3950 Clippers RdBUILDING PERMIT
To be used for SF I
Site Address 3950 CLIPPERS RD
Lot 17 Block 1 Sec/Sub. SHERWOOD DOWNS
Parcel No.
W IName JOSEPH M MILLER CONST INC
3 Address 18133 CEDAR AVE S
° city FARMINGTON Phone 431-2001
ia Name SAME
o? Address
c? ¢
'- City Phone
OW Name
~= Address
U2
<W CitY Phone
I hereby acknowlege that I have read
information is correct and agree to c
Minnesota Statutes and ' of Eagan i
5ignature of Permite
A Building Pertnit is issued to: S?
ition and state that the
all agplicable State of
CONST
on the express condition that all ork shall be done in accordance with all
applicable State of Minnesota S tutes and City of Eagan Ordinances.
• CITY OF EAGAN NOm 19140
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
?} _ 9 ? / ?u ? ?
PHONE: 454-8100 Receipt # l.J t u
'=AR Est. Value $109 , 000 Date MAY 29 .1g 91
OFFICE USE ONLY
Occupancy R-3 l'L-1 FEES
Zoning -9-1
(Actuary Const -V-- TI Bldg. Permit fi 71 _ n(1
(Albwable) y?
Surcharge 54 _ 5(1
# ot stories
Lengih 56' Plan Review 436.00
Depth 39' SAC, Cily 100.00
S.F. Total - SAC. MCWCC 650.00
S.F. Foolprints -
On Site Sewage _ Water Conn 660- nn
On Site Well Waler Meter 9 5_ f1(}
Mwcc syscem xx
Water
Ciry ? Acc
t. oe?gil 3n _ n
n
PRV Required - SJW Permit 'in_ nn
Boosier Pump - 5/W Surcharge .5
0
Treatment PI 276.00
APPpOVALS Road Unlt 3 7n _ nn
Planner -
park Ded.
Council - -
BIdg.Off. _ Copies
Variance -
0
TOTAL 3,373.0
L? __?
BUILDING PERMIt
Site Address 3950 CLIPZ?U8 RD
Lat 1 I Block Z SeclSub. $?FSKM DOM
Parcel No.
W Name 30SEPH N!lILLiR COl1$? IlIC
? Address 18133 C8DA8 AVE S
° City !'ARMINir'TON Phone 431-2401
o Mame sAME
?? Address
? Clty PhOne
r
yVj W Name
? ; Address
<W City Phone
I hereby acknowlege that I have read this
information is correct and agree to comp
Minnesota Statutes and?City of Ea4an Ordii
Signature of Permitee"
A Building Permit is issued to:
on the express condition that
applicable State of Minnesota
CITY OF EAGAN
1? 1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
a
PHONE: 454-8100
ition and state that the
all applicable State of
M eIw.ER coNsr
a done in accordance with all
of
Receipt #
r''I
k?r
19140
OFFICE USE ONLY
Occupancy 1111-3 -11--1 FEES
Zoning R-1
(Actual) Const Bldg. Permit 671•?
(AlbWab1e) v? Surcharge 54• ?
# ot starie5
?
Plan Review 4?6.00
Length
Deom 39, sAC,'city 100.00
S. F. Totat - 650900
S.F. Footprints - SAC, MC WCC
On Site Sewage _ Water Conn 660i?
On Site Well Water Meter 95•?
MWCC System ?
30
Gty Waier
?
ct. Deposit
?
•?
PRV Required _ 51W Permit 30,?
Booster Pump - $/yy Surcharge • 50
Treatment PI 276•00
APPROVALS Road Unit 370•00
Planner - Park Ded.
Council
81dg.Off. _ Copies
Vanarice - TOTAL 39373•00
. Permit No. Permit Holder Date Telephone +M
WATER
SEVYER
PIUMBING •?d?f /
H.VAC_
ELECTRIC
Mspection Qate insp. Comments
Footings I 11,). ]
Foundation
Framing
Roofing
Rough PI6g. - 9t
Rough Htg. 7 3 7
Isul. 7/5
Fireplace
Final Hig.
Orstat Test
Final Plbg. Plbg. Inspec.Kor - NoGly Plumber
Const. Meter
EngrJPlan
Bldg. Final
Dedc Ftg.
Deck Final
Well
Pr. Disp.
i-
L
. ,,. . ,.
... . ?
(ger#i#tra#ie uf (Orrupanry
Citp ot Q tagan
Eppttrbnrn# o# Buiidiag itcptr#ian
Tfeis Ceruf'uxue issued prusuan! to the reoquirementr ojSeclion 306 of !he urufarm Building
('.ode cerlifyatg lhat at the Aime of issuanae this sducture xw !n rnmpliance wilfe the viarious
ordinanars of the City regulaling building cnnsauclion or use- For the fallowiieg.
Use Cl2=TkMtkM SF DWG/GAR Bwg,Ewa N" 1q140
0-44-7 7Ya ?? ? zoamg o-o;a R 1 rra co.g VN
hN
8/23/91
POST UJ A
Address: 3950 rZ,IppERS RQ4D Lot 17 Blk 1 5ec/Sub SHERWOM DMg
These item5' were/were not complete at the time of the final inspection.
8/23/41 Yes No
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanent driveway ?
Permanent gas ?
Sod/seeded grass
Trail/curb damage t/
Porch i/
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plutnbing
systam and the shut-off of water supply to the outside.lawn faucet before
freeze potential exists. ?;
*tC.C«oM.f.
IL White - City copy Yellow - Resident copy Pink - Contractor copy
-/ ? INSPECTI4N RECORD
" CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
I I trrPFRti RD . ? .. , +?
.;? NW[j?ll+ l1i?Nhlti •? {w?fi1 ? f?fi1'-Ca:'f+f.i
I PERMIT SUBTYPE:
S : Pi.nN REvrFwrr.? 13Y .anF: vnrt 9 .
SFPARAI'E PERl4'C1 RE00TRUD FOR AN
r..Ai I 44!,--2840 IRFciAanrNc, r i t-crrri
INSPECTION D. . .•
I
F-
L
TYPE OF WORK:
l!J iK C1 1 T! #4 IJ t3 F! }( .
Y 1 f1N'
?
?
?
Permit Holder Date Telephone p
PLUMBING M&
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONOUCTIVITY
TEST
HVDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION REC4RU
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS:
'.1.1ii1i1: t??11JM3?.
I PERMIT SUBTYPE:
I •rI
F
L
1. 1 t<i W't
IAIV r.F'ViiI.ll-41 8Y t;11I a?fiA M 14 1
L APPLICANT:
? W. TYPE OF WORK:
Permit Holder Date Telephone k
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FDUND
FRAMING
ROOFING
ROUGH
PLUM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIFEPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLOG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FfG ayl? 4ee
DECK FINAL
CITY OF EAGAN METER # PERMIT DATE 05/30/1,',
3830 Pilot Knob Rd.
`??? I 5
Eagan, Mi?i 551Z2-1897 CHIP # PERMIT #
METER SIZE B.P. RECEIPT #
?1 191 ' ISSUE DATE B.P. RECEIPT DATE p5r'291
DATE
_ PRV - BOOSTER PUMP
SITE ADDRESS 331") C 1 i. p pi: r a -id PERMIT REQUESTED
LOT - BLOCK 1 SEC/SUBShe rvood Dovr¦
?i SEWER - WATER _ TAPS
APPLICANT: 1 ap rh ? r C e nmt I n c
ADDRESS: 1 8 13 3 i; e d a r Av S o - COMM/IND FiESIDENTIAL
CITY, STATE F A rto i ngton* K n ZIP 55024
NEW - EXISTING
PHONE: '0 3- 2 0 0 1
Lawn Sprinkler Meters are to be Installed
PLUMBER: ?? Q»?- R a i n Ahead of Domestic Meters on Water Line.
