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4448 Clover Lane Use BLUE or BLACK Ink For Office Uee ! ! 4 of Eajan 1 Permft#. Permit Fee: 31 I 1 3830 Pilot Knob Road 1 1 Eagan MN 55122 ! Date Received: ! Phone: (651) 675-5675 1 ! Fax:(651)6764694 i L-----------------~ 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: _ 9 _ / Nite Address: 'i 41 1-f 9 C-k {I a M _r Ly, AL., f Tenant: (4, A) b-,e yv, j Suite #I• RESIDENT I OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor hh TYPE OF WORK Description of work: , : l n e It tC, a D c -er ~c~ su= Construction Cost: 11~ 1122 rr~ Multi-Family Building: (Yes J No 3 ® C~ CONTRACTOR Name: e c t~~sb Ln e-- License* Address: _ 19 a S A~y- A) City: r"9 r c~c State: 111 A) Zip: y~ 12 S~ Phone: -7,97? - -7 S? 3 M Contact: J Ga C'.& ~l Email: Ch ~~•k sel e% r7 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 suppordng;docwnents that you submit are considered to be public Inknnadon. Pbrfons of the In wmadon'way be classiiW as non public if you proviide specific reasons that would permit the City to conclude that 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. wvuw.aooherstateonecall.ora i hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that ! 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 f plays;. h R Applicant's Printed Name ! A s Signature Page 1 of 2 JUL 1 9 Z010 I-I DO NOT WRITE BELOW THIS LINE q~61aq SUB TYPES 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 400 Occupancy AL MCES System Plan Review Code Edition - SAC Units (25%_ 100% z Zoning City Water Census Code Stories - Booster Pump # of Units Square Feet' PRV # of Buildings Length $ Fire Sprinklers Type of Construction VP-A Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC 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 Meter Size: Radon Control Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES T ZZ" P,6ek Base Fee 73 Surcharge Plan Review ? MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies -J~ ...TOTAL Page 2 of 3 ,ROSE ENGINECRING `PLANNERS andaLAND SStURVEYOAS COMPRNY, INC. 1000 EAST 1461h STREET, BURNSVIL.LE, MINNESOTA 53337 PH 432-5000 Ceipm zevi CCLA? C, Z.~Q'al .QUrr4ogion:: LOT5 44, 45, 46 AND 47, 6LOCK. EDEN ADDITIW, DAKOTA COUNTY, MINNESOTA CWF-91 DENOTES EXISTINIG ELEVATION (923.5') DENOTES PROPOSED ELEVATIU/U -00- IIJDICATE5 DIREGTIOP,1 OF 5URFACE- DRAINAGE 92 3:5"O = Fl-wJ514ED (:MRA66- F4OO2 r-LEVA-r10A1 NORTH SCALE CLOVER LANE 922 0 • ~ o p= R 4 poi 5 89° 5802" m -o t / 2 5.06 l922. 1. • 1.= 2 6(0.06"919.x,` , 916.3) o ~ 59.00 0 ;922.0, ' _ 9/4.4) 1 30 FRONT BUILDtN6~ X92 9 z 922.61 ~J SETBACIG LINE ,.a 44.67 0 • LOT LT ' W 4 ykw~- 4 I ~ !0 PROP SED t c4- . r 14 r r N N t'n t N 89 578, N UNIT 59.00-- h %-l ~o EAGAN / z _ J REVI WEB, 923. BUILDING • BY. N ~ 22,5) o DATE: 4+ \ 9zs' 6, ` zS t E'ILDIP,IC :`.1TIONS DIVI IM ( 3 2as) 9 a LOT N , N LOT 44 DRAINAGE AND \ o l5 UTILITY EPwEMEWT 930.oj _N (930.0) i 35.459299' 59.01 ~929,9 (929.0) 5 89° 58" 62"W 5 88° 55' 17"W I hereby certify that this is a true and correct representation of a tract of land as shown'and described hereon.. As prepared by me on this day of NhVEMBE2 , 19,9 . ~111nn. Reg. No. A:. eG~ y` i s- . , ? - CITY OF EAGAN 12 V ?/i 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ? BUILDING PERMIT PHONE: 454-8100 Receipt # [ C Te bo wnd fm ? • Est. Val ue Dat e Site Addresa Erect ? Occwpancy ?•,I): .. Lot ' Bbck Sec/Sub. Remodei ? 2oning Parcel No Repair ? Type of Const. . Addition ? No. Stories Move ? Length Z N?e . Demolish ? Depth ? Address City Phone Int Impc Install ? ? Sq. Ft. Name wpprovom ? uv Address Assessment i ? ? f- City Phone Water b Sew. ' Police u? ?W Name Fire ?? Addresa E?, &W City Phone Plonner ? • Countil - I hereby atknowledge that I have read this application and stote that Bldg. Off. fhe inlormotion is correct and ogree to comply with all applicoble Permit ' 1-' . f1 ' I Surcharge Plan Review i. 5 ?• • ?' ? snc Water Conn. 500 • C Water Meter -6T.7D 0 Road Unit T.of ? Stote of Minnesoto $totutes and Giry of Eagan Ordincnces. APC I Parlcs ? Var. D " ate C?ies Sipnoturc of Permiftee - '- ' • ? . ?, .: _ _, C.'. Total ' . ? . ?'. h Building Permit Is iuued to: .? on the exprcss condition Ihat E ? oll work sholl be done in occordonte with oll oppticable State of Minnesoto Stotutes ond City of Eoyon Ordinonces. PKmit No. Pe?mit Holder Data Telephone it Plum6inY L. fC,?. (SCi7Z H.V.A.C. E??? ACV Iry Softwwr Inspeetian Date Insp. Other Footinga I Footings 11 Foundatlon Framing Roofing Rough Plbg. Rough Htg. Insul. FlreFlaCe Final Htg. Fin81 Plbg. Final cervocs. .23-? GGt Water Describe Locstion: Weil Sewer Pr. Disp. PERMIT # PWMBING PERMIT RECEIPT # C-' LJ CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE ?- Sec/Sub. Name FEES %IND FEE - 1% OF CONTRACT FEE 1M - RESIDENTIAL FEE - $10.00 1M - COMM/IND FEE - 20.00 SURCHARGE PER PERMIT - .50 50 S/C IF PERMIT PRICE GOES D $1,000.00) BLDG. TYPE WOAK DESCRIPTION Res. C New ? Mult Add-on Comm. Repair Other NO. FIXTURES C TOTAL Water loset - $3.00 -7-Bath Tubs - $3.00 s " I Lavatory - $3.00 - Shower - $3.00 T- Kitchen Sink - $3.00 Urinal/Bidet - $3.00 ? Laundry Tray - $3.00 ? Floor Drains - $1.50 - ` TWater Heater - $1.50 , Whiripool - $3.00 Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 _Rough Openings - $1.50 a FEE STATE S/C: ? GMND TOTAL: " ? ' ? PERMIT # RECEIPT # DATE CITY OF EAGAN MECHANICAL PERMIT 454-8100 MINIMUM RESIDENTIAL FEE - $10.00 + $.50 MINIMUM COMMERCIAL FEE - $20.00 + $.50 FEE S/C TOTAL 1. Bldg. Type: Res L_ Comm inst 2. New k" Add Alter Repair , . c. 3. Total Bid Price 4. JobAddress r(` I ? Lot.?? Black 5ec l7???' ? 5. Owner (-r-427 6. Contractor ? ` ? ?'?` !-'?•r?.a? r -? 1e? + r tsuf,?v , ?'X . ?( • ?. ? ;y . /i ?.Zvn ( ?rti,?3.t,ef?r blkj J SGC, b (Name) (Sheet) (Ciry) (Zip) 7. Contractor Phone # 'c?;.S 1• 5?, 7 ? RESIDENTtAL HEATING - ' 01-100,000 BTU's,- $24.00. Each additional 50,000 BTU's or fraction -$6.00 RESIDENTIAL COOLING - 01 -24,000 BTU's -$12.00, Each additional 6,000 BTU's or fraction -$6.00 MODIFICATIONS/ALTERATIONS -$10.00 minimum fee `? HEATING VENTILATING HOT WATER STEAM AIR COND. eIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG. RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE. Signed: for , l Approved Inspections: Date Rough Insp. Date Final Insp. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 eUILDING PERMIT 2ece?pr 17249 , ?• ? Site Address Erect ? Occupancy Lot Block Sec/Sub. F'7':Ir Remodel ? Zoning Parcel No Repair ? Type of Const. ? . Addition ? No. Stories tv W Name ' Move Demolish ? ? Length D h ; . ( Address . Int ImPr. ? ept :. ~ ?,Ft. b ..r? ? r Citv Pnone 7P.-V_> '' 1 Install O Z? Name b? Addresa u r1} V Phl1IlP Name City Phone I hereby ocknowledge thot 1 hove reod this opplicotion ond stote that the informotion is Correct ond ogree fo comply with all applicable State ot Minnesoto Stotutes ond City of Eoqon Ordinances. Sipnaturo of Permittes ? Buildinfl Permit is issued to: dl work s1w11 be done in ocoordonte with oll opplicoble Stote of Mir luildinp Officiol Asseumen t ? C1 f Permit r 112 Water & Sew. 3urcharqe •: ? • ,? ? Police Plan Review Firo SAC Eny. water Conn. J Plonner Water Meter Council Road UNt ; Bldg. Off. Tr. PL ?_ 1) APC P8rk8 Var: Dote Co ies p ? ' . . Total a? tFN express toriditio.+ Ihot esota Stotutes ond Ciry o4 Eoqon Ordinaneas. Pnmh No. Pamk Holdw Daft Telsphone ?k Plumbina 1 C_ CSl'l. S? H.VA.C. Ehmldc Sic. q Ij Softemr Imwoction Data Insp. Other Footings 1 V,14 Footings II Foundation Framiny Roo(Inp Rouyh Wbg Rouyh Htg. Imul. ,5 FiroptaCs Flnsl Htg. Final Plbg. Final ?.. ? C+rt/Occ. Wator Desuibe loeatioe?: Ws11 Sew?r P?. Dlsp. PERMIT # CITY OF EAGAN FEE MECHANICAL PERMIT RECEIPT 454-8100 S/C ?i MINIMUM RESIDENTIAL FEE - $10.00 + $•50 TOTAL DATE MINIMUM COMMERCIAL fEE - $20.00 + $.50 1. Bldg. Type: Res ' Comm Inst 2. New L-' Add Alter Repair 3. Total Bid Price 4. Job Address '`?'-? -= C;i` L%'C "?,•'f.•', V}'L Lot Block ? Sec 5. Owner r!/,2ht L 6. Contractor , i ' ?-iC?t?,c.t?,? ` ?'i.?? ?? ? .?!•• : i ,i. ?? JL(.?/ll ,'l, a'.??rK_?c?s?l/J :;.'?