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4435 Clover Lane PERMIT City of Eagan Permit Type: Plumbing Eagan. Permit Number: EA096984 Date Issued: 11/12/2010 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 4435 Clover Lane Lot: 15 Block: 03 Addition: Eden PID:10-22750-150-03 Use: Description: Sub Type: e - Water Softener Work Type: New Description: Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Clinton Munson 4435A Clover Lane Eagan. MN 55122 651-341-4885 Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087 Valuation: 400.00 Surcharge-Fixed $5.00 9001.2195 Total: $».00 Contractor: Owner: Applicant - Clinton Munson 4435 Clover Lane Eagan NIN 55122 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 Citv of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA089190 Eagan, MN 55122 . Date Issued: 05/15/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4435 Clover Lane Lot: 15 Block: 03 Addition: Eden PID 10-22750-150-03 Use Description: Sub Type: e - Air Conditioner Work Type: New Description: Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445-2840 Larry Leacock 15966 Fennel Ct. Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: -Applicant - Owner: Haley Comfort Systems Clinton Munson 122 West 3rd St 4435 Clover Lane Hastings MN 55033 Eagan MN 55122 (651) 437-0338 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. Applicant/Permitee: Signature Issued By: Signature (Ssr#tftratt ot fttitpaxt titt rt cata #ilredr- t mt iMti" Jwpcmm fyr Gn?r? Iwolpra?r??lrre ?irwwlr?? ? ??r ?A Yi? Qrir? ???rrriArriir?i?rwe+rAi?r?rwwrria?ia?ilrrMlr w?nr ?rr QO' ?r?irt ?iis a?raMM o?rn A??i?i?ii u.a.en. 1 eE 4 !li= ..M,Monrw. 11iaL U !? .,_. v ?? Q000 VJltalt ?,?.. iM0 !3? LM, MAl? ?"9 S CL011tR !A. L 15 S J iM fSi.Z":t5rii'f Fn_u, cql,r, ;jNf'iS CITY OF EAGAN r? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ' PHONE: 454-8100 BUILDING PERMIT Receipt 116,?i Tobeusedfor 1 OF 4 PLE?C Estvalue $4$,000 Date tAIZCH 14 ,19 86 Site Address 4435 CLOVi:;:t LN Erect 0( Occupancy R 3 Lot 1-5 Block 3 Sec/Sub. EDEN ADDITZOi; Remodel ? Zoning 01 P- No. P. air ? TYp e of Const W Name- ; Address o r. o Name SAy'' Z o¢ Address ~ City Phone ?Q F W Name _x ? 0 Address i W Gity Phone I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee ;-? A Building Permit is issued to: GO00 VALtil ;>!C)ME:i all work shall be dore in accordance with all applicable State of,Minnesc P • Addition ? No. Stories Move ? Length 4 a Demolish ? Depth 24 Int. Impr. ? Sq. Ft Install ? Approvals Fees Assessment Water & Sew. Police Fire _ Eng. Planner Permit 7 Q• UU Surcharge 24.00 Plan Review 137 . 00 sAC 575.uu Water Conn. 50 0. u(l Water Meter 63.56 Road Unit 29lu • up Tr. PI. 15 6. u G Parks Copies Total $2 , O 1 11_ ; U on the express condition that an Ordinances. Permit No. Permit Holder Data TNephone M Plumbing M.V.A.C. ElscMc C 7 9 3 ?' a O(p r Softener Inapectfon Date Insp. Commenb Fooiings I Z,j FooNnys II Foundafbn Freminy Roofiny Rouyh Plby. Rough H1q. / /i y n Insul. Fireplace Final Htg. Final Plbg. Bidg. Final Q? ?-, z ? - Z .- - ? ? - Cerl. Occ. ? -? Deck Fty. Dsek Frmy. Woll Pr. Disp. ; s? + ` - . .. ' " . .. . . . . r. .. a- -, , . .. . . " . . - ' . - ` ? / ? l ? y PERMIT # MECHANICAL PERMIT RECEIPT # (If "ft CITY OF EJIGAN • 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE PHONE 454-8100 Site Addres?, BLDG. TYPE WORK DESCRIPTION Lot?? Bloc k Z5 Sec/Sub R N ' es. ew m Name lt M Add -a Address u . -on G i R omm. r epa c City Phone ` Oth er Name FEES L c Address RES, HVAC 0-100 M BTU -$24.00 p City Phone ADDITIONAL 50 M 8TU - 6.00 ADD-QN AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK ' GAS OUTLETS - 1.50 EA. Foreed Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTfAL 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 f f FEE S/C: ? SIGNATURE OF PERMITTEE ? TOTAL: FOR: CITY OF EAGAN Site Lot. PERMIT # PLUMBING PERMIT REGEIPT # ? GITY OF EAGAN • 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: c? 'RACT PRICE: PHONE 454-8100 ddress 11 BLDG. TYPE WORK DESCRIPTION Name ? Addre c City = ? Name c Addre; O CnYi-? FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMi1M - RESIDENTIAL FEE MINIMUM - COMM/IND FEE STATE SURCHARGE PER PERMIT (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) I SIGNATURE OF - $10.OQ - 20.00 - .50 I FOR CITY OF EAGAN ? Res. New Mult Add-on Comm. Repair Other NO. FIXTURES TOTAL Water Closet - $3.00 4 Bath Tubs - $3.00 - , Lavatory - $3.00 Shower - $3.00 / Kitchen Sink - $3.00 - Urinal/Bidet - $3.00 Z_Laundry Tray - $3.00 Floor Drains - $1.50 ?Water Heater - $1.50 Whirlpool - $3.00 _ ? Gas Piping OuUets - $1.50 Softener - $5.00 Weli - $10.00 Private Disp. - $10.00 i h O $1 2 R ngs - oug pen .50 FEE " - ? STATE S/C: GRAND TOTAL• ' ? ? VOlt-sALE U61Ts CITY OF EAGAN ., 116 ?? '*- •---? 3830 Pil?ot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?•- PHONE: 454-8100 <? 1 BUILDING PERMIT Receipt # ` To be used tor 1 OF 4 PL£,At. Value $48,000 Date i'&RCi-i 14 1g $ b , SiteAddress 94378 CL OVER Ltv Etect L? Occupancy 2t3 Lot 13 Block 3 Sec/Sub. EDEN A DJI'1'ION Remodel ? Zoning pn Parcel No. Repair ? Type o( Const V Addition ? No. Stories ¢ - G OOD VF,LL3E HU A1ES Move ? Length 4$ = Name 14 fi0 93RD LN Demolish O Depth 24 o Address ??-'NzN* 780-5510 Int. Impr. ? ? Sq. Ft. city hone in5tall = o Name SAVIE 0 ? Address F W Name- ? ? Address z 4 W Clh/ - e to co Eagan of Assessment Water & Sew. Police Fire Eng. Planner Council BIdg.OH. Permit Y 274.00 ? Su rcharge 2 4. 0 0? Plan Review 137. UO SAC 575.00 Water Conn. 500.00 Water Meter 63.50 Road Unit 29U• U0 Tr. P{. 156 . f10 _ _V.ac_.Daie I Copies .50 " c:ooo vAt.UE HOr•.Es ' A Building Permit is issued to: on the express condition that all work shall be:done in accordance with all applicable State of Minnesota Statutes ard City of Eagan Ordinances. Buiiding Official Permtt Mo. Pamit Holdar Date TNephone N PIumkAlnp H.V.A.C. Eloctrhe Sorisnor Inspectbn Dab Insp. CommeMs FooGngs l ?? ?, Footin9s II Foundation Framiny Y.aB ? Rooflng RoughPlbg. Rough Htp. Insul. Flr?ptace Find Htg. Flnal Plby Bldy. Final Cart. OcC. Dsck Ftg. Deek Frmq. Well Pr. Oisp. PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB RQAD, EAGAN, MN 55121 DATE: 'ite Address o ' . . BLDG. TYPE .ot? Block Sec/Sub Res. Name ^ ?- ? • Mult f) , 7ia Address ? Comm. c City?- Phone Other ? ........ _ (D Address p3 CitY - TYPE OF WORK Forced Air M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent CFM Gas Piping Outlets # Other FEE: S/C: t v TOTAL• C? WORK DESCFtIPTION New _ Add-on _ Repair - FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADOITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) ;• _?,._ _,?1({." SIGNATURE OF PERMITTEE FOR: CITY QF EAGAN PERMIT # J7 S " PLUMBING PERMIT RECEIPT #?33 CITY OF EAGAN ( /, e , ? 3834 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Site Ad r ' Lot Block ? Name ? Addre c City _ ? Name ; Addre p City'i FEES COMMlIND FEE - 196 OF CONTRACT FEE MINIMJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES , BEYOND $1,000.00) BLDG. TYPE WORK DES . l4s: New " M ult Add-on Comm. Repair Other CRIPTION N9. FIXTURES Water Closet - $3 00 TOTAL ? . T-Bath Tubs - $3.00 -7-- -" Lavatory - $3.00 Shower - $3.00 = Kitchen Sink - $3.00 Urinal/Bidet - $3.00 ZLaundry Tray - $3.00 4- Floor Drafns - $1.50 Water Heater - $1.50 Whirlpool - $3.00 7 Gas Piping Outlets - $1.50 Soitener - $5.00 weu - $10.00 Private Disp. - $10.00 ? ' Rough Openings - $1.50 - FEE STATE S/C: GRAND TOTAL• ? 'FOFC CITY OF EAGAN ?CITY OF EAG4N Remarks Addition Eden Addition Lot 15 Bik 3 parce 1 #10 22750 150 03 Owner - Street 4435 Clover Lane state Eagan MN 55122 Improvement Amount Annual Years Payment Receipt Date STREETSURF. SC' 504.70 100.94 5 STREET RESTOR. V GRADING ugo 82 232.99 46. ('o SAN SEW TRUNK i1 SEWER LATERAL 1982 1896.46 3 •2 WATERMAIN # WATER LATERAL 1982 WATER AREA • Services 1982 STORM SEW TRK 1982 2 G. OO 1.20 * STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN Remarks Addition Eden Addition Lot 16 aik 3 Parcel #10 22750 160 03 owner ? c L` ; 11 Street 4435B Clover Lane 5tate Eagan MIV 55122 ' Improvement Oate Amount Annual Years Payment Receipt Date STREETSURF, 19$2 504.70 100.94 'rJ STREET RESTOR. GRADING 00 19 232.99 4. O 5 SAN SEW TRUNK 1974 2 3 4020 15 SEWER LATERAL 9 2896.46 379.29 5 WATERMAIN WATER LATERAL 5 WATER AREA 1977 62.94 4-20 Services 1982 STORM 5EW TRK 1982 256.QQ 1.20 ? STORM SEW LAT 1982 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILOING PER. SAC PARK CITY OF EAGAN Remarks Addition Eden Addition Lot 14 aik 3 Parcel #10 22750 140 03 Owner street 4437 Clover Lane State Eagan MW 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. (Q? ? 19$2 504.70 100.94 STREET RESTOR. GRADING b4lo 1982 232.99 46.60 5 SAN SEW TRUNK 1F SEWER LATERAL 1982 1896.46 379•29 5 WATERMAIN • WATEA LATERAL 1982 S WATER AREA ,g • Services 1982 5 STORM SEW TRK 1982 256•QQ 5L20 5 1F STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN Remarks Addition Eden Addition Lot 13 Rik 3 Parcel #10 22750 130 03 Owner i' street 4437B Clover Lane State Eagan Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1982 504.70 100.94 5 STREET RESTOR. GRADING (oqD 1982 232.99 46.60 5AM SEW TRUNK 1974 2 g3 4.20 1$ • SEWER LATERAL 1982 1896.46 379.29 WATERMAIN WATER LATERAL 1982 5 WATER AREA • 3ertrices 1982 STORM SEW TRK 1982 256 •oo 51.20 5 STORM SEW LAT 1992- S CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUIIDING PER. SAC PARK INSPECTION RECORD? CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 ! SITE ADDRESS: i;, l 1 I, I ;,, APPLICANT: r PERMIT SUBTYPE: r,utiTOM (nWrPT=: Caa TYPE OF WORK: ili „ , . 1 . E '',i I:011 1 111 Nfi 0 1;4 ;5C) cii JtaKl<ta 1 (' /1 1 F1 f?Pi.A(:f ';Yi)rNG INSPECTION .