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999 Cross RdCITY OF EAGAN O 3830 Pilot KnoS Road,?P.O. Box 21-199 Eagan MN 55121N2 127o9 I I PHONE: 454-8100 BUILDING PERMIT Rece iptIf Tobeusedlor SF DWG/GAR Est.Value $63,000 Dete OCTOBER 21 t986 SiteAddress - 999 CROSS ROAD Erect C? Occupancy R3 Lot 4 Block 4 Sec/Sub. GREENSBORO liemodel ? 2oning Rl Parcel No Repair ? Type of Const iL. . Addition ? No. Stories w Name JOSEPH MILLER CONST Move ? 45 Lengih 46 18133 CEDAR AVE SO Demolish ? Depth o Address 892-1010 FARMINGM Int. Impr. ? ? Sq. Ft e City Instau o Name SAME ? Q Atldress " Ciry Phone a w w Name x ? Address o e w Cily Phone I hereby acknowledge that I have read this application and slate thatthe information is correct and agree to compl wi all a plicable State of Minnesota Stat$(es and^ of Eaqan Or i_nfes. Signature of A euilding Permit is iisued to: bSEPH MILLER CONST all work shall be done in accordan with all applicable S of Minnesota 8uilding Official Fees Assessment Permit $ 322.00 Water & Sew. Surcharge 31.50 Police Plan Review 161 . 00 Fire SAC 575.00 Eng. WaterConn. 500.00 Planner Water Meter 63 . 50 Council RoadUnit 290.00 81dg.Off.10/17/8 6 1 Tr, pi, 156.00 Var. Date I Copies rotal $2,099.00 - on the express conditian that and Ciry of Eagan Ordinances. w ? • ? •-? CiTY OF EAGAN ' 3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Recefpt # To be u:Rd for SF DWG/GAR FQf vafi„P $53, 400 nAtA OCTO, 12789 86 Site Address 999 CRUSS ROAD Erect C21 Occupancy ?i 4 GREEt? SBORO 4 Remodel ? Zoning Lot Biock Sec/Sub. Parcel No. Repair ? Type of Const 1l Addition ? No. Stories W Name JOSEPH i"IYIsLER CONS1' Move ? 0 45 Length 4 6 z 1$13 3 CEDAR AVE SO oemolish Depth o Rddress ING 92- 0 0 CA' Int. Impr. ? Sq. Ft tti WA e City Install ? c .o OV v¢ ? Phone Water 8 Sew. Police Fire Eng. Planner ?lx F W Mame ? ? Address i Wz City Phone ge that I have read this application and state that the B?d9 ct and agree to comply with all applicable State ot and City of Eagan Ordinapc.& i APC_ Surcharge Ji • ?V Plan Review 161. 00 SAC 575.00 Water Conn. 500.00 Water Meter 63. 50 ? Road Unit 290.00 Tr. PI. 1t; . t,'.; I I Copie ,099 .00 Signature of Permittee Var_ Date Total 1 ?,: -• ? A Building Permit is issued to:? JO ' PH MILLEft CO?`JST on the express condition that all work shall be done in accordance w?h all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Building Official . PermR No. PsrmH Holdw DNa Tel"bhone N P?4mWny ? 3 7 .)-- H.??.A.C. EIeCbIc g ? (?xLC 3 , -?i? i: ?• ?? <? ?' '7?'?/ C C? SofteMr Inspectlon Dab Insp. CommeNs Footings I Footlnysll Foundadon Framin9 ?? . 1 RooNny Rouph Piby. jl /S -C-a RoupA Fftp. Firepisee Final Htq. ? ? Flnal Plby. 6 Bldy. Final c«d. oco. Dock Fty. Dkk Frmy. WNI Pr. Disp. , , . Site Address Lot Block m Nan ? Add c City , Name c Addre O CitY - TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other PERMIT # MECHANICAL PERMIT RECEIPT # r G CITY OF EAGAN ? 