4721 Covington Ct
Use BLUE or BLACK Ink
1-----------------i
For Offwu Us(--
City of Ea 1 Permit 1
Permit Fee: ` j
3830 Pilot Knob Road I I
Eagan MN 55122 1 Date Received: 1
Phone: (651) 675-5675 "''cl~/FD 1 I
Fax: (651) 675-5694 I Staff:
-
JAN 1 0 2011
INFLOW NFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Ul `
Date: I Site Address: ~Ar~ CI)t I
Tenant: r 1 Suite k)i
l.LC1 C
RESIDENT /OWNER Name: Phone:
Address / City / _Zip: L4 n ! ';4 Lq+ N
1
Name: 1 1 License (4 S ✓P
Address: / City:
A41-
CONTRACTOR n
State: I ~ rl j Zip: Phone: - l
` t
Contact: - r Email:
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
Description of work: A;,ve
DESCRIPTION
FEES
$55.00 /Each (includes $5.00 State Surcharge) (Rev. 6-30-10) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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.ciopherstateonecall.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 r a permit, and work is not to start without
permit; that the work will be in accord ce with the a pro ed plan in the case of work w i requires a r view and pr plans
4,w 9AX x x
Applicant's Pri ed Name Applt ant's Si ature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-N -Final
? ? PERMIT # / '?
?`1?
i0G??
?
?
?
- ,
? MECHANICAL PERMI?
RECEIPT # ??
' C
, CITY OF EAGAN
? ? r
.
?
?
3830 PILOT KNOB ROAD, EA(iAN, MN 55121 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Addr gLpG. TyPE WORK DESCRIPTION
Lot?Block SeclSub " `?
Res. ? New 7W
m Name Mult Add-on
Address R
i
C
s r
omm.
epa
c Ciry Phone pmer
Name FEES
c Address ? 'L - ' RES. HVAC 0-100 M BTU -$24.00
p City Phone? ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR.CDND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL `6 M BTU - 6.00
GAS OUTLETS - 1.50 FA
_ Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
' Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. ? M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
Vent CFM BEYOND $1,000.00)
? Gas Piping Outlets #
Other
FEE ?
S/C: SIGNATURE OF PERMITTEE
TOTAL:
FOR: CITY OF EAGAN
cirr oF EAG?N
2795 Pilet Kwe6 Roed Eogon, MN 55112
PHOMEs 454.6100
BUILDING PERMIT Receipt
Te be wud ier ?F DWC /(;AR Est. Value S6 2.000 Date Mgy ? a , 19?_
Site Address 4721 Cov lnAton Court Erect Occupanq R-3
Lot 14 Block 6 Sec/Sub. Be-acoil 11ill Aiter p Zoniny R-i
Porcel # 10 13:00 1 40 06 Repoi? p Flrc Zone NA
Enlarpa [] Type of Const. V
W Ncme R1 t lie Co astr?ction Go. ?y{o? p # Stories
Z Address 644 Supe rior Ct. Demolieh ? Length 62
9 C; ' phor,e 454-1438 Grade p Depth 26 Sq. Ft.
°C
_o Name OWneY' Approrals F.es
Address Assessment _
Clry Phone Woter & Sew.
Pol ice
Name
I hereby acknowledga thot I have reod this opplication ond stote that
fhe informotion is correct ond ogree fo comply with oll applicoble
Stote of Minnesoto Stetutes and City of Eagon Ordirwnces.
Sipnoture of Permittee
E1
A Building Permit is iuued to:
oll work sholl be done in occordance wlth
Buildinp Officiol
Fire
Eny.
Plonner
Council
Bldp. Off.
APC
Permir 319.OCI
Surchcr{ye 31.00
Plnn check 259.50
SAC 525.00
Woter ConnAa0..?.rc?
Woter Meter 6 0• 0 0
Road Unit 250 • ?')
Totai $1794.50
_on Co.
on the axpress eor+dition ehni
Minnesota Statutes ond City of Eapan Ordinances.
Psrmit No. Permit Hoidsr Misc. Permit No. Holder
Plumbiny SC? 3-?'- i^ JG(l/?•IIF ?C- Z??