• . D. .?? ? ? ..?? Permit Holde? Date Telephone # SEWER/ WATER PLUMBING HVAC InspecUon Date Inap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOAFD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS coNOUCrivirr TEST HYDROSTATIC TEST BSMT R.I. BSMT FfNAL DECK FTG DECK FINAL " CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: .4 i ty d ? Eagan, Minnesota 55122-1897 Date Issued: `^ }t ? ' •, (651) 681-4675 I SITE ADDRESS: APPLICANT: 14 1 F,ti C i r0-trta t AMt PERMIT SUBTYPE: ?; I +1 F: h; •; •. U N I 1 t3 ? I? ? ru%:raM cUNr:FrT9 CnW,l (61:0) H"fs.._72q0 TYPE OF WORK: Ft 1=' P!1 T R Pi f ?»s'ftTf' I' 1 tt}i 14 t I'1 Ar't: ,TI'tIN(i 0; 511b10o ? ? ? ? Permk Halder Date 7elephone # SEWER/ WATER PLUMBING HVAC inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH F{EATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FI REPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATIpN METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT A.l. BSMT FINAL DECK FTG DECK FINAI ? ?INSPECTIO1\1 RECQRD??? ?s CITY OF EAGAN PERMtT TYPE: `3830 Pilot Knob Road Permit Number: 0 °43 6 2 Eagan, Minnesota 55122-1897 Date Issued: "I 1Ot{ /`jy (651) 681-4675 ? SITE ADDRESS: _ r3vFP i nMr PERMIT SUBTYPE: , 1.3 t.111u .r. t; t APPLICANT: •?', ? ?:.?? ; i+tli f i 1 TYPE OF WORK: fIF!'';I N 1 F' 1 1„+' I 11A!`:1 RFF'AIFt r?f V i ar.F ?:YnrNo', M?y?1?t?e ? ? _.._...? !c' S, s i! N 1 I F3 1 Permit Hvlder Date Telephone # SEWER/ WATER PIUMBING HVAC Inspection Date Insp. Commenis FpOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE Alp TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC h4ETER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDRQSTATIC TE5T BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ' 1NNYLU1'lUlrl KLI.;UKl) CfTY OF EAGAN PERNIIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 - SITE ADDRESS:' 1, M. 10- , t1VF" 1? I ANf PERMIT SUBTYPE: ?r1 0 w•--.1 -,T'-?p' APPLICANT: 14 ri 1.?1 C r . TYPE OF WORK: 1-1 rj? et4 1 F, T j +?fv illd Eiltl l flfNl? 613 4 A i;:l i1 i /8& f Aq ? INSPECTION D, . .. i I i ? 6 Permft Hotder Date Telephone k SEWER/ WATER PLUMBING HVAC inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING FOUGH PLUMBING PIBG AIR TEST ROUGH HEATffVG GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIF TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVfTY TEST HYDROSTATIC 7EST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL This reduest void y?? 18 months from C 7,8 5 2 ? ??, ?3 3 ?-z--? Request Date Fire No. Rouph,n InsVection Re u red? F Ready Now ,II Notity Inspec- 4? J /? Ves C] No r When Readv ? Licensed Electricai Coniraclor I hereby request inspection of above ? Owner elactrical work installed at: Street Address, Box or Route No, 4 1 CiSy..., ? ection o. Township Name ar No. Range No. Cnunty Occupant (PRINT) Phone No. Power Supplier C?_? Address Electncal Contractor ICompany Name) &-l.l , Contrar.tor's License No MailinA Address IConuactor or?Owner Meking InsteilaLOnl ?U D 6? 4_? Au ized Signature (Contractor Owner Making Installa ionl Phone Number MINNESOTA STATE BOAND OF ELECTRICITY THIS INSPECTION REaUEST rillL NOT GriOgs-Midway Aldg. - Room N-191 BE ACCEPTED BY THE STATE BOANO UNI.ESS PROPER INSPECTION FEE IS 1821 Universitv Ave., St. Paul, MN 56104 Phone 16121 287•2111 ENCLOSED. REDUEST FOR ELECTRICAL INSPECTlON ` EB-o""°?'°4 /_ //? ? See instructions for completirg this form oo beck of Yellow copy. ??P ` •? ? ' X' B e l o w W o r k C o v e r e d b y l h i s R e q u e s t f ?'R 5 ? Qdd Re0• TYOe of Build,ng Appliances Wired Equipment Wired Home Range Temporary Service Ouplex Water Heater LighUn,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Fumace Silo Unloader Industrial Bldg. Air Conditioner Buik MiIk Tank Farm ihr.r eecf v oiner (specitvi t.r Ueti y ther Qlher Compute lnspection Fee Befow M Fee ServiceEntronceSixe tt Fee Feeders/Subfeeders N fee Circuits , U to 200 Am s 0 to 30 Am s 0 to 30 Am s Above 200 qm )5 31 to 100 Amps 1 to 100 Am s Swimming Pool Above 100_Am s Above 100_Am 5 Transformers Irngation Boorns Partial• Other Fee Signs Special Inspection S 9marks ? ,TOTAL F ` ? ? ' ?i Fj ! Rough-in ? Final , ?7 ? ?; Date tJ 1 th Ele ri -14Pector, here6y certify that the ahove inspection hes been de. Thia roquest vold 18 months from Y0R-»?5rt1L8 UNi i`:; CITY OF EAGAN ? f ., 3830 Pibt Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?•-- PHONE: 454-8100 BUILDING PERMIT Receipt # 11619 4/ To be uaed tor 1OF 9 PLEX Est Value $ 4$,400 Date L1ARCH 19 .19 66 Site Address 4437 (MOVER I,t3 Erect B Occupancy R3 Lot Ialock 3 Sec/Sub. EDGN A DDITIOTJ Remodel 11 Zoning 1?D Parcel No Repair ? Type of Const. V . Addition ? No. Stories ¢ ?^QOD V?yLU?:: HOMES Move ? Length 44 W Name 14 60 93 RD LN Demolish ? Depth 24 o Address Int Impr. ? Sq. Ft. City P?LAINfphone 780-5510 Install ? = o Name- 0 Q Address s W W Name ? ? Address i W Citv Phone Assessment _ Water & Sew. Police FIfQ Planner I hereby acknowledge that I have read this application and state that the Bld9 information is correct and ?gree to comply with all applicable State of Minnesota Statutes and Ci of Eagan Ordinances. APC. Fees Permit Surcharge - ?? a • ? • ? Plan Review_ -? ? ? • ?? ?? SAC STS.OO WaterConn. -inQ?OU j Water Meter63?50 - Road Unit 2 y ?- 00 Tr. PI. 15 6_ 0 0 Parks Copies- -- - Signature of Permittes - - ?' TOtal- " ?• ? `-° ? • ? ? GOOD Vi?I.UC HUMES A Building Permit i5ued to: on the express condition that all work shall be done in accordance with all applicable ptate of Minnesota Statutes and City oi Eagan Ordinances. Building Official - xr 1 ` ' Wrmk No. PormR Hdder Dab TNephone # Plumbinp H.YkA.C. lp ? ?'f yC Ekpcbic C ' ?I g l, ?? SoftM.. InspeeGon Dats, Insp. Commenb Footlngs I Faotings II Foundalbn Frominy Roollny Rouyh Plbq. '9-916 , L[- Rouyh Htp. y? Insul. Fireplacs Finel Hty. ,2 Flnal PIb9• /y?gG Bldy. Final cert. occ. 6 te.?? Deck Ftg. Oeck Fnnq. WNI Pr. Diap. , PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION m Name -7 Res. New M l ' Add ?s Address ' - u t -• f -on C omm. Repair c Gity Phone - ? pth er Name FEES ? c Address RES. HVAC 0-100 M BTU -$24.00 p City Phone ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK -?' GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU I-t MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cand. M BTU STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Vent CFM BEYOND $1,000.00) Gas Pipingtutlets # Other ? FEE SIGNATURE OF PERMITTEE S/C: TOTAL: ? FOR: CITY OF EAGAN . PERMIT # PLUMBING PERMR ?I 3 3 RECEIPT # CITY OF EAGAN y J 3830 P ILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE: PHONE 4544100 -, Site Addr ss '_ " ' - BLOG. TYPE WORK DESCRIPTION Lot Block Sec/Sub ' . New ` ? Name • " " -' Mult Add-on ? Address- ?f 7 Comm. Repair c City ' Phone Other Fl ?ES Np. TOTAL Name 'L ? T Water Closet s ? Address - _ / Bath Tubs - $3.00 ---- p City Phone Lavatory - $3.00 Shower - $3.00 ZKitchen Sink - $3.00 FEES Unnal/Bidet -$3.00 COMM/IND FEE - 19'o OF CONTRACT FEE MINIMi1M - RESIDENTIAL FEE $10 00 /Laundry Tray - $3.00 ' - . Floor Drains - $1.50 MINIMUM - COMM/IND FEE - 20.00 / Water Heater -$1.50 STATE SURCHARGE PER PERMIT - •50 Whiripool -$3.00 (ADD $.50 S/C IF PERMIT PRICE GOES 7 Gas Piping OuUets -$1.50 BEYOND$1,000.00) Softener - $5.00 Well - $10.00 _ Private Disp. - $10.00 c Rough Openings - $1.50 dIGNATURE OF PERMITTEE FEE STATE S/C: , FOR: CfTY OF EAGAN GRAND TOTAL: ' `? f` ?Jtvi1s CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # "-7 ' To be used 1or 1 OF 4 P LEXEst value $ 4 5,0 U D Oate ti"CH 14 , y g 8 6 SNeAddress 44358 CLOVER LN Erect 12L Occupancy K3 Lot 16 elock 3 SeciSub. EDEN ADD XTION Remodel ? Zoning Pf) Parcel No. Repair ? Type of Const 3w Addition ? No. Stories ¢ Name C,OOD VALUE HOMES Move ? Length 44 W 14 6 0 9 3 RD LN Demolish ? Depth d?4 o Address Int Impr. ? Sq. Ft icity SLA7_NEphone 780-5510 Instau ? o a Name c Aj4F Approvais Fees ou Address Assessment Permit ? 274.00 ? City Phone Water & Sew. Surcharge 24 . 00 W Police Plan Review 137.00 'I 575 00 ? Name Fire SAC I . _= Address 0= Eng. Water Conn. 500.00 i W ciry Pnone " Planner Water Meter 63 . 50 ? Council Road Unit 290.00 I hereby acknowledge thet I have read this application and state that the Bldg. Off. 3/ 14 / 8 Tr. PI. 156.00 information is correct ano agree to comply with all applicable State of Minnesota Statutes and gity of Eagan Ordinances. APC Parks - Copies Signature of Permittee • -- Total , y. 50 A Building Permit,is issued to: GOUI3 VALUE 110j :ES on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan ? Ordinances. Building Official '', ' PwnN No. Permk Holder Deft Telephone # Plumbiny H.V.A.C. a.ctric , Sotlener Insp*cdon Date Insp. Commenb Footinys 1 FooGnys II Fouadetbn Framinq Roollny - Rouph Plby. Rouph Htp. s Insul. -?, "?! Y+iir ? Finplace FInM Htq. ? uJ Flnal Plby. • 3 ` Bldy. Final Cart.Occ. Oock Ftp. Deck Frmy. WNI Pr. Dbp. MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 BLDG.TYPE m hlame _ ? Address c Ciiy - L Name _ c Address 0 CrtY - TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other Phone M BTU M BTU M BTU M BTU CFM FEE: S/C: TOTAL• Res. Mult Comm. Other PERMIT # RECEIPT # DATE: v WORK DESCRIPTION New _ Add-on Repair. FEES RES, HVAC 0-100 M BTU -$24.00 ADDITfONAL 50 M BTU - 6.00 ADD-pN AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1ai6 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 BE1'OND $1,000.00) FOR: CITY OF EAGAN ' . PERMIT # PLUMBING PERMIT RECEIPT # /? 3 3 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN $5121 DATE: ? Site Addr ? 7 ? '' = ' - ?% !. • Lot e Block ? Sec/Sub ? Name m ? ? Addres? ? ?