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE M BTU M BTU CFM FEE S/C: TOTAL• TYPE WORK DESCRIPTION Res. ` New Mult Add-on _ Comm. Repair _ Other FEES RES. 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/1ND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMMIIND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) ; SIGNATURE OF PERMITTEE FOR: CfTY OF EAGAN p • - • PERMIT # PLUMBING PERMIT q CITY OF EAGAN RECEIPT # ?3830 PILOT KNOB ROAD, EAGAN, IVAN 55121 DATE: ? )NTRACT PRICE: PHONE: 454-8100 I Sne m Name ? Addre c City _ ? Name ; Addre O C?H = ?BLDG, TYpE WORK DESCRIPTION Block Sec/Sub Res. ° New 4-' Mult Add-on A Comm. Repair Phone Other FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RE5IDENTIAL 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) -1 ? SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN NO7- FIXTURES TPTAL water cioser - $3.00 $ -- Bath Tubs - $3.00 - - 7 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 $3 L T 00 d aun ray - ry . ' Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 ' Gas Piping Outle4s - $1.50 Softener - $5.00 Weli - $10.00 , Private Disp. - $10.00 ? Rough Openings - $1.50 FEE -' STATE S/C: ' , `? ? GRAND TOTAL• ; cinr oF iEAGAN WATER SERVICE PERMIT I 3830 PAot Knob Road r P.O. Box 21199 PERMIT NO.: 1. 2-4 --r. ". Eagan, MN 55121 DATE: Zoning: ~Z No. of Units: Owner. Joe '"iller Censt. Address: ? Site Addess: - 25 Cross Road L4 B4 Greensboro lst Meter No.: -2 7? ?? J d0 W p? Size: ?4;A Ro c f? . ??? Reader No.: 0,70 y6 3?.Se ore ig ?, i agree to comply wkh the Ciw??? urc Ordinances. ^ C Q? + iR?i c //- ?{ ? ? Total By Date Date of Insp.: Insp Charge: A1Sr,.,d n,oror CITY OF EAGAN SEWER SERVECE PERMR 3830 Pilot Knob Road . P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoninp: No. of Unita: Owner. - Address: S7te Addresa' Plumber. I ?lfe+ to - Ml? wM6 !M Cllp of Eqpw Ordieawea. Conr+ectton Charge: 1lcaouM Deposii: Penrht Fes: Surcharpe: AAlsc. Cho.4es: Total: Dah Paid: By Date of Insp.: ? ? G7 ? z ? O ? o .,.. ? m •z . _?' ??,1?.,,? 4?-.?_?. --,i.?.T..,a,...-..wa.r. . ? CASH RECEIPT 1.1 + CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEI V ED FROM I. AMOUNT F$ 7:: • . & DOLLARi t oo ? CASH [? CHECK F ND CBQE AMOUN ?^'? - : .. . . w _ . J, - , n v 0 m ^. ? ? ? m ? n m a 7 < 3 0 ? ; D Q = n ? ? Z ? D _ n q a o -? cy i a m ? ? ? > _ ? ? O CA Z ? T 7p ' ? ? m ' O z ? m 0 m •? ? ? S? D 0 > > ? o m ? o r ? r D ? N ty i BLDG. PERMITtiO. ?°? ?d ? G''( ?? L. `f2C?? - 01-3210 Bl.dg. Permi*_ l?? U J 01-3422 Plan Check X-' l U '? 01-3445 Surch./Adm. ^ I?i 3 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Llnit a? ? J 1 O J 20-2275 SAC 20-3865 Water Conn. 20-386$ Water Trmt. 20-3716 Water Meter --?-=-?