H.V.A.C. (0= l '7?3
WNI
WKsr '
DisP•
Sew?r .
Eketric 0-7075-? h1TEC? ?D~?( T 3
Inspection Date I?sp. Other
Footinps
d3p
L
Foundation
Framinq ?_,.ehz
. ?.
Rou4h P16q. - -? ?
Rou¢+ HVA
Inwlation
Finsl Plbg. ?
Final HVAC '
Final ?I
k
W?? Wferibe ?tiony
rGJ
-
YYali ?'L
?/'
•
Sorwr `
Pr. D'ap.
CITY OF EAGAN Remarks
Addition BEACON HILL ADDITION Lot 14 Blk 6 Parcel 10 13500 140 06
Owner .lr ?-> Street_ 4721 CoViTigtOn Court State Eagan, M 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ? 1982 1848.67 205.41 9 1437.87 A012539 8-2-83
STREET RESTOR.
GRADING -?ph 1982 537.84 59.77 9 418.32 A012539 8-2-83
SAN SEW TRUNK 1976 135.97 9.06 15 63.49 A012539 8-2-83
*SEWER LATERAL 19$2 3182.83 353.65 9 2475.5$ ti to
WATEFIMAIN
'WATER LATERAL 1952 J
WATERAREA 1982 202.00 22.44 9 157.12 A012539 8-2-83
* Stubs 1982 9
STORM SEW TRK ] 982 367.77 40.86 9 286.Q5 A012539 8-2-83
'iTORM SEW LAT 19$2 9
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD UNIT 250.00 35922 5-19-83
WATER CONN. 4rj0.Q0 " "
BUILDING PER. 8060
sac 525.00
PARK
- 41' G !
Receipt PLUMBING PERMIT Permrt No. ?
,. . CITY OF EAGAN Fee
Fill in numbered spaces S/C . f-'
TYpe or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address -" Lot - ` 81k. r? Tract
4. Owner
5. Contractor
6. Address
Phane
?
7. City State Zip f `
-
8. Buiiding Type: Residential dY Commercial O lnstitutionai ?
9. Work Description: New 0 Add ? Alter ? Repair ?
10. Describe
11,
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outleu
12. I hereby certify that the above information is true and correct, and I agree to
oomply wi?ordinances and codes governing this type of work.
Signed :
for
Roudh Flnel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved '' ± _ CITY OF EAGAN 454-$100
heceipt. .
?
E . ,
MECHANICAL PERMIT
CITY OF EAGAN
Fill i» numbered speces
1. Date 2. Inst
3. Job Address
4. Owner
5. Contractor
6. Address _
7. City
State
Permit No.
Fee I
5/C ?
Tot. -°' - ,
i0 Tract
/ 3!D
Zip
8. Building Type: Residential ?l Commercial ? Institutional ?
9. Work Description: New Add ? Alter ? Repair ?
10. Describe Fuel Type
I 11.
No.
' Eauioment 8TU - M. Ea.
Forced Air No. Equipment CFM
Air Handli
:
AAfg. ng
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby aertify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
Receipt ''' { 1^ i` I pLUMBING PERMIT Permit No. -
CITY OF EAGAN
Fse '
fill rn numbered snaces S/C
Typs or Print /egibly Tot 1. Date Installation ?
3. Job Address' r zI ? ?`?'?- ? Lot Blk. • Tract
4. Owner -- - --- ' - -- - - - / i`c r ?
5. Contractor be,,,,,,.,,,E. , E„ .. _ Phone
678 3RD /1VF_ ?
6. Address MENDOTA
7. City
8. Building Type: Residential ?
9. Work Description: New ?
10. Describe
11.
State
Zip
Commercial ? Institutional ?
Add O Alter 0 Repair 0
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Sohner
Shower wel I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed
ROUgh
Inspections: Date Insp.
for
Final
Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road pE?yIT NO•: 7 J? -
P. O. Box 21199 ?_gq
MN 55121
Eagan DA?? - 1
,
Rl Na of Units:
- Zonirg:
F'1211G C(?I'iStr
' OvVnBr:
,
i Address:
d
i
Site Ad
Plumber:
1 agr+e M omphr wieh tM Cih of Eat+n
Ordinanoes.