ADDRES9:? 7 4? 4 o Reho r t T r Credit WILL NOT be given for Deduct Meters.
CITY, STATE?!s e en o u n t, r; n ZIP 15068
PHONE: ?" ? -? -- I .. , ' .1? ?':i • . -
i AGREE TO COMPLY WITH CITY OF
OWNER:
ADDRESS: EAGAN ORDINANCES
CITY, STATE ZIP
PHONE: SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DA YS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEINER PERMITS, CONTACT ENGINE
T9)F ? ERING DEPT.
PERMIT
897
May 21,1991
OFFICE USE ONLY
METER #?q!? 1/0 7F7 PERMIT DATE 05/30/91
CHIP # 6?1?/- 5 t/! !j PERMIT # Y42 0 13
METER SIZE B.P. RECEIPT # C 13670
ISSUE DATE B.P. RECEIPT DATE 05 29 91
- PRV - BOOSTER PUMP
SITE ADDRESS -rA'td
LOT ' ? BLOCK 1 SEC/SUB 'rr"''°O
PERMIT REQUESTED
owna
f APPLICANT:Joseph M, Miller Const Inc
! ADDRESS: 18133 C e d a r Av S o
CITY.STATE VArrsing ton, Mn Zip 55024
' PHON E: '-' 3 1- 2 0 0 1
PLUMBER: Ge nz-'t v a r_
STATER.osen?ount, %in ZIP `5068
F. ! ?3 -Il44
x SEWER ? WATER - TAPS
- COMM/IND x RESIDENTIAL
X NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Crgoit WILL NOT be giv,en for Deduct Meters.
I a'GREE TO COMPLY IIVI OF
EaG M ORDI C?5'
vkvl- ri-I
S
ATURE WHEN METER ISSUED
CALL 454-5220 FOR INSPECTIONS. FOR STORM
; r
DATE: !!AY 30, 1991
RE: 3950 CLIPPERS RD (JOSEPH M MILLSB CONS7RUCTIOH IIiC)
x Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the foilowing ?
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at Ciry Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REOUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
- -- -- - -----
z 5,? - ?
? b4009 ?°`??
? ?
7 /
Pequest DaTe Fre No Rough-in Inspection
R?p1?? $1Rea0yNOw ?WAINOtitylnspeNOr
12-04-92 GYes $mo WhenReatly4
Ix.: licensed contractor D owner hereby request inspection ot above electrical work at:
Job AWress ($treel Box or Route No ) Cry
3950 Clippers Rd. Eagan
Setlion No TownsNp Name or No. Ranqe No Cou^b
Dakota
Occupanl(PRINT)
Mike Petruld Phone No
686-9734
Powar SuOPlier
Dakata electrc,Co. Atldre sS
4300-220th.St.W.Farmington
Elecmcal Convacror ICOmOany Name7
Brandon electric,INC. Conbector5 L¢ense No
CA 00307
Maling AOOress iGOnVaclor or p.vner Making Inslaitavon)
701 Colfax Ave.NO.Brookl Park,MN 55444
AuIDOn tl ur IC VadorOwner kiRg Installat
k1w PM1one Number
560-5311
MINNESOTR ST/.TE BOARO OF ELECTRICITV
Grlyqs-MfAway Bltlg. - Hoom S93
1821 Unlversity Ave., SI. Veul. MN 551DC
Wym 1612/642?0800
THIS INSPEGTION FEOUEST WILL NOT
BE ACCEPTED BY TNE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSEO
REOUEST FOR ELECTRICAL INSPECTION EB-00001-08
(?/(?,_l !/? ^I /? ? See insvuMions tor compleung thrs lorm on back ol yellow copy g
O
°O ? X" Be/uw Work Covered by This Request ??•? ew Atld Rep TypeofBUildmg ApphanceSWired EquipmeniWired
Home Ranqe Temporary Service
Duplex Wafer Heater Elec[nc Heating
Apt Building Dryer Other (Specity)
Comm/Industrial Furnace x eat pump
Farm Air Conddioner uzi pe me @
Otner (syeaN) ConVetlors Remarks
ComputelnspechonFeeBelow: W1YlIIJ heat pump & off peak meter
M Other Fee # ServiceEnlranCeSize Fee # Grcuits/Feetlers Fee
Swimming Pool p to 200 Amps 0 ta 100 Amps
Transiormers Above 200 _ Amps Above100 _ Amps
Signs Inspector5 Use only T TAL
trngation eooms $15 . 50
Special InspecUOn ?J ?
Alarm/Communicauon THIS INSTALLATION MAY BE ORDER CONNECTED IF NOT
Other Fee COMPLETED WITNIN 18 MONTHS.
I, the Electncal Inspector, hereby
certfy that the above mspection has
been made. Rough-in
Finai oace
oe+e`
OFFICE USE ONLY '
Tnis repuest vootl t8 manlns irom
I or019/
31757 1,2
Pequesa Daie ire No
7-19 - 91 f? -3n-in Inspection
Requvetl+
C Aeady Now ?iLAMIr5owMy Inspector
? - No When Reai
I Lrccensed contractor ] owner hereby request mspection of above elecirical work at
JaeatltlfP551e50%°CLIPPERS ROAD cY EAGAN
SecUOn No Townsmp Name or No Fanqe Na Counry
DAKOTA
Occupam tPRMT!
JOE MILLER CONSTR[7CTION Phone No
612-431-2007
Power Suopliar
DAKOTA ELECTRIC ASS
AtltlassFARMINGTON, MN
Ne
Erectumal c.MIDLA? ,
,
c??de
Jh?
ELECTRIC, INC, 04167
0
Maihnq Anplass iConvacwr or Owner Makinq Instpnet,n,
7630 145TH STREET WEST, APPLE VALLEY, MN 55124
nmroriien 5i at (GO^.ttactoOw nInscalauon? Pnone Yumeer
612-432-6688
MINNESOTA STATE BOARO OP ELECT THIS INSPECTION REQUEST WILL NOT
Griggs-Mitlway Bltlg. - Raam S113 . BE ACCEPTED Bv iME STATE BOARD
15I1 Universry Ave. St Vaul MN 55109 UNLESS PROPER INSPECTION FEE IS
Phone (611) 603-0600 ENGL03E0
REQUEST FOR ELECTRICAL INSPECTION E
b- SEein5lmtlions Ipr COinpl¢Ans tM1i5 lortn On beck 01 ye?bW COpy 5
: .. ? ?