[?;ti (Name) (Street) (City) (Zip) 7. Contractor Phone # RESIDENTIAL HEATING - ?. -100,000 BTU's -_$24.00. Each additianal 50,000 BTU's or fraction -$6.00 RESIDENTIAL COOLING - 07-24,000 9TU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00 MODIFICATION5/ALTERATIONS -$10.00 minimum fee HEATING VENTILATING HOT WATER STEAM AIR COND. ?141R PIPING PROCESSED PIPING AIR HAND. EQUIP. RCFFi1G. RES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $7,000 OF FEE. ? . ; r: Signed: Approved Inspections: Date Rough Insp. Date Final Insp. I Name y' ;•_ c_ c ? Address ? ?.,...<c ? Name Addrep, ?-? ?' ) City Q''?c?,:. ?? PERMIT # ? 7 PLUMBING PERMIT RECEIPT # CITY OF EAGAN , 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Sec/Sub FEES D FEE - 1% OF CONTRACT FEE - RESIDENTIAL FEE - $10.00 - COMM/IND FEE - 20.00 RCHARGE PER PERMIT - .50 S/C IF PERMIT PRICE GOES CITY OF EAGAN BLDG. TYPE WORK DESCRIPTION Res. New _ Mult Add-on Comm. Repair . NQ. FIXTURES TOTAL Water Closet - $3.00 TBath Tubs - $3.00 $ =Lavatory - $3.00 I Shower - $3.00 / Kitchen Sink - $3.00 ? Urinal/Bidet - $3.00 / Laundry Tray - $3.00 $1 5 = ` ?- . Floor Drains - 0 / Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 ' Softener - $5.00 Well - $10.00 I -Private Disp. - $10.00 _ I - Rough Openings - $1.50 I FEE STATE S/C: GRAND TOTAL: ? a - . • ' CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 QUILDING PERMIT Receipt OQ:1 Site Addresf 4 • ~ ? t ' ' _ 't < L t ] 'i'i'vN Lot Block Sec/Sub. Percel No. W Neme ; Addrecs b 7- I vC ,? Name O? Addresa ? City Phone 1 hereby acknowledge thot I have reod this opplicution ond stote thaf the info(mation is oorred and agree to comply with ali oppiicabte Stote of Minnesota $tatutes and Cify of Eagon Ordinontes. . A 9uilding Permit is issued b: ;- oll work sholl be dons in ocoordance wlth ? Buildirq Official '' n 5 i Erect U Occupency Remodel ? Zoning Repalr ? Type of Const. Addition ? No. Stories Mrne ? Length Demolish ? Depth , Int Impr. ? Sq. Ft. Instell o App.o.ols F•es /lssessmen f Permit •`' ? `?• ? ? Woter 8 Sew. Surcha?pe Police Plen Review '=a ? • Fire SAC Enp. weter Conn. 5 U;. . Planner water Meter 6 •' ' Countil Roed Unit Bldg. Off. Tr. PL 1-. APC Perka Ypr. 4ate C?les Total on the express tondition Ihat nnesota Stotutes ond City of Eoqon Ordinonces. e State of Mi R!-,% 11247 Pwmk No. Pwmk Holdar DaN TeIsphane # ?unmibi,qg HMA.C. elsewe -- SoitN»r Irapadion Date Intp. Other Footings 1 Footinys 11 Foundalion Framinp Rooflny Rough PIb9• / / Rough Htq. Intul. Firoplsce Flnal Htg. ? Finsl Plby. 6 ,. . Final Grt/Occ. wstw Describe Location: Well Sovrer Pr. Disp. . PERMIT # ??d U CITY OF EAGAN MECHANICAL PERMIT RECEIPT # 454-8100 MINIMUM RESIDENTIAL FEE - $10.00 + $.50 DA7E MINIMUM COMMERCIAL FEE - $20.00 + $•50 1. Bldg. Type: Res Comm Inst 2. New Add - „ 3. Total Bid Price 4. Job Address i • FEE _ s/C _ TOTAL Alter Repair Lot Block Sec 5. Owner 6. Contractor 7. Contractor RESIDENTIAL HEATING - RESIDENTIAL COOLING - s-$24.00. Each additional 50,000 BTU's or fraction -$6.00 -$12.00. Each additional 6,000 BTU's or fraction -$6.00 fee HEAT{NG VEN'TILAT1t.iG HOT WATER STEAM AIR CONp. ?AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RrFRIG. RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER COMM./IND. RATE - 1% QF TOTAL BID PRICE PLUS $•50 STATE SURCHARGE FOR EACH S1,000 OF FEE. Signed: for i'Ir;-t °..•., Approved Inspections: Date Rough Insp. Date Final Insp. • • PERMIT # PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAO, EAGAN, MN 55121 DATE: T PRICE: PHONE 454-8100 ;s ' "' • • . ; BLDG. TYPE WORK DESCRIPTION Name , /; C_< t* (I Address City, ` Name Addr City Sec/Sub Res. ? Mult Comm. New LAdd-on Repair FEES VD FEE - i% OF CONTRACT FEE I - RESIDENTIAL FEE I - COMM/IND FEE JRCHARGE PER PERMIT I S/C IF PERMIT PRICE GOES $1,000.00) , NO. FIXTURES I Water Closet - $3 00 . TBath Tubs - $3.00 - 7 Lavatory - $3.00 Shower - $3.00 ? Kitchen Sink - $3.00 Urinal/Bidet - $3.00 T Laundry Tray - $3.00 $??? ?Floor Drains - $1.50 20 00 Water Heater - $1.50 50 Whirlpool - $3.00 Gas Piping Outiets - $1.50 SoRener - $5.00 W II $10 00 70TAL =' O n e - . Private Disp. - $10.00 ? Rough Openings - $1.50 FEE - CIN OF EAGAN STATE S/C ? G ---. ? , GRAND TOTAL• ? ` Z-r`-',`.-;. . •1,. j eUILDtNG PERMIT CITY OF EAGAN 3830 Pilot Knob Rosd, P.O. Box 21-199, Esgan, MN 55121 PH ON E: 454-8100 Reteipt T. ?. mmA #a. OF 4 Site Address t f 4 v C..i "F'.3; 3IN Ereet ? Occupancy . Lot Block t tt,1J' .f ' E ' SeclSub ?M1! Remodel ? Zoning Parcel No. . Repair ? Type of Const. Addkion ? No. Stories ? W Name Mave ? li h ? D Length ' Z _ F emo s pepth ? Address , 7. - Int Impr. ? --'- n Sq. Ft. wPprava n ???? t Name ??• ? ' ?? Addreae Asseument Permit 0 Water b Sew. Surcharge City Phone Police Plan Review oc FW Neme Firo SAC ?? Address Enp. Water Conn. ? W City Phone Plonner Water Meter 'C) Councfl Roed Unit •. li C 1 hereby acknowledge thct I hove reod this opplicction and stote that gldg. pff. Tr. PL • U'-? tha intormofion is COrtecf and agree to tomply with oll upplicable A? Stote of Minnesota Sfofutes or?d City of Ea9on Ordinonces. Parks Var. Date Copies Slpnaturo of Permitfee Totel ? • k Building Per?nit is isswd to: '? ' on the exprcss tonditfon thai dl work shoil be dorn in accordance with oll oppliwble State of Minnesoto Sfatutes ond City of Eapon Ordinonces. Iulldinp pffkiot "'^ 11248 Pwmit No. Pwmit HoMer Daq Tslephone it Plumbinp c- H.VA.C. 6 3 EMetric ? ? f r Soft?? Irwoction Date Insp. Othe? Footin9. I FooHngsll Foundatlon Framing sv &s'f" Roofing Rouyh Plhy. Rouph Htq. Inwl. y /7 Fireplac* Final Hty. Final Plby. ,a Finsl Cert/Occ. Watsr ??ibe Location: Wsll Sewer Pr. DItP. PERMIT # RECEIPT # 7y aATE ? - 2? ' g' 1 CITY OF EAGAN MECHANICAL PERMIT 454-8100 MINIMUM RESIDENTIAL FEE - $10.00 + $.50 MINIMUM COMMERCIAL FEE - $20.00 + $.50 FEE S/C TOTAL 1. Bldg. Type: Res ? Comm Inst 2. New ? Add Alter Repair -0, 3. Total Bid Price 4. Job Lot ' '" Block "% See 6. Contractor ,%'` (Name) 7. Contractor Phone # 5. Owner ! -J If L .- /1 ,, ,--, .-_-? (Stree? (City) (Zip) RESIDENTIAL HEATING - ?1-$24.0U: Each additional 50,000 BTU's or fracfion -$6.00 RESIDENTIAL COOLING - 01-24,000 BTU's -$12.04. Each additional 6,000 BTU's or fractian -$6.00 MODIFICA,TIONS/ALTERATIONS -$10.00 minimum fee L? HEATING VENTILATWG HOT WATER STEAM AIR COND. eIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG. RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER COMM.lIND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE. ; - Signed: for , • ? ? ? -^y Approved lnspections: Date Rough ?nsp, Date Fina1 Insp. - PERMIT # PLUMBING PERMR RECEtPT # CITY OF EA('aAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: rRACT PRICE PHONE 454-8100 dpresg. 47!1.el BLDG. TYPE WOAK DESCRIPTION Block? Sec/Sub Res. New ? ? % .• _s l? i ?_ ? Name ?" Mult Add-on Address Comm. Repair City Phone Other , _. Name NO. FIXTURES TOT,L ? Water Closet - $3A0 $ ? Address 1-Bath Tubs - $3•00 ^ °?- City f` I Phone-Le L_Lavatory -$3.00 Shower - $3.00 FEES ? Kitchen Sink - $3.00 - Urinal/8idet - $3.00 M/IND FEE - 1% OF CONTRACT FEE ? $3.00 Laundry Tray - ° ? AJM - RESIDENTIAL FEE - $10.00 / . - - Floor Drains -$1.50 ? AUM - COMM/IND FEE _ 20,00 Water Heater -$1.50 E SURCHARGE PER PERMIT _ .50 Whirlpool -$3.00 $.50 S/C IF PERMIT PRICE GOES Gas Piping OuUets - $1.50 ?ND $1,000.00) Softener - $5.40 Well - $10.00 Private Disp. - $10.00 ,T- ? Rough Openings - $1.50 TURE OF PERMITTEE FEE: ?" C O STATE S/C: GRAND TOTAL• ??' ? d C(TY OF EAGAN k PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAI rRACT PRICE: / C C C• . 1" PHONE: 454-8100 ddress ?t 5LS 'L' ,.-,--e_ , r `-' BIoCk ? •? Sec/Sub •-- Name Address Cityl1y._.? P hone - ?? - ? C J Mame v= A Q c r_ 1.. Address City hOne k FEES M/IND FEE - 1% OF CONTRACT FEE AiJM - RESIDENTIAL FEE - $10.00 AUM - COMM/IND FEE - 20.00 E SURCHARGE PER PERMIT - .50 $.50 S/C IF PERMIT PRICE GOES CITY OF EAGAN PERMIT # RECEIPT # r? ? • % DATE TYPE WORK DESCRIPTION New _ Add-on Repair NO. FIXTURES TOTAL water ciosec - $3.00 $ Bath Tubs - $3.00 Lavatory - $3,00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whiripool - $3.00 Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE . S G t STATE S/C: GRAND TOTAL• -' J? CITY OF EAGAN Remarks Add;tion Eden Addition Lot 45 Rik Z Parcel #10 22750 450 02 owner D)i "- street 4448 Clover Lane state Eagan NW 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. p 9$2 ?jQ4.']Q 100.94 STREET RESTOR. ] GRADING 82 232•99 46.6o SAN SEW TRUNK / 1974 62.93 4.20 15 * SEWER LATERAL 1982 ZH C).4C 279.29 WATERMAIN * WATER LATERAL 1982 WATER AREA 1977 62.93 4,20 1$ * Services 1982 STORM SEW TR K 1982 256. Qo 51.20 5 ? STOFM SEW LAT 1982 5 CURB & GUTTER SIOEWALK STREET LIGHT WATER CDNN. 500.00 BUILDING PER. 11242-11250 SAC 525.00 PAR K CITY OF EAGAN Remarks Addqion E'den Addition Lot 44 Bik 2 Parcel #10 22750 440 02 ? ?fr., Street 4448B Clover Lane State Eagan MN 55122 Owner V ?-• ' Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, &yp B$2 504.70 100.94 5 STREET RESTOR. GRADING 40 1282 232.99 46. 6o ) 5AN 5EW TRUNK IJIZ 1974 62.93 2 1 • SEWER LATERAL 1, $Q 18 6. 46 379.29 WATERMAIN WATER LATERAL 1 ?2 WATER AREA 62-93 4-20 * Services 1 82 STORM SEW TRK ? 1982 256.00 1.20 * STORM SEW LAT 1982 S CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 280.00 5737 11 8 85 WATER CONN. 500.00 8UILDING PER. 11949-1 1250 SAC 529 PARK CITY OF EAGAN Remarks AddStion Eden Addition Lot 46 sik 2 Parcel #10 22750 460 02 Owner Street 4450 Clover Lane state Eagan NIlV 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 'C 19$2 504.7? 100.94 5 STREET RESTOR. GRADING ]. 82 2?. I36. 6Q 5 SAN SEW TRUNK ?/ 1974 62.93 4.20 15 ?F SEWER LATEFiAL 23' 1982 1896.46 279.29 WATERMAIN * WATER LATERAL 1982 WATER AREA 1977 3 4.20 15 * Services 1982 STORM SEW TRK 1982 256. 0o 51.20 5 STORM 5EW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 500.00 BUILDING PER. 11242-11250 sAC 5 .00 PARK CITY OF EAGAN Addition Eden tion Street 47 -- R1 k 2 Parcel #10 22750 470 02 'er Lane C.- Eagan NIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. s ?,7 19$2 504.70 100.94 ? STREET RESTOR. GRADING 1 S2 232. 46. GO S SAN SEW TRUNK 197 62.93 4.20 1$ 9E SEWER LATERAL 182 18 6. 46 379.29 WATERMAI N * WATER LATERAL 1082 5 WATER AREA 1977 * 8 ces 1982 STORM SEW TRK C 19$2 256•00 51.20 5 ? * S70RM SEW LAT 1982 5 ClJR6 & GUTTER SIDEWALK STREET LIGHT ril - WATER CONN. 00.00 BUILDING PER. 11242-11250 SAC PARK CITY OF EAGAN WATER SERVICE PERNIIt 3830 Pi1it Knob Rosd P. C. Box 21199 PERMIT NO.: Esgan, IfIIN 55191 DwTE: Zontrp: _ R -- ., No, of Units: `'-p eJ: ,. r.=00 alt: C. i ut tt' ;-? 1,ddf!!6: v -- ? G e!1 . t1 . Siff /1ddM?' 5 ., O V.P? ' ?118'1b01: n 7 80T1 , Z.1 ?i b te::` _ a Mehr No.: ` '"?? ?5onY1ettiol? ryr. 5??? • r' l• ? SIZO: ? • , r ?Or , . . I,???-_. ? ? ? ft. Reodsr No.: ? ?rclwr 10. .. ?0 ?.p.. te aa.rh? ww ei?.Ckr i?+N+i- roe. o.ai..so... Mi.c. cnorges: 132 . o0pa 'ri, Total: 63.t`Ond rctei By Daft Pald: Dote of Insp.: Insp.: ? CITY OF EAGAN SEWER SERVICE PERMIT j 3830 Pilo: Knab Road PERMIT NO : P. O. Box 21199 . ? Eagan, MN 55121 DATE: , Zoninp: No. of Unlts: , Qwrrr . . . y llddrom , ? Sit* Mdmss: 1. ? , . Plurnb . ? . I gem to - pIp wkh fMe Citf of yN¦ Connection C1wpe: ' , •.r? ;y; ? u. AaIM.ess Atcaunt Depasit: ? . Pormit F": Suechorye: gy Mise. Charpm DaM of Insp.: Totol: Inao.: DaM Pald: F ITY Of EAGAN WATER SERVICE PERMR Pilot Kno?4 Rwd . , . O. Bex 21199 PERMIT NO.: agun, MN 55121 DATE: ' inp: . "` No. of Unin: r. fefi: Add. C' ov? r AR ? Pcl d u. tanber :;ickelsorL r•? ._, r No.: k: .6/g Ro? It T HONE • EL EC?.?f?iSc?: ; - . ., , . . r No.: ,. ,,? : -•c' .,t.. to a.?,h? .?+? w. ?, ? . .50 c! ,wx. craro.:: 132, v o paTP Toral. /?O? ?G?,?? Dote Poid: of I nsp.: Insp.: 'OFEAGAN Pilot Knob Road Bc,x 21199 MN 55121 n 3 Goad Va1ue Aom+es SEWER SERVICE PERMR PERMIT NO.: D/1TE: - No. of Units: `'rplex Address: r. _ ' c4elsoxi Plumb: il '- ': z 5737 ft 4e40116 wo ti. CRF of f.". of Insp.: Connectian Qwr+ps: Atcounc apostt: _ Parmit Fee: Surchar+p.; Misc. Chorqm _ Totol: Doh Pold: 100. t3c) pd ? CITY OF EAGAN WATER SERVICE PERM14 ? 3830 Pilot knob Road P. a: Box 21198 PERMIT NO.: Eagan, MN 55121 DATE: Zoninp: _ r3 No. of Units: -F eX ? pwrwr, ('.ood 7:.;lue xiomes /lddresx Site ??. 4449B rl.aver I?a::.: Addn. ?IXM1blr • 'tfr'!?t i. OII PLti Msftr No.: ?&7,_1-5'0 / 5+ . QOpc s,ze: %« RotFt Bet4t! _ E.1c. 15 , oOpa Reod.r No.{?/ N 6 SSg 6W_ ' R„it F a4hj 10. 00 d .t I pn? to ao.Pyr wqh IM Cihr ?N . SOpLI " Nusc. C1,orpes: I32.00pd TF ? Totai: 63.04rd metc• , BY 196Doft Poid: ' oaft of Insp.: Insp.: cr- z.Lf -V2 GITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Krab Road . P. O. Box 21199 PERMIT NO.: ; Eagan, !AN :,5121 DATE: ? ,._ . Zanirp: No. of Units: Owrnr: 11ddress: SjtQ Address: , Plumber. 1 yms to sssoply wia !IN C11T of lwgsa OrdiMwas. By Date of Insp.: Connaction Char": /coour+r Deposit: PermM FM: SurcF?orpo: Misc. Chorpm Total: Doft Pald: ITY OF EAGAN WATER SERVICE PERM14 0 Pil4t Knob '-aW PERMIT NO : . . . O. Box 21199 egan, MN 551?,1 DATE: ? {- ? t' k p ' No. of Unita: irg . . ,oo ?Ja?ue . omes r; ross: Mdrom lis:, over La, Agn Add n. lNr1be/: . No.: r? ocl MOM?;,? ze: r No.: ?} i•t c ?. ? ? ? t • ?. , l , , , l?+ aem te eswplp ? 11? C?ihr ; d s, 1 T?' w?se... %z y:° .'? Iulis'c. Ctiofpes: p Taoi: ? .. .0 pd • ?ete ? . F Daft Paid: ? of Irnp.. IMP•• ? ? CITY OF EAGAN SWER SERVXE PLUM 3830 Pilot Knob Rosd P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 pATE; Zoninp: No. of Units: Ownor. llddrcss: ` SitQ AddfQS: ' w • ? } ? = 1 ? ? . . ' . . . . . ._. PlIRfIbQI: . . - .. . . ' . , . '. - -. . I . . I M? to wNh /M Gl?r oi ie*os Conrnttian Qar": • Or1iMmeM. r /1cwunt Depait: Peenit Fee: Su?charpa: ? BY Misc. Charpes: Dote of IrnP-: Totol: Insp.: Date Poid: ------------------ ? - ? ? j PermittF: ?,{,./'?Qt? I I ` 273 (?I i Permit Fee: j Date Received: 1 1 1 Staff: t I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION n.ta: sote aaares: Tenant• JP„/ 4-nl Sulie 6: RESIDENT I OWNER Name: Qi..W /4. 6d Phone: Address / Ciry / Zip: Applicant is: _ Owmer 4 Conhacta TYPE OF WORK pescription of work: (OnIp Construction Cost: (? 0? , 0 O Muld-Famity Buiichng: (Ves / No CONTRACTOR Name: Onl 4-pn oJcim s License g; 2(`1 4_1P 2 5? Address: Gty: F^t'"' A,) statB: mr? zip: s3z? z Phone: ?</ - Z?$ ?3y2 j Contact Person: A80b &?2GS COMPLETE THIS AREA ONLY If CONSTRUCTlNG A NEW BUILDING _ Minnesota Rules 7670 Cateaorv 1 Minnesoffi Rules 7672 Energy Code . aaaaentiai venaiaoon category 1 wwiwneei . raaw Erergy code wwksneet Category suGnitted Submined (4 submis810n type) • Energy Ernetope Caiculatiwm Submitted fn the fest 12 months, has the Gty of Eagan lssued a perrMt fw a eimllar plan based on a master plan? _Yes _No It yes, date and address of master plan: Llcensed Plumber. phone; Mechenlcai Contractor: phone: Sewer & Water Contractor: phorre: ?NOTE:ft8718871d-871(lPOPf(I?fIOlili[J7BlIt8:Mitit'')tGttBil?MlTlBt?t.(!B$ldBti2(/t0-hBlVttbJTc`?flldl1?78ff1ltt ?C/f/01790f:.: the itnfonrraNOn ntay beclaasiMe?d??i?orr`piibile It.yqu prov&? specl?c reasv?lbai' w+D4dd pemNtthe,CTt?ia ' ' ? d^ aLw y?.? .e „ 4 l 1Xr 1 hereby adcnowledge that ihis infortnffiion is complete arM accurete; that the work will be In conformance wvth the ardinences artd cades of the City W Eapan; Mat 1 understand this is not a pertnft, but only an applicetion for a permit, and work is not to with ut a permit; that the work will be in accordance Nnth ihe epproved plan in the case of? which requires a review and appro x nrjbbcls x vai/: ApPIIceM's Printed Name ApplicaM's Signeture Page 1 of 3 . 1985 BUILDING PERMIT APPLICATION - CIT3f OF EAGAN NOTE: 9LL CONTRACTORS NUST BE LICENSED KITH THE CITY OF EAGAN COl4tERCIAL SINGLE FAMILY ?ilELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF '1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND 1 c?F (?,ooo / To Be Used For: Q?.? Valuation: ? Date: Site Address 4c?-?r c/,Ivqr- J-.'i OFFICE USE ONLY Lot Block ?