`' ? c City ? Phone'.."' - Name 3 Addre; O City f? Phone FEES COMMIIND FEE - 1%OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) FOR: CITY OF EAGAN BLDG. TYPE WORK DESCRIPTION 'Rft.- New - Mult Add-on Comm. Repair Other Nq. FIXTURES TOTAL ' Water Closet - $3.00 - - ? - 7 Bath Tubs - $3.00 -/ _ - Lavatory - $3.00 Shower - $3.00 _4 1 Kitchen Sink - $3.00 - Urinal/Bidet - $3.00 _LLaundry Tray - $3.00 'Floor Drains - $1.50 - ?Water Heater - $1.50 " Whirlpool - $3.00 - ' Gas Piping Outlets - $1.50 Soltener - $5.00 weu - $10.00 Private Disp. - $10.00 1 - Rough Openings - $1.50 l FEE STATE S/C: GRAND TOTAL: ` ' 1?L TY OF EAGAN PERIIAIT TYPE: A38130 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ' T • N . : J 0 "`- '' 1549- 1 bO-O j ; APPLICANT: R.Oj. ati etor,.F?. i i I OVER E i1NU ?F ??f. N ( 6h t) :.'Ab-? +10 PERMIT SUBTYPE: TYPE OF WORK: . , t... .. . . . ,:i f;II r i{, i raCO H:i s; sc A<JI It1/qfi I I E*'A i I 1r6J INSPECTION DA • D• ?II +r; , ti=., ? lAN RFVfFW£p HY 1.fAYNE M1LtEft- ' J ilARAlF i'F"f?1IT 1 NF0t1YRr`0 FOPt 0> I 01IHTM6 WORk. -?.. , , . .- :rl' 1 i! ? L_ __ Permit Holder Date Telephone M PLUMBING ? 9 /D 9 HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING / PLBG AIR TEST C?1?/ C? IQ_?/? ({f77: ?J?• ?? 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 CQNDUCTIViTV TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 3830 Pilot Knob Road P. O. Box 27,199 Eagan, MN 55121 tVo.: ft .owyy rrNM 16. Cih of B•Y•» WATER SERVICE PERMIT _...,...? .,., . Connection Charye: AcoOUrK pepoait: _ Permit Fee: Surcharga: Miac. Chorpes: - Totoi: Dote Raid: i pote of Insp.: Irnp.: CITY OF EAGAN SE1A?ER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 2+199 PERMIT NO.: Eagan, MN 55121 DATE: Zoninq: No. of Units: - Ownsr: - - Nddress: - Slte /lddrcss: - Plumber . 1 ym to esniply wllb NN Cihr of Eegaw Conneetion t3+arpe: - OraMAtM. ACODN11t Dlposit: PaRt1It FYQt . . 5urelwrpe: By Misc. CMrqm Dote of Insp.: Tatal: ? Insp.: QoM Pold: ? ? CITY OF EAGAN ! 3830 Pilot K.:ob Roac ? P. O. Box 21199 ? Esgan, MN 55127 I Zoninp: T" Goud r: ross: ' % te /lddress: 4437 umbew. ? ic!ce er No.. 3f -0 ? •--?'i'?.. A.?n/? WATER SERVICE PHtMIT PERMIT NQ.: DATE: . No. of Un1ts: Value Homes Ct.aver Lane ` son i lu,-,i;jir 'l A ia, Ct+orgs: _ Readar No.: " 1 yrae M aowPhr wi1h OrriMntM. ? C E?u1R?DTotal: - gy _ Dote Pcid: Date of Insp.: Insp.: r 130 Pilot K-lob Rosd 0. Bor 21199 igan, MN 55121 !Iw CNp of ypw 1 TP SEMIER SERVECE PERMIT PERMIT Nd.: ' DA'1'E: ? - ; No, of Units: CO^''wetion Ciwepr. ^CODllrft dlpwt: _ PerTIIt FM: SYfCE101'Q!; _ Misc. Chorpm - Tatah ------? Dah Paid: - I ITY OF EA(3AN 0 Pilot.Knob Road . O. Box 21199 agtln, MN 551 Z1 ; oninp: "=ood s r: mm. Address: 44 "d 5i r Lan ? I ym 10 oowoly wu6 !M CH?,?r?p??t]?"''1i°*= o?.?. R Gvl" "? Mix. Choryes: Totol: - Dota Paid: e af Insp.. Irop.. C.- ?3-86 ii. 7i.-.:1 ? - ,. ? 0. 00r)-" , tlpr1 15 6 . i ' T1J i !. 1 6' . 50p:' niete- I CITY r..iAN WATER SERVICE PERMR 3830 ! .. _ Knab Road ' P. 0.:ilrx 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zunir?p: . No. of Units: Owrwr. . . , Address: Sft ressumber, Meter No.: Ra -70 do Size: a ? Reoder No..0. 3 aJ t! 70 lOte ? t? ??t? • ',I'_ I.gnw re oaevly wbb the5i? t?:-.,.,? t) pd TT' Or41Mnaa. u,[t?? ??? r?od Total: meter - By Dote Poid: Dnta of Inap.: I^sP.: ?- 1- - ?? - _ CI. AGAN SEWER SERVlCE PERMIT CiTY OF EAGAN SEWER SERVICE "itMfT 3831, c Knob Roed 3830 Pilot Knob Road . P. O. Box 21198 PERMIT NO.: P. O. Bo3x 2119-i PERMIT NO.: . Eagan, MN 55121 DATE• '° - Eagan, MN 55121 D/1TE: ' 7.oninp: No. of Units: 4- r:. ?. Zonino: No. of Units: _-`r 0?YfNr: .: n 5+p g Owner. Address: _ Address: Site Address: Site Address: kPlumber: . Piumbew. ' . r , . 1 ym ta oorsplg wNNi !Iw Cih ei Easew Adireeam By Do1+e of Insp.: Connectlon Char+pe: 3i `! AtC.oLM+f Daposit: Pema Fee: . ,?. SUfChd1'Q0: .. Misc. Charpes: Total: DoM Poid: WATER SERVICE PERMIT PEkMIT NO.: DATE: ? No. of Units: Gxnnsction Gwrgr. 4 7.5 0..0,, ACOOUnf DepOiit: Permlt Fes: SUrc1Gfge: Misc. Chorpss: Totol: Doft Pnid: wk 1ayrN ea aospl?r wk6 tw Citi Of iepw OrdinaseN. .// s ? OFFlCE USE ONLY This reqoesl void 18 monihs ham validanon daie pnnred in ihis box_ f -i S /. ?_-T I IIII I? I I I I I I II I?1I 11I I I? II II I I III ?IY'?J" P? E PRINT OR TYPE 4 3 a Reauest 7 ? RoogMin inspecnon required0 ? Y. lYou must mll tha inspeciar when reody) Inspecfion Oiher Than RoogMn -$Aeedy N. O W II Call ??a R??'. I, ' nsed conhactor ? owner hereby request inspecfion of the above elechicol wark of: lob Address ? CrcY Z'p C°d° Sechon o w ship Name or N. Range N. Pire No ny Occupon ? Phan No. Pwver Supplier Addrau EIMr Con . (Co y N. Conha or Lcense No U MusM Lc No. IPlam Elect Only) Mo" /Address onhact« «Owna P 'ng InsmlbM1On] Ati orzetlSig77 l6pnhacioror Perlormirglnabllononi %? .( A00001 A-1 8/96 y7pTE BOABO COPY - SEE INSTRUCilON3 ON BACK OF YELLOW COPY ?/?/?S/Jc'J REQUEST FOR ELECTRICAL INSPECTION / `3 ?{ 4? °i1 9 ? Minnesota State Board of Elec[riary A 1821 Universiry Ave., Rm S-128, St. Paul, MN 55104 Phone (612) 642-0800 Home Duplex Apt. Bldg. Other: New Addn Commercial Indu nial Farm Remod Re ir N irCond. Lt fltg. Equi Water Hh. Load Mgmt. Other. D er Range Elec. Heai Temp. Service "X" o6ove fhe work covered by this request EnMr remorks in rhis space and on the bnck oF the white copy only. Calwlale Inspeclion Fee - Thrs Inspecfion Request will not be occepfed wifhout the coriect fee: Other Fee # Service Entrance Size Fee # Circuifs/Feeders Fee Mobile Home Park Stall 0 ta 200 Amps l0 100 Amps -? Sheet ltg./Tmffi< Sig. Abore 200_Am s ve 8Q-Amps Transformer/Genemtor IMSPECTOfl'S VSE ONLY ? Sign/Outline ltg. Xfmr - ? Alarm/Remofe Conhol ? Swimmmg Pool I hereb cem iha ms ied ml II 'on desc.i6ed herein on ihe dares smied Ifri9alion BOOm Nough?ln DO? $pecial Inspection Invesligative Fee THIS INSTALLATION M AY BE O F. al pata RDERED DISCONN CTED IF NOT COM ETED WITHIN 18 MONTHS. Thus request void C, ?j,z? 18 mpnlhs Irom C 7 910 ? ?? ? " ??[;.YlL?•? ?? / Re t Dale Fve No. RouPh-in InsUer,bon R w eA> fleatlY Nuw W Nouf' Insoec- ? ? L ^ ? ? ?'es ?Nn r When Feady ? License0 Eleclncal ConVactor I heraby request ins0ecbon ul ebove ? Owner electrical work mstalled aY Sveet Address, Box or Rome No. C'Ey ?? V w ection o. Township Name or No. Range No. C Y Or.copani (PRINT Phone No. 1 . J Power uppM1er ? ? Adtlress Elec cal Cnnv(a?ctor I1Comvany/N?am?e) ? l C % ?'r?t r?s ? c?° No. (-• ? ?J Ma? ing Jress (ConVa'?? ar O?wnet aking Instailauon) A A ed Sipnawre ConVactor/ wn r Making Ins - Ila[ionl Phone Num er l ??/ l? l MINNESOTA STATE eOAND OF ELECTqICITY Gngga-Mitlwav Bldg. - Poom Nd91 1821 Univergity Ave., SL Paul, MN 55104 Phone 16121 297-2111 THIS INSPECTION NEQUEST WILL NOT eE ACCEPTED 9Y THE STqTE BOARD UNLESS PNOPER INSPECTION FEE IS ENCLOSED. , REQUEST FOR ELEC7RICAL INSPECTION ? EB-00001-04 ., 0 See inshuttions lor compbti,p Uis form on beck oi yellow copy ll.. 7910 "X" Be/ow Work Covered by lhis Request CC, ??? ? Fdd Nep. TVpe ol Bmltlmg Apolinntee Wired Equiyment Wired Home ftange Temporary Service Duplex Water Heater Liyhnny Fixtwes Apt Bmldmg Dryei Electric HeaUn Commercial Bldy. Fumace Silo UnloaJer Industnal Bldg Av Condiboner Bulk Milk T&nk Farm ther pee,fy Otherl5pcrify) tinr Suculy Othcr plhir Gompeite lnspection Fee Below M Fee SarviceEnbBrceSize b Fee FaeEars/Subfeeders N F5e Cvcurts , 0 to 200 qm s 0 to 30 Am s 0 to 30 !?m s Above 200 qmps 31 to 100 Arnps 31 to 100 Am • Swinming Pool Above 100_Am s Above 700_Ampy Transtormers Irngation eoorris Purtial."Other Fee Signs Speaal InspecLOn 5 _.? Aemarks A7'G T TAL WE -? ? Rough-m inal ? Dnte ? ?"'. ? ? ` I,nsthpe e ElecCnIby' Ictor, t!L hera certdy ehat the above inspection has been made. fhis request volG 13 montim irom This request vortl °5 7 I / iB rrionlhs fmm ?F % t(JlU C 7909 flequesl Date F re No. - Roueh-?n InsVertion ?-„ Reqm?eA? ?ReaAy Nuw ill Nntrtv ??sPer y_Z ( [es ?N or Wh q dy U ui,ensea uee[ncai Contractor 1 hereby reQUast mspecnon ot ebove 0 OWOpf electncal work instelletl et Street AdAress, eat or Ro?so. lc I Cily ecuon• o. 7ownsh?p Name or No. Ranye No. Counly Occapant (Pql T) Phune No. Po er Supplie Atldress Ele ical ConhacmAr (COmpanY Nnme) - Con[rar or"s Lfcensg N?, ft A h ss IC tractorp?r Ow Mokinp Insw ' aLOnl ?( ? onzed S?gnemre 1 ctor wner Ma kinB hslallavonl Phone Number •nrvrv[SpTA STATE BOARO OF ELECTRICITY Gr199s-Midway 91de. - Aoom N•191 1821 UniversiIy Ave., SL Paul, MN 55104 Phone 16121 297.2111 THIS INSPECTION NEQl1EST WILL NOT BE ACCEPTED BY THE STATE BOAftD UNLESS PROPEN INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION jIMIX Ee.ooooi.o< ,y W ? ' Sea instructions for completiM thie farm on beck ol Vellow copy. fo??o q "X` Below Wwk Covered by 7his Requesl da Ne[. Tyoe ol ewlmne Anolianeea WoroC Eqapmenl Wved Home Ranye Ternporary Service DuplFx Water Heater Lightinp Fixtwes Apt. Bwldmg Drye, Electric Heatin Commercial Bldy. Fumace Silo UnlOader. Industnal Bldg Air Condrtioner Bulk Milk Tenk Farm Omr, Soel.i y .th.=r ISnculyl t ar ucnfy Oihor piher l.0/IIOU/P 1II80Pfl/00 hPP Ka1nW M ? SarviceEntrance$ixe B Fea FenEers/Subfeetlers k Fee Crtcwts 0 to200qm s 0 to30Am s 0 tn30Am s Ahove 200 qinps 37 to 100 qmps 31 to 700 q y Swinming Pool qbove 100_Amps Above 100_Am s Transiormers IrngaLOn Booms Partial- Other Fee Signs Speciai InspecUOn . T Nemarks TAL fEE Nouph-?n ) ? CJ D:rte ? 1C? j ? - I fheF4?t.i?al? soector, he?eby final gwt? nte certdy that the above inspeclion hes heBn tlun reauest voiG 10 monlro irom Thrs reQuest void 18 months from Q 7853 4Is,g Re?uest Date fire 6/ y y / `9s47 - nsVecbpn I L?Feady Nuw p l Notrty InsPec ?NO JUo? When Hgady ? Licensed ElecVical ConVactor I hereby requesc insoecnon ol above ? Owner electncal work installed at Street AOAresS. Box or Noute Na CiIy ?a C, l ? r C?J'?.Ea Ea o.?) em?on o. Township Name or No. Ranqe No. Counly Occvpant (PfiINT) Phone No. ftupplier Power ) Atldress Electrical Conhactor ICOmpany Namel ?A A /9?