4300 Clemson CirI
CITY OF EAGAN c
'
,. ? $ 7
3
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 --,
PHON E: 454-8100
BUILDING PERMIT Receipt#
To be used far Est. Value Date ,19
Site Address OF FICE USE ONLY
Lot BIoCk Sec/Sub. On Site Sewage _ Occupancy
, MWCC System _ Zoning
ParC81 No. On Site Well Type of Const
Cit
Water (ActuaQ
a Name y _
(Ailowable)
W
3
Address * of Stories
Len
th
0 City Phone g
Depth I
F
Total
S ?
.
.
, p Neme Footprint S.F.
0? Address APPROVALS FEES
Ci
P. ty Phone Assessments _ Permit
?
V WateUSewer _ Surcharga
y
j W
W Name Police _ Plan Review _
F Fire Cit
SAC
_ ? Address _
,
y
0 =
m
City Phone Engr. _ SAC, MWCC
W Planner _ Water Conn.
Council _ Water Meter
1 hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unit
thatthe information is correct and agree to comply with all applicable APC _ TreatmentPl
State of Minnesota Statutes and City of Eapan Ordinances. Variance _ Parks
Copies
Signature ot Permittee TOTAL
A Building Permit is issued to: on the eacpress condition that
all work shall be done in accordance wlth all applicable State of M innesota Statutes and Ciry of Eagan Ordinances.
Building Official
Psrmit No. Psrmit Holder Date TeIsphone+k
Plumbing ' ? .? ? ?t? '??' . , h /?; 3' .
H.v.ac.
Electric
Softener
lnspactlon Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough PI
Rough Htg.
Isul.
Firepiace
Final Htg. )?-y- ? • ?J . ' ?
Final Plbg.
Bldg. Final
Cert.Occ. i.j,_i?
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
[
H
i
y ?' J
CONTRAGT PRICE:
Site Address
Lot Block Sec/Sub
?
? Name
?o Address
c City ' Phone -
L Name
3 Address '
p Ciry Phone'`-
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMtT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
_ J . I
SIGNATURE OF PERMITTEE
' FOR: CITY OF EAGAN
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE: 454-8100
PERMIT # 'K_'?rs ?
RECEIPT # 710 CO& a
DATE: .1Z --
BLDG. TYPE WORK DESCRIPTION
Re's. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 S
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
(MINIMUM - 1 PER PERMI7)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
- Rough Openings - $1.50 ' - FEE: -- `L
STATE S/C: ?
GRAND TOTAL• ? ? ?
CONTRACT PRICE
f Site Addres? ?-
Lot ,,/ - Block _
4&
? Name
.T Address
c Ciry
? Name ??'eal
? c Address
p Ciry
Ml&AAILAL PERMIf RECEIPT # ??0
CITY OF EAGAN p
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE ?-?,z,? - e 1
o u PHONE: 454-8100
BLDG. TYPE WORK DESCRIPTION
e.-. Sec/Sub Res. New ? :
-
- • Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
Phone (RES. HVAC INCLUDES A/C ON NEW ?
CONSTRUCTION)
GAS OUTLETS (MINIMUM -1 PER PERMIT) - 1.50 EA.
OF WORK
i Air
Unit Heater
Air Cond.
Vent.
Gas Piping Outlets #
??. M BTU
M BTU
M BTU
M BTU
CFM
1
COMM/IND FEE - 1a/o OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
? FEE:
ZL? (?c.
S/C: SIGNATURE OF PERMITTEE
E, TOTAL• ?
FOR: CITY OF EAGAN
. CITY OF EAGAN
• .' 3830 Pilot Knob Road, P.O. Box 21-198, Eagan, MN 55121
PHONE• 454 8100
BUILDING PERMIT Receipt
To be used for ? Est. Value Date ,19
SiteAddress ' ' `-•" .L` ., .° ,. ``
Lot Block ? Sec/Sub. ' RAILS OF
Parcel Na
a Name '7x HakllUN ItQPtES 1711:; I
= Address '- o, M,{ 1367
° City• Phone
¢ Name
?O
?? Address
P Ciry Phone
yVj W Name
I.X. z Address
= City Phone
tW
OFFICE USE ONLY
On Site Sewage ? Occupency ? S
MWCC 5ystem _ Zoning
On Site Well _ Type of Const
City Water = (ActuaD
(Allowable)
* of Stories
Length
Depth
S.F. Total
Footprint S.F,
APPROVALS FEES
Assessments Permit ?.
?
Water/Sewer
Surchflrge r
?
Police Plan Review
Fire _ SAC, City
Engr. _ SAC, MWCC •'
Planner Water COnn.
Council _
_ Water Meter
I hereby acknowledge that I have read this application and state Bld9. Oft _ Road Unit
that the information is correct and agree to complywith all applicable APC _ Treatment P1 •
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
Copies
Signature of Permittee TOTAL
A Building Permit is issued to: on the express condltion 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 Dats Telsphone it
Plumbing 0T37
.v.ac. ? ?? 5 Lla? ?9
f
lectric
E ??' ' ? -•,?. 2? ??'?? ? ? OC?
5ottener
Inspection Data Insp. Comments
Footings I %
Footings II
Foundation
Framing
Roofing
Rough Plbg. - - ,? J Cl . • /? ??
Rough Htg.
Isul.
Fireplace
Final Htg. +l?
Final Plbg.
Bldg. Final ?P,9p7 &j--
cert. occ.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
PRICE:
Site Addre -
Lot 1ock ?
m Name - -
? Address ' {
c City Phone
Name
?
c Address `
p City ? 'Phone. _ -- ? `'l .
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT BLDGS - COMM RATE APPLIES
TOWNHOUSE S CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.U0
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - 50
(ADD $.50 S1C IF PERMIT PRICE GOES
BEYOND $1,000.00)
1 ( ?I
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
PERMIT # '5 -? ? 7
PLUMBING PERMIT RECEIPT # l"l? ?
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
PHONE: 454-8100
- BIDG. TYPE WORK DESCRIPTION
SeciSub Res. f New
? l- ?... Mult Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTUAES TOTAL
Water Closet - $300 s -
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
(MINIMUM - i PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
__Rough Openings - $1.50
` -
FEE
STATE S/C:
GRAND TOTAL:
PERMIl #
MECHANICAL PERMIf
' CITY OF EAGAN RECEIPT # ?
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: h 7
-•--- -- --•-- ' - ^ - ' - - -
Site
BLDG.TYPE
Res. ?
Mult
Comm.
Other
WORK DESCRIPTIO
New ?
Add-on
Repair
? Name _
m Address
c Ciry _
c Address %
O City Phone
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuUets #
Other
?c..L M BTU
M BTU
M BTU
M BTU
CFM
--?-
FEE:
S/C:
TOTAL:
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA.
COMM/IND FEE - 196 OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
SIGNATURE OF PERMITTEE
FOR: CIN OF EAGAN
. CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
• ' PH ON E: 454-8100
BUILDING PERMIT Receipt
To be used for t"} L!,", Est. Value $63'0,, Date
Site Address -t 1 • 1.1
Lot 1 Block Sec/Sub. '•' { r„'
i U J .'
Parcel No.
ar Name i WN liUMES
z Address . ; .? 13
City Phone ei
0
a Name •
.o
? < Address
P City Phone
F W Name '
? za Address I
? =W City Phone
i+1AY 7
13584
19 7
OFFICE USE ONLY
On Site Sewage _ OcCUpancy
MWCC System _ Zoning
On Site Well Type of Const v
City Water _ (ActuaD
(Allowable) '
# of Stories
Length
Oepth
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments Permit
Water/Sewer _ Surcharge f
Police _ Plan Review ?F
Fire SAC, City
Engr. _ SAC, MWCC .
Planner _ Water Conn.
Council _ Water Meter
I hereby acknowledge that I have read this application end state Bldg. Off. _ Road Unit
that the information is conect and agree to comply with all applicable APC _ Treatment P1
State of Minnesota Statutes and City af Eagan Ordinancea Variance _ Parks
Copies
Signature of Permittee TOTAL
A Building Permit is issued to: . on the express condition that
all work shall be done in accordance with all appn„?b{e State of Minnesota Statutes and City of Eagan Ordinances.
Permit No. Permit Holdor Date TNsphone s
PlUmbing }T
H.V.;A.C.
Electric 733 Oc
?ofrer?r ?F - ? ? ) i ?'? ,} - .,, ??,,/ ? ?;
Inspection Date Insp. Commsnts
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Pibg.
Bldg. Final f C: ?'•
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Frmg.
Well k
Pr. Disp.
PERMIT #
' • • PLUMBING PERMIT RECEIPT #
. ' CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: • ?? ?- ?
CONTRACT PRICE PHONE: 454-8100
Site Address
Lot Block - Sec/Sub
? Name
? Address ?
c City Phone
Name
'+
..
_
? Address
p City . ;. Phone- ' -. .
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPI.IES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - FiESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20 00
STATE SURCHARGE PER PERMIT 50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
M u It. Add-on
{
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
' Water Closet - $3.00 ?
S
Bath Tubs - $3.00 ?
Lavatory - 53.00 -
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00 `
laundry Tray - g3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - S3.00
.
1 Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
SoRener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
?
FEE:
STATE S1C: ?v
GRAND TOTAL:
rcrsmi i ? ? ? ( " ?
MECHAkIbAL PERMIt RECEIPT # 7?-
, CITY OF EAGAN
3830 PILOT KNOB-ROAD, EAGAN, MN 55122 DATE 7
Site Address _
Lot -?2/ *
? Name _
m Address
c City _
Name _
3 Address
p CitY -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuGets #
Other
Sec/Sub
Phone
BLDG. TYPE WORK DESCRIPTION
Res. k1111 New ?
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CdNSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) ? - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
MINIMUM RESIOENTIAL FEE - ALL ADD-aN &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GQES
BEYOND $1,000)
y
?J M BTU
M BTU
M BTU
?L M BTU
CFM
?
FEE
S/C: SIGNATURE OF PERMITTEE TOTAL• av
• FOR_ CITY OF EAGAN
CITY OF EAGAN
454-81 00
DEPT. OF BUILDING INSPECTIONS
Correction Notice
Located at I have this day inspected fhis structure and
these premises and have found the following
viol,ations of city codes governing same:
/ i?' ? l? G ?; -? L/? L ? ? 7"1 ? c ? _? `? ` ,6 ??'? T.-
A'!
? ?
r n h,
jCi//L T
When eorrections have been made, please
call 454-8100 for inspection.
;
Date
Inspector City o( Eagan
DO NOT REMOVE THIS TAG
? _ •; PLUMBING PERMIT
w ' CITY OF EAGAN
,/ 3830 PILOT KNOB ROAD, EAGAN, MN 55121
Site Address
? Name
? Addre
c City -
Name ' -
3 Address
p City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
FOR CITY OF EAGAN
PERMIT #
RECEIPT #
DATE: _
BLDG. TYPE WORK DESCRIPTION
Res. ? New _
Mult Add-on
Comm. Repafr ?
Other
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
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE 3/C: '
? /..?
GRAND TOTAL•
- -- ` ?
ZU
PERMIT #
? MECKANICAL PERMIT
RECEIPT #
CITY OF EAGAN .
3930 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
)' ' l=? J
CONTRACT PRIC • PHONE: 454-8100
Site Address
7 BLDG. TYPE WORK DESCRIPTION
Lot ? Bloqk _ Sec/Sub
7
' ,
I
'
) , Res. New
/ . .
.. .. .',:,? ,
lt
% .i-'?..• .
Mult Add-on
?
,s
Name • Comm. Repair
Address
r 1 l,? •,,
1 ?..., Other
C City 1
??
0
89
Name FEES
RES. HVAC 0-100 M BTU -$24.00
c Address v ADDITIONAL 50 M BTU - 6.00 ;
p City Phone / (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
1 PER PEFiMIT) - 1
50 EA
GAS OUTLETS (MINIMUM
.
- .
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU APT BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
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)
Other
FEE: ?'?" ' •?i
/ : ,,r ,?? fi,, ?:.:i? :r!/.:1, .•
S/C: J? SfGNATURE OF P MITTEE
TOTAL•
FOR: CITY OF EAGAN
v/o9 ox P?Aw
? . , CITY OF
•, , 3830 Pilot Knob Road, P.O. B,
PH O N E: 454-81
BUILDING PERMIT
To be used for "i ` !. . Est. Value
i3585
Eagan, MN 55121
Receipt
Date ""'Y 7 ,19 Site Address OFFICE USE ONIY
Lot Block ` SeC/Sub. `'fp?Lc OF On Site Sewage - Occupancy "
?kc, MWCC System _ Zoning
ParCei Na _ On Site Weu _ Type of Const t
rc Name
W
= Address 3
?, , , .