- Parcel/Sub ?zej Owner ?d/ LIqauo- f'fi...,v.e 7?!'d Address ( v(v a 23 '?L 4/J i?f City/Zip Code 57W; Phone 7 Contractor Qd=t= Addres City/Z Phone Arch./ Addres City/Z Erect X Occupancy Remodel ^ Zoning Repair , Type of Const Addition # of Stories Move ? Length Demolish ^ Depth Int.Impr. Sq Ft Install 9PPROVALS FEES Assessments Permit Water/Sewer Surcharge Police ? Plan Review Fire SAC Ettgr Water Conn Planner Water Meter Council Road Unit Bldg OfF /( S Treatment P1 APC Parks Variance Copies TOTAL Phone # /? .? ? (TOWNHOUSE ) CITY OF EAGAN N° 11248 ? ' 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55121 PHONE: 454•8100 ? Receipt # BUILDING PERMIT 000 p $60 X NOVEMBER 7 1q 85 Te ee u..e ro. 1 me , OF 4 PLE e:t.vaiue x3 4448 CLOVER LN Erect O: ? Occupancv PD in Z Site Address z Remodel EDEN ADDITION 9 on t V Lot 45 siook RQpa. 0 Sec/Sub. . TypeofCons Parcel No. AddHion ? No. Stories 44 Move ? Lengtn GOOD VALUE HOMES INC Demolish ? Oepth 24 a Neme 1460 Z 93RD LN NE Int.lmvr. ? So.Ft. nddress 780-5510 ?nsta?l ? ?S BLAINE Cny phpny Approrols Fees g Name SAME Assessment ?? Address yyater & Sew. 1- City _ PhO^e Police Name City Phone Fire Enq. Plonner Council I hereby acknowledge thaf I ha reod this applicnhon ond stote ihat gidg. Off. 1 1/ 6/ 8 5 the inlormotion is correct an gree to wmply witdh all oppliccble APC permit Y J30.00 Surcharge 156.50 PlanReNew 525.00 sac 5 00•00 Wa[er Gonn. WaterMeter 63.00 2$ 4. Q Q Road Unit 13 2. 0 0 rr. Pl. Parks Stote of Minnewto is aw $tat?r ?^o^?s• Var. Date Copies Total S999.50 Slpn ature of Pe ee A LUE HOMES IC on the exvms+ w^ditioo thol if Is all work shall ne in ppli bla 5 ate of in ewta Stafutes and Cify of Eogan Ordirqncea. Builditg Official . t ? 1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED ifITH THE CZTY OF EAGAN COHlIERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATZONS AND 1 SET OF ENERGY CALCULATZONS' $2,000 LANDSCAPE BOND ID To Be Used For: ?q?_ Valuation: Site Address ?Yy ? ? ?ava?- 1,?/ Lot ? Block Parcel/Sub Gcys.J Owner (s..w c( (/44 Address `x6o C? City/Zip Code Phone Wo $J?7 ? Contractor Addres City/2 Phone Arch./ Addres City/Z Phone SINGLE FANILY DWELLINGS INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS (oO,Gbb Date: M, OFFICE USE ONLY Erect X Occupancy R 3 Remodel Zoning PD Repair , Type of Const Addition U of Stories Move M - Length Demolish ' Depth Z4 Int.Impr. ^ Sq Ft Install ? ------------ --------------- ------ APPROVALS FEES Assessments Permit 313. Water/Sewer Surcharge ? 30. Police Plan Review T?. ° Fire SAC SZS Engr Water Conn Scol Planner Water Meter 63, Council Road Unit Z o. Bldg Off Treatment P1 132. APC Parks Variance Copies TOTAL sa `, _t I (TOwNxousE) CITY OF EAGAN 3830 Pilot Krrob Roadv P.O. Box 27-199, Eagan, MN 55121 ` PHONE:454-8100 BUILDING PERMIT rtecdut Te yaud y. 1 OF 4 PLEX Est. Value $ 6 0, 000 Dare NOVEMBER 7 ly 85 SiteAddresa 4448B CLOVER LN erect KI occuPancv R Lot 44 slock 2 Sec/Sub. EDEN ADDITION Remodel ? 2aning PD Repair ? TyDe of Const. V Percel No. Addi[ion ? No. Stories GOOD VALUE HOMES INC t?nove ? ?.engen 44 w Name 1460 93RD LN NE Demolish Depth 24 ? Address ? InLlmpr S F? BLAINE 780-55 . °' . City Phone Install ? }? Neme S s Address ? City Phone G? ?w Neme ?? Addresa ? < w ?'1E AOVrovalt Faes Ci2y Phone I hereby acknowledge rhat I have read fhis application and stote tFwt fhe inlormotion is correCt or ogree to comDtY with all applicoble Sfafa of Minrxsoto $tntutes nd City of Eogan Ordimnces. Sipnoture of Perm;,.2. A Building Parmif s ro: GOOD VALUE HOMES It all work sMll be accordorxe with oyl,appY?able State qf'Mil Assessmenf _ Water S Sew. Police _ Fira Eny. Plnnner Council BIdg.Off. 11 6 85 APC N_ 11247 vermit $ 313.00 Surcnarge 30.00 Plan Review - 156.50 SAC 5 2 5 . 0 0 I WaterConrt 500•00 waterlneter 63.00 RoadUnit 280.00 Tr. pl. 132.00 Parke -. I Copies rotal $1.999.50 a+ the exprcss wndition that Stotutes and City of Eepon Ordinonces. Bulldirq Officiol 1985 BUILDING PERMIT APPLZCATION - CITY OF EAGAN NOTE: ALL CONTRACTORS M1ST BE LICENSED WITH THE CITY OF EAGAN COl41ERCIAL SINGLE FAMILY DiIELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS 8 STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BONDor / (ao' coo To Be Used For: Valuation: I-z-ago""O Date: --r?- Site Address !f Y -5TJ Lot ? Block ?-?L Parcel/Sub /`r'J y) Oxner Address City/Zip Codev- ,y Phone 2f O Contractor Addres City/Z Phone Arch./ Addres Cfty/2 Phone OFFICE USE ONLY Erect ?C Occupancy Remodel Zoning Repair _ Type of Const Addition ? G of Stories Move Length Demolish ? Depth Int.Impr. Sq Ft Install APPROYALS FEES Assessments Permit Water/Sewer Surcharge Police ^ Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off ?? 1Yeatment P1 APC Parks Variance Copies TOT9L (TOwNHOUSE) CITypFEAGAN N°_ 11249 - ? 3630 Pilot Kno6 Road, P.O. Box 27-799. Eagan, MN 55121 PHONE: 454-8100 J BUILDING PERMIT Receiot # R 8`? 7' Value $60,0 1 OF 4 PLEX En 00 p?e NOVEMBE , I q . To ba wsd fe? Erect ? occuPancy R3 Site Addren 4450 CLOVER LN Remodel ? 2oning pT? EDEN ADDITION Lot 46 gl ak Z ?ec/Sub. Repair ? rypeofConst. V Parcel No. Addition ? No. Stories Move ? Length 44 GOOD VALUE HOMES INC Demolish ? Depth 24 a Name Z 1460 93RD LN NE Int Imvr. ? Sq. Ft. Address ? 7$ 0-5510 BLAINE Inatall ? City phone Approvals Fees ? Name SAME ?? Address F? CitY Phone Name _ Address City - Phane 1 hereby ockrwwledqe fhat I hove read lhis oDDlicahon and state thot Ea9on Orth ol n?splico6le City t of comPlY the n'nnesot Statutes n o agree State of SiQnoture M af PermiM A Buildiny Permit Is issue o; GOOD VALUE HOMES oll work sholl be do n ocmrdonca with all pliwble St of ? 8uildinp Official 0 0 Asussment Parmi 30.00 Water & Sew. Surcharge 156.50 Police PlenReview 525.00 Fire sAC 500 • 00 Enq. WaterCOnn. WaterMeter fil.00 Plonner Roed Unit 980-00 Council 11/6/85 132.00 Tr PI BIdg.Off. . . APC Parks copies 50 Totel ? on tha axpress cordiHOn ttw+ inesotn Stotutes ond Ciry of Eaqon Ordinantes. ?__ / /,) ? 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS NUST BE LICENSED ifITH THE CITY OF EAGAN COMMERCIAL ZNCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS $2,000 LANDSCAPE BOND t nF To Be Used For: SINGLE FAMILY DHELLINGS INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS lao,oob Valuation: Z3o-arp-e Date: Site Address (?=_id ?-/wqrJ") Lot _'a Block Parcel/Sub Owner e;Qoo RL....VALS; ff:j?r_fl?1,.1 C.? Address 44:A .93 "-? 4"') City/Zip Code Phone 70?o Contractor Addres- City/Z Phone Arch./ Addres City/2 Phone OFFZCE Erect x Remodel ? Repair ? Addition Move ? Demolish ? Int.Impr. Install APPROYALS ONLY Occupancy Zoning Type of Const l1 of Stories Length Depth Sq Ft FEES Assessments Permit Water/Sewer ' Surcharge Police ' Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off 9 Treatment P1 APC TT' Parks Variance Copies TOTAL ' • ,, (TOwNHOUSE ) CITY OF EAGAN N°_ 11250 • 3830 Pilot Knab Road, P.O. Box 21•199. Eagan, MN 55121 PHONE: 4548100 ,S j 7? 7 BUILDING PERMIT R "01? # ? Volue $60,000 pOfe NOVEMBER 7 jq 85 1 OF 4 PLEX E t . s Ta M wad fer R3 44505 CLOVER LN Address Sit Erect 2 ? occupencv PD i Z e EDEN ADDITION e 2 47 Remodel ng on Sec/su . Block Lot Repair ? Type of Const. V Parcel No. Addilion ? Na. Stories ? Move ? Length 44 GOOD VALUE HOMES INC oemolish ? Depth 24 , W Name 1460 93RD LN NE Inclmpr. ? Sq.Ft. € 5 Address BLAINE phone 780-5510 Install ? CitY Apyrorols F•es o {F Name SAME Assessment 0 Permit . Addre3s Woter & Sew. Surcharge 30.00 ? City Phone police PlanReview 156.50 Fire SAG ?? O Name EnO, WeterCOnn. o I Address City PhO^e Vlonner Water Meter " 00 n CD1""l RoadUnit 00 13 2 1 hereby acknowledqa that I hove reod this application and stote thaf eiay. off. 11/6/85 . Tr. PI. fM inlormotion is Corre[t a ogree to complY w11h all oOGlicable ppC Parks Sfota o4 Minnesoto $totute d Ciry of Eag r i n s. Var. Date CoPies Sipnaturc of Pe 'ee Total $1,299 .50 GOO? V E HOMES INC on ihs exprcss condiflon that A Building Pe ssued to: all wark sholl be dona in acmrdance with ?ble State 0 e, so tat? Ciry of Ea9an Ordinonces. ? Buildinq Officfal "i 0 -C - L • I ? • ' • ? •I • ' • 171' • I? /• 71• • 71• •?• • •a• i• •?? • n ?? • N? ? ? ?1 • ? ; CITY OF EAGAN APPLICATION FOR PII2MIT SE[+IER ADID/OR WATER CONNECTION 1) PROPERTY ADDRESS: T.F1;AT, DESQ2IPTION: cts;_ t lAL/I310CK/SUDQ1V1510[l OZ' 'Pd7C YdrCBl l.U. LVURGJ2i) IF EXISTING STRL'CTIJRE, ?ATE OF ORIGZNAL BL'ILDING PERMiT ISSL'ANCE: (Nbnth Year) PRESENP ZONING/PROPOSID USE: R-1 SINGLE FAMILY R-2 DL'PLEX ('IDro L'nits) R-3 TOWNHOUSE (Three + Cnits) R-4 APARTMENT/COAIDOMINIL'M COMME[tCIAL/RETAIL/OFFICE IDIDCSTRIAL INSTI'IT'TIONAL/GOVII2NMENT ( Dnits) ( Linits) NAME: h( AoDREss: CITY, STATE, ZIP: PHOLNE: y3.3 ' S/ 7f • c ?+. 3) NAME: ADDRESS: CIT'Y, STATE, ZIP: PHONE: MASTER LICENSE For City L'se Plumbers 7licensf C Not Recar( 4) ?• r i?• ADDRESS: CITY, STATE, ZIP: a6'6al (/ /9? /?d --- ff? /71 E-`S' PHONE: 7-gD'" b~sorD 5) n a ? ?