In op. Dote I Foundation Frame/ins. Plumbing Mechanical 6-1 l•Q? Final 74 8- Remarks: CITY OF EAGAN " 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT Receipt # N2 6737 To bi used for Est. Value Date 19 Site Address Erect ? Occupancy Lot Block Sec/Sub. Alter ? Zoning parcel # ?- Repair ? Fire Zone Enlarge ? Type of Const. W Name Move ? # Stories 3 Address 0 Demolish ? Front ft. b 0-'..- „?--- 1..74--{:;' i Grade fl Death ft. Name _ ,o Address 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. Assessment _ Water & Sew. Police Fire Eng. Planner Council Bldg. Off. - APC Fees Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total Signature of Permittee I A Building Permit is issued to: on the express condition that oil work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Penult # Deft Issued F@Mhtee Plumbing -r3-S--( ,-- p /1, Z - /1 Mechanical 1 ?g, - ( 3 - $( i=c??; c -? X372. 4?-z4o- ash r (?c-? INSPECTIONS DATE INSP. Rough-In Final Footings Dote Insp. Dote Insp. Foundation _ Plumbing a- 2LA Fro /ins. Mechanical - J? Final -per Remarks: 1-30 - $ 2- A""-& ?G.l.?o?•- ?`??i jn?t , [? ?/ 12 4=?-?? ? iQ-..c?./'C? .utr-?---??.?i-?-? -?-•? Y /?? ?",o?,,d/1sM'coXt•LJ?.??'. CITY OF EAGAN 3795 Pilot Knob Road Eogan, MN 55122 W 6735 PHONE: 454-8100 BUILDING PERMIT Receipt # - Site Address Erect ? Occupancy Lot Block Sec/Sub. 7 '. Alter ? Zoning parcel # a" Repair ? Fire Zone Enlarge ? Type of Const. W Nome Move ? # Stories 3 Address I Demolish ? Front ft. o City Phone Grade E3 Depth ft. ar 0 Nome Approvals uV Address Assessment ~ Ph Water 8 Sew. one city U? Police WW Name F ? ire xC5 Address Eng. <1O City Phone Planner I hereby acknowledge that I have read this application and state that Council Bldg. Off. _ the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Fees 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 PW=* # Do% homd PensitM Plumbing ` i 3 ` - c,- r-IN, Mechanical (p ? - - (? 1 `723 6 -z ?&- QS ?/` ?LEC? INSPECTIONS DATE INSP. Rough-In Final Footings Foundation - $ _ Plumbing Date Insp. Date Insp. Frame/ins. Mechanical Final Remarks: Receipt -? MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Prinr legibly -. Tot. 1. Date 2. Installation Cost 3. Job Address ate, Lot Blk. Tract I 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential Il Commercial ? Institutional ? 9. Work Description: New E?' 1 10. Describe 1 11. Fuel Type No. EQipment BTU - M. Ea. Forced Air No. Equipment CFM Ai ndli : H Mfg. r a 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. Add ? Alter ? Repair ? 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 - = 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. Type No. EQuiQment STU - M. Ea. Forced Air No. Equipment CFM Ai Handlin : Mfg. g r 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 Rough for 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 - - BIk. Tract 4. Owner _- 5. Contractor Phone 6. Address ` 7. City State Zip B. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? I 10. Describe Fuel Type 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 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 j 5. 6. Address Phone 7. City State Zip B. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 1 10. Describe 1 11. Type No. Equipment _ 8TU - M. Ea. Forced Air No. Equipment CFM Ai H li Mfg. r and 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 PLUMBING PERMIT Permit No. ?i CITY OF EAGAN Fee ` Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address m . Lot Blk. Tract 4. Owner 5. Contractor e-Al 1 y nv? Phone L ( 21 . 6. Address ! '/'( _ 1J % + , °_ r; 7. City k'v T State Zip 8. Building Type: Residential Commercial ? Institutional ? 9. Work Description: New ? 10. Describe 11. Add ? Alter ? Repair ? No. Fixtures Water Closet No. Fixtures Cesspool /Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other i 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 f- ! 2. Installation Cost 3. Job Address ??' L.?• ?, ,7C Lot / Blk. ' Tract 1-4 +" i G . r C 4. Owner //f ( ?..,? L l?f F ; 5. Contractor 6. Address Phone 7. City a? f' State A. i IU Zip 8. Building Type: Residential la" Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Bath tubs Cesspool/Drainfield _ Lavatory Septic Tank Shower Softner Kitchen Sink Well Urinal/Bidet O Laundry Tray ther Floor Drains Drinking Ftn. Sl Si k - op n 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 i Type or Print legibly _ Tot. 1. Date--- ate - E? / 2. Installation Cost ! 3. Job Address Lot - Blk._ Tract 4. Owner i• i'?t•?? i f lr? 5. Contractor 7 1 Phone Y' `I I 6. Address, c v -k - ' r P. 7. City r . -r-, c.,? State \\\ N\ Zip -cjC - %? 8. Building Type: Residential L2" Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 1 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cess ool /Drainfield Bath tubs p Septic Tank Lavatory Softner Shower Well i 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 ' f 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 j Fill in numbered spaces SIC Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot BIk. Tract 4. Owner I 5. Contractor Phone 6. Address 7. City State ! 