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3255 Coachman Rd
.... . . +o ; CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE 45a-81AA BUILDING PERMIT To be used for Est Value '2' 51 Site Address _ Lot Block Parcel No. cc Name W 2 Address ° City Phone_ , o Name _ 0 L) Address ? City _ v? ? W Name _ Address U ? W Clty _ I hereby acknowledge that I have read this app that the information is correct and egree to comply State of Minnesota 5tatutes and City of Esgan C Signature of Permittee A Building Permit is issued to: all work shall be done in accordance wlth all apF Building Official :A," #k 14 Q?? Receipt # Date ,19 OFFICE USE ONLY On Site Sewage _ Occupancy MWCC System _ Zoning On Site Well _ Type of Const City Water (Actual) _ (Allowable) T; * of Stories Length Depth S.F. Total Footprint S.F. APPROVALS FEES Assessments _ Permit Water/Sewer _ SurCherge Police Plan Review Fire _ SAC, City Engr. _ SAC, MWCC Planner _ Water Conn. Council _ Water Meter m and state Bldg. Off. _ Road Unit 1II appliCSble APC _ Treatment P1 nCes. j ? 'lariance _ Parks Copies • TOTAL on the express condition that le State of Minnesota Statutes and Ciry of Eagan Ordinances. . Permit No. Psrmit Hoider Dato Tslophone Plumbing ? . A: s ,F H.V.A.C. 9a213 62 n ? Electric Softener Inspection Dats Insp. Commontf Footings I Footings II Foundation ?0 -ad-8 7 Framing !-/G Roofing 3w-.zS=d7 e` . ?f -s-F-7 !?*7 ?. Rough Pibg. lzz Rough Htg. /! Isul. 8 Ei1- ?aZ 73/-f7 Fireplace Final Htg. Final Pibg. Bldg. Final ?/ Cert. Occ. 2 i,/, Temp. LP iA -iv-X7 ., 3 ?d ,. •'' C Deck Ftg. Deck Frmg. well Pr. DisP• w4l'/rfe t/1 R 's13 .?-.2, -R ? C.f, -k :< ,-«...., s - 2-C W . o - °u. - CONTRACT PfiICE . 5. Site Address Lot ?T Block SeclSub m Name ? co Address % c Ciry Phone Name 3 Address O City Phone 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 FOR: CITY OF EAGAN ?- ? PERMIT ri - -- PLUMBING PEAMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ? PHONE: 454-8100 ' • 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 Kitchen Sink - $3.00 UrinaliBidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $300 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 weil - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: ,., STATE S/C: ? GRAND TOTAL '? t^+ 12.Z Z V / ?Z-zs-s1 , ? ?? qc?"? i_34g' G .2 , J?- ? ?'- ?? ? . PERMIT # --??-- ' ? . '. , MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE ' CONTRACT PRICE: PHONE: 454-8100 Sec/Sub m Name ? Addre c City'_ Name 3 Address p City TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other Phone M BTU M BTU M BTU M BTU CFM FEE: . A ti ? FiL_e sic: . TOTAL• ? BLDG. TYPE WORK DESCRIPTION Res. New Mult Add-on Comm. _ Repair ? ' '` ? Other FEES FiES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRiCE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN - .f-?...??_.....?. PERMIT # "X'•-- MECHANICAL PERMIT RECEIPT # ' CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE + SiteAddress . . > ".:?-^_• ?.,..,?,?: ,, j BLDG. TYPE WORK DESCRIPTION Lot Block 2 Sec/Sub New ' Res ,. . Mult Add-on m Name ,, ? f ?o Address v 11, 't-?. Comm. ? Repair ? c City kIIr7 L S Phone -S U -$t L,- Other FEES Name RES HVAC 0-100 M BTU -$24 00 c Address . ADDITIONAL 50 M BTU . - 6.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM 1 PER PEFiiiA 50 EA - 1 - M . . TYPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE Forced Air M BTU APT BLDGS. - COMM. RATE APPUES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M 8TU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other ? FEE: ., _._ S/C: SIGNATURE OF PERMt E TOTAL• - • FOR: CITY OF EAGAN PERMIT # . • • • ' • MECHANICAL PERMIT RECEIPT # ° • ' CITY OF EAGAN 3830 PILOT KNOB ROAD, EACiAN, MN 55122 DATE: -" " '- CONTRACT PRICE PHONE: 454-8100 Site Address gLpG, TypE WORK DESCRIPTION Lot Block Sec/Sub Fies. New Mult Add-on Name , Addr Comm. Repair c ess h? Ot c City Phone ? Name _ c Address o Cih+ - TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # :OJ M BTU M BTU M BTU '` A" M BTU CFM FEE: 46' S/C: TOTAL: 1? FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERiIAIn - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHQUSE & 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 GOES BEYOND $1,000) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN • ; lo'? -b? / - 8 7 Q . ? • ?° o o ?S'l ` '?°.?•-`Q'? ? ? ?i?- ?•??:?? ca- S. w -PAO ? - /! - a1v AP ?04 d4we- 6.-- @°o. i/f --/-?7 3?S-3a? iNSO?cT,?l, ^o.,? SITE ADDRESS Sect/Sub. Unit # Permit # IMSPECTION DATE IMSPECTOR OTNER fRAMIN6 ROUBN PLl6. ROU6N NTB. INSUL HREPLACE FlNAL NTB. RNAL PLe6. UNIT flNAI CERT/OCC INSPECTION DATE INSPECTOR COMMENTS P 7 ? ,. c ? ? Ga?f??1? i! - 9-S 7 i" ti n T-f ? ?, ? ' / ., • ? %? ' ? ? .! / `?J ?r? /, i??/? -'/: vfi ?• . Pl ,eu e?ls'?K ''ajW ?.. . 't?'? r? w, it o?.,??o ? L CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Esgan, MN 55121 PHONE: 454-8100 ? eUILDING PERMIT R«eivr # To ?e wd fN Est. Vclue Dcte Site Addreas Erect 0 Ocwpancy Lot Block it)i,r_ J. Remodel ? Zoning Repair ? Type of Coost. Ps?cel No. Additbn ? No. Stories , - Mave ? Langth ? Name ., Demolish ? Depth '' ' ? Address ' Int.ImPr- ? Sq. Ft. t' `C City Phone .` . Install D Name ' Aoowrals FNe AU Addret: Assessment Permit City Phone Water 3 Sew. Surcharge Polfu Plan Review ? lW Name ' Fih SAC i? Address ' z Eny. Wate?Conn. t r i City Phone Plonner Water Meter 1 hercby ocknowledpa thet I haw rood?this applica Council Rosd Unit lion ond store that eldg. Off. ' - Tr. PI. tM informution is oo?rect ond o9ree to comply with oll opOlicoble A? k P Stota oi Minnesoro Stotutes and City of Eoyon ( e er ?kdinantss: - Var. 0ete C?I? Sipnoturt of Pennittat - Total A Buildiny Pennit Is issued to: an M+e expem caditlon thar oll work shall be dont in oocordontit with all oppl ioabl* Stata of Minnetoto Stotufas ond City ot Eapan OrdinoncK. 8uildirq Offldol , , Pwmit No. Pwmk Holdw DSn TNsphon? ? ?umbing ?- . H.?A.? , a 3 EIaetHc 8oftwNr Irqpedion Dau Insp. Othe? FooUngs I .Vrakv 4 Footings II Foundation Framing Roofiny Rough Plbp. Rouqh Htp. Insul. Flreplsa Final Htp. Final Pibg. Final CerqOcc. W?? Wseribe Loeation: WaII Sswer Pr. Disp. W 0 0 d V i4 ?ptS -- ? t C ITY ' 3830 Pilot Knob Rosd. P. pH01 BUILDING PERMIT Te be wnd fer Est, Value Site Address Loi Block SeclSub. Pareel No, a Z 9 Eagan, MN 55121 Receipt # _ Erect LJ Occupancy Remodel ? 2oning Repair ? Type of Const. - Addition 0 No. Stories ? Move ? L..ength - Demolish ? Depth - Int Impr. ? Sq, Ft. iQ13 ? u ? 5ipnature of A Building Pei aH work sholl Buildinp Offici Is •---- Assessment Permit Woter & Sew. Surcharge Polite Plan Review Firo SAC Enp, Water Conn. Plonne? Water Meter Countil Roed Unit Bldg. Off. Tr. PI. APC Parks Var. Date C ' Minntsoto Stc opies Total _ on ths express condiflon Ihot City of Eoqan Ordinantes. H.VA.C. ElectMc Inspaction Data Inap. Other Footin9s I f Footin9a II Foundatlon Roofing Final :aw ?..o w.......... ? PERMfT # PLUMBING PERMIT RECEIPT # CITY OF EAGAN - 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ? ACT PRICE: ' PHONE: 454-8100 Site Address -- L ? lot W Block ? Name m _ m Address c Ciry 1 .,• " . " Phone - Name : (D Address O Ci1Y - FEES COMM/IND FEE - 1%OF CONTRACT FEE ' MINIMiJM - RESIDENTIAL FEE MINIMUM - COMM/IND FEE STATE SURCHARGE PER PERMIT (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) FOR: CITY OF EAGAN o'.)p'c • c'Sp h'tD 7 BLDG.TYPE tl? Res. _ Muft _ Comm. WORK DESCRIPTION New Add-on Repair NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 ZWater Heater - $1.50 Whiripool - $3.00 Gas Piping Oudets - $1.50 , SoRener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE ? STATE S/C: -v (3RAND TOTAL• `- J V ? oL?Y ,q-pfis • CITY OF EAGAN ? *"-"•"0 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 BUILDING Te M wed f PERMIT er Est. Value Re«ipr # - ,Dote 19 Site Addresa Erect ? Qccupancy Lot Black S+*'/Sub• Remodel ? Zo?ing Repair ? Type of Const. Percel No, - • Addition ? No.Stories Move ? Length W Narne ,` pemolish ? Qepth ; Address . Int Impr. ? Sq. Ft. b City Phone Install ? Name _ ? Addres: r Citv _ Name City _ I hercby acknawledpe thot ! haw read fhi ths iniormction is correct ond ogree ta Stote of Ntinnesota Stotutes ond City of Sipnoturc of Pemnittee /1 Buildiny Permit Is fssued to: all work slwll bs done in occordonce with Buildinp Official Feas Asstssment Permit ` Woter & $ew. Surcharge Police Plan Review Fin SAC Enp, waterConn. 5A0 i08 Plonner Water Meter Countil Road Unit id stote thot Bldg. Off. ? Tr. PL I applicoble Ices APC Parks ?T . Var. Date Copies Total on the expross Conditlon Ihot State of Minnesoto Statutes ond City ol Eaqon Ordi?ances. ` Permit No. Pamit Holdsr Dan Tslephone # Piumbinq I < r rT.v.A:c. t°I Iz ?f c Elece.ic $ y CU./ r?..? I I? I U. UG V/ r 5often?r (nspaction Date fnsp. Othw Footinys I ?1 A Footings II Foundation Framtng Roofing '? • r? Rough Pibg. RoughHtg. ??IfL at ? Rl .iI 7?fGr Insul. Fireplace Finai Htg. Final Piby. -Z/•? Final C14 CarVOcc. Water ??ibe Loeation: VE Well /P6 _ Sswer .3 --a2S- ?YG - -??n.? [' ???? ?C •(J Pr. DisA, - Cs'- `,eW , c?, 17,777 soti W-a9-?6 w,B c al,;? - ?AGAN Addltion t'VA lU Owner . ?-{f : , i?.eii'i s.- ; ?? i..L. s-?, Remarks 2-,f ?- ?? ? Lat 4 Rlk 2 Parcel 1 n 2`f517110 oaO na - Strejet State ..f'T ,en . ,_ -s aS Improvement ' Qate A ount Annual Years Payment Receipi Date STREETSURF. 9 4 STREET"??. 1975 AL 617.33 IQ 8iC3 GRAOING 1971 1097.55 10 Sid 7 486 24324.43 2432.44 10 SAN SEW TRUNK 1968 A " • 104 58 3 73 A01 554 9-12-84 SEWER LATERAL /?2 / JX f /,S * WATERMAIN 1972 3096.40 3 aid WATER LATERAL 1975 189.84 15 949.22 4 4 -12-81+ * WATER AREA 1972 STORM SEW TiiK 8 j d STORM SEW LAT I CURB & GUTTER SIDEWALK STREET LIGHT WATEF CONN. BUILDING PEfi. SAC PARK l•'l.Gv?L-K ?a? i .?t.c.? ?? ? ? .. _. _ , .?!? c. f ? r. . _ ? `, ? ? f, ? ? ? 3 . C? fl C ? ?? --ts ?v .? y y - ?1r 3- t I133? C 5;° / '? Recaipt PLUMBING PERMIT Pennit No. CITY OF EAGAN Fw Fill in numbered;paces S/C '. Type or Prini /egibly Tat. ' . 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone 8. Address - ` • , ? 7. City State Zip 8. Building Type: Residential O Commercial ? Institutional O 9.) Work Description: New -O Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures l/D i fi C Bath tuba esspoo eld ra n Se ti k T Lavatory p an c f S Shower tner o Well Kitchen Sink Urinal/Bidet Othe Laundry Tray r Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12, I hereby certify that tfie above information is true and correct, and I agree to comply with all ardinances end codes governing this type of work. Signed : for Rouyh F inal Inspections: Oate Insp._ DateInsp. This is your permit when numbered and approved. App?oved CITY OF EAGAN 454-6100 5-1- ?? .'?. s -s's C t0-)7 E- (Y-G ?/? -z ? 1? ? ?j-zs-?S C -04 fz-???s t -17-Y? ` ;422 -z2yY / 22 3 $T'Pa V 4 ?_,? _ . Rspipt MECHANICAL PERMIT Parmit No. CITY OF EAGAN • FM - ffll in numbered spaces S/C Typs w Print /egibly Tot. -? 1. Date 2. Irtstallation Cost 3. Job Address Lot Blk. Tract 4. 5. 9. Work Descxiption: New ? Add ? Alter ORepair ? 10. Descxibe Fusl Type 11. No• Eguinment BTU - M. Ea. Forced Afr No. Eouiament CFM Air H dlin Mfg. y: an Boilers Mfg. Mech. Exhaust ? Unit Heeter Mfg. Other Air Cond. Mfg. Go, Piping Outlats 12. I hereby certify that the above information is true and correct, and I ayree to comply with all ordinanas and codes govarning this type of worlr. S'igned: for ' Rouph Final Inspections: Date Insp. Date Insp. This is your permit when numbersd and approved. Approved CITY OF EAGAN 464-6100 6. Address ? . 1 7. City State Zip ? $. Building Type: Residential ? Commercial O Institutional O ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: ' + t R I [)(iE . . ,, . ., . . .. ?. , ?. ., d ,. -, ,. ,. ? • LOT ? 4 Ftl O(:K s 2 CqACHMAM Ri) ` PERMIT SUBTYPE: I ) 4XORD PERMIT TYPE: Permit Number: Date Issued: titr 1 I. 1.:1 NFi a?,s01c)p AFt/CIFy(,47 C13M%1 f.!?It{ (iSil?.'1 ??'H td71T TYPE OF WORK: i R FV n.tk (ttRF nA"prV) INSPECTION .. . .A I i, F!4 N It K..`? r i11V I T`% 129 . 229 329 932 Permit No. Permlt Nolder Date Telephone JI ELECTRIC PIUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING (?l<7 ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLOG FINAL l? / BSMT R.I. BSMT FINAL DECK FTG DECK FINAL BUILDING PERlNIT To IN w.d ier FOL SiteAddress 3255 l.oe 4 elock 2 Parcel No. W Name BRUTGI ? Address 1 SUNi city ST CLOUI Name SAME Aadren ? City ?W Name SLiiMF.l eegan, MN 55121 N° 1 Q 4 2 9, Recelpt # .. _ JUNE 20 85 Erect 4-I Occupency Remodel ? Zoning Repail ? Type of Contt. Addition ? No. Storiea Move ? Length Demolish ? Depth Int Impr. ? Sq. Ft. Install ? Aoorovals FNs Assessment Water a Sew. Poliu Firo Enp. Vlonnsr Courxil Btdg. Off. 6/ 17 / 8 5 APC Va?: Vste on 4oto.?s and City o? Permit ?1 j• vv Surcharge Plan Review SAC Water Conn. Water Meter Road Unit Tr. PI. Parks Copies Total $15 . 0 0 the express oondirfon Ihat Eapon Ordinonces. I . :. J L`' d V -- ?? i: h Z ? ?j o ° YI ?OZ . 1 (? N ? ? . Z CC .- u° .. ? Q ? ? ? .... ,. i Y La ? W a,N 0 z ? oam? C)?aujrN ? 0 i ? ? - r, C_ ? r u: t v? ? " ? ?• ?? ? ? ? ?? in c' I ? m ? 1985 BUTLDING PERfiIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS HUST $E LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: E)UN /? c>.! Valuation: Site Address: ?Z.55 (]DPC,F}MA," Pp Fc--Y,- 42-IOGe Lot: q- Block Z 5ect/Sub a,nphl, Parcel # Owner Fj(Z.uTLE'? CDM AW?r5 Address E?iG ?.1ti1 wOpp D2, BpX 9 City/Zip Code ?T, C LOC.10 Slo3o2 Phone Co I L- Z 52 - f0 2(vIz- Contractor ?4Ma Address City/2ip Code Phone Areh./Engr. ??)?uMF-NrAL-S ?cLC?-k Address (? ? (X? ?.?U M M t "r DQ. ?-Jo. City/Zip Code ?Q?kL`(hi 6T(?. 55,430 PMone # Sv Date: OFFICE USE ONLY Erect x Occupancy Remodel Zoning Repair Type of Const Enlarge # of 5tories Move Length Demolish Depth Grade Sq Ft APPROVALS Assessments Permit I -:, . 00 J Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council d Unit Bldg Offbn/ : Parks APC Treatment P1 Varianee J l S? GpU TOTAL, 1985 BUILDING PERMIi APPLICATION - CIT1C OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED FIITH THE CITY OF EAGAN C0141ERCIAL SINGLE FAMILY DifELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS ' $2,000 LANDSCAPE BOND ,?+m^^??. g,,p C) °^ Qou ?, v To Be Used For : Valuation : S Q? ? Date : k clk r-dl Site Address \1)0OFFZCE USE ONLY ? o?-- Lot Block Erect Occupancy Parcel/Sub t' Owner Address 'K , b?"t City/Zip Code Sk Phone Contractor QA o Nw,,. Q nn X t Qa-?, Address C,o Q"? \l? City/Zip Code 'sJ y, V NA•V\'SS& Phone 2&-tsaikJ - qqa-qbU u Arch./Engr. Address City/Zip Code Phone 11 Remodel _ Repair ? Addition ? Move Demolish Int.Impr. T Install ? APPROV9L5 Zoning Type of Const ll of Stories Length Depth Sq Ft FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off ' Treatment P1 APC Parks Variance Copies TOT6L ? l .. .? ? sn R , l . ?. BUILDING PERMIT CITY OF EAGAN N° 1 1083 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 i PHONE:454-8100 S 6/ & 000 Receipt jj siteqdaress 3255 COACHMAN ROAD Lot 4 Block 2 cecJSub. FOX RIDGE AD Parcel No. W Name BRUTGER COMPANIF INC ? Address _ P.O. BOX 399 City -ST CLOUD pnone 252-6262 F Name DOLPHIN POOL & PATIO Z Address 3405 NO CO RD 18 city PLYMOItTU pnone 542-9000 FW Name x43 Address Z W City Phone I hereby ocknowledge thot 1 hove reod this opplicotion ond srote fhot fhe inlormotion is corrett ond ogree fo comply with oll opplicoble $tote of Minnewto Stotufes ard of E/og9?q Ord?ronces. 519noture of Pertnifte ? '?? A Building Permil Is issued ro: all work shall be done in acm e wifh all opplicoble ote of Min Buildinp 04ficlol ered u occooaooy Remodel ? Zoning Repeir ? Type of Const, Addition ? No. Stories Move ? Length Demolish ? Depth Int.lmpr. ? Sq. Ft. Install EX _ ADVrorab D Faes Assesunenl Permit 1 58 _ Q Wate. 8 Sew. 0 Surcharge 11.5 Police Plan Review 79-2$ Fira SAC En0• Water Conn, Pla^^er Water Meter Council Road Unit Bidg. Oft. ()/23/ 5 Tr. PI. APC Patks Var. Date Copies Totel 7dQ 95 an the expren condition tho, wtu Statutes and City of Eopon Ordirqnces. 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED MTITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: 140 Unit Apdrt- Valuation: $21-,500/unit Date: MdY 31, 1985 ment Site Address: 2i2 -rj-rj ?.or?c-l-?r?Ptit 2D• Lot: 4 Block 2 Sect/Sub Fox Rldge Arirlitinn Parcel 0 owner Brutger Companies, Inc. Address One Sunwood Drive, Box 399 City/Zip Code St. Cloud, MN 56302 Phone 612-252-6262 Contractor Brutger Companies, Inc. Address One Sunwood Drive, Box 399 City/Zip Code St. Cloud, MN 56032 Phone 612-252-6262 q 80b. `° Arch./Engr. Blumentals Architecture, Inc Address 6100 Summit Dride North City/zip Code Brooklyn Center, MN 55430 Phone # 612-571-5550 > F-,B_ OFFICE USE ONLY Erect )C Occupancy Q-1 6-J Remodel Zoning P,_¢ Repair _ Type of Const , ?0 Enlarge 1/ of Stories 3 Move Length e?o Demolish Depth 2-1 0 Grade Sq Ft evnnnirer c Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off Parks APC Treatment P1 Variance TOTAL I 3'10. `- 4`l 04 5S. eco °" 56,Q21 ? 3td2DEE 6A[K 14Pxlo °° ^ PE?zr? ? ? o00 3-?50 x 25 = ___------- 12vo t 2 cao ?t- 1'10 = l 3 -7D 1?c?W (LEVIGI? ?°08 x.?' = 4904 5A c l qo n 4zo = 5g,?cx? Wac 140 x 4 cx) ' S?ooo • W PTIE(Z ti c rER I [Zoa-C) ul.i IT 224 x i 40 ? 313&C) • ?'?r??s ?F??uR? aY ? ? `?oM 7 I(-os, (40 = 38?Z.o . T p? f? loc? x I 40 ° 1?r34? ?33 ? ava 9808 13-7 c.',) 4CI04 56,600 5 c., ooo 313& 0 38? 2v = 14bj v ? 1987 BDILDING PERPffR APPLICATION - CITY OF BAGAH SINGLE FAMILY DWELLINGS ZBCLODE 2 SETS OF PLANS, 3 CERTIFICATSS OF SQRVEY, 1 SST OF ENERGY CALCQLATIOHS NOTE: ADDRESSES FOR CORNEE LOYS - COHTRACTOR/HOMEOWNER MQST DESIGNATE WHICH ADDRESS IS DFSIRED. NO CHANGSS WILL BE ALLOWSD ONCE SQILDING PERMIT IS ISSIIED. MOLTIPLE DiiELLINGS - RFSIDENTIAL RENTAL QAIRS 140 FOR S9LE ONIiS -- INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECS WITH BLDG. DEPT., 1 SET 0° SNEary cnr rpr.pT70NS COIII7ERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF EHERGY CALCULATIONS, $2,000 LANDSCAPE BOND F1(zC (Z.C?}LI2 To Be Used For: Apartment Valuation: $2,500,000 IYate: JuIY 22, 1987_ Site Address 3255 Coachman Road Lot 4 Block 2 On Site Sewage_ MWCC System _ Pareel/Sub Fox Ridqe Addition On Site Well _ City Water _ owner Brutger Companies, Inc. Address One Sunwood Drive, P.O. Box 399 City/Zip Code St. Cloud, MN 56302 Phone 612/252-6262 (d'- f0 o / - I aPYTiOVniS Contractor Same Address City/Zip Code _ Phone Areh./Engr. Blumentals Architecture, Inc nadress 6100 Surronit Drive North City/Zip Code Brooklyn Center, MN 55430 Phone !l 612/571-5550 Assessments Water/Sewer Police Fire Engr Planner Couneil Hldg Off APC Variance Occupancy Zoning Type of Const (Actual) (Allowable) R of Stories Length Depth S.F. Total Footprint S .F. EFZ Permit " 3. r2jt5r-- Surcharge DO. SO ? Plan Review SAC Cit u R \O ?, y , I q /11? SAC, MWCC Water Conn c?- Water Meter Road Unit Treatment P1 Parks Copies ToTAL 7553. a ?,SOO?od? <0 4 53 Ij ZOl-rG ?'oRh?uL/? l AL J V loo -f- C ooCD3? Cz?.OnCD -4000.?-14 = -?RD VeFuN0 C1.c? ?lg-7 ?-?- (v?Z) CITY OF EAGAN N ° 14 0 7 2 3830 Pilot Knob Road, P.Q 8ox 21-199, Eagan, MN 55121 PH O N E: 454-8100 BUILDING PERMIT Receipt# ---7 ucCn Tobeusedfor FIRE REPAIR Est.Value $2,500,000 Date AliGUST 20 19 87 Site Address 3255 COACHMAN ROAD OFFICE USE ONLY Lot 4 Block 2 Sec/Sub. FOX RIDGE ADD OnSiteSewage _ Occupancy MWCCSystem Zoning ParcelNo. onsteweu _ rypeoiConsc Ciry Water _ (ACtual) (Allowable) # ofStories Length Depth S.F. Total Footprint S.F. a Name BRliTGER COMPANIES 3 Address 1 SUNWOOD DR., P.O. BOX 3 o City ST CLOUD phone 688-8001 ,o Name SAME zt- ?¢ Address APPROVALS FEES 1- City Phone Assessments _ Permit $6.453. SC ta Water/Sewer _ Surcharge 1,100.04 F W Name Police _ Plan Review zi Address Fire _ SAC,City aw CitY Phone En c SAC,MWCC Planner _ WaterConn. Councll _ Weter Meter I hereby acknowledge that I hav ? s ap li tio d state Bldg. Off. Road Unit that the information iscorrectan ktoco y lapplicable APC _ TreatmentPl State of Minnesote Statut d of E ce& Variance Parks Signature of Permitte A Building Permit is issu to: BRIITG R COMPANIES all work shall be done in accordance with all applicable State of M Bulldina nffinial ? Copiea 70TAL tr, 7553'"50 on the express condition that esota Stat s aR City of Eagan Ordinances. 997 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN )0610 3830 PILOT KNOB RD - 65122 881 -4675 nstruction Reouirements RemodeVR ? 3 registered sRe surveys ? y copies ci plan ? 2 coples of plana (InGude beam 8 window sius; pourad fnd. design; eta) ? 2 site surveys (exterior addttions & dedcs) ? 7 enargy ealculatlons ? 1 energy calwladons for heated addttions ? 3 coples of tree preservation plan if lot platted eRer 711/93 required: _Yes _ No ' DATE: S?d 9 J CONSTRUCTION COST: ??DD, Ov0 DESCRIPTION OF WORK: 41019/19, STREETADDRESS: &JAGH ti7.4,q /C-OAA LOT ? BLOCK ?t_ SUBD./P.I.D. #: ,f,E? Scu?? y PROPERTY Name: 100ODk)O6z' ?PTS Phone #: OWNER ,.. StreetAddress: ?,.. O .bls9 .ta 3?P 32SS ?pRcf(?"«?/ i[p,q.p 4219 .r1 d32- City: &?,qGWn! 5tate: MN Zip; SS/ 2/ ^ CONTRACTOR Company: J 66-1450 'u &?,IvS r Phone #: 926,-d 717 Street Address: 7Q2-0 s< License #: '7 71d City: 5l , L091 S/'f121? State: M,t! Zip: ARCHRECT! Company: Phone #: ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer 8 water licer.ned plumber (new construciion only): . Penalty applies when address change and lot change am iequested once permit is issued. I hereby acknowledge that I have read this application and state that the iMormation is cortect and agree to compiy with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Ceriificates of Survey Received _ Yes _ No T?ee Preservation Plan Received - Yes - No - Not Required Clty of EagIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651) 675-5694 ------------------? I For Office Use ? I Pertnit#: ?j Ju (ad ? ? I I permit Fee: I ? ? Date Received: I ? Staff: L ------------------ 2008 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING RESIDENTIAL PROPERTY Address: J,?.?S C-,?C?-C? '?"?? ?d • _ OFFICE USE ONLY Property0wner: PRV required Telephone #: _ Plumber: City _ County R-O-W Permit Date of Inquiry: Contad Name: SEWER WATER 4" Sewer Service $691.00 1" Water Service $772.00 Sewer lateral charge @$28.30 I ff Water lateral charge Q 528.601 ff Sewer trunk @$1,150/ connection Water trunk @$1,200 ! connection City SAC $100.00 Water supply storage $1,150.00 MCES SAC $1,825.00 Receipt #: _, Date: _ , Date: Receipt #: Treatment Plant $690.00 _ _ Septic abandonment $50.00 Permit Fee $50.00 PermitFee $50.00 State Surcharge $0.50 Stdt@SufChafge $0.50 'PlumbingPermitRequiied-watermetertobe acquired wdh 6uilding permit TOTAL: TOTAL: SEWER & WATER 4" Sewer Service $691.00 1" Water Service $772.00 Sewer lateral charge @ S28.301ff Water lateral charge @ $28.601ff Sewer trunk @ $1,1501connection Water trunk @ $1,200lconnection City SAC $100.00 MCES SAC $1,825.00 Receipt # , Date Water supply & storage $1,150.00 Receipt # , Date Treatment plant $690.00 Septic abandonment $50.00 Permit Fee $100.00 State Surcharge $0.50 'Plumbing Permit Requi2d- water meter to be acquired with building permft TOTAL: 2005 COMMERCIAL MECHANICAL PERMIT APPLICAT ?r, -i-, C? ((? City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 JQN 2 6 10p? J Please complete for. commercial/industrial6uildings multi-family buildings when separate permits are not required for each dwelling unit Date/? z3 / ? 7 Site Street Address 30l ,5-y ?D? G!? ry? Ct ?/C062 Z Unit # Tenaot Name (if applica6le) Previous Tenant Name Property Owner WUdjr / jf? /3 Telephone # ( ) Contractor ?/ Cvt t ?Jh-?/JGLit /C S Trr: StreetAddress City Wlor7,?ti i? S70-,1 .L State n /12Sd / Gr Zip Telephone # ( 9SA ) d9W-Jd6)J Bond #: Expires: The Applicant is _ Owner ? Contrac[or _ Other Work Type New Construction _ Underground Tank _ Install _Remove *`see below fnterior Improvement _ Install Piping _Processed _Gas pl?c G 6o??e,- '?i ?` ?.J ?/oSeJ7` 7? ?i? 5'? Nature of Work: AG , r? 5e- 'v ? "When insfalling/removing underground tank, cal! for inspection by Fire Marshal and Plumbing /nspector P¢t'ml[ F¢¢S: S70.50 Underground tank ins[allation/removal $50.50 Minimum (includes S[ate Surcharge) or Contract Value $?'/, 7(? 0 x I% _ $ ??. U D Permit Fee • If ep rmit fee is $1,000 or less, add $50 => $ .Jra State Surchazge If oe rmit fee is over $1,000, add $.50 for every $1,000 permit fee $ Tatal Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the mtormation is compiete ana accuraLe; mac cne worK will be, in conformance with the ordinences and codes of the Ciry 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 be in accordance with the approved plan in the case of work which requires a review and approval of plans. 1..../QnR Applicant's Printed Name Apprl'ican' Signature Approved By: , Inspector Date: //3 ( i? ;;?, Page 1 of 1 Peggy Fleck From: Linda Dralle Sent: Monday, June 09, 2008 3:42 PM To: Barbara Kalstabakken; Connie Edwards; Peggy Fleck Cc: Scott Peterson Subject: Irrigation permit & meter I have been contacted by Superior Irrigation Company. Woodbridge Apartments located at 3255 Coachman Road removed their deduct meter many years ago and now they want to start using the irrigation system again. We had Troy out there to make sure things were plumbed corf.eetly-sovve?are-i+? g you that Woodbury Mechanical will be applying for the permit and paying for the.1.5" Displacement mete After the permit has been paid for, they certainly can stop by and pick up their meter. I u?iil??y- Thank you, Linda 06/10/2008 ?? ? r-3? e CASH RECEIPT -- y""W?-- • CITY OF EAGAN P. 0. BOX 21 • 199 ? EAGAN, MINNESOTA 55121 DATE / ? L/ 19.[y1l2 RiC[IV[O oM p? n LI AMOUNT $ I f White-Peyen CoPV vollow-Pottinp CoGY .. r _ r-... Thank You ? N_ 59479 B CASH RECEIPT ? CITY OF EAGAN P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 f; * C{?, ?,.,. ?.. s?s a F:off : DATE 19 FROM ?? • •?? ? '1(_l.i? ?-?( ?tl I ???i? ?1 / ? (1. AMOUNT $ y ) . k ooLLwws 1 ?os 0 CASH 0 CNECK Thank You ? BY WAite-PaVen Copy Vellow-POSting CopY Pink-FileCoPY -" CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 6 77 W DATE 19 REC PROM ? , [. ? ( ?? AMOUNT $ (F C l ' h OOLLARS ?ee ? CASH CNECK FOR • J`?' Thank Yo Whne-Payen Copy ? Vellow-Postin8 CoPl Pink-File CoPY FOR 1 f 6t , t- . ( n2007COMMERCIAL PLUMBING rERnuT nrrLicnTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 r ' ? ?v • ? Date'41 /01 p p Sit v? A? Add ?rr ?P b e ress f ??it Il Q• tinit # I , TenantVame Former TenantName Property Owner Shkap t M oAQ ??}ZQ Lo+ Telephone # ( ) Contracto ?l.X AddreCity ?/ A% State CW Zip GL?""-? Telephone ft W )? L(7 -a515 u -- License # ?N90 Qc)LQ em Expires: The Applicant is _ Owner ConVactor _ Other Work Type New Bldg _ Modify Space _ Irrigafion System'" Yes No Work in public r-o-w / easement? ?X RPZ _ PVB: New Y Repa"u/Rebuild _ Replace _ Remove Rain sensors are re uired on irri ation s stems Description of Work To inquire if Pressure Reducing Valve is requaed on new service, call 651-675-5646 Meters - Ca11651-675-5646 to verify that hydrostaric, conducnvity, and bacteria tesa passed orior to oickine uo meter. Irrigation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works Fire Size & Price 3/4" meter 174 00 Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _ No Flushometers _ Yes _ No PRV Required _ Yes No Permit Fee $50.50 minimum (includes State Surcharge) ConcractValue $ x 1% _ $ PennitFee Meter(s) Required ou all new buildings & boulevazd irricaUon svstems $ Radio Metex Read $ State Surcharge If oemii[ fee is less Ihan $1,000, surcharge is $.50 If nennit fee is more than $1,000, surcharge is $30 for each $1,000 owed. " "' _ " " " -' _ ' ' ' _ ' _ _ ' _ ' ' _ _ _ _ ' _ ' ' ' _ ' -' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' " _ ' ' ' ' ' _ _ ' ' _ ' -' " " -' " _ -_ ' _ ' ' " _ ' "' " "' _ ' ' ' _ ' _ " ' ' -' ' ' ' ' ' -' " " " " " " -" "' _ _ _ _ Following fees apply when installing new lawn irrigation system $ Water Permit CaII the City's Engineering Deparunent, 651-675-564 r rei?e?1'e?r?p?t?r' F "? L? ? ? ?? ? D $ Treatment Plant JlJl 0 2 2007 $ Water Supply & Storage $ State Surchazge $ Total Fee I hereby apply Cor a Coaunucial Plumbing Pertni[ md aclmowledge that the mfo[mation is cortple[e md accurate; tha[ the work will be in confo[mance with the ordinances md codes of the Ciry of Eagan md wi[h [he Plumbing Codes; that I understsnd this is not a permit, 6ut only an application for a peemit, md work is not to start, ithou[ a pertmt that ihe work will be in accordance with the approved plan in [he case of work wJ1?f h rerauires a r/ey/JCw md appmval of plans. ApplicanPs Printed ame App]icanPs Signature I hereby acknowledge that this mformaUOn is complete anG accurete; that the work will 6e in conformance with the ortlinances antl codes of the qry of Eagan, that I understantl thts is not a pertnR, but only an applirrdM1On tor a permit, and work is not to start without a permft; iha[ Ihe work vnll b- ccortla requires a review and approval of plans nce with the approvetl plan in the case of work which t X?/?I Z-L/?X 19 - ApplicanYs Printed Name ApplicanYs Signature City of Eap 2008 COMMERCIAL PLUMBING P Date: ? - 13- U S , Site Address: J1? ?-S cd-? rrnanr- /AT v -- - - ? 8353?{ ? ? Pertnit #: ? I ? I Permit Fee: ? I I ? I ? I Date Received: i I ? j Staff: I L - - - - - - - - - - - - - - - - - I PLICATION Suite #: PROPERTY Name: ? Phone: ?-4*r?' 9 OWNER CONTRACTOR Name: ? License #: -S rf? 3J- -10??Z_ Address: City: ' State: , Zip:=U74 P J l- 777' Z ZSa erson: Contact Phone: /.v _ TYPE OF New x Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. WORK - Description of work: PERMITTYPE COMMERCIAL New Construction Modify Space ? Irrigation System (_ yes 1_ ) (? RPZ /_ PVB) no ?n s?tems • Rain sensors required on irriga • Avg. GPM _(2" turbo required unless smaller size allowed by Public Works) _ Meters Call (651) 675-5646 to verity that tests passed prior to oickina uo meter. Domestic: Size & Type . s r /lIFire: Size 8 Price 3/4" meter 183.00 ' ices? _Yes _No Avg. GPM High demand de Flushometers _Yes _No PRV Required _Yes No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract Vawe S x 1°k _ $ Permit Fee Required on ALL new 6uildings and boulevard irrigation systems ?_$ Radio Meter Read - If Permit Fee is less than E1,000, surcharge is $.50 =$ ?Q _ Meter(s) - If Permit Fee is >$1,000, surcharge increases by $.50 for each $1,000 $1,000 Permd Fee (i.e. a$1,001-$2,000 Pertnit Fee requires a$1.00 surcharge). _$ State Surcharge Following fees apply when installing a new lawn irrigation system. $ ??