-- 20-2252 Acct. Dep. _ 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 11-3855 Park Ded. V, Thank You ? BY r,,• • oWU. TOTAL c This rnquest vo;d 1i,1241/8(;r? 18 months irom :y 64858 L ?? /11?? Requsst Daie ire No.? Rough-in Inspection Re ired? TR,,dy Now ? Notify eC g(o ?B5 o No M Licensed Electrical Contractor 1 hereby raquest inspection of ebove h nwnpr electricel work installed at: Street Address, Box or Route No. ,9?Cy-Q 0ad b? City 6a-Aa/ / , / ectlon o. Township ame or No. ange o. Cou2ak_o4-zP_ Occupent (PRINT) Joe, ?11,er Phone No. Po er Supplier ?a.ko-E? Efe Address f_ ao ' s License No. Ele t ical Contractor lCampany Namel Cantractor - / ?d Land 99 e cfrE c. 1 616 Mailinp Address IContractor or Owner Making Instailationl I? c r ? ?d u a n. v i ??ov W C+ Authorized i9nature lContractor(Owner Making Installation) Phone Numher e? / ' ((/ M{NNESOTA STAT BOARD OF ELECTRICITY Oriqps-Midway BIdQ. - Room N-191 1621 Unlwrsitv Avs.. St. Paul. MN 58104 Phona (812) 642-0900 THIS INSPECTION REQUEST WILL NdT BE ACCEPTED 8Y THE STATE 80ARD UNLESS PROPER IN5PECTIOM FEE IS ENCLU5ED. 0 E g-00001-06 REQUEST FOR ELECTRICAL INSPECTION Sse instructione for comple??? this fa^' °^ beck o1 ysllow copv - - __., K., T h; c Renuest ` 7- / 1986 BDILDIAG PSAIiIT APPLICATI06 - CITY OF SAG9N NOTE: ALL CANTRACTORS MOST BE LICFNSED iiITH THB CITY OF EAGAN SINGLE FAlIILY DHELLIAGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SORVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLE DiiELLINGS - RESIDENTIAL RENTAL pHITS FOF SALS IINITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIR9EY - CHECB i1ITH HLDG. DEPT., 1 SET OF ENERGY CALCULATIONS C0199LR('Tpf. INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: Valuation: qqf Site Addres?j7?„?? ? . - Lot 't Bloek ? Parcel/Sub Owner Address City/Zip Code Phone Contractor Q'aiQz\ rn ,!T?.tQ L-?' ) q? Address 0 p /4 ? ?,?,? .S • City/Zip Code Phone ? 9?L ^ lo lo Areh./Engr. _ Address City/Zip Code Phone # ?p?j?OOC7 Date: Erect ? Occupancy 12•3 Remodel Zoning (Z•I Repair _ Type of Const -?z_ Addition # of Stories _ Move Length t 51 _ Demolish _ Depth 4fo Int.Impr. Sq Ft Install APPROVAi.S FEFS Assessments Permit 37-Z Water/Sewer Surcharge 3f. so Police Plan Review 1101- Fire SAC 5-75- Engr Water Conn 500. Planner Water Meter & 3.so Council Road Unit 29D. Bldg Off 10?'186 Treatment Pl IS(o. APC Parks Variance Copies TOTAL NOTE: 6DDHBSSES FOR CORNER LOTS - CONTHACTOR/HOMEOWNES MDST DESIGHATE i1HICH ADDRESS IS DESIEED. NO CHANGES WI[.L BE ALLOiIED OHCfi BQILDING PERMIS IS ISSIIED. 24 K. 3*# - I i 2 x s(5 = s z?? ( cp ?o x 4q-r-`- 5? ?o ZZ ? 22 = 4?4 x ?2 ? S800 ? . C?2? ? . 1%. One or Tvro Famlly All Jther CITY OF BUILDING DEPARII•iENT 1:iCTt:RIOR ENV}T.OPE AVt;RAGE "U" CAI4PU2ATION (To be submltted with building pcrmit epplication) Dv+clling -?-k-_ Ovmer ?;ontractor # gs - /.?a Site Address Date Phone LZiiEI.L r'EET OF •/? EX.'O:;ED f:ALL 7EE 'lcipP' ?iN£r=T1i tt. above grade = 2)00 ? TOTAL li:C.°OSED :'iAI,L Ak::tl SQ. FT. J?:,C_U5 :Yi.LL CJ1:Sfr0T!'IJI;: "U" Value x Area rkR,'IE pull •0¢3 x :;Q. FT. 1(052•Zo. 7/•04- (U) (A) Getail rei'erence Ccwe- °U" . 