)Ci
o Ci ?1
Phone
a
O Name .
? ? Address
? City
City Phone
that I have read this
Signature of Permittee •? ?
A Buitding Permit is issued to:
ell work shall be done in accordance with all
Building Official
on and stat
811 appliCabl
?
Ciry Water _ (ActuaQ
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments _ Permit
WatedSewer _ Surcharge
Police _ Plan Review
Fire _ SAC, City
Engr.
Planner _ SAC, MWCC
_ Water Conn.
Council _ Water Meter
Bldg. Off. _ Roed Unit
APC _ Treatment P1
Variance _ Parks
Copies
? TOTAL
on the express condition that
Minnesota Statutes and City of Eagan Ordinances.
e
e
. Permlt No. Permit Holder Date Tslephona *
Plymbing
H.V.A.C.
Electric
r
Softener
Inspection Dat* Insp. Comments
Footings I
Footings II r
Foundation
Framing
Roofing
Rough Plbg. - ? ?? ,,? ? _ ? ? A
Aough Htg. '
Isul.
Fireplace
Final Htg.
Final Pibg.
Bldg. Final ? yr G. A.
C@Y1.OCC.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
PERMIT # 110? =% -= ?__
PLUMBING PERMiT RECEIPT # °-
CITY OF EAGAN
3830 PILOT KNaB ROAD, EAGAN, MN 55122 DATE: ?
ICT PiiICE: PHONE: 454-8100
Site Address
lot Block Sec/Sub
9d
Name
2
?u Address
c City Phone
? Name .`
? Address
p City Phone `
FEES
COMM/IND FEE - 1ai6 OF CONTRACT FEE
APT. BLOGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMMlIND FEE - $20 00
STATE SURCHARGE PER PERMIT - 50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00) ?
, t
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BIDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.40
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
(MINIMUM - 1 PER PERMIn
5oftener - $5.00
Well - $10.00
Prfvate Disp. - $10.00
= Rough Openings - $1.50
FEE:
STATE S/C: •?=
GRAND TOTAL:
? • • .. rtrtnnI 1 9 v " ( ,.- ?_ _-
IIVCliAM16AL PERMIZ y RECEIPT # 7-5 0 7-;i-
' • • CITY OF EAGAN `
. 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE 7
Site Address '''- ` gLpG. TYPE WORK DESCRIPTION
Lot ? Block 42- Sec/Sub
Res. New
Name
?,'?:WnNORTH AVE. S0.
Mult Add-on
S Address IN NLIS, tA P' 55420 Comm. Repair
c Cit i •' ???")
Pt?'Q Other
y ne
; , FEES
c Name
? RES. HVAC 0-100 M BTU
AODI -$24.00
Address TIONAL 50 M BTU - 6.00
O City Phone (RES. HVAC INCLUDES A/C ON NEW
' CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER P
RM
50
A
(
-
E
M - 1.
.
E
TYPE OF WORK COMM/INO FEE - 1% OF CONTRACT FEE
Forced Air ? M BTU •?`? APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. -2 q M BTU MINIMUM COMMERCIAL FEE - 20.00
V
t STATE SURCHARGE PER PERMIT - .50
en
. CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # _L • v BEYOND $1,000)
Other $
FEE:
S/C: Q1? SIGNATURE OF PERMITTEE
TOTAL•
FOR: CITY OF EAGAN
CITY OF EAGAN _ 11
454-8100 . ?
DEPT. OF BUILDING INSPECTIONS
Correction Notice
Located at
I have this day inspected this structure and
these premises and have found the following
violations of city codes governing same:
When corrections have been made, please
call 454-8100 for inspection.
Date! '/??
? Inspector City oi Eagan
DO NOT REMOVE THIS TAG
INSPECTION REC4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS:
i: ( 04 t
.. ? t t' M';r1W ( i ft
(ltAl 11; (?i I f1(?MA`+ 1 AKk
? PERMIT SUBTYPE:
i T?; 1 "14
APPLICANT:
TYPE OF WORK:
! i)1+#?
[i!I 1. 1 i1] M4;+
0'ip4 3l
Hr/ ie>/q7
INSPECTION .. . DA
I ' HAFtK.`a•_ SEf'AFtiS7t PFPMI 1': kF1111iRt f) f Ot: AH'i t"I Vf lP It:AI. t7ft f'I UIIRiN1l W0141'
Permit No. Permit Holder Date Telephona N
ELECTRIC
PLUMBING
HVAC
Inspectlon Date Inap. Commenta
FOOTINGS
FOUND
FRAMING
d
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
. ? Y . ...p. . .,. j. .??° . +! .V. x ':. . . - . ' ._?.
? SEDGWICK HEATIIVG & AIR CONDITIONING CO., CP`7"/
HOUSE HEATING TEST RECORD
ADDRESS CITY r c,C ''.( {v
,
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SQLD BY IN5TALLED BY
Electrical Work By Gas Line By _ ?' f __•+? r?_ _
TYPE OF HEAT GA_ FA Y HW STEAM SPACE HTR. UNIT HTR. ? OTHER
? GAS DESIGN CONVERSIDN
MAKE - %9 ? 1 '? '-? _, ?•", i" ; MAKE OF BURNER
Model -+ --?T Model
Serial Max. BTU Rating
INPUT MAKE OF FURNACE l
Model -
THE RMOSTAT 2?2
Vaive
Limit
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
?eat Plug
. ?,.. Z
L.W. Cut Off "`- ----
? • ? V
Pressure Percent CO2
Input CFH Percent 0
2
Stack Temp. Percent CO ?'?' - %? • ?l
Vent Size r 17
KIND OF LINER SIZE NONE
Draft Hood f?- Q , ta Regulator
Filters Size Number '
Chimney Location Inside Outse
Chimney Construction • ??
Smoke Bomb u Wiring -? "
Draft Test Tag `• :f _ ` _
Door Pressure r Lighting Inst. xDate Tested
Company Testing
Name of Tester
Form 235
SEDGWICK HEATING & AlR CONDITION,fNG CO:
• 1 ? - 'HOl/SE HEATINC TEST RtCORD
? .
ADDRESS 4300 ? CL?MSOf? C?R CITY t'l
OCCUPANT OWNER 8??B Pq fc a WESS?L
HEAT LOSS ` DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work By -_?L( 1?Di: ? Gas Line By _ ccr
TYPE OF HEAT GA_ FA --<' H1N_ STEAM SPACE HTR. UMIT HTR
GAS DESIGN
MAKE - Z?74C2!?! Ya t.1T MAKE OF BURNER
Model 44G, A 1,t?o--L90 S o Model
Serial 49 S fo A O N 4 Bv Max. BTU Rating
INPUT So F c c c MAKE OF FURNACE
CONTROLS
THERMOSTAT-3?14 Heat Plug
Valve- S?( ?Li ez- /JSoX - .Z
?
Limit ?T E "'\ C 6
Limit Setting -2!a7n ° V:-
Fan Setting _ k a o ° qF-
Pi lot Type E%-c= c-t mn N ic
Pilot Make _ SPA ai<
Pilot Model _ N SL 1
Pilot Timing N!?:T c) ,i T
L.W. Cut Off
Pressure ? • ? tA1< < - Percent CO
2
?
Input CFH So Percent 02 ?
?
Stack Temp. a?'-?° ? Percent CO
Model
Vent Size ?
KIND OF LINER SIZE NONE
Draft Hood _-?) '? S????-? Regulator S
Filters Size Number ?
Chimney Location Inside X Outside
Chimney Construction C LA S,1? 'H;
Smoke Bomb Wiring ?
Draft - Test Tag _
Door Pressure Lighting Inst.
Date Tested `f - ?w ::p '
Company Testing ?A_ C-?- G t ki 1!' K_
Name of Tester
Form 235
59 c1
SEDGWICK HEATING & AIR CONDITIONING CO.
. HOUSE HEATING TEST RECORD
ADDRESS 43C ` CITY 9-7 0 ^A r,?,
OCCUPANT '---' OWNER tQ w-1 44 -,R `u?.l +-I,I vN1r,-S
HEAT LQSS DATE HTG. INST.
SOLD BY
INSTALLED BY
Electrical Work By 13%.kq Gas Line By c'?
TYPE OF HEAT GA_ FA->-e- HW_ STEAM SPACE HTR. UNIT HTR
GAS DESIGN
MAKE ? R ti 1c-.t-l'T MAKE OF BURPIER
Model 395tGnW0a14n5C1 - Model
OTHER_
CONVERSION
Senal 4q4•6A OSOO? Max. BTU Rating --?"-"" -
INPUT - 5n• n? c-, MAKE OF FURNACE ---?
Model ?---`-
CONTROLS
THERMOSTAT T g34 Heat Plug
Valve - ?lt =3 « r
Limit - S Te rw C ?
Limit Setting .?Sr^,° F?::
Fan Se#tirrg - !_ pc-,° rl?
Pilot Type ? ?-? ? ?6 r'.l iL
Pilot hllake SPnRV_, 1[?t?l aoig
Pilot Model
Pilot Timing S'( 6- ?,17
L.W. Cut Off
Pressure 3• S"J, C - Percent CO 7°?o
Input CFH 50 Percent 02 <, °l1L,
Stack Temp. ?G e Percent CO .1?jr.'rjr-_
Vent Size ?
KIND OF LINER SIZE NONE
Draft Hood 5 < < , Regulator !?E
Filters Size Number 1 r
Chimney Location Inside Outside
Chimney Construction L_?a `-? E
Smoke Bomh ----^-•?' Wiring C?K_
Draft - Test Tag ?E S
Door Pressure -- Lighting Inst. (2SK,
Date Tested ? - ?! - C, -1 -
Company Testing
Name of Tester C--C? t-4 q? *,a
Form 235
SEDGWICK HEATING & AIR CONDITIONING CO. ? r
HOUSE HEATING TEST RECORD /? '? ?_: 19 ?
ADDRESS CITY crl
5
OCCUPANT tIC ?r C?Kr OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY tNSTALLED BY-
'` •'?Electrical Work By Gas Line By ?
TYPE OF HEAT GA_ FA_ HW_ STEAM SPACE HTR. UNIT HTR. QTHE
GA$ DESIGN CONVERSION
MAKE MAKE OF BURNER
Model ' ;!';' (>;? c ?C; _ ' ?`?.•' . C. Model - -
Serial Max. BTU Rating ?
INPUT J UG MAKE OF FURNACE r
Model
THERFJIOSTAT-
c,
Valve -? ?
Limit {
Limit 5etting _
Fan Setting
Pilot Type
Pilot IlAake
Pilat Model
7 ( , CONTROLS
Heat Plu
q ? Vent Size `
?
%?'??--7+'? '? - KIND OF LINER _
DrefiHood )ticj
Filters Size _
? { Chimney Location
Chimney Construction
Pilot Timing 4- rv S'a rk.1
L.W. Cut Off "---r
Pressure ( Percent COZ
Input CFH? Percent O ?J 7'
2
Stack Temp. Percent CO ?
? J r?c ?
? SIZE NONE
?
Regulator 1 `
Number r
Inside Ou ide
C Smoke Bomb
Draft
Wiring
Test Tag
Door Pressvre Lighting Inst.
Date Tested ' L ? 8?5-
Company Testing ' a-,` C' /;` ''
Name of Tester o% -"?- ''Form 235
? - . ? . INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ,?,•r. ?? zs377
Eagan, Minnesota 55122-1897 Date Issued: 16121 RR1-4875
SITE AQDRESS:
I e?3a0 ? ri r1,.
r , PERMIT SUBTYPE:
1; -tip 1 I.hlii
1 FINI
APPLICANT:
Lgrr
TYPE OF WORK:
N 1 1;i
111 `? ?r l i' f I ??t+l (; :d A'.t1t! )
f i: nM 1 ra11
1,)" td/1F;K'- : A',I J'f1OA l 1 }•1 i? iN l I t', 1:1 t)!l 1 l;i i1 } s)I, 1? M'v V 1 t i I t; l e 1t1 E1fjt{t
Pertnit No. Permit Holder Date Telephohe •
ELECTRIC Q-p?'?f.g ?& ? `r
PLUMBING
HVAC
Inapection Date Inap. Cvmmenta
FOOTINGS
FOUND
FRAMING
i
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TE$T
INSUL
GYP @OARD
FJREAlACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT TEST
BLDG FINAL
?GG-G
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
CITX OF E-..nN Permit No: ?? 75 -'- 5-19--?' ?