1 Zip 8. Building Type: Residential Q Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cess ool/Drainfield Bath tubs p 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 ? -- `7 ' - PLUMBING PERMIT Receipt Permit No, I , CITY OF EAGAN Fee _ Fill in numbered spaces S/C Type or Print legibly Tot. L 2. Installation Cost 1. Date 3. Job Address - + =Lot _Blk. Tract`-'' l C 4. Owner /' r > ?, 5. Contractor Phone 6. Address 7. City f State i , Zip 8. Building Type: Residential O Commercial ? Institutional O 9. Work Description: New ? Add ? Alter-Ct- 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 4548100 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: ,i I,: II IiH IEi. i r1II i l I ,; iPERMIT SUBTYPE: I I Nic, INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: t 141 u r : APPLICANT: TYPE OF WORK: I I NAI Permit No. Permit Holder Date Telephone # SNV PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Rooting Rough Pibg. Rough Htg. Isul. Fireplace Final Hlg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final p well Pr. Disp. CITY OF EAGAN PERMIT TYPE: .:.1 i• pig, 3830 Pilot Knob Road Permit Number: f, 4 4 { Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS:' APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. --------------------------------- Permit No. Permit Holder Data 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 J PAP DECK FINAL f? s CITY OF EAGAN Remarks - " L116,7/ Additign - MAR HILL 3rd ADDITION Lot 31 Bik 1 Owner f-) I I E (">0 v% Street 3876 Dolomite Drive Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. L. 1971 Paid nude parcel 10- 000 10-25 STREET RESTOR. 2? l 1975 .27 8.03 10 16.11 A011183 6-18-82 GRADING 982 123.0 24.61 5 98.44 " Street Surf (p 982 00.76 120.15 5 480.61 SAN SEW TRUNK 1968 33-61 1.12 30 16.81 ?t rr SEWER LATERAL WATERMAIN WATER LATERAL 07 1971 36.81 1.84 20 14.73 WATER AREA 1977 7.21 . 15 40.33 to " ** S/W Lat Stm L 1982 1431.44 286.29 5 1145:16 rr " STORM SEW TRK G 1982 402.73 80.55 5 322.19 to " - STORM SEW LAT 1971 20 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 185.00 25369 6-22-81 WATER CONN. 335.00 25369 6-22-81 BUILDING PER. 6735 SAC 525.00 25369 6-22-8 1 PARK CITY OF EAGAN Remarks Addition ARL1R HILL Std ADDITION Lot 32 Blk 1 Parcel 10-14992-320-01 Owner ?(? P f ?.Oyi Street 38T8 Dolamite Drive State Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ' 1971 Paid under parcel 10-C 2000- 0110-25 STREET RESTOR. 19T5 0.27 .03 10 16.11 A011187 6-18-82 GRADING s c 1982 123.04 24.61 5 7 4 A01 -0243 9-29-83 Street Surf 4 ? 1982 600.76 120.15 5 0.61 A01118 -i ' 82 SAN SEW TRUNK z4 () 11968 33.61 1.12 30 16.81 " " SEWER LATERAL WATERMAIN WATER LATERAL 19T1 36.81 1.154 0 14.73 tt ?t WATER AREA 19 6T.21 5 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 STORM SEW LAT Q CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 185.00 25369 6-22-81 WATER CONN. 335.00 25369 6-22-81 BUILDING PER. 6736 SAC 525.00 25369 6-22-81 PARK CITY OF EAGAN Addition ' LIAR HILL Owner- i= , 33 Rik 1 Parnal 10-14992-330-01 Street 3880 Dolomite Drive Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1971 Paid under parcel 10_ 000- 10-25 STREET RESTOR. 1975 80.27 8.03 10 16.11 A011418 9-9-82 GRADING C 1982 123.04 24.61 5 98.44 of Street Surf ?' , 1982 600.76 120.15 5 480,61 of SAN SEW TRUNK 40 1998 33.1 1.12 30 16.81 " SEWER LATERAL WATERMAIN f WATER LATERAL /o 1971 36-81 1.84 20 14.73 WATER AREA h 1977 7.21 15 40-33 ** S/W Lat Stm:L 4G ., 1982 1431.44 286.29 5 1145.16 STORM SEW TRK r 7 1982 402.73 80.55 5 322.19 " STORM SEW LAT 1971 20 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 185.00 25369 6-22-81 WATER CONN. 335.00 25369 6-22-81 BUILDING PER. 6737 SAC 525.00 25369 6-22-81 PARK CITY OF.EAGAN Remarks Addition BRTAR HILL 3rd AnnnTTTQ1 Lot '14 Rik 1 Parcel 30-11IM-34.0-Q1 Owner )a 01 C', iW 11 L r . Let/ dI t Street 3884 Dolaaite Drive State Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1. 1971 Paid un eel 10- W000- 010-25 STREET RESTOR. 2,11 1975 80.24 8.02 t 10 16.08 A011024 4-9-82 GRADING c 1982 123.04 24.61 5 98.44 A011024 4-9-82 Street Surf (?C 1982 600.76 0.15 5 480.61 A011024 4-9-82 SAN SEW TRUNK 1968 33.46 1.12 0 16.81 A011024 4-9-82 SEWER LATERAL WATERMAIN WATER LATERAL 1971 36.10 1.84 20 14.74 A011024 4-9-82 WATER AREA ,? 1977 7.2. 4.48 1 40.36 A011024 4-9-82 ** S/W Lat Stm L 1982 1431.44 284.29 5 1145.16 A011024 4-9-82 STORM SEW TRK 1982 402.73 80.55 5 322.19 A011024 4-9-82 STORM SEW LAT 197 20 CURB & GUTTER SIDEWALK STREET LIGHT Road 11ni t 18s ()n 25369 6-22-81 WATER CONN. . 335.00 25369 6-22-81 BUILDING PER. SAC _ _ PARK R SERVICE PERMIT T W A E CITY C EAGAN 3795 Pilot Knob Read PERMIT NO.: DATE: Eagea, MN 55122 Zoning: No. of Units: Owner: Address: F1111 TIT Site Address: Plumber: c. Meter No.: Connection Charge: ' Size: Account Deposit: Reader No.: Permit Fee: agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of I nsp WATER SERVICE PER MIT CITY OF EAGAN 3795 helot Knob Road PERMIT NO.: DATE Ea;?3n, MN 55122 : G&,iing: No. of Units: Owner: Address: '7 7 Site Address: G ? .. Plumber: :. :?. Meter No.: Connection Charge: osit: t De A Size: p ccoun Reader No.: Permit Fee: I agree to comply with the City of Eagan Surcharge: Ordinonces. Misc. Charges: -- ---- Total- P id D t By a : a e te of Insp : D Insp.: . a 01 EAGAN SEWER SERVICE PERMIT Pilot Knob Road PERMIT NO.: MN 55122 DATE: i No. of Units: c: Address: ber: Y;7co Doloriite ,r L33 '1 ??i13 ii1 ee to comply with the City of Eaga¦ Connection Charge: "noel. Account Deposit: Permit Fee: Surcharge: Misc. Charges: of Insp.: Total: WATER SERVICE PERMIT CITC OF EAGAN W"195 Pilot Knob Road PERMIT NO.: 122 DATE: Eagan, MN 55 Zoning: No. of Units: ? Owner: - Address: ' _ .? ! r-T I-'- Site Address: Plumber: Meter No.: Connection Charga -'' Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: r Ordinances. Misc. Charges: Total: B Date Paid: y Date of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MH 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: nn 1 agree to comply with tba City of Eagan Ordinances. By Date of Insp.: Connection Charge: "? r r Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: CITY OF EAGAN SEWER SERVICE PERMIT 379'e " Knob Road PERMIT NO.: Eagan, MN 55122 DATE: L- ling: No. of Units: Owner: Address: Site Address: r .. 