_ E/ Cnntractor's License No? ( - Mailing AdJress (C onVactorpr Owner Makinp InstailaboN ?? 1F_ ? ? [ A or etl SiB?atwa (COntractor?Owner Makiny I stallatmnl Phone Number ?' it, / \ ?L` ?./ , / ?-L/ W miryNE50TA STATE BOARD OF ELECTRICITY Gnqgs-Mitlway 91tlg. - Noom N-191 1821 Univarsily Ave., St Paul, MN 55104 Phone 16121 297-2111 THIS INSPECTION NEQUEST WILL NOT BE ACCEPTED BY THE STqTE BOAflD UNLESS PNOVEfl INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTNICAL INSPECTION EB-OU007-04 ' SaB inslrutliOns 10r completinB this form on Eack o1 vellow CoaY. 7 4r. "-2 "X" Below Work Covered by Thls kequesf qdd 1 flep. V V ../ Type OI BwIEinB -- APOloaincea Wrted -- Equiumanl W,red e Range Temporary Servme Duplex Water Heater Liyhtinp Fixtures Apt BwlAmg Dryei Electric Heatm Commercial Bldy. Fumace Silo Unlonder, Industrial Bldg. Air Conditioner Bulk Milk Tank Farm omer oeci v .?ne? l5non?fvi t er SVecHy Olhm Olher p .e Fee p......... . . . SarviceEnVaneeSrse b Pee Fende,s/SUbfeeders N Fae Cvcmts , V U to 200 qm s Above 200 Amps 0 to 30 Am 5 31 to 100 Amps w ' L) 0 m 30 F?m s 31 to 100 Am Ls Swimming Pool Transiormers Above 100-Amps Irrigatron Boorte; Above 100_Amps Partial,'Other Fee Signs Speaal InspecLOn S TOTAL F ? flertnrks , ii 4 PouBh-in Date L 1.11e Ele ?I p nspector, hereby cerUly thet tha nbove Final ? D°Ie/?? i^sDeeAOn has Eee- ? ea •MS m0uest volA 10 montM irom ------------------ j Permit I Permit Fee: ???, a ??? V j Date Received: ? i i 1 Staff: f I -____-___-_.._.__-__? 2008 RESIDENTIAL BUII.DING PERMIT APPI.ICATION Date: Site Address: W---3 7 Ck cl 0-j ? rv Tenant: Suite S: RESIDENT f OWNER Name: &-We,rS C(S5X fk /?J Phone: AddPBSS I Ciry I Zfp: P,pplicant is: _ Owner -f- Contracta TYPE OF WORK Descrip6on ot work: ,_ __ Y_t? 1 ?.. ?-o-OP ConsRucdon Cost:fi? lS?,i .?% 0 P Multl-Family 9uifding: (Yes / No_.J CONTRACTOR Name: ,0";86?b Nda'i? -P-pn,QlpJPr+n s Uoense#;'zQ1?`? Address: /? - YL City: rw'" e,rrM j? ^1 - StaYe: Zip: Z- P 7`? Phone: ?Ly?y tp'`> ?".p '-.3yZ j Contact Persar. COMPIETE THiS AREA ONLY IF CQNSTRiilCTING A NEW BUILDING _ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residem;ai vermiadon caftegwy 5 wnkshw • New Enw#7y Code W orksheet Category Submittea submittea (4 SubmOsaion typ9) • EnergY Envelope Ca1culadons Submitted In the lest 12 months, hes the City of Eagan Issued a pertnlt for a slmGar plan based on a master plan? _Yes _No If yes, date and address of master plan: _ Licensed Plumber: Phone: Mechanical Contractor: phom: Sewer & Water Contractor: Phone* 1Tw ? '3 rlWW ? ???T? "'"" ` ? ? y l /? l ? ? f 4 ++f- ? ? YV ? i4 sl?VlF!YI ? ? F " 'Yf y? i a N?4uy? y? y ? ??} (y ? p ? yy ? ? ` } ? Q p? ? y?.?y?.{ ? y y y y '.: llm?Ie??vll?+Rf?iV?V?x ??NiN W .1f;?T?yT"^'?q?t/?S.•V91SQ?'lPKl?fi/Y-??1lIE`?"#H ;, ; f?? ^R?N? ??i r §i. h i hereby acknowledge that this information ea complete afW acGUate; tAat tlte wWk wilt be in confumrance with the ordinences and cofts W the City of Eagan; that I understand this ia rwt a permit, but only an applwa6on fa a permit, and work is not io st wfthrjiA a perrnR; that the work wiil be in accorclance with the aFprrned plan ar riie case of which requires a review and approval o // } x ?! i L61,1f Applicant's PAnted Name Appllcant's Signature Page 1 ot 3 07Yy 2005 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. 'F i? s-o Date I Y.L ? ,]"l Unit # Site Street Address lALsi , Property OwneR?l I?? (l ?)Telephone #(?p"?? 1t I`?Z 0C5 t'l D Contractox??qF DQ C»X ?JCC?1'IP_i I 1??? Telephone # (115) ?,;2 0 W 6P? Address=l I??) 07h -p-CA City StateLL)1_ Zip aLDIIILp The Applicant is: _ Owner ? Contractor _Other Alterations to existing dwelling _ Add plumbing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). _Septic System Abandonment _Water Turnaround (add $125.00 if a 5l8" meter is required) Other: $ 50.00 ? Water Softener _ Water Heater _ new Y replacement $ 15.00 Zawn _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 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. -- ApplicanYs Printed Name ?IicanYs Signature _; i ?i JAn.? ;? 7 2 005 IUII RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAH 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Naw ConaWedon Raouiremenh • 3 registered site surveys sluwing sq. ft of IoL sq. R. of house; and all roofed areas (20°k maximum bt coveraga allowed) • 2 copies o(plan shaxirg 6eam 8 vnndow saes; poured found design, etc.) • 1 set of Eneryy Cakulations • 3 copies of Tree Preservation Plan N lot plafled afler 711193 • Rim Jo'st Detail Options selection sheel (bidgs vnU 3 or less units) DATE 9' 17' O 2 SITE ADDRESS "7 ?I3 S 8 a Jt°2 Ian ? MULTI-FAMILY BLDG ?YY _ N TYPE OF WORK F%1?6 lUf F /cpd ta['eGU&Gtr FIREPLACE(S) _ 0 1 1 _ 2 APPLICANT STREEf ADDRESS 1,;, 75 &, 1? 41 g Lc) CITY. TELEPHONE # W?' 896'117Y CELL PHONE # rd ,le STATE,Af W ZIP 55337 FAX# 952 •84-z-79lS PROPERTYOWNER ! UGleWk k1C4?1&N TELEPHONE#65l'03~V.7'? COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY l MINNESOTA Ri.TI.F_S 7672 (J submission lype) . ResidenUal Ven0latlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submiked • Energy Envelope Calculatlons Submitted Plumbing Contractor: Plumbing system includes: Mechanical Conhactor. Mechanical system includes: Sewer/Water Contractor: _ Air Conditioning , _ Heat Recovery Sysl I RanwdellReoa'v Reauiremenb • 2 copies of plan • 7 set af Energy Calculatlons for heated additions . 1 sife survey lor eacterior addiUans & decks • Indicate'rf Iwme served by septic system tor add'Aions VALUATION 4 19'toe) ? _ Phone # Iawn Sprinkler No. of R.I. Baths T SEP 1 7 2002 Phone ?0 ()-j Fee: $90.00 Fee: $70.00 I hereby acknowledge that I have read this application, state that the info ation is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi nces. Signature of Appllcant OFFICE USE ONLY _ Water Softener _ _ Water Heater _ _ No. of Baths Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 116 C?-/ 1986 BOII,DIHG PSRlQ? 9PPLICATIOH - CITY OF SAGAN NOTS: ALL CANTBACiOES MQST BB LICffiiSED WITH TEIE CITY OF EAGAH COA4IBRCIAL INCLUDE 2 SETS OF ARCHITECTORAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS $2,000 LANDSCAPE BOND SINGLS FAlQLY Di1SLLINGS INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURYEY 1 SET OF ENERGY CALCULATIONS 0 <' TU Date: ,3 -1?2-Site Address !i? 3 SL%-&'i`"q ? OFFICE IISE OHLY To Be Used For: -2Valuation: I ?SG Lot J,?- Bloek 3 Pareel/Sub Owner Address -AyGj} City/Zip Code Phone ??? - 5 ?/0 Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone S NOTS: ADDRESSES FOR CORNSR 9DDRESS IS DFSIRBD. LS ISSQED _ Ereet Remodel Repair Addition Move Demolish Int.Impr. Install Oecupaney Zoning Type of Const lk of Stories Length Depth Sq Ft APPROVALS FES3 Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off 3l'l•86 Treatment Pl APC Parks Varianee Copies ? TOT9L ?TIS L015 - CONTEACTOR/HOMFAWNEH HQST DESIGNATE WBICH NO CHANG&S ItILL BE ALLOiiSD ONCE BDILDIHG PEHIiIT Is FOR Sai.E UNITS CITY OF EAGAN N 0 11621 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721 ? PHONE:454-8100 Receipin p yl-I BUILDING PERMIT robeusedfor 1 OF 4 PLEX Est.value $48,000 pate MARCH 14 1y86 Site Address 4435 CLOVER LN erect L? Occupancy R3 Lot 15 elock 3 Sec/Suh EDEN ADDITION Remodel ? Zoning pp Repair ? Type of Const. v-- Parcel No. Addition ? No. Stories GOOD VALUE HOMES Move ? Length 44 i Name 1460 93RD LN Demolish ? Depth 2a o Address Int Impr. ? Sq. FL Ciry BLAINE phone 780-5510 Install ? SAME Approvals o Name z 1- Assessment ? i Address ? Water & Sew. City Phone Police .? F w Name Fire Address Eng. : i W Ciry Phone Planner Council Ihere6yacknowledgethatlhavereadthisapplicationandstatethatthe gld otf. 3/14 8E information is coriect and agree to comply with all applicahle State of Mmnesota Statutes and Ciy9 oi Eagan Ordinances. APC T? Signatuie ot A Buildinq Pe all work shall %ded to: in accordance with all VALUE HOMES raea i $ 274.00 Permit 24.00 Surcharge Plan Review 137.00 SAC 575.00 Water Con n. 500.00 Water Meter 63.50 Road Unit 290.00 Tr. PI. 156.00 Parks Copies 7otal $2 . 019 . 5 0 _ on the express condition that of Eagan Ordinances. Bwlding OBicial - 1986 HDILDIHG PfiRMIT APPLICATIOH - CITY OF E9GAN NOTE: ALL CONTRACTOBS M(1ST BE LICSNSED WITH THE CITY OF EAGAA COARf6RCI6L SINGLE FAMILY DWSLLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONSJ $2,000 LANDSCAPE BOND To Be Used For: Valuation: Date: 2? ?2-? Site Address OFFICE IISE ONLY Lot /k/ Hlock ? Pareel/Sub 59L_ Owner Address /5/60 93-r.?G? City/Zip Code ? Phone ZZ-0 -S?j /0 Contraetor Address City/Zip Code Phone Meh./Engr. _ Address City/Zip Code Phone # Erect Remodel Repair Addition Move Demolish Int.Impr. Install Oecupancy Zoning Type of Const U of Stories Length Depth Sq Ft APPROVALS FSFS Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off 31? BecATreatment Pl APC Parks Variance Copies TOT9L NOTS: ADDRESSSS FOR COSABR IAYS - COATRACTOR/HOMHOWNER 1IU3T DFSIGHATE WHICH ADDRESS IS DSSIRED. NO CHANGES WILL BB ALLOASD ONCE BUILDING PfiRMIT IS ISSIIID. ,,. FOR SALE UNITS CITY OF EAGAN N p 11622 Ea MN 55121 3830 Pilot Knob Road, P.O. Box 2I -799, gan, ? PHONE: 454-8100 BUILDING PERMIT Receipt # 1 OF 4 PLEX $48,000 pate MARCH 14 iy86 Est. vawe To be used for SrteAddress 44355 CLOVER LN Erect 2A Occupancy R3 EDEN 3 16 ADDITION Remodel ? Zoning PD Sec/Sub. Block Lot Repair ? Type o( Const V Parcel No. Addition ? No.Stories 44 W GOOD VALUE HOMES Name Move ? Demolish ? Length Depth 9 4 a 1460 93RD LN Address Int. Impr. ? Sq. Ft City BLAINE phone 780-5510 install ? x gpMg APProvak F ???? = o Name 00 Q Address ? Ciry Phone ?a F w Name Address i w Ciry Phone I hereby acknowledge that I have read this application and state that the information is correct er?Q agree to comply with all applica6le State oi Minnesota Statutes andJCity of Eagan Ordinances. Signature of Per ' e A Building Per s issued to: GOOD VALUE HOMES alP.work shall 6e done in accordance with all a1pph ab tate o Minn Building Otticial ` Assessment _ Water & Sew. Police - Fire Planner Council Bldg. Off. 3/14/86 0 Permit ??oa h S arge urc 137.00 Plan Review 575.00 SAC water Conn. 500.00 Water Meter 63.50 RoadUnit 290.00 7r. PI. 156.00 Parks Copies 50 T..?nl ? on the express condition thaf tes and City of Eagan Ordinances. J/?? ,?