Date:
'o
31(30 Pt?-t'Kr`ob Road Meter No: ? Size:
P.O..F3ox 21199 Reader No: ? Date:
Eagan, MN 55121 / +
??1esa l.ori2oa. I'ornes ?V
Owner.
SiteAddress: 4300D Clemaon of Thomas L.
Conn. Ch9: 5 25 . f)Ond • r8111u`'u- AS ?.tC' ' 3
?
Acct. Dep: Fl??
o.' I? A? L
o
Permit Fee: I ?- ?
?
Surcharge: ' ?'s
'
I agree !a comply with the City ot Eagan
Tr.Plant ??'?•??? ` Ordinan `
Meter r,7 I),i. +
M isc.: gr YeZ
Z2
WATER SERVICE PERMIT `
CITY O"AGAN , ?.. SEWER SERVICE PERMIT
3830 R41ot'K1iob Road
Pti%Abox 21199 9907
PERMIT NO.:
Eegarh MN 55121 DATE: 5"19"_3'
Zoning:
1
Na. of Units:
Owne S'w roL'i
r zon Iiomes
.
Address: - - - - - - - - - - ..., .
Piumber j noinpsvn r.cumo iiie' ,?^ ^ n I agree to comply wRh the City of Eayan Connection Charge; :);4p•uvizq
Ordinances. Account Deposit: 15. OQpd
I BY
t
( Date of Insp.:
i Insp.:
i
?
L-` - ? - - --'_ ? ?-' -.' -
Permit Fee: 10. 002d_
Surcharge: - S0Fd,
Misc. Charges:
Total:
Date Paid:
CITY lr1F,EAGAN
3830 Pilot Kitob Rvad
Rf). Box 21199
Eagan, MN 55121
Owner. X Ew
Site Address: ? T
Conn. Chg:
Acct. Dep:_
Permit Fee:
Surcharge:
Tr. Plant_
Meter. _
Permit No: Date: '
Nieter No: S g '?
Size: o
Reader No: z Date: ? k
emsvn r«ils of Thotnas T.'.
IJi9ree to comply with #he City of Eagan
WATER SERVlCE
- -?
?
CITa( OF EArpAN .i ,...._, SEWER SERVICE PERMIT ?
3830,10111of l4nob Road g90t_ -?
P.O. Box.21189 PERMIT NO.:
Eagan,'MN 55121 DATE: -13"3'
Zonin9? t-3 No. of Units: 1 ?
Owner idew &rizon Nocues
. .. d
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
I agree to comply wNh the Gty of Eagan Connection Charge: - 525.44va
Ordinartces. Account Deposit: _ 15. bond
CITY fiF E/[G71N Permit No: 5--1 7
Qate: CITY OF I?AGAN 49'
Permit No: L
383@Pilot Knob Raad
Meter No- 3?7Z
" oc
?5'?d Size: 5
3830 Pibt Knob Road ry
q
Meter No:
P.D. Box 27199 Fteader Na C3 ?aq8? ? 3 Date: , -,S-7 p,0.' gox 21199 Reader No: L?. a?
Eagan, MN 55721 Eagan, MN 55121
_;ew ?_ orizon iio?:;?s idew :
Owner iorizon ?iot,ie? ?
Owner
Site AddrPSS? 4301B
Clem$p Illjllk
W L?,? ??_,B2 Trails of Thomas Lk .
Site Address: 4301
Clems,plij ' ?;;? ] ^.^. Ti
Chg:
Conn - ?-' . ""`„? ,•"
.
Aect Dep: 15.
Permit Fee: 10•
Surcharge: • 5
Tr. Plant 180• 0
Meter A'
.
Misc.:
I agree to compiy with the
Ordinances.
WATER SERVICE
Qate:
Size: 1' 6-k
Date: '
Conn. Chg: 525. 0r) ? - ?ngta" +- }..,
Rl?+?
Acct Dep:
Permit Fee:
?
?py?i9,? ,
15 ? E N_ q, ?f,? .
?
r? ?
Surcharge: ~I agree to cemply with the City of Eagan
Tr. Plant Ordina ea.
Metet
Misc.:
WATER SERVICE PERMIT
f CITY OF EkGAN SEWER SERVICE PERMIT
? 3830 Pilot Katsb Road
I P.O. frpx;rr19j PERMIT N0:
Eagan, AN 551213 DATE:
Zoning: ' ?+? pr 4T
v?$ No. ot Units:
' Owner. , ` ,
,
? Address: _ I.k
Site Address:
mps
! Plumher. Ptumbtffg
(
, ..!'? 4"?;
. J iJ T. P
I agree to comply wkh the City of Eagan Connection Charge: 52$•00F"
Ordinancea. Account Deposit: 1 S. OOpci
Permlt Fee: 1 0• 00pa
' Surcharge: • SQpd
? gy Misc. Charges:
Date of Insp.: Total:
? Insp.: Date Paid:
? CITY OF EAGAN
? 3830:Pilof Knob Road
P.O. Box 21199
, Eagan, MN 55121
Zoning: P3
! Owner. New rizon HamE
G .'..
Address: ?01 ?'1,
I Site Address: ?BOn Ci?
? Plumber. Thompspn Plumbii
' I agree to oomply wlfh the Clty of Eagan
i Ordinances.
; ey
i Date of Insp:
SEWER SERVICE PERMIT
9904
PERMIT NO.:
DATE:
No. of Units;
Conneci3on Charge:
Account Deposit: -
Permit Fee:
Surcharge:
Misc. Charges: _
Total:
?,.?,.,.,.. ..,.... ' . ...
CASH RECEIPT
?.
? CITY OF EAGAN ?
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE ? 18 ?
RECEIVED . . ..
PROM ( y .
AMbUNT $
& DOLLAR!
+oo
? CASH 0'64ECK
FOR ' .• . ? ? ? ? ' ?-1 I?? ?
BY /??'2`? •r
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
.,-
-
BLDG. PERMIT NO.,"??,??"
I _ 01-3210 Bld ? f ..,;;, . . ? = y?'•l
g. Peri 01-3422 Plan Checl
01-3445 5urch./Adi
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
ZD-2275 SAC
20-3865 Water Conn
20-3868 Water Trmt
20-3716 Water Mete
20-2252 Acct. Dep. ?
20-3713 k'ater Perm: ?
20-3743 Sewer Perm; ?
79-3866 Sewer Cvnn,
11-3855 Park Ded, ?
TOT--,_?
I
Thank You ,a
Fox sALN T. H. CITY OF EAGAN ?f 0- 13585
,„r N 3830 Pflot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt# 73s
To be used for 1 OF 4 PLEX Est. Value $63,000 Date MAY 7 119 87
SiteAddress 4301B CLEMSON CIR
Lot 22 Block 2 Sec/Sub. TRAILS OF
Parcel No. thomas lake
rc Name NEW HORIZON HOMES INC
z Address P.O. BOX 1357
° City MPLS Phone 420-3900
,p Name SAME
0 a Address
? City phone
¢
w
z
n
z
W
Name _
Address
City _
I hereby acknowledge that 1 have read this application and state
that the intormation is Conect and agree to comply with all applicable
Stete ot Minnesota Statutes and Silty a(kagan OrQi}P[ioces.
Signature of Permittee
A Building Permit Is issued to: NEW H(
all work shall be done in accordance with all
OFFICE USE ONLY
On Site Sewage Occupency R3
MWCC System x Zoning PIl
On Site Well Type ot Const V
Ciry Water X (ACtuap
(Allowable)
# ot Stories
??
Length
Depth 26
S.F. Total
Footprint S.F.
APPROVALS FEES
Asseasments Permit $ 374.00
Water/Sewer _ Surcharge
Police _ Plan Review 1 R7 _(1Q
Fire _ SAC, City 100_ o0
En9c _ SAC,MWCC 599_00
Planner _ Water Conn 59 5_!1o
Council _ WaterMater 67_!lQ
BItlg.Off. _ RoadUnit 305_00
APC _ Treatment P7 180.00
Variance _ Parks
Copiea
-3O
V?
TOTAL •
INC
State of
on the express condition that
Statutes end City of Eagan Ordinance&
Building
FOR SALF• T.H. CITY OF EAGAN rJ° 13584
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
BUILDING PERMIT PH ONE: 454-8100
Receipt#23s ??
Tobeusedfor 1 OF 4 PLEX Est.Value $63,009 Date mAY 7 ,19 87
SiteAddress 4301 CLEMSON CIR
Lot 21 Block 2 Sec/Sub. TRAILS OF
Parcel No. THOMAS LAKE
e Name NEW HORIZON HOMES
z Address P.O. BOX 1367
o City MPLS Phone 420-3900
p Name_
?a Address
? City_
a
w
z
u
z
W
Name _
Address
C ity _
OFFICE USE ONLY
On Site Sewage Occupancy
?
MWCC System Zoninq
On Site Well Type of Const
Ciry Water _X- (AChaq
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr.
Planner
Council
I hereby acknowledge that I have reatl This application and state Bldg. Ofl.
ihattheinformetioniscortectendagreetocomplywithallapplicable I A?
State of Minnesota Statutes and City Ea Ordina Variance
Signature of Permittee
e
A Building Permit is issued to: NEW HORIZON HOMES
all work shall be done in accordance with all applin sor? ta Statu
Building Official MStateof M 1&-al.i
FEES
_ Permit
_ SurCherge
Plan Review
_ SAC,Ciry
_ SAC,MWCC
_ WeterConn.
_ Water Meter
_ Road Unit
_ Treatment P7
_ Parks
Copies
R3
PD
V
$ 374.00
31.50
t?n„7 np
100.00
-5^r.-`rv0
525--^0
67. 0
30-`?-. 0
--i86:80
TOTAL $.2,294„S0
_ on the express condition that
and City of Eagan Ordinances.
FOR SAE l.H.
r ?
SiteAddress 4300B CLEMSON CIR
Lot 23 81ock 2 Sec/Sub. TRAILS OF
Parcel No. THOMAS LAKE
a Name NEW HORIZON HOMES INC
= Address P.O. BOX 1367
° City MPLS Phone 420-3900
a
.o Name
?? Addre
? Ciry_
w W Name
zz. Addre
U
aW cIry_
OFFICE USE ONLY
On Site Sewage OccuDancy R3
MWCCSystem X Zoning Pn
On Site Well Type of Cons[ r
City Water (ACtuaq
-
(Allowable) ?
# oi stories
Length T+?
Depth 26
S.F. Total
Footprint S.F. APPROVALS FEES
Assessmenis _ Permit T 374.00
Water/Sewer _ Surcharge 31.50
Police - Plan Review i fi 7• 00
Fire _ SAG City 100.00
Engr. _ SAC,MWCC 595.00
Planner _ WaterConn. 595_00
Council _ WaterMeter 67.00
I hereby acknowledge that I have read this application and state BIdg.Off. _ Poed Umt 30_5- 0
thalthelnformationisconectandagreetocomplywithallapplicahle APC _ TreatmentPt 1A(l_n0
State of Minnesota Statutes and Cln Ordi'E!?n Varlance - Parks
Copies
Signature of Permittee ? ?- rornL ??
A Building Permit is issued to: NEW HORIZON HOMES INC on the express condition that
all work shall be done in accordance with all a plicable Stat"f MinAnesota Statutes and City of Eagan Ordinance&
Building Official , --0.-c?.y;/?o,e.dL.
CITY OF EAGAN N° 13586
3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT ReceiPtn 7.3-!5 G?d
Tobeusedfor 1 OF 4 PLEX Est.Value $63,000 Date MAY 7 ,1987
r
FoR Saz.F, T.H. CITY OF EAGAN -
? 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 No_ 13587
PHONE:454-8100
' BUILDING PERMIT Receipt# `73 S Y P
7o be used for 1 OF 4 PLEX Est. Value $63,000 Date MAY 7 ,1987
Site Address 4300 CLEMSON CIR
Lot 24 Block Z Sec/Sub. TRAILS OF
Parcel No. THOMAS LAKE
rc Name NEW HORIZON HOMES INC
? Address P.O. BOX 1367
? CitY MPLS Phone 420-3900
olName SAME
?Q Addrass
? City Phone
f¢
Fw Name_
xz. Address
aw City_
OFFICE USE ONLY
OnSiteSewage Occupancy
?
MWCC System Zoning
On Site Well Type of Const
Ciry Water X (ACtuaQ
(Allowable)
n ot Stories
Length
Depth
S.F. Total
FootDrint S.F.
APPROYALS
Assessmen[s
Weter/Sewer
Police
Fire
Engr.
Planner
Council
FEES
_ Permit
_ Surcharge
_ Plan Review
_ SAC, City
_ SAC, MWCC
_ WaterConn.