07(o x :;Z. FT. 9(0 48= 7.33, (U)(&) from g"U" .O¢o x SQ. FT. 117.5 Z= -1.7r, (U) (A) attacned "u" x S2. FT. _ (U)(A) sheets liust x S:;, rT. _ (U)(A) $lUll x SQ. FT. -- - (U)(A) :7I1:D0',7S: "U" '/alue x /:rea ?ia'ce & TYPe I?SVL!!si»'T uU" ' x_ SQ. FT. /.oD_ M(A) u . u. . ... _ iiUn x SQ. FT. _ (U)(A) u n nun x Q. FT. - (U) (A) n u uUn x SQ. FT. - (U) (A) f»JI7S: tf" Valiie s l:r;n • :ia;ce & . - ... : , : : Ty_oe . -• SL( - _ ,.. _. _•x-- ? S..,, .. _ .gTr 4 •oo ?o (. U)( A ..... .. ., ., . , . ... .n ._ PaTi " ° u" •47 x S:Z. FT. Z-oo =17-74 (U) (A) t t upu x SQ. FT. - (U) (A) ft "U" x S2. FT. - (U) (A) TOTALS zopg.oo Sq. t'T. /53-43 (U)(A) AVERA6E "U'; TOTAL (U)(A) Vl.LIIES - , 073 DIVID.'D BY TOTAI, ';/AI,L kR't;A ZOSg,oo ? AV ? aaLd u ' .115 r less for 1&2 family dwellinge R00 F/C EI L I N(l : TOTAL AREA: IOOZ rb Detail reference 'lUff •oZ? x SQ. FT. )OOZ. = M(p) from itUll x SQ. FT. . (U)(A) attached sheeta. 'IU11 x SQ. FT. - (U)(A) Describe onenings ieUto x SQ. FT. - (U)(A) in roof. IOUlt x SQ. F.T. - (U)(A) TOTAL (U)(A) VALUES DIVIDED BY Z? ?¢ T7?L?j 100Z- N,FT 21•01 CU?A? ? 'POTf.L R00?/CEI Ii:G :,I:?:A lppZ po .OZ? AVER:,GE "U ,025 for ventilr.ted roofa. - I s u 4)0 RK SWLET 'i F-XR05-f---D wiqc.c. 14. So X(38 t38 + 34+34)= Z? OSS• ?-? Co4e . .?7x ?38t38t-34t39? _ Pyn To?sT . 83Jc (38t38t34r3g? ? I19.SZ ? wNDaw C2 l6x 3&= 4-c, x 4= 16. oc, ZoX3(? = 5, 0 1( (o= 3pOp Z4x 3&_ !v-o x 4? zg.ao zox4s ? (v.T x 4= z?. So . Z4x 4g = $•o X 4= 3Z, oo , /28• 80 -? Dvo P-S 3° s?. = ZS.ao Z$ S7-/-. SEk = Zl. o0 (o= YAT/o - ?fZ.oo 9/.ro -k VET WW-c. E'a,,W-5 !'aRpsS wRu. Z,oB$. co LE55 Ca?C. qb.¢g ,? ,?,??f. ii4.st c'Ws rzg.go -439: Sv ?? DaaYs 91•00 - ? SZ 20 J ( . v . ? 9CVF 24 X 3 S? 4?L 9 x !o = 9 0 l1ooZ.oo , IN$ --WALL SECTZOH-- Determining "U'l valuea at Roof. Wall, Rim, and Conc. Block ROOF/CEILIN4 1 . ) Interior f.ir r'ilm z.) 5/81, ayp. Ba. 3.) Insulation a., 5.) Exterior Air Film (STILL) R VALU 0.61 .56 44.00 .61 upll iOTAL (R)= 457g ;VALL 6.) Interior Air Film 7.1 }ll GYe). Bd. 8.) Insulation 9.) gufc,T- R,7E 10.) Masonite Sidino 11.) Exterior Air Film (R Vf,LUi 0.68 .45 19•co Z•o4 .67 .17 ttUtt = 1/R= . 0¢3 TOTAL (B)=Z3,01 RIM 12.) Interior Air r'ilia 13.) Insulation 74.) 210 Fir Rim Joist 15.) ZS?3Z+ b?rt?-,e,re 16.) Maeonite Siding 17.) Exterior Air Film (R) VALUF 0.68 !9•oa 1.88 Z.o4 .67 .17 ISUBI = 1/R= .040 TOTAL (R)-z4.4¢ FOUNDATION R VALUE 18.) Interior Air Film 0,68 19.) 20.) 9-11 5r,?pm=A 21.) 12" Concrete Block 1.28 22.) 23.) Exterior Air Film .17 "U" = 1/R= .d?tv TOTAL (R)=??./3 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION z= /?,??/? 2 ` P ease Print ^^^^^^^ ^^ ^ ?1) PROPERTY ADDRESS• LEGAL DESCRIPTION: I IF E}ISTING STRCCIL'RE, DATE OF ORIGINAL BLILDING PERMTT ISS[,'ANCE: PRESENr Z(NID7G/PROPOSID L'SE: (hbn Year Q CO.tiPERCIAL/RE,TAIL/OFFICE [l IbID[.'STRIAL f-1 INSTITL'TZONAL/GOVII2PP= i ? R-1 SINGLE FAMILY ' Q R-2 DUPLEX (1WO L?nits) ? R-3 1C)WNiOL?SE (Three + Units) ( C?nits) ? R-4 APARTMW/CODIDOMINILT9 ( Un.its) 2) ? NAME:_ ?a h y ADDRESS: L??i ? 