A?:
k"N i
,07,? "X"BelowWorkCoveredbyThrsRequest ?_.„.??9
ew 'Add riep Typeof Bwltlmg qpphancesWired EqwpmantWired
Home Fange Temporary Service
?uplez Water Heater
Electnc Heating
Apt Builtling Dryer Other (Specdy)
Comm ilndustrial Furnace
Farm Au Condi6oner
OcM1er(syecJy) Conlraciprs Remarks
Compute Inspectron Fee Below
# Olher Fee k ServiceEniranceSize Fee # Circuits/Feetlere Fee
Swimmmg Pool / O to 200 Amps 1?5 /p 0 to WO Amps 04.
Translormers Above 200 _ Amps Above 100 _ Amps
SIgnS Inspecars Use Only. TOTAL
' Im
ation B
g
oo
ms
Special Ins
h J J •
pec
on ,
I AlarmiCommumcation THIS INSTALLATION MAY BE ORD
Other r Fee DISCONNECTED IF NOT
COMPIETED WITNIN 18 MONTHS.
? I the Electncal Inspector, hereby
I ceruf
th
t th
6 Ro°qn-'" ( oate _?7
y
a
e a
ove inspechon has ?
been made F1°°l
?
OFFICE USE ONLY Z
This repuest void i8 months imm •
1
? CITY OF EAGAN
3830 PdlotiCnob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: auzLozNc
Permit Number: 0 3 3 3 4 0
Date Issued: 0 9/ 2 2/ 9 8
SITE ADDRESS:
P.I.N.: 10-67670-170-01
3950 CLIPPERS RD
LO7: 17 BLOCK: 1
SHERWOOD DOWNS
DESCRIPTION:
Bualdiny? Permit Type
Build3ng? Wark Type
,-Census Cade
DECK
NI_W
434 ALT. RESIDENTIAL
4
? r
,' _ ...
REM4PWREVZEweo BY BILL ADAMS.
FEE SUMMARY:
Base Fee $50.00
5urcharge _ $.50
Tntal Fee $50.50
CONTRACTOR: PEV11NFR: - Rpplicant -
R LO MICHREL
3950 CLIPPERS Rp
EAGAN MN 55122
(651)552-6256
I heraby acknowledge tFra$ I have reed this"epplication enU state that the infiormation is cQrrect and agree: bo corr[ply: with a11 epplicabke Sxate of Mn.
Statutes and_Ckty of Eagan prdinances.
A P N7/PE ITEE SIGNA7URE -'46SUED BY SIGNATURE
.?
New Canstruetion Reauirements
BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122 ?\
681-4675 ? ? j ?J
? 3 registered site surveys
? 2 copies of plans (inGude beam 8 window sizes; poureC fnd. design; etc.)
? 1 energy calculations
? 3 wpies of tree preservation plan if lot platted after 7/1193
required: _ Yes No
DATE: JPO J nr b er
Dech ('on51-rL1,fAion -1UF-11L)
DESCRIPTION OF WORK:
ET ADDRESS: _
LOT: BLOCK: ? SUBD./P.I.D. S Vl''Z ? w G o d ? O li Y?
?--
PROPERTY
OWNER
I elrU' o
N kA e\
M%C' Phone #: gin ? O(O " t L ? ` (
i
ame: .
Lasi F'rst t
?VL SSa- 6aS&
C,ty ?a 9arn 5tate: MA) Zip: ssraa
Street Address: C-I1 A/A F('S
CONTRACTOR
Street Address:
City
ARCHITECTI
ENGINEER Company:_
Name:
Street Address:
C ity
Sewer 8 water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Zip:
Penalty applies when address cham
I hereby acknowledge that I have read this application and state that the information is cortect and ag e comply with all appiica:
State of Minnesota Scatutes and City of Eagan Ordinances.
Signature of Appticant
OFFICE USE ONLY
Certificates of Survey Received /! Yes _ No
Tree Preservation Plan Received _ Yes _ No
RemodaVReoair Reauirements
"?` ?
? 2 copies of plan
? 2 site surveys (eMerior adCitions & decks)
? 7 energy calculatians for heatad additians
CONSTRUCTION COST;
Phone #:
License #
State: Zip:
Phone #:
Registration #: _
State:
RECEIVED
Y?
_ Not Required
- F i onear Eng i r.Eer i ri?
*_*.. .-
? 2422 EntPrpriSC DtiV¢
PAN 55120
hts
a Hei
d
* PIONEER
i ?--- g
,
Men
ot
? (612) 681-1914
ng..
* eng?neer
? 4L ?*
.
,o,:JOSEPH M. MILLER
tve
f S
CONST. C0.
LJ
Cert;f;ca,e o Y
u
NoaTN
ti
? /
qV
7?
''?
9 2 S ??,5
9
bq\•
.
?q7.
b ? 9
a y
• i m 2Z.4Y . i
? ` '- ' ?
?'to r
?V`'?p'( N s 'KS9,q ?,°'"
•00 "7 X$9?
"
??
C}:
O O q`
Q ?'R' v?
?I 'IrD w W
o w'Zi
? p
•C6
Tc?
?
? y
„ MI
o ?; ? c ?
yS ? 893•Z
? q
?Oy,?
f Tr _. .
/
... TO ? ?l ? M?.O
oY1' ... . ' ? : - '.
N.
`
_ ,Y _ ?z' • - -= -
._i _..
_ N0U..?.SE - ELEVA- Tl ONS
A75ED?
x yno,oo Denoks fxisfing Efevations PfJO
f oo.oo posed Elevotions Lowest F'IOOr E/evatron 91
Denofes ?'o ?
To ooelOCk £l¢volion & 9 ?f?
----- •- drnofes Draina e"U1%li ?y Easemenf ra.?e S1o6 Elevatron s94•_
Dtnofes Oraino?e ?low ?lrrosvs
o Denotey Monumenf ? Denoies a{??ef lJub
Beqrrf7gs shown arc aspuined
, BL a Cl? I SNER woob DO wlvS
?O? ? ? ? subject to earemenfs oi?''record
04KOra CouN7Y, MiNNLIsorA ,H
? herabY cert??Y that thi? iurvey, p?en or repo?f w?e?e p??.Ped bV ,', ar ander my dirtci aVP? tsic?n B"d thBt I Bm duly R9pi5terBJ LAnd SwVeyof
? /J )
undar lAe lawf af tfie Steta of Minnesota Datad this dev of j2Y A.D. 19-- .
?//? ? ,- /• (///[/ Q//? t?- ?.(
Sca/e : 1 ?nch i LJ( 11 _e? ?/---'?._.^"?1?- .?Ci_ G. `fi'•n?3?'?el
I f ?i
Olfl?./_ IL
PERMIT
, CIT,-Y OF EAGAN
3830 F'ilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: euzLozNG
Permd Number. 0 3 2 5 9 2
Date Issued: 0 8/ 11 / 9 8
SITE ADDRESS:
3950 CLTPPERS RQ
LOT: 17 BLOCK: 1
SHERWOOD DOWNS
P.I.N.: 10-67670-170-01
DESCRIPTION:
Boildin'g,„Permit Type
,building Wo,rk Type
r'Census Cade ^
,
\
0
? ?..
i
BASEMENT FINISH
flLTERATION
434 ALT. RESIDENTIAL
r
8£ F t'?( R_?t f t ?t
?_r ..e .. . J ._J??. . . ._
REMARKS:
PLAN REVIEWED BY JOE VOELS.