_ Wa[erMeter
_ Road Unit
_ Treatment P7
_ Parks
COpies
TOTAL
I hereby acknowledge that I have read this applicetlon and atate I BICg. Off.
thattheinformationiacorrectentlagreetocomplywithallapplicable APC
State of Minnesota Statutes and Ci E gan Ordi n , Variance
Signature of Permittee G
A Building Permit is issued to: NEW HORIZON MES INC
all work shall be done in accordance with all applicable $,tate of Minne44#a Statu
R3
PD
?
?-
$ 374.00
31.50
"p
iv^^.z,0
-525-.00
`r. 00
- 3U"0
-Z80.00
?. 50
_ on the express condition that
and City of Eagan Ordinancea
Building Official L?
b
This request void
18 rtwnths trom
C 73364
ElecVical Conlractor
1 hereby requBS< inSpection ot above
elec<rical work installad et
DReadyro?1l Nntity InsPec '
lor When Ready
THIS INSPECTION HEaUEST WILL NOT
eE ACCEPTED BY THE STAh BDApD
UNLESS PROPER INSPECTION FEE I$
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-oa
? Sea instrucuons 1.1 campleling this form on beck of yellow copY.
"N" 8elow Work Covered by This Request
id Rep. . TyOa of Buildine ApOliancea Wired Equiumenl Wired
Home Ranye 7emporary Service
Duplax Water Heater Lightiny Fixtures
Apt. BuilAinp Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial 81Ag. Air Conditioner Buik Milk Tank
Fefttt Other peci y i her(Snur.ity)
t ar Sueci y Othor Other
7 Fee ServiceEntranca5iie p Fae Feeders?5u?feedars N Fea Circaits
O to 200 qm s O to 30 Am s 0 2? 30 Am s
Above 200 Amru 31 to 100 Amps 31 to 100 q y
Swinvning Pool Above 100_Am s Above 100_Amps
Transiormers Irngation Boorc?s PartialOther Pee
Signs Special Inspection
$ -
_
Aemnrks TOTAL T `E
ot? ?
Nou9h-in - Date '
I, the Eiectncal
Inspector, hmaby
' cartily ehet the above
Rnal pppqqq???
oectien has bee.
?O ?neAe.
ThiarepuestvoitliBmonMyfmm . .
MINNESOTA STATE BOARD OF ELECTflICITY
Gri09s•Midwev gl49. - Room N-191
55104
t821 Universifv Ave.. St. Paul. MN
-. , r^+?I 847-PRAO
This reques[ void 7,5-710
18 npmhs Imm
1 5 n ? R % _0.? r? ? y.rz,.1.,,? -?,1?_; $`-?? °a
?
Pepuest Date
'C., G? Rre No.
Rough,i'n'Insperuon
R ui +
Ready Nuw?l Notify In
spec-
?
Whea Pead
O lJ ?
N. v
ensed Electrical Convactur 1 here4V request inspection of ebove
? Owne,r elecVicel work installeE at:
5 r e,s,4y?d
J`? ss, x o, R Oe o. Clrv
ecimn o. Township Name or No. RanBe No. Coun[y
Oc P n[ (PRINT)
4i &-) rn-16? Phune No.
Power $upp -e i ,
(WL! V Adtlress
Electrica? tractm (COmpany Namel
r?mZ-6 oY-) F te QJ i Contr' r's LicenVeo
ailing A?Jress (Con o. wner Mzkipp?lnstailionl
? ?'
'
Authorize (Co ? aking ta
ti I Phor)CN?umber
C/ 3
MINNESOTA STATE 90Afl0 OF EIECTNICITV
GriB9s-Midwey Bltl9. - Room N•191
1821 Universi[v Ave.. Si. Paul. MN 55104
^FOne 16121 642-0800
THIS INSPECTION REQUEST WILI NOT
BE ACCEPTEO 9Y THE STATE 80AHD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
0A,? REQUES7 FOR ELECTRlCAt INSPECilON
, See nshuctons for completing lhis form on back of Yellow covV. yes-oo-yoot-os
m i C, nG-, Q "X'" Below Wark Covered by 7his Request
?
New da Aeo. TyDe o+ euiim„s Apoiancn. wuretl Eauiunient Wired
Home Fange Temporary Service
Dupiex Water Heater Ightlny Rztures
Apt. Bullding Uryer Hectric Heatin
Commerdial Bldg. Fumace 51!o Unloeder
Industrial Bldg. Air Conditioner Bulk Milk Tank
Fann
O'hnr pe<-J
(11hee ISPenivl
t er Succiiv, Otnor O+hur
Fee Sa,vice EntrancaSixa p Fee Feeders/Suhfezders a Fee Circults
0 to 200 Amps 0 io 3C7 Am 5 0 to 30 Am )s
Above 200 Ainps 31 to 100 Amps 31 to 100 A s
Swimming Pool A6ove 100_Amps Ahove 100_AmVs
Transiormer5 Irrigation 8ooms Partial-"91.her-Fee
Signs Special Inspection
TO L FE€
Hemarks
FouBh-in
. D1te
7 /r'a/1 I, ha Elecvlca
m a?m, aey
arti y at the above
I Final
r De
?"' ins0eetion has peen
made.
(hIS reQUest voi018 monlhs Irom
7his reQUest void
18 nwnths fmm L ?
0 15057?.
fle.qvest Uate
?? ?? (?['?
? Fire No, Rouphn^Insuectinn
HeQUiroid7
? ?
Ready No INo
tifv Inspec
t
Wh
(\
F N or
N R dy
??aeo uecvicai Convac?or 1 herebv re0uest insvaction of ebove
? Ownar alectrical work inatalled aY
SheepA dres , 9ox F ure Nm
j i? 75
emmn a Townshlp Name or No. qange No. Cowny
Ocm ent (PRWT)
?2c.?
r
1-
?or?
?.S
Phone Nc.
Wowe" itov"ins AdAress
E I Contractor ICOmpany Ndme Conrcact i's I.icnnse o,
Mai ing AAJress)IC nlratqr wner Makii[aila[?
e
ns
Auffiorized ien ur (Contr
tall' ?
r ner kiny I
e" Phon uniber
3 ?
mirvrvtsolq STATE 80AND Of ELECTMCfTY - IHIS INSPECTION REQUEST WILL NOT
GrieBS•MidweV Blde. - floom N-197 BE ACCEPTEO BY THE STpTE BOARD
1821 Universitv Ave.. 5i. Pwul, MN 55104 UNLESS PNOPEH INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
? ; SQUESTUFOR E LECT floeA 91Nthis SP oC on ONck ot vanow coov. EB-aooot-os
?77/O
n C)j )F,7 "X" Below Work Covered by 7his Request
HAd R.P. TyDe ot 6oilEinu Appliancef Wired Equipment Wired
Home Range Temporary Service
Duplex Wa[er Heater iyhtiny Fixtures
Apt. Building ryer Electric Heatin
Commercial Bldy. Lrnace Silu Unioader
Industrial 81dg. Air Candition r BWk Milk Tank
Farm ?nr? neciN oinci Isuccitv)
t ier uorifv ther O?h?er
l=mmr,ule lnsnorfrnn hac liolnw
N Fee Service Entrenee5ize x Fee Fentlers/5ubleeders u F. CircuHs
tp 200 qm s 0 to 30 qm s 0 to 30 f1m
Above 200 q1111s 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100-Amps Abave 100_Amps
Transiormers Irrigation Booms PartialOlher_Eee
Signs Specialinspectipn
54
TO L FEE
Hemarks
.? . - df , -n i i / 50 r lc•n )
txr_ u-u.eu t i?/r_ii? u e t•. = u? i
NouBh-ih Elecvi
nsoe eroOV
/
findl e? (" InspBCfiOn he9 hOBn
V'd- pria,.
fnia reauest voia 18 moniha irom
Thls request void
18 rcpmh5 1wm
0 15056
censed Electrical Contraclo,
n Owner
v ) -2?6
? Con?ractor (Company
[we
.r,89s-Mia.vay 91Ag. - qoom N-191
1821 Univerailv Ave.. St. Peul. MN 55100
Phone (612) 642-0800
?gh-i"Insper.?inn
lu511 iretl] OReadY Nuw?tl?ll Notilv In
saec-
s ?Na l?[or When Fleadv
I hereby request inspection ol ebove
electricel work installed et:
r r te
UCY-
THIS INSPECTION XEQUEST WILL NOT
gE ACCEPTED BY THE STqTE BOqRD
IINLESS PPOVEfl INSPECTIDN FEE IS
ENCLOSED.
_-i cLECTRICAL INSPECTION ea.ooooi-os
_u insLUCtiuns for com0letin9 "is form on Enck of yellow copy.
"X" Below Work Covered by Ihis Request
\
Hdaf Xep. Type oi 6uiltl?ng Apoliancee Wirad-- Equiumenl Wired
Home Range Teinpnrary Service
Duplex Water Heater ightiny Fixtures
APt. Buildinq Dryer Electric Heatin
CommerCial Bldg. FumaCe Siio Unloader
Intlustrial Bidg. Air Conditioner Bulk Milk Tank
Farm ornN, Sne, v otno, tsue,:,ryi
...
.......
_ ?'_ t m 5peclrv
__"'___ ,- .. . otne. oinei
p Fae Service Envanca5ize Y, Pee Fextlers
/Subfexders IX Fen Circults
0 to 200 qm s q
0 to 30 m>s 0 in 30 Am>s
Above 200 qm??y, 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_P.mps
Transiormers Irrigation Booms Partial.-0ther fee
Signs SUeciallnspection .
Hertnrks
.
)
1 TOTA EE
(?.GG
i
Rough-in p??t
•
? I the Electncxl
i
t ,??? nsoec r, na,
Final p, e carli/y that the above
?
d
'-? inspection has been
rtaae
J .
-
757
n 057 984 7 a? ? °o
Fire No Rduy;rin Inspeo[ion FeQUIr Inspectl ? Then ough-In
Reausat De;a .
iYOo musl I In;pec?or ?vhen reatlyl r
+ eatly Now Will Notif sp
Yes ? No Dare Reatly
IIlcensed contracror ? owner hereby request inspection of above electrical work at
Job Adtlress(SVeol, 5ox or Raule No cuv
Sectian P!o. Tov»snip Nam= or Nu. Hange No Cou
Or,c Udnl P ) Phone No.
Po?er SuppM1ar Hddress
EI Ii'ical Gonuaclor ( Campany Nanie) Conlr tor's Lioense No.
`
.Mai g Ads ss (ConVxmr r Ovmer F aklno Instal
v
Au-noriz naWra (COm:a or.0. cr hlaking Inslalla n) P?N}???
Y
MI ESOTA STATE OA OF ELEC CITY
riggs-Mitlway BIJ - Room 5428
1821 University A., St. Paul, MN 5 104
Phone (612)642-0900
BE FCCEPTED BY THE STATE BDARD
UNLE55 PROPER INSPECTION PEE IS
FNCLOSED.
(f /? /?5 REQUEST FOR ELECTRICAL INSPECTION
?097 ?n?ryn S 4 Ins.mctlone tor completing Ihis form on back of yellow copy-
0 :7 Q "X" Below Wnrk Covered by This Request
?
?
/WW090$
'ta4:
Neuv A d ep. ype ot Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer load Management
Comm./Industrial Fumace Other (Specify)
Farm Air Conditioner
f'
OMer (spen'ry) GonVactor's Remarks. V.>?yyy„?j,? ? y\
-Z' C_??C4-.. ?G CT.C ?^kJ\2_, , MOJZ
Compute lnspection Fee Below:
# Other Fee It Service Enirance e Fee # Circuits/Feeders Fee
Swimming Pool 0 ta 200 Amps 0 to 100 Amps
Transformers Above 200 Amps 0-Amps
S'IgIIS Inspector'a Use Oniy TOTAL
l Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M HS.
I, the Elecirical Inspector, hereby RpOq"-'" wv
certify that Ihe above inspection has
been made. Fi„ai Da[e ,
•?
OFFICE USE ONLV V V
reouest vtitl 18 monlhs Imm
This requesl voitl
1B momhs Irom
DD'.15 0 5 5?..?Gf i3? ;l?n-:C.> ,? X/G?'7__?;?;'??.?c?
He.ques! Da c?_?? Fire No. peq0h-?d.InsVertion ?Ready Nu? Nolily.lnspec-
ON. [or When Reudv
ypercensed Elecirical ConVactor I hereby reQUest insOection oi ebove
/- wmk inslelled at
" Owner
SU?`ddr ss, B. r /o;te No.
ecLOr, u. Township Namn or No. -"-
?
Range No.
City
Coumy
Or u an[ IPflWTI
. ? t. V V !