- J Water Permit Call the Cdy's Engmeering Depanment, (651) 675-5646, for required fee amounts. g- Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES 5 Zj? FOR OFFICE USE 'Approved By:=: ? Da"te: ?- ,. .. Required Inspections:' ? UnderGround RougH!In -"°i!AirTest ;. GasTest _Final Page 1 of 3 1 CITY OF EAGAN FOR CITY USE ONLY ? 3830 PILOT ItNOS ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # a , / ??OP40w DATE : / (R PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNliOMES/CONDOS WHEN PERMSTS ARE REQIIZRED FOR EACH UNIT. --------------- --------- ----------------°------------------------------------- WORK DESCRIPTION FEES NEW CONST ADD ON REPAIR OWNER NAME: SITE ADDRESS: :.•VT: LLCU.. _ JII?L• INSTALLER: ADD-ON MINIMUM $15.00 HVAC 0-100 M BTU 24.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL: $ STATE SURCHARGE: .50 iVihL: $ ADDRESS: SIGNATURE OF PERMITTEE CITY: ZIP: PHONE tt MP1MERCIAT.f?lVAd51!RX'ATtk PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, : ...... ..... .:. .. : . .. .. .. ... .. APARTMENT BUILDINGS, AND MULTI-FAMZLY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLZNG UNIT. / m--0 CONTRACT PRICE: Cc> FEES f OWNER NAME: V 47- ? b 18 OF CONTRACT FEE. STATE SURCHARGE -$.50 FOR SITE ADDRESS:??? 46WA+N/Zs?,EACH $1,000 OF PERMIT FEE. YKO(:ESar.D 'YiYlivG = j27.60 LOT:_?A - BLOCK oZ SUBD. $25.00 MINIMUM FEE. INSTALLER: ._Lv C. CONTRACT PRICE x 18 $ ? ADDRESS : r? J'Y' o K I C_G.. D(L STATE SURCHARGE CITY: 4/? ZIP: 6?53 Y ? PHONE #: e)" FOR: CITY OF EAG TOTA • 4/ U, s^o i y.?-L? tr--a-e.? (SIGNATURE) ? ?p //3 /4 ?- f?/ f`',.'7 ? ? 2005 COMMERCIAL BUILDING PERMIT APPLICATION ?V City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 . ... • d . . Improvem ent Strucfural Pians (2) sels • Architectural Plans (2) sets • Archiledural Plans (2) sets • Civil Plans (2) • Strudurel Plans (2) • Code Anatysis (t) " . Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) . Code Analysis (1) • Landscaping Plans (2) • Key Plan (1) . Projecl Specs (1) • Code Malysis (1) "* • Master Fac@ Plan (1) • Spec. Insp. & Testing Schedule " • Certificate of Survey (1) • Energy Calculations (1) noi always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always" • Meter size must be established • Meter size must be established • Meter size must be established-if applicabie 1 • ProjeclSpecs (1) 1 • Energy Calculations (1) 1 • Eledric Power 8 Lighting Form (1) d . Master Exit Plan (7) 1 1 • Emergency Response Site Plan (t) 1 • Soils RepoA (1) 1 • SAC detertnination - call 651{02-1000 • SAC determination - call 651-602-1000 • SAC detertnination - call 651 E02-1000 . • Fire Sto in Submittals Call MN Dept of Heal[h at 651-215-0700 for details regarding Food & beverage or lodging facilities. " Con[act Building Inspections for sample and if required *** Permi[ for new building or addition will not be processed without Emergency Aesponse Site Plan. Date 7 / /1 / & S/' Constructian Cost &S-0 Site Address 37 C'C` ('_tir.nr~ d CZ UniVSte # Tenant Name 64pQ6tri`d3,,g. 4V=L±-? Former Tenant Name Description of Work /L ? -' ? ?'? ? • ? N Property Owner Telephone # ( ) ; ? - - Contractor ? Address "eCJ ^?rm?n l r"• l=? CitY_&1,crdS"w State /F e ycc-S Zip '757J?fi 1 Telephone # (f ;rZ) Arch/Engr Registration # Address Cih' State Zip Telephone # ( ) Licensed plumber installing new sewerlwater service: Phone #: (_) I hereby apply for a Commercial Building Permit and aclrnowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. rrJA2 '- 4. n wc_? Gr ? . Applicant's Printed Name pplicanYs Signature PLUMBING (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 ? o r-I L+ Telephone # 651-675-5675 FAX # 651-675-5674 naceQa_/07 ?03 /?? Site Address 32?JS l'n?+c,??nAN KU/Q-Q Unit # Tenant Name Former Tenant Name Property Owner U300C) (Lt??(-D [ &QTS Telephone # ((Ojl ) `ESZ -29S4 Contractor Fpy-EmQ5T (?FC 1-?/kl\llC#?l,r Address 95?0_?? .Dt71-C\[ &/E.?RJUE city SAII\fT A.? scace Mn! z;P 5SI C?10 Telephone #((6() (ON I^L5 aS S The Applicant is _ Owner % Contractor _ Other Work Type _ New Bldg _ Add-on _ Repair ?ORPZ PVB Irrigation system * " Je Wobschall to celcula[e fees Re uired meter sixe is 2" [urbo unless smaller size ermitted b Public Works Description of Wark )eL--mQYE /e/' Z To inqmce if Pressure Redueing Valve is required on new service, eall 651-675-5646 Meters - Ca11 65 1-675-5 300 to venfy that hydrostatic, conductivity, and bacteria tests passed orior to oickioa uo meter Imgation Size & Type Avg GPM Fire Size & Price 3/4" disulacement $156.00 Domesric Size & Type Avg GPM Includes high demand devices? _ Yes _ No Flushometers _ Yes _ No PRV Required _ Yes _ No Permit Fee $50.50 minimum (inciudes State Surcharge) Contract Value $ x .Ol% _$ Base Fee $ Meter(s) Reqmred on all new buildings & boulevard irrisation sysrems $ Radio Meter Read If base fee is $1,000 or less, surcharge is $.50 $ State SLlTCh3tge If base fee is over $1,000, surcharge is 5.50 per $1,000 of the Base Fee Foliowing fees apply onty when installing new irrigation sys[em $? Water Permit Contact Jerty Wobschall at 651-675-5024 for required fee amounts Treatment Plant D?`"' ? C?$ ?I Water Supply & Storage I AUG 1 12?03 ?13 StateSurcharge --------------------------------------------------------- ---------- -- - --------..... -------------- --------?-----y-?------------------------------------------ gy_?_- 0, JV Total Fee I hereby apply for a Commercial Plumbing Permit and acknowledge that the information is complete and accurate; [hat the work will be m confonnance with the ordinances and codes of the Ciry of Eagan and with the Plumbing Codes; that I understand this is not emvt, but only an application for a permit, and work is not to start without a pecmit; that the work will be in accorQance?v?t the approved l? the case of work which requires a review and approval of plans. n ?? ?J FJIC Ov, N ApplicanPs Printed Name ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMITTYPE: Permit Number: Bur?otNG 0 3 0 5 7 0 Date Issued: 0 8/ 0 5/ 9 7 3255 COACHMAN RD LOT: 4 BLOCK: 2 FOX RIDGE P.I.N.: 10-27500-040-02 DESCRIPTION: (FIRE pAMAGE) ? ,_. B'u?ildinc-?;PermiC Type MULTI. (MISC.) BuilciingWiar,k 7ype REPAIR e;? ?Ce(?sus Code ? t ? n. b :-?Ws REMARKS: UNITS 129 229 324 932 434 ALT. RESIpENTIAL s?., x ... '..a.,. ??.. ?` ? 3 ra? i "'"? F 3? y iQ7 FEE SUMMARY: Base Fee 5urcharge Tntal Fee VflLUATION $1,387.25 $100.00 $1,487.25 $200,000 COIOTRACTOR: - Applicant - ST. LIC OWNER: BENSON CONST CORP, J 19200717 0004740 WOODRIDGE APARTMEN78 7020 WAI.KER ST ? 3255 COACHMAN RD ST LOUIS PARK MN 55426 EAGAN MN 55121 (612) 920-0717 (612)452-8954 I hereby acknowledge; tFfaC"I have reacL infQr'rr'etl'on is curr(fdtan?& agre`etb co Statwte& and Gity,o,firEagan 0,rdiijanoe5.,- ?-- AP T/PERMITEE SIGNATURE hi.s -,applicetxon?and1 SCate that t'fis ip,iy with aRpl3eable 5Caten?=Mn. ? ISSUEO : ? ATURE ?a,; - ? - --- - -- ,-- __ -- _ -i.. ------ , f'7'T'V 7f I-1i'hN I hi i C7:7Y 0?= E:A('?n?! , r:::rzM:?r?ni_. r!iae ';s7 rp1; s QrI/fli/.`i)"r' TIMI_.v 14e32:42 r,A4iH.I:Efi: S 7F_'Rt1:I:NAI._ t@0: 357 I. , DA'r'E:,: 08/05!97 i'TM!=,; 14C3003 ?n NAIc.;: 1 Ii;F:N!if1N i'i7PdSTf.'!Jt'T f.011 '-*OF.F ^ ID tq ? : ? NAME:: 1rT:1'l J [+kN;,ON CONSi1Rt )N f' 0RP '?i`It.l 9001 . 3295 ,r,pnCi..iMr:N r? ?0 n..Ctn , . . 214;5 9401 3255 ,r.,pnCHMrlN E: 100.00 300 '?tlQ! 'ii:?`i`:r GOACNMAN I; SOC].C)L 'jr.;.a:1. , ecoipi: Arrir7unh, 1:500,. 00 CFi f l i 9:°.i4 { U`;;`fi .T.Iie i.'ANI;'f I 7ota:l. FecEtipt Ainounl,: SOp.C]t) cRrn9:;4o u,r::.r, .cn: NAncv Xt?%:k%?ktyt?t?Kxt %??YXt?;Sk?tY??Yrkk;?t?X7k?k>k*?;?t?i?t?tX?#??ktl??X?'X??% !'ITY 0F 1-.Ar.,AtJ CqF;4i71=1ti: 9 TI:'f'MIiJAL 't]^ 35;i' DAl'F.:: 08/09/97 7'Ci'fP;, t4 ; `t:l.,^.% IL! :; N6dNiF..P ,t <"tF.::tJSCIN f^IlNSTRl1C'1":I'r,ltJ I,^,f:1RIP :3?:LCI 9(]i71 3255 Cr]ACI-IMi4N R 487.25 ? i ?:114'i?I I ?iit? ? ll4 ;;fVml: Jqo; i:.Ii`.! Y!!9 , 7ai;a1 Receieii; Amuunt" 487„25 GF'0 i `? 5:3`! ° K ie,o7 •i i.. I 1Y.;6::f't zD: NANrv nF tu 71011 1ti' ? %kX7kMtH(?("kYFYI.Y(?9FyFYk?k?$??, h'<)X5;(Y',.?#X<1KX<X<k?7kiKN?#tWYF>#YF.#W ` i 4 a_ : Fl ?? IGIiJ'YCe ? 1 1r?.lr? t .?'fiQJ l?'{"u.i b'?U?•b?:. C1', Fi31'tAW Nufi, V'NI 1:1.V41 ? i oU I I . \i t, 5. pl'," 1116, 7u iwnrt.;.,,. t CITY OF EAGALi 3830 PILOT KNOB ROAD EAGAN, KN 55122 PHONE: (612) 454-8100 kXMWKTM FOR CITY USE ONLY PERMIT # RECEIPT #?5 ? DATE: J0- PLEASE COMPLETE UPPER P081'IDN ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS t1RE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST _ ADD ON ` REPAIR _ OWNER NAME: SITE ADDRESS LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: _ CITY: ZIP: PHONE # SIGiv'Ai ni. OF Pr.nViiTT£E COMPLETE THE FOLLOWING: NO. FIXTURES EA. ADD-ON MINIMUM 15.00 _ SHOWER 3.00 _ WATER CLOSET 3.00 _ SATH TUB 3.00 _ LAVATORY 3.00 KITCHEN SINK 3.00 _ LAUNDRY TRAY 3.00 _ HOT TUB/SPA 3.00 _ WATER HEATER 3.00 _ FLOOR DRAIN 3.00 GAS PIPING OUT. _ (MINIMUM - 1) 3.00 _ ROUGH OPENINGS 1.50 _ OTHER WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 TOTAL SUSTOTAL S ST. SURCHARGE .50 TOTAL: Ct?I???.GI :',IbjptTSTt#Il?? z PLEASE COMPLETE THIS POR3ION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS AND ... . ? ......:...>.. .. . .., MULTI-FAMZLY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. __________________°° -----______ --------------------- '_________ CONTRACT PRICE: / aG??"?-?T?'x'T?? FEES OWNER NAME: / - SITE ADDRESS: ._2?C?S LO/?cG,sr+iYv KcL : _ LOT: 7 BLOCK a2- SUBD. Y%?J _ INSTALLER: e?,JmS/2 ///rLIn.M%tG?4 I Ce??-iGB4 i.L.z _ ADDRESS: 5,4 C ITY : oiin d 5 ?? 4:W : I?*N, Z I P: 55//a- . PHONE #: FOR: [J", ?? _ .. CITY OF EAGAN 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE $ , r0 TOTAL: ? ? S ?• JO . (SIGNATORE) a,,t4 %?"?? L CITY OF EAGAN PLUMBING PERMIT SUBD. fli (612) 681-4675 / PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. CITY USE ONLY RECEIPT # (?)? / 6) S '? DATE - ?'a D - r2 ALSO, FOR TOWNHOMES AND CONDOS ------------------------ WORK DESCRIPTION --------------- ----------------------------______-------- COMPLETE THE FOLLOWING: NO. . FI%TURES EA. TOTAL NEW CONST _ REPAIR/ADD ON 15.00 ADD ON SHOWER 3.00 REPAIR WATE[t CIASET 3.00 BATH TUB 3.00 LAVATORY 3.00 ' OWNER NAME: KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 SITE ADDRESS: _ HOT TUB/SPA 3.00 WATER HEATER 3.00 i a.vGk DRAIii 3.00 GAS PIPING OUT. INSTALLER: _ (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 ADDRESS: _ OTHER WATER SOFfENER 5.00 CITY: ZIP: _ PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE W. TURNAROUND 15.00 SIGNATURE OF PERMITTEE ?:TATE SURCHARGE .50 TOTAL: S COMMSRCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCAIPTION: ?C?/f}C.£-so7G?i ?' ?5 ?FY/Ipv ?'.<f5 LaJ/?`?S2 #T4+L2 OWNER NAME: SITE ADDRESS: 3?5S &wc:Crr»l*v oed TENANT NAME: SUITE #: I.Znrhe. Jemo?r? INSTALLER: &o2AS1L ADDRESS:rlaO°i I-ouiSA 4.11, CITY: 121M,7je Ui auii /nA.). ZIP: PHONE d FOR: CI OF EAGAN ?'.'vivTnAi.i PRICE: 1% OF CONTRACT FEE " . STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1% $ STATE SURCHARGE $ 150 TOTAL: -3d ?- (SIGNATURE) -° CZTY OF EAGAN FOR CITY USE ONLY 3830 PIIAT KNOB ROAD CA ?yl'? EAGAN, MN 55122 PERMIT ie PHONE: (612) 4??RECEIPT 3 14?CiL$N?L'AI.:T??It?4?'1' DATE: PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST _ A?D ON _ REPAIR _ OWNER NAME: SITE ADDRESS: LOT: BLDCK _ SUBD. INSTALLER: ADDRESS: CITY: PHONE #: ZIP: FEES ADD-ON MINIMUM $15.00 HVAC 0-100 M BTU 24.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL: $ STATE SURCHARGE: .50 TOTAL: $ SIGNATURE OF PERMITTEE COMMERCIAI./ZNDV$T'RTALo PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUSRED FOR EACH DWELLING UNIT. ? CONTRACT PRICE: Z,SCkp) OWNER NAME :/JR UTC ?? eff? t(/ 77 C--S , J^/ C SITE 32-s-5 CO4,c14-,,t9hlJ TLatp _ LOT:? BIACK oZ' SUBD. ? INSTALLER: /_/7- c? ADDRESS: 2-3/6 S?'- !lf- iff " CITY: RPLS , /LtAl'- ZIP: 55?? rs FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING = $25.00 $25.00 MINIMUM FEE. • 75 CONTRACT PRICE x 18 $ ? STATE SURCHARGE $ S U Z 7 1; 7V I-?3'SB 7?/v1 /?t/7zH7uSdv TOTAL: $ PHONE #: /?? ?? ? SIGNATURE) FOR : CITY OF EAGAN ?2 ' ?ICVKT?Q11 ?y()?`ftc?, ? ? i - - ?? ; t . i L H SUBD. APPROVED BY: CITY USE ONLY RECEIPT #: 9 (_"( 3 g RECEIPT DATE ? - ( ( - 1998 PLUMBINfi P£RMIT (COMMEfiCIi4L) C1TY O£ EEFfiAN S$SO PILOT KNOB RD E4fiAN, MN 551E8 (sis) 681-4675 Please complete for: all commerciaUindustrial buildings multi-faznily buildings when separate building pertnits are not required for each dwelling unit backflow preventer to be instslled in commercial areac or residential boulevards Date: Work Type: _ New Bldg. _ Add-on _ Repa'v _ U.G. Sprinkler _ RPZ Description of ? if Pressure Reducing Valve is required oo new service, ca11681-4646. F$F••S 1% of contract price or $25.00 minimum Contract Price: x 1% _ $ COMPLETE THIS AREA ONLY IF INSTALLING IINDERGROLIND SPRINKLER SYSTEM Service: Existing (if coming off domestic line) OR _ New Backflower Preventer Pemtit Fee»»»»»»»»»»»»»>>>»>>>>>>>>>> $ 25.00 Water Flow GPM Water Meter 1" @$189.00 or 2" Turbo @$871.00 $ If "new servlce" ada' Water Permit $ 50.00 = State Surcharge $ .50 = WAC $ 807.00 = Water Treatrnent $ 444.00 = Permit Eee $ 0`?. aU State surcharge is $.50 per $1,000 of ep rmit fee or minimum of $.50 per permit State Surcherge S 1 .15T Totsl Fre $ C2?1`?' i(9 I hereby acknowledge that I have read this application, state that the information is conect, and agree to comply with all applicable City of Eagan ordinances. It is the applicanPs responsibility ro notify the property owner that the City of Eagan assumes no liabiliry for any damages caused by the Ciry during its normal operational and maintenance activities [o the facilities consWcred under this pemiit within City property/right-of-way/easement. SII'EADDRESS: TENANT NAME: INSTALLER NAME: STREE'f ADDRESS: CITY: /12/ , /(/[ TELEPHONE #: ZIP:?ei?.r SIGNATURE OF PERMITTEE /-19-Y ?-Pz ? L /i' B $UBD. d?-' APPROVED BY: CITY USE ONLY RECE[PT #: RECEIPT DATE fZ YX 199$ PLUM$INfi PE{tbllT (COMMERCIAL) CITY OF EA&AN 3$30 PILOT KNO$ RD £A6AN, MN 5518E (sis) 681-4675 Please camplete for: all commerciaVindusVial buildings multi-family buildings when separate building pemiits are no[ required for each dwelling unit backflow preventer to be installed in commercial areas or residential boulevards Date: Work Type: _ New Bldg. _ Add-on _ Repair _ U.G. Sprinkler _ RPZ Description inquire if Pressure Reducing Valve is required on new service, cal? 681-4646. fBF..S 1% of wntract price or $25.00 minimutn Contract Price: x 1% _ $ ???,ao COMPLETE THIS AREA ONLY IF INSTt1LLING UNDERGROUND SPKINKLEIZ SYSTEM Service: Existing (if coming off domestic Iine) OR _ New Backflower Preventer Permit Fee»»»»»»»»»»>>>>>>>>>>>>>>>>>>>>> $ 25.00 Water Flow GPM WaterMeterl" @ $189.00 or 2"Turbo @ $871.00 $ I("new servlce" add Water Pertnit $ 50.00 = State Surchazge $ .50 = WAC $ 807.00 = Water Treahnent $ 444.00 = PermitF.ee $ p;?5 '610 State surcharge is $.50 per $1,000 of ep rmi! fee or minimum of $.50 per permit State Surcharge T¢taR Fee $ I hereby acknowledge that I have read this application, state that the information is correct, and agree ro comply with all applicable CAy of Eagan ordinances. It is the applicant's responsibiliry to notify the property owner that the City of Eagan assumes no liability for aoy damages caused by the City during its normal opentional and maintenance activities to the facilities constructed under this pennit widdo City property/right-of-way/easement. SIT'EADDRESS: TENANT NAME: INSTALLER NAME: 4: ??/ STREET ADDRESS: CITY: ?JSTA?'E: ? ?- I SIGNANRE OF PERMITTEE / a 7 7i ?iK EIDLZc: AvDt710" Y • EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER Sedrti?. ?/,& o aoit ??E,??Q?Y/7i2Tjs9?>'s • , SITE ADORESS Detertnine working square footage of each. " 1. Total exposed wal l area ..... .? d sq. ft. x : 7J 2. Total roof/ceil ing area ..... 673DCo sq. ft. x?= 'LZ p2. Z ' 3. Total exposed floor area ...., sq. ft, x = - Total exposed wall area above Toor a. Total wall window area .......................... 300 b. Total door area .. ....................... ... c. Total sliding glass door area ............... .. ??y8 d. Total fireplace wall area ................... ... . e. Total wall framing area (average 10%) ....... ....? f. Total net wall area above floor ................. 354r7 g. Total rim joist area ........................ ... Total exaosed foundation area = y h. Totat foundation window area I. Total net foundation area above grade Determine "U" value of each walt segment. ? a. 51oa %"U" D.SCo * a 968 _. e. iaf, XRU• _ E-A G!?? .;; REVtEwED , c. ?52.8 x itu^ s ; Y d. X"U° a 1 B e. 3 9 Yo x"U" 12, 087 pATFr- X FlU° .Q• o ? . 9_ X „U, s ( ' h. X "U" ; 1. X "U" . ? : 4 ................ . Total ' 912 ? L • - - • ......... ..... . ? ___ ? .. . .. . . _ ; . . . , If itan /4 is the same as, or tess than item ql, you have met the intent. . . of SBC 6006 (c) 2. . . . .. . ;' . CITY OF EAGAN N° 3830 Pilot Kno6 Road, P.O. Box 21-199, Eagan, MN 55121 10 5 5 6 BUILDING PHONE: 454-8100 P ERMIT 140 UNIT ReCe1? # _Te M wed fer APARTMF. NT Esr. Value $3,$50,OOOpate JULY 11 $S SiteAddrau 3255 COACHMAN RD Erect E{ Occupancy 19 R1 gl Lot 4 elcek Z Sec/Sub. FOX RIDGE ADD Rgmodel ? Zaniny Percel No. Repair ? Type of Cotist. Adtlition ? No. Storiec 2 ? Nanie BRUTGER COMPANIES MOVB 1:1 l.anqtn 500 Z ? Address 1 SUNWOOD DR., BOX 399 oemolish ? oeptn 270 City ST Int ImPr. ? CLOUD phone 252-6262 S9. F[. ?nstall ? g i Name SAME AvMeroM Few Addrese City Phone ?Z Nane BLUMENTALS AR HIT ' ` ?C Addreea 6100 SUMMTT DR N[1 ?W Citv BROO LY?ane 57 - 0 I hereby acknowledga thot I he pp aho on st thot thB inlormofian is corrttt and ly w a reco pble 4 Sto ro of Minnesota Stntu s an r? n $ipnotum of Permiftee A 8uildinq Perm;r is iuued roc BRUTGER C ANIES dl work shcll bs done in xmrdonea withn oll? licoble Sfat of Mi 8uildirq OHINoI Asseument _ Woter 3 $ew Pollcs _ Firo Erq. Plonner Coundl Bldg, Off. 7/11/$ 5 APC Yar. Dete Permit S 9808.00 surcnar9e 1370.00 PlanRevfew 4904.00 SAC S$$OO.OO waterCona 56000. 00 water Metei N/A_ Roaaunit 31360.00 Tr. PI.14840.0p Parks N/A Copies ' 7otal $177082 00 on Me expreaf condiMOn Ihut and Ciry o5 EoOan Ordinances. Total exposed roof/ce9ling area J. Tatal skylight area. k. Total roof/cei7ing framing area (average lb%) 5 7 1. Total ret insulated roof/ceiling area ? Deteraine "U" value for each roof/ceiling segment. J. - X Hull , k. 573 I X"U" x flu• O, oz-r 5 .................. .................. TOLdT Total exposed floor area = m. Total floor framing area (avera9e 10%) n. Total net insulated floor area m. X lluii _ n. X "U" _ 6 .....................................Total _ 5 If total of ;# is the same as, or less than #2, you have met the intent oP SBC 6006 (C) 1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of itens #4 and.#6 shall not be greater than the sum of items #1,2 and #3 • t , . . ? . a?. ? ?loc; t? Q ? oC? ? ¢? PTS. oCc.u Prat-I? $UI?pINCa SIZE c??? 13s = Ic?3 x coc? ? coco ? 'u?i = Co& ?? 34 ? Co??C Zlc? _ C?Co x q Co ? 89io K 3 10?5? X 3 l'? -1? 4 x 3 224? x 3 1 ?I E? 20 ,c ? (0 3 j So Y? 3 59 ?b? L q- S Z For? P-IOCyE A\PbN. = 2c? l 3a = 32z? ? - Co`I ?2 = 5'? 4coC? ? ? Q1 Cola x I 3S ? f/ v x c. cc - 224 4 i2. x 38 ° q Sco ? Icoio x 3 - 34ts3o ? ARe. A Z g9 Y, Zt3 x ?Oc°? ? 30Z4 (o 4oc? K 3- Iq 2 i? A(?.ER 3 8 x 38 ' ?i2 3b k C?g SqYbq-, (9& x co? = a?r8& r?voc\ q 8,9 = 5g? ¢ ?c? x za ' g? ?- ??38X ? " ZoZt4- • P?c,? S l c? ¢ x Co c9 - CD8 C?- c? ? c? a x? = Zo s? z F?R-Ea ? ( z?? z x 3 = 3e?b?co `?`l pC of? cs?? ST, • ? 1 He, 13A,si c, 19, S.1-7D MULnSr02`4 10,,?p xZ - z1,0o0 SLP. p,?L- s?D(n 2-1,ooo x z` 42,0o0 MEMO T0: JAY BERTHE, POLICE DEPT. DIRECTOR OF PUBLIC WORKS DALE RUNKLE, PLANNING DEPT. KEN VRAA, PARKS & RECREATION DEPT. JOE CONNELLY, WATER DEPT, FROM: DALE PETERSON, DEPARTMENT OF PROTECTIVE INSPECTIONS DATE: The preliminary construction ? plans for --woOp2t0(aV 16cPA2TMai-1'f5 are in our plan review section for your review and comments. Please return this form to Steve Hanson with your initialed comments and the date of review. Thank you. /JS .?., f., .-., RtJ,N MEMO T0: JAY BERTHE, POLICE DEPT. DIRECTOR OF PUBLIC WORKS DALE RUNKLE, PLANNING DEPT. KEN VRAA, PARKS & RECREATION DEPT. JOE CONNELLY, WATER DEPT. FROM: DALE PETERSON, DEPARTMENT OF PROTECTIVE INSPECTIONS DATE: The preliminary construction V/ plans for WOppR..?pCal: fkPA2TMe-w T5 15 T ?"' are in our plan review section for your review and comments. Please return this form to Steve Hanson with your initialed comments and the date of review. Thank you. rv?/2, UT T?//LM. CrdR??L .7 J / J S ----- MEMO T0: JAY BERTHE, POLICE DEPT. ? DIRECTOR OF PUBLIC WORKS DALE RUNKLE, PLANNING DEPT. KEN VRAA, PARKS & RECREATION DE,T. JOE CONNELLY, WATER DEPT. ` FROM: DALE PETERSON, DEPARTMENT OF PROTECTIVE INSPECTIONS DATE: The preliminary construction V/ plans for WOOD2kVCat= f?PA2.TMEM-1"(5 are in our plan review section for your review and comments. Please return this form to Steve Hanson with your initialed comments and the date of review. Thank you. /JS n? • a : . ?. ? ' .. : . . . ? . ? ..- . • . _ . .. minnesqta departinent of healfh 717 s.e. delawarest. p.o. boz 9441 minneapolis 55440, ? ?(672) 623b000 : '. . ' . ? ? . , . ' . . . ' yt ' . . . , . . , , . . . , . . , •W , . .' , , . ' Hsutgsr Conpanlea, Iacorposatetl. . Post Office 8os 394 ' , - pne Soavood itcive St. Clouds Mitmesota' 46362 , . , Centleaeai • . , Subjects Piuabiaa for Woodrfdite ApartnentrR Ha„p?," Mlnneaott ._. • « We'ars encloring • copy of onr•report eoxesinQ an ezaataation of plans and speclFicationa nn the above-debignated projecCi..A aet of tDe 4dentified plans md.apecificptione ie slpo being r0tn;uad te yau., IT IS T6B PxWECf OWmBB'8 l&9PONSIHILITY ?0 88'1'AIN T88 PLAlCS AT T8B PAOJHCY LbCASIOlt. • Yopr nEtention io'dtrnetedto?thQ •tQtspsnt pertaining to'laspeetion of 4Aa plwtbiag. It fe important that ve :ecaive the infoxqtation indiceted ia order tbat tse ae¢e'aaary inspectioa nay be mrde. if yon Il#ve anp qaestiousta iregard to piuaAing inepecEfoas, pleaaa contact . Aonald 8tanler nt 512l623-?328. '. ,. • . _ . . , If you tuve.pny queeCiona in regard to the fdformatioe eaiuined in ehis , . rnport, please oauunicatt'2atrick Siupkins at 612/623-5264. - ., . Sineemlp 7onra; ? . . :, '. Gary L. Engiaad, P.E. ?• Chie€ . Secti'on'of Yater.Bapply apd 8ngineering 6I.SsPl3Siniv. Encioturee CCI DalR Yetersoa„ E4LZdLIIg, IIISp6CC0! , , . _' , . . .. ? , ' , . . . .. ` MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT OF PLANS Plans and specifications on Plumbing for Woodridge Apartments Location Eagan, Minnesota Date Examined June 24, 1985 Prepared and submitted hy Brutger Companies, Inc., P.O. Box 399, One Sunwood Drive St. Cloud, Minnesota Date ReceiveA June 5, 1985 Ownership - Same as Submitter Scope - This examination is limited to the design of this particular project only insofar as the provisions of the Minnesota Plumbing Code, as amended, apply, and does not cover the water supply or sewerage system to which this plumbing system is connected. The examina- tion of plans is based upon the supposition that the data on which the design is based are correct, and that necessary legal authority has been obtained to construct the project. Tha responsibility for the design of strucEural features and the efficiency of equipment must be taken by the project designer. Approval is contingent upon satisfactory disposition of any requirements included with this report. Inspec[ions - Special care should be taken to insure that the material and installation of the plumbing system are in accordance with the provisions of the Minnesota Plumbing Code. It is necessary that the S[ate Health Department make roughing-in and final inspections of the plumbing system to determine whether it complies with the Code. Provisions should be made for applying an air test at the time of the roughing-in inspection as outlined in Minn. Rules p. 4715.2820 of the Code. In order to facilitate this work, there is attached a self-addressed card which should be returned, indicating the name of the plumbing contractor so that arrangements can be made for the State Health Department to be notified by him as to the time that the installation will be ready for test and inspections. No acceptance of the plumbing installation can be given until inspection and test of the roughing-in work (Minn. Rules p. 4715.2820, subp. 2), finished plumbing (Minn. Rules p. 4715.2820, subp. 3), and inspection of the completed installation by a representative of the State Health Depar[ment indicates compliance with the provisions of the Code. Requirements - Over Authorization for construction in accordance with the approved plans may be withdrawn if construction is not undertaken within a period of two years. The fact that plans have been approved does not necessarily mean that recommendations or requirements for change will not be made at some later time when changed conditions, additional information or advanced knowledge make improvements necessary. Approved: Milton R. Bellin? Public Health Engineer Section of Water Supply and Engineering (}?aLv.c.h. 1, . Patrick M. Simpkins Engineering Aide Section of Water Supply and Engineering 4 Requirements: 1. A statement that the plumbing system shall comply with the Minnesota Plumbing Code should be included in the specifications ( see Minn. Rules p. 4715.0320 and 4715.0330). 2. The disinfection process for the water supply piping system shall be for 24 houra. 3. Verify the second floor vents in riser 013) connect to the main vent. ^MI?^T?'?U??nM n V5?5?O// V Y 7?W(.Y_12OlJ ULYS 'V' • ONE SUNWOOD DRIVE • BOX 399 • ST. CLOUD, MINNESOTA 56302 • TEL. 61212528262 July 22, 1985 Dale Peterson City of Eagan 3795 Pilot Knob Road Eagan, MN 55121 RE: Woodridge 140 Apartments 3255 Coachman Road Eagan, MN Dear Mr. Peterson: This letter is to verify the phone conversation of July 18, 1985 with Steve Hanson regarding the handicapped units at the above named develop- ment. The three D1 accessible units meet all the requirements for handi- capped units with the exception of elevated water closet seat and grab bars at the W.C. and tub. If after the four B1 units are occupied and we have a request from handicapped person to rent one of the D1 units, we will install the elevated water closet seat and the required grab bars. If within a reasonable period of time, efforts to market these units to handicapped persons are unsuccessful, we will make them available to able bodied persons. Sincerely, BRUTGER OM WIL, Gor on Kath Project Coordinator GK/dm Blumentals0 ?hM?Wun on@ 6100 Summit Drive North • Brooklyn Center, Minnesota •(612) 571-5550 Janis Blumentals AIA President Stephen P. Hernick AIA Vice President Susan 8lumentals AIA Executive Vice President Cindy K. Bialon Corporate Secretary July 29, 1985 Mr. Dale Peterson Chief Building Inspector City of Eagan 3795 Pilot Knob Road Eagan, MN 55122 Dear Mr. Peterson; I am writing to confirm our telephone conversatlon on the morning of July 26, 1985, In which you gave your verbal approval to a substitution In a U.L. Floor Ceilfng Assembly (Design No. L528) for the Woodrfdge Apartment bulldings. As i understood it, you fndicated that furr(ng channels formed of 25 gauge primed steel and screwed into place could be subst(tuted for the furrfng channels outiined by the U.L.. We have indicated thfs to the general contractor for tha Woodridge Apartment proJect. If I have misunderstood your intent or if you have further questions please contact me at the above address. Thank you for your tlme and cooperatlon. Sincerely, Jeff Amerman JA/ab cc: Gordon Kath, ProJect Coordinator Brutger Companies, Inc. Roger Olson Brutger Companies, inc. 1 2 / 8 4 CITY OF EAGAN 114? APPLICATIO.I FOR PERMIT - -' SEPiER AND/OR WATER CONNECTIODi (PLEASE PRIH7) i} PPCp? ?DPZSS: ,uvu,???-3ass? (' WJ- 4 Z 4 S T. F 7?9 J ,2, o,, ? ,, `Ag r.Fr,I. Dy..?."?S??'?CV: (Lot/B1ock/St;:divisicn or Ta•t ?arcei I.D. ?L:,??) ? 'F .-`iIST=:G S'?'_.CC?'L':'v°. , D ;i=. Oz' CiZTGiP.i, `-_? =_•; -?_; pp°=7 -MT:C;/p?Or^CS=- ? R-1 S'l.?-.j-i.:. -- }i FPSLy ' ? R-2 EL:?... (7.<0 L„Z.S) ? R-3 YV+CF TV?..^ = L -?.-.-r.S) r?'„ ?_.?S) - 'IC;•.\a...._... (__...._._. ? P-4 ? CCi,na"._.vC_S./?EI'.'-uL?C=':??' o ?mr1'sT=-:.r. ? 7-,?Ts;'- -^rm ?.,?c,.,..-",,-?. Z) p7-a==;T (PLFSS? 'r:tr,r) DPt•:E: l-d-j o_ ACD.4ESS: CiT"!, S':AIM, ZIP: . PI:ONE : j) prz=--, PL`cASE PR1Vi) FOR CITY I15E ONLY NP.`fE: 0 ADD ? SS ? PLUHBEpS LIL;-,?iSE: . ?-- i v e ? CZT'_', .STATE, ZIP: /(9C ?ry y /j ? S/Q ? " ? Expire . PHOVE: 7 ???"r. ??5 229a PLUNBER LICENSE N_Z' OC?t f Hecard - arr :ni:ia yl CliU.HSf1'/U,??:t.iZ 1rL uae ercen7) wo'j r,?, AnnRESS: u'- CIT'?. STATE, ZIP: PFiO`IE : 5} INDZC:a"? ;?aiZCH PERh1IT IS BEID:G REQ[JESTID; [ET'CC.+:IECTICN 'In CITY SDiER 19?CO :':v'F'FCSICY 'Ib CITY SPA'I'Et Q-U iUR (PI.J-,'LE DF_SCRIBE) ,`] rrJ ?a., J F'c•? ??-` 6) L^1DIG,.... C:.:: • • EJ Pr-.r-.?SE EiOID APPP.WID PER`^.IT FOR PICK-UP BY C:IE CF AEM'E [Z °=-,SE 57lIL APP?K7VED PE-m.•LLT TJ 1. 2. (1,)4 '1SM-E P-2 ?-r???, (Circle one) DATE: O! ?! A ?1iP11s?a i? l? g?? aac?w rM s I?f+a? s?a +A ? f?s isa :s a/?[ r!?_a? r?f? f1 s rt ?e s??.? O R C I T Y U S E O N L Y PER"I'" " ISSUEO rrrs: $ ^^, '.:... $ {damc? pF'aulZT (I::C:.i;DE SuRC:iARG;) $ WA':'O:Z P9ETER/COPPE4HORN/OUTS TD : _ $ 'o+ATE3 TAP ( ZtiCLCDE CORPORATIQ-4 STOP ) $ 5::':?.R TA? $ AC^OuNT D;:PC`SIT - S•]ATrR $ ooo. ou W $ 5?5, dCO. JU St?C $ TRL'`iR [•IATER nS:ESS::°T $ T.°,;;:1K SE::E?Z yS-cE55:,iEJiT $ Ln. :?,nL Bc:vEcIT/m_?L'':IK ScS'= ' $ LA^.ERaL BLVEFIT/TpU:1K ;'IAT°:? $ WATER TREAT."1ENT PLL\T SURCHARGE $ QTHE R: $ TCm zL $ ?? P.. %+.CU::T °eIIJ;'RECEI?T D0E5 UTILITY CON:IEC TION REQUZP.E EXG,'JATION IN PUBLIC RIGHT OF Way? C YES IF YES, THE2S A"PER:IZT FOR PIOR?: WITHIN PUBLIC ROADWAY" MUST BE SSSUED BY THE ? NO ENGZNEERING DIVISION. LIST AS A CONDI- TION. SliEJEC: TO THE FOLLOS9ING CONDITZ0:4S: APPROVED BY: TI':Lc: ? DAT°: waww?m ? L? BL ? CITY USE ONLY RECEIPT#: O L 191 / 7 SUBD. RECEIPT DATE: 9/'?` /g/ 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 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 NQ. TOTAL Shower 3.00 x = Water Closet 3.00 x Bath i ub 3.00 x Lavatory 3.00 x Kitchen Sink 3.00 x 4f, 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 dwellings undet construction 5.00 x = Water Softener " for existing dwelling 20.00 x = U.G. Sprinkler ' for dwelling under oonst. 