By
Date of Insp.:
Connection Charge:
Account Deposit: ?0 00 Acl
Permit Fee:
Suraharfle:
MisG. Char9ss:
Total:
pote Paid:
? CITY OF EAGAN WATER SERVICE PERMIT
.4830 Pilut Knob Road
-
P. O. Box 21199
pE?IT NO.:
Eagan, MN 55121 D^TE:
Zonin9:
- No. 04 Units:
Owncr: L l Z l C:0I15t
:• '] ") V1Fl oYl
Addr
.
? Ct I,?-•I :-? ?'.cacon H111.
ess
5i
te
1t`•3't0v'n x'lb?
SQ'
-
Plumber: Connection Cha?se: '? 5?• d0 ?'d
Meter No :
Size: Account Deposit: 10. p (
Render No.: Permit Fee: p
I agree to eomVhr witle Hw Citp of Eegen Surcharge:
00 nCl meter
? ?
Ordieenas. •
Misc. Chorges:
Total:
Dote Poid:
BY
Date of Insp.: I^sp.,.
BUILDING PERMIT
Site Address
CITY OF EAGAN
9795 Pllet Kno? Rmd Engan, MN 55131
PHONEi 4348100
Court
Lof 14 Blxk 6 Sec/Sub. Beacon Hill
parcel # 10 13500 140 06
W Na? Blilie Construction Co.
? Addreas 644 Superior Ct.
L'..-..- CCIq'J /.C/. l/.'JO
? Name OF'ner
s? Address
Nome _
Address
I hereby ackrrowledBe fhot I hove read this applicohon ond sfote thot
the inlormation is torrecT ond ogree to comply with nll applicoble
$tate of Minnewta Stotutes and Gty of Eaqun Ordinances.
Sipnoture of Pertnittea -- - - - - B7
A Buildirg Permit Is issued to:
oll work sholl be done in occordonce with
Buildinp Officiol
N? 8060
ReCeipt .# 2-5-3? '4 -)--
Erect gg Occuponcy R-3
Alter ? Zoning R-1
Repoir ? Fire Zone NA
e„ioroa ? Type af Const. V
Move ? # Stories
Demolish ? Length 62
Grade ? Depth 26 Sq. Ft.-
Apvrorob Feas
Assessment _
Water 8 Sew.
Police -
Fire
Erq.
Plonner -
Council _
Bidg. Off. _
APC
CO.
Pertnit J17.VV
5urcnarpe 31.00
Plan check 159.$0
SaC 525.00
woter Conn.450 _ ()n
Water Meter 60.00
Rood Unit 250.00
Toeal $1744.50
on tha express condition ihnt
Stmutes nnd Ciry of Eagan Ordinancea.
itp of eagan
'_?:ThirCrrtificati iuual purru4nt to tbt rtqui+emenu of Scction 306 of tfir Uniforni B4
ldin8!;°=
? Code nrti f yiag thdt at tix time o f utrrarue tbit rtreutare wat in ram plianee witb the roarioeu
ardinuiuu o f thi City rrguloting building coniirurtion a ute. Par ibt f otlowing::
SF DWG/GAR
- u,.cwerK,nm
; omo.ocrirvu R-3 nncmm.cnm V fimn.,. -NA ' °zemmtm:umP
COUI'?t
?BY;-
? . , euuamyoMda' -jl
A.
i
_ . , . .. ,d rart 4n . wncnwaw
.11 u.+ow . s-4.
HEaTING JoeNO
SEDGWICK HEATING & AIR CONDITIONING CO
S(5-(5 y 47
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 88 .
.
1-9000 TEST RECORD
?
L/2? I C O V( C IE0' S r.,j
r
ADDRESS CITY
OCCUPANT OWNER
?vc(cwcc?
SOLD BY MSTALLED BY
'2' 36c- o T b
MAKE MODEL
SERIALNO. I INPUT
Gy
THERMOSTATJ ,r i,
ENTSIZE I:l up,`? goG
V
v! c II' I IL;
VALVE NPE OF LINER
?