_? - - -r i/Z41?2 . 1986 BOII.DIAG PERlIIT APPLICATION - CITY OF EAGAN NOYS: ?L[. COHTRACTORS M[JST BE LICBNSED SiZTH THE CITY OF F.AGAN r SINGLS FAFIII,Y DWSLI.INGS INCLUDE 2 SETS OF ARCHITECTURAL INCLIIDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONSJ $2,000 LANDSCAPE SDND To Be Used For: Valuation: Date: 'I1/?- Site Address `7"`?3 7e4"? 4 OFFICS 03S ONLY Lot Z,,4' Bloek ,?j Parcel/Sub Owner Address l,?,:52 Ciby/Zip Code Phone Contractor 3 c2?rv? p Address City/Zip Code Phone Areh./Engr. Address City/Zip Code Phone # Erect Remodel Repair Addition Move Demolish, Int.Impr. Install Oceupaney Zoning Type of Const 4 of Stories Length Depth Sq Ft APPROYALS FBES Assessments Permit Water/Sewer 5urcharge Poliee Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off3.jjgb Treatment Pl APC Parks Varianee Copies TOTAL aD i?S'a NOTS: ADDRESSES FOR COB9SR LOTS - CONTRACTOR/HOMFi0ii8ER MIIST DESIGNATS WHICH ADDRESS IS DESIRSD. HO CHANGES HI[.L BE ALLOWSD ONCE BQILDING PEAMTT IS ISSDED. <? - .. ? ?. T ` TCITY OF EAGAN '? - 11619 FOR SALE UNITS 3830 Pilot Knob Road, P.O. Box 21-199, Ea9an, MN 55121 ??? PHONE: 454-8100 ? aeceipt # BUILDINS'a PER9NIT M?RCH 14 ?g 86 1 OF $48,000 py?e 4 PLEX Est Value To be usedfor ?] ancy cu O R3 4437 CLOVER LN Erect ? c p Za??^ pB SiteAddress 14 3 A?DITION Remodel Sec/Sub. EDEN Re air ? 9 7ypeolConst. Block Lot p Adddion ? No.Stories 44 ParcelNO. Move Length GOOD VALUE HOMES pemolish ? , a Depth me T 1460 93RD LN Int.lmpr ? sq.Ft. dress 0-5510 Install 0 BLAINEphone C, ry Fees me N 7-? dre ? l ty Phone u? W W u? ?w a Address Cirv Phone I hereby acknowledge that I have read this application and state thatthe information is correct and?gree to comply with all applica6le State of Minnesota Statutes and C of Eagan Ordinances. ? Signature of A Building Permit all work shall be Building Oflicial _ % GOOD VALUE HOMES ued to: P ? ^?^ in accordance with all a ble tate of ..? ?? Assessment Water & Sew. Police Fire ? -- Planner Council 3 14 / 8 b Bidg. Off. APC Permit $ 274.00 i Surcharge _ 24. 00 Plan Review_ 137. 00 SAC 575.00 Water Conn. 500.00 I Water Meter 63 . 50 . Road Unit 290.00 Tr. PI. 15-15-00 Copies-$2 019.50 Total- on the express condition that and Ciry oi Eagan Ordinances. 1986 BIIILD7NG PERMIT APPLICATION - CITY OF EAG9N NOTS: ALL CANTBACTpBS M[TST BS LICSBSSD iiITH TH6 CITY OF EAGAB COMMERCZAL 3INGLE F6MIILY DSiffi.LINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTUAAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFIC9TIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For: Valuation: *72) Date: 3 -Zo?- k?;? Site Address OFFICE OSE OPLY Lot 13 Bloek 3 Pareel/Sub LI? Owner if??? Address ?y"G6 9 ?G? City/Zip Code Phone °'J/g?q Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone 0 Erect Remodel Repair Addition Move Demolish Int.Impr. Install Oecupancy Zoning Type of Const # oP Stories Length Depth Sq Ft APPROVALS FSES 4) 7 4 Assessments Permit + Water/Sewer Surcharge Police Plan Review Fire SAC 5 7.+ Engr Water Conn _,$ 0-a Planner Water Meter Council Road Unit Bldg Off3ll-Sb StDTreatment Pl ? APC Parks Varianee Copies TOT9L G2 L) I 1-f ' S V' NOTS: 6DDRFSSES FOR COHAER LOTS - COATRACTOE/HOMEOWNER MOST DFSIGHATS SiHICH ADDRESS IS DESIRED. NO CH9NGES fiILL BE ALLOiiSD ONCE BQILDING PERMZT IS ISSIIED. -?. FOR SALE UNITS CITY OF EAGAN N 0 11620 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ,- ` PNONE:454-8100 BUILDING PERMIT Receipt# To be used for 1 OF 4 PLE*st. Value $48,000 oate MARCx 14 1986 4437B CLOVER LN `] occupancy R3 Site Address Erect PD lot 13 Block 3 Sec/Sub. EDEN ADDITION Remodei O Zoning Repair ? Type of Const V Parcel No. Addition ? No. Stories _ GOOD VALUE HOMES Move ? Length 44 i Name 46 93RD LN Demolish ? Depth 24 # Address Inl Impr. ? Sq. Ft a Ciry BLAINFphone 7 -551 InsWll ? o SAMfi Name 0 ua Address : ? City Phone ?Q F w Name z Address o a W Gity Phone I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Mmnesota Statutes and ijity of Eagan Ordinances. SignaWre of A Building Pe all work shall Buildmg Offic Water & Sew. Police Fire Planner Council 4/86 Bldg. Off. 3/1 APC -? 274.00 Permit ?00 Surcharge 137.00 Plan Review SAC 575.00 .0 Water Conn. 5_00 ?_ 050 Water Meter?00 Road Unit 00 Tr. PI. Parks Copies--,$ '-$ p ? GOOD VALUE HOMES on the express condition that ued to: in accordance with all applwa6le State ot Minnesota Statutes and Ciry of Eagan Ordinances. I CITY OF EAGAN PERMIT 3$30 Pilo: Knob Road PERMIT TYPE: B vu z L o z iv G Eagan, Minnesota 55122-1897 Permit Number: H 3 4 3 ci 2 (651) 681-4675 Date Issued: o.x I 0 8 /99 51TE ADDRESS: 4 14 37B CI f)VER 4_FINE LOT? 13 BL[1CK: 3 EOkN PetoNee 1@-2275?-7.30-Q3 DESCRIPTION: - REPI.RCE SICIIiVG 8 0111 dingf.pPrmii: 'rypp S'i'OftM DAMAGE t3wildSrig Wty,rk Type, REP11TR '"Census Cocfs ' 434 ALY'. R4>S1:DEIVTLAL r j ti.. Z ? ~li rY ? 1? S' __T3' _ - ? •. _ r. ._i• _ REMARKS: Ut+IIT B, FEE SUMMARY CONTRACTOR: - Rnp1i-cant -- 5r. L.zc. OWNER: Cl75TOM CfJDlCEPTS C:GNST 18987290 20142417 DONNELI.Y THERESE 1G60.0 h;EfVRICK L00P/STE B 44378 GI_pWCR LEVIVE LAKEVTLLE MP! .5"6044 ERGHN PIN 55127 r 6121 898--7290 ? I hereby acknowledge that 1 have read this appl3.oatian and stats that the ini-ormatian is correct and ahree trr cnmpJ.y with all applic:able State of Mn. Statutas and C3ty ot Eaqdn Ordinancas. C.MSUED BY SIGNATURE APPLICANT/PERMITEE SIGNATURE I 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? t ,1 CITY OF EAGAN --C 3830 PILOT KNOB RD - 55122 (651) 681-4675 New Construction Reouvements ? 3 registered site surveys ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc ) ? 1 energy calculalions ? 3 rqpies of tree preservatlon plan rf lot platted after 7/7193 required: _Yes _ No DATE: 1 - 1 - Remodel/Repair Reauiremenis ? 2 wpies of plan ? 1 site surveys (exterior additions 3 decks) ? 7 energy calculahons for heated additions CONSTRUCTION COST; `t ?) -7 4?) DESCRIPTION OF WORK: STREET ADDRESS: `( 9?J7 ? 01IIAA I 09Ln"-p v LOT: I'5 BLOCK: 3 SUBD./P.I.D. #: V?- ?ame:_?J Phoue #: PROPERTY E;L ? F"st OW:NL• 12 Sheet rlddress:----------------------------------- ------Citv State: "/.ip: Cumpauy:5'e???? Yhone N: ?l?d c0NTiz?.croR StreetAddress:??_/?f1fl+??L?J ? License#2Q1kZ4/1 L'p. ?--- Ciro ARCHITECT/ EVGINEER Comp N:unc S[reet Citv Sewer & water licensed plumber (new construction only):. change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicahle State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: e."° OFFICE USE ONLY Certificates of Survey Received ` Yes _ No sc,te: _rC'?------ -r_ip id_rl?el---- Phoue #: ------- Registrauon #: --- ------ --------- S[ate: Ztp: Tree Preservation Plan Received , Yes _ No - Not Required PERMIT CITY OF EAGAN 3830 Bilot Knob Road Eagan, Minnesota 551 22-7 897 (651) 681-4675 PERMITTYPE: Buri.oz+vG Permit Number 034361 Date Issued: 01/ E 8 19 9 SITE ADDRESS: A437 CLOVER LflNE L.OT: 14 BLOCKa 3 L' tJEi1d I,.] .N.: 10--22750-140-03 DESCRIPTION: - , REPLAC:E B??ldirlq`.Pei°mi? T}+pFs ?uildinq Wbrk 7yQe ? %Census Code / - '- , i-U n...?, SIpTIVG "TORIh DAMAGE REPRIR 434 HI.T. ftESSpEIVTTAL ..?t ? ,,. ??•-i:1??? ?`, ,?_ REMARKS: FEE SUMMARY: CONTRACTOR: - Applicant - sT. LCC, pWNER: CUaTOM CONCEFI"S COiVS1" 18987240 20142417 OLSQN SUSAIV 16540 KENRICK L(lOPjSTL E `1437 CLOVER LAIVE LHKE'JIl LE hiN 55OA4 EArAtd t+IN 55122 (612} 89$-7290 ? I hereby acknot,rledqe that I havc read thi3 applzaatian and staCe that: the inYormatian Ss aorrect and aqrae to compl.y with all applicabl.e State ofi Mn. ST,arutes dnd City a'f Eagan {3rdirtanse5. APPLICANT/PERMITEE SIGNATURE I ED 8Y. SIGNATURE ? % I 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 (651) 681-4675 New ConstrucUOn Reauvements RemodetlReoair Reauiremen[5 ? 3 registered site surveys ? 2 wpies of plan ? 2 copies of plans (inGude beam & window sizes; poured fnd. tlesign; etc.) ? 1 site surveys (exterior additions & decks) ? t energy ralculations ? 1 energy calculahons for heated additions ? 3 copies of tree preservation plan if lo[ platted after 7/1/93 requved: _Yes _ No DATE CONSTRUCTION COST; 9 33 --7 !? DESCRIPTION OF WORK: STREET ADDRESS: Lor: 1 ti U"i3-I Gl ove r Lrn-e- - BLOCK: 3 SUBD./P.I.D. #: <--0Lk-t`--- Nwrie:-SL.1_S C) n -----`-`.'°s 'A--?--- i'hone PROPERTY r"s` wXN1:R Stmet Address: ------------ ' City ----- __ S[ate: ----- ---- ZJP' - ----- C onnpvy: _CZ/-S I:?An tk: 52L? t1 %L_f__?_S.?_- CON'1'lt.\Cl'OR / /? Street Address:7p ?/'-Pe-[-if?K--?-- Ucense H212_/5/Cg/ ?E.rp. ---- CuV Sta[e: ------ Zip: ARCHITECT/ rNGINEER Comp:nS.---------------- ----- -------- Yhone N: ------- ---------- --------- Rebris[raiiuu St: Strcct Address:------ --------------------- --- Qtp ----- - --------- ------ State: ----- ----- "Lip: Sewer & water licensed plumber (new construction only): _ change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicahle State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes _ No - Not Required PERMIT CITY OF EAGAN 3830 Pilot Knob Road _Eagan- Minnesota 55122-1897 (651) 681-4675 SITE ADDRESS: P<1.N,: 1O-22750-160-03 DESCRIPTION: ?r / ` 1 1 t , ttL'PLACE ? hlwi ltfLriq,_.PErmit T,if» 5"ui Ldins7 Wo,rk Tvoe ?tensus Cods i. ? ?r '\[:?