SEPARATE PERMIT REQUIRED FOR ANY PLUMBING WORK.
GALL 445-2640 REGARDING ELEC7RICAL PERMIT ANn TNSPFfTTONC
FEE SUMMARY:
!
Base Fee $50.90
5urcharge
7ota1 Fee $50.50
CdNTRACTOR:
OWNER: - Applicant -
PETRULO MICHAEL J
3950 1/C CLIPPERS RD
EAGAN MN 55122
(651)552-6256
L
I hereby acknowledge that I have read this applicetion and state that the
information is aorrect and agree to complyawith all applicable 3tats Qf Mn.
StatuCee and City oEegart`Ordinancea. '
L?D 1
PPLI NT E MITEE SIGNATURE ISSUED BY: SIGNA URE
J
?"1998 BUILDING
New Construction Reauirements
PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN ?
3830 PII.OT KNOB RD - 55122
681-4675
RemodeVReoair ReauiremQts ??
? 3 registered srte surveys
? 2 copies of pfana (inGude beam 8 window sizes; poured fnd. design; etc.)
? t enerfly wlwlations
? 3 copias of hee preservation Olan if IM plaCed aftar 711193
required: _ Yes _ No
DATE: q"
?
DESCRIPTION OF WORK:
STREET ADDRESS:
? 2 copies of plan
? 2 sRe surveys (exterior addkions 8 decks)
? t energy wlalatlons tor heated atldRions
CONSTRUCTION COST;
Sk
LOT: IM BLOCK: ? SUBD./P.I.D. #: SVl-erWao &
Name: ?f-T r U' D I` 11 U/10 {'? ? ?. Phone #:
PROPER'i'Y Lwt eirst
OWNER I
Street Address:? 5'O C- l,.1)pprS kL7 a4
? aG a,v• M n/ S5!
(650 68 - ' /?
C6 Sl SSa - ?a56 w
City E Stare: M1V Zip: 5542A
Company: ?-c T Phone #:
CONTRACTOR
Street Address: License #
City
State:
Zip:
ARCHII'ECT/
ENGINEER Company: Phone
Street
City
Sewer 8 water licensed plumber (new conshuction only):
and lot change is requested once pertnit is issued.
Penalry applies when address chang
I hereby acknowledge that I have read this appliqtion and state that the infortnatlon is correct and agree to pl with II applicabl
State of Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECEIVED
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required BY:? --
Registration #: _
State: Zip:
CITY
L ? BL USE ONLY
I n
SUBD. ?6(??l-?l? .? l.l92.e1zun
RECEIPT#: VA 0 9 79 "T ?
RECEIPT DATE: --I - , L4 " Ct S-
1998 PLUNMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT ISNOH RD
EAGP.N, 2M7 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 ? '?^? ??W ^^A ? EACH # TOTAL
Shower 3.00 x
Water Closet 3.00 x
?c
Bath Tub/0CT l 3.00 x -
Lavatory 3.00 x ?- - . 006
Kitchen Sink 3.00 x
Laundry Tray 3.00 x =
Hot TuhlSpa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet ' minimum -1 3.00 x =
Rough Openings 1.50 x =
Water Softener ` for dwellings under construction 5.00 X =
Water Softener ' for existing dwelling 20.00 x =
U.G.Sprinkler 'fordwellingunderconst. 3.00 =
U.G. Sprinkler ' for existing dwelling 20.00
Aiterations ' to existing residence 20.00 -
Water Turn Around 20.00 =
Private Disposal System ' MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems' ntandonment 20.00 =
RPZ (new installation only) 20.00 =
STATE SURCHARGE 50
TOTAL "In 5?
- - -- -
I here6y adcnowledge that I have read Itiis appticztion, state thet the infomiation is correct, and agree M comply wRh all epplicable City of Eagan ordinances.
It is the applicanfs responsibility to notify the property owner that the City of Eagan assumes no liability far any damages caused by the City during its
normal operational and maintenance activkies to the faciliGes construcled under this permit within City propertylright-of-way/easertrent.
SITE ADDRESS: -/ I 0
OWNER NAME:
INSTALLER NAME: l e I?
STREETADDRESS: )0.Vd1F H''S rICJUUZ
ciTV: l!
XA
C
SIGNATURE OF
TELEPHONE#:
7
?S6 - q? 3 q r
55? -6 a 56 ?
CDlPERMff FORMSIRPLBG PERMIT (RES) - 1998
_ CZTY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
,.. .
3lx,??,h?CA?:?;
FOR CITY IISE ONLY
PERMZT # I30.31
RECEIPT
DATE:
R"37TIAI.i PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMZTS ARE REQUIRED FOR EACH UNIT.
------------------------ ------------------------------------------'
WORK DESCRIPTION FEES
NEW CONST ?
ADD ON _
REPAIR _
OWNER NAME:--11S? ? M-? LF '(- \
SITE ADDRESS:. c n?? ? )? ? ?cP'`?i
LOT:_?l BLOCK _L SUBD. I?i
INSTALLER: ol2?b?,?C'C11 If' V
ADDRES,S: ? V , I d1?J
CITY: C?,(?(??\?G1 ZIP: ss'Zal-
., --r
PHONE #
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
SUBTOTAL:
STATE SURCHARGE:
DWELLINGS &
$15.00
24.00
6.00
3.00
$3300
.SD
G04II4WIAL%INDTISTRIAZF PLEASE COMPLETE THIS PORTION FOR ALL COMMERCZAL/INDUSTRIAL BUILDZNGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FDR EACH DWELLZNG UNIT.
-------------
CONTRACT PRICE:
OWNERNAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
PFCCESSED PIP.NG a $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
$
$
(SIGNATURE)
CITY OF EAGAN
? 1
TOTAL: S?'?
CITY OF EAGAN
3630 PIIAT RNOB ROAD
'I.AGAN, tN 55122
PflONE: (612) 454-8100
. ...
:. $s3Em
..
R> ?:<.:MMAS.?;:
WORK DESCRIPTION
NEW CONST ?
ADD ON
REPAIR
OWNER NAME:
SITE ADDRESS: 3/95-0 U, ,,,ra.?C.o Ktrat?
LOT:_" BLOCK I SUBD.
INSTALLER: GENZ-RYAN PLUMBING & HEATING C0.
ADDRESS: 14745 South Robert Trail
CITY: Rosemount, MN ZIp; 55068
T :ONE # :
S
PERMITTEE
ra.
PLEASE COMPLETE TFIIS PORTZON FOR ALL COPRMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMZLY BUILDINGS AHEN SEPARATE PERMITS ARE NOT REQIIIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BLACK _ SUBD.
INSTAI.LER:
ADDRESS:
CITY:'
PHONE
FOR:
ZIP:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
FOR CITY USE ONLY
PERI3IT # -
RECEIPT # 5
DATE: 5 /
COMPLETE THE FOLLOWINC:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
1 SHOWER 3.00 ? WATER CIASET 3.00 ?
/ BATH TUB 3.00
IAVATORY 3.00
? KITCHEN SINK 3.00 3
IAUNDRY TRAY 3.00 3
HOT TUB/SPA 3.00
? WATER HEATER 3.00
? FLOOR DItAIN 3.00 ?