1 Plumber: ' It?C.?O r I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: By Date of Insp.: I nsp.: Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: . OF EAGAN SEWER SERVICE PERMIT Oilot Knob Road PERMIT NO.: MN 55122 DATE: No. of Units: Address: lumber: agree to comply wkh the City of Ewan of I nsp.: Hill III Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: ?(0 igs 70-00 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use OnN 3 registered site surveys showing sq. ft. of lol, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams,joists Cart of Survey Reed --- , _ Y -N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _Y _ N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required Y _ N l set of Energy Calculations Addition - indicate if on-sire septic system On-site Septic System _Y _N 3 copies of Tree Preservation Plan 9 lot platted after VI 193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date 1-2,1 l 2? (o Construction Cost 2- ?(QC2?2 Site Address On Unit/Ste # n cClz2? Description of Work (? I Multi-Family Bldg x Y _ Fireplace(s) N _ 0 1 _ 2 / Owner (? Pro ert 'n ???? ,JJ^77 JCS V ?? (?? Telephone # ( (Lrx? " tLJ "jam' p y Contractor Address City State -- Zip Telephone # (`'-j-_ NQ4 .COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category I - Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y - N If yes, date and address of master plan: Licensed Plumber Telephone #( rn W, (f- Mechanical Contractor D i Telephone # DEC 1 3 2006 Sewer/Water Contractor Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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 wAl be in accordance with the approved plan in the case of work which requires a review and approval of plans. c \ n Applicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant G(?/??e12 ?ra0#9? e DescrlptloM Water Damage ` Yes Valuation -Z wU• `' Occupancy 2_3 MCES System Plan Review 100% or 25% << _ 1 Census Code Zoning City Water SAC Units Stories Booster Pump _ # of Units Sq. Ft. PRV _ # of Bldgs Length Fire Sprinklered Type of Const y Width ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. Siding Fire Repair Windows/Doors REQUIRED INSPECTIONS _ Footings (new bldg) Sheetrock _ Footings (deck) _ Final/C.O. _ Footings (addition) Final/No C.O. Foundation ?4 HVAC Drain Tile 1 Other Roof Ice & Water Air/Gas Tests Final Final Pool Ftgs _ _ Framing _ _ _ _ _ Siding _ Stucco Lath - Stone Lath -Brick _ Fireplace _ R.I. -Air Test Windows -Final Insulation _ _ Retaining Wall Approved By: ul ding Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 7(P t q(( 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Dat i'Z / 19 e Site Street Address© Q 1 Q Wl I `? I?'ttt?Jf w Unit # Property Owner (SOW tj Telephone # (?() Contractor Cc W4 lephone # ?) ??' YU ! Z - T Address 1M City - Stat I` U 1 Zip c? The Applicant is: Owner _ Contractor -Other Septic System - New _ Refurbished Submit 2 sets of plans and MPC iicense Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. If you are installing only a water softener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. -Septic System Abandonment -Water Turnaround (add $130.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 new _ replacement Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $?a 5? I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work i of to start without a permit and work will be in accordance with the approved plan in the event a plan is req it d to be r and prop Ved-- - - Applicant's Printed Name Applicant ature RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 7D New Construction Reeuirements Remode[Reoair Reouirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. h. of house; and all roofed areas 2 copies of plan _ Cert of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions _ Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks -Tree Pres Not Reqd 1 set of Energy calculations Addition - indicate if on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 1/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units 05 / ? / 0,3 "'- Construction Cost I q 7 7 Site Site Address 3 &f y ?? en r?e I )e4 ue-- Unit/Ste # U s?zz Description of Work (_.J t NOL&L.) r Multi-Family Bldg _ Y -p N Fireplace(s) _ 0 2 ry Property Owner 1 ° a, q Qt e4- O a-U-4-01 Telephone # (64?) 6 Ale _!9! 2 8 3 Contractor c[)s r ? J 9?? ?t Address m m City State ep ? 5Z) _ C) V0V1oroIe;P, Av 17 (,4 0 - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Categgil _ Minnesota Rules 7672 Energy Code Category , Residential VentllatiowCa1:6g6ry'1" orksheet New Energy Code Worksheet (J submission type) Submitted i, C, N' ?k Submitted Licensed Plumber \L Telephone #( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ?M S et nid6r e- I't') u n 2- a r o 7 Applicant's Printed Name. Applicant's Signature 5_T6 PLUM13ING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date J ? O? O1 Site Address (?