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4319 Clemson CirE'U a SALE T. i s. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, ti PHONE:454-8100 BUILDING PERMIT Receipt# 4 PLEX Est veh,p $63 N° 13137 .-? Site Address 4319 C.FMSnN CIR Erect IN Qccupancy x3 Lot4 Block 2 Sec/Sub. T32AILS OF ; Remodel ? Zoning pD Parcel No. THOMAS I,AK E Repair ? Type of Const. y Addition ? No. Stories W Name NE+J FiORIZOY ilOitilE$ Move 1-3 Length 44 7 P Demolish ? i Depth 26 3 . O. BOX 136 Address - ? 0 City ?4PLS Phone 420-3904 Int.lmpr. Insfall ? Sq. Ft = o Name s?% o? Address ~ City Phone Phone I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ., Signature of Permittee r )?.?,,JCQ?_?r? 7 Assessment Permit ? Water & Sew. Surcharge Police Fire _ Plan Eng. Water Conn. Planner Water Meter Council Bldg. Off. APC Var. Date RoadUnit -3u:).uu Tr. PI. 180.00 Parks ? Copie Total ?2,294 ' ? A Building Permit is issued to: NEw HORI'LON E10N'3N::i on the express condition that all work shall be done in accordance with all applicable State of Minnesota 5tatutes and City of Eagan Ordinances. . PormN No. Pwmit Holder Daq T~ons # Plumbiny H.V.A.C. ENctric ?' i i , ? iC? ;"?" ' ? 025??' `S•? ;C? Sotlenar InspectWn Date Inap. Comments Footinys I ? Faodnys ll Foundatbn Framiny % RooNap Rough Plbg. , Rough Hty. z?-)e -Z"47 4,2? . Inwl. FlnWacis / Final Hty. Final Plby. ? . L -v ? Bldy. Final Grt. Occ. Deck Fty. Deck Frmy. Wall Pr. Oisp. ? • .. CONTRACT PRICE: PERMIT q S j g7 PLUMBING PERMIT RECEIPT # 70 61 _7L CITY OF EAGAN 3630 PILOT KNOB ROAD. EAGAN, MN 55122 DATE: FEB 1991987 PHONE: 454-8100 Site Addrqss Lot--? Block -- Sec?S m Name THOhiPS PL N1 PJG ?o Address 12201 MTKk BL VD S Ciry MTKA Phone 933-2521 L Name c Address p Ciry _ MPLS Phone 420-3900 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 PEHMITTE 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 - Urinal/Bidet - $3.00 Laundry Tray - $3.00 - Floor Drains - $1.50 Water Heater - $1.50 Whiripool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $S.Oa Well - $10.00 Private Disp. - $10.00 ? Rough Openings - $1.50 - ' `--' FEE: ? M STATE S/C: ?v , , 11 FOR: CITY OF EAGAN GRAND TOTAL: - 1 ?? ` •' . ' 1k • ' • IMCHAKCAL PERMIT • CITY OF EAGAN RECEIPT # 00 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: _ PRICE: ,e 17? PHONE: 454-8100 Lot ? Block J,T Sec/S4b, ? - - "' .a- - Name SEDGWICK HTG. & AI COND. ;g Address 8910 WENTWORTH AV . . c City MINNEAP01? 55420 1-9 ?? , ? Name c Address O City Phone TYPE OF WORK Forced Air Unit Heater Air Cond. Vent M BTU M BTU M BTU y? M BTU CFM FEE S/C: TOTAL: BLDG.TYPE Res. ? Mult Comm. Other 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) GAS QUTLETS (MINIMUM - 1 PER PERMM - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONDOS - RES. RATE APPLIES MIMIMUM RESIDENTIAL FEE - ALL AOD-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) 'rrl, ;' LZ SIGNATURE OF PEFMI EE (? ?iYI2GsI/ FOR: CITY OF EAGAN --•.-- ?R SALF T. H. CITY OF EAGAN '--4,E' 2 3830 Pifot Knob Road, P.O. Box 21-199, Eagan, MN 5512?? -'PHONE: 454-8100 BUILDING PERMIT Receiot fi To be wed for 1 OF' 4 PLEX Est value $654,000 pate JANUARY 21 1987 SiteAddress 4319B CLEMSON CIR Erect 16 Occupancy 7'RAILS Lot_I_ Block 2 Sec/Sub Or' Remodel ? Zoning PQ . THUI?lAS Parcel No LAKF. Repair ? Type of Const V . Addition ? No. Stories W rvame NEW HORIZON HOMES Move ? Length 44 = Demolish ? Depth ? o 1367 Address P.(). HOX Int Impr. ? Sq. Ft City i'+P?-+5 Phone 4 2 0- 33 a 0 Install ? Phone Assessment Permit ? Water & Sew. Surcharge _ Police Plan Review Fire SAC Eng. Water Conn. Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that the Bldg. Off. Tr. PI. 180, information is correct and agree to comply with all applicable State ot Minnesota Statutes and City of fagan Ordinancp. ' APC Perks ? , ? ? ? Var. Date Copie Signature of Permittee?{?.? iy - 2300. + ' '?Total $ ? A Building Permit is issued ta: NEW HORI ZON HOMES on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Bullding Ofticial I I Permlt No. I Parmlt Holdar I Oab I TNphons M I Hty. Diap. Site Address Lot glock --- .' -? m Name ? Address 12201 MTKA B a MT A c City K Phone 933-2521 Name NEW HORIZON HOMES PO c BQX 1367 Address o Ciry MPLS Phone 420-3900 FEES COMM/IND FEE -1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12,00 MlNIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) StGNATUR OF PERMITTEE ' 1 ; ?. FOR: CITY OF EAGAN PERMIT # PLUMBING PERMIT RECEIPT # ?"- CITY OF EAGAN 3830 PILOT KNOB ROAD, EA(iAN, MN 55122 DATE: FEB 16? 1987 PHONE: 454-8100 BLDG. TYPE WORK DESCRIPTION Sec/Sub Res. x 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 UrinaliBidet - S3.00 Laundry Tray - $3.00 ? Floor Drains - $1.50 ? Water Heater - $1.50 x-' Whirlpooi - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIn Softener - $5.00 Well - $10.00 Private Disp. - $10.00 - i Rough Openings - $1.50 FEE: STATE S/C: C- GRAND TOTAL: ? ' '? ?? r• '• ?? r cnvn '- ? Y I?IECHANICAL PERMIT 71 3 S , ? . RECEIPT # CITY OF EAGAN - ?....?,?r 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE - PHONE: 454-8100 ' Site Address ? ? " - ? ? - BIDG. TYPE WOFiK DESCRIPTION ' Lor ?_ Block ?- Sec/Sub - ? Res. 4f._1 New ' ' Mult Add-on °-' Name SE DGWICK • • ft. Comm. Repair Address R910 wFUTw S City MINNFapO? ' " ' Other ? FEES c Name d RES. HVAC 0-100 M BTU A IT O _$24.00 ? p ress Ad City Phone DD I NAL 50 M BTU (RES. HVAC INCLUDES A/C ON NEW 6.00 CONSTRUCTION) GAS OUTLETS MINIMUM 1 PER PERMIT) 50 EA 1 ( - . . - TYPE OF WORK COMM/IND FEE - 19'o OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent Gas Piping Outlets # CFM v - (ADD $.50 S/C IF PERMIT PRlCE GOES BEYONO $1,000) Other FEE: - -?? ' "14 S/C: ? v SIGNATURE OF PERMITTEE • /y}? /?/?, TOTAL• FOR: CITY OF EAGAN j1?nR 6A?I i: T. t:. ? L i-rA-; --&v2 " BUILDING PERMIT ? Box 21-199, Eagan, MN 55121 454-8100 Receipt # :st value $63 ,000 Site Address 101 Iutt LotI_ 81ock 2 secisub. TRAIL Parcel No. THOMA W Name NEW HOtZI20N HOMES 3 Address P• O. BOX L3 67 o ..,-.t .. . ? „ ? ., .,.. Z o Name SME o¢ Address f W W -Z U ? ¢_ ? W 13134 198 7 Erect C1 Occupancy `%'' Remodei ? Zoning PD Repair ? Type of Const V Addition ? No. Stories Move Demolish ? ? 44 Length Depth 26 Int. Impr. ? Sq. Ft Install ? Assessment 1Nater & Sew. Police Permit $ 374 . 0 [, Surcharge 31, j? Plan Review I 07. 0 Ci Fire Phone Planner Water Meter Council Road Unit Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe Bldg. Off. Tr. PI. 180. Vd information is correct and agree to comply with all appHcable State of Minnesota Statutes and City of Eagan Ordinances. APC PSrk3 Var. Date Copie Signature of Permittee 42'.194.50 ' Total teo ? A Buildin Permit is issued to: NEW HORIZO:V HONIES 9 on the express condiTion that all work shall be done in accordance with all applicable State oi Minnesota Statutes and City of Eagan Ordinances. Building Official - Pormk No. PwmN Holder Date TNepha» M Plumbiny H.V.A.C. Elscerle c?IL So1tMa InspecUon Date Inap. Commenh Footinps I FooUnqs II Foundatbn Framiny J 4,,) Roofinp ? Rouyh Plbq. •1(!?? ?,? ` --o^ , 7 C/ Rouyh Hty. "1i47 &)Z -L , Insul. * Fireplaee Alr CR C( 54c CIt;-o atJ S- ? 1-J'7 G''. •? . Flnal Hty. Final PiDy. &dy. FInN Grt.Oce. ? ?.onh -?er cG a? ?•?u aC.4 ?uL Dectic Fty. Deck Frmy. Wsll Pr. Dhp. PERMIT f? ?111T ?? PlUM81NG PERMIT RECEIPT ti CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: FEtS. 10; 19S7 PHONE: 454-81 OQ Site Address Name Ciry Phone ? Name NtW FtUK1LUIV I1UMt: c Address _P4 BOK 1367 p City hSI NNEAPOL I S Phone FEES COMM/IND FEE - 146 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 OF FOR: CITY OF EAGAN BLDG. TYPE WORK OESCRIPTI 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 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 PERMIn Softener - $5.00 well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: ?4_) . GRAND TOTAL: - ? -- • ' ?- MlCHANIeAL PERMIJ rCnmi i ff ?- RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE i rO PHONE: 454-8100 Site Address 1 BLDG. TYPE WORK DESCRIPTION Lot % Block .,,L 5ec/Spb Res ? New ? i?1i-6 QND. CO . ' Name Ftqlf) TWORTH AVE. S0. Mult Add-on °- Address NNEAPOLIS MR 55420 Comm. Repair ? Other Ciry wm.? FEES ? Name RES. HVAC 0-100 M BTU -$24.00 c Address ADDITIONAL 50 M BTU - 6.00 p Ciiy Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS MINIMUM 1 PER PERMIn - 1 50 EA . - . ( TYPE OF WORK COMM/IND FEE - 19'o OF CONTRACT FEE Forced Air 5sZ M BTU p APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 Unit Heater M BTU REMODELS - 12.00 Air Cond M BXU MINIMUM COMMERCIAL FEE - 20.00 . STATE SURCHARGE PER PERMIT - .50 Vent CFM ? (AQD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # / BEYOND $1,000) Other FEE: S/C: '42 SIGNATURE OF PERMI E TOTAL: FOR: CITY OF EAGAN FQR. _SALE T.Ti. CITY OF EAGAN 3830 Pilot Knob Road P O Box 21-199 MN 56121N2 13135 8 2 Ea L? ?4 an , : . ' , . . , g , PHONE: 454-8100 BUILDING PERMIT Receipt# _., To be used tor 1 OF 4 PLEX Est. Value $ 64 ,000 Date J AVUARY 21 , tg$7 Site Address - 1617B .I = MSON U'-2 Erect M Occupancy A3 Lot2- Btock 2 Sec/Sub. TR11ILS OF Remodel ? Zoning p]] Parcel No. TI-IOIL'?S LAKE Repair ? Type of Const. v Addition ? No. Stories W Name Nr:?g iiOR I Z ON HUME:i Move ? Length 4 4 z 3 Address.P. O._ BC)X Demolish ? 