3.00 = U.G. Sprinkler 'forexistingdwelling " 20.00 = Altefations to existing residence 20.00 Water Turn Around 20.00 = Private Disposal System ' Dak Cty lic. 75.00 = (new and refurbished systems) Private Disposal Systems"auandonment 20.00 = STATE SURCHARGE .50 TOTAL no 2-9.jr I heraby adcnowledge that I have read thia applicatlon, state Mat the infortnation is cortect, end agree to comply wkh all applicable Ciry of Eagan ordinenoes. It is fhe applicanYS responsibllity to notity Ne properry owner that the Cky of Eagan assumes no liability for any damages wused by the City during its nortnal operetional and maintenance adivities to the fadlities construcMd under this pertnd wi[hin City property/right-of-way/easement. SITE ADDRESS: OWNER NAME: ui ? INSTALLER NAME: TELEPHONE #: STREET ADDRESS: ? ?- CITY: 044Z STATE: IU14V ZIP: SIGNATURE OF PERMITTEE CITY USE ONLY p? ,/ L? BL o2 RECEIPT#: OD'Y'OO SUBD. RECEIPT DATE: 9 Y- F7 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55722 (612) 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 EA NO. TOTAL Shower 3.00 x = Water Closet 3.00 x T yc? = ? Bath Tub 3.00 x Lavatory 3.00 x Kitchen Sink 3.00 x Laundry Tray 3.00 x = Hot Tub/5pa 3.00 x = Water Heater 3.00 x = Floor Drein 3.00 x = Gas Piping Outlet `minimum-t 3.00 x = Raugh Openings 1.50 x = Water 5oftener `for dwellings under construGion 5.00 x = Water Softener ' for existing dwelling 20.00 x = U.G.Sprinkler "furdweliingundarcansl. 3.00 = U.G. Sprinkler ' for existing dwelling 20.00 = ARerations " to existing residence 20.00 Water Turn Around 20.00 = Private Disposal System ' uak cry iic. 75.00 = (naw and refurbished systems) Private Disposal Systems'Abandonment 20.00 = STATE SURCHARGE .50 TOTAL ?. I hereby adcnowledge that I have read this applicatlon, state that the IMortnetion is correCt, end agree lo compty with all applicable Ciry of Eagan ordinances. It is the epplicanYs responsibility to notify the property owner that the Ciry of Eegan assumes no liability for any damages eaused by the City during its normal operetlonai and mainlenance activiifies to the faal'ities constructed under this pertnit within City proparty/right-of-way/easement. SITE ADDRESS: OWNER NAME: ? ? INSTALLER NAME: TELEPHONE #: 410'Y-3 0-.5`1?' STREETADDRESS: kV?x St. CITY: 0 ?UiP STATE: ? ZIP: C?Zz'?, (a-? SIGNATURE OF PERMITTEE oF 3830 PfLOT KNOB ROAD, P.O. BOX 21199 EAGAN, MINNESOTA 55121 PHONE: (612) 454$100 November 19, 1985 GORDON D KATH BRUTGER COMPANIES INC ONE SUNWOOD DRIVE P O BOX 399 ST. CLOUD MN 56302 Re: Waiver of Hearing - Special Assessment Authorization Lots 3& 4, Block 2, Fox Ridge Addition Dear Mr. Kath: BEA BLOM6IUIST PAayor THOMASEGAN JAMES A. SMITH JERRV THOMAS THEODORE WP.CHTER CounCN Members THOMAS HEOGES Cfty Admkilatfafor EUGENE VAN OVERBEKE CIN Clerk Enclosed are two (2) Waiver of Hearing, Special Assessment Authorizations for lots 3 and 4, block 2 of the Fox Ridge Addition. The City is requestinq that these Waiver of Hearings be siqned and xeturned to the City of Eagan in a timely manner. As we discussed last week, the City will require that the said Waiver of Hearings be signed and returned prior to the City provid- ing sanitary sewer and water service to lot 3 and 4, block 2 of the Fox Ridge Addition. If you have any questions, please contact me at 454-8100. Sincerely, EdwaKirsc t?T Engineering Technician EJK/jbd enclosures cc: Jerry Wobschall, Special Assessments Tom Colbert, Public Works Director THE LONE OAK TREE ..iHE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIiY i 't a . ? .? w ?r: "? ?' ; FiAIYF1t OF HYARIHG Special Asseasment Authorization I/We hereby request and authorize the City of Eagan, MN (Dakota Caunty) to assess the follow-ing-described property_oxned by.me/us: Fox Ridge_Addition.;_ Lot_4, B_lock__2 ) for the benefit received from the following improvements: ITIIi @IIANTZTY RATE 9MOIINT PROJE(.T Lateral Benefit 615.32 L.F. $14.35 $8,829.84 No. 8 from Sanitary Sewer TOTAL, $ 8. 8 2 9. 8 4 Any portion o£ the total amount of these special assessments may be paid without interest xithin thirty (30) days of the execution of the waiver or within thirty (30) days of plat approval if this waiver is part of the platting process. Payment on the nec+ assessment cannot be made at Dakota County during the current calendar year. The unpaid balance Kill be collected in 15 annual installments (principal and interest) on your future property tax statements. Annual installments will include interest at the rate of 10 % per year on the unpaid balance. The first year's installment on this balance appearing on the taa statement rill include interest from date of the waiver or date of final plat approval to December 31 of the following year. The undersigned, for themselves, their heirs; ezecutors, administrators auccessors and asaigna, hereby consent to the levy o£ these assessments, and further, hereby waive notice of any and all hearings aecessary, and waive objections to any technical defects in any proceedings related to these assessments, and further rraive the right to object to or appeal from these assessments made pursuant to this agreement. WOODRIDGE PROPERTIES LIMITED PARTNERSHIP, Dated: // /ZS 4S- BY: BRUTqER COMPANIES. INC. _ ?'. . ; State of Minnesota County of S t e a r n s On this 2 5 t h day of Notary Public ss. . Novembet' ? 1g85, before me, a ithin and for said County personally appeared WdllaCe T. JOhnson 8nd ______ to me personally known, who being eacfr by me duly sworn did say t: that k h e i 5py ey-are?res eet?.ve3 the ViCe - President -and- the- -- of Brutqer Companies, Inc. the corporation named in the foregoing instrument, and-tlsat?-the-seal-a€€i-xed -to-saifl_ir?stnume?k-is?l?e??epakasea??f=satdeo?+gepa?ioi? and that said instrument was signed and-aealed in behalf of said corporation by authority of its Board of Directors and said Vice President ---aerd------- acknowledged said instrument to be the free act and deed of said corporation. NO CORPORATE SEAL Notary Public Stearns County My commission expire MarCh 22 1990 sc+acv.w u.. 1 ROBERTA J. W. CANiP i? ? NOTMYpUeLiCoMIHNE907A Not .?y Public ? sr?wNS couNrY '- MYCGmmWionExpltqMer.22,t0ep ApPROVED: E gan Public Works irector Eng/Waiver Revised: 11/85 a>e m - " ])`? 66t4?- ? Vi ? •?f?lWw ? t?r 3 0 1? BLrc.2 Q ? ^ Q ?r ? ?P o?•?` ? ?'y , .. , i c.,i •°rsr GoPG 14 ? LLL?J ?i?EET- '- ?i,a? 'w?r .ii{.65 rY \ a a ? X t o ? Q , w 2 O e L.r m ? ? BLK. I 47 e ? tla h1 ?eflWV ?o?ao k m ' x ? -t u?T ? Q ? .:.?:;.• y z ..., .. m - f . ? . ?ro<.. ?.,?oo'•u`_. J' n?`?. ? ?yo? ?. ? munt r i? i'•'L 1• f ?? ?• 1• •q])??I? _ •!tt^M1 , 4tii. eeeo rur rp? o[TAIU . S g?•SI'E 566 v • .?WL. q IY00 O9 19N0 $ 1f6pp ' 8 ? tl 2 ' f? 3 !ir•I0'?. N 00 . z, b LATERAL BENEFII' FROM . m SANITARY SEWER a 3 H O a , , ,Y 0 ? OII•52 ?"CEN Y,c ' ` ^= T? y? FC ? I MAR6. M. • 4 ? I O?& 2.R: e• ??.A? sraaryC ?T? • 2 ?; ; ? ,;, ozo-n , n ApW iu. 1 - 'sm o. • / '? ?a ?0 1?.u / ?Ic. , a .onu.???u?suacowtiar- • / .,.r ? November 219 1972 Dskota Cauntq Anditor xaetings, mN 55033 ittentios?: Porms Dear Noanss Fncloaed find the aseeeament aplit for paroel 3108-A vhiah hae now bwn platted i.nto Foz Rid Addition. The folloniing changee aeed to Ds mede now that the pyWat hae baen rmwu : PARCEL 3108-B, all the easeesmente ehould nv+r be po? to LOt 2 B3?k 3, F°z R1 un A?tien PARCEL 3108-C, sll the aeeesements n ehonld now De poeted to Lot 3, Elook 20 Fox Aidga Addition PARCEL 3108-D, All the sseeeamente ezoept the Water Latessl in the amount ot f8554•10 ahould now be poeted to Lot 4, Hlook 29 Fo: gidae Additiaal PABCEL 3108-D, The Watsr Latesal saeesement in Lhe original amount of $8554.10 ehould now be poeSed to Lot 1 Blook ;, Foa Ridge Additioa Call me 1f you need additional infoxmtion. sPEcIkL assESSPMr n"asxrW enn aoesa (rire. ) Aeaeeement Clerk .3? ' 1?citVoFcagan /`1w, .7'? 40 THOMASEGAN Moyor Zoning, Comprehensive Plan and Flood Zone Designatior(EARBLOMQUSOA Confirmation Letter SANDRA A. MASIN THEODORE WACHTER Counal Members SubjeCt p rHOnnas HEDGEs Property ? Z s? OIA!'?/V) AN R Oi4? Ciry Administrctor c? 16' Z 7500 - O?/O ? O Z E. J VAN OVERBEKE `?S ? 4*- /0-? 7 Coo - (Sy0 -0 7 arv aerk name ZZp So. 2,vn S, . Mor.s. ^N SS?o/ street address city state zip The subject property is zoned ?- Ll -(V1U L-n PL E Comrehensive Guide Plan Designation O-lV - MkxE.D R,ESJdEAvr)AL- FLOOD INSURANCE RATE MAP Property appears to be in zone Shown on map panel # Z 7o i 0-7t0oo i -? Date of Map R- 11 - '? ?< Source: Flood Insurance Program - U.S. Department of Housing 8 Urban Development Federal Insurance Admirtstration. ate /- Z- 47 MUNICIPAI CENTER THE LONE OAK TREE MAINTENANCE FACILITY 3830 cttOT KNOB ROAD THE SVMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIN 3501 COAC.iMaN POINT EAGAN, MINNESOiA '5122-1897 EAGAN, MINNESOiA 55122 PHONE (612) c81-4600 PHONE (612) 681-4300 FAX (013; 681-4612 EqUal OppoftUnlty/AffIlmOflv2 ACiiOn Employef FAX (612) 681-J360 TDD (o12)d548535 rDD (612)454-8535 L 4 b Z Fox ?-toUG Awt4. Blumentals0 ?r?,M@@Nn oIN@ 6100 5ummit Drive North • Brooklyn Center, Minnesota •(612) 571-5550 Janis Blumentals AIA President Stephen P. HemiCk AIA Vice President Susan Blumentals AIA Executive Vice President Cindy K. Bialon Corporate Sec etary 6) August 15, 1985 ? Mr, Dale Peterson City ot Eagan 3795 Pilot Knob Road P.O. Box 21199 Eagan, MN 55121 RE: Woodrldge Apartments Eagan, Minnesota Dear Mr. Peterson: Please find enclosed one copy of "Detail of Roof Decking and Gypsum Board", Sheet No. 1/A9a. Approval of the detaSl was discussed with Mr. Steve Hansen over the telephone on Wednesday, August 14, 1985. This detai I 1s betng submitted to you for fi I ing wlth the above mentioned project. If you have any further comments regarding tha deta(t, please feel free to contact our firm. Thank you. Very Truly Yours, 12• a&1- R. Aflen Hoglund RAH/cb Enc: Detail CC: Brutger Companies, Inc. siN? ?l!,;e- IS't' FEE LT '/Z" fpL'CWOOp D?GK-It?l? 5/a r-Irm covp, UYmuM E!70aF-nn 5! o" MIN. oU7 rRoM 2Hz. FIr-EWALL. Ix2 Wov{7 GLEA."fSI NAIL612 ?laa. G• Wonp TIZUSS C= V-OI, D.L. DETAIL AT ROOF DECKING & c-GAL? 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T.EE. .Z4.?' ?'L.Qs3 ?ep //F.2T/f.QG. 1 ,.. ... ... ..... ...... .. , SHURAIL SUPPLY INC. 9124 GRAND AVENUE SOtJTH MINNEMOL73, MINNESOTA 55420 (s,z)ewNIIIIs aAVAZ97 'Vs.t.. ?,',p.CGlliC?2TlOiV3 4¢,P $.A6'.'Z'A DU i4.e.2.QwJ6??cs.Et?T o,C ?'QV?,aMF.?JJ?? Z? ,7J/.?l,6.tJ6/DU S .C/ST.ED &N ;;?i4.E- /tb. 2 . Y.9?2/BT70AJ5 iAl D,E6icA.) Cou.O_a r.?.rECr ?i,z?vG. ? , 68441'- ear:?t uo CcDuc_-naa ? OF CHUrE PLLOWE' e;)?- w r- P?a. 3-2.c.G :AP I- d- 15 2 Forc '?t oE15- 1ENT %I.A5P IN(o ?tOop ?PawKL?EP- 9%Ab @- 3RP FI.R. 5-0'('(OM LIIFJGED fW 5o Ooof- cEadrE quoPoats , GiFiGON D FLOO? .Jo I 5'f 5 e7o'f?fOM UIWaLP FwtiN ooo?. G H J'(f? '! 0 m0fz"tS FIRSr {?'l.vo(L - _ rtKtflVB LtNK nl>G HAR 6E 170012, ? TRASH CHUTE DETAIL IJ•T-S. Blumentals0 PIP"ECT °"TE Amhftc.wga ?(?t7'?I?E ? 1?• ?•8S ?ELrT ?! (? SING? 1??5 IGi#' F?L.T '/2ll Pi-ywoov DeLKfNel W, r-IIes GoOp. GYmuM e-'oAw 5=0" MIN, ouT F2oM 2HK. IX2 W009 GLEA?Sj NA)LEI7? lao. G. Wootg ?T2lJSS F; Z DETAIL AT ROOF DECKING & GYPSIJM BOARD SGALF- 3" = I'-ou CLARIFICATION TO DETAIL '1 /A9 Blumentals4 PpaECT OATE ETa?-r,?,,??,???m WOODRIDGE APARTMENTS A 9a EAGAN, MINNESOTA 117; • ? ?[-^?!????? t",?II'7• ONE SUNWOOD DRIVE • BOX 399 • ST. CLOUD, MINNESOTA 56302 • TEL. 6121252E262 July 31, 1986 PHA Rental Offioe 450 N. Syndicate Suite 1000 St. Paul, Minnesota 55104 ATPN: Eric Paul Sallmeli City of Faqan 3830 Pilot Knob Rcad Eagan, Piinnesota 55121 Midlanl Financial Savings & Loan Associaticn 606 P7alnut Street DeS Moines. Iowa 50307 RE: [+'oodridge Properties Ismited Partnership FAr;nV, t•7N Gentlemen: Pursuant to Section 30)(f) of the Declaration of Restrictive Covenants dated May 1, 1985, enclosed is the Certificate of Continuing Canpliance dated July 31, 1986 for the referenced developnent. As of the date of the enclosed Certificate, the Project is substantially ccmpleted arxl in the final rent up phase. Z4ie infornatgon provided is Lased on 188 leases sic,ned (94;); the peroen}age of lowPi and moderate income tenants is therefore 77, of signed leases. The attached tenant list shows units occuPled by qualified tenants as of July 1986. 7Fwenty units are held for occtqaancY 1y (Prelessed ta) 9uaiified tenants. Suhn.itted By: Woodrldge I'roperties Limited Partnershi,P, Srut9ex Companies, Inc., General Partner E"t, (- & &I BY: oberta Camp I75: Develognent Coordinator AttaChmnt CERTIFICATIQd CF COIJlIN[)IIVG (TT1Pf.TA11YR The undersigned, Wallace T. Johnson of Brutger Canpanies, Inc., the general partrier of Woodridge Properties Limited Partriership (the "Declarant") being the present avner of the real property described in the Declaration identified belaw, hereby certify as follows: 1. The undersigned have read and are familiar with the provisions of the Declaraticn of Restrictive Covenants dated as of May 1, 1985 (the "Declaration") entered into by Woodridge Properties Limited Partnership, and duly reaonded in the appropriate public xeal estate records in and for Dalcota County, Minnesota cn May 9, 1985 as Document No. 686791. 2. With respect to Sections 2 arxl 3 of the Declaration, all of the mvenants and restrictions expressed in Sections 2 and 3(1) therein have been fully anrl faithfully observed and ppsformed at all times durirx3 the 12 month perio3 prececling the date of this Certificate. 3. With respect to Sections 4 and 5 of the Declaration, all the oovenants and restrictions expressed i.n said Sections 4 and 5 have been iully and faithfully observed and performd at all times durinq the 12 month period preceding the date of this C.ertificate. 4. (a) 68 oanpleted xesidential imits in the Developnent which oonstitute 34 % of all residential imits in the Developnent, were occupied by persons or families who qualify as Iawer-Inccme Tenants or were held vacant and reserved for occupancy by L,owps-Inoame Tenants. (b) 145 ampleted residential Lmits in the Develognent which constitute 73 `k of all residential units in the Development, wpse occupied by persons or families who qualify as Mbderate Income Tenants (including Lowex Incane 'Ienants), ar were held vacant and available for occupancy by persons or families who qualify as b'bderate or Lower Incane Tenants. (c) Attached as Srhedule I is a list, 31y imit rnmibers and tenant names (if the unit is occupied) of all units enumerated in p3ragraphs (a) through (b), inclusive, above. 5. The Declarant is rnt in default imder any of its dbligations under the Declaration except as set forth on Schedule II, if any, attached hereto. 6. Wards acxi phrases used in this oertification shall have the sama meanings herein as in the Declaraticn. WOODRIDGE PROPERTIES LIIMITID PARTIURSfiIP BRiTiGQ2 QOMPANIES, INC., General Partnex' BY: i\J?i? ? V\ _ tvallace T. Joh I'I5: Vice Px+esident DATID: Julv 31. 1986 woo?? APARTMERrs Buildu?g 3255 [hut # 101 102 103 104 105 107 109 111 113 114 115 116 117 120 122 123 126 127 129 130 131 132 133 134 135 136 137 138 141 143 144 145 147 I.ow 7noa[oe Moderate Inoaoe TAN+se Vandenberg/Brown/ Harkinc Yhdson Sc3iumacher Hcsriung ViCk, C. Paoli Teaford Vick, P7. Stanich Brice Shy3er Hanson RolcPlt Tereshkav/Mask Rabests/Nish Miller, T. Harley Segal DSoore Walton Flanson/DOan Qorson Witt Boddy Doane/Hennessy 'IYnreson Richter Gln-inirgham Nfeyer/Etain9 Karkawsky CYowley ElWOOCl/T.^7eSt Horn X 4/01/86 X 2/01/86 X 3/15/86 X 6/01/86 X 4/01/86 X 4/01/86 X 4/01/86 X 3/01/86 X 4/01/86 X 6/01/86 X 4/01/86 X 5/01/86 X 4/01/86 X 6/01 /86 X 4/01/86 X 7/01/86 X 6/01/86 X 4/01/86 X 5/01/86 X 5/01/86 X 5/01/86 X 7/01/86 X 5/01/86 X 6/01/86 X 5/01/86 X 6/01/86 X 6/01/86 X 6/01/86 X 7/01/86 X 6/01/86 X 5/01/86 X 7/Oif 86 X 6/01/86 201 202 203 204 205 206 207 208 209 210 211 212 213 214 Zbnneson VanZindesen Stockwell Carlson, K. Cole Dolan/Kelliher/werdal Carlson, B. ?bdahl Huffman LVirth Balza Gibbons Monson X 7/01/86 X 7/01/86 X 4/01/86 X 4/01/86 X 4/01/86 X 6/01/86 X 4/01/86 X 7/01/86 X 5/01/86 X 3/01/86 X 3/01/86 X 7/01/86 X 3/01/86 X 6/01/86 crnit rrame Low Inoaoe Moderate Inoaoe r.ease nate 215 Johnke X 5/01/86 216 Iltis X 5/01/86 217 Pearson X 3/01/86 219 r131echa/Knutson X 4/01/86 220 Springer X 5/01/86 223 Michau3 X 5/01/86 225 Wallindes X 5/01/86 226 Richardson X 6/07/86 227 Chelstran X 3/01/86 229 Iianel X 5/01 /86 232 Phelps X 6/01/86 234 Erickson/EYikson X 7/01/86 235 Angen X 6/01/86 238 Ballard/TaYlor X 6/01/86 239 tiilson/Kharsand/Ziton X 6/01/86 241 Zorack X 6/01/86 242 Zanpa/Burger X 6/01/86 245 Van Daren X 6/01/86 247 P7ukite X 5/01/86 300 Mrachek X 6/01/86 301 Grishan/Richwire X 5/01/86 302 Obermann/Fieber X 7/01/86 303 Rote X 3/01/86 304 Garchier/Tate X 5/01/86 305 Balder X 5/01/86 306 Dougher X 4/01/86 308 Quandt X 5/01/86 309 Nbinar X 3/01/86 310 Lenertz X 7/01/86 311 Trainor/I-axmon X 5/01 /86 312 Sinith. L. X 6/01/86 313 Jaoobson X 4/01/86 314 Johnson, J. X 7/01/86 316 Pearson X 4J01/86 325 DeLisi X 5/01/86 326 Paris X 7/07/86 327 Eggleston/Skov X 5/01 /86 328 Miller X 5/01/86 329 Terrell X 5/01/86 331 Kobs/Fox :C 5/01/86 332 Pachuta X 7/01/86 333 Robichau3 X 5/01/86 335 Bellush X 5/01/86 338 Pierce X 6/01/86 339 Nolt/Ebest/Megli X 5/01/86 341 Canpbell X 5/01/86 342 Swoboda X 5/01/86 343 Pfeiffes X 5/01/86 347 Kjolhaug X 6/01/86 woorRmGE APARMENTS BOIIDING 3301 Unit # Nane Iaw 7nootne Moderate Inc+m Lease Date 101 Schrader X 6/01/86 102 Kersten/Kersten X 6/01/86 103 Dalltun X 7/01/36 104 Stenhjen/Rose % 7/01/86 107 McGhllough/Tag/Webber X 6/01/86 108 Albright/Schanck X 7/01/86 110 Halsrud X 7/01/86 113 Robinson/Pfeiffer X 7/01/86 114 Wekab X 7/01 /86 115 Geier X 6/01/86 119 Filkaaski X 7/01/86 121 Sivakumaran X 7/01/86 202 Oniskin/Kalb X 6/01/86 206 Jenkins X 6/01/86 208 westby/Zinener X 6/01/86 210 t4arketon/Christenson X 7/01/86 213 Noonan X 7/01/86 214 Erickson/Ackenaold X 7/01/86 215 Rupiper X 7/01/86 217 Muellerleile/Lbe X 7/01/86 223 Lueck X 7/01/86 302 Berrler/Hunnewell X 6/01 /86 303 Walters/Vicent X 7/01/86 307 Chapplelmenz X 7/01/86 308 Barriuso X 7/01/86 313 Sielaff X 6/01/86 314 Dcnofrio X 7/01 /86 317 Mrshall/Marshall X 7/01/86 319 Lane X 7/01 /86 !SlYSI'.?• ONE SUNWOOD DRIVE • 80X 399 • ST. CLOUD, MINNESOTA 56302 • TEL. 6121252-6262 i ! April 18, 1906 t•destinghouse Llevator Canpany Attn: Cliff Thompson 3501 South Highi-ray 100 n'.inneapolis, tdN 55416 RE: Woodridge Apartments - Phase II Eagan, Minnes;,ta Gentlemen: The local fire depart^ient is reauiring that you furnish a lock cylimayr ior t'ie key cox in li'ie front vestibzle tnat is keyed to -ri•Z•17802. Please order accordingly, if you should have any Suestions, please contact our office. Sincerely, BRUT= QJ,•IPIti - . INC. / 3ynn Christiansen C«mtruction Quality Controller LC/ms oc: Gordm Kath Jerr'l Theisen i i ? Y D D 0 ? ' UL4.Sl'7• ONE SUNWOOD ORIVE • BOX 399 • ST. CLOUD, MINNESOTA 56302 • TEL. 612/252E262 April 13, 1986 i-:inn-Da};ota Elevator Ccmpany, Inc. Attn: 'Itn IIranham 2325 Endicntt Street St. Paul, t•V 55114 RE: Vloodridge Aparts;ents - Phase I Fagan, 6linnesota Gentlenen: The local fire deasrte nt is requiring that you furnish a lock cylinder for the key box in the front vestibule that is keyed to timg17802. Please be sure that tl:e chanqe is r.ade as soon as possible. If you should have any ques- tions, please contact our office. Sincerely, I3P, 02"•,P . ? ?1C. Lynn Christiansen Construction Cuality Controller LC/ms cc: Gordcn Kath Ellie Schreifels 5 Z ox Ki D??r=- w? D?U???(?M ?JOf Y l?g[ Y N lw iSiYSV" • ONE SUNWOOD DRIVE • BOX 399 • ST. CLOUD, MINNESOTA 56302 • TEL. 61212528262 August 1, 1987 Public Housing Agency Rental Office ATTN: Ms. Terri Gindorff 450 N. Syndicate Suite 1000 St. Paul, Minnesota 55104 City of Eagan 3830 Pilot Knob Road Eagan, Minnesota 55121 Midland Financial Savings & Loan Association ATTN: Linda Beaver 606 Walnut Street Des Moines, Iowa 50307 RE: [Joodridge Properties Limited Partnership EAGAN, MN Pursuant to Section 3(1)(f) of the Declaration of Restrictive Covenants dated May 1, 1985, enclosed are Certificates of Continuing Compliance dated June 14, 1987 and August 1, 1987 for the referenced development. On June 14, 1987 the 140 unit building of Woodridge Apartments sustained a major fire which destroyed a substantial portion of the building and rendered the entire building uninhabitable. The building is being reconstructed, and we anticipate that it will be five or six months before a certificate of occupancy can be obtained. Therefore, at the present time there are only 60 units available for occupancy. These units are located in the second building which was not involved in the fire. The enclosed Certificate dated June 14, 1987 indicates continuing compliance for the period May 1, 1987 through .Tune 14, 1987 for the total 200 units which were available for occupancy during that period. The Certificate dated August 1, 1987 shows that the project has been in continuing program compliance from June 15, 1987 through the present, based on 60 units that are available for occupancy. Any questions regarding the enclosed Certificates should be directed to the undersigned. Submitted By: ldoodridge Properties Limited Partnership, Bru ge Companies, Inc., General Partner BY: Roberta Plafcan I'I5: Development Coordinator Attachment _ L L?, 6 2, Fo? R,dqe, oF 3830 PILOT KNOB ROAD. P O BOX 21199 EAGAN, MINNESOiA 55121 PHONE: (612) 454-8100 April 7, 1988 BRUTGER COMPANIES 1 SUNWOOD DR., P.O. BOX 399 ST CLOUD, MN 56302 ATTENTION: GORDON KATH RE: 3255 COACHMAN ROAD Dear Mr. Kath: VIC ELLISON Mwor 7HOMAS EGAN DAVID K GUSTAFSON PAMEIA McCREA THEODORE WACHTER CounalMembers THOMAS HEDGES CMMminufmtor EUGENE VAN OVERBEKE CiryCie? This letter is a follow up with regards to the conversation between Building Inspector, William Bruestle and your superintendent. Referencing the 24 hour monitoring of sprinkler systems, Sect. 10.310 of the Uniform Fire Code, 1982 Edition, states as follows: When serving more than 100 sprinklers, automatic sprinkler systems shall be supervised by an approved central, proprietary or remote station service or a 1oca1 alarm whicn will given an audible signal at a constantly attended location. The City of Eagan and the Eagan F3re Department strongly request that when you have your sprinkler system monitoried, you also tie in your fire alarm system. If you have any questions, please feel free to call me at 612/454-8100. Sincerely, ?Bcc01_ ?? U Doug Reid Chief Building Official DR/,js CC: Dale Wegleitner - Fire Department THE LONE OAK TREE. ..iHE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNITY CITY OF EAGAN REQUEST FOR REVIEW OF PUBLIC RECORDS I/We, the undersigned, are requesting permission to review the following public records held in the City of Eagan: NAME?/.rf/Tf??.P,.l/l/F` ADDRESS__?Y TEI.EPHONE N0. RE°RESENTING , PUBLIC RECORD (specify) RHA50N FOR REVIEWING PUBLIC RECORD _lUIPAV?C INFOR^1ATI0*1 WILL BE USED IN THE FOLLOIWINC MATTER_ ? . Signatu^e ° Approved:?//???,??? C(/G? C1-try Clerk Date • ? , _ .23 /98-7 7-"- /- 7' tj X , a? T le-04? OF 3830 PILOT KNOB ROAD, P.O BOX 21199 EAGAN. MINNESOTA 55121 PHONE (612) 454-8100 June 18, 1987 MR GORDON KATH BRUTGER COMPANY 1 SUNWOOD DR P.O. BOX 349 ST CLOUD, MN 56302 RE: WOODRIDGE APARTMENTS 3255 COACHMAN ROAD EAG9N, MN 55721 Dear Gordon: BFA BLOM9UISi Moyor iHOMAS EGAN JAMESA $MITH VIC ELLISON 7HEODORE WACHiER CouncilMembers THOMPS HEDGES CM °dminisfrolor EUGENE VAN OVERBEKE CIN Clek In reference to our conversation of Monday, June 15, the City of Eagan considers the total building at 3255 Coaehman Road uninhabitable at this time. Sincerely, ?-c?-- Doug Reid ? Chief BuildinB Official/Fire Marshall DA/js . THE LONE OAK TREE.. THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY MEMO TO: DALE PETERSON, CHIEF BUILDING OFFICIAL FROM: RICHARD M HEFTI, ASSISTANT CITY ENGINEER DATE: JULY 7, 1986 SUBJECT: WOODR GE APARTMENTS LOTS 3?)& 4, BLOCR 2, FOX RIDGE ADDITION The developer/owner of the Woodridge Apartment complex (Brutger Company) has submitted an acceptable bond in the amount of $15,000 to cover the necessary storm sewer improvements for this property. We have completed a preliminary design of the storm sewer improve- ments and will be working closely with Brutger Company to get it built. If I can be of any assistance to you regarding this matter, please let me know. -, Assistant City Engineer RMY,/j j cc: Gordon Kath, Brutger Company Ed Kirscht citV oF 3830 PIlOT KNOB ROAD, P,O BOX 21199 EAGAN, MINNESOTA 55121 PHONE (612) 454-8700 April 2, 7986 BRUTGER CO INC 1 SUNWOOD DR P.O. BOX 399 ST CLOUD, MN 56302 0 ^a N ?C0 ?v ? L-t ATTENTION: GORDON KATH RS: INSPECfIONS.OF WOODBIDGE_APT_CO1!PLE% - SAGANg M9 Dear Mr. Rath: BEA 8LOM9UIST M? nior,v.s eGw .AAMES A SMIfH VIC ELLISON 7HEODORE WACHIER Courcil Mambers n+omvs HEOCes Ory naminirrrna, EUGENE UAN OVERBEKE Ctty Clenc Due to the workload and size of our inspection staff, we vill be unable to make any type of inspections of the referenced buildings on Mondays or Fridays. Mondays and Fridays must be reserved for single family dxelling inspections. This emergency policy is effeetive immediately to you and your subeontractors. Thank-you for your cooperation. Sincerely, Chief Building Official DP/3s cc: Doug Reid, Asst. Building Official Jan Severson, Secretary 1 7 , y 7 THE IONE OAK TREE ..THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIiY oF 3830 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN. MINNESOTA 55121 PHONE (672) 454-8700 November 20, 1985 MR MARK BROWN GENZ-RYAN PLBG & HTG CO 14745 50 ROBERT TR ROSEMOUNT, MN 55068 ?uL f ?,nGn ? ?f g -2- RE: DUCT PENETRATIONS - WOODRIDGE APTS COMPLEX Dear Mark: BEA BLOM9UIST Maya THOMASEGAN JAMES A SMITH JERRY THOMAS THEODORE WACHTER CouncY MamOers THOMAS HEDGE$ Qry Admurstmtar EUGENE VAN OVERBEKE Ciry Clelk The answer to your inquiry as to whether firestopping material between floors could be minetal wood is, "Yes, provided that the vents or piping are non- combustible materials:" Combustible piping should be enelosed in a one-hour fire resistive shaft. Sincerely, ti 44 le Peterson Chief Building Official DP/js k THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNITY L 4 r) 2 Fax ( i P?-l C mUffTRt9.5 @{?T(?R?gMz?? 974.SV" • ONE SUNWOOD DRIVE • BOX 399 • ST. CLOUD, MINNESOTA 56302 • TEL. 6121252E262 November 11, 1985 Mr. Dale Peterson Citv Of Eagan 3830 Pilot Knob Road Eagan, MN 55122 RE: Woodridge Apartments 3255 Coachman Road Eagan, MN Dear Mr. Peterson: Enclosed please find copies of the test report that indicates the GPFS-XXX 5/8" thick gypboard is approved for use in ceiling design L513. As approved by you on November 5, 1985, we will be using this gypsum wallboard on the ceiling of the first floor and the second floor only. At the third floor ceiling, two (2) layers of 5/8" type X gypboard will be used as shown on the plans. 5incerely, BRUTG ? M Gordon Kath Project Coordinator GK/rtk Enclosure cc: Syl \\ ? •. 1,ntsuItn'1u1i1L5 1Nt;: "? w r•nncsu.r: MnAn noenmxfwi,.iLnMns anuct t ait urdcpcitdcrl(, noI-for-profit orga»izalion teslilig F1a?.. 261 1982 JUN 1 1982 • Georgia-Pacific Corp. , 14030 S:W. 72nd Ave. • Tigard, OR 97223 • . , Attention: Mr. C. W. Lehnert Flanager, Product Development .and Technical Service safecy Subject: Use Of 5/8 In. Thick Type GPFS-3 Gypsum Wallboard •In Design No. U911 Dear P1r. Lehnert: This letter is in response to yours of May 21, 1982, to our Pir. B. Swytnyk,'regarding the above subject, . We have conducted an..encjineering study, and have determined that the subject wallboard is eligible foz Classification in Design No. U411. Design Ncr_ U411, Classification Card R2717, and the appropriate section of Follow-Up Service Procedure File R2717 have been revised accordingly. You should receive your copies of the revised items in about three to four weeks'time. Very truly yours, -• vCJw l7 94? . GERALD D. pALIKIJ Senior Engineering Assistant Fire Protection Department Reviewed 'uy: ?. B. SWYTNYK Engineering Group Leader Fire Protection Department GDP:bg i I? I , ? i -- I . - •? Look For The (E) Listing o? Classificalian Mark On The Product ? t? If121 iriala0 T.?. 73+as! [.uc y??wC Mv?a..? l , ipany memo 3EE.BELOW - jm 0. E. Burch 1 . i.i i :ctj_ci C.P. Type XXX vs, U.S.C. Type C localion , localion p[lanta (21) dale September 27. 1982 Recently we commiseioned Underwriters Laboratories to conduct an Engineering Study to determine if C.P. Type X]CR could be successfully substituted for U.S.G. Type C in Underwriters Design No. U411. Design U411 was originally approved using U.S.G. 5f8" Type C vallboard on 2?"or3 5/8" steel studs spaced 24" o.c. : ' . On Hay 26, 1982 Underwriters responded as follovs: "We (U.L.) have conducted an engineering $tudy. and have determined that the subject vallboard (G.P. Firestop Type )XX) ie ellgible for classiEl- cation in Design No. U411. Design No. U411 Classification Card R 2717, and the appropriate sectinn of Follow-Up Service Procedure File R 2717 have been revised accordingly". Additionally, both G.P. Type lIXX and U.S.G. Type C have been approved for uae in Underwriters Floor and Ceiling Design L513. Mother indication that the tao products perform as equals. ' . Based upon the above, it ie oux conclusion that sufficient evidence eaiets to conclude that G.P. Firestop Type R]CR can be suCeessfully substituted for U.S.C. Firecode Sype C, and that similar fire resistive properties could be expected. Please bear in mind, however, that the final authority on bcand substitutions lies vith the architect on the iob. and the local 6uildin¢ code official. A copy of Underwriters lelter of 5/26/82 is attached for your use. OEB:afg, 1 Enclosure T0: J. S. Ver Nooy E.?C. Galloway J. E. Tierney • J. R. Van Dyke D. N. McCuhbin N. D. Brooks - L. N. Kaboos - D. R. Mac Farl, - Ransas Citq - Atlanta Regional - Buchanan - Grand Rapids (CYP) - Chicago N. Regional Dallas Regional Oakland Regional ind - Wilmington, DE CONTINUED ON NE7CT YACE ,,...11 0. B. ..M?. .? 