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4311 Clemson Cir
Use BLUE or BLACK Ink For Office t I - - - - a# on City Permit* of 1J j go. 0~ j I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 1 I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: o? Site Address: Y311 0 CLF_117,~P0 W a Unit Name:?• /t.S of 7fl- ,0 19_-:, CA 'i9rZAD/_J-I',' 145-*'~rPhone: -5-360 i RESIDENT / OWNER Address / City / Zip: 171 / 6 L-E MEfv7 Q!2 # t_ f{0 913 ED Applicant is: Owner _V Contractor TYPE OF WORK Description of work: -?Z /I t- A57 4WI?A e-f E 4',511 Construction Cost: /lam-7 . Multi-Family Building: (Yes / No ) Company. W r / ci &-f} r,4qE-_ .74064 Contact: IrXE~ _57~y WW'I yc--,e CONTRACTOR Address: s-:.-Ce t3/ 17eeA.1E AV- City: /vZP~,S H o f _ State: 14AI Zip Phone: ts. le co License L 3©3~06 ea Lead Certificate /V1'?T;&3 -73^1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW 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.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. f x sly ye/2~f-~ l~dz A X &P ~/J S X, Applicant's Printed Name Applic ht's Sig ure Page 1 of 3 PERMIT City of Eagan Permit Type: Plumbing Eagan. Permit Number: EA098729 Date Issued: 04/25/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 4311 Clemson Cir B Lot: I I Block: 02 Addition: The Trails Of Thomas Lake PID: 10-75865-02-110 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Kris Oien 3670 Dodd Rd Eagan, mn 55123 651-365-1340 Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087 Valuation: 848.00 Surcharge-Fixed $5.00 9001.2195 Total: $55.00 Contractor: - Applicant - Owner: Champion Plumbing Kenneth Flies 3670 Dodd Rd., =100 4311 Clemson Cir Unit B Eagan NIN 55123 Eagan MN 55122 (651) 365-1340 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature CITY OF EAGAN , ? 37$ 0 ? , 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 , ? PH O N E: 454-8 BUILDING PERMIT 100 Receipt# To be used for • Est. Value Date SiteAddress OFFICE USE ONLY Lot Block SeC/Sub. On 5ite Sewage Occupancy ?- ' MWCC System ? Zoning Parcel No. On Site well ` Type of Const Cit Water (Actual) Q NBme - y , (Allowable) ' W 3 Address # of 5tories ° City Phone Length Depth S F T l t . . o a ¢ o Name Footprint S.F. ?a Address APPROVALS FEES ? City Phone Assessments ? Permit h Q Water/5ewer , Surcharge ? W Name Police ? Plan Review Z _ - Address Fire SAC, City - ? Z 4 W City Phone Engr. Planner SAC, MWCC ? WaterConn. Council ? Water Meter I hereby acknowledge that I have read this application and state Bldg. Off. ? Road Unit thattheinformationiscorrectandagreetocomplywithallappiicable APC ` TreatmentPt State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks Signature of Permittee Copies TOTAL A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of M innesota Statutes and City of Esgan Ordinances. Building Official - Permit No. Psrmit Holder Date Totsphona ik Plurwbing H.V.A.C. Electric 5afteq.er Inspectfon Oats Insp. Commants Footings I ?. Footings II Foundation Framing - _? zi- ? Roofing t 7 Rough Htg. Isul. Fireplace Final Htg. Final Pibg. ? Bldg. Final ?q- C@rt.OCC. Temp. LP Deck Ftg. Deck Frmg_ Well Pr. Disp. L ? CONTRACT PRICE: Site Address • *' ' Lot Block S ? Name m ? Address c City Phone Name 3 Address O Ci1y Phone -' ?1? . :• 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 PERMIT - .50 (ADD $.50 S/C iF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATUFiE OF PERMITTEE: PERMIT ti PLUMBING PERMIT RECEIPT }i ? ?- CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PHONE: 454-8100 BLDG. TYPE WORK DESCRIPTION ec / S ub Res. 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 ' Ki!chen 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 PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 ' `•- FEE: . F -" ? -' STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: -- =? -'?- ' ? 1.pr I F-Y :?•`+9?JT J i CONTRACT PRICE: MECHANICAL PERMIT RECEIPT # CITY OF EAC:AN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PHONE: 454-8100 Addres$9i0 WENT c City MINN • CD c 3 O Name _ Address City _ TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent. Gas Piping Outlets # BLDG.TYPE SeclSub Res ? • Mult E. BE). Comm. 5420 Other M BTU M BTU M BTU M BTU CFM l WORK DESCRIPTION New Add-on Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GA5 OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - FiES. RATE APPLIES MINIMUM RESIOENTIAL FEE - ALL ADD-ON 8 REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRfCE GOES BEYOND $1,000) FEE: SlC: 57' SIGNATURE OF PERMITTEE TOTAL: ? G • ?'' FOR: CITY OF EAGAN CITY OF EAGAN 137 79 I • • 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PH ON E: 454-8 1 QO BUILDING PERMIT Receipt Tobeusedfor 1 "?'LL?• Est.Value av4,??u;, Date 2 `'1tJ ,19fi? 431 i ii CL?MSOt? CI k Site Address OFFICE USE ONLY Lot BIoCk Sec/Sub. "'Ali"b {-??? On 5ite Sewage ? Occupancy „ 3 _?_ MWCCSystem _ Zoning PBrcel No. On Site Well Type of Const v Cit Water (ActuaQ r` 1.!UE4 ii(:. 1 M?: N y (Allowable) s ame W 1367 'j } # of 5tories _ = " Address Len th y?? 0 City ." Phone .:O- .10 g Depth 27 F Total S , p Name . . Footprint S.F. ?? Address APPROVALS FEES ? City Phone Assessments Permit ' 3 7 7• J -' ? m v Water/Sewer _ Surcharge , WW Name Police _ Plan Review ? z x- Address Fire SAC, City f?? •'- - vZ ? City Phone Engr. _ SAC,MWCC ''• ? y ,' W Planner _ Water Conn. %• Council Water Meter I hereby acknowledge that I have read Ihis application and state Bldg. Oft. _ Road Unit l=ij', thatthe information is correct and agree to complywith all applicable State of Minnesota Statutes and City of Eaean Ordinances. APC Variance Treatment P1 - _ Parks Signature of Permittee Copies TOTAL A Buiiding Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of M innesota Statutes and Ciry of Eagan Ordinances Building Official Permit No. Permit Holder Dats TeIephono i? Plumbing H.V.A.C. Electric ' ? Softener Inspsctfon Date Inap. Comments Footings I % Footings II Foundation Framing Roofing Rough Htg. ?. Isul. Fireplace ?Js Final Htg. Final Plbg. D-7 Bidg. Final ? Cert Occ. Temp. LP Deck Ftg. Deck Frmg. weu Pr. Disp. a -. . . _ . . . .. . PERMIT # ? ?• '. PLUMBING PERMIT CITY OF EAGAN RECEIPT ti ?G CD ?G 1117-' 3830 PILOT KNOB ROAO, EAGAN, MN 55122 oArE: FEB' 161987 CONTiiACT PRICE: PHONE: 454-9100 Site Ad s Lot Blork Sec/Sub m Name _7NUMPSQN -p( (JmR jb(j; m Address c City MjKA Phone 933-2521 ? Name E R c Address p Ciry MPLS Phone 42{]-190n FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) , SIGNATURE OF PERMITTEE BLDG. TYPE WOFiK DESCRIPTION Res. 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 1 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 Outiets - $1.50 ' ??% ?•? (MINIMUM - 1 PER PERMIn ? Soitener - $5.00 Well - $10.00 .? Private Disp. - $10.00 ?Rough Openings - $1.50 •.? FEE: __... ,? STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: . . . _.. _ , .? -__` ?__ _-_.__. _._ .... _ .»??.iY?? .. . . . .... ........, ?.._ _. _ . . _. _. . .. . .. _ . r'34;y3 s- Site Address MECHANICAL PERMIT RECEIPT # 9-L CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ???• % 7 BLDG.TYPE Res. Mult. Comm. Other WORK DESCRIPTION New ? Add-on Repair ? IV8T11$"- C. ?v. m Addru,'' ?MP! 55420 c City 981 -q4.00 Phone m c 3 O Name _ Address City - TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Piping Outlets:1 ?r ?.. -? M BTU M BTU M BTU M BTU CFM / ? FEES ? RES HVAC 0 100 M 8TU 4 00 i . - -$2 . ADDITIONAL 50 M BTU - 6.00 ? (RES. HVAC INCLUDES A/C ON NEW ? CONSTFiUCTION) 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 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 ,L BEYOND $1,000) 1 ? FEE: ` S/C: •?? SIGNATURE OF PERMITTEE ? TOTAL: FOR: CITY OF EAGAN . .. . .???_._...?.?..- __ .__..."?:_..._.?,,?.:..?.?.?_.._.•_ , y CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 I PHONE: 454-8100 BUILDING PERMIT Receipt # i To be used for :+- =1EPi.AGE Est. Value ? 1, Date , 19 SiteAddress •?:-?'1? CLF'?SO"t C::: LOt r' BIOCk ' Sec!5ub?CHl' TRAT'L 01 ' OFFICE USE ONLY 1'O,•AS LAK^. Parcel No. T Occupancy -- FEES Zoning - ¢ Name - (Actual) Const Bldg. Permit W . 3 Address 4 312 f7L:'*!Sd CIA (Allowable) - h • ?G S p C,jty ..t",1 ia Phone 47 tA.- 7 514 # of stones urc arge - Plan Review Length _ o Name Depth - SAC City = . c)s Address =":?50' %+z ??"WY 1,3 S.F.Total _ , SAC . MCWCC ? Ci EUF: ;?SY; l,i.r. ty Phone 694-0156 S.F. Footprirns _ Water Conn On Site Sewage _ ? W W Name On Site Well - Water Meter ~Z ddress MWCC S stem y a W C ? Phone ty Ci Water _ Acct. Deposit S,W Permit PRV Requfred - I hereby acknowlege that I have read this application and state that the Booster Pump - SW Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: •t? ?- - ° • - < z :; P ? ::: ? f".? •? : :: Plan"ef - Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City ot Eagan Ordinances. Bldg. Off. _ Copies 26. Sty Building OffiCial Variance - TOTAL Permlt No. Permit Holder Date Telephone # WATER SEWER PLUMBIN(3 H.VAC. ELECTRIC Inapection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Freplace Fnal Htg. Flnal Pibg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. ?• ? «. .?..?... ''? '• CITY OF EAGAN .37 7 7 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 , BUILDING PERMIT 4& `"' ~ 1 ` To be used for Est. Value Site Address = Lot Block Parcel No. c Name . .... ........ W - 3 Address ? ' " ` o r.ir. SAPF: On Site Sewage MWCC System On Site Well City Water APPROVALS 3 Ct.t." ;- ?ir: z Sec/Sub. 1 F `; f 1.: Address City_ I hereby acknowledge that I have read this application and state State of Minnesota Statutes and City of Eagen Ordinances. Signature of Permittee A Building Permit is issued to: all work shall be done in accordance with all applicable State Assessments Water/Sewer Police Fire Engr. Planner Council Bldg. Off. APC Variance ?FFICE USE ONLY OcCUp2nCy _ Zoning _ Type of Const _ ? (Actuai) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. FEES _ Permit . , 7?. _ Surcharge _ Plan Review _ SAC, City ' _ SAC, MWCC water conn. - - _ Water Meter ? _ Road Unit _ Treatment P1 _ Parks CoPies TOTAL Minnesota Statutes on the express condition that Permit No. Permlt Holder Date TNephon* ?t Plumbing p) H.v.ac. , Electric % Softener ' Inspeetfon Date Insp. Comments Footings I ?d Footings il Foundation Frami?g y_1 Roofing ?-,?• `7 ? . ? . Rough Plbg. ? p _ L ' Rough Htg. 7 , 2 Isul. ? ? Fireplace ? S!-?? ? Final Htg. . , ?? . L. If • Final Plbg, Bldg. Final Cert Occ. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. ' ? • + PERMIT # PLUMBINC PENMIT ? CITY OF EAGAN RECEIPT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: FEB 1 1987 CONTRACT PRICE: PHONE: 454-8100 Site Address Lot Qlock - Sec/Sub s.- . - --- .i.i Name TFIOt'9PS N PLllMB I N6 m Address 12201 MTKA BLVd ? c;ry hfTKA Pnone 933-2521 ? Name M 3 Address p Ciry MPLS Pnone 420-8900 FEES COMM/IND FEE - 1°r6 OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) , SIGNATUfiE OF PERMITTEE BLDG. TYPE WORK DESCRIPTION Res. New M lt Add on . u - ? Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES Water Closet - $3.00 TOTAL t Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 - UrinaliBidet - $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 PERMIT) Softener - $5.00 Well - $t0.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S1C: FOR: CITY OF EAGAN GRAND TOTAL: -? '- ? /?r. J•??J .! PRICE: MECHANICAI PERMIT RECEIPT # CITY OF EAGAN - 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: d ? [ m Nan ? m Add ? c Ciry BLDG.TYPE Other WORK DESCRIPTION Res. v Mult. Comm. New Add-on Repair FEES = Name RES HVAC 0-100 M BTU $24 00 ? . - . 3 Address ADDITIONAL 50 M BTU - 6.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW ? CONSTRUCTION) GAS OUTLETS MINIMUM PER PERMI7 50 EA ( ) -1 - 1. . 'YPE OF WORK COMM/IND FEE - 1a/o OF CONTRACT FEE ? orced Air M BTU Z APT. BLDGS. - COMM. RATE APPLIES il r ? TOWNHOUSE & CONDOS - RES. RATE APPLIES o e M BTU g MINIMUM RESIDENTIAL FEE - ALL ADD-ON & init Heater M BTU ck REMODELS - 12.00 •,, ir Cond. M BTU $ MINIMUM CQMMERCIAL FEE TATE UR RGE ? - 20.00 S S CHA PER PERMIT - .SO ent. CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES ias Piping Outlets # y-''' BEYOND $1,000) ? ither w FEE: i-- _ /? ? - 1n z--•-?. .? ' `•? ?, , S/C: ' Sv SIGNATURE OF PERMITTEE J. TOTAL L Gr v ` FOR: CITY 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 * t * To be used for ,Of? ;rLn Est. Value ?63*000 Date j1'4E 16 Site Address 43135 cUMsoN Lot tu Block z SeC/Sub. Parcel No. s Name "W WORi?V HO"95 UK W ; Address •u. 1367 ° CitY Phone ¢ ,O ?< ? ? W City Phone I hereby acknowledge that I have read this application and stat Signature of Permittee _ A Building Permit is issued all work shall be done in ac Building Official 1 OFFICE USE ONLY { On Site Sewage Occupancy ? ? ?- ?- MWCC System Zoning, On Site Well Type of Const ? ? City Water (Actual} ?..e.e.?,..?.? 1-: ?8 (Allowabl#„` v * of stones ? ? Length t S ? Depth jd S.F. Total Footprint S.F. APPROYALS i FEES x 37?i.t0 Assessments Permit Water/Sewer _ Surcharge ? •j ? Police Plan Review Fire SAC, ?'ity • Engr. SA? MWCC Planner _ WaRerConn. -'1 • 'v Council Water Meter '` '0 e Bldg. Off. _ Road Unit ?.i.3•G'? APC _ Treatment P1 1[ L'. CU Variance _ Parks Copies TOTAL I11C on the express condition that Minnesota Statutes and City of Eagan Ordinances. Psrmit No. Pere?it Holder Date TelsphoM ? Plumbing 7 ? H.V.A.C. Electric Softener Inspection Date Insp.' Comments Footings I 6/ 3"lp, Footings II Foundation Framing 7 ? if , Roofing Rough Plbg. Rough Htg. isui. p Fireplace Final Htg. Final Plbg. Bldg. Final cert occ. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. • ' .' PLUMBING PERMIT CITY OF EAGAH 3830 PILOT KNOB ROAD, EAGAN, MN 55122 Site , Name THOMPSOILPI 11MAINr, V Address 192(l l I+ITKA A1 vn c City hijj(A Phone ? Name ntW t1UK 1 LUIV c Address _ PO SQx 136 / O City _ WLS FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RE5IDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES PERMIT # ??7 C>e ? RECEIPT # ?16 C^ Cc?-- DATE: FEB 1 1987 BLDG. TYPE WORK DESCRIPTION Res. 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 i Ki!chen Sink - $3.00 Urinal/Bidet - $3.00 ' Laundry Tray - $3.00 "- ` Floor Drains - $1.50 •--T-Water Heater - $1 50 Whirlpool - S3.00 Gas Piping Outlets - $1.50 -(MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 ? ;?J Rough Openings - $1.50 c SIGNATURE OF PERMITTEE ' FEE: i STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: -#??? ?. • f ,?. > j j MECHANICAL PERMIT - RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 46 =4*? o? ONTRACT PRICE PHONE: 454-8100 ? Site Address ' Lot ` Block Name 'R Address ? c Ciry a? c 3 O Name _ Address City _ TYPE OF WORK ? Forced Air Boiler Unit Heater i Air Cond. , Vent ' Gas Piping Outlets # Other BLDG.TYPE Res. LI-11 Mult Comm. Other WORK DESCRIPTION New ? Add-on Repair M BTU M BTU M BTU M BTU CFM ?- FEES ' RES. HVAC 0-100 M BTU ADDITIONAL 50 M BTU (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn COMM/IND FEE - 1°r6 OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPUES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMOOELS MINIMUM COMMERCIAL FEE STATE SURCHARGE PER PERMIT (ADD $.50 S/C IF PERMIT PRICE GOES i- ? BEYOND $1,000) $24.00 6.00 1.50 EA. A - 12.00 - 20.00 - - .50 FEE: .2?`? T_ ?'i????{is ?.-? S/C: SIGNATURE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 Site Address i; n Lot 11,C} Block rr Sec/Sub Ciry 1-P C fPhone , Name ? 4) Address O City Phone " FEES COMM/IND FEE - 1°r6 OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PEFMIT PRICE GOES PERMIT # RECEIPT # DATE: - BLDG. 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 - $3.00 Lavatory - $3.00 Shower - $3.00 Ki!chen Sink - $3.00 Urinai/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 PERMIT) ?Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FOR: CITY OF EAGAN FEE: STATE S/C: GFiAND TOTAL• - ? SEDGWICK HEATING & AIR CONDITIONING CO. HOUSE HEATING TEST RECQRD . ADDRESS_ ?q311 C'ki`7567 Cifde CITY EqGan OCCUPANT OWNER W?? ?bf-, m'1 HEAT LOSS ----DATE HTG. INST. - SOLD BY INSTALLED BY Electrical Work By Gas Line By _ 5?cc?GL?,,CkS TYPE OF HEAT GA_ FA.)? HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE I9Y? MAKE OF BURNER - Model 3 A 0 Z OSO Model _ Serial _ yO 0? M Max. BTU Rating ' INPUT SQ,000 MAKE OF FURNACE '`-"'-- Model CONTROLS THERMOSTAT T'33'1 Heat Plug `--' Valve 5 X 3 yS ! ) 5oX - Z _ Limit _ --40 m tn Limit Setting ZSOo'V Fan Setting _ rdC)^, F Pilot Type E1'r CAr rn;[ Pilot Make ?f?jffX - TLn,jnk Pilot Model i S i Pilot Timina 1n54 19n L.W. Cut Off .-?- Pressure 3- 6? w+? Percent COZ 7_ Input CFH J!rd Percent 02 Stack Temp. I9o Percent CO n"-ne Vent Size :7j KIND OF LINER SIZE NONE Draft Hood D? , (n?-7' Regulator ?c5 Filters Size Number ? Chimney Location Inside Outside Chimney Construction Smoke Bomb Wiring OK- D raft -- - Test Tag y e 5 Door Pressure Lighting Inst. r'K- Date Tested Company Testing Name of Tester Form 235 HOUSE HEATING TEST RECORD ADDRESS "?_?7 CITY ?CPCr !?;.. f OCCUPANT OWNER " HEAT LOSS DATE HTG. INST. SOLD BY INSTALLEO BY -?' ? • ? Electrical Work By ? "T!_Gas Line By _ -?r ? -== ,? ? TYPE OF HEAT GA_ FA ?! HW- STEAM SPACE HTR. UNIT HTR. OTHER MAKE Model _ Serial _ INPUT GAS DESIGN COfVVERSION, ?CONTROLS THERMOSTATHeat Plu,q Valve ? Limit __ c7-?-C r• ' ?G : ,tLimit Setting ? SU i Fan Setting ti) Pilot Type V? C i fPilot Make S 2 f a ?" Pilot Modet ,_'-'.? /T? Pilot Timing i? Lv ? L.W. Cut Off ? G Pressure z Percent CO U Input CFH Percent 02 ?^ G StaCk Temp. ? ? Percent CO lS?.? MAKE OF BURNER -""'- Max. BTU Rating - MAKE OF FURNACE Vent Sige KIND OF LINER - - SIZE NONE Draft Hood i d Regulator Filters Size Number ' Chimney Location Inside ? Outside Chimney Construction Smoke Bomb Wiring Draft J Test Tag Door Pressure Lighting Inst. ? Date Tested >, ?- ? - , yr Company Testing w + ? ° Name of Tester 7 ?-?- ? f Form 235 . -- .?ti;-.:' •..:... •fi4 :,.?, .YA_..P, SEDGWICK HEATING & AIR CONDITIONING CO. HOUSE HEATING TEST RECORD ' ADDRESS ?"?i J t - `- lr /'?` " ? =r CIfiY /U OCCUPANT- rj `'u! I ? rZ d;v OWIVER ? HEAT LOSS DATE HTG. INST. _ ,-• %! ? SOLD BY INSTALLED BY -)"CJ/ y ''t' Electrical Work By Gas Line By - r TYPE OF HEAT GA_ FA Y HW_ STEAM SPACE HTR. UNIT HTR. !? OTHER -y GAJS DESIGN CONVERSION ! MAKE MAKE OF BURNER `- Model y?'6 Model ? Serial '? `.U `7C)Max. BTU Rating INPUT MAKE OF FURNPrF Model CONTROLS THERMOSTAT? 2 Heat Plug ? )1- ; W Valve Limit 4t r-n t: U Limit Setting (? Fan Setting ? n"' Pilot Type t Pilot IlAake Pilot Riodel Pilot Timing -4-t"a-, '?