1367 I t I ? Depth t o City ?'•PLS phone n mQ?. 420-3900 mstau ? Sq. F a Name Approv als Fees ?< Address Assessment Permit $ 377.50 ~ City Phone Water & Sew. Surcharge 32•00 ? a Police Plan Review 3,88 • 75 ? Z Name Fire SAC 625.00 ?a Address En Water Conn. 525. a0 i W City Phone Planner Water Meter 67 •00 Council Road Unit 305.00 I hereby acknowledge that i have read this application and state that the gldg Off i f ti i 180.00 Tr PI n orma on s correct and agre . . e to comply with all applicable State of . . Minnesota Statutes and City of Eagan Ordinances. APC Parks ?) Signature of Permittee_ ? --- Var. Date ???_tf Copies ? • 5 ? Totel A Buildin Permit is issued to: 9 `J?'t? HORI20N HU89ES on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. I t I a+.m+u Na. ! Pe?mlt Holder ) oate I Telepnone a I C) 6%. Final Fliy. 2 ls. /?. ?` •??}. -r 7 Final Plbg. 81da. Final Ftg. Frmg. t , PLUMBING PERMIT ' ' CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 iCT PRICE: PHONE: 454-8100 Site Address Name +nv'ir.-ujr rLUlRt311Y1 R Address 12201 MTKA BLYD c City MT? Phone Name ntW IiUK1LUI4 t18Mt: c Address PO BOX 1367 p Ciiy MPLS Phone 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 PERMIT # 8/ ? S RECEIPT 13 DArE: FEB. 1A 1987 BLDG. TYPE WORK DESCRIPTION Res. r New Mult. Add-on Comm. Repair Other RES. PIBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL ? Water Closet - $3.00 ? -LBath Tubs - $3.00 ? Lavatory - $3.00 - ` Shower - $3.00 i Kitchen Sink - $3.00 ` - Urinal/Bidet - S3.00 ? Laundry Tray - $3.00 - Floor Drains - $1.50 ' Water Heater - $1.50 Whirlpool - $3.00 ? Gas Piping Outlets - $1.50 ?- (MINIMUM - 1 PER PERMIn Softener - $5.00 Well - $10.00 7__ ? Private Disp. - $10.00 F .. _Rough Openings - $1.50 •`? ?' ' ' ?; SIGNATURE E OF PERMITTEE! FEE: G=._ , STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL• :ONTRACT PRICE ?ite Address /6. ot ? Block ? Name SED( .V Address ai c City m c 3 O Name _ Address Ciry _ w,. Ik• 141ECHANIMAL PERMIT RECEIPT # CITY OF EAGAN ? 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: _ ? PHONE: 454-8100 TYPE OF WORK Forced Air qL M BTU Boiler M BTU Unit Heater M BTU Air Cond. r 1? M BTU Vent CFM Gas Piping Outlets # ? FEE: SlC: TOTAL: BLDG.TYPE Res. -? Mult Comm. Other 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) j GAS OUTLETS (MINIMUM - 1 PER PERMI'n - 1.50 EA. 1 COMM/IND FEE - 1% OF CONTRACT FEE I APT, BLDGS. - COMM. RATE APPLIES ? TOWNHOUSE & CONDOS - RES. RATE APPLIES 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 GQES ? BEYOND $1,000) j SIGNATURE OF PERMI?TEE FOR: CITY OF EAGAN L AIR CONDIT ?IING CO. J>J J ? HOUSE HEATING TEST RECORD ADDRESS )17 ? Vxj CITY '4 OCCUPANT 14! , % : , OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY22C ' Electrical Work By Gas Line By TYPE OF HEAT GA_ FA ,HW_ STEAM SPACE HTR. UNIT HTR. OTHER_ , GAS DESIGN CONVERSION MAKE MAKE OF BURNER Model ? ?'` v u ?r ' ?V SC.? Model l Serial t>? b Max. BTU Rating INPUT MAKE OF FURNACE i Model ?T CONTROLS , ' ? ?' THERMOSTAT '??' Heat Plug Vent Size -' ?•v? Valve KIND OF LINER SIZE N?ONE Limit _ S c .2:?c Q Draft Hood Regulator Limit Setting ` °^ Filters Size Number ? Fan Setting Chimney Location (nside 'r Ouuid Pilot Type ? S Chimney Construction ? Pilot flAake ? Pilot Model - 16 / Smoke Bomb Wiring Pilot Timing ttS u? Draft 'J Test Tag L.W. Cut Off Door Pressure ? Lighting Inst. 2 , 61 G Pressure Percent CO2 Date Tested Input CFH ? v ? _ Percent 02 ? ° ` Company Testing ?: - Stack Temp. Percent CO iL' Name of Tester Form 235 -? . . -? . . . ?? ,?. , ?..a? _ SEDGWICK HEATING & IR 6QN ITIpNING HOUSE HEATING TEST RECORD ADDRESS r;r'1 CITY r/ a OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA_ FAN HW_ STEAM SPACE HTR. UNIT F ? GAS DESIGN MAKE MAKE OF BURNER ? Model ?L/Model ? Serial Max. BTU Rating ? INPUT ? U. UCsC% MAKE OF FURNACE ?- ?3?CONTROL9 THERI'AOSTAT Heat Plu Valve Limit _ , ?t rr9 ( ? Limit Setting Fan Setting yi _ Pilot Type -P C iI c cy, Pilot Make Pilot Model Pilot Timing L.W. Cut Off ---•-? ---? 1?C UU Pressure J Percent C02 ? Input CFH ;jLy r ??? Percent 02- 4-4 ?0 Stack Temp. 2?= J? Percent CO ..0S-? C Model Vent Size - ? / ti c /I KIND OF LINER SIZE NONE Draft Hood ll?d ?,? r?z r Renulatar. _;% r_ Filters Size Num6er Chimney Location Inside Outside Chimney Construction Smoke Bomb Wiring Draft ? Test Tag Door Pressure Lighting Inst.? Date Tested Company Testing Name of Tester bTHER_ CONVERSION Q Form 235 J3 -Qi L ? SEDGWICK HEATING & AIR CONDiTIONING`CO. HOUSE HEATING TEST RECORD ?S ( S ? ADDRESS D{R t V C-- CITY ?-flC,0,N OCCUPANT OWNER 1,J+?1 (4AjL 1Z61.j HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY 'Sk-+?-?±-±w K- Electrical Work By _ T-;;; c-c? Lz Gas Line By S?G w?c iL _ TYPE OF HEAT GA_ FA X' HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE - MAKE OF BURNER ---'-- Model 3 4 6 W o a- -F D 5 c::, Model Serial - A'fCoS3(, A o oe:. '7 Max. BTU Rating y INPUT IVIAKE OF FURNACE CONTROLS THERMOSTAT Heat Plug Valve S X 3q5 l?l Sou - ?. Limit `?T?av1 c o Limit Setting o25 0° ? Fan Setting too Pilot Type --=c -r ;k PilotMake - ??a?qc< ???NiTafZ Pilot Model VA Sc t Model Vent Size KIND OF LINER ' SIZE NONE Draft Hood n?5?y N Regulator 2?? S _ Filters Size Number 1 Chimney Location Inside x Outside Chimney Construction Cyr-1S? C? Smoke Bomb Pilot Timing ? fa++v,T Draft Wiring biL Test Tag ??j c--, L.W. Cut Off ------ Door Pressure Lighting Inst. Pressure Percent COZ ? p Date Tested ? - 4 L4 - '2-1 Input CFH ? o Percent 02 Xi ? Company Testing ?E? S-+ IC--- Stack Temp. °F' Percent CO Name of Tester Form 235 SEDGWICK HEATING & AIR CONDITIONING CO. HOUSE HEATING TEST RECORD ADDRESS CITY 9s I OCCUPANT OWNER Q'h+?- HEAT LOSS DATE HTG. INST. --~- SOLD BY INSTALLED BY ??ac?wtic? _ Electrical Work By Gas Line By tCfC TYPE OF HEAT GA_ FA)C HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE -r- MAKEOFBURNER Model - 39L{- ?T i aa 4 o S o Model Serial ?4 4814? t1 0 041 5c-- Max. BTU Rating - INPUT ?? cr? cb b MAKE OF FURNACE CONTROLS ?-??,? THERMOSTAT?? Heat Plug Valve SX3HSN So Limit _ STf=_ wA Lo Limit Setting .2SO ° r Fan Setting ia n° V- Pilot Type 'r rZn u << Pilot Make Pilot Model Pilot Timing _ a NST0,,NT L.W. Cut Off Pressure 3• LS "W, ?. Percent CO 6 ? In ut CFH So 2 p Percent 02 9 d7• Stack Temp. :265 `-E: Percent CO NJ,?'-• 1A? Model Vent Size ? KIND OF LINER S12E NONE Draft Hood --??--1?;1 ? Regulator Filters Size IVumber ? Chimney Location (nside ? Outside Chimney Construction Smoke Bomb Wiring r= <_ Draft Test Tag ycS Door Pressure Lighting Inst. Date Tested Company Testing Name of Tester _ Form 235 I CITY OF EAGAN I CITY dix E?jGAN WATER SERVICE PERMIT ii 3830 Pilot,l?nob Road ' q1ATER SERVICE PERMIT ?30 Pilot Kne,.) Road ?? PERMIT NO.: `• ° ?. P.O. Box 21199 : ? PERMIT NO.: °`? P.O. Boz 21199 ?U?j i Eagan, MN 55121 DATE: 2/1 ?'/g7 Eagan, MN 55121 DATE: '-?3?z? ; Zoning: n' No. oi Units: 1 unit 4pleX ..2oning: f? 7- No. of Units: ? Owner. ?`'ew Iforizon 'Owner. , Horftf)lt Addrass: .- Site Addess: i Piumber. i Nn?nPSOn WA141 :3S-S 1,12 S"7 Meter No 4a00][ Q?t?4Ft1q'fi?r9e: 525. On 4 . Size: " e ore I???? Reader No.O 75291?p?-lQ?`? I ' ` peo 15. O(1 nt, 1 !1 _ 00 I sgres to mply with th Fa1lAE?D1?r?'•A prd ?Jl? Misc. Charges: 67 _(?(l mPter . I ? Total: 1 R(1 nn t?l_ gy ?? Date Paid: Date of Insp.: Insp.: ? --g? CITY OF EAGAN 3830 Pllot Knob Road SEWER SERVICE PERMIT P.O. Box 21199 PERMIT NO.: Eagan, MN 55121 QATE: '/ 13IP7 Zoning: p": ? No. oi Units: i 4p1 e: Owner: -- -- =:ew l',ori zon Address: SiteAddresAd 4,1I9$ f'lemsnn fr T.? "_.? '"i nf ThCLS 11 Plumber. Tliomx"Sn" 1/26j^:' 7n 1 ()4 100.00 I agree !o comply wlth the Clty of Eagan Connection Charge: 425,(}9- Ordinancss. Account Deposit: qp- Permit Fee: +?? 90 BY - Date of Insp.: Surcharge: - Misc. Cherges: Address: ; Site Addess: ? Plumber. Meter No.: iI? siZe: c ? Be ore b ader No.: l'2?& pgree to comply wRh the OVMV ?[` dinan o. ? te of Insp.: CITY OF E/4GAN SEWER SERVICEPERMIT 5830 Pflol Knob Road 1;7) P.O. Box 21199 PERMIT NO.: ?