1 b0r;,11„ii • E ' MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT OF PLANS Plans and specifications on Plumbing for Woodridge Apartments Location Eagan, Minnesota Date Examined October 16, 1985 Prepared and submitted by Brutger Companies, Incorporated, One Sunwood Drive, Box 309, St. Cloud, Minnesota 50302 Date Received October 10, 1985 Ownership - Scope - This examination is limited to the design of this particular project only insofar as the provisions of the Minnesota Plumbing Code, as amended, apply, and does not cover the water supply or sewerage system to which this plumbing system is connected. The examina- tion of plans is based upon the supposition that the data on which the design is based are correct, and that necessary legal authority has been obtained to construct the projec[. The responsibility for the design of strucCUral features and the efficiency of equipment must be taken by the project designer. Approval is contingent upon satisfactory disposition of any requiremen[s included with this report. Inspectiona - Special care should be taken to insure that the material and installation of [he plumbing system are in accordance with the provisions of the Minnesota Plum6ing Code. It is necessary that the State Hea1[h Department make roughing-in and final inspections of the plumbing system to determine whe[her it complies with the Code. Provisions should be made for applying an air test at [he time of Che roughing-in inspection as outlined in Minn. Rules p. 4715.2820 of the Code. In order to facilitate this work, there is a[tached a self-addressed card which should be returned, indicating the name of the plumbing contractor so that arrangements can be made for the State Health Department to be notified by him as to the time that the installation wi11 be ready for test and inspections. No acceptance of the plumbing installation can be given until inspection and test of the roughing-in work (Minn. Rules p. 4715.2820, subp. 2), finished plumbing (Minn. Rules p. 4715.2820, subp. 3), and inspection of the completed installation by a representative of the State Health Depar[ment indicates compliance with the provisions of the Code. Requirements - (OVER) Authorization for construction in accordance with the approved plans may be withdrawn if construction is not undertaken within a period of two years. The fact that pLans have bezn approved does not necessarily mean that recommendations or reqvirements for change will not be made at some later time when changed conditions, addi[ional information or advanced knowledge make improvements necessary. Approved: Milton R. Bellin, P.E. Public Health Engineer Section of Water Supply and Engineering A'?w eom Brian A. Noma Engineering Aide Section of Water Supply and Engineering 4 Requirements: l. Verif)r that cleanouts be provided at the base of all stacks. Waste Riser P12 shall be included. 2. Verify the provision that cleanouts be provided at 100 foot intervals :or waste line 4 inches and larger. The 5-inch waste line shown on page M2 shall be i_nr.llidP3. 3. Veriflj that the saninary sewer and water service pipe for outside utilities meet the standards of the Minnesota Plumbing Code. 4. Verif)r the provision that the Type "M" water pipe shall not be laid underground or embedded in masonry or concrete. 5. Verify the provision that the sterilization of the water pipe shall last at least 24 hours. 6. Verify that the plastic pipe is installed in accordance with Minnesota Plumbing Code. 7. Verify that WC-2 water closet has an open-front seat. 8. Verify that the bathtubs on Riser P4 are vented in accordance with the Minnesota Plumbing Code. 10. Use of 50-50 solder or fliix containing lead is now prohibited by State law on potable water distribution systems. Solder containing less than .2 percent lead must be used (Section 326.371). ? . .. 15.? z ? ? ?q. A??"" F Northern States Power Company Red Rock Division 3000 Maxwell Avenue Newport, Minnesota 55055 Telephone (672) 459-5580 Date: 10-21-85 Project No. EACC COA EAC APPLICATION OF THE NORTHERN STATES POWER COMPANY To: City of Eagan 3795 Pilot Knob Rd EagaJJ, Mn 55122 Agplication-is. herbymade for.permission to place,_construct and therefore inaintain: I. Type of Utility'- General Description: Install UG primary on Coachman Rd to sexve a new apartment building 3301 Coachman Rd - --- ' II. Work to be started 11-11-85 and completed by 11-15-85 Application approved: Application submitted by: NORTHERN STATES POWER COMPANY By: Date: Ron Johnson Customer Service Representative 3000 Maxwell Avenue Newport, bIN 55055 f NoRhern States Power Campany Red Rock Oivislon 3000 Maxwell Avenue Newport, Minnesota 55055 Telephone (612) 459-5580 Date: 10-21-85 Project No. EACC COA EAC APPLICATION OF THE NORTHERN STATES POWER COMPANY To: City of Eaqan 3795 Pilot Knob Rd Eaga)4, Mn 55122 Application.is herby_ made for. permission to place, construct and therefore maintain: I. Type of Utility'- General Description: Install UG primary on Coachman Rd to serve a new apartment building 3301 Coachman Rd ?-?OGuxrr,7F? ?/?l'S . I2. Work to be started 11-11-85 and-completed by 11-15-85 ApplicatiOn approved: Application submitted by: Sy:- NORTHERN STATES POWER COMPANY Date: /v?'3 ??rf Ron Johnson Customer Service Representative 3000 Maxwell Avenue Newport, hIN 55055 t?/aoc?.GrOCeE A?i' l00 c1wJs-! ?•Z A?as? a . 1,?/1-/ALL //.Z ?t?i/.4 /3 doo !/. ?Zml?'? ro ? co.?C .eErE ?? ? C-S - ?'LnS ? ??_ ? F Q c•c.? .G . . I /HNt?? vOOdit iPJ 1 ? I • f I ?j ? I • . C ?A? lE!a.r? I ? ? c-s4'?4S ? -:id?- • ?? Gc/fc t?^ ^ API 1"?' V D il ? i ?` 1i?/STRLL By ?,?-x.,. ? • e ?t.G. ?,er?o,q,2,? Dat- EAGAN NG E RIP1G S?c?S ? T C-.f4-t[/o? A.r/d ,2E .T onre cin G% OISTfliLi ..3/ aS3 sRErcN!oF! mnv» C-S FEEDEA/MnSE L 4 6 Z rox 11,D0;14-. i" Blumentals0 a???Sg- Amn an@ 6100 Summit Drive North • Brooklyn Center, Minnesota •(612) 571-5550 Janis 8lumentals AIA President Stephen P. HerniCk AIA Vice Presitlent Susan 8lumentals AIA Executrve Vice President Cindy K. Bialon Corporate Secletary August 15, 1985 1•ir. Dale Peterson City of Eagan 3795 Pflot Knob Road P.O. Box 21199 Eagan, MN 55121 RE: Woodrtdge Apartments Eagan, htinnesota Dear Mr. Peterson: ?? V &4o? ? Please find enclosed one copy of "Detail of Roof Decking and Gypsum Board", Sheet No, i/A9a. Approval of the detafl was discussed with Mr. Steve Hansen over the telephone on Wednesday, August 14, 1985. This detat I ts 6eing submitted to you for fl I ing wlth the above mentfoned project. If you have any further comments regarding the detaii, please feel free to contact our firm. Thank you. Yery Truly Yous, `'` • ? R. Allen Hoglund RAH/cb Enc: Detail CC: Brutger Companies, Inc. L4 B Z Fox Ria?c Pdnr-i . PAC E EN GI N E E RI N G, I N C. 2042 WEST 98 TH ST flEET • BLOOMINGTON, MINNESOTA 5 5431 • 672-884 -6241 July 18, 1985 Building Inspection Dept. Egan City Hall Building 3795 Pilot Knob Rd. Eagan, Mn. 55120 Attn: Mr. Doug Reed City Building Officieal Attn: Egan, Mn. Woodridge Apts. Gentlemen: Per my phone conversation with Mr. Reed this morning the following are the minimum re uirements as established by the "Authority Having Jurisdiction" ?City of Eagan Building Official). The water supply and standpipe system design will be required to supply 500 GPM from the most remote standpipe plus an additional 250 GPM per standpipe up to the tetal water supply required by NFPA Standard 14-1983 except that the residual pressure at the top of the most remote standpipe shall be not less than 50 psig. The sprinkler systems for the garage may 6e supplied through the standpipe system. This will, of course, require the water supply be increased by the demand of the hydraulically calculated sprinkler system. Thank you. Very truly yours, PACE ENGINEERING, INC. Glydewell Burdick, Jr. P.E President GB:mp cc Deborah Crowley - 6lumenthals Gordon Kath - Brutgers Joe Hernick - Northstar Fire Protection CONSULTING ENGINEERS if-citv oF 3830 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN, MINNESOTA 55121 PHONE (612) 454-8100 September 21, 1984 STEVE WILSON BRUTGER COMPANY P.O. BOX 399 ST CLOUD MN 56302 Dear Mr. Wilson: BEA BLOM9UISi Mayw THOMAS EGAN JAMES A. SMITH JERRV THOMAS THEODORE WACHTER CouncY Members 7HOMA5 HEDGES CiN Adnunutrator EUGENE VAN OVERBEKE Gty Clerk The property in question, Lots 3 and 4, Block 2, of the Foxridge Addition, is zoned R-4 (Residential Multiple Family District) and is compatible for an apartment usage. The property has access to utilities and is not in an area of special flood hazards. Sincerely, V ?. Greg H. Ingra am Assistant Planner GHI/jj THE LONE OAK TREE.. THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIN ,ry memo r ,cE BELOFI 0. E. Hurch :t;biaciIC.P. Type XXX vs. U.S.C. Type C locabon , localion ptlan[a (21) date September 27, 1982 Recently ve commissioned Underwriters Laboratociea to conduct an Engineering Study to determine iE C.P. Type XXX could be successfully substituted for ' U.S.C. Type C in Underwriters Deslgn No. U411. Design U411 Was origlnally approved using U.S.G. 5/8" Type C wallboard on 2Y"oc3 5/8" eteel studs spaced 24" o.c. ? _ . . . On Hay 26, 1982 Underwriters responded ae follovs: "We (U.L.) have conducted an engineering qtudy, and have determined that the subject vallboacd (G.P. Firestop Type XX7C) is eligible for classifl- cation in Design No. U411. Design No. U411 Classifica[ion Card R 2717, and the aPpropriate sectiun of FolYov-Up s'ervice Procedure Flle R 2717 have been revised accordingly". Addi[ionally, both C.P. Type 3IXR and U.S.C. Type C have been approved fo[ use in Underwriters Floor and Ceiling Design L513. Mother indication tha[ the tvo producta perform as equale. ' Based upon [he above, it ia our conclusion that eufficient evidence exlsta to conclude that C.P. Firestop Type XXR can be supeessfully su6stituted for U.S.G. Firecode ?ype C, and that eimilar fire resistive properties could be expected. Please bear in mind, howevec, that the final authorlty on brand substitutions A copy of Underwriters lelter of 5/26/82 is attached foz your use. 0. S. OEB:afg 1 Enclosure T0: J. S. Ver Nooy - ICansas City E.'C. Calloway - Atlan[a Regional J. E. Tierney - Buchanan J. R. Van Dyke - Crand Raplds (CYP) D. W. McCubbin - Chicago N. Regional W. D. Brooka - Dallas Regional L. li. Kaboos - Oakland Regional D. R. Hac Farland - Wilmington, DE ._. ,,,,,,.... . . ' CONTINUED ON NEST YAGE • F ,• hr:dk ,ii s ?4? 9 880043 , DRAINAGE 6 DTILITY HASSMENT TH.IS DRAINAGE AND UTILITY EASEMENT, made this ?j day of AZUtX? , 1988, between WOODRIDGE PROPERTIES LIMITED PARTNERSflI a Minnesota limited partnership, herein referred to as "LANDdWNER" and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota, hereinafter referred to as the "CITY". idITNS55STH: That the LANDOWNER, in consideration of the s wn of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the CITY, its successors and assigns, permanent easement for drainage and utility purposes, over, across and under the following,,described ptemises, situated within Dakota County, Minnesota, to-wit: That part of Lot 4, Block 2, Fox Ridge Addition, according to the plat on file in the office of the County Recorder, Dakota County, Minnesota, which lies within 10.00 feet each side of the following described center line: Commencing at the northwest corner of said Lot 4; thence South 0 degrees 34 minutes 05 seconds East, assinned bearing, along the west line of said Lot 4 a distance of 209.84 feet; thence South 88 degrees 02 minutes 58 seconds East 105.12 feet to the point of beginning of the centerline to be described; thence North 1 degree 16 minutes 30 seconds West 191.66 feet to a point in the northerly line of said Lot 4 and said centerline there terminating. Together with a temporary construction easement over, under and across that part of said Lot 4 which lies from 10.00 feet to 50.00 feet westerly and from 10.00 feet to 30.00 feet easterly of the above described centerline. Said temporary easement expires July 1, 1989. The grant of the foregoing permanent easement for drainage and utility purposes and temporary easement for construction purposes includes the right of the CITY, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits, mains or ponds and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the CITY shall restore the premise5 to the condition in which it was found prior to the commencement of () c"e.:'E.•? 2819 such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. LANDOWNER retains the right to use the easement property for any lawful purpose, provided such use does not interfere with the drainage and utility purposes of this easement. Said use shall include the right to pave the surface of the easement, but shall not allow the erection of structures upon the easement. And the LANDGWNER, its heirs and assigns, does covenant with the CITY, its successors and assigns, that it is the LANDOWNER of the premises aforesaid and has good right to grant and convey the easement herein to the CITY. IN TESTIMONY WHEREOF, the LANDOWNER has caused this easement to be executed as of the day and year first above written. - WOODRIDGE PROPERTIES LIMITED PARTNERSHIP, a Minnesota limited partnership, BY: BRUTGER COMPANIES, INC.j a Minnesota corporation ITS: General Partner n By: Its: ' STATE OF MINNESOTA ) ) ss. COUNTY OF ,S?4tin? 1 On this 3± day of 1988, before me a Notary Public with'n and for said ount , rsonally appeared () aUac? "r , l)..?Cr. of BRUTGER COMPANIES, INC., a Minnesota corporation, partner of WOODRIDGE PROPERTIES LIMITED PARTNERSHIP, a Minnesota limited partnership, on behalf of such corporation and partnership, to me personally known, who being by me duly sworn, did say that he is a partner of the Partnership named in the foregoing instriunent, and that the seal affised to said instrument was siqned and sealed in behalf of said Partnership and said 6Ei acknowledged said instrunent to be the free act and deed of said Partnership. ,.^?. CONNEE 4 COIIIR? STEMS awwm ? Notary Public Ummmm Eom.wauM -2- F-• i t ? R if . ; THM7,NSTRUMENT WAS DRAFTED BY; ?: Mc?ENOMY & SEVERSON, P.A. ° 73WWest 147th Street P.b. 1Box 24329 pp1O,-Yalley, MN 55124 (6t2)1"-432-3136 P i -3- ? p=3'2e' e0• ,y o0 e.3os.?, w ? ? w ? 0 w C E 86-2 y ?095952Z ? a 5 0'n3 55 E I15.50 f _ !./ ? - 10 FOIDi iEWON P E.SEMEN. ?--o - p y, N SE M£P ND iF ' ?PSEME $ O - oaeix.c[ sns[w[xr,?_ 1-_--_- • - f ? ?' ? ?d?i ? so?•?s 9o e _ , Sy? --- - FT: W I ' IQ "I oa rooi ? vevvnu.. sIoau W sc.eF pe EMf'DP4flY LFSFMENi E45EYEN1 PE11 OLC NG f1EE9• = N ?' ' " 1 ' <e 0 ExISiING f0 ?001 49o0 ? Oa E m rv P63.0 I1llLliv EFSEMENI-??? aos.ea ? '° $91 ]'[ NO•3<'OS"W 950.34 --- -- vE5* LIxF OF LOi a 3LOCK B PENVEIIIit SLDflM SEXEP ? ERSEwErvi GEP pOP N0. 41699a ----y? VESi LINL OL LOl 3. BLOCfi : ?Irypvi-EP COQNEA 01 10l .. BIOCx 2 POx01xG EeSFMExI IaE? = i 256 cCXFS I PEPWNENI $tOPM $FYfN exL ONnINCL[ LCSFWNI PflEP e 3.011 S? il _ iRPORqRV LONSLPVCIIOU GStuIM = ii.SGL So. fl. : 50 ]5 O 50 100 114E Irv FER ??awn B? Uate Comm Na Orr SchEIWn M-Ni As oemates. 1nc K.J.M. 9f15l88 d226.00 m? xmnm?.??.m.? ? u .: .mv iA upl?ss?u . mx ooi 6S Q'I I ? APARTMENT BUILDWG _ -`- 5 6•45'32' _ = ?=9i Ot - __ ,_ ? aE. <5 ,:. N09•29'IB, N [1M?N11 IK n.I. 9n5i8p p..ex 1IiYa ila ` °• Dwwing ii6e Sheet no EASEMENT SKETCH FOH RIDGE STORM 'NATER PGND ? SW 9 880044 PONDING 8 DTILITY SASElfENT THIS PONDING AND OTILITY EASEMENT, made this J day of 1988, between WOODRIDGE PROPERTIES LIMITED PARTNER5HZP, a Minnesota limited partnership, herein referred to as °LANDOWNER" and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota. hereinafter referred to as the "CITY°. WITNESSETH: That the LANDOWNER, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the CITY, its successors and assigns, permanent easement for ponding and utility purposes, over, across and under the following described premises, situated within Dakota County, MinnesotaF to-wit: That part of Lots 3 and 4. Block 2, Fox Ridge,Addition, accozding to the plat on file in the office of the County Recorder, Dakota County, Minnesota, described as follows: Commencing at the northwest corner of Lot 4, Block 2, thence South 0 degrees 34 minutes 05 seconds East, assumed bearing, along the west line of said Lot 4 a distance of 209.84 feet; thence South 88 degrees 02 minutes 58 seconds East 49.00 feet to the point of beginning of the easement to be described; thence continuing South 88 degrees 02 minutes 58 seconds East 76.12 feet; thence South 23 degrees 17 minutes 00 seconds East 69.92 feet; thence South 0 degrees 43 minutes 55 seconds East 175.50 feet; thence south 10 degrees 49 minutes 12 seconds East 95.52 feet; thence South 27 degrees 55 minutes 57 seconds East 64.18 feet; thence South 6 degrees 45 minutes 32 seconds west 294.01 feet; thence North 84 degrees 14 minutes 00 seconds West 46.49 feet; thence North 9 degrees 29 minutes 44 seconds East 181.45 feet; thence North 25 degrees 03 minutes 02 seconds West 263.03 feet; thence North 1 degree 49 minutes 04 seconds East 263.02 feet to the point of beginning. The grant of the foregoing permanent easement for ponding and utility puxposes includes the right of the CITY, its contractors, agents and servants to entez upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits, mains or ponds and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the CITY shall restore the premises to the condition in which it was found prior to the c t D?, ;.?v? commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. LANDOWNER retains the right to use the easement property for any lawful purpose, provided such use does not interfere with the ponding and utility purposes of this easement. Said use shall include the right to pave the surface of the easement, but shall not allow the erection of structures upon the easement. And the LANDOWNER, for itself, its heirs, executors, administrators and assigns does hereby release the said CITY OF EAGAN, its successors and assigns, from all claims for any and all damages resulting to said land by reason of the location of the ponding area or utility line. And the LANDOWNER, its heirs and assigns, does covenant with the CITY, its successors and assigns, that it is the LANDOWNER of the premises aforesaid and has good right to grant and convey the easement herein to the CITY. , IN TESTIMONY WHEREOF, the LANDOWNER has caused this easement to be executed as of the day and year first above written. WOODRIDGE PROPERTIES LIMITED PARTNERSHIP, a Minnesota limited partnership, ? BY: BRUTGER CAMPANIESp INC.F a Minnesota corporation ITS: General Partner By: Its: STATE OF MINNESOTA ) ) ss. COUNTY OF a? ) On this 3ri day of , 1988, before me a Notary P ic wit i and for sid C nty, personally appeared '! , 1UAtMt.oc?f- of BRUTGER COMPANIES, INC. , a Minnesota rporation, partner of WOODRIDGE PROPERTIES LIMITED PARTNERSHIP, a Minnesota limited partnership, on behalf of such corporation and partnership, to me personally known, who being by me duly sworn, did say that he is a partner of the Partnership named in the foregoing instrinnent, and that the seal affixed to said instrument was signed and sealed in behalf of said Partnership and -2- said acknowledged said instrument to be the free act and deed of said Partnership. -ti CONNEE L. COSSAIRT 1qTARY PUBLIC . MI1tl1E$OiA srfANNS Courm Cemm¢sm ExWa An 6.1994 Notary Public THIS INSTRUMENT WAS DRAFTED BY: McMENOMY & SEVERSON, P.A. 7300 West 147th Street P.O. Box 24329 Apple Valley, MN 55124 (612) 432-3136 JPE -3- w w ? N W 6 O 2 LN W . APARTMENT BUILDINL M BB-1 - f 5? 95.51 E f ?. -' s 0•u'ss- [ ??s so . = ?0i` !0 O?? i11APM.C1 EASE1x1 , t?.? qz y S Fq / _ ` ?-?.... . ?N} - ? " ? as.as-: ?i - --------- -- = z?aw s[rtn .xo Li OR11xACE FASFUEUi--f p•°d;' EAB (..? 501•1630"f .(A-- - ? E ?ONtl1?5G ? Z6 Ol J ? I r \ T'w - A W ? ? ?0 [OC?L ml tl P[Pn(1i11L S10PU )fWfP ry ?? `\'`ifMllqnnrEISFMEH"•• F6FyNI cFaOp, N0. 116P9A o nnn _ Y. o ?' ic r ? l 01x01•.e or[ Im °'I e63 oz . a?O?uu VIILI?? FISEMCNI-"' Iv. I 209.04 PBt.I] u 2l6.]0 --'?" N0•34'05"w 950.31 -"--- ?••• ?"- S? Lix[ 0? l0? a. ai OC. i ?E upo?uq51 CONUEX GA i m .. eLou e P[xpING F-SFNHI 1N(/. 1 IYt ACNLS • PFRUexEx1 SIOXU 5[4N 1rvu UMeIhAL[ Es514lxf aq[> . I.BJI 54. ii _ IINOCn.ar COISIPVf.?I/x? 16futxl = 1:.1W 51. fT. . ?nnw" Py Unle Comm No i n...q <.,m. 11.1 L., ,,.... p... e. Orr m.. ? Schelen M Neyeran 6 J e.J.M. 9i15/88 4226.00 AasoeieLes .lnc eon•.... . s?i.. . . rt...... o ?n..nn ?rr bw x•.n.r?n u.nu. :?u...wm vn sfao . .n ni n.. 9/I S/P _ Yq M. _ PEPGEIV.t SndM $EIIFF EA5[Y[xi PEP OM. NO 47fiB94 - - YE51 llx[ 0( L0T J. 9LOCF : So u o so ioo SCrtC Irv fEft Uwwing lilie Sheel no EASEMENT SKETCH FOX RIOGE STORM WAfER PpND ? NAME i rvvvntuc LOCATION 3Z55 BUILDING P.yH6 CONTRACTOR /NdEPE'/ CALCULATED 6YZA CONSTRUCTIONA ? ? co AREA PER SPRINKLER ?S PR N?k ERTO-R?JOZ HOSE ALLOWANCE GPM: INSIDE - AAANE v - MOOEL HOSE ALLOY/ANCE GPM: OUTSIDE Z50 OIZE-.. ZH K-FACTOii RACK SPRINKLER ALL WRN?E ? T. pERA7UR@ FiATING CULATION CAI OPM REOUIREO 4qZ • 7• PSI AEQUIRL-'p Ax ?ASE OF RISER . . SUMMAFY "C" FACTOHUSED: OVERHffAD_-- d UNOERaROUND ---Z?- -- j WA7 A F OW T ST DATE & TIME OEC. 17553 " PIJMP DATA pATEO CAPaCt7Y -' TAt,?K OR RESERVOIEi. .. ...' ... CApACITY - - STATIC PSI AT P51 ELEVATION 0. = fiESIOUAL PSI _rL ELEWA710N D N GPM FLOWINQ Z175 riELL W ELEVATION ? Pii00F FLOW - aPM F ? LOCATiON C?I ? BL?KS cso(1y-N OF UlT? ?1G.Ylr1f1E1/ AT YRAJK6E G?UGE' 4 SOURCE OF INFOfiMATION O/TY OF Ei?GAN COMMODITY C LA93 LOCA T ION W 9TqRAGE NEIGH7 AREA AISLE WID7H ---- Q STORAGE METHqDt BOLIfJ PfL6D - 96 PALLE7IZED ?- % RACK % ? y ? SINOL?e RONf 0 CONVENTIpNAL PALLET [] AUTpAAATIC STOFiAGE ? ENCAP5WLA7fiG ? WU84E ROW (] SLAVE PALLET [] SOLtO SHELVIN(3 [l NON- > r [] MULTIPLE ROW ? OPEN ENGAPSULA7EO v FLUE SPACINSi IN INCF1?3 C ? E/+RANCE FROM TpP f!F ST(?HAOE7QCEILING. O ? IN LONGf7UDINA4 TRAN$VEPSH . FT. C) NORIZONTAL BAHRIHR$ PAOVIOED - L 3? NYDfiAULIG DESIGN INFDRMATION BHEET DATE /Z - ? - SYSTEM N0. CONTRACT N0. -50/62 DRAWING NO, CEIUNO NEIOHT - F7. ` ? c± OCCUPANCY LrTOMt?+2 c? ? • , r ? NFPA 13: ? LT. HAZ. ORO, HAz, (iP. i 2 ? 3 [] E%. M?1E..' ? NFPA 231 [D NFPA 231 C: FI[3URE ; CUFiVE ? lf S OTHER -- y) pec ( 0 w 0 SPECIFIC RUUNCI --- MaDE 9Y ' pATE o ? AREA OF SPRINKLfiR OPERATION / .. S YSTEM TYPE ENSITY WET ORY ? OELUGE PR?=ACTI?N, „ 1 c '..; , 443 Lafayette Road N. ? MINNESOTA DEPAR7'MENT OF St. Paul, Minnesota 55155 ?gOR & INDUSTRY www.doli.state.mn.us May 15,2008 (651) 284-5005 1-800-DIAL-DLI TTY: (651) 297-4198 Darren Jakel APPROVED FOR U5E Stuart Company 1050 W. 80th St. Minneapolis MN 55420 RE: Hydraulic aP ssenger - Elevator ID# -15510AL08-01 Site: ,1Noodridge Apartments ' 3255 Coachman Rd. Ea pD_55129-- - Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety 5ection, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escatators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. THIS APPROVAL APPLIES TO THE MOUERNIZATION OF ONE ELEVATOR. ALL ELEVATOR RELATED EQUIPMENT 15 SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a"stop order" from the department and possible penalty of up to $10,000. For more information see ourwebsite at: http://www.doli.state.mn.us/bc_elevators.html Sincerely, CONST CTION` }?--CPt?ES -?--% & LICENSING Bill 6inke Chief Elevator Inspector CCLD/Elevator Safety Section ElFOrmCE2 This information can be provided to you in allernahve formats (Braille, large print or audiotape). An Equal Opportunity Employer ?.yf7SE 1 C ?ems ; •s? ? 'l V l ?1P P P +?... ?V ? By Dat EAGAN NG EERING .:-.?.' . r-- • e • r ? • i • , ?v Yi;.?.C._i ? o o a...L 2> T-?-?- ? i ?.?.? ? ? 5s `l - fl Aq ?3 0 1 O A?A .Z.ZG ? ? ? I _ ?-lASG .ZZ ? I I I ? i --7 C -S - ?o ?• 7:2;- G'/ c'-S4 -T3r 7 .- ?" uEr„-zrY x Far-.Era r'J , `I 6n }: ? c J O,, ti:l 0 .... ?t+'E.RA[;E - 41.4T fyl-'M Rncr:s = TIHS:[DE 41(JSES - (?U7sIllC HUSES = L 4 8 z Fox -- -- - - - -, --- - - - -- -. --\ µ =d 1 .49 ZO« 0 . FS (? 250.00 F1._UbJ fiE(.1'I7 F'Oft SY;i'1"FM ::_ 281.49 F I...!]W A'Y' PASE Uf- fi I S'Eli = 281.49 M:CIN FLOW AT Ii(-tSE OF RISI_R = 0.00 Y'C.17'AL FLOW = 531.19 STATIC I''I;ESSURE = 7200 RESIDIipL F'RE,.i.SUF:F - 67.00 IiESTx?UAL. F1_.DW _ FLC.IW F'RUM CI'fY SUF'F'l_Y AT 20l'SS = S2('v5'2 C:H'M FF'tf_'SSUftE F'ktClM CUF;NE @ TL1T'AL 1=1...(]W - EI_.EVFlTI:UN = 0.00 F'OOT - 3RSC).()U 71.83 () . . I41l, D:CA C. LFNG"TH FAC70Ft + FL.DW S 6..050 140 80,00 531,40 ADDI7TUI`IAl VA1_VE L.O,SS, ETC. LL SAI-'Y, hiA 'G];ty_. _ "'k:'['' ?......-..?_-- .. . .._ .., . __ ,-""-•-_?-- "FRESNFtEp AVAIL.RPLG FOR SYSTEM . ` • = . ......,?,.;..V.: ?_. v:.?.: ; = - - ' ' . - : °=_._,.-. _. . . . =:_w --CwSS --?C159 D, F'F FLOW VELOCT7Y 0,69 535.4() 6101 2.30 5.00 3.5 ' F , A.07 ? ? ? E-sf H=i: a=? 0"il Q: II-11 L- Ir. 1"il E B"B 0 .. i 19• 1- • <S.M .3.4. 3 SLOPE= 0.00 (F[JOT/f-DO7) C 4= 1.000 DENSITY= .1b AfiEA= 130 FT= i3.8 HD.# DIA. LENG'iW K C7A F'F F'I%I i 1.1104 13,00 5.600 20 ..80 11.42 13.5() 2 1,104 13.00 5. 600 20 ,88 5.13 13.90 3 1.452 1.00 5.600 24 .56 (),'?q 19,24 K --_ '6 -4 ., 6n [a! == . S 6 .. 2_' ?t A 94 C 9-9 L. 31 R^il F- G^$ O_ :.? B?. t7.s.v.ta.> SLOF'E= 0,00 (1=QR7/FOOT) C4= 1.000 I)EPI,STTY= .16 F1RE.A= 130 F'T= 113.8 HD.$ DIA. I.EMGTW K OA F'F F'14 i 1.104 13.00 5,600 20.80 1.42 13,80 2 1.104 13.00 5.600 20.813 5.13 13.90 3 5.452 ? 1.00 5.600 24.56 0.24 f9,24 Iti = i .4 .. eS, 0. _ !5. +S .. :? ? A 01I? AMC H LT Nl- ra eDi (s.a.) SLOF'E= 0.00 CFOflT/1=00T7 C 4= 1.000 DEhl.SITY= .16 AFiE..A= 130 F'T= 13.8 HD.# llCp, I._rN6'i'H h CIA f='1= Phf 1 1. 104 i 2. 00 5.60(? 20.i: 0 1 1,31 3 .E30 y tl?4 - P?J' n. J'' ?:d' p' y Y_K' = y+?, p - y .v:.1? 1..J' a S..?k ^ ' ? • L 0 Il x: a -a? R"il C a- I L. T Ihif ?. H"I CDi _ ?y ' • (1 f.5(7.7 SL.Of='L-,: 0,00 (1=0CJTi1=0U'i) C4== 1.0Otl D[:1`ISl"I'Y== .16 (-SFiLi:FS= 1 30 I"1 - 13. 8 FIU.# b.T.A. I. _EPfG'TH K 0A PI'= f"IN S 1..4U4 12 ,00 5.6 (1(} 20 .80 1 .34 13.80 K -°a _ Z. ": & -4 - ,.-` aZ- _ B? ??? ????-? ?.-- p C=f 2k7 ^A F'C FIT7SIYGc VFL. 6.97 13.96 92.83 F° T == :? Rp .. '-E5 'S7 VCJLUhiL = 0.118 CU..1= . VOLUME = 1.3E3 G;AL. C=12C) PC FITTIhIGS VEL. 6.97 13.96 . 52,83 F:' "fl" ,-' = 22 4D ? tF 5" VOLUML = 0.fF3 CU.f-'. VOWMh = 1.38 GAf_.. C=9 2(7 ?r ?C"E f-:[TTTI`IGS VEL. 6.97 F^ T- I ..3 a I I VOLUME -= 0.0E3 Cu.1='. VQLL1ME 0.60 GAL. (: 12 0 F'E F'Il"TTI'IG:' VE:L. F;.?7 IF-. IF _ 1 "_=; ... -? VQl...l.li ir: - 0, ^s; ",.. ,- , WiLlJMr ,._,( .. ,,., . Sr-: rT)iB4fG a-il 9_ A: N^IIE 940_ !!F r3•i-. N'Rrt/' _ (1;?.1a.ss.sF?.s: .) SLpF'F_= .. U.Op . (('npTiFpOT) CA= 1.0 00 UEhISI7Y= . 16 Af;f A= 1 30 F'1' - 13 . f3 HD.# D7A. LENGTH K 14A F'F f'iw t i,f04 53.00 5.606 20 .84 f.64 13.80 2 1.104 10.00 5.606 25 .04 3.98 14.11 3 1.452 i0.q0 5.600 23 .97 2.42 58,32 4 1.452 5.00 5,600 :.'q ,8> 9.2() 19.76 K = -a e? _ ?a e 0 =- 9, c} .. -7 n R: Aa N F- 9^9 o - e& a (A.6.) SLO1='E= 0.00 (FOOT/FOQT) CA•- 1.000 K= 19.950 F'T= 20.59 HD.0 DIA. LEhIGTH h: Op F'IV f 1.452 S.p() 19,950 90.53 7.42 20,59 B`M. - 9 :7 .. fi fi ul -V : 4?? 0 .,. ? -.i . B SR Ai A'yl 0 N--4 L- I 6'-9 t=': 9"il of ,,. 7? (f0.1:'.) SLOF'E= 0.00 (1=00T/FpUT) C4= 1 .000 K= 19.950 1?1'r::_ 20..'::9 iD.# D.T.A. I...F_I`IGTI-I K l;2A PI' I'-'1`1 1 1.452 S.()t) 19.950 9 0.7.42 0 .'5 9 < ff-5-2N C:'-1 20 F' G FITl'i19GS iE 07 OE 'ZT F°T - Z5. 1 vol.i.iME = vnLursF = VEI_. , 6.9% 14.02 12.75 17.57 ?iD -?t 0.3:3 CU.17. 2.43 GAL. C= 4:.O PF_ FTTTTI`1(;S VEL. oe •<T 17,53 F- -F _= : ." E:3, .. 4? '6 VC11_UME == 0.01 CU.1='. VOLUM.F. = 4.09 GA!_. L'= 120 ? ' 1 v F'f-: 1='I77ThIG-7 VF_i_. oE zr 17.53 -r-- ' ?0? _. o I vOLuMr = 0.01 rii.p. VULI.IMF = 0.09 r..nL. ?-? MAIAJ (b.12.17 .4?1.59.) SI_DP'E= 0.00 (FOOTIFDOl') C4= 1.000 C;= 120 _ K= 17.1 1() f''T'= 31.68 HD.4 DIA. L.I=MGTH K OA F'F F'1`f F'C FIT'iIl`IGS VF_L. 4 2.154 10.00 17.110 46.30 0.72 35.68 8.48 2 2.154 1i.00 17.110 94.49 205' 30.5() 56.79 3 2.154 53.00 16.280 90.70 6.7E1 31.04 24.77 4 2.154 3.00 0.0470 0.00 11 .99 37.82 nC 2'i 24.77 6ti: • =- 215 0 _ :3 22 C4 = '-? E3: 1 - -4 5?' (F" 1- fy- Z . °7 6S VOI_UME = U.94 CU.1=. , ttOlU31w - 7.00 GF,L.. 'q ... ? , 13 flR el 64 Cl 11 L- 3E ,?? PIC) 10-1 ?3UL? ?iti tQ.:0.2 ,.> sLor-E= o.oo (FooriFoOT) ca- 1.000 C0 20 h= 38.3 20 PT= :73.96 * ND.4 DIA. LEI4GTH K 9A F'F F'I`I F'E FT'T7SMCS' VEL. t 406() 350.00 3E3.320 283.49 7.7:.' 5306 4-L" f'T 6.33 2 4.026 5.00 0.000 0.00 1.39 61.34 -,-4?1= 5,-1 ;3:'!N .. ? -at 6Ch -- 12 Es "i _ A- 9 ` VDLlJH1= 35.08 Ct1.F. VULUME = 262.44 GAL.. --- - .: - - - --- --- - - _ _ _ - --- - - - --- - - - ----??'t?...?-.,G?•a'?? _ _ ? ? -.- - -?- _---- - ?- 3 uR ????-w' 1- ?;t?u•.,.?- r?F°T-v _ ECL-X_E;- _- ---- ---- -- - - - ---- Dr:ri,szrv x ar,r_A O.i60 X S5Ot?,00 _ 24000 OVLRAGE = 41.37 G1='M = 41,37 RACKS -- 0.00 IPISIDE IiOSES - O.oU OU'fSIDC NOSFS = 250.()0 FLOW fiEO'D 1=Ufi SYSTLM = r'Cif .37 FLOW AT BASF. OF Fi:LSCFt = 285,37 MIhl FLOW AT BA.SE 0F FiISCR ? 0.00 TQ7AI_ 1=1_OW -- 535,37 STATTC F'hESSUI;G = RF_SIDUAL. p'RC:.S,SURE = FLOW F'RI)M CITY SIJC'PL.Y F`FiCS,SUF2E FFQI`i CllfiVE f2 ELLVAI'1:C11V -- 2.0 ., 72,00 67.00 fi1=SIDUAL FLOW = 3410.0(} AT 20i'Sl: = 1 2092 GF'M TpTAL FLOW - 71.E33 J F007 = 0. 140, DIA 'C° L.EPfGTH FAf;TOR 1 6.00 140 90,00 ADDITI019AL VALVE LOSS, ETC. SAFET_Y,..MARG7'N __----_- rVRESSURE AYAILABLEYQR 3Y,STE? ? *r55 . _.?-----.?----d t FI_OW 1='F FLOW V[I_OC;:fTY 50,30 0.77 531.30 6.01 = 2.30 - 5. (?U- '----r.--v.m..=.,?,-a,???;?r'?.?g0 _' -•..?, . ?2 13 N EE: N a ?n _ i !..;: 04 2..43.44 ,45.46.4 7.) SLOPE-= 0.00 (FL101'lFOOT) C 4:=: 1.000 pEPISTTY= . 16 AR CA= 1:30 P7= 13.8 Hn.0 D]:A. L.EI`IGl'H K 0 A F'F F'I'i 5 1.104 1 3. 00 5.600 20.80 1.42 13. 80 2 1.104 13.00 5.600 20.88 5.13 93.90 3 1.452 53.00 5.600 24.56 3.18 19•24 R 1.452 i3.00 5.600 25.89 S.Etfa 21.38 5 5.687 7.50 0.()00 0.00 5.10 28.21 Iti,; 1 Ea .. eS g' 0 9' :?: . 6 ?3- 0 F4Z A E"$ C? H L T 9`N? 1`4 ? . "A . i (4 8 , 49 Sl.OFE= 0.00 (Fp0'i1Fqq1') DEINSITY= .16 Aft CA= 130 P HD.# DIA. 1 LEMGI'FI K (.?A 1 S.SO4 53.00 5.600 20,8 :,? f. h U+1 13.00 5.600 20. £3 3 1.452 13.00 5.600 24.5 4 1.452 13.00 5.600 25,6 5 1.687 7.50 0.()00 0.0 6ti: = 1 !5 .. er S7 c B.L, c=s 20 ? 6,97 13.96 12. 83 17.84 OG 2T 13.22 g'. ^ "p- _°' 2? -4 _ rt °p 'JOLUMG = 0,59 L"U.I VOLUM'C = 4.40 GFlL. F'f FI7l'TIHGS VFL. IL? 50.5S.52.53.) C4= f.U00 = i3.f3 PF PIY 5.42 i3.8C1 5.13 13.90 3.18 19,24 5.86 21.38 5, 5 o 28.21 . B; g:tl" u"?i Pil C' 9-1 L- 3: N 9^9 O ». ti dT Si_Of-'I_= 0=00 K= 5 .600 HD.# DZA. I_CNGTH f 1.1()A 10.00 2 5.504 10.00 ;x 1.452 1(?.Q(. a 1 .452 10,00 ':S 1.c5Fi% St>.?t> ?5 i , bf?7 h . (7!) µ? ?{ 11 ?.r'.1. c E,=1'y. ?.p (534.55.56.57 iF'QO'T'fF00'T'7 t:4?, F'i'= 14.01 .58.54.bG.) 1 .000 L'=520 n ofa F'r- a.E>JO 2() .96 1.11 5.600 20 .80 3.96 5.500 23 .75 2.40 5,60() 24 .6E3 4,33 0.000 0 100 2.09 000 •{.59 r-'N 14. (>1 13,80 s7.v? 1 9.42 24.6f3 - 5.17 7 .1 9, $•L. C=520 F'E `FITTIMGS VEL. 7.02 53.99 52.69 17.47 12.94 ()E :? T' S'ti.94 R::-n - .4- a;r 'dnLL1M1? = 0.65. t:t1,.f-'. V 01_ l.! t'f I:' - 4,57 Gn11._ , 6.97 13.96 i?.B3 17.84 OE 2T 13,22 q= ?° 'r = 3 ? _ .4 ? VOLUMI= = 0.59 GU,1= . VI]LUME = 4.40 GAI_.. 8. L. F'1- FTTTII4GS VE'L. r-._..r.__....r. m«,?.w«.+?-.+>--.d:.?...ei+.e.?.??ar. • 0 Iw Ai a?? C H L- g t4 1--- N 0 F-:: X MIV?'?! (R7.53.60.6S.) SL.QF'L-= {),U{) (l=DC]'i'/FDOI') C4= 1,000 C-120 K= 15,690 PT= 34. 49 . . 1 1 ' i HD.# DIA. I_CNGTW K QA F'I'= f-'hl F'E FIT7IhIf;S VFL. 1 1.687 50,0() 15.690 92.f4 2.17 34.49 13.22 2 2.554 i5.00 f5.640 92,65 2.63 34.87 16.26 3 2.5E31 53.00 15.820 96.59 1,49 37.28 DG 2T 17.25 K = -4- 47 _ ac;?' '2 iI .. ? 