> T. tt?c- ! L.W. Cut Off - ?. Pressure Percent CO `i /G Input CFH Percent O2 Z 10G?u Stack Temp. Percent C0 Ii Vent Size - KIND OF LINER ` SIZE NONE Draft Hood Na iaiO` Regulator Filters Size Number •' Chimney Location Inside ? Outside Chimney Construction ? Smoke Bomb 1- Wiring Draft ?r Test Tag 1? r Door Pressure ? Lighting Inst. Date Tested Company Testing < < Name of Tester ?-4 Form 235 .---•--.- ? CASH RECEIPT y J . CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 1 ° 19 RECEIVED FROM AMOUW1 $ I & DOLLARS iao ? CASH ? CHECK 13 .? B Y . - S ,.. White-Payers Copy Yellow-Posting Copy Pink-File Copy IT NCt.. 01-32I0 ' 13-I4ig. `permft 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 11-3855 Park Ded. TOTAL u -2 .S / s V ? ? J G r ? 7 l u c- c? ci Thank You __------- U ThiS requesl void ?/?O / ? ???/ 18 months fram /p? a L/ •???-L; ri 1 ? n a 7 , /.? ?,? ?r?.?i, Requesl Date ??? Fire No. Rougfi-fn Inspection ftequtsed? es ? No ?Ready Now i I? Noi+lV. iRSpec- tor When Ready ?nsed Electrical Contractor 1 herebV request inspection of above ? OWnef electriGal work installed at: Str Addre? I s. Boz ute No. C? ection o. ownship Name or No• TRange No, CountY OcCU ant (PRINT _ Phone No. let? Power Dlier I Address lec I Contractor (Company Name ` Contr?r's Li en ? G Maii ng Ad ress S ntra •tor o ner Makin n ta'la N W .dgnature (Contr Owner Making Installyi n1 Au ori L! / I ?4- _ / THIS INSPECTION REQUEST WILL NOT MINNESOTA S ATE RD F E BE ACCEPTED BY THE STATE BOARD G, iggs-Midwey Bldg. - Room N•191 UNLESS PHOPER INSPECTION FEE IS 1821 Universitv Ave.. St. Vaul. MN 65104 ENCLOSED. Phone (612) 642-0800 REQUEST FOR ELECTRICAL INSPECTION w EB-00007-06 See instrucLOns lor comDleting this fwm on back of yellow copy. -c;n d 7 "X" Below Work Covered by lhis Request Now Add Rep. Type of Building Aqpliances Wired Equiumen[ Wired ' Home Range Temporary Service Duplex Water Heater iyhtiny Fixtuies Apt. Buiidinc? Dryer Electrie Heatin Commercial Bidy. urnace Silo l)nloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Othr.r peci y Oiher (Su??r.ifyl t er SVecify Other OthLr [.OR7Oilt@ J/1SDBCIlOlI tPP tSElDW Fe Service Entrance Size b Feeders/5ubteeders ? FPB Circuits 0 to 200 Am s 0 to 30 Am s 0 to 30 Am S Above 200 Amps ZI 31 to 100 Amps 31 to 100 A s - Swimming Pool Above 100_Amps Above 100_Amln Transformers Irrigation Booms Partial• Other Fee Signs Special Inspection S ? Rerrarks ; , TOTAL EE /', Rough=in Date ?, the E ctri InspeCtor, heraby certify that the above F?nai nspection has been ? d made. Thls request rold 18 monlhs lrom cinr oF EaGAN 3830 Pilot Knnb Road P.O. 6`,)x 21199 Eagan, MN 55121 Owner. ' E'w R Site Address: 43111B Permit No: E,138 Date: 6-221"87 Meter No: 3 Size: Reader No: D,S p l.+ 70 97 Date: 1;_,?! D? rizon .t I onids -?U 3&45 Conn. Chg: 525.0 . eel Acct. Dep: 15. R3 Permit Fee: F Surcharge: '??? ?I I R F C? ?*+AWply with the City of Eagan Tr. Plant 130'O p Ordinances. Meter. ?`,7.00pd Misc.: B WATER SERVICE PERIQIIT ?? CITY OF EAGAN Permit No: Date: 6-,_? - S 7 ? 3830 Pilot Knab Road Meter No: Size: '? o c P.O. Box 21199 Reader No: D Date: _' _47- Eagan, MN 55121 Owner. :urizon 156r cic 30 ? SiteAddress: C1e:ason_ Cir.c 9;;" ''rail?; af '.C'.onaas Lk Plumber. 525.00pd V4 lac?but,lities ? x3 onn. Chg: cot Dep: ? : , _ ? _ O. ?5f Uni : e mit Fee: urchar e: ' ? g ? agree to comply wRh the City ot Eagan lrr. Plant Ordina es. Meter. ,7.130pa Misc.: gy WATER SERVICE PER ;CITY OF EAGAN a b ' 3830 PilGtt Kno?.,Ftoad SEWER SERV ICE PERMIT ? P.O. BoX 21199 PERMIT NO.: 9991 Eagan, MN 55121 DATE: 6-22-$7 ? Zoning: ^i No. of Units: 1 ! Owner: _ Nev kort zon :iomes Address: Site Address: 4317 " ric: rnson ircle L9 B2 Trail.s of Thomss T E Plumber: ? plumbing /4640 100,40pd I agree to comply wRh the City of Eagan Connection Charge: 515, Op^d Ordtnances. r Account Deposit: _ i S ppr„d Permit Fee: Surcharge: By Misa Charges: i Date of Insp.: Total: ? Insp.: Date Paid: ? - -- --- , _, E CITY OF Ep.GAN 3830 Pllot Knnb Road P.O. &,)x 21199 Eagan, MN 55121 ' Owner. ' ew `; ? Site Address: 431IB Permit No: 8838 Meter Na 19.7 Reader Na 6 J? p l? ad 9'7 Conn. Chg: 52 5 . 0 75. 0(. Acct. Dep: {. . l c . Date: 6--22-87 " c Size: Date: Thomas Lk It3 Permit Fee: ? Surcharge: ' *r??ply with the City of Eagan Tr. Plant I ?`' B p-a Ordfnances. Meter. 6 7. 00pd ? Misc.: 8 WATER SERVICE PER IT CI'TY OF EAGAN Permit No: =' ??° 3830 Pllot Knbb Road Meter No: P.O. Box 21199 Reader No: 4 Eagan, MN 55121 New tiorizon 'rbn,es Owner. ? SiteAddress: 4313_ Clemson. Circle.,L.9 B2 Tr, Date: 6_2' -87 Size: '? o c Date: ? e - n r, of 525.00pd ?? ?`?w Uttlities j Conn. Chg: A.Ax R3 ? Acct. Dep: Rir4o. 'Anit : i Permit Fee: A? Surcharge: !' ? agree to comply with the City of Eagan .11 Tr. Plant "? ' ? Ordtna es. Meter. n? Misc.: gy WATER SERVICE PER CITY OF EAGAN ? • 3830 Pllgtt Kno"oad P.O. Bok 21199 ` Eagan, MN 55121 Zoning: r3 ? Owner. ilev lorAddress: *16 ? Site Address: Plumber. ?.r.,. ? ft ? SEWER SERVICE PERMIT PERMIT NO.: DATE: f?-22-87 No. of Units: I ?iotaes b- I9 -87 74840 1 agres to compiy with the City of Eagan Ordlnances, By Date oi Insp.: Connection Charge: 5Z5 S. QpTd Account Deposii: Permit Fee: t n Qppd Surcharge: Misc. Charges: Total: CITY QF EAGAN Permit No: 8 a 4Date: 22 -;; 7 3830 F°Ilot KCrob Road Meter No: 5.95 Size: °C P.O. Box 21199 Reader No: ??p ??9 Date: ? d' Eagan, MN 55121 ? r ? ,. ?w :_orizon Ffo?.es U Address:4313B Glemson [;lrcle L.iu 151- nber 'rhompson Plumbing n. Chg: 525.t)0 d raning: _ t Dep: I5. O0n? No??s: nit Fee: ra1110r31 U AS E?G :har e: - ie 1 ??6g?ee tp g s with the City of Eagan tit Tl dt c AGAN PermitPJa 'j 8-? 7 Date: f- --22- `' 1 30 Pilot Knob Road Meter Na ?3g 7l °7 Siie: ° O. Box 21199 Reader No:QSp6aQ S? Date: V-1dr97 gan, MN 55121 ::w :orizf?n wner. - s_ emson. rc e ., 2 ra s o e Address: . '1`l,mmn Gnn P ttmninsL _.. w Conn. Chg: 525.00pa ?`? F`'?N?'?r" T - ities i- Z?v F ' i in ca ? Acct. Dep: • . ? CTRI?• ?"?c. Permit Fee: _.-'9 Surcharge: ?gv reAq)*ply with the Clty of Esgan Tr. Plant ` Ordinantas. Meier. 55 p3 Misc.: B WATER SERVICE PER WATER SERVIGE PERNIIT (,/,/ OF EAGAN ~ gEWER SERVICE PERMIT Pilo# "::4ob Road 5991, e_.,?•,,,ne ' PERMIT NO.: Homes No. of Units: I agree to comply with the Clty o1 Eagan Connection Charge Ordinances. Account Deposit: - Permit Fee: SurCharge: g Misc. Charges: - y Date of Insp.; Total: Insp.: Date Paid: oF LdGAN ?SEWER SERVICE PERMIT Pilot Knob Road ' 9991 3px 21199 PERMIT NO.: No. of Units: liorizan Aomes I agree !o cotnptyw7th the City of Eagan Connection Charge ? Ordlnancas. l Account Deposit: _ ? Permit Fee: } Surcharge: By Misc. Charges: - ? Date of Insp.: Total: ' Insp.: Date Paid: FoR SALE T.H. CITY OF EAGAN N_ 13778 .x ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING ' PERMIT PHONE: 454-8100 Recei t # ---I Li ? •? 0 To be used far 1 OF 4 PLEX Est. Value $63 , 000 SiteAddress 4313B CLEMSON CIR Lot 10 Block 2 Sec/Sub. TRAILS OF Parcel No. THOMAS LAKE a Name NEW HORIZON HOMES INC z Address P.O. BOX 1367 ° City MPLS Phone 420-3900 , a Name Zh P Date JUNE 16 1 g 87 OFFICE USE ONLY I On Site Sewege _ Occupancy R3 MWCC System Zoning 7i1 On Site Well Type of Const v_ Ciry Water X (ACtual) - (Allowable) ? # of Stories Length 44 Depth 26 S.F. Total Footprint SF, ?Q Address APPROVALS FEES ? City PhonB qssessments _ Permit ? 374.00 ? w Water/Sewer _ Surcharge 31, 50 W W Name Police _ Plan Review 187 np tz x- ? Address Fire SAC,Ci[y - ?Ln -.?n np u Engc _ SAC,MWCC S?S np aw City Phone Planner _ WaterConn. c_?c n0 Council WaterMeter 67. 0 I hereby acknowled9e that 1 have read this application and state gldg. Off. _ Road Unit =305.y0 thettheinformationiscortectandagreeto omply with all applicable APC _ TreatmentPl _i8??p State of Minnesota Statutes and City ag rdin Variance _ Parks Copies SignatUfC Of Pefmittee ? TOTAL p A Building Permit is issued t N HORIZON R MES INC on the express condition that all work shall be done in accordance with all applicable StatAof Minnesota ?Slatute; and City of Eagan Ordinancea Building Official a ADDRESS- OCCUPANT HEAT LOSS SOLD BY / ?- i ? --A SEDGWICKHEhTINGiAIk1CON01TIONINGQO. 36 C?? ; HOUSEHEATINGLIESTRECORO ..,, , . .,_„ ,. .. •., . ; . . CITY?t-GCl.L? .r? ? a., I rr.../M1 .'7tt AJ .- OWNER-. . . i 'E HTG. INST. Electrical Work By V. r" r TYPE OF HEAT GA= FA_L, HW_ STEAM _ SE?F GAS DESIGN MAKE n +` ? ? ? w ? ?••^. MAI<I, Model y6Ce U:t'S Z?U S-C? T3 9 -M1oh4 Serial ? ? „.Max. 8 INPUT MAKE _INSTALLEDBY ?Jr_ _ Gas Line By ? 5e O.,._[Ii CEHTR._UNIT,HTR. -OTHER, CONVERSION OFBURNER lJ Rating - iF PURNACE I 7 f.i +.i.i ..?' ..,., < Model , . . a :.. C NTROLS ?"-.., 1 l •? 7HERMOSTAT?^"'a L Heat Plug -"? )?-? Vent Size Valve ?'? ??? - KIND OF UNER ?" SIZE NONE ` Limit - Hood Drafi -E Reoulator -? .- ? limit Setting ° r Filters Size dion Loc Chi , Number. ? Inside Outsi e ? Fan Setting " - • C .. a mney i r ? IQSS ? PilotType .. on iAet ChimneYConst - -. • _ i. ?` Pilot Make i ? .., .' 4' `. ,.....:. ? ., Pilot Model - ? Smoke Bomb ? --„Wiriog c ` ? Pilot Timing . Draft I Test Tag L.W. Cut Offi Door Pressure ? Lighting InsG T t d Pressure _ercent COz es e Date Z , - Input CFH -S ercent 0 . 10S°4, Cmnpany Testing - ??^? Stack Temp.? Percent CO ?t1?? .. . . Name of Tester - . ' ..... -.. _ i SEDGWICK HEATING & AIR CONDITIONING CO. ?+EaTiNc 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 887-9000 TEST RECORD aooaESS cilv OCCUPANT / SOLD BY e MAKE I.