5l 'q ?- CITY, STATE. 2IP: ??G? ?,?. J?, R ?/_ /1Z ? PHONE: "??-J 9 F? , ? ?•+?J 3) NAP'lE: ..-r-??--- -0 ADDRFSS:?L? /G!/!'y( ? CITSt. STATE, ZIP:_ %? /• ?.z?c?`a a c? ?su-c,c.? i PHONE: 7.?j 2 - MASTgt LI(ETISE# 4) 1155-7*iy??• NAME: . AwnxFSS: CITY, STATE, ZIP: PHONE: :*R7PF': PAYMh?Tr OF FF-E AT TIME OF : apriscAzzoN DOES Nom ooxSTzzvrE ; APPROVAL OF PERNIIT. : xNsrncrioN oF sEWM Arm/CR wa7Ez : INWAr.ramrONS WII.L NOT BE SC,FgD- : ULEI) UNPII, PII2NIIT HAS BEEN : APPROVID. For City Use - Plimbers License: Active Ekpired NOt rECOLCI2CI ? fl N .?- Sta Initial •5) ? v ? r: • Di• : a • o? - M ? CONNPIIEC.TZON 1o CITY SEWER ? CONNEX.'PION TU CITY WATF]2 OTl-IER '. 6) '? .?'• ? PLEASE [iOLD APPROVFD PIIRMffT FOR PICK-UP BY ONE OF ABOVE PT•FnAE MAIL APPROVID PII2MZT 70 1, 2. 3, 4. AHOVE (Circle one) ?, FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ l v' S? SEWER PERMIT ( INCLODE SURCHARGE) $ $ WATER PERMIT (INCLLDE SL'RCHARGE) $ Ul ?J S? $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOC'NT DEPOSIT - WATER $?j*>..?} Z? $ WAC $ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ " LATERAL BENEFIT/TR[!NK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ S 6-1• ll ? TOTAL - ?O7(aq 8 /?J'o7/ RECEIPT RECEIPT DOES DTILITY CONNEC TION REQUIRE EXCA VATION IN PUBLIC RIGHT OF WAY? F__j YES IF Y ES, THEN'A " PERMIT FOR WORK WITHIN PUSLIC ROAD WAY" MUST BE ISSUED BY THE E[VGINEERING Q NO DIVI SION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWSNG CbNDITIONS: APPROVED BY: /?.JLCIc+--,(?) i(VA_.,,i-yc.o TITLE: DATE : f-?D.1??? LI-F?ntUE. Ci pzc??o Lo-r 4 AoDt TIor-.1 5-oc(1 4 OL.D ADDQeSS l69 S C 2055 P-O . N E..c "wazc55 IRq Ceoss F?O. I [•2G•gc 2005 RESIDENTIAL BUILDING PERMIT APPLICATION -10044 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 "I "I • Z S New Constmdion Reauirements RemodeVRepair Reouiremenls _............ Office?3ke?dnN 3 registered site surveys shovnng sq. ft. of lot, sq. ft. of twuse; and all roofed areas 2 copiw of plan CedoPSuFV4;Recd Y _hi (20% maximum lot coverage allaved) 1 sef of Energy Calculations for hmted additions Tce?Ptes i'f2A Recd _N. 2 copies of plan showing beam & window sizes; poured fand design, etc. 1 sile survey for addNons & decks toee Pres ReqtlitCd '<Y i N 1 sel of Energy Calculations Addition - indlcate iton•site seph'c sysfem 6Eesi12 S3ptic5ys10m ,_'Y ? N-. 3 copies ot Tree Preservafion Plan if lot platled after 7/1193 Rim Jdsf Detail Options selection shcet (buildings with 3 or less unils) Date 7/ 2 01 I(? S Construction Cost 1 y? 5?U Site Address Cv-Ds S ?A &-t G a0 5`5 I Z 3 UnidSte # Description oF Work V l 11(?l S IcQL - LQ. S YIFJ,) I,? t?t ?Ou.? ? Multi-Family Bldg _ Y oC N Fireplace(s) _ 0_ 1 _ 2 ? Property Owner `?j -4GGu2. d- (,° ?ei? I 3 Lu.m Ve Telephone # L/0 - 6 33 'f Contractor 6 rPaj A rn-eM r ny, ?P Yw(1?1 f 1 j Y?Q? c.? _ Address o2 5aa5 Y i i 15 6u,? .1 lAn.