• • a? ?? la CONNECTION TO CITY SEWEE2 0 CONNECTION 'IC) CITY WATER Q OTHER (Please Describe) 6) i? • i ? PLEP.SE HOLD APPROVID PERMffT FOR PICK-L'P BY ONE OF ABOVE C? PI.EASE MAIL APPROVID PERMiT 'N 1,G 3, 4, ABQVE /? (Circle one) 7) r ' ' ? Lr./ F O R C I T Y U S E O N L Y PE4.`1IT " ISSUED F°_ES: $ /0.)o $ /U• 52 $ ?3. ou $ $ $ $ +S 52??GG $ s as?o c, S $ ? $ s i3a.« . S $ $ SE:'fLR D.r.BMrT (INrT,l:iE Sjl?i?.C:ApCiL) WATER PE-lU1I': (IiICLVDL SliRCHARGE) WATER METER/COPP£BHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) S::•iER TAP •- ?_.: ??_ 1_ - a_..=3 ACCOliD1T DrPOSIT - FIAT°R WAC SP.C TRlii•IK [4ATt'R ASS: SS:?E::T TRii:JK SLj'ILR ASSE55ME?iT Le;TE?.:,L BEDIEFIT/TRUNK SE:,i: R LATE:t1L BEVEFIT/TRU.:K IQATrR WATER TREATMENT PLANT SURCHARGE OTHER: TOT?.L Put10L'NT PAID/RECEiPT ?'. J .7 7a DOES UTILZTY CO+::]ECTION REQUIRE EXCAVATION IN PU&LIC RIGi-IT OF WAY? L YES IF YES, THEN n"PERMIT FOR WOR!C WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY TY.E ? NO ENGINEERING DIV:SIO[V, LIST AS A CONDI- TION. SUEJECT TO THE FOI.LOS4ING CONDITIONS: APPROVED BY: TITL2: DAT°_ : ?/ ?? ? lftft • I t •'\ 1? • I •? ' • M. 171' ' I? 71' ` 71• ? • ?• s • a? i • • ? ? • ? • ? «:r• • ma?? ? ? ? 211 • • •? ? CITY OF EAGAN APPLICATION FOR PII2MIT SEWER AAID/OR WATII2 COf'ZECTION 1) PROPII2TY ADL)RESS: T,FY:AT, DFS(RIPTION: a ge-1 .Zl or IF EXISTING STRCCTURE, DATE OF ORIGINAL BiJILDING PERNffT ISSCANC.E: PRFSENT ZONING/PROPOSID LSE: (hEnth Year) R-1 SINGLE FAMffLY R-2 DCPLEX ('Itso Cnits ) R-3 TOWNHOL SE ( Thre° + I:nits ) R-4 APARTME.NP/CONIDOJ1INILM CONIMERRCIAL/REPAIL/OFFICE I6ID[:STRIAL, INSTI'IL'TIO:VAL/GOVEE2_\n1ENT ( Units) ( Onits) NAME: /G.C E/Sv.v ADDRESS: aE.- CITY, STATE, ZIP: 7Ss pxorrE: cl33 -s % 7J 3) • r.a• For City tise NAME: Pltunber ce s? ADDRESS: f'?I'' Act e CITY, STATE, ZIP: C1 ired t Recor PHONE: MASTII2 LI(?ISE #QO/t//>? ? Sta f Initial ? • i?• 4) ADDRFSS: CITY, STATE, ZIP: PHONE: (?rso ? (J ?3 ?L? E :r?o?-? cs S ?`J//?'?X/ 6? l'a'J JS 5) ,ft CONNEX,TION TO CITY SEWER Zr-CONMECTION TO CITY WATEF2 Q OTHER (Please Describe) 6) u • • i ? PLEASE HOLD APPROVID PERN7IT FYJR PICK-LY BY ONE OF ABOVE gI PLEASE MAIL APPRO PERMIT TO 13,) 3, 4, AHOVE (?le one) 7) ? L `?y//?/? F 0 R C I T Y U S E O N L y t" - PE.°_HIT °- ZSSUED ? FELs: $ l0-5-0 $ /0- SU Y? $ S $ S _ /S w $ ??-Go s S?s:o? $ $ $ $ $ $ sE:,ED DERt1T'r (I`ICL?== SU?C :?aGE) WATER PERPIIT (IiICL'JDE Sli?CHARGE) WATER METER/COPPERHORN/OL'TSID : REc`,DER WAT°R TAP (INCLUDE CORPORATION STCP) SE:GER TAP .._?CSi= - :.=__j ACCOliNT DFPpSIT - FIAT°_R WrhC SP.C TRliNK WATER ASScSS,+.E.:T TRii;IK SE[dER ASSESSMENT LnTER<',L SE.4EFIT/TRUDIK SE::-R LATc:2tlL BEVEFIT/TRU:IK WAT°R WATER TREATMENT PLANT SIIRCHARGE OTHER: TOTAL APIOU:VT PAID/RECLI2T DOES UTILZTY CONNECTZON REQUIRE EXC.aVATION IN PUBLIC RIGi-IT OF WAY? ? YES ZF YES, THEN n"PERMIT FOR Tr10RK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE F-7 NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SGBJECT TO THE FOLLOWING COVDITIONS: APPROVED BY: TI':LE: DATF: --'? PERSON56 REQUIRING, ADDITIONAL COPIFS WILti BE, CHARGED A• $20•:00 FEE' Tb; COVI CITY OF E71GAN APPLICATION F'OR PEEtMIT SEWE'2 ADID/OR WATEE2 CONNF.CTION lPloaca Printl 1) PROPIIYPY ADDRESS: T•FY;Ai• DFSQ2IPTION: IF EXISTING STRtiC'I4.'RE, DATE OF ORIGINAL &!ILDING PERMIT ISSLFINCE: (MOnth ear) PRFSE„'P ZODIING/PROPOSID USE: R-1 SINGLE FAMILY R-2 DCPLEX (Z+ao L'nits) R-3 'IbWNHOL'SE (Three + Onits ) ( Units ) R-4 APARTMENT/CO^IDOMINII'M ( units) CQNMEFtCIAL/RE"rAIL/OFFICE IAIDi;STRIAL INSTITI:TIONAL/GOVERNA?.TVT 2) ? '57 .,, A'v .6/ ADDRESS: CITY, STATE. ZIP: -/ ss0''-19 rxorE: f/33 -S/?7/ 3) • ? ,??• NAMF: ADDRESS: ??iYlE CITY, STATE, ZIP: PHONE: MASTER LICENSE #eQ /g Recor, 4) •sr • , ??• ,/ tu+ME: aoDxESS : /?i6 ? 9 3 ? ? >ciE czTY, sTxTE, ZIP: 5; 5'?l3el PxorX: 5) ?? « • ?• • y? ?? Q CONMCTION TO CITY SEWER 0 CONNECTION TO CITY WATER Q OTHER (Please Describe) 6) ? PI,EASE HOLD APPROVID PII2MIT FOR PICK-[.'P BY ONE OE AHOVE 25 PLEASE MAIL APPROVID PIIiMIT TO 1,0 3, 4, APJJVE (Circle one) » r ?. 40?e,,?4xl ? ???/ For City Dse Plumbers Licens( 1= Ar-t-ziee - _ ? .. F 0 R C I T Y U 5 E O N L Y PE°`7IT " ISSUED ? FErs' $ ??, ??Ct $ /O, S'G $ vli S S $ y ?UO $ $ /,5_GU $ $ S S S $ SE71L:? nE3?2rT (IIICLJLG SURC :?RGc) WATER PERA4IT (INCL'uDE SliRCHARGn) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDEE CORPORATIOD7 STOP) 5E:'iLR i.AP ACCOUNT DFPpSIT - 47ATER wac SP.C TRliNK SVATER ASSESSCIE.7T TRuN?C SEWER aSSESSME*iT L.-lTE?„,L BE:IEFIT/TRU.`IK SE:i"R LATcRrIL BENEFIT/TRUNK SaATER WATER TREATMENT PLANT SURCHARGE OTHER: $ TOTAL $ ? AMOL'ST PAZD/RECEI2T $ S DOES UTILZTY CONNECTION REQUIP.E EXCAVATION IN POBLIC RIGHT OF WAY? ? YES IF YES, THE:I n"PERMIT FOR 'r70RK WITHIi] PUBLIC ROADWAY" MUST SE ISSUED BY THE C] NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUEJECT TO THE FOI.LOtVING CONDITIONS: APPROVED BY: TI:LE: DATE: 17 • i ?•• • • i ?• o i?• • u r. ?. •?. •?• s •a? -?? • ? ?? ? ? ? ?? ? • • •? ? CITY OF EAGAN APPLICATION FOR PERNLTT SEWEFt ADID/OR WATER CONNECTION 1) PROPERTY ADDRFSS: r,Hr;ar, DESQ2IPTION: IF EXISTING STRC'C'ILRE, DATE OF ORIGINAL &!ILDING PERMLT ISSCANCE: (Month Year) PRESENT ZONZNG/PROPOSID LSE: R-1 SINGLE FAMILY R-2 DL'PLEX (1Go Cnits) R-3 TOWNII-IOOSE (Three + Onits) ( Units) R-4 APARTMENT/COPIDOMINICM ( Onits) COP'A'ERCIAL/RETAIL/OFFICE IDIDL'STRIAL INSTITOTIONAL/GOVII2DIlKFdV7' 2> ? : /S?a.nr NAME ADDRESS: ?ax- '/ Z, k CITY, STATE, ZIP: Jgwp/i,q PxorrE: _4"33 -.5-/7/ 3) ? r.?• NAME: ADDRESS: CITY, STATE, ZIP: PHONE: x E MASTER LICENSE Recor, 4) ?? / ? 7 / NANE: ?6Bd C/ fa. /G? E ?d/?iG"S aoDREss: /y!a CITY. STATE. ZIP: PHONE: ? 7g0- S'S/Q 5) i? • ?• • 7• ?? ,gj CONNECTION TO CITY SEWII2 _&tCONNECTION TO CITY WATEE2 [) OTHII2 (Please Describe) 6) u • ? PLEASE HOLD APPROVID PERNIIT FbR PICK-C'P BY ONE OF ABOVE ? PLEASE MAIL APPROVID PERNLiT Z+U 1, C2? 3, 4, ABOVE (Circle one) For City Ose Plutnbers Licens F O R C I T Y U S E O N L Y PERMIT y ISSUED FEES: $ $ $ $ S +S *5 ?S- U fJ $ +S J?2.S?GG $ tb t $ $ $ $ 3R vu $ $ SE.:LR n?R}1T'P (I_`]C:.:.D? SUBC??RGE) WATER PERt'lZT (INCL'uDE SuRC°ARGE) WATER METER/COPPERHORN/OUTSID: REi,DER WATER TAP (INCLUDE CORPORATION STOP) SE:vEF TAP : 'I' -?CSI- ACCOUNT D.F.PCzSIT - WATER WtiC SPC TRU`7K WATER ASSESS:?E.`:T TRli::K SEWER aSSESSM°`iT Le`,TE?. ;L BE:IEFIT/T'.a,U.IK SE?•: :R LATERAL BENEFIT/TRU:IK WATER WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL $ AMOL'\T PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RZGHT OF WAY? YES IF YES, THEN A"PERMIT FOR W0RK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE Q NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TI;LE: OATE: ? `r b(flU MECHANICAL (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits aze rcquired for each unit A3C _-S-b DeteG c) ?3-" LrJ Un,t # Site Address 'L" ? C L N 55 1zZ- 2 G ? r\ A 3--S(3 ^ Telephone # ( (o5 l ) (oP-7 ? ? Z I Property Owner ctor t C on ra Cit Street Address Z(-a(oy y Mf?j Zip,S G6 GNSSTelephone# (G5I ZZ-Rf/Z'? state The Applicant is ?? Owner _ Contractor _ Othec Add-on, modi?cation or alteration to esisting dwelling unit $ 30.00 furnace replacement air exchanger ?,- air conditioner ^\4f I ? ti other i n- .1 CG?; 1 , ? '. ? .50 State Surcharge - ' _ _ s ?i: r-?CJ Total ?L041.GG I hereby apply for a Residential Mecbanical Perarit and acknowledge that the information is complete and accurate; that the work will be in wnformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an applicarion for a permit, and work is not to start without a pemut; that the work will be in accordance with the approved plan in the case of work wLich requires a review and approval of plans. ApplicanYs Printed Name ? ApplicanYs Signature J / S ?- 73g34 zoos RESIDENTIAL PLUMBING PERnniTaQpLicArioH CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 551-675-5675 Please camplete for modifications to existing residentiai dweilings. i Date Site Street Address Unit # Telephone #??c?}-a?YQ-9? Z ' Praperty Owner -/ a'J 7?'91J I Telephone # (9So'?-? I Contrector City??ovt?81!/?? State,&_ Zip $~ Address The Applicant is: _ Owner ? Contractor _Other Refurbished Su6mit 2 sets of plans and MPC license New Septic System ?nt?fee Include$ Co _ ? I 0 Per as-built $ 10.00 ? Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. 