0, F?-A'" = -4- 7 - 2? E3.1 VOLUHE = 0.91 CU.1=. - VCtLWME = 6J8 GAL, x 0 ?'+." AF @'i 0-- R-N L S " E: B"$ 0 - 'b vp (6i.62.63.) 5'LUP£= 0.00 (F"q0T/1=t]OT) C4= 5.000 K= 40. 920 F'T= 47.2E3 C=12U HD.# DTA. I_rMGTH,;p* h nA F'F F'1`I S 4.260 590.00 40.920 281.37 12.23 47.2.Sfi 2 4.026 5. 00 0. 000 0. UO S. 39 59 . 1 7 K = a. es. _ .006 U _ 2! ? ? - -_3 .? SuWK MkIA1 F'E FITTIMG,S VEL. 4E 1T 6.33 51.OF)F 7.0_9 v?ac?'??`?,s?: F. , VULUME = 440.12 GAL. r P7 AIaiL. _ 42 90 -_-- ?,. ? - --- .-?- -?-... DI'hl.S'lTY X AftEA 0.160 X 15op.00 - 240.00 C1VEF:AGC = 4107 GT'M = 41.37 liAChS = IN,SIDG I-fOS'E S 0.00 , = OlJ'iSIDE HOS'F:S = 0100 4W00 FLOW REO'D 1=UFi S'YSTFM = 281.37 FLOW AT LiAS'E pI` F[.Srfi •-: 28107 M7:h1 FLOW AT IiASF_ qF R:[SEF; _ (),00 TUTAl._ f"LU(J •• 531.37 STATIC F'RES'SIJf.E: = 7200 FiESIDUAL PfiESSUFtE = 67.00 C;CSSnUAL f-"LC7LJ FLOW FRC1M C::[TY SUPPLY AT 20f'ST = 12092 GF'M FFtH,SSUfi'G 1=Rf.]M GlJRVM. C'f'OT(if.. FLOW E:LEVATSQM - 4.00 F007 - - -------- ,• - 3410. (7() 7103 ?- 1. N(7. DIA ?°C' I_EING'T'hl FACTOPt + FLOW PF FLOW i 5.010 140 9p,00 531.30 0.77 53100 AllDITIDf4AL VALVE LpSS, Gi'C. _ 2,30 SFJFE7'YwMA FiGTLY . ^5^00- -?<? Fi -- f . ..-----R..r_ (sF`ES'UF<Cr' 'ArfAILABLE:--?^.>. -- ;F'Ok STSTEt4''=";?'r;?°"--. :?_03 L 4' _ ~ ?- ?? S • ?4?5?. - - . , - _ ???? -. . V[LpCI7Y 6.01 0> V ?s lfu: o'•"a II"il tL:: N-il ft- -d.: !I"-R i? ?^0 ?a . - ? c42.a:9 S'I_ OF'L== 0.00 (FQqlic00'S') DEI'IS ITY=• .16 ARCA= 130 I-' hID. 4 Dl:A. L.E.i`IGiH h nA 1 1,104 13.00 5.600 20.8 2 1.1()4 13.00 5.600 20.8 3 5.452 53.00 5.600 24.5 4 f. 452 1 3. 00 5.600 25.8 5 1.687 7.50 0.()00 010 l< = -1 !5 . as 9' U. r? B.L. L.rnh - ~--?? -? 6 -qqw F'E FITT IINGS VFL. 6.97 53.96 12.83 17.84 O[ 2T 53.22 IF.T= 34, . A 'dOl_l1Ml_ = 0.59 CtJ.F. VOLUME = 4.40 C.AL. ,1A.4=;.46.4:-?. } C4- 1.()U0 13.8 FF F'14 1,42 1:i.gU S,S3 13. 90 3.18 19.24 5.86 :'1.:38 5.10 28.21 -- °9' :;?: .. ''d 3; r P. Fc A M C a-e L- a N E: ra o _ ?t 96 (4 8.49.50 .5s.s2 .53.) SLOF'E= 0.00 (FL107/FDO7) C 4= 1.000 DEI•ISTTY= .56 Af; •L•A= 130 F'T:= 13.8 HD.* DTA. LF:I`IGTFI K PA PF F'tY f 4.t04 13.00 5.600 2().80 1.42 13.80 2 1.104 13.00 5.600 20.88 5.13 13.90 3 5.452 53.00 5.600 24.56 3.18 19.24 4 1.452 13.00 5.600 25.89 5.86 21.38 s 1.687 7.50 o.c>oo o.on 5.10 zB.z+ itti. = i '!5 . aS 9 L-4 = S' a - 'd -25 rE's Fz G-ih " c- H-H 6•L. e=520 F'E FITTINGS VEL. L T U-II E? B`I 01 - 1 .-'' SI_OF'F_= 0.00 K= :ii. 6 O0 FID,# AIA. LCNGTH 1 1.1()4 10.00 2 1.104 1U.00 3 1.452 10.00 4 5.452 SG.0U 5 1.687 1 0. oU b 1.6F17 6.00 A+:. = 'tf ' 4 . . E :t'v (54.55.56.57.58.59.60.) (F00'i/FDQT) C4= 1.000 C=120 F''i'= 14,01 h OA F'F f-'I`I PG S.fiVO 20.96 1.15 S$.Of 5.600 20.90 3.96 53.8() 5.600 23J5 2.40 17.49 5.600 24.68 4.33 19.42 0.000 ().00 2.09 24.6E3 0.000 0100 4.59 26.77 uyi :: :__ C;T (-:? _ 9 °r' oc 2T ?--r= VOLUME _ VOLIJME = S. L. 5.97 53.96 h 2.83 57.84 13.22 - -4 sr 0.59 CU.F. 4.4!) GAI_. F'tTTINGS VEL. 7.02 13.99 52.69 17.47 12.94 OE 2T 1 2. 94 IF ^ lf" == YS: :"::?: _ -dt VOL.Ui`f{c = O.61 CIJ.F. V01_L!hfE = 4.57 GIIL. . Ec Fa' A irii C, iFA ? I r-O IE NO m I E-3 (47.53.60.65.) SLOF"1==- 0.00 (FOD'T/FOQT) C4= 1.000 C=120 K= 15.690 F''T= 34.49 HD. # DIA: i_r•_riG'iH K QA F'F F'I`i 1 f. 6E37 10.00 15. 690 92. S4 2.17 34.49 2 2.154 4i.00 15.690 92.65 2,63 34,87 ' 3 2.5511 13.00 15,820 96.59 1.99 37,28 K -' '4- 'D _ °.R' -?. 0. `?" ES 'if ., ? a X- Ma?N F'G FITTINGS 0E 2T IF^ -F _ VC)LUMC = VCtLUM1= ? VFL. 13.22 16.26 57.25 7 - :he 0.91 CU.F. b.7F3 GAI_. 0 rR A? ?i r_: a-A L_ T u--u E: oA ?-i . ?? (:a QULk N1?lt I?J , . ibq.65.hF.1 SL01°'E= 0.00 (1= OQ7/FO CiT ) C4= 1,000 G- i 20 K= 40.. 920 f'7= 47.28 FiD.# AIA. L.EMGTN K nA F'F f-'H F'E FTTiSNGS VEI_.. f 4.260 626.00 40.920 281.37 12 .91 47,28 4E 17 6.33 2 4. 026 5.00 0.(?UO 0. ()t} 1 .3 '.? 5??'.8? 5-1- E}F-?_:0?--»-- „ ,. . -Q ,F_?.,;. ? ? - ^J? 5' w q? 'L.?i 6?'1 ? ? y -• ? ? y k p . ?? ? CJ? uotu?s?_ = ??. at> cu. r- , VqLUMG: = 466.78 GA(_. FT AvNL.= &2.03 « CEFd=CA'1ZCN CF OONFIINOIIM (S7APf.TAN[S? The undersigned, Wallace T. Jdhnnson of Brutger Canparues, 7nc„ the general partner of Woodridge Properties Li.mi.ted Partnership ( ttae "Declarant" ) being the present a,aner of the rnal rJTOFJ2Yty described in the Declaration identified bel.av, hereby certify as follows: 1. The undersigned have read and aze familiar with the provisions of the Declaraticn of Restrictive Covenants dated as of May 1, 1985 (the "Declaration") entered into by Woodridge Properties Limited Partnership, and duly recorded in the appropriate public real estate recards in and far Dakota County, Minnesota on NI3y 9, 1985 as Document No. 686791. 2. With respect tn 5ections 2 anl 3 of the Declaratian, all of the covenants arrl restrictions expressed in Sections 2 and 3(1 ) therein Y?3ve been fully and faithfully observed and pPxfornied at all times during the 12 month periocl precading the date of this Certificate. 3. With respect ts> Sections 4 and 5 of the Declaration, all the mvenants and restrictions expressed in said Sections 4 and 5 have been fully ard faithfully observed azxl performed at all times during the 12 month period prececling the date of this Certificate. 4. (a) N/A arnpleted residential imits in the Development which constitute N/A $ of all residential Lmits in the Develolxnent, were occupied by persons or families who qualify as Lower-Incame Tenants or were held vacant and reserved for occupancY Yy Lower-Income Tenants. (b) 44 arnpleted residential imits in the Develognent which constitute 22 % of all residential imits in the Developnent, wPSe occupiecl by persons ar families wkn qualify as Moderate Incare Tenants (inclixiirig Lower Inconne Tenants)r ar were held vacant arri available for occupancy by persons or families who qualify as Nbderate or Locver Inoane Tenants. (c) Attached as Sdiedule I is a list, by imit numbers ara3 tenant names (if the unit is occupied) of all units enumerated in paragraphs (a) thrangh (b), inclusive, above. 5. The Declarant is mt in default imder any of its cbligations under the Declazation except as set forth on Schedule II, if any, attached hereto. 6. Words and phrases used in this oertification shall have the sattie meanixigs herein as in the Declaraticn. WOpDRIDGE PROPIIYfIF55 L7MI7ID PARrTIERSfIIP BRiFPCER QJNIPANIES, INC. r Generdl Partne2 BY: I15 : June 14, 1987 Idoodridoe Apartments BuildinQ 3255 Through June 14, 1987 Unit # Name 105 Vick, C. 108 Aars 120 0'Raurke 127 Segal 129 Witt 132 Corson ? 135 Hanson 137 Richter 141 Ptayer 142 liallis 143 Karkoiosl:y 144 Brown/Thedene 145 Elwood/irest 203 Ackmann 20+ Stoclaaell 205 Carlson m 208 Piaus 212 Balza 215 Peterson 216 Iltis 217 Pearson 218 Quello 220 Springer 232 Phelps 303 Rote 306 Olson/Ail:en 311 Chorski 312 Smith T 314 Sohnson 316 Pearson 328 Anderson/131awd/Christopherson 329 Terrell 330 Peid 342 Svoboda BuildinQ 3301 101 Schrader 112 riirsberger/*Jicl:el 114 ilebb ? 115 Geier 119 Filkowski T 223 Lueck T Replaces income certification previously sent WOOORiOGE APAnTMEhTS (1401 i?SS Caacriman Road Tiiraugti Juri? 14, 1937 QUAIIFIED UtilT ----- TENANS ----- LEt1SE ----"-- LuK '------- 105 'v'ick, G. 04-61-26 :ti 108 fsars 08-01-86 n 169 ;ea'ord 04-01-96 X qi=k 01•0I-807 120 u'Rourke 09-01-86 X 127 3ea81 09-01-85 S{ 129 W;tt os-ut-as x 132 Corsvn 07-(?1-56 fi 135 f;aasan 05-01-81 % 137 rcicntEr 06-01-16 ;d 141 May?r 91-01-86 :d 142 n:llts 02-01-86 X 143 earkonski 06-01-35 R 144 BroanlTiiedens II-0I-86 X 155 Eipoodli+est 47-01-E6 X 203 Acrmeen 09-01-86 X 204 S+.ockweii 04-01-36 .. 205 Larisor., K. 64-01-86 8 zoa n<us as-oi-a? r 212 eeiza 07-01-66 i: 215 Pe±erson 05-01-87 X :ib iitis 05-01-86 X 217 Pearson 03-O1-36 ., 21'.'• 3uel)o 08-91-86 X 220 SArin3ar 05-01-85 X 232 F'r;elps 65-01-56 'f. 303 Rote 03-01-i6 X 306 L'ISGt1/M7CB."I QI-US-Bi X. Jil iharski 02-i?i-3i % 312 Saith, L. 06-0I-£5 R ?iV John;an, J. 67-013& X 316 "rearson 04-01-S6 X 329 ierreii 05-Q:-86 n 330 'r,eid 08-91-105 n 742 .vat,ada X , i9U0DR[DuE APAF.TMEY':5 i59) 3301 Coxchaan Roao Thraugn June 14, 13$i AU(iLiFiED UYIT ----- TE'r,'AH1 ------ I EASE -----°- LOW - ------ i0l SchradFr 96-41-36 ° X 112 ,'aiirsGer9er!?lickei 49-01-E•h X 114 qie6b 07-n1 -36 X 115 6eier 05-01-8e 8 119 Fi;koMSki 0-0:-85 X 211 nci 10-C-1-036 X 223 Luerk 07-01-a5 K +Ob t;u-baue 08-01-86 X 3114 Lane 07-01-35 k 9 44 _ s.._s_. __ n_ ...? _ . ?... . . . ??? WOODRI DGE APHRINEMrs 3255 FACd1N, MINNESOTA / =3301 UN[T # , %' I `- Woodridge Apartments were financed with Tax Exempt Industrlal Revenue Bonds. As a condition to recelving thls below market interest rate financing, the developer/owner is required co obtain the following Income Certiflcation Information. This form must be completed with regard to anttcipated locome and ezpenses during the 12-month period following the earlier of the date of occupancy or the date you sign a lease. This form must be prepared by you with regard to each member of your fam3ly that wlll live in the unit (even if the member ls tempo- rarily absent). A separate form must be pr2paied by each person that you anticipate will live in the untt if that person, or persons, is not presently related to you. You understand thet, pursuant to the lease agreement you will have or wilt enter into, you are not authorized to sublease your apartment, accept roommates or enter into any type of unlt-shartng arrangement without the express written permission of the landlord. 1. INOQvE iNF'OI"dv1ATI01V 1, the undersigned, state that I have read and answered complete- ly and personally each of the following questions for all persons who are to occupy the unit in the above apartment development, all of whom are listed below: Relatlonship to Head Age Nmnes of Occnpants of Honsehold if under IS C7 2 I I. IPIOQvE The anticipated Income of all of the above persons during the 12-month period beginning on the effective date of my lease, and the sources of income are listed below. Place of dnploym ent or Source of_Income ._?Cl - /•?C-??il 1 T C ?11 ?7?- . ?'"?f 1^ ?v lii 2 3 1?411U?' 4. 'POI'AL 1NOQW FFtCM SWF2CES LISThD ABOVE 6. IN(X.tvE FTtUA ASSEI'S L t S7'ID QV PAG£ 2 'I'OrI'AL HNNUAI- H0USE]-10LD I1JOR+E (Line lA plus Line 1B) Total Amount of Annual Salary or Other Income $ $ $ $ $ L1NE lA $ -'? Ql-Z' L I1YE 1 B $ ' :Z -? ? L[ne 1C g0? 1?qO.v'p The amounts listed as tncome include, hut are not Ilmited to,all lncome and earnings to be reported on my federal lncome tax return(s), and represent all wages and salarfes (including overtime pay, comnissions, fees, tips and bonuses) ; net income from business operations, rental of real or personal property; annulties and pensions; social securtty payments; payments in Iieu of earnings such as employment and disability compensation, worker's compensation and severance pay, unless such payments constitute lump siun additlons to family assets such as inherlt- ances and insurance payments (including payments under health and accident insurance and worker's compensation); alimony, child support, AFDC payments and regular contrlbntfons or gifts from persons not residing in the household; income from interest and dividends; and alt other payments, contributions, and/or earnings derived from employment and other sources. NOTE TO PCRSOIV(S) CMiPLETING 7i-I!S F'OFZn4: A detalled 1lsttng of lncome inclusions and excluslons is available. if you have any questions about what is or is not income, please ask the resident manager for assistance. II1. ASSEI'S If any of the persons listed In Section I(or whose income or contribution was lncluded In Line lA) has a savings, bonds, equity In real property, or other form of ca tal investment, please compiete the following. Please note t at net family assets do not lnclude the value of necessary i ms of personal property such as furniture and automobiles. a. 'Cotal value of ail assets u% L'INE 2A b. Amount of income expected to be derived from such assets ln the 12-mon[h period commencing this date. (Enter this amount $.. on Page l, Line IB). L1 E 26 IV. S1'UDENf STA'R!S Wi I l al l the persons tisted In Section I be or have they been full time students during flve calendar months of this calender year at an educational institution (other than a correspondence school) with regular faculty and students? Yes No Y Is any such person (other than non-resident aliens) eligible to flle a jotnt federal income tax return? Yes No ? V. AQQ4C7NLIDGIIvffTIf/CFI2TIF[CATIQV marr(ed and We acknowledge that ali of the above information is relevant to the status under federal income tax law of the interest on bonds issued to finance \Yoodrldge Apartments. We consent to the disctosure of such informatlon to the issuer of such bonds, the Cfty of Eagan, Midland Financial Savtngs & Loan Associatton, the holders of such bonds and any trustee acting on their behalf. , ? ?. 2 The undersigned does hereby certlfy that the informatlon set forth above is true and correct in all respects, and the under- signed acknowledges that the lease executed by the undersigned may be cancelled upon 10 days written notice if the undersigned have misrepresented any of the information set forth above. ? Date Head of Hafisehold Spouse Subscribed and sworn to before me thia ?D "" day of V\??i?.,--+ 1J • ? .7 ` l? Notary Publ ic in and for the ?,??,,,;;?r,?;? ? 5tate of ? : _.. r.tv,a- rEn ts.19C2 'nqy Commission Expires: '' ' . AUI7-IQ2I7AT I ON F'Ol2 RELFASE OF I NKAM VFR I F I CAT IQV (To be compleced bq Employee/Tenant) TO: TZe)i,d C:Ti[z rPCS?/t?Plff Cc'.U7C-/?FROPA: 2csE/y/H,Q?/ C' ??=??, Name of rinployer Name of Employee Tenant) ? ? y ,srl,.c;?rH?,f?1- ?} ?c. s Street Address Boz Number 3 3 0 / i / ?--- Apartment Number lluilding Number A9iN,vrAf'cu.s /L941 5 5-4t/ 7 City State Zip 1 hereby grant you permission to disclose my income to 1Vood- ridge Properties Llmited Partnershlp wlth respect to my ren[al of an apartment located in their development, whlch has been ftnanced with Tax Exempt Industrial Revenue Bonds. REQUEST FOR I rl0dME VII2I F ICAT IGN (To be completed by Manager or Development Owner) .I.O. Twin Cities Research Center ATTN: Personnel/Payroll RE: Rosemary C. Geier [Vame of Fmployee The employee named above has rented an apartment !n a develop- ment financed with Tax Exempt Industrial Revenue Bonds. Please lndicate below the esnployee's current annual lncome from wages, overtime, bonuses, comnissions, or any other form of compensatton received on a regular basis. INOQME VIItIFlCATION (To be completed by E}nployer) The anticipated annual income as of the date hereof for the above-named employee ls as (isted below: Annual VVages Overtime Bonuses Comnissions $ - $ S T07'AL ANI'ICIPA'CID APdJUAL INOQ?E $ ? ?.? 90 I hereby certify that the statements are true and complete to the best of my knowledge. Date• Signature Title This form may be hand delivered or mailed to: Woodridge Apartments Wo o d r i d g e P r o p e r t i e s L i m i t e d c/o Hegg Property Management partnership, 4530 Excelsior Blvd. c / o B r u t g e r Com p a n t e s, 1 n c., Minneapolis, MN 55416 General Par[ner P.O. Box 399 St. Cioud, NTI 56302 ATTN: Roberta Camp FOR CQeg'LET i ON BY DEVELOP'A:1FNP d-1NfR C(MPUI'AT I OiV OF GROSS I NCCZv1E Lower Income Tenants 1. Calculation of tenant income: a. Enter amount entered on Line IA b. If the amount entered on Line 2A is greater than S5,000, enter the greater of (i) the amount entered on Line 2B (this amount should also be listed on Line 1B), or (ii) 10°0 of the amount listed on Line 2A) c. TOTAL ELIGIBLE INCCX.E `" ? s -)?? 2. The amount total eligible income listed above Is: ?. Less than or equal to 80%'0 of inedian income for the area in which the Development is located. PAore than 80% of inedian area income for the area In which the Development is located 3. Number of apartment unit assigned ?//z- 4. This apartment unit wa was last occupied for.a period of at least 31 consecutive days by persons whose aggregate anticipated annual income as certified in the above manner upon their occupancy of the apartment unit was less than or equal to 804% of inedian gross income in that area. Prioderate Income Tenants 5. a. Enter amount of Line 1C from Income ? Certification b. Enter totai amount of alioNvable deductions for persons occupyin; unit ($750 for each unit co a maximum of two, and $500 for each other dependent) $ GROSS FAr,11LY INCMIE Applicant qualifies as: Y? Lower Income Tenant (800'0 or of all tenants must meet) 4 less of inedian area income - 20°/u nloderate [ncome Tenant (?J:'ore than 80%, but less than or equal to 110010 of inedian area income - 55°0 of all tenants must meet) Does not qualify for either ca[egory - S I GNED: ( 6Lo? 0 DnTC: ?- C--) ' K?TerIANT 11rAnE: G ? LtL? DEVELOPOII`1T/UNIT # ?=?ll ?'3?3ri (- /I Z ? .?_ _. . . ..... ? . Uepartmenf of the Treasury-Intemal Revenue Serv¢e {?? 4 1 04OU.S. Indlvldual IncameTax Return UcyJ8S ' FortheyeaNanuaryl-Dxember31.1985.aroIDertaxyearbeginning ,1985,enGing Use Yourfl CAR-RT SORi **RR O4 e las 1a6e1. XX 395-34-5952 S08 20 ?I Other- Preser ROSEMARY GEIER Rj wise. 635 5 ROdERTS RO 6375'I please Pri^t C'ty"`?HU7CHINSUN HN 55350 or type. - - I Soou Election Campaign Filing Status Checkonly one box. Exemptions - Aiways check - the boa labeled , Yourself. Checkother boxesifthey / apply, Income Please attach Copy B of your Forms W-2, W-2G, -? andW-2Phere. If you do not have ? a W-2, see ; page 4 of _Instrudions. • ?i_. 4 = = . Please - attachcheck ormoney ? ortlerhere. Adjustments to Income (See Instructions an page 11.) _ Adjusted 19 . DMB No. 1545-0074 Your soaal security num0er SOOUSe's soclal seeurity numEer ' Do you want $1 t0 go to this fund? .... ........ 1 x Yes No Noie: Checkmg "Yes"wdl h n t t Ifjointreturn,doesyourspousewant$ltogotothisfund?. '. Yes No ge your c a ax or ?,: no •,eeuceyou.rcnmd. • 1 . F -' " ' -• "• .,, _ . Por Privacy Att and Paperwork Reductian Act Notice, see Instructions. . . ... Single . ? : -.? . _.. 2 . .. ., , ,? ,.. . , .. . . . Marriedtilingjointietum(evenifonlyonehadincame) _ 3 Married liling separate ahrn. Enter spouse's saial sewrity no ahove and full name here ' 4 -`" , . Head of household (with qualifying person). (See page 5 of Instruttions.) If the qualifying person is your unmartied child bu[ not your dependent write child's name here ' 5 , ualifyin widow(er) with depende . nt child (year spouse dietl ? 19 ). (See page 6 of InstmctionsJ ba E Yourself .C.'z:.???.':-,_ Spouse .65or over ... 65 or over ..., _, . Blind r;,•r.I . . ?„- Blind -.?:•,::3,=r...r ) EnhrnumherM } hoxeschaked ) on 6a and b? a c First namespf your dependent children who lived wRh yau T"c "I'; S JC N n/ c r...-? r,.n ->? c?r.? ) )} Enhr numkr ° I s?ed'oe 6t ? a , ? E d First names of yourdependent children who Citl not live with you (see page 6). ?I A I? If re-1985a reement,checkhere?? nter aumEer atchild2n I ? hskd on 6d ? ?? / I ? • .1 e Otherdependents: - - (1) Name ?-"-. . (2)Relation5hip (3)Numouoi manm:hrea inmurhame (pDiddepenaent IuveiMOmeaf f010ormorN (5)DMyoumwiae monlhanoa,mlloi EepenEenfssuppart. , i } Total number of exemptions claimed (also complete line 36). . 7. Wages, ulanes, tips, etc. (Attach Form(s) W-2.). .. , 8 Interestincome(alsoatfachSchedule8ifover$400). f ? .• .'?. ?.. . 9a Dividends(alsoattathSchedufeBi/aver8400) I 911o 6cclusion e Subtract line 9b from line 9a and enter the result. . . . . . . ., , 10 Ta%a61e refunds of state anC local income taxes, if any, fram the worksheet on page 9 of Instructions.11 Alimany received . . . 12 Businessmcomeor(loss)(attachScheduleC)._.;. . .:,:,,,..•;.,,:_.;. ._ 13 CapiWlgainor(loss)(attachScheduleD) . ... . .. .. . . . ...:°?ri''.:..: . .;;-(a-. 14 40%af caDital gain distributions not reparted on line 13 (see page 9 of Instruc[ions) 15 OthergainsorQosses)(attachForm4797) . . .. . . . . . : :. .. .. 16 Fully taxable pensions, IRA distributions, and annuities not reparted on line 17 (see page 9). 17a Other pensions and annuities, mcluding rollovers. ToWI received I l7a I I - b Taxable amount, if any, from the worksheet on page 10 af Instrudions 18 Rents, royalties, paRnerships, estates, tmsts, eta (attath Schedule £) 19 Farm income or (Iws) (aKach Schedule F) . . . . . ' " : 20a Unemploymentcompensation(insurance).Totalreceived ,.., .. I 24a I• b Taxableamount,ifany,fromtheworksheetonpagel0aflnstructions. . . . , , 21a Soeial security benetits (see page 10). Total received. . •: 1218 ?- Taz evtmpt b Tazable amount, if any. Trom worksheet on page 11. { rme.m }••,•- . 22 Other income (list type and amount-see page 11 of Instructions) 23 AGA lines 7 throu h 22. This is our total income .. ? 24 Movingezpense(attacbForm3903or3903F) . . . . . 24 25 Employee business expenses (attach Form 2106). .... 25 26 IRA deduction, from the worksheet on Dage 12 ..... 26 27 Keoghretirementpiandeduction . ... . • • • • . . 27 28 PenalTyaneartywithdrawalo}savings . . . . 28 29 Alimony paid (raipient's Wst name and -' socul saurily na. ) . . . 29 30 Deduttionforamarriedcouplewhenbothvrork(attachSchedulevo 30 31 Add lines 24 through 30. These are your total adjustments . .? 32 Subtract line 31 from line 23. This is your adJusted gross Income. 1/ fhis line 's less lhan SI1,000 and a child lived wrth you, see "farned Inrome CrediY" (line 59) on page 16 0l " ' F ?^.3tf.,?'i(! Enter numher ? M other dependenls ? Ilddnombers r.? 6ocesabove ? "T 7 -;?G sc - 9e ' 0 l7b i 1e "l 3 ) 19 VMS 206 21b 22 23 33 S *3 - k / i Form 1040(1985) 33 Amount from line 32 (adjusted gross income). . . 33 / TaX 34 a Ifyouitemize,att achScheduleA(Form1040)andentertheamounttromScheduleA,line26. . 34a COIIIpU- Caution: If you have unearned income and can be ciaimed as a dependent on your parents' %?/?q tatian return, check here ?? an0 see page 13 of Instructions. Aiso see page 13 if you are married filing a separate return and your spouse demrzes deduUions, or you are a dual-status alien. (See 6 If you do not itemize but you made charitable coMributions, enter Instructions your cash cantributions here. Qf you gave $3,000 or more to any : on page 13.) one organization, see page 14.) . . , , , 346 e Enteryournoncashcontributions(yaumustattxAform8183iloverS500) 34c d Add lines 34b and 34c. Enterthetatal . : . . . ?d a Divide the amount on line 34d by 2. EMer the result here . . ? 34e 35 Subtractline34aorline34e,whicheverapplies,fromline33 .. . . . . . , . . , 35 i 36 Muitiply E 1,040 by the total number of exemptions claimeA on line 6f (see page 14) ...., 36 J4 ? 37 Taxable Income. Subtract line 36 from line 35. Enter the result (but not less than zero) ... . 37 G d1' - 38 Entertax here. Check if from STax Table. [I Tax Rate Schedule %, Y, or Z. or 0 Schedule G 38 39 Additianal Uxes. (See page 14 of Instructions.) Enter here and check it from ? Form 4970 , Form 4972, or - . ? Form 5544. 39 40 Atld lines 38 and 39. Entei the total ., " . . . . . . . . . . . . . . . . . . qp / i/ Credits 41 CredittorchildandEependentwreaxpenses(attachFvrrtr2441) 41 42 Credit for the elCerly anC the permanently and totally disabled (attach Schedule R) . . . . . . . . . . . . . . 42 (See Instructions 43 Resitlential energy creAit (attach Form 5695) ...... 43 on Oage 14.) 44 partial credit for political contributmns for wh¢h you have reeeipts 44 45 . Adtl lines 41 through 44. Theseare your total personal creCds ........... 45 7e- - _ 46 Subtract line 45 from line 40. Enter the result (6ut not less than zero) ....... , 46 f - 47 Foreigntaxcredit(attachFormI116). . . . . . . ... 47 48 Generolbusiness credrt.Checkiffrom ? Form3800, ? Form 3468. ? Form 5884. ? Form 6478 . . . . . 48 - 49 AdOlines47and48.TheseareyourtoWlbusinessantlothercredits . . . . . . . 49 50 Subtract line 49 from line 46. Enter the result (hut not less than zero) . .? 50 51 Self-employmenttax(aMachScheduleSf) . . . . . . . . . . . . : . . . . . 51 Other 52 Alternativeminimumtax(attachForm6251). . . 52 Taxes 53 Taaframretaptureofinvatmentcredit(attachForm4255). . . . . . . . . . . 53 • (Including 54 SocialseeurityUxontlpincomenotreportedtoemployer(attachFOrm4137) . . . . . , . 54 AdvanceElC 55 TaxonanlRA(attachForm5329) . . . . . . . . . . . . . . . . . . . . 55 Payments) 56 AGd lines 50 through 55. This is yourlotal W: . .? 56 57 FeCeralinwmeUawithhelA. -. Payments /32 3 -3 .5-5 58 1985 estimated tax payments and amountapplied from 1984 return 5$ 59 Earnedincometredit(seepagel6) A 59 ttachForms W2,W-2G. 60 AmountDaidwithForm4868 . . . . . . . . . . . 60 and W-2P 61 Extess social security Wx and RRTA Wz withheld (two or more to (ront. -emplayers) . . . .. . . . . . . . . . . . . . 61 62 Credit for Federal tax on gasoline and special Tuels (aBaM form 4136) 62 . . 63 Regulated Investment Company credit (attach Foim 2439) .. 63 64 Add lines 57 through 63. These are your total payments . • 1- 64 65 If line 66 is larger than hne 56, enter amaunt OVERPAID . - ? R t d 65 e un ar 66 A f . mounto line65tobeREFUNUEDTOYOU . , 1, Rmount 66 67 Amountofline65toheapPliedtoyour1986estimatedtax . . . ? You Owe 68 M line 56 is Wrger than line 64, enter RMOUNT YOU OWE Attach check ar money order lor full amount payable to"Internal Revenue Serv¢e." WrRe your socwl setunly numberon0'7985 Form 1090" on R. . ? 68 Che[k ?? d Form 2210 2210F is attacheC. See a e 17. Genal . ? s? ? ? ? e ?? ? u?inre ariai i iie.e ezammw ims remm ana accampanying scneawes antl statemenb, an0 to the best ot my knowletlge antl Please belief,theyaretrue,carrect,andrnmDlete.Dxlarationafpreparer(otherthantaxpayer)isDaseOOnaliinfarmationolwhichpreparerlufam/knowledge. Sign ? `c ? • :u ; ?. ? • ------ . Here «<• ;-- I ?i •? ??. Voursignature Date Spouussignature -(itLlingpmNy,80THmustsign) Preparer's Date Preparcr's sxtal securiry no. Paid signature ' Checkif sell ? Preparer's -em lo eA Firm's name (ar J yours. if self-employed) ? E.I. No. Use Onl anE address ZlPcotl. , N500DRIDGE APAR7A/IENfS x 3255 ; FAGAN, M1N6VESOTA 3301 UNIT # /3-f Woodridge Apartments were financed wlth Tax Exempt Industrlal Revenue I3onds. As a condition to receiving this 6elow market interest rate financing, the developer/owner is required to obtain the following [ncome Certification information. This form must be completed with regard to anticipated Income and expenses during the 12-month period foilowing the earlier of the date of occnpancy or the date you sign a lease. This form must be prepared by you lvith regard to each member of your family that will 1[ve in the unit (even if the member is tempo- rarily absent). A separate form must be prepared by each person that you anticipate will live ln the unit if that person, or persons, Is not presently related to you. You understand that, pursuant to the tease agreement you wi 1 I have or wi l I enter into, you are not authorized to sublease your apartment, accept roommates or enter into any type of unit-sharing arrangement tivithout the express written permisslon of the landiord. 1. I NOCW I NF'Of2NIAT 1 ON I, the undersigned, state that I have read and answered complete- ly and personally each of the following questions for atl persons who are to occupy the unit in the above apartment development, aif of whom are IIsted below: Relationship co Head Age Names of Occupants of Household Tf under 18 1. .Q+??K?EocJ 6. 2. K?('/S77 ?Le? /"'^/l2?OhJ enJlr? 3 4 5. I I . 1 NK7(AE The antlcipated income of ali of the above persons during the 12-month period beginning on the effective date of my lease, and the sources of income are listed below. Place of Flnployment or Source of Income 1. ?o.vs7?PO?s /ftvuF-Ac ;zc2i?Jl . .z nJt 2. /LI-54.1 NoRizrn? : :..U,0CR114t2s 3 4 5 TOTAL I NCJCM FRCM SOUCtCES L I STm ABOVE 6. INCJCTI(E FRONS ASSETS L I STID ON PAGE 2 TOrI'AL AANUAL }-K)USII-TOLD [NCCAE (Line lA plus Llne lI3) Total Amount of Annual Salarv or Other Income g 161, 906 $ ? $ $ ? L(g2 QlS(2 LINE lA $ , LINE, IB $ ??-?r? , N?) [ ' Line IC The undcrsigned does hcreby forth above is true and corre signed acknowledges that the may be cancelled upon 10 days have misrepresented any of the i /Zc-167 Date / ? certify t h a t the informatlon set 2t in all respects, und the under- lease executed by the undersignec( written nottce if the undersigned information set forth above. Ilea FHousehold Spouse Subscribed and sworn to before me this day ofJ (.i/1 19?. - ?'? Notary Pubiic in and for the : ?tw ELLEN MAG, - ti , 140". , - • ? UAun,n rn1!ury ? S t a t e o f ,lnA. C,Q ?,?? tsvz ? n P : ty Conri i s s i o n Ex p 1 r e s:?_.?z?(,-.??/ 3 The amounts listed as income inciude, but are not Iimited to,ali income and earnings to be reported on my federal income tax return(s), and represent all wages and salarfes (including overtime pay, comn[ssions, fees, tips and bonuses); net income from business operations, rental of real or personal property; annuities and pensions; social security payments; payments in lieu of earnings such as employment and dlsability compensation, worker's compensation and severance pay, unless such payments constitute lump sLffn additions to family assets such as inherit- ances and insurance payments (includlnp, payments under health and accident insurance and worker's compensation); allmony, child support, nFDC payments and regular contributlons or gifts from persons not residing in the household; income from interest and divldends; and all other payments, contributions, and/or earnings derived from employment and other sources. NOTE TO PCP.SON(S) Oa1,1PLETiNG 'Il-fIS F(Y.'.fV4: A detailed Iisting of income inclusions and exclusions is available. If you have any questions about what is or is not Income, please ask the resident manager for assistance. III. ASSETS If any of the persons listed in Section !(or whose Income or contribution was included in Line lA) has any savings, bonds, equity in real property, or other form of capital investment, please complete the following. Please note that net family assets do not tnclude the value of necessary items of personal property such as furniture and automobIles. a. Total value of aii assets b. Amount of income expected [o be derived ' from such assets in the IZ-month period corrmencin? this date. (Gnter this amount on Page 1, Line IT3). 1V. S7UDE]VI' STA7lJS Wi 1I al I the persons Iisted in Section I be full time students during five calendar months year at an educational institution (other than school) with regular faculty and students? Yes No L $ -0? LINE ZA s - o LINE 2B or have they been of thls calendar a correspondence Is any such person fother than non-resident aliens) married and eligible to file a joint federal income tax return? Yes No/ V. AQQNQ9[.IDGEAIENI'/CFRTIFICATIdN 1`?e ackrlowledge that all of the above information is relevant to the status under federal income tax law of the lnterest on bonds issued to finance 1VoodridEe Apartments. We consent to tiie disclosure of such information to the issuer of such bonds, the City of Eagan, Niidland rinancial Savings 8_ Loan Association, the holders of such bonds and any trustee acttng on their behalf. 