/•? Eagan, MN f5?121 , DATE: u Zoning: No. ot Units: " ew :,orizo:! Owner. Address: ' , Site AddressA 115 rlO*; ccn ['r I.t! t; 7 Tr n F Th p,s 11 Plumber: 711019n5«" ? /'6,/`?7 701,14 1C)??, ?tl I spree to comply wNh the City of Eagan Connection Charge: 525_^,() , Ondnances. Account Deposit: ?..5 , ??- • Permit Fee: By Date of Insp.: Insp.: Surcharge: .50 Misc. Charges: Total: Date Paid: It n oF ??G NWATER SERVICE PERMIT 30 pfiot fCi`ob Raad 34 2 7 O. Box 21199 PERMIT NO.: gan, MN 55121 DATE: 2 Z' 87 ning: No. ot Units: 1 unit 4nl ex ner: tiek I ;c?ri zon dress: eAddess:1617B Clemeon i?r '?'r of Thos I,k Plumber. Meter Nc si:e: -13) 1 agree to compfy wRh ey Date of Insp.: 6 -/0 177 ' i • cin vF k.,uk.W WATER SERVICE PERMIT ! 3830 Pilot Knob Road _ ??tq ? P.O. Box 21199 ,?\i???rrT l PERMIT NO.: 3426 ? Eagsn, MN 55121 ./?? ?? ??1 DATE: - . 2413 187 Zoning: R' No. oi Unita: Owner. New ?ri ?on Address: 1617 Site Addess: - em5orl r . _ r o 1 . omPsor. ? A ? ?, 1?;'? . . ;? '? Plumber. ? ti?? ? bction ge. on ' J 1 S S eier No.:a - dia? ?? i?y?? : .. ?i itl?S?l?$sit . I ? t f j ?EiG. 16.95 3P Reader No.:Q T ?st?c1NE rmit ?F iar e- ? Off . 5Q 00 met er 67 , 1 agree to comply wNh 1he CMyyf,??p?p ??rc$a1De. • me er Ch p Mi li C . i n nances. sc. arges: 1°0,00 tP ; Total: P paid: ln,?10 ; enalty j By, r ?? ? ? Date Paid: ??. 00 4?enAlty Date of Insp :? Insp.: - - -- - .z? ? - --- ? - IS-r7 -- - -- .. _ _ - - ____ aWAIf.irks; cIn oF EAaAH SEWER SERViCE PERMIT 3830 Pi1M Knob Road '' ; "' ,? P.O. Box 21199 PERMIT NO.: Eagan, MN ?121 DATE: ? ° Zoning: `'' No. of Units: uni e Owner. _:ek .`oriz.on Addi Site Plun I agree to comply wlth the Clty ol Eaysn Connection Charge: 525' 0t) 15.00 ? Ordlnances. Account Deposit: 10 00 Permit Fee: . Surcharge: ? ?, •?'? ''?1?? 1 i y ? BY Misc. Charges: j Date ot Insp.: Total: d Ingp : t:- Date Paid: j l CITY OF EAGAN 3830 PNoI Knob Road P.O. Box 21199 EaQan, MN 55121 Zoning: n -z. Owner: Address: SEWER SERVIC. ?.?RMIT PERMIT NO.: ? DATE: 2I13/S7 No. of Units: 1 unit-4plex SlteAddress16 17 Clemson Drive j'1t'z 1r of Eizos LK Plumber. -n.Qmnson 1/26/?'7 7119" lf)fl.flo 1 agree to comply wlth the City of Eagan Connection Charge: 51 F,? 84 Ordlnances. Account Deposit: Ira 00- Permit Fee: i !i , op By Surcharge: .?? Misc. Charges: Total; i BLDG. PERMI'T Nn. 7,%.? !! l r yr ld t P a r. ?•??' l;?J n• (. ? 01-3210 g. ermi B ., ' 01-3422 Plan Check - ---7 ? O1-3445 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. 1 CASH RECEIPT CITY OF EAGQ.N 3830 PILOT KNOB ROAD EAGAN. MINNESOTA 55122 ? ? & OOLLARS _ 1 oo ? CASH Q CHECK Fow ? %.::,"> ; i _- . ; • . j ? . "-._, CoPY g CoPY Y SEDGWICK HEATING & AIR CONDITIONING CO. ?+EanNG JOBNO. ? IC?Lf 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD ADDRESS / 6I4- 6 c n? OCCUPANT SOLD BY ?f i MAKE SEfl1AL ND !2 / 4? x? U? • THERMOSTAT V VAIVE 1 ?`r • LIMIT /'? LIMITSETTING- bcS ? ` FAN SE7TINGr, ? ??'? ` PILOTTYPE- I ' ? T IGNITION MODEI ?f tcc-i ? PILOT TIMING "t4 PRESSURE nl -/? ? PERCENT COz INPUT CFH r2 (I PERCENT Oi STACK TEMP. ?? e7 PERCENT CO ?(1 FORM 235 (REV. 1 V89) S4 n CITY / OWNER???? INSTALLED BV MOOEL t/ Hv INPUT l P .nov VENT SIZE , TVPE OF LINER LINER 512E t r FIL7ER5: SRE A NUMBER WIRING AA TEST TAG l LIGHTING INST . - I -?U DATE TESTED COMPANV TESTING - NAME OP TESTE FORMDISTflI : WH FILE VEILOWCOW - CITY r'9R SALE T. H. CITY OF EAGAN Ll-4, B, 2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N-° 13135 PHONE: 454-8700 BUILDING PERMIT Receiptp 7obausedfor 1 OF 4 PLEX Est Value $64.000 Date JANUARY 21 1987 SiteAddress 1617B CLEMSON DR Erect LN Occupancy R3 Lot 2 Block z Secisub. TRAILS OF Remodel ? Zoning pn Parcel No THOMAS LAKE Repair ? Type of Const. y . Addition ? No. Stories a NEW Name HORIZON HOMES Move ? Length 44 i Atldress P• O. BOX 1367 Demolish I t I ? ? Depth?7 Ft S o Ciry MPLS pnone 420-3900 n . mpr. Instau ? . q. a 0 = UV ,< Name SALXE Adtlress City Phone ?Q F w Name ? ? Address a W City Phone I hereby acknowledge that I have read this application and state that the in(ormation is correct and agree to comply with all applicable State of Minnesota Statutes and Ci f E an Ordinan7ces. ///? Si9nature of Permittee (r-- ?(W?'i.'Z1 A Building Permit is issued to: NEW HORIZON HOMES all work shall be done in accordance with all applicable State of tvlinneso Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Var. Date Permit ? .3 1 i . :)v Surcharge 32.00 Plan Review 188. 75 SAC 625.00 Water Conn. 525.00 WaterMeter 67.00 Road Unit 305. 00 Tr. PI. 180. 00 Parks Copie r,..?i ',,. 3 6-,-.-2 5 on ihe express contlition that and City of Eagan Ordinances. Building Official d FOR, SALE T.H. L 1-4, B 2 BUILDING PERMIT N° 13134 Receipt N 7obeusedfor 1 OF 4 PLEX Est.Value $63,000 Date JANUARY 21 1y87 SiteAddress 1617 CLEMSON DR Erect Occupancy R3 Lot 1 Block 2 Sec/5ub. TRAILS OF Remodel ? Zoning PD Parcel No. THOMAS LAKE Repair ? Type of Const. v Addition ? No. Stories a w z Name NEW HORIZON HOMES Move Demolish ? ? Length 44 Depth 2 3 Address P• O. BOX L367 Int. ImPr ? Sq. Ft ° city MPLS phone 420-3900 Install ? c $amE Aoorovals Feee i o Name $ a Address ? Ciry Phone a F W Name ? a Address < w Ciry Phone I hereby acknowledge that I have read this application andstate that the information is correct and agree to comply with all applicable State of Minnesota Statutes and it of E an Ordinances. Signature o( Permi A Building Permit is is ed to: NEW HORI ZON HOPSES all work shall be do in accordance with all applicable Sta of Minnesota Building OHiclal CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Var. Permit $ 374 _ 00 Surcharge 31 _ 50 Plan Review 187. 00 SAC 625.00 water Conn. 525.00 Water Meter 67. 00 Road Unit 305.00 Tr. PI. 180. 00 e I Copies rotal $2, 94.50 on the axpress condition that and Ciry of Eagan Ordinances. FOR SAL,E T.H. CITY OF EAGAN 4 B 2 l' N0 13136 , L - 3830 Pilot Knob Road, P.O. Box 21-7 99, Eagan, MN 55121 - PHONE: 454-5100 BJILDING PERMIT Receipin Tobeusedlor 1 OF 4 PLEX Est value $64,000 oate J1-1NUARY 21 1987 SiteAddress 4319B CLEMSON CIR Erect C? Occupancy R3 Lot 3 81ock 2 Sec/Sub. TRAILS OF Remodel ? 2oning PD THOMAS LAKE Parcel No ? RePa'v Type of ConsG V . Addition ? No. Stories W Name VEW HORIZON HOMES Move ? length 44 Ef)X P O i 1367 Demolish ? Depth 97 . . 3 Atldress 420-3900 MPLS Ph ? Cit Int Impr. ? ? Sq. Ft y one Install o Name SAME APPravals Feet ?¢ Address Assessment Permit $ 377.50 " Ciry Phone Water&Sew. Surcharge 32.00 ? a Police Plan Review188.75 Frvame Fire SAC 625.00 ¢? Address Eng. WaterConn. 525.00 a W Ciry ahone Planner Water Meter 67 . 00 Council Road Unit 305.00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. Tr.PI. 180.00 information is correct antl agree to comply with all app?cable State of Minneso[a Statutes and Ci of gan Ordinance APC Parks ??T ,Q ? Var.Date Copie s Signature of Permittee $2,300.25 Total A Building Permit is issued to: NEW HOR I ZON HOMES on the express condition that all work shall be done in accordance with all applicable S e ot Minnesota tatutes and Ciry of Eagan Ortlinances. BuildingOBicial ? FOTd 3P,T-E T.H. Ll'-4, B 2 `BUILDING PERMIT ReceiptN 70 6e used Ior 1 OF 4 PLEX Est. Value $ 63 ,000 Date JANUARY 21 1g 8 7 4319 Site Address CLEMSON CIR Erect CN Occupancy R3 Lot 4 Block Z Sec/Sub. TRAILS OF Remodel ? Zoning pn Parcel No THOMAS LAKE Repair ? Type oi Const p . Addition ? No.Stories p Name NEW HORIZON HOMES Move ? 44 Len9th 3 Address P• O. BOX 1367 Demolish I l ? ? Depth 2 ?+ S Fi ° MPLS Ciry 420-3900 Phone nt. mpr. Install ? q. . F Name SAMF i 0 a Address ? Ciry Phone : W Name F ? ?-y Address a zw. City Phone I hereby acknowledgethat I have read this application and statethatthe information is correct and agree to comply with all applicable State of Minnesota Statutes and Ciry Of Ea n Onances.. n Signature of Permittee ?- A euilding Permit is issued to: NEW HORIZON HOhIES all work shall be done in accordance with all applicable StateQf Mipneso CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 1313y r PHONE: 454-8700 ?i Faes Assessment water R Sew. , Police Fire Eng. Planner Council Bldg. Off. APC Var. Date Permit $ 374.00 Surcharge 31.50 Plan Review 187. 00 sAC 625.00 Water Conn. 525.00 Water Meter 67. 00 Road Unit 305. 00 Tr. PI. 180.00 Parks Copies Totai $2, 294.50 - on the express condition that of Eagan Ordinances. Building Thig reQUest vold 18 mpn[hs lrom Q 7 3 2 9 9 rRequ2et Data. yyy--- Fire No. Roueh-in InsVection Qeq1+retl? ?ReaOy Now II Notify InsPeo- ? ? D .Yes ?No ?or When fleady L}?,L-?? ti y? censeA Electricdl Contractor I hereby requast insDection ol ebove ? Owner electrical work instelle0 et St [ dr s Box F te No. , CitV ??ems Y? ?t? Eas- Section o. Townshi0 Nama ur No. Range o. Counly Oc pan[ IPqINTI ' Phone No. ??eto k C) z rn Po upDlier Address ?al Contractor ICompanv Namel ' ?ep o Cont clor's Licen` ?? O n , ? ? ??111. I G ? ?f ? Ma ?