(1 l U it # j c n " Property Owner Telephone # L `)C? (- (51 C' Contractor ? fl ? ? n Address ?? lam . city l l A? 7 J - , \ p q ? I State ?y 1 Zip ?1 lk Telephone #0 t,5) ?!Y"Q ' O! Q 15 The Applicant is Owner \1L Contractor Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 - Adding fixtures to lower levels or room additions, excluding water softener and water heater - Abandonment of septic system - Water turnaround (+ 5/9" meter if needed - $121.00) Other: llri ??? RPZ i t ll ti i b _ new ns a a on _ repa r _ re u ` 30.00 Ati l - Lawn irrigation system Water softener _ Water heater BY-"_ J $ 15.00 replacement _ additional State Surcharge $ .50 Total $ /557-0- I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. I , Applicant's Printed Name h 1-#&ant's-9ignature CITY USE ONLY PERMIT #: RECEIPT DATE: 2008 RESIDENTIAL MECHANICAL PERMIT APPLICATION crrY OF FASAN L 1 3830 PILOT KNOB RD J >EAGM MN 551 E2 651-681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: oG J ci Z SITE ADDRESS: OWNER NAME: 1 r t??O J?? 1 y INSTALLER NAME: U. STREET ADDRESS: 22. TELEPHONE #: ('1 (a 8 ( - ? Z83 _ TELEPHONE #: (_j -.P- (i - (61-32z-c1c CITY: kl? 4- STATE: `ILN? ZIP: ?iJCi-O`FJS Place a check mark next to the permit work type r vin i2 F _ Add-on, modification or alteration to existing dwelling unit T ZCO? $ 30.00 • furnace replacement (J • air exchanger _ I • air conditioner • other -- Nature of work: ?`st State Surcharge $ .50 Total $? BI gxTuRE OF PERMITTEE 1/02 . s.. ?• ? a a1 ` } 4 • ?* i s r? 3? 1 3 Fly , ; y.?/f? 1, / o? [Y ' Y I X ,'Y O w.yi7,aA? !- SyC ? b•i?ri I' y" } ry n, ,A?-'y.?A T?• Rl4nM,dwf ?y. c?oi:?r,7?c7n. R9n: ;??l31 S $1? , ' ' (hone ©?3a 149 „ ...; i: p: Pl.au 11=* .' a u ' O J!TI a f10'iLr ,?" I_^_;sllP? T:°9C?2IF'»P it C!? ° ? ._ , ?. . s .. !ti^ X03: _R4t'c 102 I1? rm 0 ADJU'PICES PATS -4 tpn {5 f 1='.^ ?7.G 17 't,Oi [ C I'V CQ ' P MiATIC` T . . . . M RA r'TzT dJp r-:Pc r.. IfA9,7_, + ,? ? n M . ? 1Q n NOT % ?Q. e G? of 1+ O f ^;' t r Ma [ 'CM LF"fi:90? " P572 t TOTAL S(_, Fie c7 roepci f S, r .? m>Ffl1'i . Q^ Ir dLAT2C:i. in 1mF_,f:S 'r' G. P etS" T ' < , . TI.1 C1: Ty M, CD 117-:1L9TM7 In cl°rLre r 1r 1 r t.. 1 C)" n THICK AT, " rni>n c7 !1 . oon ?.'t % . VAT? " r ey 6V ai! L?? m J s CA T f^ 07 d i C t: PtE i!7 AnGl• F,QF tir^ r . , " I1F7I.I G? eET bGR 07^ AL'D ^ -- - ? . IJyApit:'SI C7 M 70!2 (3; ,T rill f `lin: Z - , ?C y 1 too 1- ?j 4 t A i 4611 n t C7 u, C t ? IL 1 > U" POOTACE --• u1F tr ) I Iq ? 9 . f g l47_. ?rar.a?. j {I i? Cr tt TOTALS r r, r. noT. TUTAT D0L)R =::=..._ .?? rte.. .gym TOTALS Dr-TA IL SQt TT Sti. FT 5t ,. 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Ay r g r. ..I . • G !Y? i' PERMIT CITY OF EAGAN 3-T -? `? 3830 Pilot Knob Road PERMIT TYPE: BUILDING - Eagan, Minnesota 55123 Permit Number: 023160 (612) 681-4675 Date Issued: 03/28/94 SITE ADDRESS: 3878 DOLOMITE OR LOT: 32 BLOCK: 1 BRIAR HILL 3RD P.I.N.: 10-14992-320-01 DESCRIPTION: Building`,' Building building Building ermit Type DECK 6 k Type ADDITION Width 12 10 n REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $,50 Total Fee $30.50 CONTRACTOR: OWNER: - Applicant - JOHNSON DUANE 3878 DOLOMITE OR EAGAN MN 55122 (612)454-8546 I hereby acknowledge that I have read this information is correct and agree to comply Statutes and City of Eagan Ordinances. L_ APPLICANT/P, application and state that the with all applicable State of Kn. /S')V--0'0t L a, i ' - - - 0 ISS ED BV: NATURE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Knob Road Permit Number: 023160 Eagan, Minnesota 55123 Date Issued: 03/28/94 (612) 681-4675 SITE ADDRESS: LOT: 32 BLOCK: 1 APPLICANT: 3878 DOLOMITE DR JOHNSON DUANE BRIAR HILL 3RD (612) 454-8546 PERMIT SUBTYPE: TYPE OF WORK: DECK ADDITION INSPECTION TYPE DATE INSPTR. INSPECTION TYPE D FINAL 'FOOTINGS 131CO CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 'un 0 / 3 ;S, J4 i i SINGLE & MULTI-FAMILY - ---- - 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work ldVO, ?Jc?7 Site Address: p<9/Dlj_Z???? STREET SUITE # Tenant Name: (commercial only) LOT J1_ BLOCK _L_ SUB', p¢? if !I +i? J P.I.D. # Description of work: e k X ?Z 1-7 The applicant is: O-OWner ? Contractor ? Other (Describe) Name ? r- r1 Phonel?Z/4S 34 ' Property Owner LAST FIRST • J ?7 YV? Address Z I? STREET STE # ? ? J? City 4 L State `t Z i p Company 1,0;-2 eo - Phone Contractor Address License # Exp. City State Zip Company Azfay /2 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. ?J Si n r f A li t t /? g pp a u e o can : ll? b M O i i I -? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: CRAq130 &j1 U BUILDING 025442 04/24/95 I SITE ADDRESS: P.I.N.: 10-14992-330--01 3880 DOLOMITE OR LOT: 33 BLOCK: 1 BRIAR HILL 3RD DESCRIPTION: 8ya 3ding ,Permit Type DECK RVildipg Wo§r.k Type ADDITION ?rz `. V£I? f°s, 3as E V NI) REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee $30.00 $.50 $30.50 CONTRACTOR: OWNER: - Applicant - STEVENSON GREGORY 3880 DOLOMITE DR EAGAN MN 55122 (612)688-6997 -? ISSUED BYJ si nTUa CITY OF EAGAN -, 3830 PILOT KNOB RD - 55122 4411996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 ? 3 registered site surveys ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 1 energy calculations ? 3 copies of tree preservation plan if lot platted after 711193 required _Yes _ No DATE: IIU I4•5' DESCRIPTION OF WORK: A?nt9n . STREET ADDRESS: LOT ^3`? BLOCK SUBD./P.I.D. #: ? 2 copies of plan ? 