2 AUI7-lO1t I7AT I ON FQI2 I2ELEASG OF I NOQv1E VFR i F I GqT I ON (To be completed by Flnployee/Tenant) TO: CROn?STk'oi+?1= /'vfiUU.F?_ii+Qnt/?j J?G Fl'.CI'.I'l dt? G?'-•-H.?^--?? Natne of Gttployer Signat Tmployee/Resiil-ent `fZZS j/,q4i.aT1/i4 /QiF. Street Address/Box Number ,49.,V1V,rA,rous /eu City State Zip 135 - 3.;? s-s Apartment Num6er Building_Numher I hereby grant you permission to disclose my income to lVoodridge Properties Limited Partnership with respect to my rental of an apartment located in their development, which has been financed ivith Tax rxempt Industrial P.evenue Eonds. itEQL/EST FOTZ I r'OQa'E VERI F I CAT ION (To'be completed by DAanager or Development Owner) TO: ATIN: RC: Name of f-inp I oyee The employee named above has rented an apartment in a develop- ment fInanced with Tax Exempt Industrial Revenue Lionds. Please lndicate below the employee's current annual lncome from wages, overtime, bonuses, comnissions, or any other form of campensation received on a regular basis. I iVOClVIE VER [ F I CAT I ON (To be completed by Fmployer) The anticipated annual income as of the date hereof for the abov.e-named employee is as listed below: Annual tYages ? 17,000.00 Overtime $ Bonuses $ Conmissions $ 'I'O I'AL ANI' I CI PATID Ai44[1AL I NOQ41E $ 17 , 000. 00 C•mployment is full time part time If part time, please indicate hovi many hours per weetc or month. per week per month $ hourly rate I hereby certify that the statements are true and complete to the best of my lcnowled.-e. '",: , Da t e: February 10, 1987 T Signature Accountina Administrator Title This form may be hand delivered or nailed to: VJoodridge Apartments c/o Ilegp, Property Ptanagement 4530 Excelsior 131vd. Minneapolis, MN 55416 FOR COAIPLETION BY DGVELOPMENT 0;fNER CO:fPUTATION OF GROSS INCOME Lower Incooe Tenants 1. Calculation of tenant income: a. Enter amount entered on Line 1A $ Z1d06 b. If the amount entered oa Line 2A is greater Lhan $5,000. enter the greater of (i) the amount entered on Line 2B (this amount should also be Iisted on Line 1B), or (ii) 10Z of the amount Iisted on Line 2A) S c. TOTAL ELIGIBLE INCOME -.0' 2. The amount total eligible iacome listed above is: ? Less tha? or equal to 809 of inedian income for the area in which the Oevelopment is Iocated. Pfore than 801, of inedian area income for the area in which the Development is Iocated 3. Number of apartnent unit assigned LY' 3!?- 4. This apartment unit was/was not Iast occupied for a period of at least 31 consecntive days by persons whose aggregate anticipated annval incon,e as certified in the above manner vpon their occvpancy of the apartment vnit was Iess thdn or equal to 807 of inedian gross income in that area. Applicant: V_qualifies _does not qualify SIGi`lED: DATE: TENAn'T A3Ah1E: ?C4.1`117?)? DEVELOPhfENT/UNIT ll 4 i? E400DTt t DGE t1PA}r[MEIJI'S FACaAPI, MIAdVESOTA LJtVIT t. INOU7E INFOFd1M1TI0[V Noodridge Apartments were financed with Tax Exempt Industrial Revenue Bonds. As a condltion to recelvtng thls below market interest rate financing, the developer/owner is required to obtain the tollowing [ncome CertifIcation information. This form must be completed with regard to an[Icipated income and expenses during the 12-month period following the earlier of the date of occupancy or the date you sign a lease. This form must be prepared by you with regard to each member of your family that wili Ilve in the unlt (even If the member is tempo- rarily absent). A separate form must be prepared by each person that you anticlpate will live in the untt if that person, or persons, is not presentty related to you. You understand that, pursuant to the lease agreement you wt I I have or wi 1! enter into, you are not authorized to sublease your apartment, accept roommates or enter into any type of unit-sharing arrangement without the express written permission of the Iandlord. I, the undersigned, state that I have read and answered complete- ly and personally each of the following questions for atl persons who are to occupy the unit in the above apartment development, all of whom are Ilsted below: z Relatlonship to Head Age Names of Occupants of Househotd if under 18 s. 11. InraW The anticipated income of all of the above persons during the 12-month period beginning on ths effective date of'my lease, and the sources of income are tisted below. Total Amount of Annual Place of Eknployment or Source of Income Salary or Other Income .- I.?, r?77n rJ R L l_:3:r`USS Sy?<-7-6a?S , n1 C.. , $ 2. $ 3. $ 4 5. TOTAL INCX,W FRQVI SOURCES LISTFD ABOVE 6. INOQdE FCt(M ASSETS LISTID (DN PAGE 2 'I'OTAL /UWUAL I-IOUSF]30LD 11VCCRIE (Line lA plus Line 1[3) X 3255 3301 $ $ ?w, 00c) c) 1,INE lA L1NE 1B Line IC 1 The amounts lis[ed as Income include, but are not Iimited to,all income and earnings to be reported on my federal income tax return(s), and represent all wages and salarles (including overtime pay, comnisslons, fees, tips and bonuses); net income from business operations, rental of real or personal property; annuities and pensIons; social securlty payments; payments In Ileu of earnings such as employment and dlsability compensation, worker's compensation and severance pay, uniess such payments constitute IumQ sum addltions to family assets such as inherit- ances and insurance paymen[s (lncluding payments under health and accident insurance and worker's compensation); alimony, child support, AFDC payments and regular contributlons or glfts from persons not residing tn the household; income from interest and dividends; and all other payments, contributions, and/or earnings derived from employment and other sources. NOTE TO PCRSON ( S ) COMPL ET I NG 'I1-I 1 S F'Of2A4: A d e[ a i t e d I i s t i n g o f Income inclusions and exclusions is available. If you have any questions about what is or is not income, please ask Che resldent manager for assistance. III. ASSEfS If any of the persons ]lsted i? Sectlon [(or whose income or contrIbution was included in Line IA) has any savings, bortds, equity In real property, or other form of capital investment, please complete the following. Please note that net famfly assets do not include the value of necessary items of personal property such as furniture and automobiles. a. Totat value of all assets $ - ? - ?< L[NC 2A b. Amount of income expected to be derived from such assets in the 12-month period comneneing this date. (Enter this amount $? on Page 1, Llne 1B). LINE 2B IV. S1UDrNf STANS lV( ] l al l the persons listed in Section I be or have they been full time students during five calendar months of thls calendar year at an educational institution (other than a correspondence school) with regular faculty and students? Ye s No Is any such person (other than non-resldent allens) married and eligible to flle a joint federal income tax return? Ye s No -_'?/ V. AQQNChNLIDGIIv1QW/CII2T[FICATION tVe acknowledge that al( of the above informatlon ls relevant to the status under federal income tax law of the ihterest on bonds issued to finance 1Voodridge Apartments. We consent to the dfsclosure of such information to the issuer of such bonds, the Clty of Eagan, Midland Financial 5avings Pz Loan Association, the holders of such bonds and any trustee acting on their behalf. 2 The undersigned does hereby forth above is true aod correi signed acknowledges that the may be ca e ted upon 10 days have misr pr sented any of the ? ?ate certify that the information set ?t in all respects, and the under- lease ezecuted by the undersigned written no e lf the undersigned inform s fo th above. ead o Household Spouse Subscribed and sworn [o before me this ? day of I%;''C4 19 %i- -Notary Publlc in and for the xr.n?an?.?aasaa?ear.na?,..uu«asaa?,amnraaiu,ax ?? . E. M. ?w'."uN ? State of ? ?/!// ?? `Y.%c'ue-•??-; aoT: cuwrr p1Y Comnission ExPires: .•,.12.19sa X.ryy?.?.jr?q?r•fyS+VC?V°T4G:?ii'V ? 1'7'v'ti"nYVO^Ytl'?/}( FOR COAiPLETION BY DEVELOPMENT OWNER CO:IPUTATION OF GROSS INCOME Lower Incooe Tenants 1. Calculation of tenant income: a. Enter amount entered on Line lA $ :_? U, GCi U b. If the amount entered on Liae 2A is greater than ,$5.000, enter the greater of (i) the amount entered on Line 2B (this amount should also be Iisted on Line IB), or (ii) 10/', of -- the amount listed on Line 2A) c. TOTAL ELIGIBLE INCOPIE 000 2. The amount total eligible income listed above is: 14 ^ Less than or equal to 807 of rsedian income for the area in which the Development is Zocated. _ Ffore than 80% of inedian area income for the area in which the Development is Iocated 3. Number of apart.nent unit assijned ? b 4. This apartment unit was/oas notlast occupied for a period of at Ieast 31 consecuti`?ce? by persons whose aggregate anticipated annual income as certified in the above manner upon their occupancy of the apartment ?nit was Iess than or eqnal to 80% of .median gross income in that area. Applicant: X qnalifies _does not qualify SIGA'ED: ?? 0G.l"nr DATE: Sf ? ? D 7 TENAA'T l1APIC: CE.I.u' DEVCLOPh1ENT/UNIT N WR- 4 {400QiiL)GE APARIN&NfS ?3255 EAGAN, MIMVESOTA 3301 UNIT Woodrldge Apertments were flnanced with Taz Ezempt lndustriel Revenue Bonds. As e conditlon to recelving thls below market interest rate flnancing, the developer/owner Is required to obtaln the following lncome Certificatlon information. Th1s form must be completed with regard to entictpated income and ezpenses during the 12-month period following the earlfer of the date of occupancy or the date you sign a leese. This form must be prepared by you with regard to each member of your family that w(11 Ilve tn the unlt (even i[ the member is tempo- rarily absent). A separate form must be prepared by each person that you anticipate wlll Iive in the unit If thet person, or persons, ls not presently related to you. You understend that, pursuant to the lease agreement you will have or will enter into, you are not authorized to sublease your epartment, accept roommates or enter into any type of unit-shartng arrangement without the ezpress written permission of the lendlord. 1. IN00VIE iNFGPMALTIQV I, the undersigned; state that 1 have read and answered complete- ' ly and personally each of the following questfons for ell persons who are to occupy the unit !n the above apartment . developmenc, all of whom are llsted below: Relatlonship to Head Age Names of Occupanta of Household if under 18 3. . 4. 5. i I . INLCME The antlcipated income of all of the above persons during the 12-month perlod beglnn[ng on the eftective date of my lease, and the sources of income are listed below. Place of FSnploYment or Source of Income 2. Total Amount of Annual Salarv or Other income g o? ?c, UOC $ 3. $ 4. 5. 'IIII'AL I MOQvE FT2QN SO[A2CES L 1 STED ABOVE 6. I NJJCJJONE FitCM ASSETS L I STID RV PAGE 2 'POr1'AL /1N]UAL HOUSI?]iDI.D INOQM (Line lA plus Llne 1B) $ $ $ ?IE lA $ ,?""Lu LINE 1B ? x a C. :C? Line 1C ^.. iJ -? ? 1 2. The emounts listed as lncome inciude, but are not Itmited to,all Income and earnings to be reported on my federal income taz return(s), and represent all wages snd salaries (including overtime pay, comnisslons, fees, tips and bonuses); net income from buslness operations, rental of real or personal property; annuities and pensions; social security payments; payments In lieu of earn(ngs such as employment and disabllity compensation, worker's compensatton and severance pay, unless such peyments constitute lump strtn additlons to famlly assets such as inherlt- ances and insurance payments (including payments under health and accident insurance and worker's compensatton); alimony, chiid support, AFDC payments and regular contributlons or gifts from persons not residing in the household; income from interest and dividends; and all other payments, contrlbutlona, and/or earnings derived from employment and other sources. NOTE TO PERSCN(S) QONff'LETING THIS FORA4: A detailed lfsting of Income inclusions and exclusions is available. If you have any • questtons about what is or is not lncome, please ask the resident manager for assistance. III. ASSEfS ?[f any of the persons Iisted !n 5ection I(or whose lncome or contribution was iocluded in Line IA) has any savtngs, bonds, equlty in real property, or other form ot capltai investment, please complete the following. Please note that net famlly assets do not Include the value of necessary ltems of personel property such as furntture and automobiles. a. Total value of all assets $ LINE 2A b. Amount of income expected to be derived ? fram such assets in the 12-month period --? cotrmencing thls date. (Enter this amount $ on Page i, Line IEi). LINE 2B 1 V. S'IlA7HTJI' STA'R1S Will ail the persons listed in Section I be or have they been full time students during five calendar months of this calendar year at an educational instltution (other than a correspondence school) wlth reguler faculty and students? Yes No ? Is any such person (other than non-resident aliens) merried end eligible to file a Joint [ederal Income tex retarn? Yes No 11__? V. AQa401'Y[.EDGIIv1ENf'/(YIRTIFICATICft We acknowledge that ell oE the above informatlon Is relevant to the status under federal lncome tax law of the Interest on bonds Issued to flnence Woodrtdge Apartments. We consent to the disclosure of such information to the Issuer of such bonds, the City of Eagan, Mfdland Flnanclai Savings & Loan Association, the holders of such bonds end any trustee acttng on thetr behalf. 2 The undersigned does hereby forth above Is true and corre? signed acknowledges that the mny be cancelled upon 10 days heve misrepresented any of the ' llate certi[y t h a t the lnformatlon set ?t In all respects, and the under- lease executed by the undersfgned wrttten notlce tf the underslgned InformaQion ?set ?fort ab?oveC. , ?- ?/GC.U! ? ?11eac'of Household Spouse SubsCr bed and sworn to before me this ? dQY oi_??`"???1? ? 19 i ? ? ? '?r??az,l? No t a r y P u b 1 1 c i n a n d f o r t h e r.?. ?w?,r..v?a r ?curaiY . S t a t e o f `I?` A,Yrrryyrevrvrrv+vrrbn1y Corrm 1 s s 1 o n Ex p i r e s: ?2- FOR COMPLETION SY DEYELOP.KENT OWNER COMPUTATIDN OF GROSS I.YCOIIE Lower Income Tenants 1. Calculation of teaaat inco.me: a. Enter amount entered on Line 1A b. If the amount entered on Line 2A is lareater than $5,000, enter the greater of (i) the amount entered on Line 2B (Lhis amount should also be listed on Line 1B), or (ii) 107 of the amount Iisted on Line 2A) $ c. POTAL ELI67BLE INCOME g D (?, DOO SC 6 2. The amovnt total eligible income listed above is: K Less than or equa2 to 802 of inedian incor.ae for the area in which the Development is Iocated. Ffore [han 80`,$ of inedian area income for the area in which the Develop.ment is Iocated 3. Number of apartment unit assiOned ?.! S 4. This apartment uni was vas aot last occupied for a period of at Ieast 31 cons cutive days by persons mhose aooregate anticipated anaual income as certified in the above manner upon their occvpancy of the apartment vnit was Iess than or equal to 809 of inedian gross income in that area. Applicant: Lqualifies does not qualify SIGI'ED: DATE: TENANT DEVGLOPMENT/UNIT # 4I \ 4 ? MODRIDGE APAR'INff•NI'S FAGAN, r41HAVES01'A UNIT A La2-3 3255 =3301 Woodridge Apartments were financed with Taz Exempt lndustrial Revenue Bonds. As a condition to receiving this below market interest rate flnancing, the developer/owner is required to o6tain the following lncome Certification information. This form must be compieted with regard to ant[clpated income and expenses during the 12-month period following the earlier of the date of occupancy or the date you sign a lease. This form must be prepared by you with regard to each member of your family that wlll live in the unlt (even !f the member is tempo- rarlly absent). A separate form must be prepared by each person thac you anticipate will iive In the unit lf that person, or persons, is not presently related to yov. You understand that, pursuant to the lease agreement you will have or will enter into, you are not authorized to sublease your apartment, accept roo[imates or enter into any type of uni t-sharing arrangement w3thout the express written permission of the landlord. 1. INCXM INFC7[ZIATION I, the undersigned, state that I have read and answered complete- ly and personaliy each of the following questions for ail persons who are to occupy [he unit In the above apartment development, all of whom are lisced below: Relationship to Head Age Names of Occupants of Household if under 18 1 ?/PG ue-r K 2. 5. I I. INOM The anttcipated income of all of the above persons during the 12-month period beglnning on the effective date of my lease, and the sources of income are listed below. Total Amount of Annual Salary or Other Income Place of F]nplorment or Source of Income 1 Fcst i s ?t t3 Vs1rJass ?e,?-+r-? u Nic,Pslon? 5. 'I'OT7U. I NOQVE fRCFA SQiJRCES L I STFD AHOVE 6. INCXME FitQM ASSEfS LISTFD C1N PAGE 2 "1'OrfAL ANiVUAL HOUSII-1DLD INCCME (Line IA plus Llne 1B) 1 $ $ $ $ g ;?-7_oE0 L[NE lA $ 95, ' L[NE 1B $ ?'7C`DO Line 1C ? _?. .. . ,. . The amounts listed as income tnclude, but are not limlted to,all Income and earnings to be reported on my federal income tax return(s), and represent all wages and salartes (including overtime pay, comnisslons, fees, tips and bonuses); net income from hustness operatlons, rental of real or personal property; annuitles and pens(ons; sociai security payments; payments In lieu of earnings such as employment and disability compensation, worker's compensation and severance pay, unless such payments constttute lump si.un additions to family assets such as lnheri[- ances and insurance payments (including payments under health and accldent lnsurance and worker's compensation); allmony, child support, AFDC payments and regular contributlons or gifts from persons not residing in the household; income from interest and dividends; and all other payments, contributions, and/or earnings derived from employment and other sources. NOTE TO PERSON(S) QO1viPLETING 'Il-IIS F'ORM: A detailed listing of income inclusions and exclusions is availabte. If you have any questions about what is or Is not income, please ask the resident manager for asslstance. III. ASSEfS If any of the persons l(sted In Section I(or whose lncome or contribution was included 1n Line IA) has any savings, bonds, equity in reai property, or other form of capItal investment, please complete the following. Please note that net family assets do not tnclude the value of necessary Items of personal property such as furniture and automobiles. a. Total value of all assets $ 0 LI E 2A b. Amount of tncome expected to be derived from such assets in the 12-month period cotmiencing this date. (Enter this amount $ on Page 1, Llne 1[3). LINE 2B I V. S7UDIIII' STANS Wi I l al t the persons Ilsted In Section I be or have they been full tlme students durtng five calendar months of thls calendar year at an educational institutton (other than a correspondence school) with regular faculty and students? // Ye s No `? ls any such person (other than non-resident aliens) married and ellgible to file a Joint federal Income tax yeturn? Yes No " V. AQWU'VL.IDGIIMffNI'/CF72TIFIG1Ti0N INe acknowledge that all of the above informatlon Is relevant to the status under federal income taz law of the interest on bonds issued to finance \Yoodrldge Apartments. We consent to the dlsclosure of such informatlon to the issuer of such bonds, the City of Eagan, Midland Financiai Savings & Loan Assoclation, the holders of such bonds and any trustee acting on their behalf. 2 The undersigned does hereby forth above is true and corre, slgned acknowledges that the may be cancelled upon 10 days have misrepresented any of the ?- ??-F16 Date certify that the information set :t in all respects, and the under- lease execnted by the undersigned wr3tten notice If the underslgned tnformation set forth above. ??-V?--- Head of Household Spouse Subs,Fribed and sworn to before me this?day of 19 V (C. , Notary Publ ic in and for the '+.'T?JG-i ;i6;i?ES?S f CpJ?!iy 4 e State of niy i,mnn;;;iun Ezyrts F[B 18, 1592 d _,.o..e...---?Ay-43orrmi s s i o n Ex p i r e s: ALTI1-IOftI7AT10N F(7R RELE4SE OF INOQv1E VE•RIFICAT1qV (To be completed by Dnployee/Tenant) TO: /?iTSu 1305111v°sS 2-Cc7rit IVame of Employer Name of Employee Tenant C??•?D F,'?/1r'ccf /?r/? S?iTZ?3a y 5treet Address Box Number MNA ,Nl !J 5-41117?- City State Zip ,2,,? 3 - 33c I Apartment Number Building Number I hereby grant you permission to disciose my lncome to Woodridge Properties Limited Partnership with respect to my rental of an apartment located in their developmer.t, which has been flnanced with Tax Exemp[ Industrial Revenue Bonds. RDQUEST P'dR INOQv1E VII2[FICATION (To be completed by Manager or Development Owner) Tp; Fujitsu Business Communicatins p'["[TY: Personnel/Payroll RE: Thomas Lueck Name of Fmployee The employee named above has rented an apartment ln a develop- ment financed with Tax Exempt Industrial Revenue Bonds. Please indicate below the emptoyee's current annual income from wages, overtlme, bonuses, comnissions, or any other form of compensation recelved on a regular hasis. TNCME VIIt I F I CAT I GtV (To be compleced by F}nployer) The anticipated annual income as of the date hereof for the above-named empioyee Is as listed below: Annual Wages Overtime Bonuses Comnissions TOR'AL AKC I CI PATID AN&VUAL 1TIOQME FJnployment is full time $ -?+, ? D c? O $ - $ " $ ' , $ y-- part time [f part t.ime, please lndicate ho?v many hours per week or month. ?1(i per week per month $ hourly rate I hereby certlfy that the the o my knowledge. ?? This form may be hand delivered or mailed to: 4Voodridge Apartments c/o Hegg Property Management 4530 Excelsior Blvd. Minneapolis, MN 55416 statements are true and complete to S i g3ra t u re t?2 T1 . ??e Date: FdR O[I?+.PLEI' f ON BY DEVELOP".•iEF7V1' ?ANF12 CCMPUI'AT I O'iV OF GROSS I NCCivIE Lower Income Tenants 1. Calculation of tenant income: a. Enter amoun[ entered on Line lA b. [f the amount entered on Line 2A is greater than $5,000, enter the greater of (i) the amount entered on [.ine 2B (this amount should also be listed on Line ]B), or (ii) 1090 of the amount listed on Line 2A) c. TOTAL ELIGIBLE [NCCri9E s 'DoC 2. The amount total eligible income (isted above is: -?'-Less than or equal to 800% of inedian income for the area In which the Development is located. P:1ore than 80°,% of inedian area income for the area in which the Development is located 3. Number of apartment unit assigned 0 - 4. This apartment unit was was not last occupied for a period of at least 31 consecutive ays by persons whose aggregate anticipated annual income as certified in the above manner upon their occupancy of the apartment unit was less than or equal to 80°% of inedian gross income in tha[ area. PAoderate Income Tenants 5. a. Enter amount of Line 1C from Income ? Certification b. Enter total amoun[ of allowable deductions for persons occupying unit ($750 for each unit to a maximum of two, and .?',500 for each other dependent) $ GRCSS FAP,SILY INCQ`.IE Applicant qualifies as: 2LLower Income Tenant (800'0 or of all tenants must meet) ? less of inedian area income - 209'0 - Rdoderate Income Tenant (A/:ore than 804'?, but less than or -equal to I10°'o of inedian area income - 55°'0 of all tenants must meet) Does not qualify for either category SIGNED: ?(-' Cc ???Ir DATL: 6? TLNAN'I' rlAP,1E: '/ DEVGLOP;I,?V"C/UNIT # 1?/f '? ? ?3 ? WOODRIDGE APARTMEN75 ? UNIT #3_ 355 Woodridge Apartments were financed with Tax Exempt Industrial Revenue Bonds. As a condition to receiving this below market interest rate financing, the developer/owner is required to obtain the following Income Certification information. This form must be completed with regard to anticipated income and expenses during the 12-month period following the earlier of the date of occupancy or the date you sign a lease. This form must be prepared by you with regard to each member of your `amily that will live in the unit (even if the member is temporarily absent). A separate form must be prepared by each person that you anticipate will live in the unit if that person, or persons, is not presently related to you. You understand that, pursuant to the lease agreement you will have or will enter into, you are not authorized to sublease your apartment, accept roommates or enter into any type of unit-sharing arrangement without the express written permission of the land- lord. 1. INCOME INFORMATION I, the undersigned, state that I have read and answered completely and personally each of the following questions for all persons who are to occupy the unit in the a6ove apartment development, all of whom are listed below: Relationship to Head Age Names of Occupants of Household if under 18 1.0900??LUiUL z. 3. 4. 5. _ II. INCOME The anticipated income of all the above persons during the 12-month period beginning on the effective date of my lease, and the sources of income are listed below. Total Amount of Annual Place of Employment or Source of Income Salary or other Income 1 2. 3. 4. 5. $ $ $ $ Total Annual Household Income LINE 1 The amounts listed above include, but are not limited to, all income and earnings to be reported on my federal income tax return(5), and represent all wages and salaries (including overtime pay, commissions, fees, tips and bonuses); income from interest and dividends; income from the assets listed on Page 2 of this form; net income from business operations, rental of real or personal property; annuities and pensions; insurance payments; child support and AFDC payments; and all other payments, contri6utions and/or earnings derived from employment and other sources. Income Computation & Certification Woodridge Apartments Page Two III. ASSETS Enter below the present net amount of all assets, including real estate, stocks, bonds, savings and other assets of value. * TYPE OF ASSETS Net Value S S S Total Net Asset Value LINE 2 $ 0 *Net Family assets means the value of any equity in real property, savings, stocks, bonds and other forms of capital investment, excluding interest in Indian Trust Land, The value of necessary items of personal property such as furniture and automobiles is excluded. Net Family Assets include the value of any assets disposed of by a tenant for less than fair market value except for foreclosure or bankruptcy sales and disportions pursuant to separation or divorce settlements during the two year period preceding the certification. I certify that not all of the unit occupants will he full-time students during more than five calendar months of the certification year, unless one of us is entitled to file a joint return pursuant to the Internal Revenue Code of 1954, as amended. I, the undersigned, certify that the statements contained in this form are true and complete to the best of my knowledge and belief. I understand that false statements or information are punishable under federal law. Ddt2: vP.'i (. ALAU-b HOU4LHULU +?--s.,...??.e.....,e..?.r,_..._.._y STATE OF MINNESOTA ELLE?J 1e!ACSG?d ? NOTA2Y Pl1FS!.!P '-,IN PdESOTA ?. (? ? ) '•a D1i?OT!, G l ;dIY ? My Corm;sion :xpr.es FcD 18, 1932 COUNTY OFI?JaR.1? ) 6 p $ ..,.,?...........o.u?..e.?...?.?.m.?..m ?....y Subscribed and sworn before me this day of 19 96?• ? I /, NU 3Mp 3 AUTHORIZATION FOR EMPLOYER TO RELEASE INCOt4E INFORMATION c-,. .. (_. T0: r;i ..:r,. ?; • ,,., I he eby, gr t?!6u permission to disclose my income *o . 'C?d?C', ?''< <'Kr`(=s ,?,;,,;j?,? ;.;??.;SJ? ?? _with respect to my renial o an apar ment oc ted in t eir eve opl ment, /which has been financed with Tax Exempt Industrial Revenue Bonds. ? / DATE: ?. ? i Signat?? INCOME VERIFICATION T0: ATTN: ?-3) RE: J (1! eQ?U2It L1Q, ? n u?f/1 S(5 (J ame of tmpioyee The employee named above has rented an apartment located in a development financed with Tax Exempt Industrial Revenue Bonds. Please indicate below the employee's current annual income from wages, overtime, bonuses, commiss.ions or a^y othe;- fprln of compensation received on a reaular basi,s. dy11-(od1Gl,4 Annual Wages t43b 0,7',D $ 9(O 73, 3 z- Overtime $ Bonuses $ -' Commissions $ - Total Current Income $ 9M, 59 I hereby certify that the statements above are true and complete to the best of my knowledge. DATE: 64b-6 & Please return form to: Woodridge Apartments c/o }IegP Property Management 4530 Excelsior Blvd. Minneapolis, Minnesota 55416 Signature Po-,C!rte{,? Tit e ?-3ass-?1 -+ FOR COMPLETION BY DEVELOPMENT OWNER COMPUTATION OF GRO55 INCOME Lower Income Tenants l. LINE 3a: If Total Net Asset Value (Line 2) is greater than $5,000, enter lOq of Line 2: ?? otherwise enter "None" LINE 3b: Enter amount of income from assets included in Family Income (Line 1) LINE 3c: Income from Net Family Assets $?_ (Line 3a minus 3b) LINE 4: Enter amount from Line 1 here $;)-0 C)G C) LINE 5: GROSS FAMILY INCOME (lines 3c and 4) 2. The amount entered in Line 5 is: s Do ooo ?eLess than or equal to 807 of inedian income for the area in which the Development is located. More than 80% of inedian area income for the area in which the Development is located. 3. Number of apartment unit assigned 4. This apartment unit was/was not last occupied for a period of at least 31 consecutive days by persons whose a99regate anticipated annual income as certified in the above manner upon their initial occupancy of the apartment unit was less than or equal to 80°k of inedian gross income in that area. Motlerate Income Tenants 5. A. Enter amount of Line 1 from Income Certification $ B. Enter total amount of allowable deductions for persons occupying unit ($750 for each unit to a maximum of two, and $500 for each other $ dependent) GROSS FAMILY INCOME $ Applicant qualifies as: X Lower Income Tenant (80% or less of inedian are income - 20% of all -tenants must meet) Moderate Income Tenant (MOre than 80°0, but less than or equal to 110% -of Median Area Income - 550 of all tenantsmust meet) Does not qualify for either category SIGNED: 61? -ti--?J DATE: ^^ J/ r?I bb cERTIFzcAZZav oF aaNrINErINc aonmranraCE The undersigned, Wallace T. Johnson of Brutger Cannanies, Inc „ the general partner of Woodridge Praperties Limited Partnership (the "Declarant") being the present avner of the real property described in the Declaration identified below, hereby oertify as follows: 1. The undersigned have read and are familiar with the pmvisions of the Declaration of Restrictive Covenants dated as of May 1, 1985 (the "Declaration") entered into kry Woodridge PropPxties Limited Partnership, ara3 duly recorded in the apprapriate public real estate zecords in and for Dakota County, Minnesota cn Nhy 9, 1985 as Document No. 686791. 