+dS ess ICo Vector or O n r Making InsF If h tioN nB ? /J ! ?. Au hor ed iynatwe 1 onV Owner Makine nstallati n) Phone Number MINNeSUIq 4Tp7E?VApO 6F ?RT[]YM'- THIS IIVSPEGTION HEpUEST WILL NOT Grigpa•Mitlwey Bldp. - Roam N-191 BE ACCEPTED BY THE STqTE BOAND 18I7 Uni?eesitv Ave.. St. Peul. MN 65706 UNLESS P0.0PEN INSPECTION FEE IS '° f612J 642-0800 ENCLOSED. / REQUEST FOR ELECTRICAL INSPECTION 1 See ins4uctions for comoletinB this form en beck o/ vellow coPV. ?E78-00007-05 7070 0 "X" Below Work Covered by This Request \S 1 l J - - Adtl ReD. TVPe ol BuilCing AaOlianem Wirad EquiVment WireA Ho" Range Temporary Service Duplex Water Heater ? Lightiny Fixtures Apt. Building Dryer Electric Heaun Commercial Bldy. -Furnace Silo Unloader Indusirial BIAg. Farm Air Conditioner. oenr, oecI v Bulk Milk Tank tner (sncurO t er Suecily Other Othr;r ompute lnspection fee Be/ow Fee Service EnVanCeSize N Fee' Fanders?Sobieeders IX Fee Circuils to 20U Am s 0 to 30 qm s 0 tn 30 Am s ? Above 200 qm ps 31 m 100 Amps 31 to 100 Amps Swimming Pool Transiormers A6ove 100_Am s Irrigation Boorcis Above 100_Am 5 Partial."Other Fee Signs Special Inspection TOTALPEF,r> Nertarks / , ? L.jX ? Rough-in ? 0??/g I, fhe ElectHCal (0! Inspectoq hereby certify thel the above Final ? D'nte inspection hes Eeen =l34 rnM rapuest vole 18 montha trwn ihis request vo'a .? /- ??f'7 18 mon[hs fmm C 7 3 3 0 0 i _ ? x?, 7c 5?% ?- Rery;. Oa ??? i Fire No. Rou6h-in Inspection Requ red? CReaOy NiII Notifv I?scec- es ? N. Lor When Peady ___13??en6ed ElecVical ConVactor 1 hereby repuest inapac<ion oi above ? Owner elechicel work inslalled at r e Atldr ss, Box r Hoate 7' G ecuon o. 7ownship Nama or No. anBe No. County Occ a ?t(PflINT) )1 1 C-VY l - ??'1??/? / ?`-? Phone No. Power DPlier AGtlress EIal Conhactor (Company Name) oz, ! J ConVacAr's icense N. ? Mai i Addres5 ICOn U f - actpr wner Maki ? °^ Insxailati 1 V / ? ? ?Gc2 Authorized & r nh dZwr - n . Phonp-?lu?ber ?? MINNESOTA STqTE BOARD OF ELECTflICITY Grigpa•Mitlwev BlGg. - Noom N•191 7821 UniversitvAVe..St. Vaul, MN 65100 wn„-. ?c`121 642-0800 .r- TNIS INSPECTION PEQUEST WILI NOT BE ACCEPTED BV THE STpTE BOANU UNLESS PROPEX INSPECTION FEE IS ENCLOSED. ,?/7c/?b=7 REQUEST FOR ELECTRICAL INSPECTION ee-00001-05 Sea inatruclions lor completlrq this fwm on back of Yellow copy. ? 7qqn n"X'' eeloW Work Covered by 7his Request Ad Nep. Typa o18uilCin9 Apoliaocas Wired EquiVmenl Wiretl Home Hange Temporary Service Duplex Water Heater Lightiny Fixtures Apt. BuilAing Dryer Elec[ric Heabn Commercial Bldg. Pumace Silo Unloadar Industrial Bldg. Air Conditioner Butk Milk Tank Farm tner oeci v ( ?ner ISpecity) 1 er Vecify Other Oth" C0?IDUIB IASOBCLlOl1 F?P BEIOW p Fee SBrviceEntrenCeSiza b Fee Fexders/SUbleeders N Fae Gireuits Uto200Am s 0 to30Am s 0 to30Am Above 200 qmps 31 to 100 qmps 31 to 100 A Swimmin Pool Above 100_Am s Above 100_Am s TransrormerS Irngation Booms Partial•'D e Signs Special Inspection TOT C Remvrks ? L FE6?, -6 Lf. Rauph-in Dnte the Elecvicel Inspeclor, pereby cartily thet The above Final Oate Insoection nes eeen made. TNe reauest valE 18 montM trom Thls repuest vald 18 wnths tmm ? 7329 7z/. g.,? GRedue t pa?e ^ Fire No. ouph-in Inspection J l/ 'V? eq retl7 ?Heatly No1ll Notify InsPe?- 1 ?es ?No Ior When fleady ?K- censeG Eleclricel CoiiVaclor 1 hereby request inspection ot ebove ? bwner electrical wark installed at: Streel Address, Bi" r Route No. Ut B ? 1 . ? V ecLOn a. Township ame or o. Range No. Counly Oc upnnt IPRINTI • Phone No. Power p0??er I Address Elechica Contractor ICOmpany Namal - Contrac L lM ' M ilinp AdJresS ICon c or' wner ?e 1 1 i lationl 1 3 Authonzed 5- na re Con acio @ran Making Ins I onl Ph e NumCer 33?-5 MINNESOTq AqTE BOAND OF EIECTRICITY Gripgn-Midwey Bldv - poom N-781 7827 Universitv Ave..St. Peul. MN 5570d Ghone (612) 642-0800 THIS INSPECTION flEQl/E5T WILL NOT BE ACCEPTED BY THE STATE 80A0.D UNLESS PROPER INSPECTION FEE IS ENCLOSED. 2/?SL/SS 7 REQUEST FOH ELECTRICAL INSPECTION ea-00001-05 7c y? / , See inatruttions lor complelin9 Ihis form on Geck of Yellow copy. ((`' _707 07 "X" Below Work Covered by Thrs Request 47 ( J J 1 APOlianCe! Wirod Equipme?? Wired V AAd flBP. Ty00 Of Builtling Temporary Service Home Duplex Heater Lightin, Fixtures pt. Buildinc? A Electric Heati?? Commercial Bldy. = U Silo Unloader InduStrial Bldg. ,Air Bulk Milk Tunk ?her (St?er,?fyl Farm ( 9! $VCCIfY otner o mpute lns pectron Fee 8e/ow i: p Fee ServiceEntrenceSize k p Fea Fexdars/SUbfeadars s rcu ¢a c 0 tn 30 M? 0 to200Am s 0 to30Am s , 31 to 100 A Above 200 AmDs 31 to 100 Ainps Am ' Swimming Pool Above 100_Amps P.bove 700_ ' Irri ation Booms Other Fee PartiaL Transiormer5 Signs Special Inspection S? r TOTAL F r ? Remarks 411 ? • flough-in a1e ?7Ir7 9.. y ? I,the Elec el inspectoq hereby ) e• certity lhat tha above Final ?de?tio^ has been m TMa repueet vdC 18 moniM from This requesI void 18 months from 0 7 ? ? G R 7o s e: / ?. ? _.. . q¢pue?e, ?^ Fire No. ?RauOh-in InsDection ?/ Required7 ?Ready N?W.?I Nmity.InSDe?- ? J'? ?es ? N. ?or When Reatly ?censed Elecvical Contractor 1 herebv request insoaction oh abova fl nwue, electrical work installed et: Sveei Address, Boz or Routelllo. / ! \ acuon o. i Township Name or No. anB¢ No. Coumy O cu ant IPRINT - ° .. Phone Nn. lll 60 L Pow up r ? , .4dtlress ? EI?rT al ConVacror ICOmpany Namel--I Co ractors Li e e o. o?- Mai'Iiqe Atl<ress I ntractor r ? ? er aki n9tailati nl n^ ? Iv ???? ??' ( ?i? AuMOrized /n}I/ur?e/ lCo act w r Making In II i nl P Number ? MINNESOTA'tTATEv80AR0IOF EwLECTRICI?TY Grippe-Midwev Bidp. - Room N-181 1827 Universilv Ave.. St. Yaul. MN 55100 Phone (612) 642-0800 TMIS INSPEGTION NEOUt51 WILL rvUT BE ACCEPTED BV THE STATE BOARO UNLESS PHDPEH INSPECTION fEE IS ENCLOSEO. 7 REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-oe ?yy?? , See insbuctions for completinq this fwm on beck of Yellow coOY. ro 9 It /-3-lClO •rY•• Qn/nw W-L (`........d A.. TA:.. .a Acf ? ?/ fleD. L TvDe of Buildino AoPlioncea Wired Eauipmenl Wired Home Range Temporary Service Duplex Apt. BuilAing Commercial Bldg. Water Heater Dryer Fumace . Lightiny fixtures Elec[ric HeflUn Silo Unloader Industrial Bldg. Air Conditioner ? Bulk Milk Tank Farm Otner oeu y ?n¢rlsper.lfy7 t.r SueufY t er Other oompute nspection Fee Below icdEnhe?ceSi¢a k Fee Faxtlars?Subfeeders k fna Circuits E o 200 qm s VAbove 200 qmps 0 to 30 Am s to 100 Arnps 0 tn 30 Am 31 to 100 q s nunin Pool siormers s ove 100_Amps Irri tion Boorc?s Specialinspection - Above 100_Am s Partial,Oth -ee rks T7 /J / f S 70T L FE& Q i7 U ?? ? Nough-in " v ? On[e _?? I, the cal losPecbr, heraby Final certily Ihet tha above p. ?y G'?Y?t?? ? ??? ?oac1ion has bean de. mla reuueat voltl 111 momM Irom CITYOF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) pROPERTY ADDRESS: LEGAL DESCRIPTION: NO'193: PASMTP' QF FSE AT TIle QF' r+PP.xC+xIaa noES Nar aoeszzZM APPROVAL aP PERMmr. , INSPEMort oF sEWEt arD/M MM Tt1SMTIATiOj$ FIUL Wr ?'.' SCHE[>- tn.m UxrM PERMIT aAS aEEN APPROM. . . ,---•----..,.,.....,..?.,???v.. vc rax rarcei tu al IF E7QSTING STRL'Cl[.?RE, DATE OF ORIGINAL B.'IIaIM PERMIT ISSC'ANCE: Mon ear PRE SEDTt' ZON7ING/PROPOSID C'SE: ? CU44ERCLAL/RETAIL,/0FF ICE C] R-1 SINGI,E FAFIILY . Q INX'STRLAL Q R-2 DPPLEX (1t+v Cfiits) ? INSTI7L?TIONAL/GOVIItm4Dp R-3 1owNHOLISE (7nxee + Units) ( Units) • [? R-4 APARINIINP/COPID(k1INIUIN ( Units) 2) ? NAME: AImRFSS: CITY. S'!'ATE, ZIP: 3) ' i: ?• NHM; AMxxESS: . cixY, srPSE, zIP: PiiONE: 4) •• ?• i?• NAME: _ ADDRESS: CITY. SfATE. 2IP: PHONE: Active . r ?=aea - Zc5Z4 msrm Licamg ? st Jsutiai 'S) 'r • «• • ?• ^ a a, . c.??10N TO CI+y SMM OM==IoN M CITY WAMM C] OMM 61 '? ' • r ? PLEASE HOID APPROVID PERMIT ECY2 PICK-UP SY CNE OF ABO{7E ----- [.? PZEASE MAIL APPROVID PERMIT R+0 1, 2, ? 4. ABpVE 7) a. 1 ]/i 1?' /?1 /L?w ?1 (Circle one ) /7 0 f) -7 . 0 . FOR :CITY USE ONLY PERMIT # ISSUED p yj C i ' ) - Pd w/Bldg. Permit FEES: ?<o $ S 1p SEWER PERMIT (INCLODE SLRCHARGE) SD $ $ /p WATER PERMIT (INCLUDE SURCHARGE) $ D D $ WATER METER/COPPERfiORN/0[)TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ O $ ACCOLNT DEPOSIT - SEWER a U $ $ ?S ACCOUNT DEPOSIT - WATER D $ $ • WAC $ $ SAC $ , . .:? $ % t '• ? • , ;•. ;-r; TR?(;?IQK •WATER ASSESSN}ENT $ $ . * ?,?'.:._ • . ' .T?C'NK -$$felER;ASSES$MENT , ? '= _ s.? • ? .. $ . $ , . LATERAL'$TNEi'I?'P/'??L'P]K SEWER ' - $ $ LATERAL BENEFIT/TRI:NK WATER / 00 i •i - . ' .'1:? : ., ` ? -'11: '1 i'•.'. i.-? .:. $ • . WATE$,TREATMENT. PL'ANT SURCHARGE . . . i . ?. .. . J`. . i; .i $ $ bTHER': .,'.`. ' $ A197 a . . .. _•', TOTAL ,C RECEIPT ?