GAS PIPING OUT.
? (MINIM[TM - 1) 3.00 3' d?
_3_ ROUGH OPENINGS 1.50 ?
oTHER
_ WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
_ U.G. SPRINKLER 3.00
SUBTOTAL $ 1 o. S ?
ST. SURCHARGE .50
TOTAL:
$
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIIRED FOR EACH UNIT.
(SIGNATURE)
CITY OF EAGAN
1991 BUIII LIAPPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
14fJLTIPLE DWELLINGS
CO?IliERCIAL ?
3
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKZNG DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE SUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: Ne.u Nome Valuation: „g.t=ge.g-nb Date: May 21, 1991 -k
Site Address 3950 Clippers Rd
Lot 17 Block 1
Parcel/Sub
Owner
Address
Sherwood Downs
City/Zip Code
Phone
Contractor Joseph m. Miller Const
Address 18133 Cedar Av So
City/Zip Code Farmington, Mn 55024
Phone 431-2001
Arch./Engr.
Address
City/Zip Code
OFFICE IISE ONLY
1a9, 000 ?
FEES ?ry
Occupancy R 3 M-1 Bldg. Permit Z/,DO
I Zoning P-- I Surcharge S?J-Ss7
Actual Const y- N Plan Review 6,00
. Allowable V-N SAC, City ' (PO, DO
# of stories SAC, MWCC (?4b.00
I Length $(o ! Water Conn. &tpd,
? Depth Water Meter 9S,041
I S.F. Total Acct. Deposit ,ov
I Footprint S.F. S/w Permit 70,100
S/W SurchaYge
On site sewage_ Treatment P1. ?7 ,Oa
On site well ' Road Unit p,p o
1kWCC System Park Ded.
City water ? Trail Ded.
PRV _ Copies
Booster Pump _
SUBTOTAL
APPROVALS Penalty
Planner Lot Change
Council TOTAL
Bldg. Off. SzY-3/ 9
Variance
Phone #
1
L( agrees that all work shall be done in accordance with
(S'g ature of Contra o )
all applicabie State of Minnesota Statutes and City of Eagan Ordinances.
vALua-no?-l ? •
.. t. .;
Z2x2z= 'i gy x,s= '7260
?6 X !?3 = Z38
?i?I(=
a+? o
91
? L?'? 3 X
? ST ?i. 0o
= i 4--13
14 = Zo bZ2
? s!'1 >[ `S3 = 8 0 40 ?
/0$2e 3 ofe, /4°1lOoo"'
2422 Enterprise Drive • Mendota Helqhte, Minnesota 55120 ' (612) 687-1911
1
PioneErEnsineerins 68194$9 • 2
*n *4
* plop
* engir
? * 7?*
2422 Enterpris0 Deive
Mendota Heights, MN 55120
(612) 681-1914
Certificate of Survey for:JOSL'-I"N M. MILLER CONST. C0. C?-
MORT14
v
?
G S
bq`pL q;I. 7J $s?'?,.•3?
b
2 ?,yZ'
i qO?.
2?
892• 7 ?
p
5
w q, ?- `' X g9z•5 ` `,?
a:• f ?
. ? ?
q`
? ?
y.4MI
O ,.n °' w°
D N ? v
?X
O -
`` ?\
?
h ? Cs
20 4
„
?
Q?c e
.? n q 7
I
-?
i
?
vq
D' _
, EAGp,ly EAIGIYd ER3
x 500. 00 Denoks fxisfin¢ E(evations PaQE2sEa NousE EcE?arrorvs
f oo.oo Oenofes Proposed Flevofions Lowest floor EJevation E59i.I
----- -- Umofcs broina?e € U1%lif y Easemenf ?ip o? BJoek EYevnlron 8 9?`,,?
Denoles Oroino e Flow ;?lrrows Gora e S/n6 Elevaf?an s94. 6
o Denofes Monument "
BCQ/'+O?S ShoWn ort pslutnep' ? Oeno{cs o 1fsef tJub
LDT 17 , BL 4CAl 1 , SNER woaD D4 wNS
DAKOTA CoUNTy, MINNE'sOTA -N 5ubject l'o Pasemerlh oj^recDrd
I herabvi certify that thh survey, plen ar report wee p*r?ared by mp /pr under my di.ese supervision and that I em duly Reglstered LnnJ Surveyw
under (he lawe ot the Stete oT MinnesOta. Dated tbisdey of I'?Y A.D. 19 ? ? .
?
Scale ------
ann . M `apeEAi 9.s?i'•?Gil..^. E rl0 ta891
Owner
^ Slte Addre
Con[ractor
Doors - A?ea 7
7hickness
Type of Constructlon
Manufacturer
Total door's perimete'r
Bu(lding Classification: Type Al (Single Family b Duplex)??TType A2(Residentlal)
(3 stories or less ?
NOTE: Complete pages 3 and 4 first. . (Other) • (Over 3 stories)
GENERAL INFORMATION
1. Bul lding Perfine[er S?Ct,? (04K 5Nq-_' i
2. Wall helght (ground to eave) ft.
• 2?
3. 1. x 2. (above) gross wall areaft.,
4. Bufldln9 dimensions (L) X(W) =?ft.2 roof 6 floor area
5. Square_f_oot'area of rim joist - Floor Joist stze (2 x O 1 ) l?s
1 X Perimeter = Rim oist area ?ft2
12 /71. . . . . ••,?iii;'? ,
6
7
8
, Adoption Ef ect ve
. & - f
Phone Date'
(n. U factor-/ 144 47 • '.'' Perimeter . ft.
-? ft.
Windows: Manuf cturer '
U factor ? ?7
TYPE SIZE
State approved
AREA (Ft.,Z) NUMBER OF TOTAL FtET 2
EACH UNITS
? . 9. Total ft.2 Glass ,' z?-j -
)0. Fireptace area; Width X height = X i '-'
11. Exposed foundation; Helght X;Perimeter MX
COMPLETION OF THIS FORM IS REQUIRED FO,R AI.L Au fRUC ON, MAJOR REMODEL
MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED.
, N121/4
MINNESOTA STATE ENERGY CODE CALCUlATI0N5 7 z
BASED ON CHAPTER 5 OF THE r?r f3 {?
MODEL ENERGY CODE - 1983 EDITION
f 1 1 1/ '
Ft.2
Ft.2
NGS BEIN
12; Fr,aming area = 10% of gross wall area. IQ-T/?l A-`f ?
13
,Gross, ivall area
Window area A ft.2
Rim joist area A 1"T J _ ft.z
_ .. 2
bscr a,r?eya? A- ft.
• 'an area A ?T ft.Z ,
Exposed foundation A ft.2
Framing area A 1, 60, ft.
Net wall area A ft.
ft.2
U windows U x A a 119__. ,?
U rim j01$t ° U x A a
U door area =U x A=
U fireplace = U x Aq,4 g7
?-
U foundation °.01 V U x A=AAq-
U framing area U x A= ZS,ik
Uwall = U xA=?
? (.138) TOTAL . . . . . . . . . . U x A?
19
15
? .