<- C? City ? State vVLp Zip 7i 44 Telep6one #((otz )q( U-1a72- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Mn°esota Rules 7670 Cateeoiv 1 _ h4janesota Rules 7672 • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the Ciiy of Eagan issued a permit for a similar plan based on a master plan8 _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanicai Confractor Sewer/Water Confractor 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 plan in the case of work which requires a review and approval of plans. _?s G??V-? ? e- h-ar [ +b? Applicant's Printed Name C` A";zi/?.??31i7-7 App icant's Signature 0 tRi-LAND C0. SURVEYING SERVICES 4656 NICOLS ROAD EAGAN, MINNESOTA 55122 / :t .. 9 W O (01 M I z 1, a SITE PLAN FOR; MILLER CONST. 4gN E 135 N I E'SE??N ? , / /it. 4(/ o` y^ //0'r ? HovS9 6' I Ra152.89 90.0 g N? A= 33°431 44" ? r- --? _ 'CROSS ROAD ? PROPERTY DESCRIPTION LOT '4 , BLOCK-4, aeeordinp to fM rseaM?d plat ths?sof pAKOTA County, M,n„esotQ LECaEND o pENOTES IRON MONUMENT • DENOTES WOOD FNB SET OENOTES EXISTING 9P0T ELEVATION OENOTES PROPOSED SPOT ELEVATION ?- DENOTES DRAINAOE DIRECTION I Mr?I eertify tAat- this aurwY,Plan o? reporf wos preparod by me or undsr mr pirwt wpwvbian and Mat I am a duly ? Ryistored Land Swv"o? Yndw tM Lara of fM Stote of Minnewta 8 ? 90.s?8 ? so? SCALE " 1"= 40' PROPOSED GARAGE FLOOR ELEVATION= IL.O = PROPOSED FIRST FLOOR ELEVATION PROPOSED BASEIIENT FLOOR ° ELEVATI O!1 NOTE ' VERIFY ALL. FLOOR HEIGHTS MIITH FINAL HOUSE PLANS BradN?Sw?nson? Mn. R?q. No. l?id Dcte: Io?9?4L . Use BLUE or BLACK Ink r For Office Use (_!t__ 4111° Permit#: /V3gE I II City of Eaaau • Permit Fee: /v —, ,- * 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL9 BUILDING PERMIT APPLICATION Date: (� "30 I-1 Site Address: `T-U Cro-c-s " GQ (-;•- y-,,,,,-) Unit#: Name: 54,e \l G' BlIA I/h�C Phone: (p ) !�/- � indent/ / n m '� Owner , Address/City/Zip: Q Q'I (, %33 Ad Applicant is: Owner )Contractor IAv 7,..,", e, r ^ r`� > Description of work: 1e G 1,-- - c Re-ra Q-(') Construction Cost: `J j 7 Multi-Family Building:(Yes /No)( ) 47• x Company: E) C G! C �� ,)r, C Contact: ,- A A � .. Address:G 3 0 (��"� S3' N ii �0Q City: Cio l.t,dole f ,4: iract©r �£A n e t State: ,N Zip: S S ) phone: 6-72-'99 99O9Email: 06,, 0-L7;1<?c 1 0 Cil. c License#: '7 GO 7 7 Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE dans ®yup ng tlocumentswat you sub f - i©ler l to a c in ormation ® hs off' the in or~mati� mar? classifi s on ublic if eu ro 'e P ecific a it to � P y s°that would permit', y conclude that they are . « s rets gin' 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.qopherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota St. =uilding Code must be completed within 180 days of permit issuance. x �Gi n ._J »S Bin x _.. Applicant's Printed Name Applicant's Signature Page 1 of 3