- RECEIPT DOES UTILITY CONNECTION REQDIRE EXCAVATION IN POBLIC RIGHT OF WAY? F__j YES IF YES, THEN A"PERMIT FOR WORK WITHIN P[7BLIC ROADWAY" MUST BE IS5UED BY THE ENGINEERING Q NO DZVZSION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CpNDITIONS: . APPROVED BY: ? TITI.E: . . . DATE: ? 14' 7 . ; : CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTa: PAS@lMP' QF FP.B AT TiM OF Appuamuaa naEs Nar azsizrom AePxvvar, aP PERruT. niSPncrioN aF SEWER Arn/M NAM n,firarramrODS WIIS. NOT BE 9CRED- cuu?sn UNrII, pmraT tA.s BEW r,rPRovrn. . ,.,.w,.=x_,.:=,.,.,.,._=x_,.,.__,._.._w___w,.,.,.x P ease Print ??1) PROPERTY ADDRESS: LEGAL DESCRIPTION: •- IF E7QSTING S1RC'CMTE, DATE OF ORIGINAL &1IIDING PERMIT ISSUANCE: - PRESEENTTP ZOfIIN.,/PROP06ID LISE: Mon ear - ? CU44ERCIAI./RETAIL/OFFICE Q ZNID[JSTRIAL ? INSTI4[TlIONAi,/C,OVIItiZEM 2) AE CITY, S'fATE 3) ' r.a• AMRESS: CITY. STd1TEr ZIP: 4) •• 0 ? -t 2? ? P,ctive EXpired Not recoraea ? rt-aTF =nitial aDnxEss: crrY, srAxE, zxP: PHONE: 'S> " ' ?' ' ?' : ? • o. ?, • ? ?dCMEMON TO CI?y S? ? ?ICN M CITY WATER o Onm- 6) ?? • •? ? PI,EASE HOLD ApPROVID PIItpIIT EOI2 PICK-C@ BY ONE OF ABOVE [vy PLEASE MAIL APPROVID PERI•ffT TO 1, 2, (P3 4 r ABfn7E (Circle one) 0 R-1 SINGI,E FANIII,Y - Q R-2 iH]PLEX (Rt`o C?nits) R-3 7OWNiOPSE (Three + Units) ( Lfiits) [] R-4 APARMd=/CONIDOMINICIM ( Units ) • c?u rmsTm LICENSE$ 11 FOR -CITY USE ONLY PERMIT # ISSUED ?- ? Pd w/Bldg. Permit c S $ `? fL7 (L? $ $ $ $ $ $ $ $ $ /rQD ? D $ $ S _ 74r FEES: $ /D 5e) $ /0 5'0 S SEWER PERMIT (INCLODE SURCHARGE) WATER PERMIT (INCLODE SURCHARGE) . WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLC'DE CORPORATION STOP) $ SEWER TAP O d $ /.S ACCOUNT DEPOSIT - SEWER $ ACCOC'NT •DEPOSIT - WATER $ • WAC $ SAC • I $ .i: . .,? , % { • . ' TAl1QK •WATER ASSESSNJENT . ? . . ? . . ._.I ?' $ ? , 'ti?. • . ? -TRL?NK .$9TOjER ;ASSES'SMENT ... T?T, '• • 'i. i .... _ ?.. .''t L ?:i $ ,. _ i . ' "$gNEk-P/.fi?C'AIK SEWER LATERAL . ' - $ LATERAL BENEFIT/T$L'NK WATER S SLRCH RGE R T ' ' - } 47A E ,TRZATMENT. F ANT A L $ .'. ? ..? y OTHER.. , . :,` • r ' ? ,= -' :. •,... ; TOTAL ?- RECEIPT RECEIPT DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MLST BE ISSOED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CpNDITIONS: . APPROVED BY: TITLE; . . DATE: . . , ? ? „ . ?y .: . .. . . ? CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: F*IOTF': PAYMh:Rl' OF FEE:E AT TIME OF F ArPLIcAazorr ooES rxrr CONSTITUTE F APPRC)VAL OF PFTtNIIT. F FINsrBMoN oF sEWEt ArID/CR MY= ; Tnicmar.rATrON.S WII.i. N(Yf BE SCfm- : tLEn tna.IL PIItruT tms BEEN : APPROVED. or IF E7QSTING SIR[.'C.`Ii,?RE, pATE OF ORIGINAL BC'ILpZNG PERMIT ISSL'ANCE: ' P12ESENT 7ANING/PROPOSID L'SE: Mn ear ? CavERCIAL/REI'AIL/OFFICE Q IbIDLISTRIAL ? INSTI7VTIONAL/13OVERNMENT 2) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 3) ' .?• NAN1E: ADDRFSS: CITY, STATE, ZIP: ? R-1 SINGLE FAMILY Q R-2 DLPLEX (Tdo L?nits) R-3 TOWNiOf]SE (Three + Units ) ( Units ) ? R-4 APARIVEM/CObIDOMINIUNl ( Units) LICENSE# ActiVe FStpired Not recorded tSitial 4) •• ? NAMEo_??. _ ADDRFSS: . CITY, STATE, ZIP: PHONE: • '5? " ' ?' ' ?• : a • aa - ?? d CONNE(,TION 1lT CITY SEWFI2 ? cp?,-pION SO CITY FATER ? pTim '. 6) ?? • • r ? pMME HOID ApPROVID PEf2PIIT EpR PICX-L?P BY ONE OF ABOVE ----_ - ? PLP'.ASE MAIL APPROVID PETtMIT TO 1, 2,(D3 4, ABOVE (Circle one) , FOR -CITY USE ONLY PERMIT # ISSOED M Pd w/Bldg. Permit S $ $ S ? 7 00 $ $ $ $ $ J?o?S0 o $ ?o'fs ° v $ $ $ $ $ /fDeU $ s - 7a/ 9 y RECEIPT S FEES: S? j0 SEWER PERMIT (INCLUDE SURCHARGE) So WATER PERMIT (INCLODE SURCHARGE) $ WATER METER/COPPERHORN/OOTSIDE READER $ WATER TAP ( IIVCLUDE CORPORATION STOP ) $ SEWER TAP 04) $ ? s ACCOUNT DEPOSIT - SEWER O b $ ?S ACCOC'NT DEPOSIT - WATER $ • WAC $ SAC $ t • TRUNK •WATER ASSESSNJENT . . . .? $ p?• ' TRONK $EWER,ASSESSMENT .`... . ? .. . , t $ LATERAL. B$NEF•IJI'/T.RONK SEWER $ • LATERAL BENEFIT/TRUNK WATER $ i p .W.ATER.TREATMENT*PLANT SURCHARGE . .. , $ ?D• OTHER: . • $ ? I..oo . TOTAL , . . ?D RECEIPT DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR LVORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CpNDIT20NS: APPROVED BY: TITLE• DATE: ? -?3 ? CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: Al()743: PA7MEiP OF PM AT TIMEOF nr?ac?aN noFS No?r oo?siz? rPPtaovnt OF rER141r. ncmcriaN aF SEWE2 nrD/toR MM naTU,r.ATTOrs wua. ruT BE sCHED- tu.? nNTIL rmrntT xAS BEEN arPRovED. IF E7QSTING STRL'C11-7E1 DATE OF ORIGINAL BCILDING PEEtMIT ISS[:ANCE: . PRESE;Nf ZONING/PROPOSID LSE: Nbn ear ? COMMERCIAL/RE7PAIL/pFFICE Q SN4)!1SPRIAL ? INSTIILTIONAL/GUVII2AA?N'p 2) ? NAME: Aooaess: CI'PSC. STATE, ZIP: G PHONE:LI-7C? . /Yl 3) • i: ?• AL?R?,S: CITY, STATE? ZIP: ' PHONE= lR?S"!gt LIC?ISE$ EX23M 4) •• . • ?NAME•? PIDDRFSS: , -' CITS[. STA1E, ZIP: PHONE: - F,r,tive EcPlred Dlot recarded UMf Init-i"al •51 n - r• • ?? : o • a? ?? • ' r?COMEMON TO CIW SEPER CMMCTIoN?CM MMM o ODM_. 6) ?? •^ [? PLEA.4E HOLD ApPROVID pgtAIT FM PICK-Up BY ONE OF ABWE v? PI.EASE MAIL ApPRWID PERMIT 1+0 1, 2, ? 4. AB(7VE (Circle one) " ? R-1 SINGLE FAPIILY ? Q R-2 DUPLEX (7WO CTnits) 6 R-3 TOWNHOL'SE (Three + Units) ( Units) El R-4 APARTMENP/COAIDOMINI[m ( Units) FOR :CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit $ $ $ $ $ $ $ s 5?5 B o S lo?.S a v $ $ $ $ S $ a? s_ RECEIPT FEES: S_ 14-0 50 SEWER PERMIT .(INCLUDE SURCHARGE) S• /D. 5? WATER PERMIT (INCLUDE St?RCHARGE) $ WATER METER/COPPERHORN/OUTSIDE READER S WATER TAP (INCLL'DE CORPORATION STOP) $ SEWER TAP S ACCOLNT ?EPOSIT - SEWER $ ACCOC'NT DEPOSIT - WATER $ • wAc $ SAC • f $ ? ? • . TRtlIQIf •WATER ASSESSIMENT . . .._. t . ,. $ , ,TRDNK -$,EIOjER,-ASSES'S,MENT $ LATERAL'13rNEPIT/.?FCUAIK SEWER . $ LATERAL BENEFIT/TRCNK WATER i .; `. ' '.` . :"'. % ?•. 1 S'..si i . NJATEB, TREATMENT, PUANT SURCHARGE bTHER': - , $ . .-: . . . ... 1 (1ti? TOTAL 70??3 RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F__j YES IF YES, THEN A"PERMIT FOR NIORK WITHIN PUBLIC Q ROADWAY" ML?ST BE ISSOED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: . APPROVED BY: TITI.E: ? - . . a DATE:` ??? /-f ? -_. . ? L ? BsL,?? L ci CITY USE ONLY RECEIPT #: RECEIPT DATE: 1999 f'LUMBINH PERMIT tUS1DENT1AW Cl'['Y OF £Afi!?N 3830 PaoT Kxos en EE1fiAN. MN 55122 _ (651) 691-4675 Please complete for; ? single family dwellings D townhomes and condos when permlts are requfred for each un{t ? backflow praventer for underground sprlnkler system FIXTURES EACH . _# TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot TublSpa 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 dwellings under conslructlon 5.00 X = WaterSoftener ' forexlstingdwelling 30.00 x U.G. Sprinkler ' for dwelling undet const. 3.00 = U.G.Sprinkler ` (orexistlngdwelling 30.00 = Alterations ' to exfatfnp resldence 30.00 = Water Turn Around 30.00 = Private Disposal System ' MPC iic. 75.00 = (new andrefurbished systems) Private Disposal Systems " a,bandonment 30.00 = RPZ (new inst811ationlrepair) 30.00 = em' der: Call 881 -.t675 for Inspectlons of water heatera, STATESURCHARGE .50 water softeners, alterations, etc. . TOTAL ............--------- •-- 1 hereby adcnowledga' It Is the applipnt's ras ----------------------------------- - ROESCHLEIN KATHLEEN -.,_ ................................................. .................. is cortect, and agrae to comply wNh all appl(pble Clty o} Eagan ordinances. opereUonal and malnt , 1617B CLEMSON ORIVE a9an assumas no Ilability for any damages caused by the City during Its normal I pertnit wilhin CIb' property/Aght-oi-way/easement. EAGAN, MN 55122 SITE ADDRESS: (651) asa-oaas OWNER NAME: WSTALLERNAME: ?yokev-nm TELEPHONE#: &7 7- `fO33 STREETADDRESS: CIN' --?{?L-S STATE; N ZIP: S OE SIGNA'r•G?bF PERMIlTEE CO/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 - Y 1 1313 1986 HIIILDING PBIt14T APPLICATIOM - CITY OF SAG9N BOTS: ALL CONTRACTORS M03T BB LICENSED WITH THB CITY OF EAGgP 3INGLE F6MffLY DAELI.INGS INCLUDE 2 SETS OF PLANSo 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS M[ILTIPLS DWMLIAGS - HESIDENTIAL RENTAL i1NITS FOR SALS QNITS ? INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVSY - CBEf$ itITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND l dF 4 To Be Used For: R-W? Valuation: "G3,om°`" Site Address 43\q CJs„w?l p'& ?oF cE Lot 4 Block 2 Address Parcel/Sub Owner 6,kw Address City/Zip Code Phone 42 Q S(?b Contractor dJ14U-Q City/Zip Code Phone Arch./Engr. Address Date: I /3n/87 Erect ? Occupancy R 3 Remodel _ Zoning r?) Repair _ Type of Const V- Addition # of Stories _ Move Length Demolish Depth Zb Int.Impr. Sq Ft Install APPRODALS FEFS Assessments Permit 174, Water/Sewer Surcharge '31. 