'j
?/! ???,(?
VC " Phone No.
Power Su0V11R[
? )%A Ai 1
V`•?? v
?J Address
le ' al Contractor ICOmVany Namel Cnotrappp???ppp r s License o
y?..
Mai in AJre?s 1 nVac or o ner aking latio
?
?U ? V /--5 30413
J
?
Authori ed t ICOnv tor er akinB Insta ati PhupyN? er ?? - `
f
rWis irvSPEGTION HEQUEST WILL NOT
MINNESOTq SATE BOAPD OF ELECTHICITY
Griges-Mitlwev eldg. - Room N•191
1821 Universilv Ave.. SL Paul, MN 55104
Phone (612) 642-0800
BE ACCEPTED eY THE STATE eDAND
UNLESS PflOPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTHICAL INSPECTION es-ooooi-os
/n ?7 J'?
U? / ? Sae insM1UCpons for comoletin9 this form on back oi Yellow ropy. ,.'7?j '1V
-'1 -:G (1 G C "X" Below Work Covered by 7hrs Request
E60
AAd
Neo.
TvVa ol auildins
Aoo???ncee wired '_
men? wired
i
Home miye
ee
Serv
Duplez Water Heatar ixtwes
Apt. Buildinc?
Dryer V
eaLn
Commecal Bidy urnace der
Industrlal BIAg. Alr Condltioner Tenk
Farm Othei aer.i v cilv)
t cf 5uccirv O,ner ? FBB SarvicaEntrencaSize H =AbovelOO-Amps lee?e?s ? f GIlCU??S
0 to 240 Am ps ? tn 30 Am s
Abave 200 Amps ps 31 to 100 Am s
Swimming Pool P,mps Above 100-AmPs
Transtormers ms PartialOth er Fee
Signs ection ? 707 FEE
Remarks ? vti
ftough-In ? D11e . [h Eiec< - al
7,-64 s0a . hereby
c4? fy thet the above
Final D'?? eclion has baen
'
mla rapuest vold 18 monttre irom
?N??g
2007 RESIDENTIAI. BUII,DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6oae # 651-675-5675 FAX # 651-675-5694
New Canshucfim Reauhenenls 3 m9MmW sitesol`reYb showen8 59. R ofbt. s41L of Aurse: and E9roded mreas
(2(Y%mazfiwm bt cwaage aVowedy
7 SoOs RePOrt ifptopmed huildmg is to 6e-ptaced on dishuhed sao
2 wWies dDm ahow'sg bemn 8wMNidaw s¢m Paured famd dasign, ea
i set of Energy Cdadetioris
3 oVies of Trae Preservatian Alen N lot plgCed afla 711193
Rim Jaist Delml Op6onv selec6m sheet (buddrMs wiffi 3 a less units)
Mmnegasco mechenx29 m61efim tam
RarlodellRmeir Reuuirements Olfire Use ONv
2capiesoFdanshowu9fo*gs.6aems.psls Catd9uvayRecd _Y _N
isetotEnagyCaluMmsforhe0adadditions . Sab Repat _V - N
75deauveyforad&tionv8deft TreeResPlanRed _Y _N,
Ad64un-iwfcafer7ona&eso* syslem TreePresRequired _Y _Itl
pr? SepticSysEam _Y _N
Pians are considered ubiic information unless ou state the are trade secret and the reason.
?
Date 0 -7
Coostrnction Cost d9 Q, O C7 d
site naaren a o - 43 0 0 ? - Y p/ 443 p 1 ? Unit/Ste M
G/c.... lei
?
Descriptan of Work E b o ? I I? f r?i?l?ll?l G?? '?(
Multi-Famity Bldg {o!? _ N Fireplace(s) _ 0_ 1 _ 2
Property Owner o? 74a n. c.f L S/<< Telephone #((' j -,) L 4 S' ?? Q U
Contractor C ?1 Or,'L to Q .
Address . ? . aty;Qw-rusu • 1(e
State fA ti( . Zip Tdephone # (qS-Z) ? 3 S 'e!;)
COMPLETE THIS AREA ONLY IE CONSTRUCTING A NEW BiJILDING
Energy Code Category - MinnesM Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
(J submtssion lype) 'Reside^tla1 VentilaBon Category 7 Worksheet • New Energy Code Worksheet
Submitted Submitted
• Energy Ernelope Calculations Subnifted
In fhe last 12 months, has the City of Eagan issued a pertnii for a srcnilar plan based on a master plan$
_ Y _ N If yes, date ond address of master plan:
Licensed Plumber
Mechanical Conhactor
Sewer/Water Contractor
Telephone #(
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 Fagan 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 star[ 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 ofp(ans. '/
?(JCt' l?r?r.r1 !7 r?C.f
!?e-? re -r. L,0 e. L. .--,
Applicant's Printed Name 1 ,-,6? *(- 3 a,;1 y
A- z6a?
Applicant's Signature
i c76::?
1987 BIIILDING PERMIT APPLICAYIOH - CITY OF SAGAN
SINGLE FAMILY DWELLINGS
nICLODE 2 SSfS OF PLANS, 3
OF SOBVSY, 1 SBT OF ENERGY C9LCQLATIOHS
BiOTE: ADDRESSES FOR COENfiR LOTS - C09YRACTOR/HOMEOANEB MDST DESIGHAiS AHICH ADDRESS
IS DFSIRED. NO CH9NGfiS WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSIISD.
HOLTIPLE DiIELLINGS - R&SIDENTI9L RENTAL DPITS FOR SALE OAiYS V
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF 511BVSY - CHECK WITH BLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANSt
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Rp,p40-rlQ Valuation: Date: 16-7
Site Address 43UU CL-9msoiU Ci
Lot 24 Block 2 On Site Sewage_
S MWCC System
Parcel/Sub v-T,? (,g???,{v?„cw On Site Well
City Water ?
Owner ??
%M oio-? JIAI`
Address P.0. f3ox-
City/Zip Code Tft?,A•, /PI/n S544D
Phone -42D -`3qn() I 6PPROVALS
Contractor ,g.ZVVrlQ
Address
C3ty/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone U
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Occupancy ?71 ?
Zoning ID
Type of Const
(Aetual) ?
(Allowable) ?-
# of Stor3es
Length ¢¢
Depth Zb
S.F. Total
Footprint S.F.
FEES
Permit 374-
Surcharge 31. s°
Plan Review l ?57
SAC, City VOO.
SAC, MWCC .5 ZS.
Water Conn 525-
Water Meter l07.
Road IInit ?,05,
Treatment Pl l SO.
Parks
Copies
TOTAL
?
1987 BDILDING PBR@ffT APPLICATION - CITY OF SAGAN
SINGLE FAMILY DWELLINGS
IBCLIIDE 2 SET3 OF PLAAS, 3 CERTIFICATSS OF SQRVSY, 1 SET OF ENSRGY CALCOLATIOHS
HOTE: ADDBESSES FOF CORNER LOTS - CONTRACTOR/HOMEOANEH MOST DESIGHAYS HHICH ADDRESS
IS DS3IRED. HO CH9NGfiS WILL BS ALLOWED ONCB BQILDING PERHIT IS ISSQED.
MOLTIPLS DTiiELLINGS - RFSIDENTI9L EfiNTAL iAiITS FOR S9LE ONITS I?
INCLUDE 2 SETS OF PLANS, CERTIFICATS OF SDRPSY - CHECg iiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COM@ffiRCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Ppd,UQ?E Valuation: $C3, Date: IS/ d K7
Site Address q3C(?g CLeNlsc,)v Ct2cL?e
Lot 2-'-') Block Z_
Parcel/Sub ?'?-?,q?? 69? qho++w6
Owner TPe.r -?g?{? ??rnBO c?rrtL
Address p. 0. QU-K,
City/Zip Code °YYL?., "s\, 55-4dD
Phone A2o- 3qCO
Contractor 1«m,k
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone S
On Site Sewage_ Oecupancy ?3
MWCC System ? Zoning pp
On Site Well Type of Const
City Water ? (Actual)
(Allowable)
# of Stories
Length 4-4-
Depth Z6
S.F. Total
Footprint S.F.
APPROY9LS FEES
Assessments Permit
Water/Sewer Surcharge
Police Plan Review 18 l.
Fire SAC, City ? q0-
Engr SAC, MWCC S2S-
Planner Water Conn 525
Council Water Meter 67
.
Bldg Off Road Unit 305.
APC Treatment Pl I gO,
Variance Parks
Copies
TOTAL
1987 BIIILDING PERMIT APPLICATION - CITY OF SAGAN
SINGLE FAMILY DWELLINGS
IPCLDDE 2 SEfS OF PLA9S, 3
?-
?-0
OF SDRVSYt 1 SST OF ENERGY CALCUI.ATIOHS
NOT6: ADDEESSES FOE C08NER LOTS - COHTRACTOR/HOMSOfiNER MUST DESIGHAYS iiHICH ADDRESS
IS DESIRED. NO CBANGSS HILL BE ALLOWED ONCE BIIILDING YERMIT IS ISSIIED.
MOLTIPLE DWELLINGS - R&SIDENTIAL RSNTAL IIAITS FOR SALE OHIYS V
INCLUDE 2 SETS OF PLANS, CERTIFIC6TE OF SDRVSY - CHECg WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COhAFRCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Q¢p;3Dm? Valuation: Date: SW??
S3te Address 4??D? CLEti,sC)U CkT_rtiq_
Lot 2 1 Block 2. 1 On Site Sewage
MWCC System v
Parcel/Sub On Site Well
ater ?
City W
Owner _ _ ?r ??thervx?. 1?? cOrnc-
Address n 0 80X I3(A
City/Zip Code 2411 /)A-n ,
Phone Q 2D - 3q 00 APPROV9LS
Contractor ,zyamQ
Address
City/Zip Code
Phone
Areh./Engr.
Address
City/Zip Code
Phone !I
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Occupancy ?• 3
Zoning P D
Type of Const
(Actual) ?
-
(Allowable) ?
# of Stories
Length q-q
Depth 26_
S.F. Total
Footprint S.F.
FS65
Permit 3T+.
Surcharge 2 .
Plan Review ( 5"I.
SAC, City 1C)p.
SAC, MWCC 525-
Water Conn 525
Water Meter (97. -
Road Unit 3Cs-.
Treatment Fl l Y?-
Parks
Copies
ToTAL
r?o?
1987 BQILDING PEH[?ffT APPLIC9TION - CI1R OF EAG9N
SINGLE FAMILY DWELLINGS
IRCLIIDE 2 SEfS OF PLANS, 3 CfiRTIFICATBS OF SORVEY, 7 S8T OF ENERGY CALCOLATIOBS
HOTE: ADDRESSBS FOR COHNER LOrS - COHTRACTOR/HOMEOANEE MUST DESIGHA2S SiHICH ADDESSS
23 DFSIRfiD. NO CH9NGSS WILL BE ALIAWED ONCB BIIILDING PERMIT IS ISSD&D.
MOLTIPLE DiIEI.LIHIGS - R&SIDENTIAL
INCLUDE 2 SETS OF PLANS, CER
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
RENTIL. DAITS FOR SALE UBITS ?
OF SDR7EY - C9ECB BITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STROCTURAL PLANS,
7 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Valuat ion: 9(03,C0(7.00 Date: 5),4/ fl
Site Address 3O\t3 (LLEMSC)U OFFICS OSS ONLY
Lot 22 Block 2 On Site Sewage Occupancy ? 3
p ?
MWCC System
Zoning
Parcel/Sub g?tiQ? ?, ` I
p?ze On Site Well Type of Const
City Water 7 (Actual)
Owner 01K (Allowable)
# of Stories
Address F3erx ?3{0? Length -14-¢
Depth 26
City/Zip Code 5-S114U S.F. Total
Footprint S.F.
Phone 42c) -3q c) CD APPBOV9LS FSES
Contractor ?g- u"nk Assessments Permit 3 ??-
Water/Sewer Surcharge 31.$°
Addresa Police Plan Review l8-7
Fire SAC, City lo O.
City/Zip Code Engr SAC, MWCC 5 z5
Planner Water Conn 52s.
Phone Council Water Meter l07.
Bldg Off Road Unit 3D5.
Arch./Engr. APC Treatment P1 1E?0-
Varianee Parks
Address Copies
TOTAL
City/Zip Code
Phone #
? V?ov_% zvr.a ' ; , .
; '?Gt\?... Tcs?na+?1)a? fea.
HEAT LOSS CALCULATIONS H EATI ING &A1R
CONDOTIOMING CO.
N A.7C 26, 7 54
MINNEAPOIIS, MINN.
Wenthe
retrips
A.S.H.V.E.