2. With nespect to Sections 2 and 3 of the Declaration, all of the covenants arrl restrictions expressecl in Sections 2 and 3(1) therein have been fully and faithfully observed and perforned at all times during the 12 month pericd preoedinq the date of this Certificate. 3. With respect to Sections 4 and 5 of the Declaration, all the cuvenants and restrictions expressed in said Sections 4 and 5 have been fully and faithfully observed and perfornied at all times during the 12 month pexiod preoeding the date of this Cestificate. 4. (a) N/A ompleted residential imits in the Develolment which constitute N/A % of all residential i.mits in the Develogient, were occupied by persons or families who qualify as Lower-Inoare Tenants or were held vacant and resexved for occuPancY bY Iove-r-Income Tenants. (b) 12 cxmpleted residential wuts in the DeveloFxnent which constitute 20 % of all residential imits in the Developnent, wpxe occupied by persons or families who qualify as Moclerate Inocrte Tenants (including Lower Income Tenants), ar wpre held vacant and available for occupancy 1y persons or families who qualify as Dfoderate or Lower Incane Tenants. (c) Attached as Schedule I is a list, by imit raunbers and tenant names (if the unit is occupied) of all units enumesated in paragraphs (a) through (b), inclusive, above. 5. The Declarant is mt in default imder any of its obligations under the Declaraticn except as set forth on Schedule I2, if any, attached hereto. 6• Words and phrases used in this oertification shall have the sam meanings herein as in the Declaration. FAODRIDGE PROPERTTFS LUII'IED PARTTIER.SfIIP BR[fI'GER (JP)TIINIFS, INC., General Partrier BY: Wallace T. Joh I25: Vice President DATED: August 1, 1987 WoodridQe Apartments Building 3255 August 1987 BuildinA 3301 Unit # Haoe 101 Schrader 108 Paris 112 iQirsberger/Niclcel 114 Webb 115 Geier 206 Skurdalsvold 209 Reid 211 Ost 223 Lueck 306 Nusbaum 319 Lane 321 Yhelps 'T Replaces income certification previously sent WOeGRS06E APARThEYTS (64) 3301 Caachaan Rnao qu9ust 1987 CUALIF[EO "Vii TENAK7 - LEA"sE ----- L0W ------"' '---- IUl ----- Sthrader -- 06-41-86 X Paris 07-01-87 X ii? W.irsberger/Nickei 09-01-86 X 114 Wec6 07-91-86 X i15 ti?ier 06-01-805 X '[Ce Skurucl5void 0$-6F-67 X 2139 Re;d 07-01-87 x zi1 o,t ia-0i-H x 223 Lueck 07-li1-85 X 306 Nusbauo 08-01-86 x 319 Lane 47-O1-55 X 321 P'rtelP= 07-01-57 k TOiAL AiiflL[fYIi16 12 • ?. ?.. /f??Ji. . ?..?¢ _?? _ V?OOD[LIDGE APAR'INiENCS ?;,? ??3255 EAGA[?1, AQ11?9NESOTA ? l?? __??_3301 IMIT 3•7?'?? ? Woodridge Apartments were financed with/-7`ax Fxempt IndustrSal Revenue Bonds. As a condition to receiv3ng this below market interest rate financing, the developer/owner is required to obtain the following Income Certification inFormation. This form must be compteted with regard to anticipated income and expenses during the 12-month period following the earlier of the date of occupancy or the date you sign a lease. This form must be prepared by you with regard [o each member of your family that will live in the unit (even iF the member ls tempo- rartly absent). A separate form must 6e prepared by each person that you anticipate will live in the unit if that person, or persons, is not presently related to you. You understand that, pursuant to the lease agreement you will have or will enter into, you are not authorized to sublease youc apartment, accept rooimnates or enter into any type of unit-sharing arrangement wlthout the express written permission of the tandlord. 1, I NCJCIv1E I NFdFdvWT i ON I, the undersigned, state that [ have read and answered complete- ly and personally each of the following questions for all persons who are to occupy the unit in the above apartment development, all of whom are listed below: Relatfonship to Head Age Names of Occupants of Household if under 18 1 JRmc s4 PAR 1 5 4 5 11. 1 PIO(ME The anticipated income of all of the above persons durtng the 12-month period beginning on the effective date of my lease, and the sources of income are lis[ed below. Place of En lo ent or Source of Income ,. NsP 5 '1O1'Al, I NCME FTt(M SOih2CES L[ STf•D AHOVE 6. ITK.YIvE FR(M ASSEfS LISTFD ON PAGE 2 TO'fAL ANNAIAL HDUSF]-iOLD [NCXKE (Line lA plus Line lB) 1 Total Amount of Annual SalarY or Other income $ Z 9j 700, do_ $ ? $ $ $ LINE 1A $ LINE 1B $ 29j 700 , o0 Line 1C The amounts listed as income lnctude, but are not Iimlted to,ali income and earnings to be reported on my federal lncome tax return(s), and represent all wages and salarles (Including overtime pay, comnissions, fees, tips and bonuses); net income from business operations, rental of reai or personal property; annuitles and pensions; socia( security payments; payments in lieu of earnings such as enployment and dlsability compensation, worker's compensation and severance pay, unless such payments constitute lump sum additions to famlly assets such as inhertt- ances and insurance payments (including payments under health and accident insurance and Nvorker's compensation); atimony, child support, AFDC payrnents and regular contributions or gtfts from persons not res3ding In the household; income from interest and dlvidends; and all other payments, contributions, and/or earnings derived from employment and other sources. NOTE TO PER50N(S) OOMPLETiNG TI-IIS F'ORA9: A detailed listing of income incluslons and exclusions is available. If you have any questions about what is or is not tncome, please ask the resldent manager for assistance. III. ASSEI'S [f any of the persons Itsted In Section I(or whose income or contribution was included in Line lA) has any savings, bonds, equity in real property, or other form of capital investment, please complete the lollowing. Piease note that net famity assets do not include the value of necessary items of personal property such as furniture and automobiles. a. Total value of ait assets b. Amount of income expected to be derived from suc6 assets ln the 12-month period comnencing thls date. (Enter this amount on Page t, Line 1B). [V. S'RiDENP STA'IVS Will atl the persons llsted 1n Sectlon I be full time students during five calendar months year at an educational institution (other tha schoot) with regular faculty and students? Yes /? No $ 0 LINE 2A $ ?% LITJE 2B or have they been of this calendar n a correspondence is any such person (other than non-resident aliens) marrled and eliglble to file a]oint federal income tax return? Yes No x V. qQQVl7W[,EDGIIVESLI'/CkItTiFYCATIQV We acknowledge that alt of the above lnformation is relevant to the status under federal income tax law of the interest on bonds issued to flnance 1Yoodridge Apartments. We consent to the disclosure of sach information to the issuer of such bonds, the City of Eagan, Midland Flnancial 5avings & Loan Associatlon, the holders of such bonds and any trustee acting on their behalf. 2 The underslgned does hereby certify that the informatlon set forth above Is true and correct in all respects, and the under- slgned acknowledges that the lease ezecuted by the underslgned may be cancelled upon 10 days written notice if the underslgned have misrepresented any of the information set forth above. Date ?j . ?Head of liousehold Spouse Subscri6ed and sworn to before 19?_r.,?.....?,?.,.,-,.L'?°?:? 3Y ?'? 4?is:' f.9?? Gmam?,?oa .aners FEB iA !892 F ,..?.?..?.?.,-,.,.=..v..m...?.,m.?..?..._. ! me th i s-.10_day of Yll.CLiy_ ?J Notary Pubilc In and for the State of p v?L'Ylil.t- • Afy Cormiission Expires: . ALJII-IOR I ZAT [ ON FCXt RELFASE OF I NCCN1E VER 1 F I CAT I ON (To be completed bq Fmployee/Tenant) To: I??S t? r-Re??.rt: ?,.?Cf, ?a?,?, / "vg Name of Gnployer Nam'e of Fmployee Tenant) l ? The anticipated annual income as of the date hereof for the /?/ / empioyee is as li?? beloi ?' C \ ? c?? ? lX?' U ?j J o 1 Annual 1Vag?'s G? i?'l3- s?, ? ?b?O- ?Cr1V N ? Overtlme $? ? Bonuses $ O ¢/4 /VICo[_?T f?i'?/tLL 32- ro -3aSS Street Address Iiox Number Apartment Number Suilding Number MN City State Zip I hereby grant you permisslon to disclose my lncome to tVood- ridge Properties Limited Partnership with respect to my rental of an apartment located in thely development, whtch has been financed with Tax Exempt Industrlal Revenue Bonds. REQUEST FOR I IVCXIv1E VII2I F I CAT I ON (To be compleced by Manager or Development Owner) ,ro: NSP A11T+1: Personnel/Payroll RE: James A. Paris Name of Fmployee The employee named above has rented an apartment in a develop- ment flnanced wtth Tax Exempt Industrtal Revenue Bonds. Please indicate below the employee's current annuat lncome from wages, overtime, bonuses, cortmissions, or any other form of compensation received on a regular basis. INOQME VQZIFICATIQN (To be compleced by dnployer) Corzmissions $ ? TOTAL AIYI' I C I PATID AAIVUAL I NCJQW i hereby certify that the statements are true and complete to the best of my knowtedge. na t e : ln This form may be hand delivered or malled to: ,za?? ref Si nature / Ti e Woodridge Apattments c/o Hegg Property Management 4530 Excelsior Blvd. Minneapolis, MN 55416 Woadridge Propertles Ltmlted Partnership, c/o Brutger Companies, Inc., Genecal Partner P.O. Box 399 St. Cloud, MV 56302 ATIN: Roberta Camp FO'.2 0Q`.4'LETION BY DEVELQP°.':ENt O.VNF'-R CQMPUCAT IOV OF GROS S I NQQvIE Lower Income Tenants 1. Calculation of tenant income: a. Enter amount entered on Ltne lA b. If the amount entered on Line 2A is greater than $5,000, enter the greater of (i) the amount entered on Line 2B (this amount should also be listed on Line 1B), or (ii) 109'o of the amount listed on Line 2A) c. TOTAL EL I G I[3LE I NC(XvE ? - ,_- ? m ? ? 7 Uj 7 c cJ 2. The amount total eligible income listed above is: Less than or equal to 8000 of inedian income for the area in tivhich the Pevelopment is located. `.1ore than 80°S of inedian area income for the area in which the Development is loca[ed 3. Number of apartment unit assigned 4. This apartment unit was/was not last occupied for a period of at least 31 consecutive days by persons whose aggregate anticipated annual income as certified in the above manner upon [heir occupancy of the apartment uni[ was less than or equal to 80% of inedian gross income in that area. PAoderate Income Tenants 5. a. Enter amount of Line IC from Income Certification ?.?G i-10 0 b. Enter totat amount of allowable deductions for persons occupying unit ($750 for each unit to a maximum of two, and $500 for each other dependent) $ GROSS FMl LY INCQ`;IE Applicant qualifies as: ? Lower Income Tenant (800'0 or of all tenants musc meet) 7 '? o q ?? r5 u less of inedian area income - 204'0 - I? Aloderate Income Tenant (A/;ore than 80%, but less than or equal to 110°,'0 of inedian area income - 55°'0 of all tenants must meet) _Does not qualify for either category ;i s,??: ??; DATC: TG11L4N'C NAP.'E: ??•`LLI.J DEVELOP,\,IEN'P/UNIT Ct ? C VYOODR I DGE APAIZ INIENCS FAG4N, n41 MVES07'A UNIT # - 3255 =3301 Woodridge Apartments were financed with Tax Exempt [ndustrlal Revenue Bonds. As a condition to receiving thls below market interest rate financing, the developer/owner is required to obtain the following Income Certiflcatlon Information. This form musc be completed with regard to anticipated income and expenses during the 12-month period following the earlier of the date of occupancy or the date you sign a lease. This form must be prepared by you with regard to each member of your family that will live in the unit (even if the member Is tempo- rarily absent). A separate Eorm must be prepared by each person that you anticipate will live in the untt if that person, or persons, is not presently related to you. You understand that, pursuant to the lease agreement you will have or wilt enter into, you are not authorized to sublease your apartment, accept roormnates or enter into any type of unit-sharing arrangement wlthout the express written permission of the landtord. 1. INUCM INFOIdvIAT10[V I, the undersigned, state that I have read and answered complete- ly and personally each of the following questtons for all persons who are to occupy the unit in the above apartment development, all of whom are listed betow: Relatlonship co Head Age Names of Occupants of Ijousehotd if under IS l_ lA1 F'lf . ?S?,l.l I'('i (1)?'?VC?? i d 4 5 II. INKJQW The ant icipated income of al t of the above persons during the 12-month period beginning on the effective date of'my lease, and the sources of income are listed below. Totat Amonnt of Annual Place of Finalovment or Source of Income SalarY or Other lncome ,X iZ hfi'c I Cl & n k. ,4_7n i.r,t- Cc? . . $ I I ? 5 20 2. $ 3. $ 4. $ 5_ $ "i'OTAL I NCYME FRCM SOi1RCES L I STED ABOVE $ I I,?"JZU LINE lA 6. I IVC7Q+E FfKM ASSEI'S L I STID dN PAGE 2 $ LINE IB mrnr. Ar.NuAr.. HovsEHoi.D irioaVE $ I I,`_?Za (Llne lA plus Line IB) Line 1C /I t The amounts listed as lncome tnclude, but are not limlted to,all income and earnings to 6e reported on my federal lncome taz return(s), and represent all wages and salaries (including overtime pay, cortmisslons, fees, tlps and bonuses); net income from buslness operations, ren[al of real or personal property; annulties and penslons; social security payments; payments In lieu of earnings such as enployment and disabllity compensation, worker's compensation and severance pay, unless such payments constitute !ump siun additions to fam3ly assets such as inherit- ances and insurance payments (including payments under health and accident insurance and worker's compensation); alimony, child suppor[, AFDC payments and regular contributions or gifts from persons not residing in the household; income from Interest and dividends; and ail other payments, contributions, and/or earnings derived from employment and other sources. NOTE TO PLRSON(S) OOl1APLETING Il-t[S FCx2A4: A detailed listing of income inclusions and exclusfons is available. If you have any quest3ons about what is or is not Income, please esk the resident manager for assistance. III. ASSEI'S [f any of the persons listed in Section I(or whose income or contributlon was included In Llne lA) has any savings, bonds, equity In real property, or other form of capital lnvestment, please complete the following. Please note that net family assets do not [nclude the value of necessary items of personal property such as furniture and automobiles. ? a. Total value of ali assets $ U LINE 2A ? b. Amount of income expected to be derived from such assets In the 12-month period comnencing this date. (Gnter this amount $ C) on Page 1, Line 1[3). LINE 2B 1 V. S'IUDF?]VI' STA7VS tiVl(1 all the persons listed in Sectlon I be or have they been full time students during five calendar months of this calendar year at an educational institutlon (other than a correspondence school) with regular faculty and students? % Yes No X Is any such person (other than non-resident allens) marrted and eligible to file a Joint federat income tax return? Yes No 1? _ V. AQQV01'VL.IDGfIv4E]+IP/CEI2T I F I CAT I ON 1Ve acknowledge that all of the above informatlon is relevant to the status under federal income tax law of the interest on bonds Issued to finance 1Voodridge Apartments. We consent to the disclosure of such information to the issuer of such bonds, the City of Eagan, fviidland Flnancial Savings & Loan Association, the holders of such bonds and any trustee acting on their behalf. The nndersigned does hereby forth above is true and corre, signed acknowledges that the may be cancelled upon 10 days have misrepresented any of the n Date certify that the information set :t in atl respects, and the under- lease ezecuted by the undersigned wrltten notice if the undersigned information set forth above. n1C( Head oE Household • Spouse Subscribed and sworn to before me 19 ?. ? E. t.1. ;,4V_i4?Cid y, < I:OTf.Ri PU?I.iC _. ?? ,"lC,r.:iPliY ??..v;:.?•y F{Ef1f??P ??yo T `A'-";r:ry Gam:nssun Lsour Rov. iLg 4YS1YN`???G'3V?vinlP'Jg'W?'('0('?dX y,VdYbW'VMd this-,?L-day of Notary ubiic in and for the State of ?- hfy Cormiission Expires: 1?????9d ALrI]-K7[2[7ATION FQR RELEA.SE OF [NOC11/lE VERIFICJ1Ti0N (To be completed 6y E3nployee/Tenant) To: '?iCE'?Fir-1('I ?G_r?k d-lna?-t CG Mam: Oi2n.r_ S?UOQ,1<5?,'YV(l, Name of Gnployer Signature of Employee/Resident f??cz5 Liinc'foiC -Gue 5o, Street A dress Box Number 10'LdC) Vfv 1-5 4 7?'l City S[a[e Zip Apartment Number Building Numbe= 1 hereby grant you permission to disclose my income to IVoodridge Properties Limited Partnership wIth respect to my rental of an apartment located In their development, which has been financed with Tax Exempt Industrlal Revenue F3onds. REQiJEST FdEt ING(PAE VFRIFICATIGN (To be completed by Manager or Development Owner) 7'O: ATIN: i ? RE: Name of Finp I oyee The employee named above has rented an apartment in a develop- ment ffnanced with Tax Exempt Industrial Revenue Bonds. Please Indicate below the employee's current annual income from wages, overtime, bonuses, comnissions, or any other form of compensatlon received on a regular basis. INCCW VERIFICATION (To be completed by Fmployer) The antlcipated annual income as of the date hereof for the above-named anployee is as listed below: Annua I Wages Overtlme Bonuses Comnissions 1'OTAL A[YI'ICIPATFFD AAHdWL INOGAE Enployment is v fu?t time $ $ ? $ - $ /?3 o -zo, azJ part time If part time, please indicate howmany hours per week or month. per week per month ly hourly rate I hereby certify that the statements are true and complete to the best of my knowledge. Da t e: S,ignature,2 k_ ' ti e This form may be hand delivered or mailed to: Woodridge Apartments c/o Hegg Property Management 4530 Excelsior Blvd. Minneapolis, MN 55416 FOR CO?IPLETION BY DCVELOPP9ENT OiiNER COMPUTATION OF GP.OSS I;JCOiIE Lower Incon,e Tenants 1. Calculation of Cenaat income: a. Enter amount entered on Line 1A -4;- :2?? - b. If the amount enterect on Line 2A is loreater than $5.000, enter the greater of (i) the amount entered on Line 2I3 (this amount should also be listed on Line IB), or (ii) 107 of the amount listed on Line 2A) ? c. TOTAL ELIGII3LE INCO,"•1L•' -? 2, The amount total eligible income listed above is: ? Less than or equal to 807 of median income for the area in iahich the Development zs located. Pfore than 307 of inedian area income for the area in which the Developtnent is located 3. Numher of apart.nent unit assigned ?n 4. This apartment unit was as notjlast occupied for a period of at Ieast 31 consecutive ays by persons eohose agUregate anticipated annual inco,ne as certified in the above manner upon their occupancy of the apartment unit was less than or equal to 80" of raedian gross income in that area. Applicant: x qualifies _does not qualify SIGP+ED: DATE: Ts,vnNT hArrc: S k.Lt-? Q /.s vrl DEVGLOPMENT/UltiIT N 10i? d '- Zr7 C-? 4 WOODRIDGE APARTMENTS UNIT--#- ? Woodridge Apartments were financed with Tax Exempt Industrial Revenue Bonds. As a condition to receiving this below market interest rate financing, the developer/owner is required to obtain the following Income Certification information. This form must be completed with regard to anticipated income and expenses during the 12-month period following the earlier of the date of occupancy or the date you sign a lease. This form must be prepared by you with regard to each member of your family that will live in the unit (even if the member is temporarily absent). A separate form must be prepared by each person that you anticipate will live in the unit if that persoant eto nthe,lease presently related to you. You understand that, pursu agreement you will have or will enter into, you are not authorized to sublease your apartment, accept roommates or enter into any type of unit-sharing arrangement without the express written permission of the land- lord. 1. INCOME INFORMATION I, the undersigned, state that I have read and answered completely and personally each of the following questions for all persons who are to occupy the unit in the above apartment development, all of whom are listed below: Names of 0 Relationship to Head ..r u„?ohnlri Age If under 18 3. 4. 5. II. INCOME The an ticipated i ncome of all the above persons during the 12-month period beginni ng on the effective date of my lease, and the sources of income are listed below. Total Amount of Annual Place of Employment or Source of Income Salary or other Income o C? 5 0,0 om 2 3. ??. ?-?-,-, _? :?? mo $ / ?, 1oU• - 4. $ 5. Total Annual Household Income °O LINE 1 The amounts listed above include, but are not limited to, all income and earnings to be reported on my federal income taxcommissions, a feesPr tips and wages and salaries (including overtime pay, bonuses); income from interest and dividends; income from the assets listed on Page 2 of this form; net income from business operations, rental of real or personal property; annuities and pensions; insurance payments; child support and AFDC payments; and all other payments, contributions and/or earnings derived from employment and other sources. Income Computation & Certification Woodridge Apartments Page Two III. ASSETS Enter below the present net amount of all assets, including real estate, stocks, bonds, savings and other assets of value. * TYPE OF ASSETS Net Value ? oo?o $ Total Net Asset Value LINE 2 $ ? ?J *Net Family assets means the value of any equity in real property, savings, stocks, 6onds and other forms of capital investment, excluding interest in Indian Trust Land. The value of necessary items of personal property such as furniture and automobiles is excluded. Net Family Assets include the value of any assets disposed of by a tenant for less than fair market value except for foreclosure or bankruptcy sales and disportions pursuant to separation or divorce settlements during the two year period preceding the certification. I certify that not all of the unit occupants will be full-time students during more than five calendar months of the certification year, unless one of us is entitled to file a joint return pursuant to the Internal Revenue Code of 1954, as amended. I, the undersigned, certify that the statements contained in this form are true and complete to the best of my knowledge and belief. I understand that false statements or information are unishable under federal law. Date: ??fix? ? Sp0 ?_.,.....?....?,m.?.a..?..,,,...,.?.?..........?..m..? STA7E OF MINNESOTA _TA :. ? ?x:,;?iF?,•? ..1„i i:?? ''"f'1 4 ,..? ? 3 ? ti??t??'i,:•',?v? Id/C?ns:.,;.a,iCxF?.'?riB i? 13?2 7 "'°"°"t COUNTY OF W?e?La? ) ?..~~,.-.""""'"°'°"_° Subscribed and sworn before me this _L_day of 196 • 0 The First State Bank 3025 145th St. West Box 479 Rosemount, Minnawta 55068-0479 Aree 8121423•1121 8-11-86 William 6 Violet Reid 3635 Pilot Knob Road Eagan, Mn. 55122 RE: Social Security Deposits Dear Bill & Violet, Our records show that your social security deposits for the month of August where made on 8/1/86 and for the amounts of $197.00 and $465.00. Si cerely ? Stev?Toombs Asst. cashier WORKSHEET FOR DETERMINING LOW INCOME ELIGIBILITY (OLD FORM) 1 2 Total Annual Household Income from page 1 of Income Certification Amount of Income from Assets included in total annual household income Annual Household Income Less Income from Assets (line 1 minus 2A) 3 Total Asset Value from page 2 of Income Certification TO DETERMINE TOTAL ELIGIBLE INCOME: 4. If Total Asset Value is over $5000, enter the GREATER of (a) Income from Assets (Line 2A above); or (b) 10% of Total Asset Value (Line 3 above) ENTER: 5. Line 2B above TOTAL ELIGIBLE INCOP1E (Line 4 plus Line 5) If total eligibile income (Line 56 above) is 527,500 or less, tenant qualifies lower income. If total eligible income is more than $27,500 but less than $37,800, tenant qualifies as moderate income. , $ Q L NE 1 $4vd LI E 2A $ 5 0d LINE 26 s 1d51Qd0 LINE 3 l S Sod? s j LINE 4 $ 7S 0? LINE 5A s ?r ? LINE 56 4/86 (rc) FOR CM'PLETION BY DEVELOPAVff3*t O.VNER CCNF'UTATION OF GROSS INCQv1E Lower Income Tenants 1. Calculation of tenant income: a. Enter amount entered on Line lA b. If the amount entered on Line 2A - is greater than $5,000, enter the greater of (i) the amount entered on Line 2B (this amount should also be listed on Line 1B), or (ii) 10°0 of / c/s?o the amount listed on Line 2A) b1 c. TOTAL ELIGIBLE INCCtvIE ? °?BOv 2. The amount total eligible income listed above is: --)-(Less than or equal to 800/o of inedian income for [he area in which the Development is located. P.4ore than 80% of inedian area income for the area in which the Development is located 3. Number of apartment unit assigned 4. This apartment unit was/was not last occupied for a period of at least 31 consecutive days by persons whose aggregate anticipated annual income as certified in the above manner upon their occupancy of the apartment unit was less than or equal to 800/o of inedian gross income in that area. PAoderate Income Tenants 5. a. Enter amount of Line IC from Income CertifIcation $ b. Enter total amount of allowable deductions for oersons occupying unit ($750 for each unit to a maximum of two, and $500 for each other dependent) $ GROSS FAb11LY 1NCQ\7E Applicant qualiffes as: Y, Lower Income Tenant (801,10 or of all tenants must meet) ? less of inedian area income - 20% Moderate Income Tenant (More than 8091u, but less than or equal [0 110°b of inedian area income - 554'0 of all tenants must meet) Does not qualify for either category S 1 GNED: DATC: 1'ENANT W'1E : ? C! DEVELOPMQNT/UN1T # ??? ?o1SS For Office Use I I Permit n *r Cit y of ~ 3830 Pilot Knob Road I Permit Fee. I Eagan MN 55122 j /7 Phone: (651) 675-5675 I Date Received: I Fax: (651) 675-5694 I I Staff: I 2009 COMMERCIAL PLUMBING PERMIT APPLICATION Date: c/ t~ 24 Site Address: Z S SCe' c,, ,,,r a„, Tenant: r t' 'I Suite PROPERTY Name: Phone: OWNER CONTRACTOR Name: ► "avt~ a.r► License OSF YSL- PM Address: -l- -7oX 7-37 City: State:/ Zip: S Phone: 9:5'Z- try y/i7a Contact Person: l~ TYPE OF New _ Replacement Repair -Rebuild - Modify Space - Work in R.O.W. WORK Description of work: e- 2, . rS PERMIT TYPE COMMERCIAL New Construction Modify Space Irrigation System yes / _ no) RPZ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: Size & Price 3/4" meter 203.00 Avg. GPM High demand devices? Yes _No Flushometers -Yes No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract Value $ x 1% _ $ S ©r 0 Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read If Permit Fee is less than $1,000, surcharge is $.50 = $ Meter(s) If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ State Surcharge Following fees apply when installing a new lawn irrigation system. $ _Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ _Treatment Plant $ Water Supply & Storage $ State Surcharge TOTAL FEES $ gS S-0 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 Oki Le, zu~-O~ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Approved By: Date: Required Inspections: -Under Ground -Rough-In -Air Test -Gas Test Final PRV Required: Yes No Page 1 of 3 Jan. 15. 2010 8:13AM (o-7 1238 r,P. 1 Use BLUE or BLACK Ink l ~ MOM tie - Perm" City of Eap Cl,-Lcc~ Permit Fee: 6 • i 3830 Pilot Knob Road Eagan MN 65122 to (lG`) S Date Rece Phone: (651) 67'5-5675 ~ 1 i Fax: 657) 675-5894 staff. i 2010 MECHANICAL PERMIT APPLICATION Date...1 110 SifgAddress; 3 aj6s C o & a;h,n-tn Tenant: V~/Q1~j 4 Ts suite RESIDENT / OWNER Name: I A CO- Phone: jvA- to. Address/ City/ Zip: /000 CONTRACTOR Name: 14 r}i S License C Address: I) 0 City: vc, State: _Y7_ Zip: SS Nko I Phone: 3 ' Ljz,~ 170b Contact:. de 1.~1(.rtk i/ Email: dtrld i G5 C, t t7lm TYPE OF WORK New -,VReplacement Additional Alteration Demolition Description of work: . 0 4ef`Vt-Vr L a-C - p'l le P-ILkA WAft-) [VOTE: Roof m untecl. and grw l f Rl94000 ~echa ~~cal equlpij~~rtt is regt~lred to fie scre lied by City Code. ;,Please,cgfi#~ir t tjre Mechanical I *ie' for fob Irifo(rliatlon oil perti jlted screening methods, RESIDENT/AL COMMERCIAL PERMIT TYPE _ Fumaee New Construction _ Interior Improvement Air Conditioner - Install Piping - Processed Air Exchanger Gas "ExteriorWAC Unit Heat Pump Under / Above ground Tank L Install ! Remove) "when Insiallinglremoving tank(s), call for Inspection by Fire Other Marshal and Plumbing lWotor RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.60 Fire repair (replace burned out appliances, ductwork, etc.) (Includes $.50 State Surcharge) $ TOTAL FEE COMMERCIAL FEES; $70.50 Underground tank installation/removal OR contract Value 7 x1% $50.50 Minimum (includes State Surcharge) OC) permit Fee - IfPermit ee is less than $1,000, surcharge Is $.50. , - If Permit ~ is ? $1,000, surcharge Increases by $.50 for each '0 Surcharge $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $9.00 surcharge). 5C)-- TOTAL FEE CALL BEFORE YOU DIG, Call Gopher State One Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utllitle9. www.aophmstateonecali.ora I hereby acknowledge that this Inronnallon Is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of ragas; that l understand this Is not a permit, but only an application for a permit, and worts Is not to start without a ermll; That the work will be in accordance with [he approved plan In the case of work which requires a review and approval of plans. x ;~Q't't't ec Ahen,-K, x Applicant's P Inted Name Agp c Signature t'QR OFF[CE U5E' R943.6WeSf E1Y,y` ~a>te', . I e ttf rod Inspectons: _ Gro n I re , T s't ~ ?1dst 4t .d at,?9I1, ~ s$ S$tyjse:x' _In-Aaor Heat Fi~rel . ` Sere, Eilferior FIIiAG e t ris:~tvn: 1!n .g.l. pea 1 Use BLUE or BLACK Ink 1-----------------n For Office Use My o EaLan j Permit L 7 ZS I Permit Fee: 1 3830 Pilot Knob Road I 1 Eagan MN 55122 I Date Received: Phone: (651) 675-5675 j I Fax: (651) 675-5694 1 Staff_ 2010 COMMERCIAL PLUMBING PERMIT APPLICATION ,,rr~~ / Date: 'V Site Address: Add Tenant: C~ (J Suite PROPERTY 0 e- V, ~ yj E C Phone: OWNER Name: C IL71 f°1 Name: License U/ D ~y~Lz CONTRACTOR V/~/ Address: 20 iCity: State: / 1/~ Zip: Phone: Email: TYPE OF //New _Replacement -Repair _Rebuild _ Modify Space/ _ Work in R.O.W. WORK Description of work: f / 3 / / PERMIT TYPE COMMERCIAL New Construction Modify Space _ Irrigation System yes / _ no) RPZ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? _Yes _No Flushometers _Yes _No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract value $ X1% $ Permit Fee DSO Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read If Permit Fee is less than $1,000, surcharge is $.50 = $ Meter(s) If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge). = $ State Surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. } ~f,~ t x ifVy yl Na ~nc f!1Y\ Applicant's Printed Name App is nt's Signature FOR OFFICE USE Approved By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final PRV Required: _ Yes No Page 1 of 3 Use BLUE or BLACK Ink For Office Use j Permit I My 0 E*n 7~ I.