- -..- ? i? PERMITTYPE: R usL nsN Q Permit Number: 0 3 4 3F) H Date Issued: 011 08_' 9 ` SIDING STORN I)flMRGE REFAIR 434 ALT. FYFSIrJENTTAL REMARKS: u i•lz ?i? s, . FEE SUMMARY: CONTRACTOR: - APplicalit - sr. i.rr.. OWNER: CU?Y0M CONCEF7S CONSI' 10987290 2FT1.42417 KAEL6LE NORMAN 15S4m KEPIRICK LOl7F7tSTr 6 4 q"368 CLOVER LAnF LAKEVI4.l.E MN 55044 EFii3hPJ MN 56122 (612) 848-7290 I hereby acknnwledqe that Zhave read L-his aaplicai:ion arid state Lhat tkie i.ntprination is correct and sqree tb comotl+ wit,li a11 applicable StatE? of Mn. Sta'L'i.tt es and C3,ty o'Y Fa4an prc4inances. L- APPLICANTlPERMITEE SIGNATURE 44358 C'LOVEft I-ANE LGT: 7.6 csLOCK: 3 EUEhI J 44tz"? ?? lzz) IS D BY: SIGNATUPE 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 P( 51) 680 4RD - 55122 ?a f L New Canstruction Reowrements ? 3 registered site surveys ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? i energy calculations ? 3 copies of Vee preservation plan rf lot platted after 711193 requved. _ Yes _ Na DATE: _ 1 ? -9 j Remodel/Reoair Reauirements ? 2 copies oF plan ? 1 site surveys (exterior addi6ons & decks) ? 1 energy calculatwns for heated additions CONSTRUCTION COST; q J-I t) OESCRIPTION OF WORK: IJ /? 0 " U STREET ADDRESS: '/l 3S lZ? 1?ok 'b A (?sno LOT: I (, BLOCK: 2p SUBD./P.I.D. #: Ekv_ VN_ \:une:_?'? ! ? ` ? --- I V U (_M G?(1 ??Phoue ,Y: PROPERTY [ AVNh:R SLrcct Address _ ------ ------ City ------- ---------------------------- State: "Lip: Comp.ury':_f-, _? YLone #: -------- c<?v r?znc'roit /?s p StreetAddress:_??12/,_.`/? 16 % ?? ?,?? __L> License N `?0_??(2?//?__Exp. ! Ci[v 9RCHITECT/ ENGINEER Comp IV;une StrccL City Sewer & water licensed plumber (new construction only): . change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all appiicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Signature of Applicant: i OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Sta[c: __/r!! ? --- /1P' f-??F C{~'--- ----- Phone #: ----- _ _ Repshntion N: ----- - ------ State: ---------- ---- Zip: Tree Preservation Plan Received _ Yes _ No - Not Required PERMIT CITY OF EAGAN 3830 Piiot Knob Road PERMIT TYPE: 8 uI L p z iv e; Eagan, Minnesota 55122-1897 Permit Number: 0 :? 1 -'? F? 9 (651) 68 t-4675 Date Issued: 03,108199 SiTE ADDRESS: 44i5 CLOVER LANE L07e lEi 61-UCKe 3 EDEM1d P.I,Ne: 18-22750-150-0.3 DESCRIPTION: RcPt ar_E szDtrIc Buildrn#, p?rmir. rvne SroitM oNmAec U?Uildin4 I?orN: 7?/pe Rci'HIR y?ensus Code i134 A1.1". RESIDENTIAL ? ?.. - REMARKS: FEE SUMMARY: CONTRACTOR: - Appticant=. -- =7, LzC? OWNER: CUST6M CDfdCEF75 CONST 18987290 :25142417 DAVIS CORFY 165qQ? KENRICK LOOI'(STE B 4435 CLO`dER i.ANE I.AKEVSI LE MN 55O44 Ef) (1) l',N PIP! »122 (67.Z) E,' 19 Q'-7i90 i I herPby acknowledcIe that 'C hcsve read thi,. apolicati4n and statra that the intormatinrA is correct anci aoree tti comply wil:h alY apPlicabJ,e SCatE nt hfii. SL;a'tit'tes and CitV Qf Eaqon drefinanres. , ? APPLICANT/PERMITEE SIGNATURE ??F a N UtiSUED BY' SIG-NKrUREI--- -1 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN ?-r 3830 PILOT KNOB RD - 55122 ' (651) 681-4675 v New Construction ReQUirements ? 3 registered site surveys ? 2 copies of plans (include beam & window sizes; poured fnd. desgn; etc.) ? 1 energy calculations ? 3 copies of tree preservation plan if lot platted after 711193 reqw2d: _ Yes _ No DATE: 1- Remodel/Reoair Repuirements ? 2 copies of plan ? 1 site surveys (extenor additions & decks) ? 1 energy calculatlons for heated additions CONSTRUCTION C05T; _Z, -7 '?1 DESCRIPTION OF WORK: STREETADDRESS: Lqll 35 C Orrr 9a.- v?D v LOT: 1 S BLOCK: 3 SUBD./P.I.D. #: sz?? V11- t V-WlC?,- Yhonc #: PROPERTY L't v F"g` O W"NL:lt StieetAddress:--- -------------- ----------- - City State: Zip: Comp:ury.. '4L_ 14-0 A/I L-C9 Phonc -e-9-D - - ---------------- r - ---- CON'1'1tACCOR ?? ?-y? p Stree[ Address: ? y„L y1?2ftr1 ' r ---__- -? _12 Ltcense # ?„?(y_,??t2_?-?P• Ciiv --------- ----?-"-------- -- Statc: _-- - ----- "Lip: ARCHITECT/ bNGNEER Coinp:iuN: N:unc: Slrcct Adc Ciq -- Sewer & water Iicensed plumber (new construction oni change and lot change is requested once permit is issued. Ylionc #: --------- Regs[ntion #: --- ------ - ------- --- Statc: ----------- Zip: Penalty applies when address I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. / G? Signature of Applicant: OFFICE USE ONLY Certificates oF Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)? CM'Y OF EAGAN 3830 PILOT I{r70B RD - 66122 ? 681_4676 ,-, New Construaion Reauirements RemodeVReoair Reauirements ? 8 registerad site surveys ? 2 copies of plans (inGude 6eam 8 window slzes; poured fid. design; etc.) • 1 energy celwlations ? 3 copies of tree preservaGon plan H lot platted afler 7/7l93 raquired: _ Yes No DATE: ? ?i oL9S ? 2 copies of plan ? 2 site surveys (exterior addHions & decks) ? 1 energy ealculaGons for heated addkions CONSTRUCTIONCOST; 61.7nQ DESCRIP N OF WORK: ST ETADDRESS: _ Vy35 (io?t.? Gqnot LOT: /-r BLOCK: .3 SUBD./P.I.D. #: ?e?ro i`?°?z7.sb-???3 ` ?°j 2?S 2yb2 Name: DG V ? 5 & rty Phone PROPERTY Last Fint OWNER StreetAddress: _ yy3S Cfc2?el City 912 State: ?"?? Zip: 53?'L"Z Company: 5,Aqrk-A- Phone #: CONTRACTOR Street Address: License # City State: Zip: ARCHITECT/ ENGINEER Company: Phone #: Nazne: Regisuztion #: Street Address: City State: Zip: Sewer 8 water licensed plumber (new construdon only): and lot Change is requested once permit is issued. Penalty applies when address chang I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applica6l 5tate of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ?? ?/ OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes _ No _ Not Required B? BL CITY USE ONLY SUBD. _ .?2? EACH 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 1.50 5.00 20.00 3.00 20.00 20.00 20.00 75.00 1998 PLLJMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3630 PILOT KNOB RD EAGAN, hIN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when pertnits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES Shower Water Closet Bath Tub Lavatory • ? Kitchen Sink Laundry Tray Hot Tub/Spa Water Heater Floor Drain Gas Piping Outlet ` minimum -1 Raugh Openings Water Softener "for dwellings under construction Water Softener ' for existing dwelling U.G.Spfinklef 'tordweliingunderconst. U.G. Spririkler `forexistingdwelling Alteration5 " to ezisting residence ? Water Turn Around Private Disposal System ` MPC iic. (new and refurbished systems) Private Disposal Systems * Abandonment RPZ (new installation only) x x x x x x x x x x x x x RECEIPT #: 01 JI ? ? 3 RECEIPT DATE: # TOTAL = 2000 20.00 = STATE SURCHARGE TOTAL m no 50 Z0,5a -- --------------------------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state thst tha infortna6on is correct, and agree to comply wkh all applicable City of Eagan ordinances. It is the applicanYS responsi6ility W notiy the property owner that the Ciry of Eagan assumes no liabiliry for any damages eaused by the City during its nortnal operational and maintenance activities to the facilities constructed under this pertnR within City property/right-of-way/easement. SITE ADDRESS: 'flWS Ll.?<O?e? (?orre OWNER NAME: ,- /t# (Jct ?i5 i \ INSTALLER NAME: 6?Py ?Ual ?i S TELEPHONE #: (o Fy l 74613 STREET ADDRESS: z-/V3 S- cfIedr,- 4-?e CITY: e? aqq.-? STATE: T /9? A? ZIP: 53- 1 ZZ SIGNATURE OF PERMITTEE CDlPERMIT FORMSlRPLBG PERMIT (RES) - 1998 q- 1I4S- LA/ B` ? CITY USE ONLY RECEIPT #: _ 7156 ? SUBD. h-x- RECEIPTDATE ? a5 g7 1997 MECHANICAL PERMIT (RESIDENTIAL). CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for. . single family.dwellings o townhomes and condos when permits are required for each unit New construction ? Add-on fumace Add-on air conditioning Add-0n air exchanger, i.e. Vanee system, etc. Date: FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge .50 TOTAL L, SITEADDRESS: G? 5n No?P(/L Cfy 00 OWNER NA INSTALLER ME: ?/????? Z?4LI ?l?L PHONE#:?Q?? NAME:P[2L,?LLa_6I, /?1( Z1?97?/CGrI PHONE#: STREET ADDRESS: Lk' ,) I 0 ' /r- n CITY: ? / STATE: ZIP: -?- IGNAT E OF P MITTEE PERMIT# d O RECEIPT DATE: ? 'I C7 ?V ( RnIDEPTIAI. PLUM$INe PERM1T APPLICATION crrY oFEasatx 3830 Pu oT icivos Rn EAs,qx, auv S5i sa 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system I?VC/Y SITEADDRESS: -1`1?l ? OWNERNAME:: 1W!JU` 141i11rULII? TELEPHONE#: ?? L4U)9l_W'l v9 (AREA CODE) INSTALLER NAME: 1W TELEPHONE #: ?V0 g^ STREET ADDRESS: lu?qD ?'n? Y V IIIA.oi ft (AREA CODE) CITY: AI.'1f.A .l r.hark mar4 narfi tn tha narmit wnr4 tuna STATE: I V 14V New residential dwelling unit under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existinq dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • waterturnaround Nature of work: ?4L ?- Septic System, new/refurbished - • $ 225.00 • includes County & Consulting Inspector fees • requires MPC license State Surcharge $ 50 Total $ Reminder. Be sure to schedule inspections of alterations, i.e. water I herebyacknowledge that I have read this applicafion, state that the information is correct, and a is the applicanPs responsibility to notlfy the property owner that the City of Eagan assumes no li operational and maintenance activities to the facilities constructed under this permit within City water softeners, etc. all applicable Ciryof E?gan ordinances. If ges caG§ed 6y th?ly during its normal RE OF PERMITTEE ' Updated 1f01 C1TY OF EAGAiV APPLlCATION FOR PERMIT SEWER AND/OR WATER CONNECTION DATE: PAYMMTd' QF k'EE AT TIME OF APPLIC'A'['ZON DOES AIOT COI1S`PIRL7M APPROVAL OF PII2F1I"P. INsPncizota oF sDmt r,rro/ox WATER IN=,r.TTONS wa r. rror Bs sc«n- UI.ID UNtII. PERMIT HAS BEET7 APPROS7ED. +?? *?? **» *?,r+**? *,r*?********,r * ** * ? P ease Print ? 