50 Police Plan Review 10Q. Fire SAC b7 S. Engr Water Conn SZS Planner Water Meter (,-7 Couneil Road Unit 3 05, Bldg Off Treatment P1 ?bO. APC Parks Variance Copies TOT9L g2 , City/Zip Code Phone # I NOTE: ADDRESSES FOR CORHER LOTS - CONTRACTOR/HOMEOWNEB MQST DS3IGHATE WHICH ADDRESS IS DESIRED. 90 CHANGES Ti'iL,L Bfi 9LLOiiSD ONCE SOILDING PERMIT IS ISSQED. ` - 13134 1986 BpILDING PERMIT 9PPLICATIOH - CITY OF E6GAN MOTE: ALL COPTRACTOES MUST BS LICENSED WITH THE CITY OR EAGAN SINGLE F9lIILY DiiELLINGS INCLODE 2 SETS OE PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATION3 M[JLTIPLB DiiELLING3 - RESIDENTIAL RENYAL II9ITS FOR SALfi ONITS ? INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRYSY - CHECg WITH BLDG. DEPT., 1 SET OF SNERGY CALCULATIONS CUMAlERCIAE: INCLUDE 2 SETS OF ARCHITECTtIRAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND I O F 4- To Be Used For: R¢a?&m,cn Valuation: ffi!'0,4rOD0,°p Date: I /aDlr? Site Address 43iq [3 Ualh.ae, UiFsk OFFICE II3S ONLY Lot 3 Bloek 2_ Ereet ? Occupaney (Z '3 ' kt" ? ? Remodel Zoning PD Parcel/Sub .°? t Repair _ Type of Const ? Addition IF of Stories ' Owner '(lpasf)4tr ? cQ,y,c Move Length 74_ _ Demolish Depth 27 Address ]3ex /3(0`] Int.Impr. _ Sq Ft Install City/Zip Code ?? ?r, 55dQf.? Phone 4ad 3900 APPROVAIS FEBS ^ Contractor A&r? 6z AVU-- Assessments Permit ?i^f?•? Water/Sewer Surcharge 32. Address Police Plan Review l8 8.75 Fire SAC laZS. City/Zip Code Engr Water Conn L3z5• Planner Water Meter (9-7. Phone Council Road Unit OS. Bldg Off Treatment P1 116p. Arch./Engr. APC Parks Varianee Copies Address TOTAL a pa . S City/Zip Code Phone S HOTE: ADDRESSSS FOR CORNER LOTS - CONTRACTOH/HOHEOiiNER MDST DESIGNATE WHICH ADDRfiSS IS DESIBED. NO CHAHGES SiILL BE ALLOifSD ONCE BDILDING PERMIT IS ISSIIED. 1986 BQILDING PERliIT APPLICATION - CITY OF SAG9N AOTE: A[.L CAdTRACTORS M03T HE LICENSfiD iiITH THE CITY OF E9GAN SIBGLE F6FIILY DHELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SIIRVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLE DiiE[.LIAGS - RBSIDENTIAL RENT9L ONITS FOR SALS IINITS INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SIIRVSY - CHECB WITH BLDG. DBPT., 1 SET OF ENERGY CALCULATIONS COlAfERCIAt: INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND 1 OF ? ?fo3,000o00 To Be Used For: Valuation: ?? Date: Site Address po 0 IC OSE ONLY Lot ? Block 2 Ereet v Oceupaney {Z•3 Remodel Zoning pl?;'_ Parcel/Sub ?"?h 'J(?6 Repair _ Type of Const ? _Cj ,?? ? Addition # of Stories Owner `I wu.r *-,7\Qp ? Move _ Length 4+_ Address P ? e6,( Int? P Impr. _ SqFt Install City/Zip Code ?., ??,. ST'?j11Q(? Phone 420 - 3GOD ArrxovALs FsES , Contraetor s2me as above Address City/Zip Code Phone Areh./Engr. Address City/Zip Code Phone # Assessments Permit --b14' Water/Sewer Sureharge 1. gO Police Plan Review l. Fire SAC b Z ;; Engr Water Conn S25 , Planner Water Meter ^?9111_ Council Road Unit 305 Bldg Off Treatment P1 I APC Parks Varianee Copies ToraL 5'1 ?--- NOTE: ADDRESSSS FOR CORNER LOTS - CONTRACTOR/HOMEOiiNER HOST DESIGNATS i1AICH ADDRESS 13 DESIRED. NO CHANG&S WILL BE ALLOWED ONCE BOILDING PEIMIT IS ISSUED. :. . 1 1313-s--, 1986 BOILDING PERMIT APPLICA?ION - CITY OF EAGAN HOYE: 9LL COATRACfORS MOST BE LICIIN.S6D iiITH TBE CITY OF EAGAN SIRGLE F6NIILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS PlULTIPLE DTiiEELLINGS - RESIDENTIAL RENTAL DNITS FOE SALS QNITS N/ INCLUDE 2 SETS OF PLANS, CfiRTIIriCATE OF SORVSY - CHECB itITH HLDG. DBPT.t 1 SET OF ENERGY CALCULATIONS COMM6RCIAt INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND ?0f? 4 To Be Used For: Rpd,?, Valuation: 064,000.0° qu-rrwW.? Site Address 1(oila ? ? OFFICE ' Lot 2- Bloek 2 Parcel/Sub `? Owner q)aw ?)AVL?Uwm *W& jv- Address P.0. City/Zip Code INLL. ; (Mn Phone 420- Contraetor -1&me ap q,Q?,? Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # nate: 1(aDl97 Erect ? Oecupancy ;? 3 Remodel _ Zoning PI7 Repair Type of Const s' Addition # of Stories Move Length 44 Demolish Depth 1--7 _ Int.Impr. Sq Ft Install APPROVALS FSSS Assessments Permit So - Water/Sewer Sureharge Police Plan Review Fire SAC CozS • Engr Water Conn 525 • Planner Water Meter (01 Council Road Unit 3os. _ Bldg Off Treatment P1 I$o. APC Parks Variance Copies TOTAL ? NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOHEOiiNER liDST DESIGNATB WHICH ADDRfiSS IS DESIRED. NO CH9NGES HILL HE ALLOiiED OPCB BllILDING PERMIT IS ISSIIED. ,Ll) ?3 ?, 1/?,z,Z •r `??.?Ai_?°.p._ 1'+:??.'71??i?L?S°?J? ?? ?(4t? WAX Gtl y / ?J'? 1 HEAT LOSS CALCULATIONS HEATING&AIR CONDITIONING CO. MiNNEAPOUS,rniNN. Weniherslrip3 A,S.H.V,E. Consttuction No. Ineulalion VJindows Doors Guida Refarence put. Wall Int, Wall Ceilinp Roo( Floor Kind How Applied Yes-No Yes-No 79? FL??YIN;._fro <:CRoom Length Width) Height ? F1. Qje.pRoom Length ?X 0 .Wi4H* Heighl Vdi ndows a nd Doors -Cracka ge and Ar ea Windows and Doors-Crackage and Area Nu. Main ol ane Heipht ot oane No, ol Ii0h19 Lmeal h. 0l craek Area sq, ft. NO' W,dlh of ane Hotp?t of ane Nn. of li hts Lmeal ry. of crack /bea sp. 1l. ?_ .a^.? t 2'?1 ZIF Z 2 I 1°7 ? ? r' Jf I? ' ? ?y ,?? ? ?Q 15 Coef 8tu Coef Btu InfiltretiOn InliltratiOn 21 -7 C'i? Glass o Glass 11 ???? S Exp. wall ?,.17 Exp. wall Ne[ exp. wall a ,?.. ?> ?. ? y1 Net exp. wall R?' `(• ?La q "hR'mFT- o O?' 1 t t 7 22,23 Int. wal I Ceiling 2 Ceiling 2 Q(4 2'S I Ploor . Floa Total Btu. 7 5'? 7otal Btu. 3?. Required Sq. ft. E.D.R. or 5q. ins. W.A. Leader atea Raquired sp. ft. E.D.R. or sq. ins. W.A. Leader area fL Roan Length f? Wid(h HeiBht +I1tnctom Length Width IHeight Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea No. K'id,n ol ane Melqht Of ane No. of h h[9 L?o eal 1,. ol crack 4rea ?4• ??. Na W,dlh ol one H.uqni nl ana No. uf b hls Lineal fo ol crack Area sq. fI. r"•`!u 2? 1. Coef Btu Coef Btu Infiltration .,. ? '1 2240 Intiltrotion ' ?]a'? Glass Z{ ( S? ;Z(:) U (T Glass I Exp. wal I Exp. wal I ? "Z :' Net exp. wall Nef exp. wail 7:? .3? Int. wall Int. wnll Ceiling ?,) 7C.-1 ',Z•S 2 Ceiling l.`?C3 .'.. j C ?J Flow Floor ?yUU Total Btu. ?j 7otal Btu. 3?^ r 'Y Required sq. tt. E.D.R. or sq. ins. W.A. Leader are. Required sy. ft. E.D.R. or sq. ins. W.A. Leader area FI, Rown Len th Width ` l Hei ht rt ..` c 9 •,.) ; iBht FI. Room Len th ! Width He ? ?? 9 ?. ? 6 YJindows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea NO' Wiam of ane Her 9ht al pnne No. ul ii ht! lmenl H. of crock A-ea S4fL N?' nnm uf nr?e ?UnO??t ul Pnnr Nn. nl b bls L?neal l?. ol vack Aren eQ. IL Coe! Btu Coef Btu Inliltration InliltrelfOn Glass Glass Eap. wall Exp, wall Net exp. wall Net exp. wall Int. wall Int. wall Ceifng i.Z.X, ? Za=.` ?,` 2 ?Q Ceiling Floor flnor Tutal BW. Total Btu. Hequired sq. lt. E.D.R. or sq. ins. W.A. Leader area ? U RaquireJ Sq, ft. E.D.R. or sq. ins. W.A. Leader area HEAT LOSS CALCULATIONS 7"• HEATING&AIR sell4xµLCl CONDITIONING CO. MINNEAPOLIS, MINN. Nfeothaistrips A.S.H.V.E. Construction No, Insula[ion NTindows Doors Guide Re/erence Out. Wall Int. Wall Ceiling Fbo1 Floor Kind How Applied Yes-No ves-No 19__ ?, FI. Room Length Width Height GI. Roan LenBth Width Height YJi ndows a nd Doors- Cracka ge and Ar ea Windows a nd Doors- Cracka ge and Ar ea No. H"dlh of ane Heiph[ ot pane No. ol ii hts l?neal it, ol erack Area sq. h. NO' Widtn of ane Naiph? of ana Nn. of li his Lineal fi. of crack Qre?t z°, z. 2 ara ?? Coet Btu Coef Btu Infiltration 7cyQ IntiUration Glass Z01) Glass Exp. wall Exp, wall Net exp, wall 230 Net ezp. wall Int. wall Int. well Ceilin0 Ceiling Floor Floor iotal Btu. Total Blu. Required 6q. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.O.R. or sq. ins. W.A. Leader area PI. {'.,rr..,- p Room Length 1 Widlh 11 Height FI. Roam Length Width Height Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea No. Witlth of ane Heiqht of ene ryo, of li h(n Lineal tt. of crack Area s0. ?I. No' WiAth ol ane Mx?q01 of ann No. ot Ii his Lineal II, of c,ack 4rea sp. It. Y 9 .2 ? ?Dcr ?•? ?, ii` ry .`, .?.... '??? Coef Btu Coef Btu Intiltration I 11"7 2223 Infiltration Glass 0O0 Glass EKp. wall Exp. wall Net exp. II 20-0 -1. I 1 k Net exp. wall ?u a?;: f 2 `7U 22 int. wAii Ceiling Ceilinp Floo. "?,.yx ?? 4-z •5 1 ? Fioo. Totel Btu. I cb ?q -i Total 8tu. 