Construction No.
Insulation
NPi ndows
I Doors Guide
Refarence Q? yyall Inf. Wall Ceiling floof Floor Kind How Applied
Yes-No Yes-No 19_ .
FI.Liy1Ni,?Fo PRoan Leng[h `Z, I Width) 2- Height ? FI. (Y,f\'itF?, ?-4 Room Len9th "Y 0 -Iili Height
YJi ndows e nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Are a
No. wmn
at ana Hai ani
of oane No. ot
li hts Lineal iL
ol crack Area
a9. ?L
No' w,em
ol ana No'am
of ane Nn. ot
? nu ???aa? ??.
ol crack nrea
sa??.
l
1
2
L
2
2 l
? 7
1 ° '? R 19 .,2
? '`-? ts 1 1 f?
Coei Btu oef
C Btu
IntiltratiOn ? 33 Infiltration 21 7
J -1 ..1 O
Glass 2q Glass 1-1 90 S
Exp. wall "1 02 Exp. wall tQ
Net ezp. wall 9,' 91 Net exp. wall fn 9- ?as?
-mr-wwh o6'r 1 {1't a Int. wall
Ceiling t? Ceiling
Floor Floa
Totel etu. 715-171 -TOtel gtu. 3?
Requir9d 5q. ft. E.D.R. or sq. in5. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader erea
FI. lN/N? R;^ Lenpth 1?3 WiMh HeiBht FI. ?')'< ",.pefLjm length ? 5 WiMh I? Height ?
Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Ooors- Cracka ge and Ar ea
No. Witl?h
ol ene Neiqbt
of ana No. ol
h ?ts Lineal ry,
a1 crack Area
s". fl.
No' W,d,ry
ol ane Hx.qht
of ann No. ol
b Ms Lmeal H.
af crac4 Aree
eG• 4•
,
U ? IPYI(]
" ,. ']
?L ?1Q
l O ^
.L ?l
4 1
Coef Btu Coet Btu
Infiltration 22.4(3 Infiltration z ? R
Glass Glass I? ?Il .
Exp. wall Exp. wall
Net exp. well ` Net exp. wall @ '?. 37
Int. Wall Int. wAll
Ceiling ? 7.-j
? ?
,`?•S
2
CeilinQ
?vQ
«?, j -?f
{
Floa Fioor E`C. n UJ
Totel Btu. s Total Btu. 3-->4
Required sq, ft. E.D.R, or sq. ins. W.A. Leader area Required sq, ft. E.D.A. or sq. ins. W.A. Leader area
FI. 'K',j-rX\r Room Length ?Z Width HeiBht ? PI. Roan Length ? Width NeigNt'
Windows and Doors-Crackage and Area Wi ndows a nd Doors -Cracka ge and Ar ea
NO. Wid, h
ol dnB MeiqM
01 PAna No. uf
li hb Lineal t[,
ol craCk Area
g9. It.
No. N•inro
ol :ane H?;?qh?
ut Pnx No. nf
b hls Lmeal (L
ol crack 4rea
80. 1t.
COE} B[U COB( B?II'
Infihration In}iltrati0n - ?_
Glass Glass
Exp. wall Exp. wnll
Net exp. wall Net exp. wall
Int. wall int. wnll
Ceiling 11-41-1 j Q Ceiling
--_
--
Floor - - .'- f-loor
? jC7 (.p ajl}
Total Btu. Total Btu. 1123
Required 5q. h. E.D.R, or sq, ins. W.A. Leader drea ??? Reluired 9q, ft, E.D.R. or sq, ins. W.A. leader area
f, r
?HEAT LOSS CALCULATIONS
Cem. $e?
NEATIiNG& AIH COIIIDITIONING CO. MiNNEAPOLIS, MfNN.
WeatheBtrips A.S.H.V.E. Construction No. Insulation
Wndows Doors Guide
Referen Ou[. Wall Int. Well Ceilinp Roo1 Floor Kind How Applied
Yes-No
Yas-No ce
19
g,F?• QRoan Length 1Q Width Height FI. Roan Length Width Neight
Yd indnws and Dows -Crack age and Ar ea Windows and Doors-Crackage and Area
No. WiNh
ol ane He, ph1
o/ ane No. of
Ir h?y L?neel h.
of crack Area
sa. It.
Na.
h
Of eW?4??B
HM
OI o?q dn0
Nn. oi
G h18
Lmeal !t.
OI CrBCk Area
9U. it•
2U I?n
Coef Btu Coef 8tu
Infiltretipn ? Q 7l Infiltration
Glass zk() Glass
Ezp, wall Exp. well
Net axp. wall 2 Q Net exp. wall
Int. wall Int. well
Ceiling Ceiling
Floor Floor
iotal Btu. 3 Total Btu.
Rgquired sp, ft. E.O.R. or sq. ins, W.A. Leader Brea Required sq. ft. E.D.R. or sq. ins. W.A. Leader erea
fl. j-\r.n,, Room Length -;L_ Width 11 Height FI, Room Length Wid[h Heiyht
Wi ndows a nd Doors- Cracka ge and Ar ea Windows and Doors-Crackage and Area
No. Witlth
al ane Heiqht
ot en0 No. al
M1 hta L?neal h.
of [rack Area
s4. fl.
No•
o?? e?ne
???19nu
No.hls
o '( cr l eck
BOr?ll.
Y 9 a
t V ° t? W' 3 ?..
Coe! B tu Coef 8 tu
Inliltration ' 117 2223 Infiltration
Glass ? OOO Glass
Exp. wall Ekp. wall
Net exp. II 292 -{, ( (, Net exp. wall
lat-?+a11 f 2 U 22 lnt. wnll
Ceilin8 Ceilinp
Flpor ?X I I '4?. t { Ffoor
Totel Btu. Total Btu,
Required sq, tt. E.O.F. or sq. in5. W.A. Leader ere. Required 6q. It. E.D.R. or'sq. ins. W.A. Leader area
FI- ,r fj" Length 13 Width Height FI, Room Length WidSh Height
Wi ndows a nd Ooors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea
Nq, itlth
Or BM1@ Haiqh[
Of fl06 No, uf
II 1118 0meal h.
OI CIBCk Area
tQ. fL
No' ?y.h?i?
OO AnB H' qbn
Ut AnN No. nl
b h19 Lineal fL
0l crack 4ren
8• It.
Cae( B?u Coef Btu
Infiltrdtion Infilttntion '
Glass Glass
Exp. wall Exp, wa11
Nat exp. wall 7 xh _Net exp. wall
Int. wall Int. wall
Ceiling Ceilinq
Floor R1 ? 1 ?• 5 1.1-6.a? -_'Floor
iotal Btu. - Total Btu.
Repuired sq. It. f.D.R, or sq. ins. W.A. Leader area Ropuired 5a. ft E.D.R. nr sq. ins. W.A. Leader erea
COMMERCIAL
2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
? • ??
Foundation Onl New Construction Interior Im rovement
• SWCturel Plans (2) sets . ArchitecWral Plans (2) sets • Architedural Plans (2) seGs
• Civil Plans (2) . SWctural Plans (2) • Code Malysis (1)
• Certificate of Survey (1) • Civll Plans (2) . Project Specs (1)
• CodeMalysis (1) "• • landsppingPlans (2) • KeyPlan (1)
• ProjectSpecs (1) . CodeAnalysis (1) •' . Master Exit Plan (1)
• Spec. Insp. 8 Testing Schedule " • Certificate of Survey (1) • Energy Caiculations (1) not always"
• Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & LighUng Form (t) not always"
. Meter size must be esfablished . Meter size must be established • Meter size must be established - if applicable
• ProjedSpecs (1)
1 . EnergyCalculations (1) " d
1 . Electric Power 8 Lighting Form (1) " 1
1 • Master Ezit Plan (1) 1
l • Emergency Responsa Site Plan (7)'"• y
1 • Soils Report (7) 1
• MClES SAC detertninalion letter . MGES SAC determination letter • MGES SAC determina6on letter
call 651-602-1000 call 651-602-1000 call 651-602-1000
rooa & beverage or lodging facilities - su6mit plan to MN Department of Health. Call 651-215-0700 for details.
Contact Building Inspections for sample.
Permit for new buildings or additions will not be processed without Emergency Response Site Pian. Ask Building Inspections for requirements.
DATE: q O WORK TYPE: NEW REMODEL CONSTRUCTION COST: I
SITE ADDRESS:
TENANT NAME:
SUITE #:
FORMER TENANT NAME, IF APPLICABLE: Y ?
DESCRIPTION OF WORK
Name: Phone #: ?
PROPERTY Last irst
OWNER p
CONTRACTOR
City: State: Zip:
Company:
City:
ARCHITECT'/
ENGINEER Company:
Name:
Street Address:
Phone#: ((01?/ ) / /?Cl?`f??VV
Phone #:
Zip: bEm
City: State: `Zip: - i
Licensed plumber installing new sewer/water service: Phone #i-(--?-- -_ -?
I hereby acknowledge that I have read this application, state that the information is correct, and agree to omply ' II applicabl?te of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
dated 7/02
State:
75865 THE TRAILS OF THOMAS LAKE
CLEMSON CIRCLE
1 430
/0 1
0 75865 240 02 (4-PLEX)
? 430013/ 230 02 ,
4301/ 210 02
4301B 220 02
4302/ 10 75865 250 02 (4-PLEX)
4302B/ 260 02
4304/ 280 02
4304B 270 02
4303/ 10 75865 200 02 (4-PLEX)
4303B/ 190 02
4305/ 170 02
4305B 180 02
4306/ 10 75865 290 02 (4-PLEX)
4306B/ 300 02
4308/ 320 02
4308B 310 02
4307/ 10 75865 160 02 (4-PLEX)
4307B/ 150 02
4309/ 130 02
4309B 140 02
4310/ 10 75865 330 02 (4-PLEX)
4310B/ 340 02
4312/ 360 02
4312B 350 02
4311/ 10 75865 120 02 (4-PLEX)
4311B/ 110 02
4313/ 090 02
4313B 100 02
4314/ 10 75865 370 02 (4-PLEX)
4314B/ 380 02
4316/ 40002
4316B 390 02
4415/ 10 75865 080 02 (4-PLEX)
4315B/ 070 02
4317/ 050 02
4317B 060 02
4318/ 10 75865 410 02 (1/2 OF 4-PLEX - OTHER 1/2 IS 1613/13B CLEMSON DR.)
4318B 10 75865 420 02
4319 10 75865 040 02 (1/2 OF 4-PLEX - OTHER 1/2 IS 1617/17B CLEMSON DR.)
3
, .,
O
?
X000.0
(000.0)
-f-
Q,OODd=2?L6pp.,
? CUMSON ClRCLE
Denotes Iron Monument
Denotes Wood Stake
Denotes Existing Elevation
Denotes Proposed Elevation
Denotes Direction of Surtace Drainage
?
`
Proposed Top of Foundation Elevation=
Proposed Garage Floor Elevation= 935.5
Proposed Lowest Floor Elevation= q36.0
I hereby certify that this is a true and correct representation of a survey of the boundaries of:
Lots 21, 22, 23 and 24, Block 2, THE TRAIIS OF THOMAS LAKE, Dakota County,
Minnesota.
And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 29th day of Aoril 119 87 ,
Paul A. Johnson
Land Survevor. Minn. Rea. No. 10938
i%°w, CERTIFICATE OF SURVEY
C OMBS-KNUTSON ASSOCIATES, INC. ?K aE for
l ?M, ?? AC?
. WIIiUli1NG d6111[lIIS M 1A110 SVIIY[IOPS 0 SITE P{AIINFRS qLE ryp
IC WNNEIVOL4uqNUttHINSON,MINNE[OiA 7931 IYGrr Vlr MYIC
/06, ob 1ve9• 5?/'08 "W 136- 90
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
NCYl4:: PAST4KNP OF FSB AT TIMEOF
?? ? ? ??
?
?
APPROVAL OF PE20SET. ;
nNSPacizorr OF sENM AND/aR Kox ;
TNL4Pni7ATfQj$ {+]jlL NOj' ?'. SCEE>- ?F .
tu.m Urrrb rERrsr HAs BEEN
•
AePFDM .
. * ?
*
.
_ w-iD?vcxiauaaivision or Tax Parcel ID #T--
IF E7QS`1'ING SlRL'C1URE, DATE OF C2IGINAL BL?2I.DING PII2MIT ISS[:1+,NC'E:
Mon ear
PRFSIIJf ZONIIJG/PROPOSID LSE:
? cOMrERcrat./RErAIL/oFFIcE
Q IMX'STRIAL
[] INStT7L*PIONAL/GO?T7f
2) ?