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: Lot B ock Subdivision or Tax Parcel ID IF EXISTYNG STRL'L7LIRE, DATE OF ORIGINAL BPILDING PERMIT YSSL'ANCE: PRESE[7P ZONING/PROPOSID L'SE: P'bn Year ? ca44MCIAL/PEPAIL/0E'FICE ? R-1 SINGLE FAhffLY Q IbIDL'STRIAL, ? R-2 DL'PLEX (Two Onits) [] INSTIZ[7TIONAL/GpVERNNE?T ? R-3 ZOWNHOOSE (Three + Units) ( Dnits) • [? R-4 APARTlE]'P/CpNIDOMiDTIOM ( vnits) 2) ff?? NAME: I/iref? ADDRESS:?? c+' X / :2 ss - CITYe STATE, ZIP: S'?! 14?V' D/ i "q ??J.?i <? 7 5' PxoNE: y3 3 -- 5 % i 3D f?7?uw: ?: NAME: ADDRESS; CITY, STATE, ZIP: F PHONE: MASTII2 LICENSE# q) .?• °:u • NAtE: _ ADDxFSS; CITY. STATE, ZIP:J2 ? PHONEe '7 -ti - 5 SJ?I Active FStpised Not recorded Sta££?Initial 5) ? :? w• t a: • a?• : a • a? - ?? ? CONMC.'TION 'IO CITY SEFF7EEE2 F:?j CpNNID[,TION TO CITY WATER rl pTH0_ 6) ? ?• •?- ? PLEASE HOLD APPROVED PIIPMT FY)R PICK-C?P BY ONE OF A80VE ? PI,EASE MAIL APPROVID PERMIT 1U 2. ? 3, 4r A?SFE /? ? /? (Circle one) 7) .Y?r?7? '?l"/„ ?%_ .,/ /?, F4R CITY USE ONLY PERMIT # ISSUED 73?? / 7, ,I?, Pd w/Bldg. Permit FEES: $ $/4 ? So $ 8 /U Sa r ...* SEWER PERMIT (INCLLDE SORCHARGE) WATER PERMIT (INCLLDE SURCHARGE) $ T'? S U $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUIVT DEPOSIT - SEWER $ $ 16 'ACCODNT DEPOSIT - WATER $ d D U-? $ wAC $- h 7.?- ? S sac $ $ TRLNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ • LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRONK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ TOTAL ? 3? RE EIPT f RE EI T DOES LTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? 71 YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC Q NO ROADWAY" MUST BE DIVISION. LIST ISSUED BY THE ENGINEERING AS A CONDITION. SDBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY; TITLE: DATE: t CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION r*##i#**#************t********#?? DATE: PAYMFTTP QF FEE AT TIIME: OF r,PPLscxMoN DoFS Nar corb-rizcrrE APPR0VAL OF PERPffT. xNsrECTIori oF sEWEa nrm/ox MaEa IN$`LAiS.ATTQP7$ WjLS, b70'P $E $(HED- ULID UNi'IL PERMIT AAu BEQd APPROVID. *+,r*?s?x*?x**,r?******rtt*?+r*P ease Print) 1) PROPERTY ADDRESS: GJl'??,??? ??L i>?'r/-" ?/q,?{/?- •• LEGAL DESCRZPTION: - _ Lot Block Subdivision or Tax Parcel ID ) ZF EXISTING STRC'MRE, DATE OF ORIGINAL HLIILDING pg2N1IT ISSL'ANCE: ' ? . . P?? ZONING/PROPOSID L`SE: t"bn Year [] CONAMCIAL/RE,TAIL/OFFICE C] IAIDCSTRIAL, C] YNSTY'ILTIONAL/GpygtiZ= 2) 9? D711ME a ADDRESS: 0 R-1 SINGLE FAMILY ? R-2 DpPLEX (7.t,v L?nits) ? R-3 'IOWNEiO[JSE (Three + Units) ( C?nits) R-4 APARZMENT/COPIDOMINIUM ( Units) CITYa SPATE. ZZP: PHONE: c/S 3- 7% 3) • u i: ?• NAME• or City Use Pliunbers License: ADDRFSS: Active CITY, STATE, ZIP: ' Expired Not recorded PHONE: MASTER LI(ENSE# Star Initial 4) ..r • • i?• NAME° _ ADDRFSS: 93 ? CITY, STATE, ? PAONE,_??f?? •5) n «i r. • ?• : a s? - ? CONfIECTION TO CITY SEWEE2 fK CpNM?CTION 1O CITY WATII2 Q pUM '. . PLEASE HOLD APPROVfD PERMIT EC)R PICK-C'P BY ONE OF A&7VE -- ? PLEASE MAII, APPROVED PERf4iT 1O 1, r2; 3, 4, ABpVE (Circle one) /' /? 7) n r• u• - ?/?y // l/+':??>_ r.s.'rM U/ /r: /' LY%? ??/,SGN r? H /_ ,c[r _. ? FOR -CITY USE ONLY ? PERMIT # ISSUED -73v z 1,F6 Pd w/Bldg. Permit FEES: $ S /D - S--b SEWER PERMIT (INCLUDE SURCHARGE) $ $ /0•S_6 WATER PERMIT (INCLUDE SDRCHARGE) $ 3,5 v $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP $ $ l S ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ WAC $ SAC $ $ TRLNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRLNK SEWER $ $ LATERAL BENEFIT/TRLNK WATER $ WATER TREATMENT PLANT SURCHAR E G $ $ OTHER: `S--o $ TOTAL RECEIPT RECEIPT DOES LTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES Q NO IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MLST BE ISSUED BY THE ENGINEERING DIVISION. LIST AS A CO[VDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE; ?/ ? 3 i CI1'Y OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTT: PAYMEW OF kEE AT TIME OF APPLICATION DOES NOT 0ONSiZR[Ti'E APPROVAL OF PERMIT. nasPncr?torr oF sEWM nrm/ox Vm= 7Nc•rars_nmrONS WIIS. NOT BE SQ-IFD- UIED UNT7S, PER1'-ffT HAS BEEN APPROVED. +?***f#**?********+***t*+*******#* (Please Print) 1) PROPERTY ADDRESS: 1A137- ? F. ??.Y E . _ LEGAL d)ESCRIPTION: _ Lot B1ock Subdivision or Tax Parcel ID Tr EXISTIM STRCCiSJRE, DATE OF ORIGINAL BUILDIIVG.PEE2MffT ISSL'AP1CE: ? . - PRESENt' 7ANING/PROPOSID USE: Mon Year) q coI'VERcIAL/xErnir./oFFicE [] IDIDC'S'TRIpI, (] INSTITUTIONAL/GpVUWMT 2) KN;7r? . [] R-1 SINGLE FAMILY ? R-2 DLPLF.x (Tr,a pnits) f? R-3 TUWNIIiOC?SE (Three + Units) ( LTnits) R-4 ApARTNENT/CpNDpMINIC,M ( Units ) NAME:?/c???sc7iy ADDRESS:? ? V -- CITY, STATE. ZIPs SC q N C?, sa ,?',? PHONEeL/33 7 .i) putuv- :laA- NAME: ADDxFSS: S ff /?iE CITY, STATE, ZIP: gHOM: MAST'ER LICENSE# ? 4) ??• • ? - NAME: ADDRESS: cm!!? /-/v ;?, -: CITY, S"fATE, ZZP: Q PHONE s? Active Expired Not recorded Staff InTtial '5) ? ? ?• ? i ?• . ?. . : a • o. - ?? ? cocarEcrioN To cizsc sEWER ? wNrmcTZON Zo ciTr wa,TEu rl oMM . 6) ? '?- •?• Q PLEFV.,E HOLD APPROVFD PERMIT FC)R PICK-PP BY ONE OF ABOVE --- -- ? PLF.ASE MASL APPROVID PEI2MIT 7O 1,2'd 3. 4. ABOVE 7) r.??: ?u: • ,P'" rt?? ??, fi ?? ?CSfcle one). , j / . FOR -CITY USE ONLY PE IT k ISSUED 7 ? Pd w/Bldg, Permit FEES: $ $ $ $ / $ $ " $ $ $ $ $ $ $ ? Sr u--b s gao. ? $ $_ r??J 7S, 6--e) $ $ $ $ $ $ $ . $ $ $ $ $ R ECEIPT 33 RECEIPT F , ` SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLODE SORCHARGE) WATER METER/COPPERHORN/OL'TSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOONT DEPOSIT - WATER WAC SAC . TRLNK WATER ASSESSMENT TRONK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRONK WATER WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL DOES UTILITY CO[VNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MLST BE ISSUED By THE ENGINEERING A1O DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: TITLE: DATE: CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION ? R-1 SINGLE FAMILY ? R-2 DL'PLEX (74,p Dnits) ? R-3 TOWNHOUSE (Three + Units) ( L?nits) R-4 APARTMENT/CpNDpMIb7ICTM ( Units ) ? 1) PROPERTl° ADDRESS: LEGAI, DESCRTPTT(1U• - Lot Block Subdivision or Tax Parce ID ) IF EXISTING STRL'CIURE, DATE OF ORIGINAL HL'ILDING PERMIT ISSL'ANCE; . i . PRESENT ZONING/pROPOSID L'SE: (Mon Ye? COI41ERCIAL/RETAIL/OFFSCE Q IbIDPSTRIAL ? INSTIZiPl'IONAL/G0VII2fAMjr 2) ? NAME:- f ADDRF.$5: / CITY, STATE, ZIP: ? PFiONEe ? • 3) NAhIE: .4iUDRESS e j CITY, STATE, ZIP: PHONE: 4) ..• • ? NAhE:? ADDRF55e I(/ CITY, ST'ATEr ZIPe '?`?,? ?_c?.C_? - a PHONE: 7 ¢() - MASTER LICENSE# ATCYl?': PAYMFNr' OF FF.E AT TIME OF APPLICATION DOFS NOT CON','FZ2[TIE APPROVAL OF PERMLT. nvsPECrxotv oF° sEWmt AND/ox MM aSTALT.amIors wIIa. Nar $s scHEn- UI.ID UNTIL PFI2NIIT HAS BFEN APPROVID. Active Ecpired Not recorded St? Initial •5) ?:? v? d• •?• •ia ae avM?? ? CONNF.CTION RO CITY SEWF:R ?- CONNEGTION TO CITY WATER 0 OTIM 6) " •-• i' [? PLEASE HOLD APPROVF9 PII2MZT EC)R PI K-[JP BY ONE OF ABOVE -•--- ? PLEASE MAIL APPROVID PERMIT TO 1"L3, 4, ABOVE ' (GTiicle one) 71 r ru• - FOR CITY USE ONLY ? ?• _ PERMIT # ISSUED 30 V ?Pd w/Bldg. Permit FEES: $ $ lCJ ' S-D SEWER PERMIT (INCLLDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SURCHARGE ) $ $ WATER METER/COPPERHORN/OC`TSIDE READER $ ' $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /?- rt-U ACCOUNT DEPOSIT - SEWER $ $ L`Ti ACCOONT DEPOSIT - WATER $_ <<?-7C D c?-p $ WAC • $ $ SAC . $ $ TRLNK WATER ASSESSMENT $ $ TRLNK SEWER ASSESSMENT $ $ • LATERAL BENEFIT/TRLNK SEWER $ $ LATERAL BENEFIT/TRLNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ TOTAL /' a ? I/ R ECEIPT RECEIPT DOES LTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC Q NO ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION LIST AS CONDI ION . . A T SOBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: ?r? TITLE: DATE: 37 PA6E 5q r AOBE (?ING CONSULTING PLANNEFIS o dGIAND StUBYEVOAS COMPRNY, INC. < 1000 EA57 1461A STpEET, BURNSYIILE. YIHHESOTJI 55337 PN 432-3000 CeT?Z?ZCCt? S'I?C7'YB[? Qr-yC?"4p21ofZ • LOTS l3, 14,15 ANU /bj BLOCK 30 EDEN ADDITION, DAKoTA COUN7Y, MINNESaTA C9$s?o ; pENO'TE'S (1156,c) DEMOTES -o lNOicATrS 933.0 = F'lNISNEL7 NORTH SCALE : 1"= 30' DRAlIJA6E AF.ID u71LITY EASEMENT ? ? ? V r ? - ? ` ; /. N Ip? ? P? ? `60 3?? w, `\ I I Q;r . m? LoT ?o 14 Q?Qv .-? v F s4 / ?a ?Q?`- ? CLOVE/z \\o., LANF Ex157'/i16 ELE-VA"TioN PROlt7SEU ELE'yf]T/oN DIRECT/OA/ OF S[hQF/aCE" DRA(NA6E GAh'l?SE F'LOOFt' 6LEVi4771OW N 89° 58' 02" E / 59: 22 116.9) ? i ? L07 /3 ?2) )Y Ja`,? R a? . . \ .' , ca . t J ? I L? / ? s 6 aa \1 ? 29 • ? 07 3? ?a„ j 1 \ ?/ ° LoT f / 19\2 ei ?q? / 0 , 5 e'l Inl 3, 6-1 37.72 - -? I ( I LoT /b T h ? l o , O ? Z I5 . ,t 1 l?? 1 1.' --4 Lr ; 1 \\/ 30' FRON7 8UitAlN6 SETflACK L /NE 3o x zb' I 1?ere?by certify thet thia ie a true and correct n prneentation of a traat of land as shown'and deacribed hereon.. As praparnd by me on this 7*1 day of InA?e? i( ? 19 8e- , . 'v?A. ,E 1Sinn. ltes. No. y0 ?? /,9-3?i?- a ?rS32 ?2 PERMIT CITY QF EAGAN 3830 Pilot Knob Road - Eagari', Minnesota 55122-1897 (612) 681-4675 PERMITTYPE: auzLozNG Permit Num6er: 0 3 3 2 3 6 Date Issued. 0 9 I 18 J 9 8 SITE ADDRESS: 4435 CLOVER LANE LOT: 15 BLOCK: 3 EDEN P.I.N.: 10-22750-150-03 DESCRIPTION: B,pv,jj,dJ:-dV_,.PermiC iype Efw,?ldarig_"kqrk Type ,.. ?w,.?. g,Ce?rsus,,.ctrde % - ? s'a a '. ? t4 ?g'? 3 i<<?ov@.?aw?Y? ?'ark`u ?S•n5ew{n.??'?"vv. t KK 8R5EhIENT FINISH flL7ERATION 434 ALT. RESIfIENTIAL ? Mr! J?i'i5'svreI4 ?q:f Liu ilumL ` ^ 3 " t?i ?"g• . J WrvrY Rlk.'a+ lq? aTtb?°e dj??+ rv ?g?q? :gU'25 ?$ki ri m'F',?n P?3-a:? ...i? i ?? i?+w R » ?{ wr 6i {b.v ?5?= ??•W, g ?? 