1f you are insfalling on! a water soffener and/or waier I II heater, do not comPiete this section, move to the next_.section and-check ;tfie,! ; i ?'' ? ' ? ? - ; ? • , ? ?-: , i ?9 ? appliance(s) you are installing. F ?' 'i ,.??'..'I•? ? , ????D ? ? _Septic System Abandonment _Water Tumaround (add $130.00 if a 5/8" meter is required) ? •-- _ Other _ - - i i Water Softener ? Water Heater $ 15.00 _ new ? replacement I Lawn Irrigation _RPZ `PVB _new _repair _rebuild $ 30.00 $ 50 State Surcharge $ ? Total ?.,a,,.??fir.? i< rmmnl ate and accu-2t2: theY thB I hereby apply for a Kesidenuai rwmoing reinuL dilu o?MFu.v e.y? ?.- •? I'll ...• -- --- . work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that 1 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 accordaneelwlth the approved plan in the event a plan is reqwred to brviewed andaQproved. App A Iic Ys Pnnted Nam 9Sc?lnYS Signature City of EalaIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ------------------ ? Ka.Offi? Use I j Permit#: ? Permit Fee_ ? Date Received: I Stafl: ? I I -----------------? 2008 RESIDENTIAL BUILDING PERMIT APPLICATION "_/? Date: 1I -I`' 0a Site Address: Tenant: 0 Suita 8: RESIUENT / OWNER Name: p l.l IIMe_ Caa;eW* q??firxrc. ?Phone: Address / City / Zip: Applicant is: _ Owner __)(Contractor TYPE OF WORK Desaiption of work: 2 oe Gz Construction Cost: 1 b? !1o Mul6-Family Building: (Yes No ? CONTRACTOR Name: D?rl ? License A AAN? Address: 0 - ? City: e Yl e? State: !n U Zip: 66 Phona: Contact Person: COMPLETE THIS AREA ONLY IF GONSTRUCTING A NEW BUILDlNG Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code • Residerrtial Yentilaiion Catepory t Worksheet • New Energy Code Worksheet CffiBtJOry Submitted Subrnitted (4 submission type) • Enargy Envelope Cakulations Submitted In the last 12 months, has the City af Eegen issued a pertait for a simllar Qlan based on a master pien? _Yes _No If yes, date and address of master plan: Llcensed Plumber: Phone: MechaMcalContractw: Phone: Sewer & Water CoMractor: Phone: NOTE: Plans and supporling dacuments that you submit are consFdered to 6e puWk intormatton. Porttons of the informaflan may be alessiiied as non publlo i/ you pravide specifo reasons that wou(d permN the Cffy to conclude that the are trade secrets. I hereby adcnowledge that this informalion is complete and accurate; that the work will be in conformance wiM the ordmances and codes of the Ciry of Eagan; that I understand this is not a permit, but only an application fw a permit, and work is not to start wNiout a that the work will be in accordance with the approved plan in Me case W wvrk which requires a review arid approval of pla X .;?:o?a( )6? : ?.?.??G? Applicarrt's P nied Name ApplicanYs Signature Page 1 of 3 L.N DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? OS-plex ? 16•plex ? Accessory Building ? Pool ? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt - Multi ? 01 of _ Plex ? 07-plex ? Garege ? Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? OS-plex 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 Bui lding ? Reroof ? Demolish Interior ? Alteration ? Fire Repair ? Windows ? Demolish Foundation C1? Replacement ? Egress Window ? Water Damage ' DemolRion (enhre building) - give PCA handout to applicant DESCRIPTION: Valuation Occupancy MCES System Plan Review Code Edition 2W -7 SAC Units (25%_ 100% ? Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length ? Fire Sprinklers Type of Const. Width ? Footings (new bldg) Sheetrock Metar Size: Foatings (deck) ? Fina11C.0. Footings (addition) ?A FinallNo C.O. Foundation HVAC Drein Tile Other: Roof: _Ice & Water _Final Pool: _FOOtings _Air/Gas Tests _Final Framing J Siding: _Stucco Lath _Stone Lath _Brick Fireplace:_R.I. AirTest _Final Windows Insulation ? Retaining Wall Reviewed By: Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Page 2 of 3 (' ?- ??. s? o?J I ? ?? R.? ,a:q5•R ? SB9°58'o2"w -` 6poo oi }ge e0? ? N6?45501 i ??.9 b?,'73 ?;.97 l.o! i 66.06 59.OO ? y?y•??? p ?, _ _ 1? _ ?z4.9a' o , p0 7 /1 \ o i . ^? I r ?z\ •i 45 42 m 9 9° ' N ?a ? .1V m R ? ? q a? 6(a oco sq o0 p ?^%q ?\ N? 1 syosg. ?..E I az 43 , °41 4 O? ?i ? ? __._'_0 3. . __._. • 4 IN ? 0 94. O ) ?u I °'`°%4 S 96k? 2 - yo, z -+-?? .h 9 o `"FO 3 0.00. ?o I ry?3vo ?9S ?,q? .a3 35.-4r Sg.oI ?" sg Ta?` 2.a ss9'se'oY'w °'?7°w r, _ 7e.9Z 78.00 e W--g?.oo EASr ' ° ?BV?J?J???uV? 61'Itl?E?U City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 6755694 ?????T T 0 5 2008 ------------------ ? Fw Office_Use I ; Pam„t.: g7?a ? Permit Fee: j Date Received:? i Staff:_ I ---------------- 200 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I zA- o? 5ite Aderess: C! D U or LfJ Tenant: Sulte #: RESIDENT/OWNER Name: rjelj4) ttbirq WP? Phone: Address / City / Zip: Applicant is: _ Owner X Contractor TYPE OF WORK Description of work: P,.Q (a c "P_ %K, 0Q rl Constructbn Cost: --,_7,j0o. C;o Multi-Family Building: (YesNo ? CONTRACTOR Name: ,9,t)h,6 P ?f?(???enea3'Cicense#: 20 Address: ciry: aTM srate: f"w ziP: gSaZ-7 Phone: Cb?/_ 2?12 3 Gontact Person: " COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUItDING Minnesota Rules 7670 Cateaorv 7 Minnesota Rules 7672 Energy Code . Residential Ventilation Categay 7 Worksheet • New Energy Code Worksheet Category submined Sudmiaed (d eubmission type) • Energy Envelope Caleuia6ons Submitted in the last 12 months, has the Clty of Eagan issued a permlt for a similar plan based on a mester plen? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: MechaNcal Corrtrector: Phone: Sewer & Water Contrector: Phone: NOTE: Plans and aupportMg documents that you submit are considered to be public in/ormaSon. Porttons of the informatlan may be classrtied as non-pu6lk lt you provide specific reasons that woufd permit the City to conctude that the are, trade secrets- I here6y adcrwwledge tha[ this inlarmation is cwnplete and accurate; Nat the wark will be m confoimance xiiVi the ordinances and cades d the City d Eagan; thffi 1 understand tliis is rxo[ apermit, but onty an applicaAon far a perm@, arrcl work is no[ [o start witholit a pertnit; tlwt tlhe work vnll be in accordance wtlh the approved plari in the case of woAc which requires a review ard approval oF x plans (\ U `?!'?l/? X Appliqnt's Prlnted Name Appllcent's SignaWre Page 1 of 3 -7 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. AIt.- Multi ? 01 oT _ Plex ? 07-plex O Garage ? Porch (4-season) ? Ext. AIt. - SF ? 02-Plex ? OS-plex X Deck ? Porch (screen/gazebo/pergola) ? Multi Misc. ? 03-Plex ? 10-plex ? LowerLevel ? Storm Damage 0 04-Plex ? 12-plex O Miscellaneous WORK TYPES ? New ? Interior Improvement ? Siding ? Demolish Building` ? Addition ? Move 6uilding ? Reroof ? Demolish Interior ? Alteretion ? Fire Repair ? Windows ? Demolish Foundation Replacement ? Egress Window ? Water Damage Demolition (entire building) - give PCA handout to applicant DESCRIPTION: ? ,.? 1L p? 1 MCES S t Valuation ?i Occupancy 1 em ys Plan Review Code Edition jllwj?SAC Units (25°/,_ 100°/, ? Zoning City Water Census Code Stories Booster Pump # of UnNs Square Feet PRV # of Bulldings Length Fire Sprinklers Type of Const. w- Widih Footings (new bldg) X Footings (deck) ? Footings (addition) Foundation Drain Tile Roof: _Ice & Water _Final Framing Fireplace:_R.I. _Air Test _Final Insulation Sheetrock Final/C.O. ? Final/No C.O. HVAC Other: Pool: _Footings Air/Gas Tests Final Siding:_Stucco Lath _Stone Lath _Brick Windows Retaining Wall - Jr - Reviewed By: Building Inspector ----- -------- --- ---------- ------- RESIDENTIAL FEES: Base Fee Surcharge ' Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total ?0 -,> ? ?? ? / Page 2 of 3 This req.e5t void 78 nionffis from o) h q.c`i Q 7 d L04S. 121: if .,/`.. 40 16 s? * c17. ,n, Request Date 3l r I l l Fre No. poaPh-?n InspecUOn ?uvreA? ' ?fteady Nuwll Nouty Insueo- ri. es ? No r WhPn Ready ? ??..-oeu uecvicai Convactor 1 hareby reqaest mspection of above ? Owner elactrical work installetl at: ' SVeet Addrass, Box or Poute No. 44? 