`-?,JN U`FSERIALNO. ????? [?'ICJCSD ? ? ? ? ? ? E THEFMOSTAT??) t JAN 1 3 2006 VALVE LIMIT LIMIT SETTING FAN SETTING ?([/ nY (e? ' PILOT TVPE ?I CIY? IGNITION MODEL ff S ? PILOTTIMWG ? • 5^j? (k)•(?-• ?? PRESSURE PEPCENTCO z C INPUT CFH ? PERCEM O ? z STACKTEMP. ? PERCENT CO - JOB NO.U.15-6 ? 3'3 OWNER V"'C iNSrnLLeosv DR lJ fo'.{)l'1. MODEL "6 C) (J?? 3g PH () -7C? INPUT W V Jt / I LJ? vo r VENT SIZE P TYPEOFLWER6 `)"4 LINERSIZE S/!?`l FILTERS: S?IZE ?? NUMHER ? WIRING S/_! ?!?CUP IyKMC TEST TAG - LIGHTING INST. DATETESTED??/ ?? COMPANY TESTING NAMEOF7ESTEF ?C O- PORM 235 (REV 11189) FOfitd DISTRIBUTION: WHITE COPY- JOB FlLE YELLOW COPY -pTY FOR SALE T.H. CITY OF EAGAN Np 13779 %' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454•8100 Receipt #? ?[ ??L[(:) Tobeusedfor 1 OF 4 PLEX Est.Value $64,000 Date JUNE 16 1987 Site Address 4311B CLEMSON CIR Lot 11 Block Z Sec/Sub. TRAILS OF Parcel No. THOMAS LAKE a Name NEW HORIZON HOMES INC z Address P.O. BOX 1367 ° City MPLS phone 420-3900 o Name SAME ?4 Address r City Phone Name C ity I hereby acknowledge that I have read this apl thattheinformatloniscorrectandagreejA Comy P State of Minnesota Statutes and Citv6f Ea?n Signature of Permittee`` 41%- A Building Permit is issued t N HORI Building Official and state all work shall be done in accordance with all ap OFFICE USE ONLY R3 OnSiteSewage Occupancy MWCCSystem ? Zoning PD On Site Well Type of Const p City Watef ? (ACtuel) v_ (Allowahle) # of Stories - Length T+4 Depth ?7 S.F. Total Foatprint S.F. APPROVALS FEES 50 ? 377 Assessments _ Permit . Water/Sewer _ Surcharge 32.00 Police _ Plan Review 1 RR _ 75 Fire _ SAC,CiTy tno_no Engr. _ SAC,MWCC $2$.00 Planner _ WaterConn. 595.00 Councll _ WaterMeter 670 Bldg. Off. _ Road Unit 305 _ flp APC _ 7reatmant P7 1 RO _ 00 Variance _ Parks ? Copies 70TAL 5 INC on the express condition that Df Minne?* Statyytes and City of Eagan Ordinances. FOR SALE T.H. CITY OF EAGAN N? 13777 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 "PHONE: 454-8100 BADING PERMIT Receipt# U ? To be used for 1 OF 4 PLEX Est Value $63 , 000 Date JliNE 16 ? 9 87 SiteAddress 4313 CLEMSON CIR Lot 9 Block ? O 5it S Parcel No. Sec/Su6. TRAILS OF THOMAS n e ewage LAKE MWCC System On Site Well City Water w Name NEW HORIZON HOMES = Address P.O. BOX 1367 o City MPLS phone 420-3900 o Name SAME 0a Address ? City Phone ts W w Name i? Address ?w Ciry Phone I hereby ecknowled9e that I have read this application and state thattheiMormationisconectandagreet omp withallappl'if.a6le State of Minnesota Statutes and CI mac+4?? Signature of Permittee ? A Building Permit is issued to: all work shall be done in accordance Building Officlal ZON APPROVAIS Aasessments Water/3ewer Police Fire Engr. Planner Council Bltlg. Off. APC variance all applicable State,pf Minnesota OFFICE l1SE ONLY Occupancy R3 X Zonin9 PIl _ Type of Const v _X_ (ACtuap (Allowa61e) -? - #otstories Length Depth 26 S.F. Total FootOrint S.F. FEES _ Permit _ Surcharge _ Plan Review _ SAC, Ciry _ SAC,MWCC _ WaterConn. _ Water Meter _ Road Unit _ Treatment P1 _ Perks Copies TOTAL $ 374.00 31.50 1R7_nQ 595_Op 57S_(lQ 3-6-7 80 2 294-.50 _ on the express condition that and City of Eagan Ordlnancea Y Fox SALF T.H. CITY OF EAGAN , i 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 PH ON E: 454-87 00 ,, BUILDING^PERMIT To be used for 1 OF 4 PLEX Est. Value $64, 000 SiteAddress 4311 CLEMSON CIR Lot lZ Block 2 Sec/Sub. TRAILS DF Parcei No. thomas lake a Name NEW HORIZON HOMES INC z Address P.O. BOX 1367 o City MPLS Phone 420-3900 °L Name SAME I ?0 Q Address P City Phone Um wW Name_ w i? Address aw CitY- Receipt # I N_ 13780 cI-b Date .TUNE 16 ,19 87 OFFICE USE ONLY On site sawage Occupancy R3 -? MWCCSystem Zoning R1 On Sita Well Type of Const V City Water X (ACtuaI) ? (AllowaGle) # oi Stories Length DePth z7 S.F. Total Footprlnt S.F. APPROVALS FEES Assessments Permit $ 377.50 Water/Sewer _ Surcharge 0 Police Plan qeview 1 RR _ 75 Fire SAC, Ciry 100. 00 engr. S:4C,rnwCC 595_O0 Planner _ WaterConn. 57 5 _ (10 Council _ WaterMeter 67-f10 I hereby acknowledge that I have read this epplication end state BIdg.Off. _ Road Unit 305 _ f10 thattheinformationiswrrectandagree comy dywith pplicablel APC _ TreatmentPl 180_00 State of Minnesote Statutes and Cit t 5u Or i? es variance _ Parks Copies Signature of Permittae roraL 3b?: 25 A Building Permit is issued to: NE HORIZON OMES INC on the express condition that all work shall be done in accordance with all appl'?bA State of Minne,§ota Statutes and City of Eagan Ordinances Building , CITYOFEAGAN ?JQ 16099 ' 3830 Pilot Kno6 Road, P.O. Box 21-799, Eagan, MN 55121 PHONE: 454-6100 ? c) ? ? BUILDING PERMIT Receipt # ? j To be used for FIREPLACE Est. Value $1, 000 Date f) , 19 Site Address 4313 CLEMSON CIR Lot 9 Block ? Sec/Sub.THE TRaT .?OF OFFICE USE ONLY ParC21 N0. THOMAS LAKE Oxupancy - FEES Zoning - m Name DAVE ROBBINS (Aduai)COnst - BIdg.Permit 26-00 w a Address 4313 C.F.MSON . R (allowable) - h 5o arge Surc • City EAGAN Phone 474-7574 #ofSrodes - Plan Review Length _ Name HEAT-N-GLO FIREPLACES Oepth SAC City aip U Address 3850 W HWY 13 S.F.Total - , - ¢ ? City BURNSVILLE Phone 890-0758 S.P.FOmprims snC.nnCwcc _ Water Conn On Site Sewage _ r z Name on sae wen - water nnac e ? Addfess MWCCSystem ar _ 0 i aw City Phone cirywe?r Acct Oeposit _ W P S i PRV Required erm / t _ I hereby acknowlege that I have read this application and state that the Booster Pump - S!W Surcharge intormalion is correct and agree lo comply with ail applicable Slate oi Minnesota Stamtes and C' of E?an Or ' . ? ireatment PI ? Signature of Permilee ?An+ APPROVALS Road Unit A 8uilding Permit is issued to: HEAT-N-GT.O FT RFPi A('F S Planner - pyrk Ded. on the ezpre55 condition ihat all work shall be done in accordance with all Council applicable State of Minnesota Statutes a nd City ot Eagan OrdinanCes. Bldg. Dff Copies p y ? A 26.. 50 Build?ng O(ficial ?,mq ,+. ?p???j ! j Variance - TOTAL This repuest voitl ? 18 vwnihs (rom D 1505(? I wn?4 in¢fn11aA a17,;i ?/d request inspection oi above 0-D Str e AdAress, Bo or Ro e 'o/.?{?}??. ?/'. / !•.?L/ ?l i?? ecLOn I. Township Name or No. ange i o. County O co rnl (PRINT) 0 '/^ Q Phane No. Y L PoWe! Svppli2! DaAeo AdAre53 I Nec[ I ntracmr ICOmDeny Namel I -c Conhe c(?/rJy Mailing A Jr ss (Coot a tor ? Qw er E kine bista ion) ? ? ? Authorrzed Sig tu IConva o / r akine Inst?l Phonu? mber caviq STATE BOARD OF ELECTNICITY Griggs•Midwey Bldg. - Noom N-191 1821 Universitv Ave.. St. Paul, MN 55104 Phone (612) 642-0800 THIS INSPECTION NEQl1EST WILL NOT BE ACCEPTED BY THE STqTE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSEO. uM Ee-00001-06 ; SQUEST FOR S EL ? ECTR ?I CAL ? INSPECT ?^ON ct et veuow coov. D 1 5 05 0 "X eeloW Work Covered 6y 7his Request AAU Pep. Typn ot Builtling AOOilancns Wiratl Equipment Wired Home ange Temporary Service Duplex L ater Heater ? ightiny Fixfures Apt. Bulldinc? ryer I Hectric Heatni Commercial Bldy. umace I Silo Unlonder - Industrial Hldy. Air Contlition 4r Bulk Milk Tbnk Farm omer Soeci v Other Isi?c?:?rvl th" $pOCify thC/ OthC, Comou[e fnsoeCtlOn Fea Ralnw I p F Service EntrencaSize tt iae Faxtl rs/Suhf¢pders k Fee Circults 0 to 20D Am s 0 to 3p Am s Q to 30 An+ s Above 200 qinps 31 to 000 Amps 31 to 100 Am s Swimming Poot A6ove 100_Am s Above 100_A?n s Trenstormers Irrigatlion Booms Pertial,Other Fee Signs Special Inspection TOT F Pemarks . y L F& n] .-?f rti /?-c `W - - ) I, thx Elecvical ?J ?nspector, berBby certify that the abovB Final O ?/? inspection has Caen meea. This reouasl voie 18 manlha Irom I Thfs reQUast vold 18 nwnths trom ? 15 0 4 q xl?!fVl/:?„? ?. _-7) U - ReRUest Uate ' ? Fire No. Rouph-1n InSVeetion Aequired? ReadY NivA§J:0?ll Notify Inspeo- ? ?No lor When Headv ,,&'f!-?sensed Elecinc,l Contractor I heraby repuest inspeclion oi above ? Owner electrical work inslalled at Sve t Address, Boa or o te No. 3 msc? C+ fc If, Ciry Fe?qo-n acuon o. ownsh71 N me or No. Fange No. Counrty Occuu?n ? I'2NT) ? ?-i,? ?i ZCn rn Phene No. Power SupoliD Adtlress Electnc act?^o?r ICom,u?aGny /N?amel p /^ Contrac or ?s Li?c ins ?Q/f ?V?.V?.J??. ) ?.?4-. ?\? o [ VV Mailine AdJress ICOnvact r or Owp r aking InsY 'Iati\or/il 1 v ? ?r AuthonzeG - n re Con acio ?n r Making Ins II on) Pho °?'?`? MINNESOTp gTATE BOAflO OF ELECTNICITY Griggs•Midway Bidg. - Room N-191 1827 UniversiN Ava_ SL Peul, MN 55104 Phone (612) 642-0800 THIS INSPECTION REQU[ST WILL NOT BE ACLEPTED 6V TNE STATE 80AHD UNLES$ PNOPEH INSPECTION FEE IS ENCLOSED. REQIIEST FOR ELECTRICAL INSPECTlON ea-ooooi-os ? See instruc[ions for completin9 this lorm on back ol yellow copy. ~?• 7?71<9 ?'? 