NAME:
ADDRESS:
CITY. STp,TE, 2IP:
PHONE:
3) • ?: ?• iVAME:
AMRESS:
. CITY, STATE? 2IP:
PHONE:
0 R-1 SINQ,E FANIILY
Cl R-2 DL?PLEX (7WO C?nits)
-R-3 4bWNiOC?SE (Three + Units ) ( Lnits )
R-4 APAmEw/COAIDOMIDTI[7M ( Units)
LIC'ENSE#
C1UlIWCLS L1C2I152:
Act1ve
Exp1YEd
IBot rec:orded
Staff Irutial
4) •• • ?NAME.?
. ADDRESS: , .
CITY, STATE, ZIP;
PHONE:
5) '? "' ' ?' • o• a? •
' .r?ak"mczzoN m c:xzy sEwm ? onocrioN Tv cixy waxEt rl OTHM . .
6) ?? • r ? PLEASE HOID APPROVID PERMIT FC)R PICK-UP BY ONE OF ABUVE .-- ----- .
[v PLFASE MAiL APPROVID PIIiMIT 7O 1, 2,0 4. ABOVE . '
(Ciscle one)
» ?s? . ?, 'L• ?, •?7 '
n • :!iSi'iTiS? ?_r
?WA
FOR -CITY USE ONLY
PERMIT # ISSUED
97,5-- ?
Pd w/Bldg. Permit
$
$
$ 1,4 7??-
$
$
$
$
s SzS'o?
$ [cZ 5r00
$
$
$
$
$ $
s ?7'0-D
--- 735'fC-f
i
FEES:
$ /Q-S? SEWER PERMIT (INCLUDE SCTRCHARGE)
WATER PERMIT (INCLUDE SURCHARGE)
$ WATER METER/COPPERHORN/OOTSIDE READER
$ WATER TAP (ZNCLLDE CORPORATION STOP)
$ SEWER TAP
$ ACCOLNT DEPOSIT - SEWER
$ ACCOONT DEPOSIT - WATER
$ • WAC
$ SAC ,
-:. , ' ?'•.,rl,
$ TRrC1QIF •WATER ASSESSNJENT
. • \-• • '? .. _ r • ' ? .-• 1
L?NK _$$TpjER.;ASSFSSMENT
r..•??-„'' ., _• ."i. 1 :.:_ 1. i''1 L• ij
$ LATERAL''f3UNEliI-P/.?DNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ ' • ., H]ATE$ ,TRFATMENT, PL'ANT SORCHARGE
. i. . '? . .? . . . ? a :l ; '" i, , _ i .
$ TOTAL •+?• ? ?1
? GG3 REC IPT RE EIPT - _ .. j ??%
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMZT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSOED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CpNDITIONS:
?
APPROVED BY:
.
TITLE; • • " =?,
DATE:
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) pROPERTy ADDRESS:
LEGAL DESCRIPTION:
N(r!*:: PA7Q+1FNf' QF FFE AT TIlM 0P
aPPr.icATxaa naES rar ooesrrTUM
APPRoVAr. CP PERruT.
irsPE.-rioN aF sE,ER Arn/UR kWMx
aa-rALtrazors wIIa. rxrr ]BE scHE!>-
11 [nNtIL PERMET xAS EM
ArrRavEn.
. %-iD?ucaiauDaivision or Tax Parcel ID #)
IF EXISTING STRL'CiLR2E. DA1£ OF ORIGINAL BL?IIDING PFRMIT ISS[)ANCE: " -
PFMarr zorrzNc/PxoPOSm esE: Mon Par -
? cM4ERcIAr./RETAxr./oFFIcs
Q INIDL?S"PRIAL
? INSTITL*PIONAL/GpVII2NMENp
2) ?
AD
CITY. STATE
? R-1 SIIgaE FANIILY
R-2 DL'PI.EX (1t,v Cfiits)
E R-3 7CXaM0L?5E (Three + Units) { Lfiits)
Cj R-4 APARM21'P/COAIDOMINIUNI ( Units )
3) • ?: ?• tVAME.
I'M ? For City Use ..
Plucnbers License:
AMRESS: I A Active
CI7'Y. STATE. ZIP: ' u E>cplred
Not z'ecorded
PHONE: MA.STEE2 LICFSVSE# _17C93M btatt IniEral
4) NAME:?
_ ADDRES5: . .
CITY. S`fATE. ZIP:
PHONE: -
'S? " ' ?' ' ?' • a? ?? •
` e'12MON 70 ?? .
CITY SEWM M/ ODW?7C.TION TO CITY WATER Q OTfM '-
6) ?? • •? ? PiEASE HoiD 1PPROVID PmNIIT FQR PZQC-uP BY ONE OF ABOVE
Q? PLEASE MAIL 31PPROVID PmnT 7o 1, 2, 3 4. ABWE
(Circle one) ,
is
FOR -:CITY USE ONLY
PERMIT # ISSUED
?7 7-S- z-
Pd w/Sldg. Permit
S
s
7. U C>
$
$
$
$
$
s
???•?
$
$
$
$
$
??d • U 0
$
$
s /39
RECEIPT
FEES:
5a
s /D- S-z>
S
$
,. . ?
..?
,
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLODE SLTRCHARGE)
WATER METER/COPPERHORN/OCTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ (? ?U I) ACCOUNT DEPOSIT - WATER
$ • WAC
$ SAC ,
$
% ? : •'" . • , ` „/,
TR114R •WATER ASSESSNaENT
.. . y .. , • '?•"';1
.
?
T$C?NK _$EIOjER;ASSESS,MENT
.?-.?..
, i
•
'
$ LATERAL'
1?$NE?I+P/.'?L?NK SEWER
? .
$ LATERAL BENEFIT/TS['.NK WATER
, . [ .. ., ._
..vi.'t:i' . ,e•' : . ..... .
i?•.J ' ?..i.'.,?i'1{1.1i;!
? •
,
, NjP(TEEt ,TRF,
ATMENT, PitANT SURCHARGE
. E+
y
.W i_ , '•. . ,
?
?'?_'. . u ?: ^ i
$ •!., r -.? y ,
dTHER':
, ,
`.? G t? •, • ??
TOTAL :-^?'•-• . .
RECEIPT # - ? '
i
. ... .. _ , _
: s .. ..
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F__j YES IF YES, THEN A"PERMIT FOR FIORK WITHIN PUBLIC
Q ROADWAY" ML?ST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CpNDITIONS:
APPROVED BY:
?
TITLE; . .
l1' i
DATE: _? . - • ?/I ? ?? 7
.
``
?
? .
: ?
?? `
.., . .
? .
, ..
.
CITY OF EAGAN
APPUCATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) pROPERTy ADDRESS:
LEGAL DESCRIPTION:
NO19:: PASQKVlP OF PM AT T'IM C1F
APPLIcATzorr noFS NDr aorsTrnrTE
mPPROVnr, oF PERM.
nsPEcrzox oF sEaM aru/?at FmM
nsrAra.P,Tioes wa.L NDr ]BE scHED-
cu? UrrrII. reRMIT HAs BM
APPROM.
, %--,-.,caiauDa-ivision or Tax Parcel ID #)
I£ EXISTING STRCCZURE, DATE OF ORIGINAL BOII,DING PERMIT ISSCAIVCE: .
PRFSIIdt' ZONING/PROPOSID LSE: Nbn ear --
q caMMEzcIAL/RETAU./oFFxce
0 IrIDL'ST'RIAL
[] INST'I1LfiI0Npi,/GdVIIiNMENr
2) ?
NAME:
ADDRFSS:
CITY. STATE, ZIP:
. PHONE:
3) • i: ?•
N11ME:
19DDRFSS:
CITY, STATE, ZIP:,
PffiNE:
C] R-1 SINGI,E FANIILY ?
C] R-2 DC?PI.FJC (TWo Units)
Cg"R-3 10WIMOUSE (Three + (ni.ts) { Dnits)
Q R-4 APARTmTP/CONIDOMINICM Units)
MASiEt I.ICENSE#
4) •' •. ? NAME:?
_ ADDRF.SS: •
ciTSC, sTr+TEr zIP:
rhom:
Active
Hxpired
Dlot recorded
Staff U=tial
•5) n - «: • ?• : a - o, • ?, •
Er COPIINIIX.TION 10 CITY SE,WfR ? COPII9E)LTION 70 CITY WAM ? O141ER.
6) M?r
[] PLEASE HOID APPROVID PEltPIIT E'OR PICK-C?P BY 0NE OF ABCNE
? PLFASE MAIL APPR(7VID PERMIT ZO 1, 2, 3 4. ABC7VE
(Circle one) '
r
FOR -CITY USE ONLY
PERMIT # ISSUED
5 7 "
Pd w/Bldg. Permit
$
$
g ?7a?J
S
$
$
$
$ s
$
$
$
$
$ $
S
- 7ss"Ff
FEES:
• ?
'? .
$ ?D 'Sa SEWER PERMIT (INCLODE SURCHARGE)
$ d WATER PERMIT (INCLUDE SURCHARGE)
$ WATER METER/COPPERHORN/OL'TSIDE READER
$ WATER TAP (INCLL'DE CORPORATION STOP)
$ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
S ACCOUNT DEPOSIT - WATER
$ • WAC
$ SAC , .
$ • .:: . - " .• • ,?_r
TR?LiQIE •NATER ASSESSNJENT - - -
.?
''
•
$ . ..
? ;q
?tL?NK
-$ETRER ;ASSESSMENT
`
,i
1
$ ' LATERAL' kF,NE?I+PI;CIlL?NK SEWER
? -
$
• LATERAL BENEF
IT/T8L'.NK WATER
+
'\Z: i Y?) \'?..\
?S ?
`
$ .
.
• ,TRF.ATMENT, PIPANT SURCHARGE
Tl?F,TE$
. : 3 .. .
5 ,
? ?•. : {i t. ?- 1 .
. bTHER'':
. .. - , -. ?
, TOTAL ?-'??- ' . •
?a??3
RECEIPT RECEIPT#^- --
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q
ROADWAY" Mt?ST BE ISSDED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
v
APPROVED BY:
I
TITLE; -- ? . :1 •
DATE:?-l• ? r7?y???
, .
CITY OF EAGAIV
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
?l) PROPERTy ADDRESS:
LEGAL DESCRIPTION:
NO'iB: PAYMFM!' OF FEB AT T!ME OP
aPPLxcATIaH nors tar oorsizIUM
APPRovAw CP PERruT.
naReclzCN oF sEaM nrn/CR hmTER
7'NISTAT.fATTQm F]jjL NOP BE SCHED-
tam urrrII. PERraT H+s smN
AePRovm.
IF E7QSTING SiRL'L't[JRE, DA1E OF CRIGINAL BLILDING PEEtMIT ISSL'ANCE: .
PRESIIJf ZONING/PROPOSID LSE: t'bn ear
[] CMERCIAL/RETAII./OFFICE
Q I@ID(ISTRIAL
[] IAISTITuTIONAL/CbVEw4ENT
? R-1 SINGLE FAMIII.Y :
C] R-2 DUP= (TWo [lhits)
[v?11--R-3 7S%WNHOUSE (Three + Units) ( Units)
R-4 APARTf4NP/OODIDO4IDTIUNl ( Units )
2) ?
NAME:
AAMRESS:
CITY, STATE
PHONE:
3) ' ':3' NAME: ? For City Use ..
Plimd?ers License:
ADDRESS:
? Active
CITY. STATE, ZIP: ExpiTed
Not recorded
PHONE: MSTM l.TCENSE# ?al
4) ?• ?? NANE:?
_ ADDRESS: •
CITY. S'PATE, ZIP:
PHONE:
' «' ' N ' • a• - Eo •
? e OOMM,TION TD CI19C SEWffI2 (;? ODAIIE.TION TO CITY WATgt d1Ult_
6) ?
? PLEASE EiOLD APPRWID PUiiNIIT FYR PICK-PP BY ONE OF ABCRM
[v? PLEASE MAIL APPRCJVID PEEiNIIT TO 1, 2, (9 4, ABOVE
(Circle one) .
,
f OR -CITY USE ONLY
?
PERMIT # ISSUED '
O7S c? ?