LIMIT LWEfi51ZE
?J? t? ? ?
??
LIMITSETTING NUMeER " v?
FILTEIiS: SIZE /?' X
/
FAN SETTING WIRING
`-J
?
PILOTTVPE ci? TESTTAG
I
IGNITION MODEL
^ ?
`
' LIGHTING INST. ?'-------
tiU
•,
PILOTTIMING i?I ??
? 0
? DATE TESTED
?
PRESSURE PERCENTCOz
A
Lo ?
COMPANY TESTING
"
INPUT CFH PERCENT Oz
STACK TEMP PERCENT CO NAME OF TESTE
FORM235(REV11/69) FORMDISTRIBUTI N WHITECOPY-JOBFILE VELLOWCOPI' - CITY
7b Be TJsed For
Site Pddress
CITY OF EAGAN Include 2 sets of plans,
- ' 1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set of energy calculations.
OL Alav
/02j'? Date ?// -
Valuation ^
jtt7
OFFICE USE ONLY
Lot ? block 4;?, sec./sub.
Parcel #: (D 13 S O O l40 p b
Owner:
Address: City/Zip Code:
Phone #:
Contsactor:
Address: ?
City/Zip Code: C 0.?
Phore # : t!?[
Arch./Eng.
Address:
City/Zip Code:
Phone #:
I?2
x
E ?
rect oooupan
cy
Alter ? Zonirig ?
Repair Fire Zone
Ehlarge _ TYpe of Const.
Nbve # Stories
DEmlish Front p ft.
?
Grade ft.
Depth --',
APPROVAIS FEES
Assessnents Permit 3J9-
Taater/Se,aer Surcharge ? I am
Police Plan Check /?
Fire ? S ? ?
gnq, Water Conn. ycS`O
planner Water Meter &a ?
Council Road Unit oZ
Bldg. Off
AFC
= l`Mtsb
This requesl void `/ o 7
from
?''
? /n, n
Request Date
I Fre No. qe?urted??nspecuon %qeady Now Q Wt I I NnUty inspec-
?Yes No ior When q¢ady
CXL?ceosed Electncal ConVactor 1 hereby requestinsoecUOn of above
? Owner alechiwl work installed et
Street Address. eox or floute No.
`7z t `41I??CrTON a CuY
Ef'tiCrAlJ
eclion o. Township Name or Na. Raoee o. Counly T
Occupant (PRINT)
L L_ tW`l Phone Na. `? l1 - l1
Power Supuher
l..>./ 1
CA! Address
Electncal Contractor ICompany Name)
'Pt??. C_?rno?i?U-
? ConVac,tor's Uwnse No.
3z.cozbz0
Maili
?Iess IContra tor or Owner Makmg Ins[ailanonl
MoiS _?. )` 3I
?3 CQ - Bl?t I tJ G?TO?. ?
Authoraed ICon aqtor Owner Mak?ng In tallauun) Phon
e Numbe`
sia
MINNESOTA STATE BOAND OF ELECTNICITY
Grices-Midway 81dg. - Noom N-197
1821 llniversity Ave., St. Vaul. MN 55104
Phone 16131 29]-2111
IHIS INSVECIIUN XtUUt51 WILL NpT
BE ACGEPTEO BY THE STATE BOAFD
UNIESS PROPEX INSPECTION FEE IS
ENCLOSED.
4- REQUEST FOR ELECTRICAL INSPECTION L EB-00001 -04?
' See instructions for camplating this lorm on back o1 vellow copy.
v° H14 X` Be/ow Work Covered by 7his Request AAd p p T p f 8 Itl g ,1GDtiantee Wtred Eqmpmant Wvea ?
r Nmm? FLvxw Temoorarv Service
F__F__F_I Commercial 81dq. I I Fumace I I Silo Vnloatler, ?
r_-T__7 ---- T RhinAv Conditioner I I Bulk MiIk Tank J
...,..
p .r..... .....
Fee r.._........... __._..