2 else surveys (exterior additions & decks) ? 1 energy calculations for heated additions PROPERTY Name: tti Phone #: OWNER u.. 530- Street Aridraccg?C7 States-? Zip: 2--2- City: v? CONTRACTOR / Company: hone #: Street Address: License # City: State: Zip: ARCHITECT/ Company: Phone #: ENGINEER Name: Registration #• Street Address- City: State:, . Zip: Sewer 8 water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued 1 hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No APR 17 1995 Tree Preservation Plan Received - Yes No CONSTRUCTION COST: `t (0r 3 OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 _ plex WORK TYPE ? 31 New ? 33 Alterations R? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth P:1 »tt•1'l l k1 Planning ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? L-P? 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Variance Permit Fee Surcharge Plan Review License MCMS SAC City SAC Water Conn. Water Meter Acct. Deposit M .0 S/W 'Permit i , . Rr°. -• S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: d Valuation: $ /00-0 C, h P f 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. Yoh' SAC Code d/ Census Bldg i Census Unit O % SAC SAC Units CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.T.N.: 10-14992-310-01 PERMIT PERMIT TYPE: Permit Number: Date Issued: 3876 DOLOMITE OR LOT: 31 BLOCK: 1 BRIAR HILL 3RD DESCRIPTION: SIDING & SHUTTERS BUfkd1mq Permit Type MULTI. (MISC.) ttildin?prk Type REPAIR j eri?ue Ooc5?"-jk? 434 ALT. RESIDENTIAL & nk. rv ga*.' ',, is :a aia *1? gee m+ e!. V.x+ BUILDING 031943 05/20/98 REMAM?uoes: 3878, 3880, 3884 DOLOMITE DRIVE L32, L33, L34 FEE SUMMARY- VALUATION $19,000 Base Fee $274,75 Surcharge $9.50 Total Fee $284.25 -- nIJ X11 J.Carl 1. - J I. LIU (??/N ?R T4<?VJ ?'{Wpl{t,?V6 & SIDING INC 12816363 0008077 BKIAR ILL ASSOCIATION P 0 BOX 5937 3800 HEATHER DR ROCHESTER MN 55903 EAGAN MN 55122 (612) 281-6363 (612)683-9659 (_ APPLICANT/PERMITEE SIGNATURE • 1' 4 EA 14h 1 ... ...'V! f , .. N. ! .. , .,*r li oqvl TAM, CITY OF L.f:'...NO DAM 95/210/22 TIMEs 15 0.601 c f ' RYAN ix%OPO .. S I:G '.L: 1 .:. i 2210 9001 0276 DOLOMME D 274,W., 3210 9004 Fa5w qMMITE 1.1 262 2".., f DWI! 55 9001 126Q, ! !P! ONT -i l? 21 , n ! :i•., MAN& '4 Phi, !n7 ., _ jmt :is•ma ?i ., .. , _:rl., y NOW ... }:n„ NAJO -+ C i06'dA wPI 94 1 1 !x:;, , ccon .. ?,, ?. ,. ,.. iI ...? •.., . fit ,. ?j ?•?? 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) / 7? CITY OF RAGAN 3830 PH OT KNOB RD - 55122 681-4675 New Construction Requirements Remodel/Repair Requirements ? 3 registered site surveys ? ? 2 copies of plan 2 copies of plans (include beam & window saes; poured hut. design; etc.) • 2 site surveys (exterior additions & decks) • 1 energy calculations • 1 energy calculations for heated additions ? 3 copies of tree preservation plan If lot platted after 7/1193 required: _ Yes _ No DATE: CONSTRUCTION COST; DESCRIPTION OF WORK 4? L 3?. L3 3 43 LOT: BLOCK: SUBD./P.I.D. #: STREET ADDRESS: 3?(0 -3,P7f-_???D-38?? ?d/Dmi14 Q?iue . Name: pr:a.? d?t-el /'d_$S'OG% CriJ?`Dh Phone#: ?<Z-&Y3-rj6 $S PROPERTY Last First OWNER ?t Street Address: 3?IJD Mea?l??e.- ,fit City L' l¢ L^C?Yr state: 0192A) zip: 5'51 Z Z. Company: d,"n W/ 11,4'BtQ5 V-J ?V%2Phone #: y?0 7 ?! ? ?p 36 3 CONTRACTOR Street Address:_. ?• es" &dr 5 9 3 7 License # ?D # Sd7'7 city >L-ev- state: /12V zip: ?35?'D3 ARCHITECT/ ENGINEER Company: Phone #: Name: Registration #: Street City Sewer 8 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 correct 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 State: L t BL I CITY USE ONLY susD. Y2VW-Y W1I EACH # 1999 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGRAN 3$30 PILOT KNOB ftD EACIAN, MN 55122 (651) 661-4675 Please complete for: > single family dwellings > townhomes and condos when permits are required for each unit > backflow preventer for underground sprinkler system FIXTURES TOTAL Bath tub $ 3 00 = $ --------- 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 = $ Minimum fee alterations to existing dwelling 30.00 x = $ Private Disposal S stem new/refurbished ' requires MPC tic. 75.00 x = $ Private Disposal System abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground srinkler if dwelling is under construction 3.00 x = $ Underground srinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x 1 = $ Water softener if dwelling under construction 5.00 x = $ Water softener if existing dwelling 30.00 x = $ Water turnaround 30.00 x ---- _ $ State Surcharge .50 > > > $ 50 Total .... > $ ISO Reminder. Cali for inspections of alterations, i.e. water heaters, water softeners, etc. -° - - - -- --- --- ---- - --- Ihereby acknowledge that have read this application, state that the information is correct, and agree to comply with all applicable City of 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-way/easement. SITE ADDRESS: ANANTAPHONG, SOUKHAPHAT 1 3876 DOLOMITE DRIVE OWNER NAME:: _ EAGAN, MN 55122 TELEPHONE #: (651) 688-9240 (AREA CODE) INSTALLER NAME:-,_ WOQLIZ nu.Iunr.r?. TELEPHONE #: STREET ADDRESS: (612) 827-4033 (AREA CODE) CITY: MINNEAPOLIS, MN 55408 STATE: RECEIPT #: v RECEIPT DATE: ? G 43W p PERMIT # 7 ZIP: S E OF PERMITfEE ?1 31 415, f 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION 0 e1u,-A- CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Data ! Site Street Address 3V b ( n,(( } ?lo d t?, X Unit # LL' ' c ? I ? - ` q Property Owner ?U419t kAJ /,11r ' ?C Q Telephone # (uq') tO? / qjao Contractor CHAMPION WATER SEpvnCr Telephone# ((c60 S03-1340 2i2 pg. Address Burnsville, MN 0 City State Zip The Applicant is: _ Owner '!Contractor Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. ff you are installing onlir a water softener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. -Septic System Abandonment -Water Turnaround (add $130.