Gross wall area x 0.11 (A-1 single family 5 duplex = allowable U x A/Code
(13..above) .
x 0.23 (A-2 other residential)
x .23 (Other buildings)
x .28 (Over 3 stories) BTUH Must be larger than
A --- ?(9rJ nj x U Cg'e, '07. 13B above '
C'eiling framing area (Ap) equals 10% of ceiling area (. o?' the same as) i
.. . ° ?
= (L)
ISA. Gross ceiling area x (W) ft.z
15B Joist areA (Af) =
15C. Net ceiling area
U ceiling x A C=
u framing x, A f=
15D. TOTAL' U x A
10% ceiling area - ft.2
(Ac) (15A - 158) _ ft.2
,bZZ x?- _ 3o,os -
`. az3 X
• I ,
.................................? ....
,
16. Ceiling area. (15A) x 0.026?(A-1 single family i duplex - code allowable U x A
x 0.033 (9-2 other residential)
x 0.06 (other) '
00 y BaUN • Must 6e larger than •15D (above)
A(15A) J`J' 10 x U ode = .4(,4?7 F (or the same as)
NOTE: Use U and A.values obtained from pages I,•3 and 4.'
CERTIFICATION:' I hereby certify that I have calculated the "U" factors and "R" values
herein and that [he bullding here descrfbed meets or exceeds the State of Mlnnesota
Energy Conservation Act. ' .
te
gnaturea
? 2.
. ' ,
WALL
SECTION
STUD
SECTION
2ND NALL
SECTION.
U VALUE CALCULATIONS
ALUE U VALUE
Inside air film .68 Interior wall •4-f? (Hail) U - 1 +
R
insulatlon C7 Sheathing
Slding •?07
Outalde air ELIm .11
R TOTAL p ?
Instde.aLr fLlm ? .68
Interior wall .??
410 sCud R' 4.3$ (FIaming) U
Sheething ?Z.D(O
Stding U7
Ou[slde alr fllm ' .17
R TOTAL Inside air film R= .68
Interior vall
Insulation
SlteaGh ing
Exterior wall covering
Extetiot air film R - .17
R TOTAL
.?s
?---=
(Nell) U+ R-?/
.
r \
Interior air film R= .68
RlFI lnsnlationl ??•? ' ?
'-?-- {.
JOLST iTICh BOft WpOd R=1.88 (Rim ' U v? a
I JOiSC) ?`TI
? Slieathing Z,.O(D
Exterior r+lall covering ,rp'1
' •
E:c[ertor air film R' .17
? R TOTAL Z?" . ?tD
\
Interior air Ellm R= .68 ,
lnsulatlon 11,0 ?
•? m Foundation • ? ?Zg (Fdn. ) U = R =
Exterior air film R' .17
, ? ? F TOTAL
?Exposed:8luck •
'?,??'?- • : ?`,rade 3.
• CEILlNf WITH VEtiTED ATTIC SPACE ABOVE
R '/?LUE LUE
FRAMING CEILING
?.
0.61 Air Film 0.61
?
C> Insulation ? ?
j?
?-• 3g Joist
?
.Gj(p Ceiling _ •?P
0,61 Air Film 0.61
2.. Total R 4j5; - -7g
I
, . ,ez3 . o?Z
u =
FLAT ROOF OR CATHEDRAL CEILING '
Va ue R 'JALUE
FRAh1IN6 CEILIttG
0.61
0.17
Inslde air film 0•61
Ceiling
Joist (stu
Insulation
Air space
Roof decking
Insulation
Built-up roof
Outslde air f11m 0.17
Total R
, ° U
R -
Jindow infiltration 5 cfm/lineal foot of crack
desidential door infiltration 0.5 cfm/square foot or door and minimum code requlrementA.
•lon-residential door lnfiltration 11.0 cfm/11nea1 'foot of crack
1
)b 12" concrete block no,lnsulation =.47 R 2.1,
Jb 12" concrete block insulated cores =.26 R 3.8'
1b 12" ligliCweight block =.32 R 3.1j
Jb 12" lightrreight block,insulated'cores = .12 R 8.3I
,
J single glass = 1.13;
1 double glass =,.55.
J triple glass = .41
with storm taindow .54
i11 exterior walls and ceilings must have a vapor barrier (0.10 perm max.).
:apor barrier must be on the inside (heated slde) of Vrall.
,apor barriers of the polyethelene thin film have no R value.
' ? •
:
4.
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL?
CITY OF EAGAN (
3830 PILOT KNOB RD - 55122
651-681-4675
New Conahuetbn ReaulremeMs
? 9 reglsfered sHe surveys showing aq. H. of lot, sq. H. of house
and gLI roo}ed areas [20% maximum lot coveraae allowed)
D 2 copiea of plans (show beam i window si=es; poured ind. design; etc.)
? 1 set W energy calculaNona
D 3 copies of hee preservaHon plan B lot phMed dter 7/11/93
DATE: ?? I? ( /
DESCRIPTION OF WORK: ?G rl ? i
STREETADDRESS: 01 ? )? /I
LOT: \1 BLOCK: SUBD./P.I.D. #:
S
Name: Pl°1-, 6 10 I Y I tekA e\ Phone #: f-?'M 6R6
PROPERTY last ' First
OWNER ????D?(/S ?Uad
Street Address:
Ciiy
Remodel/Reoafr ReauUemeMs
2 coples W plan
1 aM of energy cakulaNons for heated addHlons
1 ske aurvey for endedor addlNons a decb
47
COST:
State: y 1 ? Zip: ? Company: Phone #:
(area code)
CONTRACTOR
Sheet
City
License * Exp.
State:
ARCHITECT/
ENGINEER Company: Name:
Telephone *: area code ( )
StreeY
City
Stafe:
Sewer 8 waler Ilcensed plumber (reaulred for new construction onlvl:
?
Penplfy applies when address change and lot change is requesfed onee permN is luued.
Zip:
Zip:
1 h0eby acknowledge fhat I have read thia application, state that the Information Is correct, and a t comply wBh all applicabl
Sfate of Minnesofa Statutes and CfFy of Eagan Ordinances. ?
Signature of Appllcard:
?-? -
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No A+JG ") 0
Trce Preservation Plan Received
- Yes No Not Required
- -
___ -,?1.---- -
Registrartion k:
%, ?7o .6 b
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Cons4vcNon Reauiremen6 RemodeUReoair Reauiremenis
3 regisfered site surveys showing sq. ft of lot sq. ft oi house; arM all roohd areas 2 copes of plan C'eit 6fSurvey, ReW'-?,? _Y? _tJ
120% mazimum Wt coverage allowed) 1 set of Energy Caloula6one for heatetl add'Nons 7`fg?As P_(9n1ft`e7Y???'-,N.
2 copies of plen showing beam & window sizes; poured found design, etc. 1 sde survey for additlons 6 decks ee.P2s,'Reqti,?,ied?,;??:?_ ,_Y,?a,..?:lN,
isetolEnert?yCakulations Add'Aron-ind?catel/onsAesep6csystem On3ite5eRtic
3 copies o(Tree Preservadon Plan if lot platted aflaz 7!7193
Rim Jo'st Oeiail Options selection sheei (bldgs with 3 or less units
Date ? I /U l ?? Construcfion Cost
v
Site Address ? 5 5-U (f i,w P' S 1?' UniUSte #
4 ( $ !? "' ?" ts
Description of Work ?/'.' • - ?