ServiceEnVaneeSixe
p
Fee
Fandafs/5ublexders
Fee
Gucwts
0 to 200 qm>s 0 to 30 Am s 0 tn 30 Am
Ahove 200 qmps to 100 Amps
31 31 to 100 A s
Swinvning Pool Above 100_Amps Above 10D_Am s
Transtormers r
Irgation Booms ; ParvaL Other Fee
Si
aVeaaiinspecuon I$
Inougn-m °.` I. ?he Eldesrrcxl I
? / ? Insoector, heraby
-erLfy that tha bove
Finel ?--_-'????? `?/ ` W ,??• insuaeLOn hes been
repuast voia
REQUEST FOR ELECTRICAL INSPECTION
n beck of
t EB-00007-04
vellow moV.
orm o
' Sae inetrucLOns far completiqq thus
17 ??
pv or o ered by This Request
k
gD APPlmnces Wired
Typa oi Bu?ld?n9 Enui=ment WireA
Temporary Service
Hame Range
Liyhtiny F?xwres
Duplea Water Heater Elecvic Heatu,
Apt. Bwlding ryef Silo Unloader
Commercial Bldy. Furnace
eulk Miik Tank
Indusinal Bldg. Air Condrtioner . . ivl.
de Inspecuon Fee 8elaw
Fae ServiceEnhenca5iza
V.ZAIFe ?
Oto30Ams
31 to 100 Amps 3
oh??e 100-Ainps F
"C",
Final
TNf requeat voitl 18
?f
1, «a ao .,??i
?(•v Inspactar, heroby
? cervty thnt the above
„_ ^l O?yM inspaction hes baen
T ?
made.
This requesi void 6L L'? ? /3?? ?????• ? ? ? ? ? "' Z ` /
16 nwnNS irom
?n9 070753
Raquest Da
?Q
3 Fire No. NouPh-tn Inspecuon
.nu? r ?
es ?No
?ReatlY No
W?II Nnufv InsOeo
Ior Whun Beady
Licensed Elec[rical C(Mracror I hereby request mspactmn ol above
wnrk mstalled at:
_, vwiief
Sveet A ress, Box o Route No.
??)
ecuo o. ownship Namo or o. Bange No. County
Or.cupd fP N) ? Phoi e No. -4 3
P w Su lier ?
i Addre
Electr I Convac r (Corn?me) ? C d var.mr's License No.
34 .? 3
Mailine dJress ICOnuac or Owner Making retaila onl
t, L 3 zo - ?^
/ J
Authonzed atur1 racto wner i In tallaLO
•
r
Phone Numb(J
Y
t?
ninncr?+?nu ? CCT WII I N(1T
MINNESOti'h-6FlC?E gOARD OF ELECTflICITVe ? BE ACCEPTEO 9V THE STqTE BOARD
GrigBS-Midway Bldg. - floom N-197 UNLESS PROPER INSPECTION FEE IS
1821 UniversitV Ave., SL Peul, MN 561U4 ENCLOSED.
Phone (812) 297-2111
40? City of BapIl
3830 Pilot Knob Road
Eagan MN 55122
Phone:(651)675-5675
Fax: (651) 675-5694
------------------
? I
j Pertnit #:
? Pertnit Fee:
? Date Received: j
I I
I Staft: I
i
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:-q? a - (3(} SiteAddress:
7enant:
RESIDENT/OWNER I Name:
Suite A:
Address / City / Zip:
Applicant is: _ Owner XContractor
TYPE OF WORK Description of work: R .. 4 ° " 1 CIL
Construction Cost: U C'; ulti-Family Building: (Yes _/ No
CONTRACTOR Name: r? License #: (a? ?1 ? ?.0 ri Lp
Address: 13H6_ f f 1 I il Rd,. 1
Ciry: W I11TC_ U( 1 U.L.Y'fP
Phone: ' J l5-004 Lj Contact Person:
COMPLETE THIS AREA ONLY IF CONSTR
_ Minnesota Rules 7670 Cateaorv 1
Energy Code . Residential Ventilation Category 1 Waksheet
Category Suhmitted
(4 SubmiS3ion type) • Energy Envelope Calculatlons Su6mined
Zip:
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a mester plan?