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 _ _ new _ placement Lawn Irrigation _RPZ _PVB new -repair -rebuild $ 30.00 State Surcharge $ .50 $ 5,50 Total I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be viewed and approved` a M D ![ D,bar^?' ?fn l/? ? D v . JUL Q 9 2007 Applicant's Printed Name Applicant's Signature ??65 5 - - - - - - - - - - - - - - - - - I For Office Use C ity Ol Ea~11 Permit#: RU,G ® i~ I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694. j Staff: C Cl 1.- - - - - - - - - - - - - - - - 2009 RESIDENTIAL PLUIMBING PERMIT APPLICATION Date: 7131/6)9 Address: Soukhaphat Anantaphong Tenant: 3876 Dolomite Drive _ Suite Eagan, NIN 55122 RESIDENT / OWNER Name: 6516889240 e: Address / City / Zip: nn / CONTRACTOR Name: NORM OM PI I WRING r() License ©(1/ 1 ~)-A P~~/~ i i Address: 512) 827-4033 City: 2905 GARFIELD AVE. SO. State: Zip: MINNEAPOLIS, MN 55408 Phone: Contact Person: Ailm TYPE OF WORK _ New 1X Replacement Repair _ Rebuild - Modify Space _ Work in R.O.W. Description of work: Y ' I v Y a-~er V)e.a PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ / - PVB) Main Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) *Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes Ci unty fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a ;review and approval of plans. x ~orbt DYE x Applicant's Printe Name A icant's Signa ure FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-l,n Air Test Gas Test Final r_________________, For Office Use I n Permit City of EaRdll I Permit Fee: r 3830 Pilot Knob Road I I Eagan MN 55122 Date ReceivAUG 2 4 2009 Phone: ~ (651) 675-5675 I I I Fax. (651) 675-5694_ I Staff. 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: A` X0 a~ Site Address: 4r,7, g 2 L i c~ w ~~os~ S Tenant: 3'6 -2 to t-o At 1 `r`£ Suite RESIDENT / OWNER Name: ~5SOC r3T.oa1 Phone: '7&1- y! y- 37.Z-7 Address / City / zip: Applicant is: Owner X Contractor TYPE OF WORK Description of work: Q £ - A Q j t o\ 6 £ t e~ Construction Cost: ocro Multi-Family Building: (Yes X / No CONTRACTOR Name: i ,F/ ex7-zta10)z zolzgp License#: Address: 4-/c s' L-3. 6 c fi S; City: M PL S, State: M.~ Zip: S Syl Phone: G"I/Z- 9 6;z Y3 Contact Person: D ,9 y z 4 u Q f21 S 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 (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: I Sewer & Water Contractor:' Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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 ans. X I~Ji t✓ / b 3,a 2,s2 i .S x Applicant's Printed Name Applicant's Signature Page 1 of 3 3Fr7o 361c m -QC- Ir DO NOT WRITE BELOW THIS LINE Ol 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 V Deck ❑ Porch (screen/gazebo/pergola) ❑ Multi Misc. ❑ 03-Plex ❑ 10-plex b 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 PCA handout to applicant DESCRIPTION: Valuation O Occupancy MCES System Plan Review Code Edition SAC Units (25% 100% T 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 4 Footings (deck) Final/C.O. -tom 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. -Air Test -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 d f y~ I g~ sY o _ ♦ y~gpyr 4 'W' ~ f r Q gggaa~~~ w W w w 1 li'' w. M '4~ p Q rb 0 vrv f / ~ Mwe. ..~wa e :O e o 2.% w 6 , ~ Jl V (PAS rf v • Yjeaeo NP. e. ~ awa f W m eV d J ~gLL ~ s.r w ~ pa P V 5"~b b Vr7 v f tlI ,Y~1 a ~ ° +I w,xaq ~y,~ dq•ugo~~q, ~ ~"5 •oo+ f• `a7n r1r) T Y` r•' ~Y ~gw.. M ..„w.e ww. p gIP f pz ArLo N qV~° i rW ` dbg :da w b a f J MwM J 0 . o ly) 0 o t , a y i .ear 4 C ~ `N' ~ aa~ ffff ~pW' RIOr Y w MC L W 0 Y `+J \ ~ 6 ae a Y.~.erxw ppp ~ Y r Y 1'6 e r 8, A r era e lk~ /e)oa687 Use BLUE or BLACK Ink For Office U qlr City of Eatan ; Permit #:~(~d~ 1 --3 it I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 38 7~ - 3878 - 3 8 so - ?gsq ~®Garrsf~TE y ~ //E~ Tenant: cc Suite RESIDENT / OWNER Name: /O P5SO6, ~ ,NANU A-(.- /1/1 &71.4 Phone: 7~ 3 - ~19y- 37~ Address / City / Zip: 7Z,00 F FIS-I LlC 0 M R-p [,E C &vir M N 3 (l Applicant is: Owner -X Contractor TYPE OF WORK Description of work [Z ! CM wc- Aly g zcloz-'qGE v~ Construction Cost: t 13, 6 06) Multi-Family Building: (Yes X / No ) CONTRACTOR Name: OE/ t-k Tr, !°2 10,41M 6W License a~D .3/ Address: ~©sr A. 6&' u T City: 1 11VA1 &IS State: tj Zip: S~5q g Phone: 6 (.2 r- .0 6 / (o; ~13 Contact: L)A-V11) Email: IA/~o a 6efx M . &6W 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 to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gol)herstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan ' the case of work which requires a review and approval of plans. x CFf/Lt S AWZ , j/ X ' Applicant's Printed Name Applicant's Signature Page 1 of 2 Use BLUE or BLACK ink For Office Use I My ~ l of E~an P~ 5830 Pilot Knob Road I i 1 Eagan MN 55122 t Date Received- 1 Phone; (651) 678.8675 1 I Fats: (651) 67646694: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Ske Address: 31?7-~, 31s' 7 S, 3 46, :S SS,1j o 9.0 A -r8 A Q . Unit 111: Name: L/0. A C r r>' r4 ,j ra ibt E T 'w) C Phone 763 - s'4 3- 9 7 7 0 AddressI City I Zip: VS'O a Z: e W ,e 4y A~ Applicant is: Owner Contractor Description of work "7"'£ 1,2 ©F-r- a• QE - kc*F Construction Cost: 9 C~Ca C1 Multi-Family Building: (Yes I No Company: GCE ) tx-F. rS /ylF.a - &ftelP Contact b^vr,& Address Yes' to btu S? . CRY: MPG 5 ?fate: /V AJ Zip, S'ryl 9 Phone: A Y3 ucs. d: a e Lead Cerfificats M If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) ~aa465 L3 f:2r- R~~tr Poe; ! 