? ?.,,"
? ?
Multi-Family Bldg _ YI N Fireplace(s) _ 0 2
PropertyOwner M,'(Ce 'r A'C tA-v ? el Telephone k(Bsl 2 3t
Contractor G Y 1-P- %?•? G?kk??? ?" ?^'?5 7^' c
Address ?l ( a c) L•131o a? • F ? e e•? 1q City /??c, c+-•, '
State r? ti Zip S7'f' 31 Telephone #( 9 5-D) 8Cf 5-0 3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateeory 1 Minnesota Rules 7672
Energy Code Category , ResidenUal Ventilatlon Calegory 1 Worksheel • New Enerqy Code Worksheet
(4 submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone # (
N If so, 25% plan review
?? lirJ L ? v I' I??I III
? ,5 annn
I hereby apply for a Residential Building Permit and aclanowledge that the information isico6plete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan ,andthe e 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.
r
Applicant's Printed Name ApplicanYs SignatujW
6 543k
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete foc single family dweliings & townhomes/condos when pernrits are required for each unit
Date 0(0
Site Address Unit #
Own
r
P
t Y ) liJC7 (Q " ( ?? ?7
Tele
hone # ( (Q
roper
y
e i p
-.,
Contractor
StreetAddress ?/I?l? ? ? 7?? ??• w• City
St
t Zi ??&a Tele
hone # ( ?G/ S? ) ?? _ ? ??(L7
a
e p p
Bond #: Expires:
The Applicant is _ Owner ?ntractor _ Other
Add-on or altera[ion to existing dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
? airconditioner _New ?=Replacement
other
?
State 5urcharge JUL 1 6 200 .so
T
l S )
? 5
ota y -
I hereby apply for a Residenrial Mechanical Pemut and aclmowledge 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 ' e Mechanical Codes; that I understand this is not a
't, 6 only an application for a permit, and work is not to start without rnut; that the wor will be m accordance with the
appr v plan in the case ork }vlu?? e? a review and approval of s
7 C JA44
Applicant's Printed Name ApplicanYs Signature
RESIDENTIAL
BUILDING PERMIT APPLICATION
GTY OP EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reuuiraments
• 3 regislered sde surveys showing sq R. of !ot, sq. A. of housc and all roo(ed areas
(20°'o mauimum lot coverage allowed)
• 2 copies of Dlan showing heam 8 window srzes; poured found Cesign, etc ?
• 1 set of Energy Calculations
• J copies of Tree Preservation Plan if lot platteC afler711193
• Run Joist OetaJ OpUons selection sheel (51dgs wiU 3 orless um45)
DATE 42-6 leZ
SITE ADC
TYPE OF
ULTI-FAMILY BLDG _ Y _ N
FIREPLACE(S) _ 0 -( 1 _ 2
APPLICANT
STREETADDRESS -7?? Ale CIl? STATEZIPS5W23
TELEPHONE #AZ 4l 013 CELL PHONE #112" /c/C?,77? ?7 FAX #
PROPERTY OWNER TELEPHONE #
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ N(IN\1:50"C.\ RCI.ES 7670 G\'1'EGOItl' 1 MIYNESO'C.1 R[iLES 7674
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Woricsheet Submitted
• Energy Envelope Calculalions Submitted
Plumbing Contractor.
Plumbing sys[em includes:
Mechanical Contractor:
.vIccli:uiic.il systcm includcs:
Sewer/Water Contractor:
Phone #
Phone #
Fee: 590.00
?
\??: -570.60 ? ? ,' I
??"? I I
?? •
By-?
??'
I hereby acknowledge fhat I have read this application, state ihat ihe information is correct, an agree to comply
with all applicable State of Minnesofa Statutes and City of Eagan Ordi s
Signatore of Appllcant
OFFICE USE ONLY
_ Water Sottener _
Water Heater _
No. of Baths
_ Phonc #
[.awn Sprinkler
No. of R.I. Baths
Air Con<liUOning
-- Hcat Rccovcry Systcm
sr-lo.oi)
RemodeVReoair Reauiremenh
• 2 copies of plan
• 1 sel of Eneryy Calculations for heateE additians
• 1 site survey fw exterior additions 8 Gecks
• UMkate d home served by seplic system for addi6ons
VALUATION ;?Ox ?
Certificates of Survey Recerved Tree Preservation Plan Received _ Not Required _
- Upda[ed 4/02
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 1r7I ?v 7
/V
Site Street Address sU h/&y S-r/dd Unit #
PropertyOwner a C'l l Telephone# ?66 J7 3LI
Qpy .
Contractor ??ppqPn cv n Pr Telephone #( )
Address City State Zip
The Applicant is: Z-Owner _ Contractor _Other
Alterations to existing dwelling $ 50.00
X Add fixtures to rooms, excluding water softener and water heater
_Septic System A6andonment
Water Turnaround (add $121.00 if a 5!8" meter is required)
Other LoGl)e?. /1)1,,c;A
Water Softener Water Heater $ 15.00
_ replacement _ additional
Lawn Irrigation System RPZ new repair _rebuild $ 30.00
StateSurcharge $ 50
Total $
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
AL'!'JQ el J. / WYtJ lU r
Applicant's Printed Name ApplicanYs S re
/aik
I;K.e
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 ?`? d -Uv
Telephone # 651-675-5675 FAX # 651-675-5694 _o a_*
New ConsWCtion Reauiremen4s RemodeUReoalr Reauirements Oflice Use OnN
3 reglstered sile surveys showing sq. tf. of lot, sq. fL of house; and all roofed areas 2 copies of plan CeR of Survey ReW _Y _ N
(20% maximum lot coverage albwed) 1 set o( Energy Cakulations for heated addiBons Tree Pres PWn Reod _ Y_ N.
2 wpies of plan showing 6eam 8 windax sizes; poured found design, elc. 1 sfte survey for additions 8 decks Tree Pres Required _ Y_ N
7setofEnergyCalalations AddRbn-indkatedon-sitesepticsysfem OnsiteSepticSystem _Y _N
3 oopies of Tree Preservatlon Plan rf bt platted afler 711193
Rim Joist Detail Options seleqion sheet (bldgs wifh 3 or less units
Date -o?/0 7/ d Q!J ?l Construcdon Cost
SiteAddress 3 cfso L` , 4-py '< Oq UniU5te #
? k a ?S d
Description of Work
Multi-Family Bldg _ Y!?N Fireplace(s) _ 0 J? 1 _ 2
ProperTy Owner Telephone # 4J ( ) / 12T /70
` 6?a, 538P
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted 5ubmitted
• Energy Envelope Calculatlons Submitted .
Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber mri? g ?-? Telephone #( )
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #( )
7,7?
GeII
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.
1, ? fru lo ?
Applicant's Printed Name ApplicanYs Sigri e
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt- Muiti
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex M' 19 LowerLe
vel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex /
PIbg,_gYor_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 38 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
ig 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire B ldg) - Give PCA handout to applicant
Valuation ry ? ? d Occupancy R- 3 MCES System
Census Code ? Zoning ?Ir City Water
SAC Units Stories Booster Pump
# of Units ? Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const s//V Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaVC.O.