Yes _NO If yes, date and address of master plan:
Lfcensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
I here6y acknowledge that this infortnation is complele and accurale; that the work will be in conformance with ihe ordinances and codes of ihe 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 permih that the work will be in
accordance with ihe approved plan in the case of work which requlres a reviaw and approval of plans.
X?", re or c .? o lai %f-Y
?
Applicant's Printed Name Applicant's Signature
Page 1 of 3
. ,
u 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when pemuts aze required for each unit
7* 3o.s0
Ck . w, 0I6p-T
Date
Sitc Address Unit #
Property Owner Telephone # (?Vs/ ) ? /? "7o?`9d
Contractor SEDGWICK HEATING & AiR cetinrriONuUr 1
C'
1
-
-
8910 Wentworth Ave. So.
Street Address Minneannlis MN 55420 City
State (952) 881-9000 Zip Telep6one # ( )
Bond #: Ezpires:
The Applicant ia _ Owner VI Contrador _ Other
Add-an or alteration to exiating dwelling unit ?-ep
? furnace _Additional ? ReplaCmtnt"' ' $ 30.00
_ air exchanger
?z airconditioner
_New ? Replacement?.?/""hG
other
State Surcharge $ 50
Total $ ? ?L-
I hereby apply for a Residential MecLanical Permit and acknowledge that the information is complete and accurate; tltat the work will
be in conformance with the ordinances and codes of the City of Eagan and with Ihe 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 permil; that the work will be in accordance with thc
approvedp?lapn?inp th3e case of work wlrich re uimsa review and appmval of plan/s.
?. .
?Ei7?'uL'??r6tu+: E B' `i?, d430'i .6? . ? ?j irwr.f _ / (o .?7f7?-?
Applicant's Printed Name
Signature /
V
!) , 2005 i ??I
,, ,
7a, w
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reaulremenls RemodeUReoair Reauirements OfFlCe Use Onlv
3 registered sde surveys showing sq. R. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert M Survey Raod _ Y_ N
(20% marzimum lot coverage allowed) 7 set of Eneigy Calculatbre for heated additions Tree Pres Plan Recd _ Y_ N.
2 capies of plan showing beam 8 window sizes; poured found design, etc. 7 site survey faradditlons & decks Tree Pres Required _Y _ N
iselofEneyyCalculations Adddion - indicatelf on-sifesepticsystem On-sileSeptlcSyslem _ Y _N
3 coples of Tree Preservation Plan'rf lot platted after 7/1193
Rim Joist Defail Op[bns selectbn sheet (buildings wiN 3 or less uniGS)
Date '-I
Site Address
Description of Work
Multi-Family Bldg _ Y ?,/ N
Construction Cost
Fireplace(s) _ 0 _ 1 _ 2
Unit/Ste #
00
Property Owner JOY \r' d.Jl) ? Telephone #((L61) 'NO '937 6
PELLA WINDOWS & DOORS
Contracmr 15300-25TH AVE. N. STE. 4100
Address p[,YMOUTH, MN 55447
state 763-745-1400
LICENSE#20165884
Telephone # (
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category . Residenlial Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculatians Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of 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 pl in the case rk which requires a review and
apiCk',k roual of plans. _
F, LX? ?nSO n.
Applicant's Printed I?Vame A icant's ignature ,) 2005 I ?
I
City
" ` Wd9E:l •.g •uop awil paaiaaaa
Pelta Windaws Sc Doors -Twin Cities, Inc, 15300 25THAVE. N. STE. #100
PLI'MOUTFI, MN 55447
763Y745-1400
Iune 8, 2001
Ciry of Eagan
3836 Pilot Knob Road
Eagan, MN 55122
Dear Jan:
Hider Jones Corporation is authorized to pull building permits for Pella Windows &
Doors - 'Itvin Ciries, Inc. Please a11ow their representarive fo ptovide that setvice for us
in Eagan. This authoriaation shall be valid until suah time as the division manager
exgressly revokes it, in writing to the City.
I request that this authorization be accepted exgeditiously, so as to not de3ay the
processing of our building permits any further. Please call me if diere aze any questions,
I canbe contacted at 763-745-1432.
Your iiivnediate attention to this matter is appreciated.
' cerely,
Bryan . May. ?