97 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the fast 12 months, has the City of Fagan Issued a permit for a similar plan based on a master plan? -Yes `No If yes, date and addrw of master plan: Licensed Plumber. Phone: Mechanical Contractor. Phone: Sewar a wow Contractor: Phone: 117°."". '~~,•i1F (ice y,' ' CALL BEFORE YOU 010, Call Gopher Stabs One Call at (651) 464-0002 for protection against underground utility damage. Call 46 hours before you Inters to dig to raceue kxotes of underground Wildes. www.a00harMt00n% I.0r0 I hemby aftowledge that this information is complft and aoxrrate; that the work vAll be in conformance vA the ordinances and codes of the City of agar: r, I Understand this le not a permh, but only an ap0loadon for a permit, and work is not to *W without a permit: that the work Wo be in aPP'owd plan In ttw am@ orwmtx winch ragWme a redsw ano approval of plans. Exberlor work m tftwb vd by a brulding permit issued in accordance with the Minnesota State gulldin Code must be completed wiqun 180 days of permit Issuance. x 6AV1 a pav 2t2 rS x 7%$y Appliaanfb Printed Name ApplleartYs Signature page 10(3 ZO/ZO 39Vd 1NIt1W 1X3 I3S L9Z9T98ZT9 OZ:ZT ETOZ/bT/TT CiIy of Eag,all 3830 Pilot Knob Road Eagan MN 55122 Phone: (551) 675.5675 Fax: (651) 6754694 Use BLUE or BLACK Ink Far Office Um Permit#: I I (00 Permit free: a 73 00 Oats Received: , 042-1 13 Staff 2013 RESIDENTIAL BUILDING PERMIT APPLICATION /A- - /_ddtess: 3 74, 3f7S, 3580, 3E87_ MiT t unit g; Renident/ Owner . Name: etc 4C`% Miml 4tbZMtE431i -7-wr C. Phone: 741 - S73— 4770 Address / City / Zip: SSC' D E e wry Q 4v, A), I A Got.d Sti t' ,42 r /x.J ~ Ss- 4'.t 7 Applicant is: Ower X'Contractor Typ6-ofWOrk DeecriPtiee ofwork: Pf...o:• a a- RE Pc..e-e-E-- S lJiJ 6 a p-d1G/a /4 Z7.IA 4_ Construction Cost / yC Yo0 • 0-0 _ Multi -Family Building: (Yes Z / No „_J Contractor • ComPany: {as E 1 ,c r "/014 Mid, ."T . 612 Contact !NW, 6 as -a/ S Address: 4/°s" f.4) t.o fr. City: /71 PG. S State: /'4,3 Zip: S5'41/ 9 Phone: [o/ A - / / - !o 2 4/3 License ht: 4.3 C- 2 y/ / 3 / Lead Certificate #: If the project is exempt (11-4/s. from lead certification, please explain why: (see Page 3 for additional information) Q,-,rL�- Posr. J y759 In the Inst 12 months, _Yes _No If Licensed Plumber. Mechanical Contractor: Sewer & Water Contractor: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has lbs City of Fagan issued a permit fora similar plan based on a master plan? yes, date and address of master plan: Phone: Phone: Phone: NOTE. and fo 9MM + ► 'J : J a• CALL BEFORE YOU DIG,. Can 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. wwyroEhersteteonecall.orq I hereby acknowledge that this i ernaton is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eaganaccordance that I ae w understand this la not a panne, but only an application fora permit, and work is not to sleet without a permit that the wait Wit be in approved plan In me case of wadi whlch requires a rewewand approval of plane. Exterior work authorized by a building permit issued in accordance with the Minnesota Stats Bufldk Code must be completed within 180 days of pest issuance. x 4 v, 0 /24,4-/Z../.3 Applicant's Printed Name ZO/T0 39dd x Applicant's Signature 77Page 1ofs 1NIVW .X3 I3>3 L9Z9198ZT9 EE:0T ETOZ/Z0/ZT RESIDENT I OWNER Name: /O ,S5c C. I%../�/vc- A-r— /V' Ui1i4T Phone: 7L 3 -'/9Y- 3 727 Address /City /Zip: 7101) E. FISH Lk 0 MPrPLE G&vvE MN 55311 Applicant is: Owner Contractor TYPE OF WORK Description of work: gCM DVE AN & 1- 44,A- Construction Cost: i 3, 6 ao Multi - Family Building: (Yes X / No ) CONTRACTOR Name: 3E/ E+4 Trev0/2 /NT, CO,e, License #: at 'V // 3/ ( /1M Address: 5 10 u . 60' T Cit / i/wv Ai96GdS A State: Ai Zip: 5 Phone: (1 26/ - 625/3 r - Contact: DA -t/19 Email: Info C. 6 etgM . Co /I/I In the last 12 months, Yes No COMPLETE has If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: e 0 IY t " atIo orti of , City of Ea�ali Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x 6i/14 S /ivVE /Z ,cp, Applicants Printed Name Applicants Signature /o2637 Use BLUE or BLACK Ink Permit #: q 3Cp o 7 Permit Fee: c. Date Received: Staff: J 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t//2 0// 0 Site Address: 3 876, - 38 78 -38 F0 - 3SY ,doe-c. /7 ,' Suite #: CALL BEFORE YOU DIG. CaII Gopher State One Call at (651) 454 -0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan }fm the case of work which requires a review and approval of plans. x4" Page 1 of 2 CITY Cif EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: Meter No.: — Connection Charge: Size: Account Deposit: Reader No.• Permit Fee: agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By G �� ! Date Paid: Date of Insp.: 9- jj CITE O EAGAN SEWER SERVICE PERMIT 30 5 Pilot Knob Road Eagan, MN 55122 PERMIT NO.: DATE: Zoning: Owner; No. of Units; Address: Site Address: Plumber: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: By Surcharge: Misc. Charges: Date of Ins p.: I nsp.: Total: Date Paid: Date: City of Eaaaa 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #- I D 04 2, Permit Fee: 1`47( S-3 Date Received: / 60- -S - Staff: \\5 2012 RESIDENTIAL BUILDING PERMIT APPLICATION C,� a R, AR I} 7-4-• xl /04-0.K 5 Site Address: 32778 Apr -o M i Y' L D ik . Unit #: rfPE:9F 11WQ $ Name: 2% Assoz-,Prid. f:f1,-)C '4L- h9A.146Z r L..") -r- Phone: 743 `/%l/- '3 72 7 Address / City / Zip: 7 co 7-.