5(1 Q(? "X" Be/ow Work Cavered by This Request Naw HAtl ReP. TYPe ul Builtlin9 APCliancxa Wiretl EpuiUmenl Wired Home Fange Teinporary Serviw Duplax Water Heater Liyhtiny Fixtures - Apt. Building Dryer Electric Heatinq Commercial 81dy. umace Silo Unloader IndusVial Bldy. Air Conditioner Bulk Milk Tank H Farm Otner Soecir Oiner ISO?citvl [ 4I SUff:l(y Qlhef 01F1(!! Uomaute rnsner.rinn ree rtamw M Fee ServiceEntmnceSize M1 Fee Faeders/SUbfeeders tt p Circuits U ro 200 qmps 0 to 30 qm s 0 to 30 Am)s Above 200 qmps 31 to 100 Amps 31 to 100 Am s Swimming Pool Above 100-Amps Above 100_Amps Transiormers ?rrigation Booms Partia60ther Fee Signs Special Inspection 7 Rertw?ks ?. pTAL F L E flough-in Final ?r Dnte "7..?? fJnte 4 ?, the Elecb Insoeclor, heroby certify that the above insvee?ion has ?een mede. Tnlb raduest volo ltl moniN Vom This request void,? y 18 nnmhs from / lfll '! ?,M f2 1'Jr? ? Request }]??e ^ '/? ^^ Fire No. BVenUph-in InsVection IimreA? ?Ready Nu ?oII Notit Inspec"I r When Reatly ' r ONo P'S"ensed EIecV+cal ConVacto, 1 hereby reouast insDection oi above ? Uwner elecM1icel work installed al: 5[re t AO r s, Bo o? Rou I? ? - m ecLO . Township Name or Nn. i n9e No. County Oc nt (PHINT) I ? Phone No. Power Sup ' r Al Adress EI ct I Contractor ICOmpany Name) ?e Coatrp tor's Licens No. ? ?: a Mali Ad ess ICO trac or or ner Makm tail sY N ? -/?j/ ?? J??: <<y ? Authorired 5? JA?trac ?ear -ng Insi $I Phon umber ? /. ? 3 i tu lc iNCPFCTION AEQUEST WILL NOT MINNESOTA STATE eDARD OF ELECTNICITY Griggs-MidweY Bldg. - poom N•191 1821 Univarsitv Ave.. St. Peul. MN 55104 Phone (612) 6420800 BE ACCEPTED BY THE STATE BOARD l1NlES5 PROVER INSPECTION FEE IS ENCLOSED. - - REQUEST FOR ELECTRICAL?INSPECTION EB-00001-06 See insUUCtions tor comple?ling this brm on beck ol Yellow coov. .7 5 /1 /1 ? '"X" Below Work Covered by lhis Request ' 1 ?} 4- 1 . Equiumen'Wired Tvon o1 0ullding Ap?lpnc.s W d al ServiceEntrencaSize I tt I Fee 7 Mi 31 to fnspectoq hereby certify lhei tpe above insoection has been Final Thi6 rBVUeaI vold This reauesl void 7 ? 18 months hom 1 7-3366 flequest D?aTte ?i Fire No. ?ou.p?V-in Inspection Oqeatly Now 71 Notify InsOec- 2- ??4Yes 7 ?]No ror When NeaCy ? ?icensed Elecnncal Conttector I hereEy request inspection ol above .ie?ntenl urm4 instelled et: No. St t AdCress G??? ?o1l Namo. ect Z CoutoPt, O c pnnt (PPI Phone No. e? ,(), lier /- Power 5 Add.ess n (N/\ V L? ' omDany Namel tor IC Electric ConVac s License No Cont actor qZ1 U 7 ? / P Me.ilinp Atldres6 1 onVact r r Owner Mak g nstai g[ionl -? ./? [r ' Aufhorized Sie r ract r O ta ^ BI^s Number Phona ocnuccT wu ? NnT MINNESOTA STATE BOAND OF ELECTNICITY Gfippe-Midwey Bldp. - poom N-197 7821 Univn•xitv Ave.. St. Peul. MN 55104 BE ACCEPTED BY THE STATE BOARD UNLE55 PPOVEH INSPECTION FEE IS ENCLOSED. /16 '7 REQUEST FOR ELECTRICAL INSPECTION e.ys.ooooi-os . 11, Sea ins<ruciions for completinp this torm on beck o1 vellow coov. "X" Below Work Covered by7his Request / Nfor Ad Rap. Tyoa ol euildine Apptlancee Wiwd Equipment Wi.ed Home Range -Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric HeaLn Commercial Bldy. Furnace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tenk Farm Otner Peci y thmrlSnecity? . 1 Tr Suecity Other ? Other cO/110(/IB IOSOECIIO/1 FPP QBlOW M Pee Service EnhencaSize d Fee ' Fexders/SUbieeders Circul?s UtoZQOqms 0 to30Ams Oto30Am Above 200 qmps 31 to 100 qmps B 31 to 100 q Swimming Pool Above 100-Am s Above 100_Am Transformers Irrigation Booms Partial.'Other Fee Signs - Speciailnspection 5 TOTAL E E L? ? J 1 CN? L V L-_.-' NouOh-in Dnte e el Inspec Final tor, M1e?eby cerfilv ?M1?t t?e above 0 inspaction hes bean ? haea. Tla teaueat roid 18 monche from ClTY OF EAGAN APPLICATION FOR PERMIT ? SEWER AND/OR WATER CONNECTION , ' ? P ease ] 1) PROPERTY ADDRESS: ??? WAO?l LEGAL DESCRIPTION: 12- Z ? 2F E7ffSTING S1RL'CIL?RE. DATE OF ORIGINAL BC?ILDIM; PERMIT ISSL'ANCE: PRF SENP ZONING/PROPOSID LSE: I 9(Month/Year) - ? CMHERCIAL/`RET'MCE ? R-1 i! SINGLE FAFIILY ? n-m'?STRIAL R-2 DL?PI.EX (7t+v Cfiits) II +] I11STI2LTIONAL/COVIIW+EIJp FJ? R-3 1t'%MOC?SE (Three + Units) ( Units) • [? R-4 APARTm2TP/COAIDOrINi[.?Nl ( Units) 2) ? DFiM ADDRFSS CITSC. S'PATE. 2IP . PfIOm 3) NAD?: ? For City L?se . Plim?s License: AMRESS: ? A Active . CITY. STATE, ZIP: ExPlred Mrf Not recorded PHOM: MASM LICFTm# - n?iy ; 3t-aTf -?-t?al a) •• •:,? ...???:a NAM:? - ADDPZM: . ; aTY, SI up: . PH=: 5) i. - «. • ?• • a. ', ? ? d?? ? ?? ? ??ION M CITY WATM 6) ?• • ?- p plEAss HOrn r,pPxovm R"PLEASE MAIL ApPROVID FOR PICK-UP BY ONEi OF AB(7VE _-- 7M 1, 2, A) 4. ABOVE ICircle enel ?' . . NM0 PAYNFW' OF F'i AT TIl? OP APPI.ICATIfRI DOFSS WT QOKSPIZSTIE APPI20{7AL CP PENIIT. nHsrHcrioN aP sEWM Arn/tR W-M XNs`rara.ATza?s waa. No?r ?, sa??- tA.Fn rn?rra: rutrQT Ms am ArPROM. i h . FOR -CITY USE ONLY PERMIT # ISSDED 7 -? Pd w/Bldg. Permit FEES: SEWER PERMIT (INCLODE SURCHARGE) $ $ /G • S? WATER PERMIT (INCLUDE SDRCHARGE) $ "- a--v $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP $ ACCOUNT DEPOSIT - SEWER $ S c' c ACCOUNT DEPOSIT - WATER $ ? Z S, G G $ • wAc $ (o Z S- 0 Z) $ SAC ' • ?i.,,',J: $ $ - X :.. `;'Rti1QiE -WATER AS$ESSlMENT y . .., ; ,, - _ : , • t',-: t $ ;•T?L'NK -$ETOjER.f;ASSFS'SMENT :....k„' $ S ` • LATERAL- 13$NE?PP/.'r9C?NK SEWER . _ $ $ • LATERAL BENEFIT/TRL'NK WATER G ? ?.4 i.' 1_i 'e?`•'F'. , ?. '. ?it } 1'..:: i $ /0 G?- Z- S • . WATER,TRFATMENT. PItANT SLRCHARGE $ ? ,.. {.:E? .., ; '?. ?. ?: t; i' ;'- i 1 ?. : • . bTHER'• ?? . . i TOTAL •-"• .• r?`!:, RECEIPT RECEIPT -.... -e: . , .J?l ?. .. DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN POBLIC Q ROADWAY" MLST BE ISSLED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SOBJECT TO THE FOLLOWING CONDITIONS: J APPROVED BY: ? TZTLE; , • . '• `. ` y?. • y..:; ? DATE;'?7rl 1987 BIIILDING PEAMIT APPLICATI08 - CITY OF EAGAPI Uki T 1q SINGLE FAMILY DWELLINGS IHCLIIDE 2 SETS OF PLANS, 3 CERTIFICAT6S OF SORVEY, 1 SET OF ENfiRGY C9LCOLATIOPS HOTE: ADDSESSES FO& COSNBE LOTS - CONTRACTOR/HOMEOiiNEE HUST DESIGBATS WHICH ADDRBSS IS DSSIRED. NO CHANGSS WILL BE ALLOWED ONCS BIIILDING PERMIT IS ISSQED. H[TLTIPLB D{iELLIRGS - RSSIDENTI9L INCLUDE 2 SETS OF PLANS, CER 1 SET OF ENERGY CALCULATIONS INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE SOND I or + To Be Used For: ?)k,0k&,nC,2 RENTAL B1iIT3 FOR S9LE UHIYS ? E OF SQRVSY - CH6CB WITH BLDG. DEPT., & STRUCTURAL PLANS, SET OF Valuation: (od,CcUG.o" Date: C-- /I2 /97 Site Address 431? CtF-msruN CiRC1.F Lot 12 Block 2 Parcel/Sub Owner ClY+-e Address P, n- QPx f 3??`7 City/Zip Code Phone 420 - 3cwD Contractor Address City/Zip Code Phone Arch./Engr. 9ddress City/Zip Code Phone S On Site Sewage Oceupancy {2 3 _ MWCC System ? Zoning 12 I On Site Well City Water ? Type of Const (Ac'cual) ? (Allowable) 8 oF Stories Length 44 Depth 2-7 S.F. Total Footprint S.F. APPROVALS FE&S ? Assessments Permit M. - Water/Sewer Sureharge 3Z. Police Plan Review I 58 i-5 Fire SAC, City ?pp. Engr SAC, MWCC 525. Planner Water Conn . S27 Council Water Meter to7. Bldg Off Road Unit 30S. APC Treatment Pl Variance Parks Copies TOTAL ?,?30lo , a 5 ! '. . ? 1987 BDILDING PE APPLICATION - CITY OF EAGAN UN i ( 9,? SINGLE FAMILY DWELLINGS INCLDDE 2 SETS OF PLAN3, 3 OF SQRVEYp 1 SBT OF ENERGY C9LCOLATIOHS HOTE: ADDRESSES FOE COHNER LOTS - COBTRACTOR/HOHEOWNSR MOST DESIGBATS AHICH 6DDRE5S IS DSSIRED. HO CH9NGSS WII.L BE ALLOWED OPCS BUILDING PERMIT IS ISSIIED. MOLTIPLE DWELLINGS - RFSIDENTIAL RENTAL OPITS FOR SALS OSITS INCLUDE 2 SETS OF PLANS, CEBTIFICATE OF SIIRYEY - CHBCH SiITH BLDG. DfiPT., 7 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND I nFp 4- To Be Used For: ?pA/lQnLtp Site Address 4 311 B CL & STRUCTURAL PLANS, SET OF Valuation: (o4, U00.00 nate: C'IWv Lot ? Block 2 I On Site Sewage 1 M4ICC System ? Parcel/Sub ' h ?.?-,?,?U, ?»,? On Site Well City Water ? Owner %US q4-61,? C.Q11?T Address 2,0-k I 3rv? City/Zip Code %n, 55440 Phone 42D-`:?qOO I APPROYALS Contractor ?.pT'p Address City/Zip Code Phone Arch.lEngr. Address City/Zip Code Phone Ik Assessments Water/Sewer Poliee Fire Engr Planner Council Bldg Off APC Variance Occupancy K 3 Zoning P p Type of Const (Actual) i? (Allowable) -Z7 # of Stories Length 44 Depth Z"]_ S.F. Total Footprint S.F. FE&S Permit '?a Sureharge 32.. Plan Review SAC, City 106 SAC, MWCC 5Z5, Water Conn 5'2-5 Water Meter (o?. Road IInit BDS? Treatment Pl 180. Parks Copies TOTAL ?;.?r70. gS QNI f 16 SINGLE FAMILY DWELLINGS IPCLDDE 2 SETS OF PLANS, 3 OF SORVEY, 1 SBT OF ENERGY ?_ . 37 NOTE: ADDRESSES FOR COENEH LOSS - CONTRACTOR/HOMEOSiNEE MDST DESIGHAiE iiHICH ADDB&SS IS DFSIRED. NO CH9NGFS iiILL BB ALLOWED ONCB BUILDING PERMIT IS ISSQSD. MOLTIPLE DTi1ELLINGS - RFSIDEN?I9L HENTTA[, DAITS FOR SALE iTBIiS V INCLUDE 2 SETS OF PLANS, CERTIFICATB OF SORVSY - CHSCg iiITH BLDG. DHPT., 1 SET OF ENERGY CALCIILATIONS CONMRCIAL INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND I o F4- To Be Used For: RqfyL(bnlQ & STRUCTURAL PLANS, SET OF Valuation: &3, GCx?,"10 nate: G/10 191 Site Address 4313 CLF-?AsC)k? Ck2cLF Lot C Block 2 Pareel/Sub Owner ?P?,U `]?tqt?n,,?a„ ?J°?Q•noa c ?nc Address p, LI EM L?`J City/Zip Code Phone q20' -NDb Contractor Address City/Zip Code Phone Areh./Engr. Address C1ty/Zip Code Phone 4k PEMIIi APPLICAYIOH - CITY On Site Sewage MWCC System ? On Site Well City Water V/ 9PPROYALS Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off APC Variance Oecupancy r2- s Zoning Type of Const (Aetual) SL (Allowable) "SZ !1 of Stories Length ? Depth ZC? S.F. Total Footprint S.F. FSES Permit ?'?4 Surcharge 31. ? Plan Review 1537. SAC, City pp SAC, MWCC S15. Water Conn szs- Water Meter (0'7. Road Unit 30S, Treatment P1 Ie'o. Parks Copies TOTAL 0?, a 4?450 ? - ?- ? 