Replacement Sales Manager it,?pps
cc: Kaza-EidcrJones
Denna Krafty - Replacetnent Sales Process Coordinator
Windows, Doors,
& Skylights
WATS 2-800-462-5359
F.4Y763i145-1401
7nnFfi OATT71 ATTLT T11.1 RIST CS/ 9TO ?J lT•OT TVS TI?/nnlnn
° . 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675 ?
New Conshuction Reauiremenfs Remodel/Reoatr ReauiremeMs
? 12 9, z5
----
-?---7 - ? I
? 3 regbtered aHe surveys showing aq. tt. of lof, sq. M. of house 2 copies of plan
and gll rooted areas (20% moximum bf eweraae allowed) 1 set of energy cakulaHOns fa heaTed addRlons
Y 4 coples of plana (ahow beam a window sKes; poured fid. design; Mc.) 1 tke survey for extedor addHlorm i decb
D 1 set of energy cakulafbm
? 1 coples M hee preiervaNOn plan C lot plaried a(ler 7/1 /93
DATE: ?rl 2S ?19 CONSTRUCTION COST: %5.0 S d 0•c;'(>
DESCRIPTION OF WORK: 'P, no f
STREEf ADDRESS: 412-I CoJ !n ai ?l ? C?Z.. r fi
??
LOT: ? BLOCK: ?o SUBD./P.I.D. #: Q C[>iv? ?
Name: [* Zd? •?"¢?ht? l.Rr49 S Phone#?I?S/)
PROPERTY ast -? FUd
OWNER I
Street Address: q -7 21
Ci?y Ca Q CWi State: 111 ?°IJ Zip: s S 1 2 2
Phone?k-C,41,23 SC X02'-SCO9ub
?..r?.?.
(area code)
CONTRACTOR r- w 1 ?
G 5C!'.P,L Scd ?/ d License # QO O j 0 Sb 7.crvD
Sfreet Address: ?{ l?7 v ?
ciy Lo? i c Pa rstote: rh t? ziP: S 5?f l?
ARCHRECT/
ENGINEER Company: Name:
Telephone /k: area code ( )
Shed1 Address• Registraiion #:
Ci{y State: Zip:
Sewer R wafer Ileensed plumber (reauired for new conshuetlon onlvl:
PenaHy applies when address change and lot ehange h requesFed once permN Is Issued.
I hereby aeknowledge fhat I have read fhiz applieaHon, atafe ihat fhe informaNo iseO eef, and agree to comply with all appNcabl
Sicte of Minnesota Statutes and CMy of Eagan Ordinances. ?
Signature of Appllcant
OFFICE USE ONL
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
No
No Not Required
- - ??
AUU 26
???
-•------?,eT /y..?L?li R?L/lCO?./i?GL:,,
?1eJ?r??'`?L PLOT PLAN
Jf.iile.` - ?Ill'?
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, . i ? f? ?i ?..? ii•, ? I ? '-:-I. '•_ - . _._.
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-------- - -----
LSu • :;. :- io<:a::rm nf :rruet.^., lot and propose(! ,tuildings, 9ivc lot dimension.^..
.,v• lo tit,ikcu i:cfore opprareai is requested) .
? - --- ? --- ? -- ----- -- ? -- --- --------•- ? -
.__--------?-'- ---------'--------"----__.,.
--- --'---- . .
J
? EXTERIOR ENVEL"OPE AYERAGE "U" COMPUTATION
OwNER
SITE ADDRESS
CONTRACTOR{/>Z/L& DATE PHONE 4 ST/ ` I 438
Detei°mSne working square footage of each.
1. Total exposc,d wall area ..,,,. sq. ft, x - .17 az Z fl t
2, Total rvof/ceilin; arE?? ..... (DFiS-oo ? sq. ft, x -,05' •
Total exposed trall area above floor •!ZC°,pO
a, Total wall uindow area ........................... AkAd
b. Total door area ... ............................. 17.
c. Total sliding ylass door area ,,,,,,,,,,,,,,,,•.,
,,.......••,
d. Total fireplace wall area............
e, Totel wall frarn;ny arc-a (averaqe 10%) .............
f, Total net walt arra above floor ................. 7
g. Total rim jois2 5r4:d .................... ........ 112_o d
Total e;:posed founclation arsa = 1) j 0 -
h. ToCai folindaticn, window area ..................... 7- 7
.....
i, Toal net foundaiion araa above grFtie .......