12 5g91F REMARKS: PLAN REVIEWED BY WAYNE MILLER. SGPARA7E PERMIT REQUIREQ FOF2 PLUMBING WOf2K. CALL 445-2849 REGARDING ELECTRICflI PERMIT AND TNSPECTTON_. FEE SUMMARY: Base Fee $50.00 5urcharge _ ?50 Total Fee $50.50 CONTRACTOR: ? x_ I OWNER: - DAVIS 4435 GL EAGHN {651)205-2902 Applicant - COREY OVER LANE MN 55122 ° Z her'4thy a,ckrrawleJg.e I ha-V?; -stati, tY??t tb'c?_ ? in??rrm_?traii:.iscrt?:=rreeC, a'nd; agre', Ctr th app?icabSS Sta te.resf 11,P:?. ' 4ZCAPPI nd' ?? ty' a'Fag?rs €krtt=1_n :?rrceg ,. ? _n . ? ANT/PFRMITFF AIGNATI TI IRF?` UE? BY' SIGNATUR? r" - - - - - - - - - - - - - - - - - error Office Use j j Rlq~ Permit yCI of a~ Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I~ 0 Site Address: q L13 CL A Tenant: Suite M RESIDENT / OWNER Name: (-LI 1~7 Phone: Address/ City /Zip: L 43 CLOVE-A- L-fV r'-1 Applicant is: Owner Contractor TYPE OF WORK Description of work: V j w IS1 / L~7"l z Construction Cost: 6 r Multi-Family Building: (Yes No 1 3 P CONTRACTOR Nam 16N &Fn__~_ License 6 20 Address: '300 City: L/tLA16 State: 11'1 ✓ Zip: g) am/ lf~ Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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. 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 F/41 L- /2 OH/z/ C,-",L- xy eM=S==Q_ Applicant's Printed Name Applicant's Signature Page 1 of 3 40~ I For Oif<ceUse I 1 Permit City of Eapn I Permit Fee: ! 3I) I CJ~ 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 i staff: 7 Fax: (651) 675-5694 1 I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION L_( - - Date:' 7 - Oq Site Address: 100 L1tV Tenant: Suite RESIDENT / OWNER Name: o p r TL m)~ _WkL'r 4-SO ✓i i~i PPhone: Z - 2 ~ 2 - 6I.a Address I City / Zip: Applicant is: Owner _X_ Contractor TYPE OF WORK Description of work: !r, r^ Construction Cos d • 00 Multi-Family Building: (Yes No ) CONTRACTOR Name: 'j c, Is . .46o 'Kt (_X I M PA+5License c Address: o 2 o City: ran, " ( ' 00 Statue: /r) IV Zip: ~ Z Phone: 6i 1 _ Contact Person: &2!" k tle,] L5 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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 am 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. 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 _hr f .0 L'4 t_)c s> x ~ 0 =ko~: Applicant's Printed Name Applicant's Signature r~~ Page 1 of 3 ~1I / Z (t,~ DO NOT WRITE BELOW THIS LINE SUB TYPES ❑ Foundation ❑ 05-plex ❑ 16-plex ❑ Accessory Building ❑ Pool ❑ Single Family ❑ 06-plex ❑ Fireplace ❑ Porch (3-season) ❑ Ext. Alt. -Multi ❑ 01 of - Plex ❑ 07-plex ❑ Garage ❑ Porch (4-season) ❑ Ext. Alt. - SF ❑ 02-Plex ❑ 08-plex X Deck ❑ Porch (screen/gazebo/pergola) ❑ Multi Misc. ❑ 03-Plex ❑ 10-plex ❑ Lower Level ❑ Storm Damage ❑ 04-Plex ❑ 12-plex ❑ Miscellaneous WORK TYPES ❑ New ❑ Interior Improvement ❑ Siding ❑ Demolish Building' Addition ❑ Move Building ❑ Reroof ❑ Demolish Interior ❑ Alteration ❑ Fire Repair ❑ Windows ❑ Demolish Foundation ❑ Replacement ❑ Egress Window ❑ Water Damage ' Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation Occupancy MCES System Plan Review Code Edition- SAC Units - (25% 100% Zoning- City Water Census Code df 3yl Stories Booster Pump # of Units Square Feet GO PRV # of Buildings _ Length Fire Sprinklers Type of Const.~ Width REQUIRED INSPECTIONS Footings (new bldg) Sheetrock Footings (deck) Final/C.O. rl~- Footings (addition) Final/No C.O. Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace:_R.I. _AirTest -Final Windows Insulation Retaining Wall Reviewed By: , Building Inspector RESIDENTIAL F S: Base Fee J.3D Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Page 2 of 3 ti OD CD i pi ~ ~ ~~EPrE~4N D ~ 91: NP, JI.A s Use BLUE or BLACK Ink r For Office Use I 1 j ~ Permit City of EaRd~ I 6~ Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: 2 ~o'/ Z Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: t~ I I I 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7-2 L Site Address: Unit Name: Phone: RESIDENT / OWNER Address / City / Zip: Ll 5 Gov Z_ Applicant is: Owner X_ Contractor Description of work: fie N~qC TYPE OF WORK Construction Cost:ko0 Multi-Family Building: (Yes / No ) Company: 0-ec/-c s by Trams Contact: 70/1 CONTRACTOR Address: 4 -epc ~l~z City: State: ,4 IZ--*" Zip: 2 ~ Phone: 61Z 2 6 U ;7Z License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) L } is fr 7 t_ 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 they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 Minneso tate Building Code must be completed within 180 days of p mit issuance. Ap cant's Printed Name Al; 'cant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES II3~ C ~d✓e r ~4 Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows _ Demolish Foundation Replace Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25% 100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: L , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge SSW Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Date: C!ty of kali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink r � For Office Use Permit#: /0q ( / 0-7 Permit Fee: 0 - Date Received:' --y-13 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Unit #: Resident/ Owner Type of Work Contractor Name: 6J Address / Cit / Zi c/ r Phone: Applicant is: Owner ,�j' Contractor Description of work: Construction Cost: t ems Multi -Family Building: (Yes / No ) Company: ,r /41r �=� -77 Address: 5 (U t.� if 4 , 5 Contact: State: j'" '/ Phone: License #: „". 1, ), ;� City: r/ c f -/1I L/ / Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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 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 they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in 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 A ppf icant!s-P r+nted -Nam Al!,/')/„.6-ei/ p eant's-Signature Page 1 of 3 Fram:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:35 #582 P.032/079 Use BLUE or BLACK Ink For Office Use I 6 ; Perm it# City of Emu 11 S Permit Fee: I 3830 Pilot Knob Road f~I 1 Eagan MN 55122 I Date Received: t 1 7 Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: ct 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: q 15 2D13 Site Address: 4435ILWIISibi 1~~1y37 B CIoYfXX Lflnei unit Name: ~~Pi ~IgSST,17 ~OrhDOlf'N Phone: Resident/ h prg(rie. MN [ CgCgNL4 Owner ;Address /city /zip: "f30 Gi 1 n wCSt Parkyrrav t I Applicant is: Owner Contractor Type of Work Description of work: My off q ye -lTd T Construction Cost: I'1DD 60 Multi-Family Building: (Yes /No Company: AJl t wt~M WAUt/l rLU-, Contact: i0t IlafAU f Contractor Address: 51y5 ihdUStrial stee+ * ID3 City: Mot IRAIn State: 4 _ Zip: 551;J' 1) Phone: "ICJZ- 9LQ - 1L4(;9 License BC 1o315-15 Lead Certificate NA'T Wgf04-f) If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) z 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: t i Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that t M atat! trade secrets ^ µ aaW 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.aooherstateonecall.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 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of 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 I X Jut Applicant's Prin ed Name Appl cant's Sig ature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 12:54 #301 P.003/022 401111' City of £aall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675.5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use 6-5t 2 Permit Fee: Permit #: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 4o7d4o44p Site Address: Resident/ Owner Type of Work Contractor 0/35- W37 £/i/4 L.An� Name: 39(//4 r ,P6/� -' �.1 874 No,4 /, Address /City / Zip: `�7 l3S rf77 �1d✓ %,77g Unit #: �,r8 Phone: /t///, plicant is: Owner Contractor Description of work: A* -.S/4 W/ 1n y/ 5.7eZr lr' "Pr, Construction Cost: 11:R6.) a Multi -Family Building: (Yes / No ) Company: A I I 4LE 61$40-c4441'01,1 , j /fir/ 1 rfl ee Contact: J I W% A al t' rn er n Address: St 4!S 1nafwS4-rrAE S77-S`fad-t /03 City: Jv1 p/e- RA -14 State: ms! Zip: 5'535' Phone:154,-90.7161 Email: ,16//S-/,. 4 License #: 136 GJ9'O3S 0 Lead Certificate #: AMI - 074;910V If the project is exempt from lead certification, please explain why: 5 k ;,4 X993 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: 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 they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq 1 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 Buildin yu: mpleted within 180 days of permit issuance. 'i \ AilliMan Applicant's Printed Name Applic nt`s Signature Page 1 of 3 oo�. •tee®EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(a2cityofeagan.com -------------- For Office Use I I Building Permit #: I I I I S&W Permit #: Permit Fee: I I I I I Date Received: I I I I I I Date Issued: I---------------------J RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3h qhQ23Site Address: Unit #: Applicant is: ❑ Owner Contractor Name: �G(�t/� b vy`e— (t> - tr-�Q_v' S'S b C'_ I ct-4 i 6 lf, Homeowner Address: 14R A JR city: o` State: i Phone: Email: Description of work: 2 Q C3 Type of a q Work Construction Cost ` Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan Q Building Address: �� it"� WQS'T� City:_FVGQ\-,C-l� Contractor / '/ State:&&6p: 5 Z Phone6t ZJIf 5- Email. vtke Z Cr�co S cp - 1_ License #: Expiration DateEL Sewer S Company: Contact: Water Contractor i Address: City: Required for State: Zip: Phone: Email: new construction License #: Ex iration Date: 1�I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications. 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 they are trade secrets. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.00pherstateonecall.org for protection against underground utility damage. Contact Gopher State One 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. Applicant's Printed Name A licant's Signature