1987 BOILDING PERMIR APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS IPCLIIDE 2 SSTS OF PLANS, 3 CERTIFICATES OF SOBVSY, 1 SET OF EAiERGY C9LCOLATIOHS NOTE: ADDRESSES FOB COSNEE LOTS - CONTRACTOR/HOMEOiiNEE MOST DESIGHAYB WHICH ADDRESS IS DFSIRED. NO CHANGfiS iiILL BE ALLOWSD ONCB BIIILDING PBRMIT IS ZSSIIED. HOLTIPLS DHEI,LINGS - RFSIDENTIAL AENTAI, QpITS FOR SALE OHITS v INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQEVEY - CHfiCB iiITH BLDG. DfiPT., 1 SET OF ENERGY CALCULATIONS COMlERCIAL INCLUDE 2 SETS OF 9RCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND ? oF 14- To Be Used For: Rk'14jry(y2 & STRUCTURAL PLANS, SET OF Valuation: (03, bpp, ?? Date: Site Address q313 g CL-L-MSpN C ii--cL? Lot I C)_ Block 2 Pareel/Sub qtaL L4 r??WA ? Owner Address P• (). Qft 1"?-7 City/Zip Code ?„ sYn,??, ?jS4A? Paone 420 - 39DC7 Contractor ,4?vmA Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone Ik On Site Sewage_ MWCC System On Site Well City Water ? ArraovALs Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off APC Occupaney K 3 Zoning P? Type of Const (Actual) ? (Allowable) ?L # of Stories Length ? Depth 2(? S.F. Total Footprint S.F. FEES I Permit Surcharge 31.50 Plan Review 1 a-i. SAC, City 100. SAC t MWCC 52S, Water Conn 525- Water Meter (0-7. Road Unit ps. Treatment Pl I gp. Parks Copies TOT6L o? a2 gv. 5 D Variance ' CLAIM VOUCHER - REFUND REQUEST ClTY OF EAGAN MAKE CHECK PAYABLE TO: JEANETTE O'BRfEN ADDRESS: 4313 B CLEMSON CIR EAGAIY MN 55122 LOCATION: RECEIPT #/DATE: REASON FOR REFUND: 4313 B CLEMSON CIR P.I.D. #: 10-75865-100-02 L10, 62, THE TRAILS OF THOMAS LAKE 89818/04/20l98 VALUATION: N/A PLBR TOOK OUT PERM[T PERMIT H:N/A TYPE OF REFUND: Electrical Permit 3211-9001 $ Plumbing Permit 3212-9001 $ 20.00 Mechanical Permit 3213-9001 $ Building Permit Fee 3210-9001 $ Plan Review Fee 3422-9001 $ SAC (MC/WS) 2275-9220 $ SAC (City) 3866-9379 $ SAC (Admin) 3446-9001 $ Water Connection 3865-9220 ? SewerPermit 3743-9220 $ Water Permit 3713-9220 $ Accoun[ Deposit 2252-9220 $ Water Meter 3716-9220 $ Road Unit 3860-9375 $ Water Treatment 3868-9220 $ Surcharge 2155-9001 5 Utiliry Acct Overpayment 2250-9220 $ Curb Box Deposit Refund 2253-9220 S Canstruction Meter Dep Refund 2254A220 $ Water Usage Charge 3711-9220 ? TOTAL $ 20.00 he penalties of I tha[ [his account, claim, or de mand is just and tha t no part of it has been paid. ?// . D M 47;; AY 7 1998 CITY USE ONLY pp ? ? /? g?? /RECEIPT#: O / ?I SUBD. ?yu I" ?l?u)YV?UnP4? RECEIPTDATE: /0 -%5gG5 -t o- 0.r 1998 PLUMSING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KPIOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are re? uired for each unit ? backflow preventer for y(nderground sprinkle?system FIXTURES Shower Water Closet Bath Tub Lavatory Kitchen Sink 6 Laundry Tra Hot Tub/Sp Water Heate Floor Drain Gas Piping Outlet ' minimum - t Rough Openings Water Softener ' for dwellings under construction Water Softener " for existing dwelling U.G. Spflnklef `for dwelling under const. U.G. Spflnkler ' for existing dwelling Alteratlons ' to existing residence Water Turn Around Private Disposal System ' MPC iic. (new and returbished systems) Private Disposal Systems * Abandonment RPZ (new installation only) DZ ? STATESURCHARGE 50 0 TOTAL aV s? I hereby adcnowledge that I have read this epplication, state that the information is correct, snd agree to comply with all applicable City of Eagen ordinances. It is the appliwnt's responsibility to notify the property owner that the City of Eagan assumes no liabiliry for any damages caused by the City during its normal operational and maintenance adivities to the facilities constructed under this permit wdhin City properry/right-of-wayleasement. SITE ADDRESS: ?? ?l -z>-B CI P mcl-t? l/ /-. OWNER NAME: c - y„ ¢wwn 0 ? C? ?0 3.00 3.00 ? 3.00 3.00 3.00 3.00 3.00 3.00 1.50 5.00 20.00 3.00 20.00 20.00 20.00 75.00 20.00 20.00 10 INSTALLER NAME: STREETADDRESS: CITY: ?? 1?-,> STATE: # TOTAL X - x = x = x = x = x = x = x = x = x = x = x = x = _ ? 1C1 ? TELEPHOI' E#: ?J e ZIP: S? TS?4TURE OF PERMITTEE CDIPERMIT FORMS/RPLBG PERMIT (RES) - 1998 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) FROPERTy ADDRESS: LEGAL DESCRIpTION: N0743: PA7aKRStP' Otr' FEB AT TSHS ?' ??? Do? ? ?? APPROVAL oF PER?aT. nwnMcxv oF sE,M nrD/bR MOat na-rnra.p,zzors wII.r. riar EE scHI![>- tif vNrII. PERMuT Has sM . APPROM. . •-?"a?vusiauoaivision or Tax ParceID „ If' E7Q5'TING S'litC'CIL?RE, DATE OF ORIGINAL BLIIaIIdG PEtPffT ISS[)ANCE: . PRFSFNf ZONING/PROPOSID [?SE: ?ear -q CR?RCIALAIETAILroFFIcE Q IPID[JSTRIAL ? ZNSTITLTIONAL/GOVMZ2W 2) JMZE? PAME; ADDRESS; CITY. STAM. ZIP: PHCNE: 3) • c ?- NArE: a?onxESS: C'ITY, STATE, ZIP: PHONE: 4) •?• • • ?• NAME: C] R-1 SINGI,E FAMILY R-2 DLIPLEX (4t,v CRiits) R-3 ZOWICOUSE (1luee + Units) ( ifiits) R-4 APAR'IIMERr/COAIDOMINIUM ( Units) 19A5'M LICEN,Eg ADDRESS: • CITY. S`fATE, ZIP: PHONE: Active EV1red Not recarded rt?.I n i U al 5? " ?' ' ?' =a • o• ?? • d CXRIDCl'ZON RO CITY S. G;r' ODPNII]CTION 1n CITY PATER r-3 pmm . ., 6) ?? • •- ? PIEASE HOID APPROVID PIItNIIT FC)R PIQC-DP BY ONE OF ABOVE ---- --- PLF.ASE MAIL APPRWID PERMIT 1+0 1, 2, 3 4. ABCI{7E . ' (Circle one) ' » .tr;?? #,-' .-..?. n 2 #i s .. PERMIT # ISSUED ji 3 9 Pd w/Bldg. Permit $ $ $ $ $ $ $ $ J Z S L' Z' $ $ $ $ $ S /" ?' `I ? • c; z? FOR -CITY USE ONLY FEES: $ A) -5-L) S ?C SZ? S 1 SEWER PERMIT (INCLLDE SURCHARGE) WATER PERMIT (ZNCLLDE SORCHARGE) WATER METER/COPPERHORN/OOTSIDE READER $ WATER TAP (INCLC'DE CORPORATION STOP) $ SEWER TAP $ ACCOUNT DEPOSIT - SEWER ACCODNT DEPOSIT - WATER $ • WAC $ SAC , $ - %'• 1 : -_ , ''RvCHtK •FIATER ASSESSIIENT ?. . , • $ ? ? !T?tL?NK $$TQER -ASSESS'MENT ; ` 'S i; sit ? r.' 3 $ _ .t. _, _. . LATERAL'$$NEFPP?L?NK SEWER , _ $ - LATERAL BENEFIT/TRL'NK WATER ? • . . • ..'d i :' ? ' . ... ?.. - . . ,. . : ;.} J: $ • 9PiTE$,TRFiATMENT. PI:ANT SORCHARGE ± . '.. . '1. { . 5. . 1; 1...?- ' i . $ . ' :L.. ; -•.? s ' ?- `i ?. ? . . 1 bTAER : ? '41 D .. . . TOTAL i-'a`- °•"1 RECEIPT RECEIPT , DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR 4VORK WITHIN POBLIC Q ROADWAY" MUST BE ISSOED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: J APPROVED BY: TITLE: • . • : ;`.r_• • ? .,_ ?? ? 't; _. DATE: -?-- J ? ?{ . •?r• .: . - • - CITY OF EAGAN ? ?? ° ?,,? ? .. ? iaePF40M oF PErMr. * APPUCATION FOR PERMIT * ?ON OF SEVM AND/CR %ATER * • ,*? rramrOrS WIIi, NOT HE 9GHED- ,*f SEWER AND/OR WATER CONNECTION 'r UIID MuII. PEMT AAS Bm . . ? APPROVED, s ? . -------- u- _______-s l) pROPERTY ADDRESS: LEGAL DESCRIPTION: s 2) R?gIII 2 IF EXIS"PIM STRCC1LiRE, DATE OF pIiIGINAL BL'II,DIN32 PERMiT ISSCANCE: . . PRESENP ZONM/PROP06ID CSE: Mon th/Year ? R-1 SINGLE FAMILY ? R-2 IXJPLEX (JUv Chsits) ? R-3 1t74i1Ni0i)SE (Three + Units) ( Chiits) [] R-4 APARTMENP/COAIDONUNILTi ( Units) ? iCE 1-7 INIIN)3PRIAL ? INSTI7UTIONAL/C,ppERm4EZqT NAME: ADDRESS: CZTY. STATE, 2IP: . PFIONE: 3) • r ?• NAME: 4) AMRE^aS: CITY. STATE, ZIP: PfiONE: •• • i?- NA[•1E: ADDRESS: • QTSC. STA7E, ZIP: . PHONE: MASTII2 I.ICENSE$ Ac:tive Expired Not x'ecorded Sta Initial .gy a . lm' ',i' M?s • . • COMECTION 1U CITY SEWER .?CONNIDCfION M CITY WATER 0 pnm?-? 6) ?? • [3 PLEnSE IiOID APPROVID PIIMT EYHt PICK-CTP BY ONE OF ABWE v? PLFASE MAIL APPROVID PII2MIT 70 1, 2, 3 4. ABCR7E (Circle one) 7) r?Es?'ra., ? ?, g n» n-, fOR -CITY USE ONLY PERMIT # ISSOED f 470 Pd w/Bldg. Permit $ $ $ $ $ $ $ $ _S Z- S $ $ $ $ S $ $ f'3'% 7?c`3CJ --- -7?/? ?l o RECEIPT FEES: i i $ /C - SZ` SEWER PERMIT (INCLUDE SURCHARGE) $ WATER PERMIT (INCLUDE SDRCHARGE) $ WATER METER/COPPERHORN/OL'TSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SEWER TAP $ /S • L/ZZ ACCOt?NT DEPOSIT - SEWER $ /S^?Gf U ACCOUNT DEPOSIT - WATER $ • WAC S sac , ,_ :. .• .. . .: • ' ;.;;?/, TRrC'LfIE -WATER ASSESSIIENT - - $ T1tC?NK _??fpj'ER.;&SSES'SMENT ...?'i.t 'r'?:.? $ ' LATERAL'$TNEFIT/-*CA1K SEWER . . $ • LATERAL BENEFIT/TRLNK WATER i •? . t"": ?' # •..? l.'`1:? . I. ' i.., J.. w•1 Y.1: ? i S . - }[^jATE$ , TRFATMENT, PItANT SORCHARGE $ ?-' ?? •.? y bTHER'• . .. . , _ -s, . -• -x, • . $• ?''.a7??< <` a TOTAL i-.Jt„:-.. ., a RECEIPT DOES UTILZTY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMZT FOR FIORR WITHIN PL'BLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CpNDITIONS: ./ APPROVED BY: TITLE; ,`1• i; ..' . •??;:: , .. DATE: Z / c7 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Ro$d, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 td? Consaud'mn RmuBanmits 3 re9mWW sib swreYs showug sq. fL Mlad, s9. ft of hause; and a6 `ao(ed aravs (2096 mMmmn bl mvmage Omed) i 50ffi Rapoit if PrWOSed doldmg "s lo beOaoed on 4faWr6ed soa 2 0oiies of plmi shaving heam 8 wuMow skm Paumd fanM desgn, etc. 1 set oF Energy Celaletions 3 copies of Tree Preaervatim Plan'rf IM Platted after 711133 (8m Jast OeM Oplions sdectian sheet (6utldimgs wtlh 3 a less wils) Minnegesco mechamcal ven04ation tam Rrmaddf RBDa'v Reawemenk 2 caDies MPhm ftwin9 kofi94 bwms, jds6 i sel ol Enegy Cakuletiais tor heated addtlrons 1 ate siuveyfor add'?tlons & deck.5 AdOOn - uwYcafe ff awTe s ePtlc SYSfem 31-1t' ';Z? Onica (ke OnN CertotSurveyRecd _Y _N ShcsRepod _Y _N heeP2sPlan Recd _Y _N, T22PresRequir¢A _Y _N On-sipe5epticSystem _Y _N Plans are considered public informa#ion unless vou state thev are trade sscret and the reason. Date ?/ b S/o-7 ConstruMion Cost d Q, p c7 a ^- Site Address 5/ 3 i/ - y.3i/ 6 - - Y? i 3 48 Unit/Ste # Gl e... ...1 'r Descript?on of Work ? 5 o - „ ' > i r??. I ? Malti-FamiFy Bldg f/ Y_ N _ 0_ 1 _ 2 Fireplac4s) 1 Property Owner jrt."/ ( a? T p n,, c S L vL ?- Tekphone #(zo', ) L 4 o U ContracMr C l- U Address .b • n.;4 5 a GStY ?LCI'JI?SCJ' He_-, Smte - zllj , Zip Telephone # ('?