8 C. ? Ci emnon o Township Name ur No. Range No. ounty OccupantlPRINT n\\ Phane No. PO Ef`.uppllC Atltlf255 Elec al Coniractnr IComOanY Name) C? hactor's License No. ? ???? ' - 4 Ma, lmg AdJress (Contractor or Owner aking InstailaLOnl 09 3 ?) r`? (7c(x . nawre (COntractor/Owner Mxking Installavon) Phono Numh¢r = w?ia 51qiE eOAND OF ELECTNICITV Gri995-Midway BIAg. - floom N-191 1821 UnivarsitY Ave., SL Paul, MN 55104 Phone (6121, 297-2111 nis irvsrtcJloN qEUUEST WILL NOT 8E ACCEPTED BY THE STAiE eOAflD UNLESS PROPEN INSPECTIpN FEE IS ENCLOSED. REQUEST FORELECTRICAL INSPECTION ee-ooooi_aa ?p(?r ' Sea in81ructlons for campletinB this form on back of yellow copy. ? y"? Q?7 / Q "X" Below Work Covervd hv Th,c ao.,,-. TYPe of Builtlinfl Home AppliOncBe WrtBd Eqmpmen[ Wi?eA ' Range Temporary Service Duplex Water Heater Li[?htiny Rxtures 7 Apt. Bwldmg Dtyer Hectnc Heatin Commerci2l Bldy. Fumace Silo Unloeder Industnal 81Ag. Air Condrtioner Bulk Mllk Tenk Farm othxr Speci v ornr.rl5uenilyl t er ueu y t er Oth??r omput J e F aa Rnln_ Dec[lon p Fee • a Servwe Entra.ce ?ze ? to 2 d Fee Feedars/Sabfeetlers # Fee 'c?`°"'t° a A6ove m ? s 0 to 30 Am ?s 37 to 100 Amps , D to 30 Am Swinm 31 [0 100 qrn S Transi q bove 700_Amps Irrigation Booms Above 100_Am s ' Signs c..._...? Partial- Other Rertwrks S-fl'G- TOTAI Rouen-in , , _ {(p 1. tne Elec? -?-• ' Inspector, hereby ?ate certify thet the abova inspaction hes been meae. requaet This request void 08 mo0 9 5 9 6 RequesPDate ? Fne No. Rough-'n Inspeciwn ReOUiretl' E]Reatly Now ?I Notity Inspec- Ves ?N tor When Ready U Licensed Elec[ncal ConVactor I hereby reqaest inspecbon of above ? Owner eleclrical work installed at' Street Ad os ' Bo or re No. ? . C i ???? 0_?) ecuon o. Township N.M. or No. Ran9e No. c y OccupantlPRINTI y1r 1 l.l V ?? \ . Phonc No. Power Supp ier AAdress , Ele cal Contractor ?Companry- ?Na?m?el ? /? ? -C.onttactor' l ic nse No, '.?.[j^-'1 J 1 ? Mailing Atldress (COntra mr or Owqer Making Instailauon) ? ? nonzed Smnature IContta<to ?Owner Makiny InslallaUOn) Phone Number t MINNESOTA STATE BOARD OF ELECTHICITY C+rigga-Midwey Bldg. - Noom N-191 1821 Unrvarsity Ave., SL Paul, MN 66104 Phone (612) 297.2111 THIS INSPECTION REQUEST WILL NOT BE ACCEVTED BY THE STA7E 90APD UNLESS PFOPEP INSPECTION FEE IS ENCLOSED. Ee-ooooi.cu -s REQUEST FOR ELEC7RICAL INSPECTION Aftk, 3-rc ? 3 Sae ins2ruCt,onS 101 COmpleting thi5 iOrm on back oi yellow copy. p ,q? q?? Below Work Covered by This Request ( H JM. TVDe of builtl4ng APpliancea WireJ Equi4ment Wiretl Home Range Temporary Service Duplex Water Heater Lightmy Fixtures Apt. Bwldmg Dryer Electnc HeaUn Commercial 81dg. fumace Silo Unloader Industnal BIAy. Air CondiLOner Bulk Milk Tank F2Y01 Ner peu y Iher (SPar,ifyl t er TS_P_e_1_1TyF_ Other Oih,,r C.O/PDt/IC IOSOP.fIIOb hPe XelnW N Fee ServweEnfranceSize # Fee Fenders/5u1hleeders N Fee Cvcwts U to 200 qm s 0 to 30 Am s 0 to 30 Am s Above 200 qm ,s 31 to 100 Amps 31 to 100 A nips $wimming Pool Above 100_Am s Above 100-Am s Transtormers Irngatwn Booms Partial 'Other Fee Signs Speciallnspecbon C 7' 5 Remarks j ? 4 ,T L F;E 1 1 Nough-,n . D.te 1, ha Elec,.ic ? Ins ct reby Lt th t Findl L:ne cer y at he above i t h b =? nspec ion as een made. Tnis request vola 18 moNlb Irom This repuest vmd gI 18 months trom n 47• n 4 D(o54 ? ?..J :? ? I ?7 Y .r ?. - - - - • lnspecbon h n ?,?/? R.ques te Fire No. e? , Ro?uu ` ?qeady Now`?'?'?'1II Notity.InsOec- ? J L ?es ?No ?`ml When Ready E] Licensed Electncal Convactor 1 heraby request inspecLOn ol nbove U Vvmer . t1?\ Lection AAtlress, 9ox or_ROUte N o. To? hi Neme or No. R.?e C?tY V?(PRINT) LS.pp1iAddress ' Electnc I ConHactor (Company Namel ? s License No. Con1rar.mr ? IContracmr r !?ir Ma ?: thor¢etl Signature IConvacto!/Owner Makine InstallaUOnl Phone Num er ' • ?? ? ? ? rwc ?NSaFCTION REQUEST WI?L NOT MINNESOTA STATE BOARD OFELECTHICITV Griggs-MiCwey Bldg. - Aoom N•79t 1621 University Ave.. St. Paul. MN 55100 Phone 16121297-2111 BE ACCE"ED BY THE STATE BOAHD UNLESS PNOVEN INSPECTION FEE IS ENCLOSEO. 348-8? REQUEST FOR ELEGTRICAL INSPECTION Ee-ooooi_os See instruc4ans lor completing this form on back o1 yellow copy. r ? 6o6Sy ? n q? a 7 , '1 ,? ""R"' Below Work Covered by This Request QlavqTfdi Heo.1 Type af euilding I ApOliances Wired I Equipment Wired I - 1 I Water ? Gommercial Bldg Furnace Silo Unloader ? ? Industrial HIAp. Au Condiuoner Bulk Milk Tenk ? M Fee ServiceEntranceSize b Fee Fexders/5ubfeeders N Fen Cvcurts (1 to 200 qm s 0 to 30 Am s to 30 qm s Above 200 qm n 31 to 100 qmps 31 to 100 Am Swimmmg Pool Above 100_Am s Above 100_Amps Transtormer$ Irrigation Booms Partial.'Other Fef- I aigns apeciai inspecuon Remerks TOTAL F ? flough- i n Da le r 3 /?' 1, the Electhe?ari Inspectoq by Final P ?? ?? oaie ?? • ? ?' ?I ce?biy thet the nbove made?t?on has been iliia raqueat voitl Thisrequestvoid 3-??-?? / J 18 rtronths from ?y 0 J V?- 0 095963 L ??-) e Raqoest Date Fre No. floueh-in Inspecuon equrtetlJ ?Heady Nuw W?II Novfy Inspec- '- Vi;s ?No lur Wh¢n Ready LJ Licensed Electncal ConVactor I heraby repuast msoecM1On otabove ? Owner electricel work inslalled et. Strevt Address. Bon or Foute 4 c Cily ection o. TownshiD Name or No. Rnnge No. i?ty G? Occu ant(PRINT ?c Phone No. P-wer Supplier Address Electncal Contmr.lnr ICOmpany Namel Contrar.mr's Lic nse No s ? , Ma-ling AtlJres (COnhacmr or Owner Ma k,ne nilation) 4 0 c 0 Y"C+ ? l n zed SiBnaWre ICOnhact r Owner Making Inst;allaM1on) Phpne Number 7 ? l R+JNNESOTq STqTE BOAND OF ELECTflICITY Griggs-Midway Bldg. - floom N-191 1821 UniversitV Ave., St. Paul, MN 55109 Phone I6121 297.2111 IMIS INSPEGTION NEQUEST WILL NOT BE ACCEPTED BY THE STATE BOAND UNLE55 PflOPEN INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-ooaoi_oa 941 ????See instructions for wmpleLna this lorm on back o1 yellow copy. r-, o "'R" " Below Work Covered by 7his Request U ? Atltl HeD. Tvpe of 9uiltling ApPIioncea Wired Equipment Wired l'iome Range Temporary Service Duplex Water Heater Lightiny Fixtures .Apt. Buildmg Dryer Electnc Heatin Commercial 81dy. Furnace Silo Unbader Industnal Bldg. Av Conditioner Bulk Milk Tank Falfp Othpr Oe6y pther ISPCrify) ( 9I VCG? y Otll&! Qthu, 60/nOU1E //ISOEC[l00 hPP /fF/OW N Fee ServiceEntranceSixe # Fee Peatlars/Subfeeders tt Fee Cvcwls D to 200 qm 5 0 ta 30 Am s 0 to 30 Am s A6ove 200 qmps 37 to 700 Amps 31 to 100 qm s Swimming Pool Above 100-Amps Above 700_Am s Transiormers Irngation Booms Partial.'Othcr Fee Signs Special Inspection 1 Nerrrerks 4 TO%<FEE 7 inn ?V flough- in p ?ly soectaq hereby Fnal certity that the above D;rte ?pgpecllon hes Eeen ???-?'J 'rd 3? mada. This reQUast voiG 10 montlu twm ?9z?•?s ? DENOTES EXiSTING ELEVAT/olV NORTH ScqLE : i"= 30' i 4 i6..?c 9/6. (9z3,s) OENOTES , PRUPOSED ELEVA"TIUN ? IlJDIC,qTES DIRECTIOhI OF SURFrACE. D12AINACaE 923:50= F/NISNEP 64RA6E FC002 LLEVqT/ON CLbVER LANE I >° 47`'- ' S 89° 58' 02" W ?, Z?,o I i 2S O6 b?a.06 ?9/9.3,? ? • ( 9/9. Z ? 30' FRON7 BUiI.D?N6 ? ue ? SETBACK LINE ? LO'?' W? 1 4? W ` l I N 89° 58'02!"E ' ' , \ ?- _'66106-.-'_ PRoP -4' ? , i `- o R\ ro i922 ?0%) 0 m (922. 3) 59.00 0 - - ? I 5 I LoY , 45 >ED h ? M 8 N ?. uNir ? -- 59.00- m ? I? 3 " I ? V I N V1 Q? . ;-- ? ? I 2 \J ? ? Z N W ? q2y,5) N J ? DRAINA6& qIJD 5\ UTILI7Y Eh65EMEN1" ? -?- ?°? r / ry LI IN6 i ? P ? 49?. 6"1 `925, 4? I r 3 N 6. s? N LOT h ? a ? ? 4 ;pZ8.5,135-.45 ?929. ` 59.0! Y"LY.6i (929.0) 5 89° 58'oZ"W S 88° 55' l7"W I heriby certity that thia ie a true and corract rnp eentation of a tract ot land a• shovn'and deacribed heraon.. Aa prepared by m on thii isr day of NovE.+?aeR ? 19 B? . ' p?L ?????L Minn. 1tsg. No. /Gj Fs . .?.. , ». OFROBE llONSUITINd EN3INEERS ENGINEEAING PLpNNEAS and LAND 3UflVEYOflS COMPANY, INC. 1000 EAST 1461A STREET, BURNSYILIE, YIMNESOTA 55331 PM 432-3000 Cer?i}'z cacU aSu.rYe y Lgvat -Qwcrl'oZion: Lors 44, 45, A-6 AND 47, BLoCK 2, EDEN ADDI710NI , DAKO7A CDUNTY, MINNESU7q '• II .9z?d_? DENO"fE5 EXISTIIJG ELEVAT/ON (e23,5) DENOTES . PROPOSED ElEVA710N ?-- INDIGATES DIRECTION oF SURFACE DRAINAGE 923?W= Fl,vl5146D 6a42A6E FLOOR t-LEV,qT/OM NORTH ScqLE : i"= 30' U.R_?1'18.ov . cN „?1.ol £ \ o n I5 DFZAINAf?& qIJD ? 5 ? _ ? UTILITY EASEMENT -? 93aor '? ?930'?? r` ?J2g.s, 35.45 `92%9' 59.01 929. i (929.0) 5 890 58' o2"W 5 88° 55' 17"W . I hersby certity thnt this ia a true and corract rapreeentation of a tract ot land at shovn'and described herson.. Aa praparad by me on this isT day ot MOvE,rrseR. CLOVER LANE '922 0%? 4, 56 4'0 771 U-1 - - 5 89° 58' 02" w i 25.06 b?.ob I ? m O M l9z2.3) Z --- 30' FRONT BUILDI1.16 1 .922.?. 