Pd w/Bldg. Permit FEES:
SEWER PERMIT (INCLUDE SURCHARGE)
$ $_ WATER PERMIT (INCLODE SURCHARGE)
$ (0 7'?? S WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ S SEWER TAP
$ S /,S' Q-7} ACCOUNT DEPOSIT - SEWER
$ $ ? ?I) ACCOUNT DEPOSIT - WATER
$ $ • WAC
$ ?pL s' 0`a $ SAC ,
, :_ . • . . ./
$ $ - ! % { '• . ' TR'tlIQIF •WATER ASBESSNENT --
`,
$ $ ?Y ?.•• . ?•fPjtC'NIC _$B?dER;AS
• SESSMENT
a,'?. ,` S'i i: tij'
$ $ ?. LATERAL'$PNEI?I?I'/.?ItUNK SEWER
' -
$ $ LATERAL BENEFIT/TRL'NK WATER
d `.'1 i*:??a:": •:.t.J4; i .:_?. ??i i r:l. ! ;
$ $ • . WATE$ ,TRFjATMENT. PIIANT SURCHARGE
7.
$ S '' ? `-> > .bTHER": ' -
$ Z :3 9 7' CT-O TOTAL •-?? = ' ??^
- -) -:3 s'e S 706 63 _
RECEIPT # RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
F__j YES IF YES, THEN A"PERMZT FOR WORK WITHIN PLBLIC
Q
ROADWAY" ML?ST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SLBJECT TO THE FOLLOWING CpNDITIONS:
l
APPROVED BY:
-- . ' ?
TITLE: ?• . . _ ? ? . `t '.
,_ s• ? Yy . `. •?;:: : ? ?•. ?
DATE: I-7
. . ' i . . ..'. .. W_ . a .s.? ay .`. .. 7
I
_..
? CiTX OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE:
Permit Number: Bur?o=N?
030431
Date Issued: 0 7/ 15 / 9 7
SITE ADDRESS:
4301 CLEMSON CIR UNIT B
LtlT: 22 BLOCK: 2
THE TRAILS OF THOMNS LAKE
P.I.N.: 10-75865-220-02
DESCRIPTION:
84"il'dinlj-.Permit Type
Suilding Wo,rk Type
'"Censae C?rde
?
i
?
BASEMENT FINISH
ALTERATION
434 ALT. RESSDENTIAL
i q ?
r'1'l t Z? .LnT f
Jf ?i
E ? 7 i:d
..., C?+
REMARKS:
SEPARATE PERMITS REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CQNTRACTOR: OWNER: - Applicant -
CHRISTENSEN TODD
? 4301 CLEMSON CIR B
EAGAN MN
(612)456-0054
I hereby aeknowledgE that?3 have read'-this agplication and state that the
informatiort is oorrect and agr'Ee to campTy with m1]:;applicatale;StaCe a# Mn.;.
Statutes and C3ty of Eagan Ordinances.
? .. m . ° .._.: ?
- APPLICANT/PERMITEE ISSUEO BV' IGNATUR
. 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55722 7/ / S
681-46T5
New Conatruetion Reauiremen!e RamodeVReoeir Reauirementa
? 3 rogistered sde surveys • 2 copias a Dlan
• 2 coples of plans (include beam 8 window saes; poured fid. design; etc.) ? 2 aite aurveys (exterior atlditions 8 dedcs)
• t energy calwlatlons ? 1 energy cekulations tor heated atlEkions
• 3 eopies ot tree preservation plan if lot platted after 711/93
required: _Yes _ No -
eo
DATE: 7/I q a 1 CONSTRUCTION COST: ?? 11100 =
DESCRIPTION OF WORK:
STREET ADDRESS:
?
LOT BLOCK
PROPERTY Name: 24ri S4ra Sr?, -r. phone #: y sG' OOSy
OWNER ?
StreetAddress: ?301 Ctrc
Ciry: C-aa a V. State: AA V_ Zip: 5Qe22
CONTRACTOR Company: st ?T Phone #:
Street Address: License #:
CitY: State: Zip:
ARCHITECT/ Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
City: State: Zip:
Sewer 8 water licer.5ed plumber (new construction ony):
and lot change arc , equested once permft is issued.
Penalty applies when address change
I hereby acknowledge that I have read this applicatlon and state that the information is correct and agree to comply with all appiicable
State of Minnesota Statutes and City of Eagan Ordinances. , ?????
-?////
Signature of Applicant: .?.
OFFICE USE ONLY RECEIVED
Certificates of Survey Received _ Yes _ No J U L 1 4 1997
Tree Preserva6on Plan Received _ Yes _ No _ Not Required B•
? SUBD./P.I.D. #: -,L TA4,1' ° f ""`n..`v AL.
, PERMIT c017119
; ?. `CITY OF EAGAN ?4z?IQJ?
3830 Pilot Knob Road PERMIT TYPE: B u L D I N G
Eagan, MinneSOta 55122-1897 Permit Number: q 2 5 3 7 7
(612) 681-4675 Date Issued: 0 4/ 21 / 9 5
SITE ADDRESS:
4300-B CLEMSON CIR
LOT: 23 BLOCK: 2
THE TRAILS OF 7HOMA5 LAKE
DESCRIPTION:
(3-SERSDN)
B'uilding'P,ermit Type SF PORCH
guilding Wo'rk 7ype NEW
, . ?
,u? _l ;«;
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRZCAL WORK
FEE SUMMARY:
vaLuarzoN
ease Fee
Surcharge
Lic. Search
Total Fee
$72.00
$2.50
Fee $5.00
$79.50
$5,000
CONTRACTOR: - p,pplicant - s7. Lrc. OWNER:
CUSTQM HANDYMAN 15521599 0007765 HOFF RICHARD
139 S CONCORD EXCHANGE 4300-B CLEMSON CIR
S ST PAUL MN 55075 EAGAN MN 55122
(612) 552-1599 (612)687-0563
?
I hereby acknowledge that I have read this
information is correct and egre`e to comply
L Statutes and ity of Eagan Ordinances.
f ,
A P ICANT/P M I T
J
application and state that the
wi:Ch a11 applicableState oF Mn,'
,
ISSUED B : SIGNAYgFE
93 CITY OF EAGAN
1141 1994 BUILDING PERMIT APPLI ^AA
681-4675 ? ?6??L?'DD (?.?t¢G??-Iz
,..,
06 tc;94
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered si "'?r'd`.,?; ',-?? f 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 QP,2iL / O. //945 Valuation of work 6, ?•°-°
Site Address: 43008 &Cn,f6.-_n/ 01/tCi,6
STREET SUITE #
Tenant Name: (commercial only)
LOT ? BIACK 9_ SUBD.Jj' ^
?? P.I.D. #
Descri tion of mork: 3 5e?q'JG1A/
The applicant is: ? Owner ? Contractor ? Other (Describe)
Name V-kaFF RiU+'Nfzi1 Phone (od7- o54P3
Property LAST FIRST
Owner pddress A-3006 LWgSnn[ Cr,ec[-5
STREET STE Il
City EA64N State MN Zip 551Z2-
Company Cu6rcM N94UDYA44nl4 lNG• Phone 552-1599
Contractor Address OM /39 varYNC."olU(?,6eD ElIC'. License #`TI/0S Exp.a19-T
City ?b • ?q" P40 L. State /VIItI Z i p 550747
Company -rA51WI /IOR68 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.
i
f
gnature o
S
Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition 0 08 8-Plex ? 13 Garage/Accessory
004 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 Sf Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
CO-31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
SAllowable)
UBC ccupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
O .Site
? Wallboard
Basement sq. ft.
lst F7. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Footing
? Final
? Framing
? Draintile
y3y
o/
i
O
? Insulation
O Fireplace
Permit fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
vatuac;m: S ' Si omo
/zx/v - iZOxyo= yooo
;-?
... . ...?•"?,
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Requ9red
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
SAC %
SAC Units
For Office Use
Permit `7Y 7
City of Eapn
Permit Fee: <5Z)
3830 Pilot Knob Road
Eagan MN 55122 Date Received: f
Phone: (651) 675-5675 Fax: (651) 675-5694 Staff:
2009 MECHANICAL PERMIT APPLICATION
Date: Site Address:
Tenant: G~741e L . Suite
RESIDENT / OWNER Name: C2 Phone:6 7 ' OJ
Address,,I City / Zip: i
CONTRACTOR Name:_ License
Address: 1~ t, 11 City: State: Zip: / 2-- -
Phone:6S7 19Contact Person: f~ LIC
TYPE OF WORK New Re lacement Additional Alteration Demolition
Description of work: f r~~z
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE New Construction Interior Improvement
-,Furnace _
Air Conditioner Install Piping Processed
_ Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank Install / _ Remove)
When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) 1
TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
$ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that the work will be in conf rm peit ha rk will be in accordance with the approved
plan i th case of work which requires a review and approval of plans.
--Kz
Applicant's Printed Name ant's ure
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: Under Ground Rough In Air Test Gas Service Test ___In-floor Heat --Final
III Exterior HVAC Screening Inspection
€ity of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use j
Permit#: / CC)Q / �0
Permit Fee:
8 5- o c'v.
Date Received: V11 4- 13
Staff: _\m
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / ^ / ) S Site Address: I -1;O ,
Unit #:
Name: 7r)') ?J4 H e I r
Phone:
Address/City/Zip: LI C1F'►MSv?✓ (1. RC I(''
Applicant is: Owner X Contractor
c1 tiCSOcY5-
Description of work: lC'M 0 vie Irse 1-; UC T 0i)c` aka / k-' i5P 61/
p taro) c9 ati s J r ,} t o C i s
Construction Cost: 11/0r'� L �'
Company:
Multi -Family Building: (Yes / No
Contact: J Oe--) 1 D(- V r l rs
Address: CY L-)?.- /tff'Nl`.f:t5 City: in W 71, Lz'f
State: /Ail) Zip: <. s ?G,
Phone: 6 / 9 7'17 7 .5 (
License #: j?t L%z( 3 5-- ' Lead Certificate #: N74
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
re
Si
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x S (? ( I)f7 Ir
/e
Applicant's Printed Name
Signature
Page 1 of 3
v
)
•
4300 C k/ vl--�Y\ C i r
DO NOT WRITE BELOW THIS LINE
I DS CTS
SUB TYPES
Foundation
Fireplace
Single Family _ Garage
Multi _ Deck
_ 01 of _ Plex _ Lower Level
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
#of Units
# of Buildings
Type of Construction
Porch (3 -Season)_ Storm Damage
Porch (4 -Season) _ Exterior Alteration (Single Family)
Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
T Pool — Miscellaneous
_ Interior Improvement
_ Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
Fireplace: _Rough In Air Test _Final
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Insulation
Sheathing
Sheetrock
Reviewed By:
Siding
Reroof
Windows
Demolish Building*
Demolish Interior
Demolish Foundation
Egress Window l Water Damage
*Demolition of entire building – give PCA handout to applicant
W, r1 7
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / 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
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
orivr"0., (1/
43
,aQ
Page 2 of 3
Use BLUE or BLACK Ink
~r I For Office Use
non Permit
12
~5,()D
t io EaV
~ Permit Fee: I
3830 Pilot Knob Road
Eagan MN 55122 ; Date Received:
Phone: (651) 675-5675 i i
Fax: (651) 675-5694 1 Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date; Site Address: 0 ) )-1301 X ~'_IC►wtSO L C ~ Unit
Name: ~
(~1UAl Phone: bIR Z~Z7S`~
i Resident/
I Owner Address / City / Zip: tl t'e
Applicant is. Owner Contractor
Type of Work Description of work: &01tiCP iw It Irv J_a
Construction Cost;.... F LQ._ tidtnT-(Yes tRb
- -
Company: TL8
Contact:
Contractor Address: q3 , Ko ' C~ r te, N City: 4 ti(-(L0
111(1✓~ 3 (a0--7q7- 75
State: Zip:- Phone:
f
L;LZ,-, - ea e i ica e
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
` t
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 they are trade secrets -
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota S to But i Code m st be completed within 180
days',,ofjpermit issuance.
Applicant's Printed Name App i nt's Signature
Page 1 of 3
} Use BLUE or BLACK Ink
- - - - - - - - - - - - - - - - -
I For Office Use
Permit non
City of EaKd
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 ; Date Received: ;
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 ; Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
{ Name: d &4Z 4 &//n Phone: 'J c2 7 7 R 7-aa
Resident!
Owner Address/ City /Zip: d„ S'9 N Z
Applicant is: Owner Contractor
Type of Work Description ofwork: /j,~-_11 ~1 n 6 Dc /l~°c
E Construction Cost: J rG D Multi-Family Building: (Yes No
Company: h~ Contact: 11(' i
Address: 23`2 City: (VA d ~ 4-l
Contractor -~-_j
State: _(1J Zip: ~5 Phone: (n ) 7 ~ 7 2 2 1
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: 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.
w - - - -
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.oopherstateonecall.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 I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued In accordance with the Minnesota tate Building Code must be completed within 180
days of permit issuance.
x ) 0C S x
Applicant's Printed Name A li nt's Signatur
Page 1 of 3