~ I I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 I Date Received: Phone: (651) 675-5675 j I I Fax: (651) 675-5694 1 Staff-------- 2010 COMMERCIAL PLUMBING PERMIT APPLICATION Date: H01/0 Site Address: ~l I~ 62(hamL 0L Tenant: Suite PROPERTY y G OWNER Name: 7 f ` Phone: 0 CONTRACTOR Name: /License Address: 232 City: 7 m Vi/4/& State Zip: ff-Zl Phone: Email: TYPE OF _ New _ Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W. WORK Description of work: ' IXZ,) COMMERCIAL / PERMIT TYPE _ New Construction v Modify Space _ Irrigation System yes / _ no) RPZ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? -Yes No Flushometers Yes No COMMERCIAL FEES: $50.50 Minimum (includes State Surcharge) OR Contract value $ X1% = $ Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read - If Permit Fee is less than $1,000, surcharge is $.50 = $ Meter(s) - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge). = $ State Surcharge Following fees apply when installing a new lawn irrigation system. $ Water Permit Call the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ n State Surcharge TOTAL FEES $ ~Q Sr 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.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start witho 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 0V111 P, a 1SI Applicant's Printed Name Appli is Signature FOR OFFICE USE Approved By: Date; Required Inspections: Under Ground Rough-In Air Test Gas Test Final PRV Required: _ Yes No Page 1 of 3 Use BLUE or_B_L_A_CK Ink 1 For Office Use o~~3 1 I 1 City of Ealan Permit V1 I i I . : I Permit Fee: C!~ 1 3830 Pilot Knob Road I I Eagan MN 55122 1 I Date Received: Z~' (2 1 Phone: (651)675-56751 I I Fax: (651) 675-5694'' y Staff: 2012 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. 4W jole Date: Site Address: S^,~ 1/!7 a ~0 ~ i~ao~9 Tenant: I~~U n kr o r-F ~~T S Suite -'PROPERTY OWNER Name: Phone: Name: An R u t-r2Z 4/G License cflrlTRAC-roR Address: !y01 akI5 6c- &FAtity: State:Nl1lL Zip: iLk/!77//~~ o'1 PhoneA,3-,55a3 19M Email: TYPE OF _ New _ Replacement - Repair _ Rebuild _ Modify Space _ Work in R.O.W. WORK Description of work: COMMERCIAL - New Construction _ Modify Space Irrigation System yes no) RPZ 1 _ PVB) • Rain sensors required on irrigation systems 'PERMIT TYPE . Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? Yes No Flushometers Yes No COMMERCIAL FEES: $60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ x1% _ $ Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 $ Radio Meter Read - If the Permit Fee is less than $10,010, the surcharge is $5.00 $ Meter(s) - If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee i.e. a $10,010411,000 Permit Fee requires a $5.50 surcharge) $ State Surcharge Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage 41 $ State Surcharge = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.ora I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x x C~ Applicant's Printed Name Applicant's Signature FOR.OFF)CE USE Approved By; Date Required Inspections: Under Ground Rough-In Air Test Gas Test Final PIRV Required ~ Yes . No Page 1 of 3 443 Lafayette Road N. St. Paul, Minnesota 55155 www.dli.mn.gov 11/26/2012 MINNESOTA DEPARTMENT OF LABOR & INDUSTRY Stuart Company 1050 W. 80th St. Minneapolis, MN 55420 (651) 284-5005 1 -800 -DIAL -DLI TTY: (651) 297-4198 APPROVED FOR USE RE: ,HYDRAULIC PASSENG Elevator 1 ELV-13890 Sit=. Woodridge Apts 3255 Coachman Rd EAGAN, M Dear Sir a•am: Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. NOTE: THIS APPROVAL APPLIES TO THE ELEVATOR MOD. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincerely, Ccgd.STR-UCTION CODES & LICENSING ToddAix State Elevator Inspector c: ALL CITY ELEVATOR INC Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. St. Paul, Minnesota 55155 www.dli.mn.gov 11/26/2012 MINNESOTA DEPARTMENT OF LABOR 84 INDUSTRY Stuart Company 1050 W. 80th St. Minneapolis, MN 55420 RE: HYDRAULIC PASSEN R Site: -Woodridge Apts 3255 Coachman Rd CEAGAN, IAN.55121 Dear-Sir/Madarn ___.-- Elevato (651) 284-5005 1 -800 -DIAL -DLI TTY: (651) 297-4198 APPROVED FOR USE Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of, 1990. NOTE: THIS APPROVAL APPLIES TO THE ELEVATOR MOD. ALL ELEVATOR RELATED EQUIPMENT IS SUBJECT TO ANNUAL RENEWAL OF THE OPERATING PERMIT: It is the owner's responsibility to maintain and keep current with all tests in accordance with the ASME A17.1 and the ASME A17.3. Frequencies for the required tests can be found in Chapter 1307 of the Minnesota State Building Code. Failure to maintain and perform the required tests may result in revocation of the annual operating permit. Operation of an elevator related device without a valid operating permit may result in an issuance of a "stop order" from the department and possible penalty of up to $10,000. For more information see our website at: http://www.dli.mn.gov/CCLD/Elevator.asp Sincerely, C ODES & LICENSING Todd State Elevator Inspector c: ALL CITY ELEVATOR INC Dale Schoeppner, City of Eagan Building Official ElFormCE2 This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer .- Date: City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant Name: r Use BLUE or BLACK Ink For Office Use Permit #: 1 --)-617 Permit Fee: `i ` 95 Date Received: S l 5113 Staff: 2013 COMMERCIAL BUILDING PERMIT APPLICATION 22 Site Address: 3--55 lOa YY)ari (Tenant is: New / Existing) Suite #: Former Tenant: Property Owner Name: Phone: Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: ` k rr\ t • 1 Construction Cost: tjOOO e' e�t* le Contractor S bC �a e Name: lel5 ez. v- l c3 � t c License #: 5 q -1(f i (3 n Address: "Lp )Ci �;� S 'V .City. b l,t F eliei State: VA v---- Zip: 5 S (-I Li, (4 Phone: 7 Lo 3 ` 1-4c113 ACOS Contact: ES AC_ Email: Architect/Engineer Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and supporting documents that you submit are considered to be public information. v4 Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in dance with the approved plan in the case of work which requires a review and approval of plans. r Applicant's Signature Page 1 of 3 Applicant's Printed DUame 3 55 : DO NOT WRITE BELOW THIS LINE //act' 7 SUB TYPES Foundation Commercial / Industrial Apartments Miscellaneous WORK TYPES New Addition Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review (25% 100%) Census Code #of Units # of Buildings Type of Construction Public Facility Accessory Building Greenhouse / Tent Antennae Interior Improvement Exterior Improvement Repair Water Damage REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Occupancy Code Edition Zoning Stories Square Feet Length Width Roof: _Decking Insulation Ice & Water Final Framing / Fireplace: _Rough In _Air Test _Final Y Insulation Meter Size: Final C/O Inspection:Schedule Fire Marshal to be present: Reviewed By: Gj 1 1((,I 1'3 , Building Inspector Exterior Alteration -Apartments Exterior Alteration -Commercial Exterior Alteration -Public Facility Siding Reroof Windows Fire Repair Demolish Building* Demolish Interior Demolish Foundation Retaining Wall *Demolition of entire building - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required X Final / No C.O. Required Other: Pool: Footings Air/Gas Tests _Final Siding: Stucco Lath _Stone Lath Brick Windows Retaining Wall Erosion Control Yes No Reviewed By: , Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Water Quality Water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL Page 2 of 3 ‘,60dc__ • /iaa97 815/ /3 um�v X4tCoe Lcfflcj , Sh�4-tock 4-0 sz.,X (v S-cS c\A/Na-4 ae- C- OL -8r ou,‘c •;:rli 4- cMV dawrIci ntW aX cp S4-c.tds s h et} eocAc-- , Lv� S u.ta-4. w\ , S c4 t*r.c, a -(- c` (mak- u 4S800Cr )=wr‘ci.3c. n" r\ EX`fL-ibtcrs 03/06/2014 10:19 952-935-9544 OityofEaftaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 MN RUSCO RECEIVED MAR ri 6 2014 PAGE 01 Use BLUE or BLACK Ink For Office Use Permit #; 7_111 Permit Fee: Date Received: Staff: 2014 COMMERCIAL BUILDING PERMIT APPLICATION ,-014-11 Date: . J 1 1) "14 Tenant Name: Site 4355 (Tenant Is: New / Existing) Suite #: Former Tenant: 'Prb i 74( OWnIer Name: 61) Phone: 52" 94•9510 Address / City / Zip: /00D gO*' c.3 .1"7 /,5.! Ar 5 420 Applicant Is: Owner Contractor j(.: 6 Typ 'of Work, • olltractor Description of work: Construction Cost: Name: Address: /7i8Ao30 DO 130) wits License #: " 11 /73 Ziff City: r� i State: //// s Zip: 5559 Phone: 152. 9 " - / Contact: Ar hitect/EFigs.fear ati.( k mail: Off/ g- 41 /JL eso7Z (Lcs&b. d it, Name: Registration #: Address: State: _ Zip: Phone: Contact Person: Email: Licensed plumber Installing new sewer/water service; Phone #: Awe. Ilns andsupporting documents that you submit are considered to be pub'Iic.informatlon ,Portions of the.ihiorMation may be classified as non public if you proVide specific reasons that would oennit the ciity to. conclude that the r 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.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 t understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that thy work will be in accordance with the approved plan in the case of work whighfequires a review _n+ arproval of plans, bb City: x Applicant's Printed Name Applicant's Sigjature Page 1 of 3 03/06/2014 10:19 952-935-9544 MN RUSCO DO NOT WRITE BELOW THIS LiNE PAGE 02 1-1 SUB TYPES Foundation Commercial / Industrial 'Apartments Miscellaneous WORK TYPES New Addition Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review ( e^ Census Code #of Units # of Buildings Public Facility Accessory Building Greenhouse /Tent Antennae Interior Improvement Exterior Improvement Repair Water Damage A f 79Ittd • / Occupancy Code Edition Zoning Stories Square Feet .( Length Type of Construction V • A Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Decking Insulation _Ice & Water Framing Fireplace: Rough In _Air Test _Final Insulation Meter Size: Exterior Alteration -Apartments Exterior Alteration -Commercial Exterior Alteration -Public Facility Siding Reroof ✓ Windows Fire Repair Demolish Building* Demolish interior Demolish Foundation Retaining Wall `Demolition of entire building - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers ailk Sheatrock /Final / C.O. Required ✓ Final / No C.O. Required Other: Pool; _Footings Air/Gas Tests Final _ Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wail Erosion Control Final C/O Inspection: Schedule Fire Marshal to be present: Yes 1/No Reviewed By: CG , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee Surcharge Pian Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality /S3 o. 7g 67. n5 D.o-o Water Quality Water Sampling Fee water Supply & Storage (WAC) Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL # Ay 70. Page 2 of 3 Use BLUE or BLACK Ink �-----------------i � ►�y ,� � For Office Use � n ��t� � . �� �, I � �' � Permit#: � �� I C�t a� �� a� � . /���— � � � � Permit Fee: t_./ � 3830 Pilot Knob Road Eagan MN 55122 � � '- ��� � � �� I � Phone:(651)675-5675 � Date Received: � � F <t - �r�� � I Fax:(651)675-5694 . �.f_=a�g ° � � Staff: � `�������������_�_J 2014 COMMERCIAL FIRE ALARM PERMIT APP�ICATION* Date: �b��`i��_Site Address: 3a'S� Cv4c,�n rrr.�, � �, Tenant: LUocX�1�� '�. Suite#: ���� �� � S�-Vc�r� � Name: �c...r�.s Phone: ', `�������� �� Address/City/Zip: �,:��,� , �. � � ' �,�, Applicant is: Owner Contractor j� :,, 7 ���,� , = Description ofwork: _�ery.w� a..� fP�lc,�_ F�"�- A{w.r.�pa„e). c.,.l G�ev�2a.s �- e�e�� reec.\ ���� �� � ��� �I � ���? Construction Cost: !�� • Estimated Completion Date: � '� �-�� Name: L(�ec,j-ri z. r�rc.. � �.c,�r`.k., License#: �'fF000 S$'3 � � �Lu� cit T ln t-! ���,��,�����, Address:���1 ��,��c y: ���� �` ` <���� : State: mN Zip: �"�Z`T Phone: 6��- y�-v3Sa � �� � ,� t,� _ � ;', Contact kJn�n Email: r ��u,� �F �7.N .C.�n� r� �"� v�'` ° New Remodel '��a. — — ~ ������� —Addition _Other: � ;� �,`�; erations DESCRIPTION OF WORK: Commercial Residential Educational FEES Contract Value$ �6�'� x.01 $55.00 Permit Fee Minimum 'If contract value is LESS than$10,010, Surcharge=$5.00 -$ �•w Permit Fee ""If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 =$ �.�' Surcharge"` "`"`"`If the project valuation is over$1 million, please call for Surcharge _$ 6V�W TOTAL FEE *Requirements:2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;that I understand this is not a permit, but only an application for a permit,and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x ��c.� �.c,c,�, x ApplicanYs Printed N me A li ignatur �C?F��?����E U�� � R� �eci E�y a`��� t'�ate � � �l � � � � ��t � � � �'���'�� `��� �i���I�t�p� �� ��s�. .:�=�;,,,f��u�: �r � l������rttn Test v� z�3� u - t� , - � �° �.. �. � � � Use BLUE or BI.ACK ink � For Office Use ` ` � I � j Permh#: J I City of�a an � . . - /��. �s � �'� � � Permd Fee,li(U � 3830 Pilot Knob Road Eagan MN 55122 � Date Received: �� �✓ J�� j Phone: (651)675-56T5 i � -• Fax: (651)6y5-5684 ' � Staff: � �����������rr......�....J 2014 COMIVIERCIAL BUILDING PERMIIT APPLICATION oa�:� ✓�' Site Address:��s _ ��r,�r� �oo+�l /�i✓�'�� 7enant Name: (Tenant is:__New/ Existing) Sulte#: Former Tenant: t�a,�„ry •:;; �r.:r, ,. ,. , , ,., ,,. .., .. . ,�wi;3yw � �hF� r�t Tf��,,.i:��:• i �y� ir �u�m! J; ,�. � �e,l�.... ...- --- --- — — ---_._.. .___..___ ------ ��� - ---.._._------- s� G�,�,4���'�rY�"�� �u•r;�;,,;,,' Nama: Phone: �.,,� '�is �' i.-;y:� �s'�',>.aJr,:;ys�.,'yC'r,f•N�•, �%::;i�: c�/l�j� �•�.���r�.��!h!�.�`�i�":x: Address/City/Zip: �Of.Y� �*" c��j ,� c�7�C�L/ r�} (�, �T%.y ,,yk,rypy1 'IIpr�Afi �:yry� � ��iJ �1,���1)"y.�,'��� '.,'!�!�^"r�yii.rlR,'�;�7��.yPi^• � �1���TMI�f�._4�^�/il.�{'�:11T.:4;iAq�'i,rlJ%P'I��a„:: I I •� h��i��✓'thu"��'&��:�T,���:�;:��-�:,-- Applicantis: Owner Contractor ��. ...�,.,..�,�:i.;.,..._„_;_,..,,. ��,., :�Ar:?,�6!&�(':1�'A:%11^��w��'��;r'n;`�'i Plip`Jyo�'�'::`:;:: �J... ; .-, 1§, A:;.C�^l?„ � / �j����� ,. v'h•'�.r?•,. . r /���wVcr� v,=:.-cc�•:���;::�a�-:<. ;,;�;•:;,;;;•.. , Description ofwork: lAS�-�I f /��5 � .:��-. ~����-•° ti:;:"�JT�pe'of'ilf�ork�u;;�:; . � ,'�'�r.. ^,;,, „ � ��.�.�'// �(� ';';� � ,a� ,•�':s`:1'A'"f �:.�y..�, . i1 ., �. fA'�:oµi. :.�._yl�hrr,:.n�.i;�rio:i•`7»JJ,...,t.ri"' ��/✓/ I :r% ','#�.;., ,.,;.,.,. r::,� �a;�.: Cons vr� i s•.�.MX,�;:�»i:'�-:<u;;.,:;M>, :�:- �:;�` truction Cost: � . `;7yy�"ii""�;;.fr;:,'l,,Y,r;�iu'��;"!' c'.ii,,.�.^.::�.. ► �J �i��J ;; �` : � � *`}'d�,:..:.°�-, 1�� �I� /�/�/�� � +•I��YZ':KiM�:!(:1•7.tu.�_./-.'i:�:.1y';:.}�.i.,�;i�..}':'.:: ;y�. ...,.r.��;r:•�;::��-:r�+:r,,;:;'::.f''';,,;;: Name: _License#: ,'S�?G:�'� . '.., ..,•�: .,.�:;..,. � . i�t:tit•�;��t;'i✓ti+;fa�i'l�`f'y;,Fzrye;�;ser^�<-. �� ��,.o,,,. i�•.�'rh„�'.�yi„�:::;.., a;�^�;'.:i, � ���//!L��GLilff�l �� :G,v.���j;t..,a;:t%:�x�;;:,�{�a;:�t-�;�,�7,.yr':�;,:': Address: .��7v �- --- ---- ---__ �,CiEy: �� ',�'��;w,F;C;�l�tracfo�;;'..`;;;;,>:_. Y'�!�: ..r,�t,.:..,:,�.,;�p,:p,ii�:_•�,�;�"r�r,_..^.�.- �(.�� • �i'iV / „:;rw;� •;;:.;.,,;;;;;:,.:., State:�Zl �.55��3 Phone: ���� � F"1� '..�r.'-`;y;": M�%h.:�;�i;..i;�-;.�,-v'i:.,.f�.:: p: �y��L.i:J%�>:n5• ;,. :_: r,y�;t;•:,:.:y,;r:'�':x�`l.� ^�i•':', ,�.,,.,,:!-�.��.::. ':.;;, ,: ;::;�;�:;'-� lrl��f � rl�•teso�zt. rusea.eorn. �:,�.�;.;,. ;:yi>;i�;: .`,�:�t;4'c;':,.,;.-:;:` Contac� � mail: � :.., ' .� ',;..;,,�:,c;.w,�. .._ '���:;:,.'•'.::::,;,::;;;:;,;�:..,,. �•�::::�:; :<�`�;wr�' �� 4.:�;�.,i�;;;;:�:. •;;:,� . '�::;. •`;r,:• .,i,;: �a�!�;'�:F;.•:r� ;:�;5�!y ��;.•^.�}.: ,'.�,�� :er '�- • ���- �� Name: Re istration#: �i�i:��::«':a�..:.,•.jp/r,yx�:�'�:�'::�;�: . 9 �^3wi'�1;:'a�- '"p^t'i(:.';,:,�,, w.,�.,.f,..,., 'r. y.i;�.,�':';.�����•,<,:.��. 'fr�fi''�iW�';;�i;[. •':'7iJ,',4'i�:::;::,�4`;�..:G S°:?1�i.:�. , ;;��.,,; .:.. .,,,,�: .;:. s� E;�:,,,,..-,>-•,.. Address: (:ity. �s7!`�^...•..,;.-c7 `,p►r:c�iit�ctlEh i �er�; �'r,H+;., ,�,��, �::;:�.,,�,�;,.� � n �; :i}:�.;,�;�'^ �;;�,,:.{. ��,�:.,,.,.: �.���a, - 'W:�p=i„r,r;'r::•..y^:,,. ,��,,�.a ,r�, . ,.. ..� ,. State: Zip. ,�z� :, :;s•,r,rF,.:.•.a,�?•::;>.:.,... .,;.,: Phone: �ry "d>;.�'.�:y,�n:lrt!,..,.�,:,.i'%c.�A`,i;'+_�.n>, l;h•�`" ;,, ?'+.�j',hr,�'-':;.,.:�,:: .�.�rwy��:^.;��,.� „1:'a: �� :.;,; :.j��iiC� W:: 1�'..1;���'��.,5^,1��";e/�.'" �;::� .. .-rlr,��,,.'�,;+• .`C.i..;':�.,�.�,�:-�4, ContactPerson: a.. �:;:�:. �:� Emaii: Licensed plumber installing�r sewer/water service: Phone#: 'NO,TE /i(aos a�ql supporting doCumenfs ttist you subm�t.are consldered i�o be publiC�nfo�ri�atlo.n:".Pocf�ons of .' �� �tfre�rnfo;�inatton may be classifred as:non•publ�C 1f you pCovlde;spec�fic rc�asons thaE would p�rmit�t�e C�ty(p ; , . , . .. .,:. , a< ,. ! ���.. .�: �„ . , ; . , conclude that fhe :are'trade secrets. .. �'� . � " , , , CA�L gL�Ot2� YOU DIG. Call Gophsr Stafe One Cal1 at(651)454-0OQ2 for protection against underground uClllty damage. Call 48 hours before you Intend to dlg fo receive locates of underground ufilifies. www,o.opherstateon�call.ora � I hereby acknowledge iha; fhis information is complEfe and accurafe; that tha evork will be in conformance wlth the ordlnances and � codes cf the City�f Eagan; that I unde�stand this is not a permit, but only an application for a permit, and work is not to starC wltnout a permlt; that th�work wlll be in accordance with the approved plan in thc+case of work whi ;�equires a revlew n a proval of plans. / � ��S � X � X � ApplicanYs rint@d Nama Applicant's Sic ature I Page 1 of 3 � 50/Z0 3J�d O�Sflcl NW bbS6-S�6—�56 8� �0Z 5i0Z/9�/b9 . `- �� c�� J� ��C�,�Z��Z-- ��� DO NOT WRITE BELOW THIS LINE / �� �f� SUB TYPES _, Foundation _ Public Facility �Exterior,Alterativn-Apattments _ , Comm�rcial/Industrlal � Accessory Building _ Exte�ior�Alteratlon�Commercial _ Apartments _ C�reenhouse/Tant � �xterior,Atteration-Publlc Facility _ Miscellanoous _ Antennae WORK TYPES � New � Interior Improvement � Sidinp . � Demolish Building"' _ Addldon ,_ Exterfor ImprovemeM _ Reroot ; _ Demollsh Interivr _ �Alteration ` Repair ✓Window9 . � Demolish�oundation � Replace _ Water DamaBe � Fire I�epair _ Retaining WaU � Salon Owner Change •Damolitlon of enqre buildiog-give PCA handout to appllcaM DESCRIPTION Valuatlon I78��J� Occupancy � MCES System Plan Revlew �� Code Edipon SAC Units (25%_100%_j 2oning City Water -- — ------ --- --_ Census Code Storles Booster Pump �of Units Square Feet PRV ' #of Buildings Length Fire SpHnklers 'i Type of Construction �� 'I REQUIR�d INSp�CTIONS Footings(New Building) SheetrocN� Footings(Deck) �inai/C.C1.I�equired �'ootings(Addition) Final f No C.O.Required Foundallon Other• drain Tile Pool:„_,f-oo6ngs Air/Gas Tests ,_,Final Roof:,�Decking ,,,Insulation ____Ice&Water _Final SldinB:_Stucco l.ath _Stone Lath _Bridc �raming wndoWs Fireplace:_Rough In Air Test _Final Rebining Wall Insulatlon Lrosio�Control Meter Size• ..-� Final C10 Ihspection: Schedule Fire Marshal to be present: Yes Y No Reviewed By:�f� L , Buildin Ins ector Revie�wed 9 P By: , Planning COMMERCIAL���5 Bas�Fee .��0. �Sf Water Quality Surcharge _� Water Sampling Fee Plah Review Wate�Supply&Storaga('WAC) MCES SAC Storm Sewer Trunk Cfty SAC Sewe�Trunk S&W P�rmit& Surcharge Water Trunk Treatrnent Ptant Street Lateral Treatment P(ant(Irrigationj Street Park Dedication Water Lateral Trafl Dedfcafion Other: Water Gtualiry rt�T1�Lr�(� l. s page 2 of 3 S01'�0 �9�d O�SfI�! NW bbS6-S£6-Z56 8��0Z St9ZI9T/b9 Use BLUE or BLACK Ink -----------------, � For Office Use � 1 � (�+ ���� j Permit#: ' �oL�� I i U16� �� � I Permit Fee:_�� • � � 3830 Pilot Knob Road � n/ l I I Eagan MN 55122 � Date Receive ��C."7—!�� Phone:(651)675-5675 �(�� � �; �o�� � �,,^ � Fax:(651)675-5694 � Staff:�✓ � � ____________���__J 2015 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date:__�`l7`�� Site Address: 3��j �` C�� C- /h�-1U � Tenant• ���� � �,Q ��' �-l��� suite#: o s � s„ � � q o2 y S� � � ��� �., � Name: W��1� ����� ���-S Phone: � � `7 � � `9 �C �� "� // � i���� ° \ ///� / -T . :��� , �� �,H,�/ ��. . ; � ��� Name: / � 1.1J I T Z-, �[.. � �i License#: �i�//�6�/�i��i9 ��#H/4i%rrirr��dN���9r ' � � Address: ��d � �UE��G ,��� /�City: ��� `�vP� State:�Zip: ���oz0 1�����1�� ��' ,/�����p�/���j� . p ri ����y�'� . ,� � �Phone:��'-� `�..3$-��O 7 � Email: ��U�,1� /T4�f�tJ frZ !lU G C�n� �� �� � � � "� _New _Replacement _Repair ��Rebuild _Modify Space _Work in R.O.W. �� � �� �U1�D 6,2,� �/C�J�'� $� �, '%"' ,;�` Description of work: � � �0�'�°���/ ���,` t �� COMMERC/AL _New Construction _Modiy Space � � � ��� �� _Irrigation System(_yes/_no)(�RPZ/_PVB) � �'� �� � �%��� • Rain sensors required on irrigation systems � �� • Avg.GPM (2"turbo required unless smalier size allowed by Public Works) � �� Meters Call(651)675-5646 to verity that tests passed qrior to pickinq ua meter. � � � f � %�� A � ��� - � � Domestic:Size�&Type Fire: 1 ,��� ,,,p�"�� Avg.GPM High demand devices? Yes No Flushometers Yes No COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum, includes State Surcharge _$ �� • �� Permit Fee �If contract value is GREATER than$2,010, Surcharge=Contract Value x$0.0005 =$ Surcharge* If the project valuation is over$1 million, please call for Surcharge _$ � U� - � � TOTAL FEE Following fe�s apply when installing a new lawn irrigation�ystem $, Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ State Surcharge _$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State Qne Call at(651)454-0002 for protection against underground utility damage. \ 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 /�r4 u� T/Z.�--v8 x � Applicant's Printed Name Applic nt's ignature u ,-, ;-�� �' \ ��' � �� �i �� �, �� � ,, � � � � , //� � � i ' i9 � a i�/�%o. '. �r„�, %'��� . ���'/��, � /��///%/!� ��� %/�9/��y. � ��l �� � ✓.�e k�� , :y��//�� '<�����`ai � ,:� /r��/ �. /�/i �� /�.;,�,`��, ���,,, ; ��� � .:�� ��., ,.� " . �# ��%� �,� %� `�` 3 '7'� ,��/�/ a� �.r ������ < r �Cl �� � �� ; � � n r.�\� .���F� ,„ � . ';%�� ���, ���.,„ ; ' '� '^� ���, �" ,� �i���� } Y� � �, �_.�ni .��€ / 7� '���. � f :;,�. � � �,,r;, y b g ..� /.,.+ ^�z�� - � � ��Nq �� �/ . ��^ � F 9Y'�� � / A � � , � / � � � / � / // � �i � ��j �� H � �� �������� � i ����x �f � ..���{ a,iu,%/i ��,;, �.����.�ii' a� � ii � � �e,,�, ��� :� "'�, '. � . �,�. Q� Page 1 of 3 03/15/2016 14:06 952-935-9544 City of Eaaaii 3830 Pilot Knob Road Phone: (651) 676.5675 Fax: (651) 675-5694 Tenant Name: MpR 15 2016 MN RUSCO PAGE 02/04 Use BLUE or BLACK Inkf v For Office Use Permit #: / 355 7 Permit Fee: (/47�0' ' UUIc RCVeiveu. .�3 ' - I CP Staff: 2016 COMMERCIAL BUILDING PERMIT APPLICATION Slte Address:` 55 CO acJi1 ?VLSI') toad tJ ti T i f J (, I th lq I 66 /'"T` (Tenant is: New / V Existing) Suite #: • CALL BEFORE YOU DIG. Cali Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities, www.geoherstateonecall.orq I hereby acknowledge that this Information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit: that the work will be in accordance with the approved plan in the case of ork which requires a review and_approval of plans. x VWelirVe Wikt1 son x ' ' (4) ( -�- Applicant's Printed Name Applicant's Signature Page 1 of 3 Property Owner Name: 4" CUr Phone: 9'5o 5o "4:11-(46 • 1 So 0 Address / City / Zip: U W C Sk SO4 S)1f.9.--i" 1 i/ttc _LvD Applicant is: Owner Contractor Lk ll A ILLC-- I a V T" a of Werk yp Description of work: t Gt ri- W 1 r1 a OW S 4- p Od 1 O CI IO r S 3 Cf 0 _.2& 1Q% ('7 1) "" / r, Construction Cost: - 1-7e 9 `f S i/ 1 �` • Contractor •' Name: M1nnR.SDi0.. e.A.ASCU License#: C2"ooa f 3 (, ; Address: 5550 S}V1 c- -o.K ot. r IV R. -City: M n V1..f! -%"Or1 (e-Gt.. state: MNI zip: 553 3 Phone: 5a " 9 35 - I Leto' a -';41r °n - le-ro+1^e.v eryvi eso+a rtASC.QG• Contact: of d i e Email; rrtaddt e r Architect/Engineer Name: Registration #: Address: city: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE: Plans and supporting documents that you submit are considered to be public information, Portions of the infonnation maybe 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. Cali Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities, www.geoherstateonecall.orq I hereby acknowledge that this Information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit: that the work will be in accordance with the approved plan in the case of ork which requires a review and_approval of plans. x VWelirVe Wikt1 son x ' ' (4) ( -�- Applicant's Printed Name Applicant's Signature Page 1 of 3 03/15/2016 14:06 952-935-954, MN RUSCO G { 1 /! DO NOT WRITE BELOW THIS INE SUB TYPES Foundation Commercial / Industrial ✓Apartments Miscellaneous WORK TYPES New Addition Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review (25%_ 100%_) Census Code # of Units # of Buildings Type of Construction v -A REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile _ Public Facility Accessory Building _ Greenhouse ! Tent Antennae Interior Improvement Exterior Improvement Repair Water Damage l7qcoo meWc- Occupancy Code Edition Zoning Stories Square Feet Length Width PAGE 03/04 Exterior Alteration -Apartments +_ Exterlor Alteration -Commercial Exterlor Alteration -Public Facility Siding --y Reroof Windows Fire Repair Demolish Building` _ Demolish Interior Demolish Foundation Retaining Wall 'Demolition of entire building -give PCA handout to applicant Roof: _Decking _Insulation _Ice & Water _Final Framing Fireplace: _Rough In Air Test Final Insulation Meter Size: MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers /v/A Sheetrock Final / C.O. Required Final I No C.O. Required Other: Pool: _Footings Air/Gas Tests _Final Siding: Stucco Lath Stone Lath _Brick V Windows Retaining Wall Erosion Control Concrete Entrance Apron Final CIO Inspection: Schedule Fire Marshal to be present: Yes /No Reviewed By: I" `� L , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality /3-3a 7.f Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOT *i20. 925 Page 2 of 3 Citi of Eaoali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 APR 6 2016 Use BLUE or BLACK Ink For Office Use Permit #: / Ce Permit Fee: Date Received: Staff: 2016 COMMERCIAL PLUMBING PERMIT APPLICATION D Please submit two (2) sets of plans with all commercial applications. Date: Site Address: 3 `) � C o 4:°^'• cvN. Tenant: Ua c c C • Suite #: arty $ , C v ` a e tier Name: Name: t _hd A: Name: 'A. " � j-1- `") License #: Cont o c) 4 C w',Je �) �t Address: �'� City: `f State: '�2ip: SS' CD Phone: 6- 4 - 3CD - Co (ACC Email: p) .ft.‘ k Q ),--y,b.-., i''n‘k‘ ( , (G New Replacement Repair Rebuild Modify Space Work in R.O.W. Type Mork — _ .. i Description of work: ;,d••54-�.1) iL �O �.1fovv SioT'St 1,c,.ank$ COMMERCIAL New Construction Modify Space flk k 4 l C ,,q 1 Irrigation System (_ yes / no) (_ RPZ / PVB) n • Rain sensors required on irrigation systems / L Gbh Permit Type . • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? _Yes _No Flushometers _Yes _No COMMERCIAL FEES Contract Value $ it 3s -dc, ,00 x .01 $60.00 Permit Fee Minimum 6 = $ &C • 0 Permit Fee $60.00 PVB/RPZ Permit (includes State Surcharge) = $ /' -75 Surcharge Surcharge = Contract Value x $0.0005 / If the project valuation is over $1 million, please call for Surcharge = $ 1; ` ` /5 TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. \ 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 1',K#c..)1 Applicant's Printed Name Applicant's Signature Page 1 of 3 PtQ �Vl- V(„e,L 1 For Office Use ' 9 , %� i ; ,� Permit#: !J r/r %- r •.:. EAGAN _‘..,_ _ , Permit Fee: 211 Date Received: 1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 JAN 2 $ (tij!� (651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 Staff: buildinoinspectionsta'�.citvofeaaan.com L. -1 2019 COMMERCIAL FIRE ALARM PERMIT APPLICATION Date: Illi h q. Site Address: g?ST. 004.3^0.ar. (AA Tenant: `Nl2�Lt: _ Suite#: 0 Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components se Name: e5+ vc.r$,- ew,,,,,,.,,;,e5 Phone: 6s-SOS-6,026 @ � ) s A• ddress/City/Zip: /Ov) W JO J.. ST GiQon.,." mi-) s 5 t-(ac) E h 3�� '" Applicant is: Owner ontractor , T D• escription of work: I/4 t#�t. V ra . :; Construction Cost: I SOW) Estimated Completion Date: 3 � Name: f t,,_A.,,L F;re d SQC.vr vb License#: 274-4. 0s12)1 f:,,,,,-5,..,,,'.'s-r.-%,-• ,111 aAddress: y�1�1 bc��c,4. {,¢„�� City: LC-1 I4 ; • State: �� Zip: SS?)71 Phone: 6SJ-4 0 -ate ,.- Contact: ISo 2rkr., Email: RO a-�c^Zt. C ..GS»W,Ca-vr. � " _.r :r _ New Op:model a7 1 _ Addition Other: _Alterations DESCRIPTION OF WORK: WV.mmercial Residential _Educational FEES Contract Value$ I 7.X7 x.01 $60.00 Permit Fee Minimum _$ I fti.1" Permit Fee Surcharge=Contract Value x$0.0005 =$ 5.CA) Surcharge* If the project valuation is over$1 million, please call for Surcharge =$ I J (b .(X) TOTAL FEE 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.citvofeaaan.com/subscribe. I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;that I understand this is not a permit,but only an application for ae permit,and work is not to start without a permit;that the work will be in accordance with the approva- .an in the case of work which requires a review and appeal of plans. x t5 r, x _/ Applicant's Printed Na c- �e Ap.I nat re ._. ... �, ,‘fiey ., .e � �11. " I ' ` . " !t � � e . ..: : . : _ For Office Use ::::ee:E Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinqinspections@citvofeaqan.com L CROSS CONNECTION CONTROL PROGRAM INSPECTIONS PERMIT APPLICATION Date: a' 16 -au Site Address: J a ✓S C 6 w� "+ "n Tenant: w (5 a + `1 P �- Suite#: Property Owner Name: S `� `+� Co Phone: Name: CIN 'rl 1-\ `n'\ l`' + '^ )\-K- License#: d et 3 Contractor .l Address: 3 8 6 b �e� 5 i city: `l ves 1`/ Stater w Zip: 5'.5-310 Phone: Email: V New Replacement Repair Rebuild Type of Work Description of work: .1--v-\ k Q P2 COMMERCIAL Irrigation System( yes/_no)(\RPZ/_PVB) k S w C c-t,o W.N Permit Type • Rain sensors required on irrigation systems • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Avg.GPM High demand devices?_Yes_No Flushometers_Yes_No Permit Fee $60.00 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.citvofeaoa n.comtsu bscri be. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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. Applicant's Printed Name Applicant's Signature