_ Footings (deck) Y FinaUNo C.O.
_ Footings (addition) ? Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
Y Framing _ Siding
Stucco
Stone
Bnck
Fireplace _ R.I. Air Test Final _
_
_
Windows
? Insulation _ Rebining Wall
Approved By: 6 ? ? ? 1 '5 G 4, Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
41,11
City o[Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: S 13
Permit Fee:
Date Received: -3-1- -I 2—
Staff: Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: J' $ ' 11- Site Address: 3 /3-0 f) Unit #:
RESIDENT /
OWNER
Name: /V) i k..t P. / r v I l9 Phone: CS- ILt6 57 3i
Address / City / Zip: 39 c 0 (1; it f.rr,( r �1
Applicant is: Owner ),Z. Contractor
TYPE OF WORK
•.—'
Description of work: t t( t vv i wS �a _
it,":-....,-..--�1 -� " `��J•t
Construction Cost Lfe @ et. d) Multi -Family Building: (Yes / No K )
CONTRACTOR
Company: A,/ Cep' S' C6 c, j tr v of r ®* v I L Contact: 4) / OA 6 Ue -v r
Address: 13 31 a v., Ay , 1 ANL City: g A
%r
State: /1n w Zip: s`1 1 l I Phone: 6s- 1 ,3 /{0 . i Sir
+
License #: CA b 3 Sr) 3 p Lead Certificate #: N H i 6071w- 1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes _No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be pctbl informatlan n of
the information may be classified as non-public if you provide spew"tic rens int would Viii #m E; r
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.aopherstateonecall.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
accordance with the approved plan in the case of work which requires a review and; approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x al/ /31bCoc-it
Applicant's Printed Name
�1
Appl cant's Signature
x
Page 1 of 3
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
APR 022012
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
.c)\VC(
1-( (2 1
RESIDENT;/
OWNER
Name:
v1Ih..4 A./Pv Ie
Address I City /Zip:
39i V C
Phone: (:,r/ CP& ?7 3y
Applicant is: Owner )( Contractor
Description of work: ,r I k ; ,• f 'l'� (� S' i/9lJL
Construction Cost: '35'00, cru Multi -Family Building: (Yes I No y )
Company: Il .et Cw G Si Cb +. 5 1 < < t
Address: / 3 3 7 3-Qr
Contact: 'iv / �v c
State: Pvt. w Zip: $$/ 1
License #: CR 6 3f 13i
Phone:
City: l=
Gs -I 3 YO .1. Sir
Lead Certificate #: A//it
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
13kft- r i4 9/
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE:Plans and supporting, documents that you sul
the Information may be classified as nan-public rf yc
nc
fe
.t t
mit are considered
u provide specific re
de:secrets
a„re,
a
to be public information `Teneiie
asons that would permit the City to
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x AU! fid Lack
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
3 tfSO
l� tS O NOT WRITE BELOW THIS LINE
/&37:5
SUB TYPES
Foundation Fireplace
Single Family
Multi
01 of _ Plex
Accessory Building
_ Garage
Deck
Lower Level
WORK TYPES
New Interior Improvement
Addition _ Move Building
Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%
Census Code
# of Units
# of Buildings
Type of Construction
93,1
REQUIRED INSPECTIONS
Footings (New Building)
,r Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water Final
Framing
Fireplace: _Rough In Air Test
Insulation
Sheathing
Sheetrock
Reviewed By:
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Pool Miscellaneous
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
/03S'1 -
Siding
Reroof
Windows
Egress Window
Demolish Building*
Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building — give PCA handout to applicant
1`26 12
,2 ao?
12-i
Meter Size:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings _Air/Gas Tests -
Siding: _Stucco Lath Stone Lath
Windows
Retaining Wall: _ Footings _ Backfill
Radon Control
Erosion Control
, Building Inspector
Final
Brick
Final
Page 2 of 3
2422 Enterprise Drive
• Mendota Heights, Minnesota 55120 • (612) 681-1914
s'
* PICINEEP
* c?ng eerinlg „
***7.'
Pioneer• Eneineer ine
6819488
P. 02
l
/037-53-
2422 Enterprise Drive
Mendota Heights, MN 55120
(612) 681-1914
Certificate of Survey for:JV55 l M. MILLER CONST . CO.
Et.GAN 01211-1
REV! - WED
BY:
[�('}
''',TIONS DIVISION
5 8942eP'S2"E
en Li
o cc
NTk
a
39.33- eys.
„C . /64., 9() s
89.44:/5" /%J
soo, oo Denotes Existing Elevations
14.00 Denotes Proposed Elevations
- Denotes Drama e '(1fili/ Easemen>'
- - Denotes Orainoe Flow Throws
a Denotes Monument
gearing, shown are cu,umed
13
EAGAN ENGIN ERING D PT
iiPat
Pg9pJEP Nouse 14Ei/ATFONs
lowest floor Elevation *547-1, 9
Grp or Block Veva/ion 8 9'x,1
Gorase 5'/rbb Elevalinn S 4.6
❑ Denotes o Thef flub
LOT 17 , BL OCA , S ERWOOD DOWNS
04KOTA COUW/TY, MINNESOTA •n Subject to eacemenfs or record
hereby certify that this survey, plan or report wet Bred by mr qr under my direct sup rvision end that I am duly Registered Lend Surveyor
under the laws of the State of Minnesota. Dated this /Cc day of r-` y A D 19 2.1.1
ltst)r 111
Scale 1 4'D
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117362
Date Issued:10/17/2013
Permit Category:ePermit
Site Address: 3950 Clippers Rd
Lot:17 Block: 1 Addition: Sherwood Downs
PID:10-67670-01-170
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Michael Robinson
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Michael J Petrulo
3950 Clippers Rd
Eagan MN 55122
(651) 686-9734
Great Roofing & Restoration Llc
5650 Greenwood Plaza Blvd, Suite 113
Englewood CO 80111
(720) 389-8371
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA126997
Date Issued:09/18/2014
Permit Category:ePermit
Site Address: 3950 Clippers Rd
Lot:17 Block: 1 Addition: Sherwood Downs
PID:10-67670-01-170
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Tony Boerner
2090 County Road 42 W
Burnsville, MN 55337
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Michael J Petrulo
3950 Clippers Rd
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA160788
Date Issued:04/14/2020
Permit Category:ePermit
Site Address: 3950 Clippers Rd
Lot:17 Block: 1 Addition: Sherwood Downs
PID:10-67670-01-170
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Anthonay J Caruso
3950 Clippers Rd
Eagan MN 55122
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179556
Date Issued:10/10/2022
Permit Category:ePermit
Site Address: 3950 Clippers Rd
Lot:17 Block: 1 Addition: Sherwood Downs
PID:10-67670-01-170
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Anthony J & Natalie J Caruso
3950 Clippers Rd
Eagan MN 55122
Ashton Mcgee Restoration Group Llc
5555 W 78th St, Suite J
Minneapolis MN 55439
(952) 426-3736
Applicant/Permitee: Signature Issued By: Signature