Determine "U" value of each r:01 segment,
BG_-00 X "u° _r 5-3_.- ' 47• 3 a
b.3 7-5i ____ z ^u° 1/3 4 9/
c.q o. 01, ^ g 'lull
?-
d. X
nUu
? r
•
e. I3 5. 3S X Fluu ,?Z a 4
f, ?46- 7°f ?07 , ,r"q.41
e. 1 2_v0 z ltu° -oL .
n,.-??-17-7 X
"U° ,
• 4??z
i. g3-93 X „u" < <?? • 40-
3:.?? ............
?a
5
?
3 .... .Tota1 • o! 2
.
.
.
. ,.,...
]f item 13 tis the sam2 as, or less than item /1, you have met the Sntent
of SBC 6006(c)2.
.
?otal exposed roof/ceiling area = ? pBS op
?
j. Total skyliqht area.............................
k. Tota? roof/ceiling framing area (average 10%),.,
1. Total net insulated roof/ceiling area.... ....... / O BS.oti?"
Determine "U" value for each roof/ceiling segment.
' - -- K ,lUil a
k. X "Ul. ,
i. raf?s.oo X " u „ .ol' = rq-zr"
4 ............. l,O.9.S',od.....,..,,Total ' L ?
lf total of 04 fs the same as, or less than 02, you have met the intent of
SBC 6006(c)l.
Alternate Bullding Envelope Design
7o utilize the total envelope system method, tne vatues established Dy the
sum of 1tem5 #3 and #4 sha11 not be greater than the sum of items 11 and 02.
1, 2?0 - l 4 - ------- '
3. + a. K??f•z1? = 2 s3 -? Y
1804 Melody Lane 8963083
Bumsville, Minnesota
WEPJA CO. PLAN SBRVICE
ED ANDERSON
pPCMITECTUML OE4IGNING ANO PLANNING
01hCe:
172or??A-v+ 230 Yf«h'k nrq&Q" OffMe:
Burnrville, Minnesota et A.eLa 8964636
Use BLUE or BLACK Ink
r________________
I For Office Use I
/ I A) I
n r 7r- .Y,-~ City of Ea a~ I Permit C '
I Permit Fee:
c
3830 Pilot Knob Road
Eagan MN 55122 Date Received: e '
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: r Site Address:!
Tenant: Suite
RESIDENT I OWNER Name: Phone:
Address / City / Zip: g7Z- ll
Applicant is: Owner > Contractor
TYPE OF WORK Description of work: lA5 ~~tlt ^~S 1 tl 4 in -6
Construction Cost: J' { Multi-Family Building: (Yes / No
CONTRACTOR Name: l 51 LL L\-S-ern=: Q. rr. License#: 7&_C> IZt"~(~Ci
Address: C i R? ~c~ z V a ~ HIV,
City: `~`4 1z~,j State: 1v\, Zip: i 1
Phone: 3 / C-4 Z_ Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.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.
r. r
Appli6h s ri ed ame / Applicant's Sim ature
_ Page 1 of 3
Use BLUE or BLACK Ink
r----------------- I
For Office Use
C I /0
~r t`[ V E I Permit I
l
City of EaEdft I ~
b 012 I Permit Fee:
3830 Pilot Knob Road 1 I
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675 I
Fax: 675-5694 1 staff:
(651) L------------------
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: '9 l L } Site Address: C~n C+
Tenant: L `l~1 Suite
RESIDENT /OWNER Name: Phone:
Address / City / Zip: ) ~T t y ~t
Name. License
~E
CONTRACTOR Address: ~1 1 City: X11
Stateiv-0_Zip~~~) Phone
Contact"apr Email:
TYPE OF WORK . New Replacement _ Repair _ Rebuild ^ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation L_ RPZ PVB)
PERMIT TYPE Add Plumbing Fixtures Main Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 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.
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
App tcant's Printed Name Ap is is Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final