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.? r.;,?? rRj"9oan Length 1'3 Width ? Height FI. Ropm Length Width HeiBht YJindows and Doors-Crackage and Area Wi ndows a nd Doors -Cracka ge and Ar ea N?. W, dih ol ane Hei9ht of nne Nn. of li hIS Lmeal ft. of crnck 4rea sq. M1. No. W?pii7 uf :?ne He p?q of pane Na nl b htg l?neal h. of crack 4ren ea. h. Coef Btu Coef 8[u Infil[ration Infiltration Glass Glass Exp. wall Exp. wnll Net exp. wall 7 Xp Net exP_wall Int. wall Int. wnll Ceiling Ceiling Floor ? V'-02- '_Floor Total Btu. Total Btu. Reyuired sq. ft. E.D.R. or sy. ins. W.A. Leader area poquirad sq. it. E.D.R. or sq. ins. W.A. Leeder area ? CITY USE ONLY RECEIPT#: _ iSUBD. ? //GYi I S c? /hOrYJaT S CM /?E RECEIPT DATE: PERMIT# y S ,??00 2000 PLIII•ffiING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT IQd08 RD EAGAN, 2MI 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 FIXTIIRES Fsru s TnreT Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gaspipin outlet "minimum-i 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laund tra 3.00 x = $ Lavatory 3.00 x = $ Septic System newirewroisned • requires MPC uc. 75.00 x = $ SeptiC System abandonment 30.00 x = $ RPZ new ins}allation/repaitlrebuild 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ UndBf found Sprinkler if dwelling is under construction 3.00 X = $ Underground sprinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dwelling under construction 5.00 x = $ Water softener If existing dwelling 30.00 x = $ Waterturnaround 30.00 x $ State Surcharge .50 --? --> ---> $ 50 Total -> --> ---> --a $ Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. -------------------------------------------ication, s--------tate ---- that ---- the infortnation ------------- is ----------- and - agree ---- to comp -y -w--d - h --all -applicable ----------Cit-y--of -Eagan -...-- ordinan--------ce-s. - I hereby acknowledge that I have read this appl corteG, It is the appliwnPs responsibilily to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational end maintenance activi6es to the facllities wnstructed under this pertnit within Ciry property/rlght-of-wayleasement. SITE ADDRESS: I ROESCHLEIN,KATHLEEN 16770 CLEMSON DRIVE ? OWNER NAME: : EAGAN, MN 55122 TELEPHONE #: (651) 454-0406 (AREA CODE) INSTALLER NAM . TELEPHONE#: NORBLOM PLUMBIN? (AREACODE) STREET ADDRESS: G.'.A VENTG9/ARPIlAPdCE It;,TP.; t"' `o y c^OQ.?i GAFiFItL6 AVE. SOL'T°` CIN: MINNFAPnI IS RAN 554u:: STATE: zIP: - SIGNATURE O MITTEE 6v?t3 2007RESIDENTIAL BUILDING rERNnT nrrLicaTiox City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Now ConsWctlon ReauiremeM.s 3 registmed site suneys shaving sq. R of bt, sq. 2 of hase; and @q rao(ed areas (20%meximum lol mraMe aAawed) 1 Soils RepoR if proposed 6uilding is to beplaced on drsWrbed sal 2 capies of plan showirg beam & wuidow sizes: poured found design, etc. 1 set of Enetgy Cakuletions 3 topies of Tree Preservation Ran if lot platled after 711193 Rim Jdst Detail Options selection sheet (buildings with 3 w less unils) Mtinnegasco medmical venblatim fam ?q ;?? RemodeURmeir Reauirementc Office Use OnN 2 capies of plen shwring footings, 6eems, jdsls Cert of Survey Recd _ Y _ N 1 saf of Eneigy Cakulations (or heafed additions Shcs Repat _ Y - N 1 site survey tar eddilbm & Aedcs Tree Res Plen Recd _ Y _ N, Additian-irMfcateBOnsHesepficsyslem TreePresRequired _Y _N OrFSIe Seplic SysDem _ Y _ N Pians are considered nu6lic intormation unless vou state thev are trade secret and the redson. Datet ! I / d sl0 ConstrucNoo Cost C) 6i o d J " Site Address `/ 3 / q - -l /3 - % - / 4 / 2 Unit/Ste # ,J TVG?? escription oCWork ?? D ?6 p?l Il( G- Z J l?? I? ?' " ?1 i??l ?t?? ?.?° ?•?? Multi-Family Bldg _? Y_ N Fireplace(s) _ 0 _ 1 _ 2 Property Owner t.%s' o:C %/\o?. ,r Telephone N( CJ"/ ) L S S3 o e? Contrector L Y J/ Aj_ v fu Address , D . City ?LCfiI?SV • ??e. State ?Ii . Zip S 3 ? Telephooe # (q$4 12 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Eflefyy COde Categofy . Residentlal VentiWtion Category 1 Wwksheet • New Efcergy Code WOrksheet (4 submission rype) Submltted Submitted . Energy Envelope Calculatlons Submitted In the last 12 months, has the Ciiy of Eagan issued a permit for a similar pian based on a master plan? _ Y _ N If yes, date and pddress of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Coniractor I hereby apply for a Res Telephone #( and acknowledge that the information is complete and accurat e; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN 5tatutes; I understand this is not a permit, but only an appGcation 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 approvat of plans. ?' P ?, c- G"Lie ej ???-- Applicant's Printed Name Applicant's Signature L r c '? ?3 0?- Y Telephone #( Telephone #j Q ? 3 v? 0 v fn ` eg ? ? 9 r C5g3 L' 107.Z1 Q= 413.7p' p_ ?4°50s(u C LEMSOti N -74- 30' oo, ?V (9a. B.QS'C93g s? / N 74°?. 8c? o •o ? Qo"w ? / 0 A 8 bp W / u ? (0 ? 0 ? J U o 4 0 Denotes Iron Monument ? ° Denotes Wood Stake ?o X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation= (000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= -*- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 938.0 I hereby certiry that this is a true and correct representation of a survey of the boundaries oE Lots 1, 2, 3, and 4, Blcc'„ Z, THE i'RAII,S OF THOC;AS 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 locatfon of the stakes as set for a proposed building. As surveyed by me or under my direct supervision this lZth day of Ja;.uar'v 19 87 ? 3ll A. O SOIl Land Survevor. Minn. Rea. No. 10938 :OMBS-KNt1TSON ASSOCtATES, iNC. CDIISUti1MB EM61N[[IIS 0 IAMY SYIIYfY0X3 N SIT[ fUMYFl13 1.tlMNENOLtS " NYTCNIHfON. WHMEiOTw ;`i4o, ? CERTIFICATE OF OR MGEfor -19a1 , NF-W HORiZ01J 1-40ME5 lNC *A 2007 RESIDENTIAL PLUMBING aERnnir aPQUCaTioN CITY OF EAGAN - 3830 PtCOT KiV08 ROAD, EAGRN MN 55122 651-675-5675 Please compiete for modifications to existing residentiai dwellings. ??? Y/)Z) ? Date ?/ Dianne Martin Site Street Address 4319 Clemson Circle Unit # Eagan, MN 55122 6514059805 Property Owner ione # ( ) Contractor /!/0/?ld?? ?l?,[?yp9 _ Telephone# (GIZ) YZ7-U033 ? Address2qOS ly,trfit?? ' City /?"/' G o? State!4N,4/ Zip tlOg The Applicant is: _ Owner ? Contractor _ Other " Septic System _ New Refurbished Submit 2 sets of plans and MPC license Includes County fee _ [ $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 Alteretions to existing dwelling $ 50:00 _ Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. If you are insta/fing onlV a water soffener and/or, water heater, do not complete this section; move to the next. section and check the ? appliance(s) you are installing. - _Septic Sysfem Abandonment _Water Turnaround (add $136.00 if a 518" meter is required) Other: Water Softener ? Water Heater $ 15.00 _ new ? replacement Lawn Irrigation _RPZ uPV6 _new _repair ^rebuild $ 30.00 State Surcharge H J i Total __ , I hereby apply for a Residential PluGnbing Permit and acknowledge that the inforrnation is c I Erikill ? h the work will be in conformance with the ordinances and codes of the City o£ Eagan ane?lEd5 t I understand this is not a permit, but only an application for a per , work is not to start wifho per? in ac cordance with the approved plan in the event a plan is requ' d be revi wed and appro )UN 2 O 2007 je-(T- Aloeb)om ApplicanYs Printed Name icanYs Signature Use BLUE or BLACK Ink For Office Use x ~.m,~n r 6 I I Permit t City of Eancin ac~ Permit Fee: n 3830 Pilot Knob Road pn Eagan MN 55122 Date Received: I Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 1 Staff: I I t 2013 RESIDENTIAL BUILDING PERMIT APPLICATION . e 1.0 sad Date: l Site Address: 1617 ZL/7/~~St~P2 ~ 319 't-5 l 9 _ Unit 1 Name: f homes 1=K_ Phone Resident/ Owner Address / City / Zip: _ Applicant is: Owner Contractor Description of work: &J 14# A66 l-ICGe' /Al 7,6 fit!Ce r 0 f/4 S O/n~q i Type of Work t f - Construction Cost:._~ _-lti-Feint Yes ti~to _ t Company: TL8 R,5~a 1 h Contact: O~ " 7L / ~ , N6 city: } j Contractor Address: _ 7 -14 State: Zip:- ~5~G Phone" 440--7q7 . i _ 93 DRO ~ WA ea e i ica e If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) d a~' /fit obe), D(,!~Cv n, f ast+ 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 r~VQrmation may be classified as non-public if you provide specific reasons that would perriiit the Citv to i conclude that theyare 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.gooherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 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 Minnesota State Building Code must be completed within 180 days of'p'ermit issua e. / 44 c x x Applica s Printed Name Ali-cant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA145273 Date Issued:08/31/2017 Permit Category:ePermit Site Address: 4319 Clemson Cir Lot:4 Block: 2 Addition: The Trails Of Thomas Lake PID:10-75865-02-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: 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. Contractor:Owner:- Applicant - Debra S Brown 4319 Clemson Cir Eagan MN 55122 (612) 220-3491 Home Depot USA dba The Home Depot 2455 Paces Ferry Rd Atlanta GA 30339 (952) 345-6057 Applicant/Permitee: Signature Issued By: Signature --v- c.E.1\1_6--- 0-641 'FEB 0 8 2018 For Office Use icA ik permit* /II-7 9,3t E Permit Fee: • v...