$-2.) S 'cTD I Y' 'D COMPLETE THIS AREA ONLY IF CONSTRUCTlNG A NEW B911LDING - Minnesota Rules 7670 Catesory l Minnesota Rules 7672 Ener9Y Code CetBgOry . ResideMial Vendlation Category 1 Waksheet . New Energy Code Wwksheet (J subndasion type) Submftted Submltted • Energy Envelope Calcuiations Submitted In the last 72 months, has the City of Eagan issued a permit for a similar plan based on a master plan$ _ Y _ N If yes, date and address of master plan: Licensed Plumber Telephone #( ) Mechanical Confractor Telephone # I ) Sewer/Water Contractor Telephone #( ) I hereby apply for a Residentiaf Building Permit and acknow(edge that the informaYion is compiete and accucate; 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 pemtit, 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. r !<r-Ar.rf a.I 'T.St_ 9P Sr /-7L1Ae?, J Applicant's Printed Name 4 ,-& Id- 3 A- Z&'?x? Xpplicant's Signature . CITY OF EAGAN APPUCATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTy ApDRESS: LEGAL DESCRIpTION: NO'143: PAYMM' OP Psi A'P TlM OF ArerIcATIaN noEs Nar oMarrivM nprRavar. aF PERMrr. INSeECTIoN oP sEWER Aru/oR k'AM nRrDT7.ATTONS FTB1T+ NOP B'F. .?? ?ED UNTM PERMr1' HAS EM APPROVED. ' '• • ?? aYA Ga14.C.1 1L p? .. IF EQSIZNG S'PROCIVRE. DATE OF ORIGZNAL &LIIaZNG.PERMIT ISS011N(E: • PRESEKf ZONIIJG/P'ROPOSID LSE: ? ear .. ? CMfMRCIAL/RE7PAIL/tFFICE Q INC'STRIAI+ INSTITLVIONAL/GOVWMEMP 2) NAM; ADDRESS: CITSt. STATE. 2IP; PHONE: 3) ? . a• NAM? ?: AA?RESS: CITY. STATE, ZIP: PHONE: ? • [] R-1 SIIdCLE FAMILY . R-2 DC'P7M (1Wo C?nits) ? R-3 1U4WIOC?SE (Three + Clnits) ( Unit.s) R-4 APARIMNP/COIIDOMINILTI ( Units) MASTER LICENSE$ 4) ' • ' ' • NAME.- [K. _ ADDRFSS: • ' CITY, STATE, ZIP: • PHDNE: - 5? " ' ?' ' ?' • n? - ?? • ? ?dCOMMMON TO CI?y SENM CDNNDCnON TO CITY WNTER Active Expired Alot zecorded St-a-ff Znitial oOnML-L 6) ?? • • r ? PLEASE HOID APPROVfD PEfiNIIT F!OR PICK-OP BY ONE OF ABOVE _..-- ? PLEASE MAIL APPROVID PEItNIIT 10 1. 2,3 4. ABOVE . 7) . ? i?i LUI .??rl?1? (Circle one) .:«.o /7 _ 2 .D.-1 0 'FOR -CITY USE ONLY PERMIT # ISSOED y 3 Pd w/Bldg. Permit c FEES: $ /D - S a $ $ WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP $ S / S?Lt`1t ACCOUNT DEPOSIT - SEWER $ $ ACCO['NT DEPOSIT - WATER $ $ • WAC $ s SAC . { $ $ TRb14K •WATER ASSESS4ENT T • $ $? '_. : .T$CNK $$fotER,ASSES$MENT , • : Z '". . ' • ?' J.' i Y C f ? I . $ $ ` LATERAL?$F,NE?I-T/.?L'NK SEWER . . $ $ ' LATERAL BENEF IT/TRCNK WATER $ ? ? O • C?L . i .? . • . w 1 .`?:`1 $ .,.` ? , T, •- , lJ' i. . J .-. `'? ? ?'.i'• ? i .[QATE$ TRkiATMENT. -PUANT SLRCHARGE $ -a`z ' ' • .bTHER': '," •? ? ?. i $ . . .. . • TOTAL -'a`- ' ?.?.• Vo ?t 6 63 RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR N10RK WITHIN POBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SLSJECT TO THE FOLLOWING CONDITIONS: ' . APPROVED BY: SEWER PERMIT (INCLODE SURCHARGE) . TITLE; . . ; t DATE:` ?• ?(/? ?/e 7 , .. , •?r.. _ -- ? _ PERhll7 # I5?J a-oA, RECEIPT DATE: S-iS'OI ?? MIX.NTIAL PLIJM$IN6 PERM1T Af'PLICATION crrY oF EAsm 9830 PILOT KNOB RD f.AfiAN, biN 5.5122 ssi-681-4675 Please complete for: i single famiiy dwellings r townhomes and condos when permits are required for each unit • backflow preventer for irrigation systein SITEADDRESS: _?3( I C\'2 m-ziYl1'\ CA C O-2 OWNERNAME:: _?('aTELEPHONE#: (p`o (AREA CODE) INSTALLERNAME: nn4r.1)1REgFCOW TELEPHONE#: gSa g3I'9?p?? STREETADDRESS: 605 12th Avenue Socth (AREACODE) n 5n t, 43 CiIN: Place a check mark next to the permit work tvpe STATE: ZIP: New residential dwelling unit under construction and not owner/occupied $ 90.00 ? Add-on, modification or alteration to existin dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ _ • lawn irrigation system ' • water tumaround ? Nature of work: &a\nc,t r A)12? h2ni t2J _ Septic System, new/refurbished - $ _ ?25.0Q- • includes Counry & Consulting Inspector fees • requires NIFC license State Surcharge $ .50 r Tota I $60 EO ? Reminder: Be sure to schedule inspections of alteretions, i.e. water heaters, water softeners, etc. I hereby acknowledge that I have reatl this application, state lhat the information is « ect, and agree to comply with all applicable Cityof Eagan ordinances. It is the applicant's responsibility to notlfy the property owner lhat the City of Eagan k-Numes no liability for damages caused by the City during its normal operational and maintenance actlvities to the facilities constructed under this perm • ithin Ciry property ri -of-wayleasement. Updated 1101 I Bl ? CITY USE ONLY suso. rhP rrar?o 6f jjo r,.e Lak/ RECEIPT #: 61D 0 -3 RECEIPT DATE: (7C) PERMIT # 1412 7J 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT IINOB RD EAGP.N, MN 55122 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas pi ing outlet " minimum - 1 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laund tray 3.00 x = $ Lavatory 3.00 x = $ Septic System newlrefurbished ` requires MPC lic. 75.00 X = $ Septic System abandonment 30.00 x = $ RPZ new installation/rapaidrebuild 30.00 X = $ Rou h opening 1.50 x = $ Shower 3.00 x = $ Underground sprinkler if dwelling is under construction 3.00 x = $ Underground sprinkler if existing dwalling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ ,36. C-o Water softener If dwelling under consWCtfon 5.00 x = $ Water softener 'rf existing dwelling 30.00 X = $ Water turnaround 30.00 x $ State Surcharge .50 -> -> -? $ .50 Total _> __> ?> ---> $ , D • SD Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. -------------------------•----------------•--•---....-th at ---the infortnation --------------is- corred ---, and agree --------• --t o comply with al---------------l applicable C------------ ity of Eagan o------------•rd? i--nances----- .- I hereby acknowledge that I have read this application, state It is the applicant's responsi6iliry to notify the property owner that the City of Eagan assumes no liability for any damages caused by the Ciry during its normal operational and mainfenaoraactivities.fo.thelacitities x4nsWictnd.Lpdecthis permit within City propeKy/right-af-wayleasement. SITE ADDRESS: I THOMPSON, CHERYL 4313 CLEMSON CIRCLE OWNER NAME: : I EAGAN, MN 55122 I TELEPHONE I (651) 688-3031 I (AREA CODE) INSTALLER NAME: TELEPHONE #: 6EA VENTCO!APPLIANCE INBTALLER6 (ARE.n cooe) STREET ADDRESS: CIIY: YINNEAPOLIS. IiAN 86409 STAT ZIP: SIG OF PERMITTEE rh\"{ t 7 ?°9cc/J(.P'?-i cf?a`L . 1 y4?t-?„l 1 1?1'?`? ? 4L ?? ?... " • ??1?? ? nJt:Q'J ? J j V ?,; ?j N-kX 2(s --752 ?HEATLOSSCALCULATIONS HEAT[BNG&A!R COMDITIOAIl111G CO. ?' MINNEAPOLI ,MI?N. Weatherstrips A.S.H.V.E. . Constructipn No. Insulation NTindows Doors Guide Reference Out. Wall Int. Wall Ceilinp Hoo1 Floor Kind HowApplied Yes-No Ye5-NO iy FI.L?y?Nf?IF?W?,Hoom Length Width Height ? FI. 8.-,Y)Room Length 0 .N49lh °'(i Height ;._" YJi ndows a nd Doors- Crecka ge and Ar ea Wi ndows a nd Ooors- Cracka ge and Ar ea No. w.mn .I dOU Height O I pdn0 No. oi ?, o nl9 ?mea? h, OI 118C14 area 64. ?L N? ' WiAm O? eqB Ho, Of 8nfl No. o/ ?? h14 LaIC?df,k nenl iL O ?ea sV. ??• ` ` ' '} 1 ' -7 2 ?=1 i ? 1 1 O ? Coe1 Btu Coe( Btu Inliltration Infiltratipn .dpj Glass h(r) I Glass 1-7 r+,(} S Exp. wall - ?` v,'(•, ?. Exv. wall !q ??.5.. ?.., ? Net exp. wall Nat exp. well n ' 4. 25A -irlr-w3fi- ptlr l !L'y 222 Int. wall cailinB Ceiling ?C3Id .?,S i5 Floor Floor Total 8tu. 7 5^1 Total Btu. Required sq, ft. E.D.R. or sq. ins. W.A. Leader area Required sq. tt. E.D.N. or sq. ins. W.A. Leader area FI. I..,tW_ Room Lenath 13 Width Height ` 1 ? I widcn I Q Height FI. "?"' .tdt om Leneth 5 ;?e7 .2 11 tL9. NJi ndows a nd Doors- Cracka ge and Ar ea Windows and Doors-Crackage and Area No Monh OI q1rQ HeipM1t O? 3l1B No, of lI Iq9 lineal 11, OI GBC4 Area ^+4. ftL Na Widrh OI 000 Ne. q M Of dOd No. ul h ht3 laneal 11. OI C1BL4 4Fea RQ. II. V Ft', r,> - :L 2R 2 2 t 1 Coef B[u Coef Btu Intiltration Infiltration ?. ( "-, Glass Glass Exp.wall ExP.watl Nei exp. wall Net exp. wall 32 Int, wall Int. wAll Ceiling t J K^) •9 ? ',Z•S 2 Ceilinp ??C'? .?•J -15 Floor Floor Totel Btu. Total Btu. ?- g Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq, ins. W.A. Leader area FI. Room Lenqth % 2. Width Height e ' FI. Room Length f(") Width ?) Heighl YJi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea N?' WrLp of ane Height ol pxna No. ol 1i hts Lmeal h. of erack 4rea sV. fI. NO' N'inri, ol nnp H 911t ul O+nr. N2 nf 1i M1IS l?neal fl. of eeaek 4reA sa. ft. Coef BW Coef Btu Inliltration Infiltration Glass Glass Exp. wall Ezp. wall Net exV. wnll Net exp. wall ---' .. Int. wall Inl. wall Ceil-ng 14"A.E Q?'?? ?„`? 2tp Ceiling .. Floor Pln(x ? - ... tbtai Btu. Total 8tu. , RequireJ s4 ft. E.D.R. or sq. ins. W.A. Leader area ,? Raquired sq. tt. E.D.R. or sq, ins. W.A. Leader area y ?HEAT LOSS CALCULATIONS HEATIRIG&AIR CO111DITOONiNG CO. MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation IATindows Doors Guide Relerence Out. Wall Int. Wall Ceiling fbol Floor Kind How Applied Y85-NO Yes-No 19_ Room Length OQ Width Height FI, Room Length Width Height Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea No. W??1,h of anc Ha,pM ol one No. al li hts Lmeal N. of craC4 Area It. eq . No' W?A?M1 ol ane Mo?p?i ol nne Nn. of h h?s Linanl 1t. ol c?ack Area 0U??