923.2 9zz.bi SETBACK LINE LpT " 44 bI LoT I 8 °° ?` 46 45 W ? o: \ I ?` .v- ?,- PROP SEO i 3 c+ I M NLn 89° 58, o2"E ^ i p? I 0h. :•\ _ -_66.06-__ 4? ? ,_-_ O ? ' UN17 -"- s9.oo-- r%, 4 i m \ - J ^ 92 3. BUIL ING ? N w 92y,5) - ?c ° i+4. bl r ^? -? 1925 ? ,9?S, 4 ? ?? \ ? ryz6.s) I LOT --og 3 --?L4 ? /?„'?xinn. R.s. xo._ From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:47 #582 P.062/079 Use BLUE or BLACK Ink I For Office Use (n I j Permit (I City of Eagan I Permit Fee.^ 5 I 1 I 3830 Pilot Knob Road I Eagan MN 55122 Date Received: N Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2 Site Address: ~)~G'1 HIB14~%'1yc_pg C, oyck Lam Unit M Name:WM Niq COQ. US= Phone: Resident/ Owner . Address / City / Zip: ~j 3y Applicant is: Owner Contractor aY 8 t Ye Type of Work Description of work: itay Off Construction Cost: $I1 11`5 8D. Multi-Family Building. (Yes X / No f Company; oy, ma t Contact: € Contractor Address:51% l Yd ftal cam. a 1 reti 10 -City: MWt Nib c. State: M_ Zip: ICJZ- I'12" IL4 Phone: t W License f 031''J)J Lead Certificate Nr1T' ~q~Dy'~ 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: 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, f you provide specific reasons that would permit the City to ~v ---conclude thattare 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.oopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be,in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x / ;(Lij ~n x `t ! C1 ' Applica 's Printed Warne A li ant's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 10/21 /2015 12:25 #269 P.007/020 Use BLUE or BLACK ink � For Office Use i �� R�CEIVED � Permit#: �u_ � y �� ; � � 3830 Pilot Knob Road ��OT � 1 �O� � Permit Fee: � Eagan MN 55122 � Date Received: � Phone:(651)675-5675 � � Fax:(651)675-5694 I Staff; � I � ��_��.�__��J 2015 R�SIDEl��`!A� ��tLDl�C� PER[��T APRLlC�►YlON Date: Site Address: Unit#: �..-,�.�-,,,.,�.< ._�..,...��,.�,,�.,..�..r,,._.....�.:�..,..,�.�:4,_.�.,��:.�,,..�.,..�,..._..,.:.�,... .�,.�...� — - ��-- r ,. , . �...��...�,._�..-.s,,� �,A..�...,.�,,,,�.,�,...,�..�.�,M,�,_,.�.:� Resident! � Name: ��,A✓f►: J Frti31t� ��.i �de4 Phone: /►//� � � OWIt@t Address/City/Zip:°�7��'7`/s� � . � �j¢r° __ /�� 1_q-,J � ��-, � Applicant is: Owner � Contractor s ; _.,,�..A._,k�.� . �Description ofwork: r.�,��:4�r�C...�MA.wn..,..i,R...�,.,.�.�,_�.,.�.1.�.,.:....�.. .�.�.,�.,v,..,.,.�.�._..._„�,.�x.._� _.�„�,..��...d„_,._.�__ --� Type.of Work � � , � � Construction Cost: � ��l�e✓C� Multi-Family Building (Yes �No .:.�..M,.�.,.�....,�.�...��..,R,..,=.z,......,,.�..,�,�..�,,.�,,.,.,..m,.....,.�.�.�,..,.�.�.�,�.�_.:.,�„__.,,.��.�.._,...,,_...,..:_._.,a...�...-,.��..,.n...,.,..R,z..,,..�;.._...,�.�-� , ) ...,.� c Company:��lSth/� lisn5'�iZuG�,�re t��l�on�finlzJt�� Contact � s� :,�.,..��__...�, ...,�.�,� � � � , .� � ' A I��.�,�-..� k � � � COt1tflCtOr, . Address:�ti/S �n��r5��-��-L.��- - ��;+� �C3 c►ty: �V1�,��t t�'(��i-� ; State:�Zip: ��'-�r` `� Phone:��2-`i'�2=75/5'7j Email: ��tc� ca.1 �'7'zr/°'. b'Z.. � � . - f . License#: �� G'9�`� �� Lead Certificate#: fr��s• �*Jy(d'� Z � .x„� __....�•.�._..._,�.�..,.�..,,�..,..:_ . _ _ . ...�,�..�,��,.�,.,.�,,..,-�,.....�_..�,�..�.� If the project is exempt from lead certification, please explain why: ,��L� ;,,,� 6�f�3 � e 8 � �� COiUIPLETE THIS AREi4 ONLY IF CONSTRUCTIAlGyA NEW BUILDiNG�tt��M ry� � In the last 12 months,has the City of Eagan issued a permit for a similar pian based on a master plan? � s � � Yes No If yes,date and address of master plan: � �� Licensed Plumber: Phone: � ; � Mechanical Contractor: Phone: � , � Sewer 8�Water Contractor. Phone: � � �� Fire Suppression Contractor: � ��» �� M phone: ', NOTE:P/ans and supporting documenfs that you submit are considered to be public informaGon. Poriions of� ' # the information may be ciassi�ed as non-public if you provide specific reasons that would permit the City to � I� �� conclude that th�aie trade secrets. � F..,�.��.:.�.A.�.,_-.._-�.,�<.��.�.:_��<.,�.�..K..�„w..,U,.._,.1..,,.�.<.�.�,�...,�.�_�_u.F,�.�,��.»�. _,�,�..�.�.........�.,.,�...e>,..�.,K.�..�....<,�..,ss�...,,...a#,.,,�....�..�.,,�.�.�:_�...�.,<._,..��,.��_r� ;. CALL BEFORE YOU DIG. Call Gopher State One Cal)al(651)456-0002 for protection against underground utility damage. Ca1148 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.ory I hereby acknowledge thaf this information is compiete and accurate;that the work wiit 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 aceordance with the Minnesota State Building Code must be co pleted within t80 days of permit issuance. ,�,�......... �,,,.—'� ,,,_._...�..___� � . . x -ml� .�/�f'rr�.� � � :. '} ;.w � Applicant's Printed Name Applic nt's Sig�ature J Page 1 of 3 � For Office Use ••• ; ; ;; Permit*: I It-1 6 b 1./ .„, ,",„,, E AG A N .-.. ,"., Permit Fee: LQ,Ur �� ECEI ``"" '.. Date Received: to-f r U 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 JUN 1 1 2018 Staff: 4,:y buildinainspectionsCu�cityofeaQan.com L __1 2018 MECHANICAL PERMIT APPLICATION Q Please submit two(2)sets of plans with al o4mme ial applications. Date: (O '' q -1 Site Address: eN a � 41-) Tenant: GOed--k-yr `-' Suite#: ,�,� 7- � � ,.,� 9tii. % � Phone: r /Res dent/Owner Name: A _ �- ,� �./ j'� Address/City/Zip; 1-",/4/j ei TY`�dam. `^ � 5 ' 1 z Name: ----h,fdr44-1.1-4),/iese rr n/tiLicense#: Contractor Address: /ti gd (� idi4/1� 1 ,, 1// City: , ." ,LL, State: 41. Zip: 1 cita. Phone: (5/ g2; - /y%/ Contact: A) Email: p,;�;e Pe°r I/ ✓ / .s ,� ' i` New X Replacement Additional Alteration Demolition — Type of Work Description of work: � 1.--- NOTE:Roof mounted and d mounted mechanical eqadpmentequipment isto be screened by City the Mechanical for info •on on screening methods. RESIDENTIAL COMMERCIAL i Furnace _New Construction Interior Improvement — Permit Type —Air Conditioner Install Piping Processed —Air Exchanger Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank ( Install/_Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit,includes State Surcharge // $100.00 Residential New, includes State Surcharge =$ C.o 0 • D 6 TOTAL FEE COMMERCIAL FEES $60.00 Permit Fee Minimum Contract Value$ x.01 $75.00 Underground tank installatiordremoval,includes State Surcharge =$ Permit Fee Surcharge=Contract Value x$0.0005 =$ Surcharge If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaqan.com/subscribe. 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 i 4 �L e-i- Sie/ rt- x41 - ' 1"''✓ Applicant's Printed Name Applicants Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Unotbignmurmil Rom*are d@k'T T I l `,•:; 1'a,.' L PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA169738 Date Issued:06/08/2021 Permit Category:ePermit Site Address: 4448 Clover Lane A Lot:45 Block: 02 Addition: Eden PID:10-22750-02-450 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - John & Barbara Lehman 4448 Clover Ln Saint Paul MN 55122--244 (651) 214-8010 Wenzel Heating & Air Conditioning 4145 Old Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature For Of--------------1 fice Use Permit ®e � , ®� i Building #: I I I ®I �, �, �e EAGAN I S&W Permit#: I I Permit Fee: I n I I I Date Received: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I 1 (651) 675-5675 �FAX: (651) 675-5694 I I Date Issued: I buildinginspections(a)cityofeagan.com I----------------------j RESIDENTIAL BUILDING PERMIT APPLICATION Date:, Df Z % & (J.�Q Site Address: Applicant is: ❑ Owner aContractor Unit #: Name: Homeowner Address./ in2ld P1(e,iiIUPA/ L3'1 City: b�Q0. v-, Stater V�ip: �1 -?_ Phone: Email: P� Q J Description of work: e C, Type of Construction Cost � y Work Type of building: ❑ Single Family ❑ Townhome, of units Twin Home 1,1Compan RQM Contact: Building Address: L/5 �� lJlle�4-v�y City:�GLe t�iG�\1r i2, Contractor State:m&LIp: .5_3�T`� Phone611-2�/ - Email. v� � z 6p(l n License #: Ex iration Date: o�,S Sewer & Company: Contact: Water Contractor 4 Address: City: Required for State: Zip: Phone: Email: new construction I License #: Expiration Date: 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.gopherstateonecall.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. /( '0. V -�2 L\ <_� � C �/ti �� - x Applicant's Printed Name A licant's Signature