„,... -.,,,,.., /1/7 S-3 ,.........---•:-....... Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TOO:(651)454-8535 I FAX: (651)575-5694 Staff: buildinoinspectionspcitycfeagan,com 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 02/07/2018 Site Address: 4319 Clemson Cir Unit*: :,,i,..-t•tk,,,,,,,,,yrq.,.111,11111.,144,:r":"11 Name: Debbie Brown Phone: 612-220-3491 ,qtrologrooKi-:••ikl... Address/City/Zip: Cir,4319 Clemson Eagan 55122 -.11,,,tif.i. •,:••,,,ecion, 14,;,,,„ :ri i II A• ili $'1$ $ i •w*i r., E!.31 t 1- Applicant is: Owner X Contractor Description of work: Bathroom Remodel 14,-,,.•„•taiti,, . ,,,w.p,,, 5000 liftylito.1,,,,tsr717 Construction Cost: Multi-Family Building:(Yes i No .. Company: contact Great Lakes Window & Siding Derek ,,,Iss, 4.„,,,,•47,,,ro Ili* ilkinift 4'kit,2:t120; 2 Address: 14690 Galaxie Ave City: Apple Valley it -.,,,Aftt.*.,,,..„-i•ozi.,,s!, State: MN Zip: 55124 Phone: 952-891-3400 Email: derek.glvvsco@gmail.com ,41),..L•!:-.3t l'i...4.44. t. license#: BC060427 Lead Certificate#: NAT-23297-2 i.,..„1:1,,,,, „-f -,4,•;,14.4...) If the project is exempt from lead certification, please explain why: \') 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: Fire Suppression Contractor Phone: F.d,:r.i°,:rrrr TrriPt.i:r.,r7r",0E,D.-..,,,:q. ....E.3.--r-EEr--- ,,... '.'.-.! ;....:2E4',.,-,:-.7i'-Ti'=E:.--..i-,,.. :-..p.• .-%--- . ,.,.-,...:--,----.1.--t':-:.--:„, ,- --'... --- -.,-1,--,,,,,.,---'.. , .,,, 0,,,,u Okitlijgitrik: ',.,^i;0.4 i,:r..i.r.; ,...i.4.e.x'4.4 itiltli:'•,, •r.,r....!:,,,,;..,ir,,,,,,,,..,:13:A.,`,,,t',.",I: -." ". „,if:':,•",,4,':,'':,,, '' I.:1,...'-,,:,: ,,:•.;.: 1 4..'3,'3"i 2:;,^„3.; ''' . 33'.1"..43,1:‘;1,•,,,4,3,3.',"!..,.„:3:',"Ii.4,::,3:-Et:33.,, 3:;2,73,7„..,..t.„33„3—::: ' ..::: ., , 1"(.,3::, '.;'3:„.I.,,,; In3.'3‘:c'.:311''..; " ,3 '3;.*' ''3'. 32:;3'.1. .' ;,. ' '`14%."3'3j.t:3,1' ` '— , - You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at wvvwcitvolitrattart.corrtisubscribe. 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. CALL BEFORE yOU DIG. can Gopher State One Call at(661)464-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. wwwooDherstategnscall.prq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit,but only an application for a permit, and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x --3e. 1 *-t# e i?e-o--,!;iit.,--- x Applicant's Printed Name Applica nature Li 1 9 CfQ � C( � - mDO NOT WRITE BELOW THIS LINE /779 SUB TYPES — Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) Single Family — Garage — Porch(4-Season) _ Exterior Alteration(Multi) _ Multi — Deck — Porch(Screen/Gazebo/Pergola) Miscellaneous X 01 of j Flex _ Lower Level Pool _ Accessory Building WORK TYPES New 7'6' Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish interior _ Alteration — Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation ZOO ."2 Occupancy :17.1Z-C." '3 MCES System Plan Review Code Edition Mho 201 .-- SAC Units (25%_ 100% X) ) Zoning 1)7 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V? Width REQUIRED INSPECTIONS _ Footings(New Building) Meter Size: _ Footings(Deck) Final/C.O. Required _ Footings(Addition) _ -Z4 Final/No C.O. Required Foundation �O HVAC Gas Service Test Gas Line Air Test — Roof:_Ice&Water _Final Pool: Footings Air/Gas Tests _Final Framing Drain Tile _ Fireplace: Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath Brick Insulation Windows _ Sheathing Retaining Wall:_Footings—Backfill Final _ Sheetrock Radon Control _ Fire Walls Fire Suppression:_Rough In_Final _ Braced Walls Erosion Control Other: eviewed By: l V in 9 / (7A , Building Inspector ESIDENTIAL FEES �a 4( Base Fee 13 ' xU ! � ,,, , �,. Sri . , -fi surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 For Office Use % . i e >#+ PZe: 0. ., E AG A N � - # P (U0._ °° Date Received: 4 II 10 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675 5694 Staff: buildinginspections(c�citvofeagan.com L 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: t`':;-, Site Address: its f5 C1641.....0�. /�� Tenant: 13Z61`11--- Suite#: 3....,..... ,. ......... ... .... .,............ ..., ...... ,.mwµ ...... ......w,...., ...,.,......... .,...,....... ..m............ .._. .,..,,,... . ReSident/Owner Name: tZ6a>1 Phone: Address/City/Zip: 3 1 C/ cu:1 (//1'1,_(,. Name: J Y1,cL f iHr,1);�`` License#: x/a-711 J Address: 67fJ'y /v4',? 7-_,,, ,,4,„ City: �' f Contractor �.. /S �/:"( ✓ xf�/ C cia`State: Zip: S-416)"--1 Phone: ,7 ,,r o /lei bContact. j ma : Type of Work —New /Replacement —Repair _Rebuild Modify Space _Work in R.O.W. Description of work: C&)4-i �j C 1 v'�fJ c'yj ✓�" '4/' ' RESIDENTIAL Water Heater Lawn Irrigation(_RPZ/_PVB) Water Softener _ Permit Type Septic System Add Plumbing Fixtures( Main/—Lower Level) New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) "Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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.00pherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance vgith 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 n. to sg)rt wi/./ thout 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 plan ., rl x t L-C %Va,1e - x Applicant s Printed Name Applic.f s Si!nature T FOR OFFICE USE Reviewed By: bate: Required Inspections: Under Ground Rough-ln Air-Test Cas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: PERMIT City of Eagan Permit Type:Building Permit Number:EA153962 Date Issued:02/06/2019 Permit Category:ePermit Site Address: 4319 Clemson Cir Lot:4 Block: 2 Addition: The Trails Of Thomas Lake PID:10-75865-02-040 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 Total: 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. Contractor:Owner:- Applicant - Barbara Crist 4319 Clemson Cir Eagan MN 55122 Glowing Hearth And Home Llc 100 Eldorado Dr. Jordan MN 55352 (952) 492-9276 Applicant/Permitee: Signature Issued By: Signature NIlel. r For Office Use/Y " ' ' \ 5 &' , i. fi -, ,A, n i ? p, 66 604416 ., s,• Permit Fee: IIECEIVE Date Received: 47--/9-17 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I (651)675-56751 TDD: (651)454-8535 I FAX: (651)675-5694 JUL 1 9 2019 I Staff: buildinginspections aAcityofeagan.com I _--,, 2019 RESIDENTIAL PLUM ING PERMIT APPLICATION Date: , 0,U1C1 Site Address: 131 1 -f.*IrfAin,U !'�k Tenant * , I ,,t w_e" Suite#: _ ...,....._—,-777,,,,,7,,,.:7,77—' Name: _ r_.._. r._____ _. :f�la 1-?4.37' weer' '_ ScIAN j Phone ?5 R•e's'Idetltl0 ,, �' � �� 2;..;`; ;s Address/City/Zip: 1� n/1 lir i•- `537c Name: MILBERT COMPANY dba CULLIGAN WATER License#: WC641376 :Co n:trac :to:r. Address: 1801 50TH STREET EAST City: INVER GROVE HEIGHTS • State: MN Zip: 550.77 Phone: 651-451-2241 • Contact: BILL MILBERT Email: gloria.abas@culligan4water.com New Replacement Repair Rebuild Modify Space Work in R.O.W. Ty,�p:e',of:Work — -- Description of work: Water Heater . .. . ... : Lawn Irrigation(_-RPZ/_PVB) y Water Softener DeScripti`om Add Plumbing Fixtures( Main/_Lower Level). ___Septic System Description:- New - Abandonment Connection to City Water from Well RESIDENTIAL FEES -----_...�..w..` .. .--•--- _... � ........_._ ._.,_..,.._-_.�........ $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.0.0 New fixtures, adding or removing piping(includes State Surcharge) $60,00 Septic System Abandonment $100:00 New Residential (fee collected with Building Permit) $11".00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well* -+- $290 for Meter and $190 for Radio Read = $540 *Sewer&Water Permit also required for connection charges TOTAL FEES $ 64'00 LL B CAEFORE Ur YODIG. Call Gopher State Ono Call al(651)454-0002 for protection against underground utility damageC , all 48 hours before you intend to dig to receive locates of underground utilities. www.gopherslaleonecall.ory You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cilyofoactan.com/subscribe. 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; at he work will be In accordance •h the approved pl i In th ase of wo k which requires a review and appro I of ens. , x \ c� c x • • A )Ilcan 's Printed Name Applicant's Signature • • Page 1 of_2 PERMIT City of Eagan Permit Type:Building Permit Number:EA165018 Date Issued:10/14/2020 Permit Category:ePermit Site Address: 4319 Clemson Cir Lot:4 Block: 2 Addition: The Trails Of Thomas Lake PID:10-75865-02-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: 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. Contractor:Owner:- Applicant - Barbara Crist 4319 Clemson Cir Eagan MN 55122 (612) 695-4338 Sandau Construction 9025 Hwy 101 W Savage MN 55378 (952) 403-9100 Applicant/Permitee: Signature Issued By: Signature