• ^ - r Coef Btu Coef Btu , Iniiltretion *760 Infiltration Glass Glass Ezp. wall Exp. wel I Net exp. walt 2. Q Net exp. wall Int. well Int. well Ceiling Cailing Floor ?0 7< <,D-f Floor 7otal Btu. Total Btu. RBQUired sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq, ft. E.O.R. oi sq. ins. W.A. Leader area FI, ^r.„+ Ropn lengih ? Width 11 HeiBht FI. Room ?eng[h Width Meiyht Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea No. W?d, ol nne Haiqht al ane No. oi b hts lmael it. af cr ck 4rea +V• h. No' w,d.h ol ane Hmqhj of ana No, uI b Ms lineal it. o1 c.ack 4rea sV. h. ? r 9 ? G Coef 8tu Coe1 Btu Infiltranon ? 117 2223 intiltre Glass .() QQj 0 Glass Exp. wall Exp. wall Net exp. uy011 ??z `{. ? ? 1 Net exp. wall r 2 -rU 22 int. wAil Cei I ing Cei I inp Floor Ploor Total Btu. ??+g-? 7otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leadar are. Required sq. ft. E.D.H. or sq. ins. W.A. Leader area Fl,1?T•?t9oom lengih 13 . Width ? Height FI. Room Length Width Height Windows and Doors-Crackage and Area Wi ndows a nd Doors -Cracka ge and Ar ea Witl,h ol ane Heiqn? ol pqne No. ul li his LmBal 11. ol Crack ABa sa. ft. NO' R'?in uf nne Mr ylq ul panx Na nl L hts L?nael 11. ol crack Ared eq. fl. Coel Btu Coef Btu In}iliration InfiltrAiion_ Ginss Glnss. Exp. wall Ezp. wTll Net exp, wall 7 ?Cb Net exp_wall Int. wall Int. wxll Ceiling Ceiling _ Floor 0 -?? Flonr Total Btu. Total 8[u. Reqwred sq. It. E.O.F. or sq. ins. W.A. Leader area Roquired sy. ft. E.D.R. or sq. ins. W.A. Leader area 1989 BiIILDING PERM[IT APPLICATION - CTTY OF EAGAN SINGLE FAMILY DWELLINGS ? ? / t I INCLUDE 2 SETS OF PLANS, 3 CERTIFICATFS OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDAFS3ES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER M[1ST DESIGNATE WEiICH ADDRFSS IS DESIRED. NO CHANGES FiILL BE ALLOIiED ONCE BOILDING PERMIT I3 ISSOED. M[TLTIPLE DWELLZNGS RENT9L DNIT3 FOA SALE DNITS # OF ONIT3 INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECB NITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMAfEACIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: 2Qyp 0 leOtQN(P F-P Valuation: Date: Site Address O31? Npw54h o!Yd`P Lot q Block ?- Parcel/sub Owner _ _AUP Address City/Zip Code Phone Contractor Address ?65Q N/6}' City/Zip Code Ui"'R,Sl?lk4hL-3?/ Phone a (V.u u I 'K Arch./Engr• y(), j/y/e Address City/Zip Code Phone 0 Occupancy Zoning Actual Const Allowable ll of stories Length Depth S.F. Total Footprint S.F. On site sewage_ On site well MWCC System _ City water _ PRV required _ Booster Pump _ APPROVAi.S Planner _ Couneil Bldg. Off. Varianee Couneil FEES Bldg. Permit A' ? Surcharge ? Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acet. Deposit 5/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Copies TOT9L ? NOTE: Sewer & Water Permit fees and aecount deposit fees will be included in the building permit fee. Processing time For sesrer and uiater permits is two days onae a licensed plumber has applied for a permit at City Hall. L? gL ? CITYUSEONLY RECEIPT#: SUBD ' /'f4 ut0 01? RECEIPT DATE: -? 1998 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PIIAT IINOB RD EAGP.N, MN 55122 (612) 681-6675 Please wmplete for: ? single family dwellings K ? townhomes and condos when pertnits are required for each unR ? backflow preventer for underground sprinkler system - -----°-- FIXTURES --------- EACH ---- -- -°----------------------------- # TOTAL Shower 3.00 x = VVater Gioset 8.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x Floor Drain 3.00 x = Gas Piping Outlet ' minimum - 1 3.00 x Rough Openings 1.50 x = Water Softener `for dweilings under wnstruction 5.00 X = Water Softener ' for existing dwelling 20.00 x = U.G.Sprinklef `fordwellingunderconst. 3.00 = U.G.SpfinklEt "forexistingdwelling 20.00 = AIt2f8ti0(IS ' to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' MPC tic. 75.00 = (new and refurbished systems) Private Disposal Systems `Anandonmenc 20.00 = STATE SURCHARGE 50 TOTAL V. °-- •-----------------• -------ve -------- ------------- •-- • • • ------------aEo------•-------------------- ? ------------------------------------------ I hereby adcnavledge that I ha read this appiication, sWte that the informn- is corted, and agree to comply with all applicable Cily of Eagen ordinances. It is the applicanPS responsibility to notify the propeRy owner that the Ciry of Eagan assumes no liabilily for any damages caused by the City during its nortnal aperaiional and maintenance activities to the facildies constructed under this pertnit within City propertylright-of-way/easement. i - - . n SITE ADDRESS: A/ OWNER NAME: AN-c-Sf? (f)lD R i AA) INSTALLER NAME: C/ i Ifcle:8 (;CB C\• TELEPHONE #: D D Y?.l 'C C? STREET ADDR V`L CITY: 49STATE: ? PERMITTEE ZIP: !a?V-yz JSlFORMS BLDG/PLBG PERMIT (RESIDENTIAL) 1998 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit '*30?:o Datela /4 /"?f Site Address ?'/ J ? ? ? =M ?/l - Unit # O hone # Tele Property wner p Contractar NOmoNiNC uc Street Address 8910 W811tW0Id1 AVB. City lnneSpolI8, MN 55420 State Telephone # ( ) Bond #: Expires: The Applicant is _ Owner _ ConVactor _ Other Add-on or alteration to existing w ling unit ??ze# ? ??e0 )z) $ 30.00 YZ furnace %-d"ditional r ? Replacement _ New air exchanger air conditioner / ? heat pump other State Surcharge $ .50 0. so s J Total ' I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with tfie ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will e in accordance with the approved plan in the case of work which requires a review and approval oFplans. Applicant s r?? rth AVe. Applicant's Signature Minneapolis, MN 55420 (952) 881-9000 ?. 1?'c'1Cr3 2007 RESIDENTIAL MECHANICAL rEUMiT areLicaTtoN City Of Eagan 3830 Pilot I{nob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dwellings & townhomcs/condos when permits are required for cach unit ? Date-7/20 /0-1 - ? ? l ?IN?YI sCJI'? ?'lQG I`i? d Unit il SiteAd ress V Telephone # ( Pc?) 9R6? ? O _1Glaj_ wner Property Contractor 1.3 C C!, An e-- Strect Address ?acpc:2 City State Zip -Z;?Ao_q Teleplione # Bond #: ?3 Expires: The Applicant is _ Owner ? Contracror _ Other Fire repair (replace burned ou[ appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelliug unit $ 50.00 _ furnace _Additional Replacement _ New air exchanger ? air conditioner heat pump other State Surcharge $ SO $ C'? Total I hereby apply for a Residential Mechanical Pernvt and acknowledge tUa[ be in confomiance with the ordinances and codes of the City of Eagan ar pemvt, but only an applicatimi for a permit, and work is not to start wit approved plan in the case of work which requires a review and approva] o Applicant's Pnnted Name u ormation is complef d accuratc; tha[ tUe work will the Mechaniwl Codes; that I understand diis is not a ill be in accordance with the l ?l/? _? ? I j ? M '^ Q - ? N e-10 . - - ? - J ? (9.37 S I N o 30 30 ? Op•'? nM Z2.oo /9io, l?? oy H ?pQ E\ \ 99 3? zz. zo/? o Ilk \(v??' / L 1, _ ?? ?2°' \ \ \?/0 M ?? v ? . 0 u ? L 96 / G m W ?.?o, ? A1 _ ri zad 4J ?\ N 0 Jr . M p . _ . LYb =:.33ti b fiF-10 "s t9nol Stakr° l°/ ? 7 ,...' U°`IUL-.? jririC) E.]BV3l:1G(1 ???_!,? i?\ I p fw? 1_?li Ge'" otes Pr,pused E1e•ia*..iun Ur.,,lote? Jiiect,ion o` jurfare Urainage PtOpn;r.G i')n Of Fpu'1c7aCion 't1t-vBt:cn = ? 86 o ss I V F?.?C -,ec Gnrag; F_: or E1c:va; i m = q36.$ - 4=*-• ? Pk'?Y1? 6 JUN 12 ?8r ?.' . ?? ??. 1?i. .-' .. • I d I_.,wPst r.upr t,PVdt],,n =437.3 30 30 I / rve rier?by u'y 'nd t th is i; a true and currect represenratipn of a survey rF th- oounc;aries o? : Lots 9, ;J, 11 ano 12, Bior..k Z, THE TRAII_S OF I-HOp"qS LAKE, Cal:ota County, Hi?nesuY.a „-r? If r_ne 1r.r_aLi,1115 of a;l b?iilcin?;s, thereon, and all_ aisible encrnachm2nts, ii ary, Y'r?m )r on saiti :aod. As survcyed by me, or ?inder my direct su{,>-:vi=i+:-, tr,is 9tn day or .hine, 1987. Mr..COMH - UT;;UPJ ASSOCIRTES, INC. Paul A. Johnson Land Surveyor, tii?n. Rey. No. 10938 VV UNDEPMVOIRECTSUIFNVISION1NDiMATIAN,ApUIVflEGISTEN ?ypl ? SNEET flEV. EoLAAN5aav6yok UNDEflTHEUWbOGTMESTATEOF PREPARED FOR ? D- AMROVfD MINNESOT?. BDOK YAGE K McC MBS-KNUTSON ASSOCIATES, INC. )?? CSUl1iNG fXGIXFFPS N 4M0 SOPV[IONS 9 SIIF PIANNFRi MO. OATE Bv qEMAPS E F ?? A FliE NO N OF REVI$1?I1$ Q ?/??7 OATE NEG.NO. ' PLYMOVTH,MINNESOiR n, 1N3o EUN HORIZON HOMES °J za9.s;7 , _ ` 4 Use BLUE or BLACK Ink For Office Use 04 Permit 1L I 0 oe~ 1 C*ty of Ea Permit Fee: 38,30 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 1 n Fax: (651) 675-5694 1 Staff:) I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ~ 3 1 13j) o ji3 j -3 x}3,3)3 C 1 em so, - O_1'~ Unit F~ -_i Name: -24Tr l 5 0 ,•1 A 0,14-A-5z L~4 1•~~L1)eh Phone: '!~4o2 7 7 Resident/ Owner ' Address/City/Zip: { UJQ W Applicant is: Owner Contractor i Description of work:/aka tkp~~ gk Ae' w Type of Work 7 V li' C....,.. _Constructi4n..Cost:_ IVD TLS -,5~aCrllilc ~h C. • o v I Company: Contact: Contractor Address: City: 6 f 2- 7 - I State: •Zip: 552i (a Phone: titertse # - Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 'r ~ 9 A 0 fold V'_1 I 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: i 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.aooherstateonecall.org 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan',; that l 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 Minneso State Building Code must be completed within 180 days of permit; issuance. X_ x Applicant's Printed Name rant's Signature Page 1 of 3