& 6. f SH 2,4 - Te4?I. /Lo vt. 1,1.3 SS -31 / ' Applicant is: Owner X. Contractor Description of work: R u L _ £ C12- /4 G-1/ /,// 414..L 1 Construction Cost: 7, R 9 0 - en.) Multi -Family Building: (Yes )‹ / No Company: ( :t Ex7- LA, ,,/L / 4)„.) . Address: 'Y 's • 47 e, RR. Contact: Davi �,, tuz r s State: In kJ Zip: -CS-4// S Phone: City: /-4 aPL .5 _ /x -.t/- /Izv3 License #: '3 C A K / / 3 i Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) .0o'T 4,.1" ,�� .S )��� i r 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: u t 'U1 r.QY`su It aiCe'' t dt be pubhKt l n• P 00I 0c Ifg•I vIde si c oils that, fpuld'po, l ct ncludeahat they are;tradesect ts'. 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, aooherrtateonecall_orq I hereby acknowledge that this Information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this Is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of wort( which requires a review and approval of pians. Exterior work authorized by a building permit Issued In accordance with the Minnesota State Buildi Code must be completed within 160 days of permit issuance. x Aar„r, [1.411:2-215 Applicant's Printed Name Z0 3EJvd x Applicant's Signature Page 1 of 3 1NIVW dOId31X3 I3g L9Z9I98ZT9 btI'I ZtOZ/08/OT • 1 Y7061of 1 Or DO NOT WR)TE BELOW THIS LINE SUB TYPES Foundation Fireplace Single Family Garage Multi Deck 01 of _ Plex Lower Level _ Accessory Building WORK TYPE$ New Addition Alteration Replace w Retaining Wall Interior Improvement _ Move Building Fire Repair Repair DESCRIPTION 3aa& Valuation Plan Review (25% 100%_Zr" Census Code At 34i # of Units # of Buildings Type of Construction REQUIRED INSPECTIONS Footings (New Building) _X_ Footings (Deck) Footings (Addition) Foundation Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) P001 Occupancy Code Edition Zoning Stories Square Feet Length Width Drain The Roof: _Ice & Water Final Framing Fireplace: _ _Rough In Air Test Final Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FEE$ Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit S Surcharge Treatment Plant Copies Sfrx TOTAL E0 3JCd Siding Reroof Windows _ Egress Window • lag/L-1-z-. Storm Damage Exterior Alteratlon (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building" _ Demolish Interior Demolish Foundation Water Damage "Demolition of entire building - give PCA handout to applicant ..26 -3 MCES System Aafol SAC Units PhD City Water eLaa /a eta Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required ik Final 1 No C.O. Required . HVAC Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _Final Siding: Stucco Lath Stone Lath Brick Windows Retaining Wall: Footings Backfill — Final Radon Control Erosion Control Building Inspector ' D4c4, g..10* /got 411.111111111, Page 2of3 1NICW d0I831X3 I3E1 L9Z9T98ZT9 6T:bT ZTOZ/0E/0T • aft •••••••• • . .<1 oo 4,0 lb&1147- sN- mac, So. 11 P • ^ ate— uw. •.... ti,ww elit* P as 4 \,+� (vim LD .4> 09 dor" N . e 6 VU ,fir e/ a ! .46 Mb p tl INIvW aOR131X3 I3g L9Z9198Z19 N bt:I ZZOZ/0E/0T r� CiIy of Eag,all 3830 Pilot Knob Road Eagan MN 55122 Phone: (551) 675.5675 Fax: (651) 6754694 Use BLUE or BLACK Ink Far Office Um Permit#: I I (00 Permit free: a 73 00 Oats Received: , 042-1 13 Staff 2013 RESIDENTIAL BUILDING PERMIT APPLICATION /A- - /_ddtess: 3 74, 3f7S, 3580, 3E87_ MiT t unit g; Renident/ Owner . Name: etc 4C`% Miml 4tbZMtE431i -7-wr C. Phone: 741 - S73— 4770 Address / City / Zip: SSC' D E e wry Q 4v, A), I A Got.d Sti t' ,42 r /x.J ~ Ss- 4'.t 7 Applicant is: Ower X'Contractor Typ6-ofWOrk DeecriPtiee ofwork: Pf...o:• a a- RE Pc..e-e-E-- S lJiJ 6 a p-d1G/a /4 Z7.IA 4_ Construction Cost / yC Yo0 • 0-0 _ Multi -Family Building: (Yes Z / No „_J Contractor • ComPany: {as E 1 ,c r "/014 Mid, ."T . 612 Contact !NW, 6 as -a/ S Address: 4/°s" f.4) t.o fr. City: /71 PG. S State: /'4,3 Zip: S5'41/ 9 Phone: [o/ A - / / - !o 2 4/3 License ht: 4.3 C- 2 y/ / 3 / Lead Certificate #: If the project is exempt (11-4/s. from lead certification, please explain why: (see Page 3 for additional information) Q,-,rL�- Posr. J y759 In the Inst 12 months, _Yes _No If Licensed Plumber. Mechanical Contractor: Sewer & Water Contractor: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has lbs City of Fagan issued a permit fora similar plan based on a master plan? yes, date and address of master plan: Phone: Phone: Phone: NOTE. and fo 9MM + ► 'J : J a• CALL BEFORE YOU DIG,. Can 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. wwyroEhersteteonecall.orq I hereby acknowledge that this i ernaton is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eaganaccordance that I ae w understand this la not a panne, but only an application fora permit, and work is not to sleet without a permit that the wait Wit be in approved plan In me case of wadi whlch requires a rewewand approval of plane. Exterior work authorized by a building permit issued in accordance with the Minnesota Stats Bufldk Code must be completed within 180 days of pest issuance. x 4 v, 0 /24,4-/Z../.3 Applicant's Printed Name ZO/T0 39dd x Applicant's Signature 77Page 1ofs 1NIVW .X3 I3>3 L9Z9198ZT9 EE:0T ETOZ/Z0/ZT